Search results for: treatment methods
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21377

Search results for: treatment methods

1127 Caribbean Universities and the Global Educational Market: An Examination of Entrepreneurship and Leadership in an Era of Change

Authors: Paulette Henry

Abstract:

If Caribbean Universities wish to remain sustainable in the global education market they must meet the new demands of the 21st Centuries learners. This means preparing the teaching and learning environment with the human and material and resources so that the University can blossom out into the entrepreneurial University. The entrepreneurial University prepares the learner to become a global citizen, one who is innovative and a critical thinker and has the competencies to create jobs. Entrepreneurship education provides more equitable access to university education building capacity for the local and global economy. The entrepreneurial thinking, the mindset, must therefore be among academic and support staff as well as students. In developing countries where resources are scarce, Universities are grappling with a myriad of financial and non-financial issues. These include increasing costs, Union demands for increased remuneration for staff and reduced subvention from governments which has become the norm. In addition, there is the political pressure against increasing tuition fees and the perceptions on the moral responsibilities of universities in national development. The question is how do small universities carve out their niche, meet both political and consumer demands for a high quality, low lost education, fulfil their development mandate and still remain not only viable but competitive. Themes which are central to this discourse on the transitions necessary for the entrepreneurial university are leadership, governance and staff well-being. This paper therefore presents a case study of a Caribbean University to show how transformational leadership and the change management framework propels change towards an entrepreneurial institution seeking to have a competitive advantage despite its low resourced context. Important to this discourse are the transformational approaches used by the University to prepare staff to move from their traditional psyche to embracing an entrepreneurial mindset whilst equipping students within the same mode to become work ready and creative global citizens. Using the mixed methods approach, opinions were garnered from both members of the University community as well as external stakeholder groups on their perception of the role of the University in the business arena and as a primary stakeholder in national development. One of the critical concepts emanating from the discourse was the need to change the mindset of the those in university governance as well as how national stakeholders engage the university. This paper shows how multiple non-financial factors can contribute to change. A combination of transformational and servant leadership, strengthened institutional structures and developing new ones, rebuilding institutional trust and pride have been among the strategies employed within the change management framework. The university is no longer limited by borders but through international linkages has transcended into a transnational stakeholder.

Keywords: competitiveness, context, entrepreneurial, leadership

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1126 Pond Site Diagnosis: Monoclonal Antibody-Based Farmer Level Tests to Detect the Acute Hepatopancreatic Necrosis Disease in Shrimp

Authors: B. T. Naveen Kumar, Anuj Tyagi, Niraj Kumar Singh, Visanu Boonyawiwat, A. H. Shanthanagouda, Orawan Boodde, K. M. Shankar, Prakash Patil, Shubhkaramjeet Kaur

Abstract:

Early mortality syndrome (EMS)/Acute Hepatopancreatic Necrosis Disease (AHPND) has emerged as a major obstacle for the shrimp farming around the world. It is caused by a strain of Vibrio parahaemolyticus. The possible preventive and control measure is, early and rapid detection of the pathogen in the broodstock, post-larvae and monitoring the shrimp during the culture period. Polymerase chain reaction (PCR) based early detection methods are good, but they are costly, time taking and requires a sophisticated laboratory. The present study was conducted to develop a simple, sensitive and rapid diagnostic farmer level kit for the reliable detection of AHPND in shrimp. A panel of monoclonal antibodies (MAbs) were raised against the recombinant Pir B protein (rPirB). First, an immunodot was developed by using MAbs G3B8 and Mab G3H2 which showed specific reactivity to purified r-PirB protein with no cross-reactivity to other shrimp bacterial pathogens (AHPND free Vibrio parahaemolyticus (Indian strains), V. anguillarum, WSSV, Aeromonas hydrophila, and Aphanomyces invadans). Immunodot developed using Mab G3B8 is more sensitive than that with the Mab G3H2. However, immunodot takes almost 2.5 hours to complete with several hands-on steps. Therefore, the flow-through assay (FTA) was developed by using a plastic cassette containing the nitrocellulose membrane with absorbing pads below. The sample was dotted in the test zone on the nitrocellulose membrane followed by continuos addition of five solutions in the order of i) blocking buffer (BSA) ii) primary antibody (MAb) iii) washing Solution iv) secondary antibody and v) chromogen substrate (TMB) clear purple dots against a white background were considered as positive reactions. The FTA developed using MAbG3B8 is more sensitive than that with MAb G3H2. In FTA the two MAbs showed specific reactivity to purified r-PirB protein and not to other shrimp bacterial pathogens. The FTA is simple to farmer/field level, sensitive and rapid requiring only 8-10 min for completion. Tests can be developed to kits, which will be ideal for use in biosecurity, for the first line of screening (at the port or pond site) and during monitoring and surveillance programmes overall for the good management practices to reduce the risk of the disease.

Keywords: acute hepatopancreatic necrosis disease, AHPND, flow-through assay, FTA, farmer level, immunodot, pond site, shrimp

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1125 Antiplatelets and Anticoagulants in Rural Emergency General Surgery

Authors: Jeong-Moh John Yahng, Angelika Na

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Introduction: Increasing numbers of general surgical patients are being prescribed antiplatelet and anticoagulant medications (APAC) for various cardiovascular and cerebrovascular conditions. Surgical patients who are on APAC present a management challenge as bleeding risk needs to be balanced with thromboembolic risk. Although guidelines exist in regards to APAC management in elective surgery, there is a lack of guidelines in the emergency surgery setting. In this study we aim to characterise APAC usage in emergency general surgical patients admitted to a rural hospital. We also assess the impact of APAC usage on clinical management of these patients. Methods: Prospective study of emergency general surgical admissions at Northeast Health Wangaratta (Victoria) from 2 July to 25 Oct 2014. Questionnaire collected demographics data, admission diagnosis, APAC usage, anaesthesia techniques, operation types, transfusion requirement and morbidity / mortality data. Results: During the 4 month study, 118 patients were classified into two groups: non-APAC (n=96, 81%) and APAC (n=22, 19%). Patients in the APAC group were older compared to the non-APAC patients (mean age 72 vs 42 years old). Amongst patients younger than 60 years old, only 1% of them were on APAC. In contrast, 49% of patients older than 60 years old were on APAC (p<0.001). Patients who were admitted with a bleeding problem were more likely to be on APAC (p<0.05). 19% of emergency general surgery patients were on APAC. The majority (91%) of them were on antiplatelet medication, with two patients being on dual antiplatelet agents (aspirin + clopidogrel or ticagrelor). 15% of emergency general surgical patients requiring operations were on APAC. 11% of all laparotomies and 33% of gastroscopy for haematemesis/melaena patients were on APAC. Both of the patients operated for bleeding following surgery at another hospital were in the APAC group. In regards to impact on clinical management, 59% of APAC patients had their medications interrupted or ceased, on average by 3.5 days (range 1-13 days). 2 out of 75 operations were delayed due to APAC usage. There was no difference in the use of central venous or arterial line for increased monitoring (p=0.14) or in the use of warming blanket (Bair Hugger™) (p=0.94). Overall, transfusion rate was higher amongst APAC patients (14% vs 3%) (p 0.04). The recorded morbidity (n=2) and mortality (n=1) in this study were all in the APAC group. Discussion: Nineteen percent of emergency general surgical admissions and fifteen percent of operated patients were on APAC. The prevalence of APAC usage was higher in those aged sixty and above. General surgical patients who were admitted with a bleeding problem were more likely to be on APAC. Two patients who were operated for bleeding following surgery at another hospital were in the APAC group. Note that there was no patient in the non-APAC group who was admitted for post-operative bleeding. We observed two cases in which operation was delayed due to APAC usage. Transfusion, morbidity and mortality rate were higher in the APAC group. Conclusion: In this study, nineteen percent of emergency general surgical admissions were on APAC. The use of APAC is more prevalent in the older age group, particularly those aged sixty and above. Higher proportion of APAC compared to non-APAC patients were admitted and operated for bleeding problems. There is an urgent need for clinical guidelines regarding APAC management in emergency general surgical patients.

Keywords: antiplatelet, anticoagulants, emergency general surgery, rural general surgery, morbidity, mortality

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1124 A Village Transformed as Census Town a Case Study of Village Nilpur, Tehsil Rajpura, District Patiala (Punjab, India)

Authors: Preetinder Kaur Randhawa

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The rural areas can be differentiated from urban areas in terms of their economic activities as rural areas are primarily involved in agricultural sector and provide natural resources whereas, urban areas are primarily involved in infrastructure sector and provide manufacturing services. Census of India defines a Census Town as an area which satisfies the following three criteria i.e. population exceeds 5000, at least 75 percent of male population engaged in non-agricultural sector and minimum population density of 400 persons per square kilometers. Urban areas can be attributed to the improvement of transport facilities, the massive decline in agricultural, especially male workers and workers shift to non-agricultural activities. This study examines the pattern, process of rural areas transformed into urban areas/ census town. The study has analyzed the various factors which are responsible for land transformation as well as the socio-economic transformation of the village population. Nilpur (CT) which belongs to Rajpura Tehsil in Patiala district, Punjab has been selected for the present study. The methodology adopted includes qualitative and quantitative research design, methods based on secondary data. Secondary data has been collected from unpublished revenue record office of Rajpura Tehsil and Primary Census Abstract of Patiala district, Census of India 2011. The results have showed that rate of transformation of a village to census town in Rajpura Tehsil has been one of highest among other villages. The census town has evolved through the evolutionary process of human settlement which grows in size, population and physical development. There must be a complete economic transformation and attainment of high level of technological development. Urban design and construction of buildings and infrastructure can be carried out better and faster and can be used to aid human habitation with the enhancement of quality of life. The study has concluded that in the selected area i.e Nilpur (CT) literacy rate has increased to 72.1 percent in year 2011 from 67.6 percent in year 2001. Similarly non-agricultural work force has increased to 95.2 percent in year 2011 from 81.1 percent in year 2001. It is very much clear that the increased literacy rate has put a positive impact on the involvement of non-agricultural workers have enhanced. The study has concluded that rural-urban linkages are important tools for understanding complexities of people livelihood and their strategies which involve mobility migration and the diversification of income sources and occupations.

Keywords: Census Town, India, Nilpur, Punjab

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1123 Case-Based Options Counseling Panel To Supplement An Indiana Medical School’s Pre-Clinical Family Planning and Abortion Education Curriculum

Authors: Alexandra McKinzie, Lucy Brown, Sarah Komanapalli, Sarah Swiezy, Caitlin Bernard

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Background: While 25% of US women will seek an abortion before age 45, targeted laws have led to a decline in abortion clinics, subsequently leaving 96% of Indiana counties and the 70% of Hoosier women residing in these counties without access to services they desperately need.1,2 Despite the need for a physician workforce that is educated and able to provide full-spectrum reproductive health care, few medical institutions have a standardized family planning and abortion pre-clinical curriculum. Methods: A Qualtrics survey was disseminated to students from Indiana University School of Medicine (IUSM) to evaluate (1) student interest in curriculum reform, (2) self-assessed preparedness to counsel on contraceptive and pregnancy options, and (3) preferred modality of instruction for family planning and abortion topics. Based on the pre-panel survey feedback, a case-based pregnancy options counseling panel will be implemented in the students’ pre-clinical, didactic course Endocrine, Reproductive, Musculoskeletal, Dermatologic Systems (ERMD) in February 2022. A Qualtrics post-panel survey will be disseminated to evaluate students’ perceived efficacy and quality of the panel, as well as their self-assessed preparedness to counsel on pregnancy options. Results: Participants in the pre-panel survey (n=303) were primarily female (61.72%) and White (74.43%). Across all class levels, many (60.80%) students expected to learn about family planning and abortion in their pre-clinical education. While most (84-88%) participants felt prepared to counsel about common, non-controversial pharmacotherapies (e.g. beta-blockers and diuretics), only 20% of students felt prepared to counsel on abortion options. Overall, 85.67% of students believed that IUSM should enhance its reproductive health coverage in pre-clinical, didactic courses. Traditional lectures, panels, and direct clinical exposure were the most popular instructional modalities. Expected Results: The authors predict that following the panel, students will indicate improved confidence in providing pregnancy options counseling. Additionally, students will provide constructive feedback on the structure and content of the panel for incorporation into future years’ curriculum. Conclusions: IUSM students overwhelmingly expressed interest in expanding their pre-clinical curriculum’s coverage of family planning and abortion topics. To specifically improve students’ self-assessed preparedness to provide pregnancy options counseling and address students’ self-cited learning gaps, a case-based provider panel session will be implemented in response to students’ preferred modality feedback.

Keywords: options counseling, family planning, abortion, curriculum reform, case-based panel

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1122 Quantifying the Effects of Canopy Cover and Cover Crop Species on Water Use Partitioning in Micro-Sprinkler Irrigated Orchards in South Africa

Authors: Zanele Ntshidi, Sebinasi Dzikiti, Dominic Mazvimavi

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South Africa is a dry country and yet it is ranked as the 8th largest exporter of fresh apples (Malus Domestica) globally. Prime apple producing regions are in the Eastern and Western Cape Provinces of the country where all the fruit is grown under irrigation. Climate change models predict increasingly drier future conditions in these regions and the frequency and severity of droughts is expected to increase. For the sustainability and growth of the fruit industry it is important to minimize non-beneficial water losses from the orchard floor. The aims of this study were firstly to compare the water use of cover crop species used in South African orchards for which there is currently no information. The second aim was to investigate how orchard water use (evapotranspiration) was partitioned into beneficial (tree transpiration) and non-beneficial (orchard floor evaporation) water uses for micro-sprinkler irrigated orchards with different canopy covers. This information is important in order to explore opportunities to minimize non-beneficial water losses. Six cover crop species (four exotic and two indigenous) were grown in 2 L pots in a greenhouse. Cover crop transpiration was measured using the gravimetric method on clear days. To establish how water use was partitioned in orchards, evapotranspiration (ET) was measured using an open path eddy covariance system, while tree transpiration was measured hourly throughout the season (October to June) on six trees per orchard using the heat ratio sap flow method. On selected clear days, soil evaporation was measured hourly from sunrise to sunset using six micro-lysimeters situated at different wet/dry and sun/shade positions on the orchard floor. Transpiration of cover crops was measured using miniature (2 mm Ø) stem heat balance sap flow gauges. The greenhouse study showed that exotic cover crops had significantly higher (p < 0.01) average transpiration rates (~3.7 L/m2/d) than the indigenous species (~ 2.2 L/m²/d). In young non-bearing orchards, orchard floor evaporative fluxes accounted for more than 60% of orchard ET while this ranged from 10 to 30% in mature orchards with a high canopy cover. While exotic cover crops are preferred by most farmers, this study shows that they use larger quantities of water than indigenous species. This in turn contributes to a larger orchard floor evaporation flux. In young orchards non-beneficial losses can be minimized by adopting drip or short range micro-sprinkler methods that reduce the wetted soil fraction thereby conserving water.

Keywords: evapotranspiration, sap flow, soil evaporation, transpiration

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1121 Analyzing the Construction of Collective Memories by History Movies/TV Programs: Case Study of Masters in the Forbidden City

Authors: Lulu Wang, Yongjun Xu, Xiaoyang Qiao

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The Forbidden City is well known for being full of Chinese cultural and historical relics. However, the Masters in the Forbidden City, a documentary film, doesn’t just dwell on the stories of the past. Instead, it focuses on ordinary people—the restorers of the relics and antiquities, which has caught the sight of Chinese audiences. From this popular documentary film, a new way can be considered, that is to show the relics, antiquities and painting with a character of modern humanities by films and TV programs. Of course, it can’t just like a simple explanation from tour guides in museums. It should be a perfect combination of scenes, heritages, stories, storytellers and background music. All we want to do is trying to dig up the humanity behind the heritages and then create a virtual scene for the audience to have emotional resonance from the humanity. It is believed that there are two problems. One is that compared with the entertainment shows, why people prefer to see the boring restoration work. The other is that what the interaction is between those history documentary films, the heritages, the audiences and collective memory. This paper mainly used the methods of text analysis and data analysis. The audiences’ comment texts were collected from all kinds of popular video sites. Through analyzing those texts, there was a word cloud chart about people preferring to use what kind of words to comment the film. Then the usage rate of all comments words was calculated. After that, there was a Radar Chart to show the rank results. Eventually, each of them was given an emotional value classification according their comment tone and content. Based on the above analysis results, an interaction model among the audience, history films/TV programs and the collective memory can be summarized. According to the word cloud chart, people prefer to use such words to comment, including moving, history, love, family, celebrity, tone... From those emotional words, we can see Chinese audience felt so proud and shared the sense of Collective Identity, so they leave such comments: To our great motherland! Chinese traditional culture is really profound! It is found that in the construction of collective memory symbology, the films formed an imaginary system by organizing a ‘personalized audience’. The audience is not just a recipient of information, but a participant of the documentary films and a cooperator of collective memory. At the same time, it is believed that the traditional background music, the spectacular present scenes and the tone of the storytellers/hosts are also important, so it is suggested that the museums could try to cooperate with the producers of movie and TV program to create a vivid scene for the people. Maybe it’s a more artistic way for heritages to be open to all the world.

Keywords: audience, heritages, history movies, TV programs

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1120 Getting It Right Before Implementation: Using Simulation to Optimize Recommendations and Interventions After Adverse Event Review

Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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1119 Poly(propylene fumarate) Copolymers with Phosphonic Acid-based Monomers Designed as Bone Tissue Engineering Scaffolds

Authors: Görkem Cemali̇, Avram Aruh, Gamze Torun Köse, Erde Can ŞAfak

Abstract:

In order to heal bone disorders, the conventional methods which involve the use of autologous and allogenous bone grafts or permanent implants have certain disadvantages such as limited supply, disease transmission, or adverse immune response. A biodegradable material that acts as structural support to the damaged bone area and serves as a scaffold that enhances bone regeneration and guides bone formation is one desirable solution. Poly(propylene fumarate) (PPF) which is an unsaturated polyester that can be copolymerized with appropriate vinyl monomers to give biodegradable network structures, is a promising candidate polymer to prepare bone tissue engineering scaffolds. In this study, hydroxyl-terminated PPF was synthesized and thermally cured with vinyl phosphonic acid (VPA) and diethyl vinyl phosphonate (VPES) in the presence of radical initiator benzoyl peroxide (BP), with changing co-monomer weight ratios (10-40wt%). In addition, the synthesized PPF was cured with VPES comonomer at body temperature (37oC) in the presence of BP initiator, N, N-Dimethyl para-toluidine catalyst and varying amounts of Beta-tricalcium phosphate (0-20 wt% ß-TCP) as filler via radical polymerization to prepare composite materials that can be used in injectable forms. Thermomechanical properties, compressive properties, hydrophilicity and biodegradability of the PPF/VPA and PPF/VPES copolymers were determined and analyzed with respect to the copolymer composition. Biocompatibility of the resulting polymers and their composites was determined by the MTS assay and osteoblast activity was explored with von kossa, alkaline phosphatase and osteocalcin activity analysis and the effects of VPA and VPES comonomer composition on these properties were investigated. Thermally cured PPF/VPA and PPF/VPES copolymers with different compositions exhibited compressive modulus and strength values in the wide range of 10–836 MPa and 14–119 MPa, respectively. MTS assay studies showed that the majority of the tested compositions were biocompatible and the overall results indicated that PPF/VPA and PPF/VPES network polymers show significant potential for applications as bone tissue engineering scaffolds where varying PPF and co-monomer ratio provides adjustable and controllable properties of the end product. The body temperature cured PPF/VPES/ß-TCP composites exhibited significantly lower compressive modulus and strength values than the thermal cured PPF/VPES copolymers and were therefore found to be useful as scaffolds for cartilage tissue engineering applications.

Keywords: biodegradable, bone tissue, copolymer, poly(propylene fumarate), scaffold

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1118 Enhancing Mental Health Services Through Strategic Planning: The East Tennessee State University Counseling Center’s 2024-2028 Plan

Authors: R. M. Kilonzo, S. Bedingfield, K. Smith, K. Hudgins Smith, K. Couper, R. Ratley, Z. Taylor, A. Engelman, M. Renne

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Introduction: The mental health needs of university students continue to evolve, necessitating a strategic approach to service delivery. The East Tennessee State University (ETSU) Counseling Center developed its inaugural Strategic Plan (2024-2028) to enhance student mental health services. The plan focuses on improving access, quality of care, and service visibility, aligning with the university’s mission to support academic success and student well-being. Aim: This strategic plan aims to establish a comprehensive framework for delivering high-quality, evidence-based mental health services to ETSU students, addressing current challenges, and anticipating future needs. Methods: The development of the strategic plan was a collaborative effort involving the Counseling Center’s leadership, staff, with technical support from Doctor of Public Health-community and behavioral health intern. Multiple workshops, online/offline reviews, and stakeholder consultations were held to ensure a robust and inclusive process. A SWOT analysis and stakeholder mapping were conducted to identify strengths, weaknesses, opportunities, and challenges. Key performance indicators (KPIs) were set to measure service utilization, satisfaction, and outcomes. Results: The plan resulted in four strategic priorities: service application, visibility/accessibility, safety and satisfaction, and training programs. Key objectives include expanding counseling services, improving service access through outreach, reducing stigma, and increasing peer support programs. The plan also focuses on continuous quality improvement through data-driven assessments and research initiatives. Immediate outcomes include expanded group therapy, enhanced staff training, and increased mental health literacy across campus. Conclusion and Recommendation: The strategic plan provides a roadmap for addressing the mental health needs of ETSU students, with a clear focus on accessibility, inclusivity, and evidence-based practices. Implementing the plan will strengthen the Counseling Center’s capacity to meet the diverse needs of the student population. To ensure sustainability, it is recommended that the center continuously assess student needs, foster partnerships with university and external stakeholders, and advocate for increased funding to expand services and staff capacity.

Keywords: strategic plan, university counseling center, mental health, students

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1117 The Epidemiology of Dengue in Taiwan during 2014-15: A Descriptive Analysis of the Severe Outbreaks of Central Surveillance System Data

Authors: Chu-Tzu Chen, Angela S. Huang, Yu-Min Chou, Chin-Hui Yang

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Dengue is a major public health concern throughout tropical and sub-tropical regions. Taiwan is located in the Pacific Ocean and overlying the tropical and subtropical zones. The island remains humid throughout the year and receives abundant rainfall, and the temperature is very hot in summer at southern Taiwan. It is ideal for the growth of dengue vectors and would be increasing the risk on dengue outbreaks. During the first half of the 20th century, there were three island-wide dengue outbreaks (1915, 1931, and 1942). After almost forty years of dormancy, a DEN-2 outbreak occurred in Liuchiu Township, Pingtung County in 1981. Thereafter, more dengue outbreaks occurred with different scales in southern Taiwan. However, there were more than ten thousands of dengue cases in 2014 and in 2015. It did not only affect human health, but also caused widespread social disruption and economic losses. The study would like to reveal the epidemiology of dengue on Taiwan, especially the severe outbreak in 2015, and try to find the effective interventions in dengue control including dengue vaccine development for the elderly. Methods: The study applied the Notifiable Diseases Surveillance System database of the Taiwan Centers for Disease Control as data source. All cases were reported with the uniform case definition and confirmed by NS1 rapid diagnosis/laboratory diagnosis. Results: In 2014, Taiwan experienced a serious DEN-1 outbreak with 15,492 locally-acquired cases, including 136 cases of dengue hemorrhagic fever (DHF) which caused 21 deaths. However, a more serious DEN-2 outbreak occurred with 43,419 locally-acquired cases in 2015. The epidemic occurred mainly at Tainan City (22,760 cases) and Kaohsiung City (19,723 cases) in southern Taiwan. The age distribution for the cases were mainly adults. There were 228 deaths due to dengue infection, and the case fatality rate was 5.25 ‰. The average age of them was 73.66 years (range 29-96) and 86.84% of them were older than 60 years. Most of them were comorbidities. To review the clinical manifestations of the 228 death cases, 38.16% (N=87) of them were reported with warning signs, while 51.75% (N=118) were reported without warning signs. Among the 87 death cases reported to dengue with warning signs, 89.53% were diagnosed sever dengue and 84% needed the intensive care. Conclusion: The year 2015 was characterized by large dengue outbreaks worldwide. The risk of serious dengue outbreak may increase significantly in the future, and the elderly is the vulnerable group in Taiwan. However, a dengue vaccine has been licensed for use in people 9-45 years of age living in endemic settings at the end of 2015. In addition to carry out the research to find out new interventions in dengue control, developing the dengue vaccine for the elderly is very important to prevent severe dengue and deaths.

Keywords: case fatality rate, dengue, dengue vaccine, the elderly

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1116 Predicting Blockchain Technology Installation Cost in Supply Chain System through Supervised Learning

Authors: Hossein Havaeji, Tony Wong, Thien-My Dao

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1. Research Problems and Research Objectives: Blockchain Technology-enabled Supply Chain System (BT-enabled SCS) is the system using BT to drive SCS transparency, security, durability, and process integrity as SCS data is not always visible, available, or trusted. The costs of operating BT in the SCS are a common problem in several organizations. The costs must be estimated as they can impact existing cost control strategies. To account for system and deployment costs, it is necessary to overcome the following hurdle. The problem is that the costs of developing and running a BT in SCS are not yet clear in most cases. Many industries aiming to use BT have special attention to the importance of BT installation cost which has a direct impact on the total costs of SCS. Predicting BT installation cost in SCS may help managers decide whether BT is to be an economic advantage. The purpose of the research is to identify some main BT installation cost components in SCS needed for deeper cost analysis. We then identify and categorize the main groups of cost components in more detail to utilize them in the prediction process. The second objective is to determine the suitable Supervised Learning technique in order to predict the costs of developing and running BT in SCS in a particular case study. The last aim is to investigate how the running BT cost can be involved in the total cost of SCS. 2. Work Performed: Applied successfully in various fields, Supervised Learning is a method to set the data frame, treat the data, and train/practice the method sort. It is a learning model directed to make predictions of an outcome measurement based on a set of unforeseen input data. The following steps must be conducted to search for the objectives of our subject. The first step is to make a literature review to identify the different cost components of BT installation in SCS. Based on the literature review, we should choose some Supervised Learning methods which are suitable for BT installation cost prediction in SCS. According to the literature review, some Supervised Learning algorithms which provide us with a powerful tool to classify BT installation components and predict BT installation cost are the Support Vector Regression (SVR) algorithm, Back Propagation (BP) neural network, and Artificial Neural Network (ANN). Choosing a case study to feed data into the models comes into the third step. Finally, we will propose the best predictive performance to find the minimum BT installation costs in SCS. 3. Expected Results and Conclusion: This study tends to propose a cost prediction of BT installation in SCS with the help of Supervised Learning algorithms. At first attempt, we will select a case study in the field of BT-enabled SCS, and then use some Supervised Learning algorithms to predict BT installation cost in SCS. We continue to find the best predictive performance for developing and running BT in SCS. Finally, the paper will be presented at the conference.

Keywords: blockchain technology, blockchain technology-enabled supply chain system, installation cost, supervised learning

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1115 Methods Used to Achieve Airtightness of 0.07 Ach@50Pa for an Industrial Building

Authors: G. Wimmers

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The University of Northern British Columbia needed a new laboratory building for the Master of Engineering in Integrated Wood Design Program and its new Civil Engineering Program. Since the University is committed to reducing its environmental footprint and because the Master of Engineering Program is actively involved in research of energy efficient buildings, the decision was made to request the energy efficiency of the Passive House Standard in the Request for Proposals. The building is located in Prince George in Northern British Columbia, a city located at the northern edge of climate zone 6 with an average low between -8 and -10.5 in the winter months. The footprint of the building is 30m x 30m with a height of about 10m. The building consists of a large open space for the shop and laboratory with a small portion of the floorplan being two floors, allowing for a mezzanine level with a few offices as well as mechanical and storage rooms. The total net floor area is 1042m² and the building’s gross volume 9686m³. One key requirement of the Passive House Standard is the airtight envelope with an airtightness of < 0.6 ach@50Pa. In the past, we have seen that this requirement can be challenging to reach for industrial buildings. When testing for air tightness, it is important to test in both directions, pressurization, and depressurization, since the airflow through all leakages of the building will, in reality, happen simultaneously in both directions. A specific detail or situation such as overlapping but not sealed membranes might be airtight in one direction, due to the valve effect, but are opening up when tested in the opposite direction. In this specific project, the advantage was the overall very compact envelope and the good volume to envelope area ratio. The building had to be very airtight and the details for the windows and doors installation as well as all transitions from walls to roof and floor, the connections of the prefabricated wall panels and all penetrations had to be carefully developed to allow for maximum airtightness. The biggest challenges were the specific components of this industrial building, the large bay door for semi-trucks and the dust extraction system for the wood processing machinery. The testing was carried out in accordance with EN 132829 (method A) as specified in the International Passive House Standard and the volume calculation was also following the Passive House guideline resulting in a net volume of 7383m3, excluding all walls, floors and suspended ceiling volumes. This paper will explore the details and strategies used to achieve an airtightness of 0.07 ach@50Pa, to the best of our knowledge the lowest value achieved in North America so far following the test protocol of the International Passive House Standard and discuss the crucial steps throughout the project phases and the most challenging details.

Keywords: air changes, airtightness, envelope design, industrial building, passive house

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1114 Environment Patterns and Mental Health of Older Adults in Long-Term Care Facilities: The Role of Activity Profiles

Authors: Shiau-Fang Chao, Yu-Chih Chen

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Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.

Keywords: activity, environment, mental health, older LTC residents

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1113 Burnout in the Resident Physician and a Simple Means of Improvement

Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

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Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

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1112 Structural Balance and Creative Tensions in New Product Development Teams

Authors: Shankaran Sitarama

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New Product Development involves team members coming together and working in teams to come up with innovative solutions to problems, resulting in new products. Thus, a core attribute of a successful NPD team is their creativity and innovation. They need to be creative as a group, generating a breadth of ideas and innovative solutions that solve or address the problem they are targeting and meet the user’s needs. They also need to be very efficient in their teamwork as they work through the various stages of the development of these ideas, resulting in a POC (proof-of-concept) implementation or a prototype of the product. There are two distinctive traits that the teams need to have, one is ideational creativity, and the other is effective and efficient teamworking. There are multiple types of tensions that each of these traits cause in the teams, and these tensions reflect in the team dynamics. Ideational conflicts arising out of debates and deliberations increase the collective knowledge and affect the team creativity positively. However, the same trait of challenging each other’s viewpoints might lead the team members to be disruptive, resulting in interpersonal tensions, which in turn lead to less than efficient teamwork. Teams that foster and effectively manage these creative tensions are successful, and teams that are not able to manage these tensions show poor team performance. In this paper, it explore these tensions as they result in the team communication social network and propose a Creative Tension Balance index along the lines of Degree of Balance in social networks that has the potential to highlight the successful (and unsuccessful) NPD teams. Team communication reflects the team dynamics among team members and is the data set for analysis. The emails between the members of the NPD teams are processed through a semantic analysis algorithm (LSA) to analyze the content of communication and a semantic similarity analysis to arrive at a social network graph that depicts the communication amongst team members based on the content of communication. This social network is subjected to traditional social network analysis methods to arrive at some established metrics and structural balance analysis metrics. Traditional structural balance is extended to include team interaction pattern metrics to arrive at a creative tension balance metric that effectively captures the creative tensions and tension balance in teams. This CTB (Creative Tension Balance) metric truly captures the signatures of successful and unsuccessful (dissonant) NPD teams. The dataset for this research study includes 23 NPD teams spread out over multiple semesters and computes this CTB metric and uses it to identify the most successful and unsuccessful teams by classifying these teams into low, high and medium performing teams. The results are correlated to the team reflections (for team dynamics and interaction patterns), the team self-evaluation feedback surveys (for teamwork metrics) and team performance through a comprehensive team grade (for high and low performing team signatures).

Keywords: team dynamics, social network analysis, new product development teamwork, structural balance, NPD teams

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1111 The Re-Emergence of Russia Foreign Policy (Case Study: Middle East)

Authors: Maryam Azish

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Russia, as an emerging global player in recent years, has projected a special place in the Middle East. Despite all the challenges it has faced over the years, it has always considered its presence in various fields with a strategy that has defined its maneuvering power as a level of competition and even confrontation with the United States. Therefore, its current approach is considered important as an influential actor in the Middle East. After the collapse of the Soviet Union, when the Russians withdrew completely from the Middle East, the American scene remained almost unrivaled by the Americans. With the start of the US-led war in Iraq and Afghanistan and the subsequent developments that led to the US military and political defeat, a new chapter in regional security was created in which ISIL and Taliban terrorism went along with the Arab Spring to destabilize the Middle East. Because of this, the Americans took every opportunity to strengthen their military presence. Iraq, Syria and Afghanistan have always been the three areas where terrorism was shaped, and the countries of the region have each reacted to this evil phenomenon accordingly. The West dealt with this phenomenon on a case-by-case basis in the general circumstances that created the fluid situation in the Arab countries and the region. Russian President Vladimir Putin accused the US of falling asleep in the face of ISIS and terrorism in Syria. In fact, this was an opportunity for the Russians to revive their presence in Syria. This article suggests that utilizing the recognition policy along with the constructivism theory will offer a better knowledge of Russia’s endeavors to endorse its international position. Accordingly, Russia’s distinctiveness and its ambitions for a situation of great power have played a vital role in shaping national interests and, subsequently, in foreign policy, in Putin's era in particular. The focal claim of the paper is that scrutinize Russia’s foreign policy with realistic methods cannot be attained. Consequently, with an aim to fill the prevailing vacuum, this study exploits the politics of acknowledgment in the context of constructivism to examine Russia’s foreign policy in the Middle East. The results of this paper show that the key aim of Russian foreign policy discourse, accompanied by increasing power and wealth, is to recognize and reinstate the position of great power in the universal system. The Syrian crisis has created an opportunity for Russia to unite its position in the developing global and regional order after ages of dynamic and prevalent existence in the Middle East as well as contradicting US unilateralism. In the meantime, the writer thinks that the question of identifying Russia’s position in the global system by the West has played a foremost role in serving its national interests.

Keywords: constructivism, foreign Policy, middle East, Russia, regionalism

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1110 Assessment of a Rapid Detection Sensor of Faecal Pollution in Freshwater

Authors: Ciprian Briciu-Burghina, Brendan Heery, Dermot Brabazon, Fiona Regan

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Good quality bathing water is a highly desirable natural resource which can provide major economic, social, and environmental benefits. Both in Ireland and Europe, such water bodies are managed under the European Directive for the management of bathing water quality (BWD). The BWD aims mainly: (i) to improve health protection for bathers by introducing stricter standards for faecal pollution assessment (E. coli, enterococci), (ii) to establish a more pro-active approach to the assessment of possible pollution risks and the management of bathing waters, and (iii) to increase public involvement and dissemination of information to the general public. Standard methods for E. coli and enterococci quantification rely on cultivation of the target organism which requires long incubation periods (from 18h to a few days). This is not ideal when immediate action is required for risk mitigation. Municipalities that oversee the bathing water quality and deploy appropriate signage have to wait for laboratory results. During this time, bathers can be exposed to pollution events and health risks. Although forecasting tools exist, they are site specific and as consequence extensive historical data is required to be effective. Another approach for early detection of faecal pollution is the use of marker enzymes. β-glucuronidase (GUS) is a widely accepted biomarker for E. coli detection in microbiological water quality control. GUS assay is particularly attractive as they are rapid, less than 4 h, easy to perform and they do not require specialised training. A method for on-site detection of GUS from environmental samples in less than 75 min was previously demonstrated. In this study, the capability of ColiSense as an early warning system for faecal pollution in freshwater is assessed. The system successfully detected GUS activity in all of the 45 freshwater samples tested. GUS activity was found to correlate linearly with E. coli (r2=0.53, N=45, p < 0.001) and enterococci (r2=0.66, N=45, p < 0.001) Although GUS is a marker for E. coli, a better correlation was obtained for enterococci. For this study water samples were collected from 5 rivers in the Dublin area over 1 month. This suggests a high diversity of pollution sources (agricultural, industrial, etc) as well as point and diffuse pollution sources were captured in the sample size. Such variety in the source of E. coli can account for different GUS activities/culturable cell and different ratios of viable but not culturable to viable culturable bacteria. A previously developed protocol for the recovery and detection of E. coli was coupled with a miniaturised fluorometer (ColiSense) and the system was assessed for the rapid detection FIB in freshwater samples. Further work will be carried out to evaluate the system’s performance on seawater samples.

Keywords: faecal pollution, β-glucuronidase (GUS), bathing water, E. coli

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1109 A Clinical Cutoff to Identify Metabolically Unhealthy Obese and Normal-Weight Phenotype in Young Adults

Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

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Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

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1108 Assessment of Dietary Patterns of Saudi Patients with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

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1107 Driver of Migration and Appropriate Policy Concern Considering the Southwest Coastal Part of Bangladesh

Authors: Aminul Haque, Quazi Zahangir Hossain, Dilshad Sharmin Chowdhury

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The human migration is getting growing concern around the world, and recurrent disasters and climate change impact have great influence on migration. Bangladesh is one of the disaster prone countries that/and has greater susceptibility to stress migration by recurrent disasters and climate change. The study was conducted to investigate the factors that have a strong influence on current migration and changing pattern of life and livelihood means of the southwest coastal part of Bangladesh. Moreover, the study also revealed a strong relationship between disasters and migration and appropriate policy concern. To explore this relation, both qualitative and quantitative methods were applied to a questionnaire survey at household level and simple random sampling technique used in the sampling process along with different secondary data sources for understanding policy concern and practices. The study explores the most influential driver of migration and its relationship with social, economic and environmental drivers. The study denotes that, the environmental driver has a greater effect on the intention of permanent migration (t=1.481, p-value=0.000) at the 1 percent significance level. The significant number of respondents denotes that abrupt pattern of cyclone, flood, salinity intrusion and rainfall are the most significant environmental driver to make a decision on permanent migration. The study also found that the temporary migration pattern has 2-fold increased compared to last ten (10) years. It also appears from the study that environmental factors have a great implication on the changing pattern of the occupation of the study area and it has reported that about 76% of the respondent now in the changing modality of livelihood compare to their traditional practices. The study bares that the migration has foremost impact on children and women by increasing hardship and creating critical social security. The exposure-route of permanent migration is not smooth indeed, these migrations creating urban and conflict in Chittagong hill tracks of Bangladesh. The study denotes that there is not any safeguard of the stress migrant on existing policy and not have any measures for safe migration and resettlement rather considering the emergency response and shelter. The majority of (98%) people believes that migration is not to be the adoption strategies, but contrary to this young group of respondent believes that safe migration could be the adaptation strategy which could bring a positive result compare to the other resilience strategies. On the other hand, the significant number of respondents uttered that appropriate policy measure could be an adaptation strategy for being the formation of a resilient community and reduce the migration by meaningful livelihood options with appropriate protection measure.

Keywords: environmental driver, livelihood, migration, resilience

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1106 Global Experiences in Dealing with Biological Epidemics with an Emphasis on COVID-19 Disease: Approaches and Strategies

Authors: Marziye Hadian, Alireza Jabbari

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Background: The World Health Organization has identified COVID-19 as a public health emergency and is urging governments to stop the virus transmission by adopting appropriate policies. In this regard, authorities have taken different approaches to cut the chain or controlling the spread of the disease. Now, the questions we are facing include what these approaches are? What tools should be used to implement each preventive protocol? In addition, what is the impact of each approach? Objective: The aim of this study was to determine the approaches to biological epidemics and related prevention tools with an emphasis on COVID-19 disease. Data sources: Databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, and ProQuest were employed for data extraction. Furthermore, authentic sources such as the WHO website, the published reports of relevant countries, as well as the Worldometer website were evaluated for gray studies. The time-frame of the study was from 1 December 2019 to 30 May 2020. Methods: The present study was a systematic study of publications related to the prevention strategies for the COVID-19 disease. The study was carried out based on the PRISMA guidelines and CASP for articles and AACODS for grey literature. Results: The study findings showed that in order to confront the COVID-19 epidemic, in general, there are three approaches of "mitigation", "active control" and "suppression" and four strategies of "quarantine", "isolation", "social distance" and "lockdown" in both individual and social dimensions to deal with epidemics. Selection and implementation of each approach requires specific strategies and has different effects when it comes to controlling and inhibiting the disease. Key finding: One possible approach to control the disease is to change individual behavior and lifestyle. In addition to prevention strategies, use of masks, observance of personal hygiene principles such as regular hand washing and non-contact of contaminated hands with the face, as well as an observance of public health principles such as sneezing and coughing etiquettes, safe extermination of personal protective equipment, must be strictly observed. Have not been included in the category of prevention tools. However, it has a great impact on controlling the epidemic, especially the new coronavirus epidemic. Conclusion: Although the use of different approaches to control and inhibit biological epidemics depends on numerous variables, however, despite these requirements, global experience suggests that some of these approaches are ineffective. The use of previous experiences in the world, along with the current experiences of countries, can be very helpful in choosing the accurate approach for each country in accordance with the characteristics of that country and lead to the reduction of possible costs at the national and international levels.

Keywords: novel corona virus, COVID-19, approaches, prevention tools, prevention strategies

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1105 Assessing Children’s Probabilistic and Creative Thinking in a Non-formal Learning Context

Authors: Ana Breda, Catarina Cruz

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Daily, we face unpredictable events, often attributed to chance, as there is no justification for such an occurrence. Chance, understood as a source of uncertainty, is present in several aspects of human life, such as weather forecasts, dice rolling, and lottery. Surprisingly, humans and some animals can quickly adjust their behavior to handle efficiently doubly stochastic processes (random events with two layers of randomness, like unpredictable weather affecting dice rolling). This adjustment ability suggests that the human brain has built-in mechanisms for perceiving, understanding, and responding to simple probabilities. It also explains why current trends in mathematics education include probability concepts in official curriculum programs, starting from the third year of primary education onwards. In the first years of schooling, children learn to use a certain type of (specific) vocabulary, such as never, always, rarely, perhaps, likely, and unlikely, to help them to perceive and understand the probability of some events. These are keywords of crucial importance for their perception and understanding of probabilities. The development of the probabilistic concepts comes from facts and cause-effect sequences resulting from the subject's actions, as well as the notion of chance and intuitive estimates based on everyday experiences. As part of a junior summer school program, which took place at a Portuguese university, a non-formal learning experiment was carried out with 18 children in the 5th and 6th grades. This experience was designed to be implemented in a dynamic of a serious ice-breaking game, to assess their levels of probabilistic, critical, and creative thinking in understanding impossible, certain, equally probable, likely, and unlikely events, and also to gain insight into how the non-formal learning context influenced their achievements. The criteria used to evaluate probabilistic thinking included the creative ability to conceive events classified in the specified categories, the ability to properly justify the categorization, the ability to critically assess the events classified by other children, and the ability to make predictions based on a given probability. The data analysis employs a qualitative, descriptive, and interpretative-methods approach based on students' written productions, audio recordings, and researchers' field notes. This methodology allowed us to conclude that such an approach is an appropriate and helpful formative assessment tool. The promising results of this initial exploratory study require a future research study with children from these levels of education, from different regions, attending public or private schools, to validate and expand our findings.

Keywords: critical and creative thinking, non-formal mathematics learning, probabilistic thinking, serious game

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1104 The Comparison of Physical Fitness across Age and Gender in the Lithuanian Primary School Students: Population-Based Cross-Sectional Study

Authors: Arunas Emeljanovas, Brigita Mieziene, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen

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Background: Gender differences in physical fitness were tracked in many studies with lower effect in preschool children and increasing difference among genders across age. In Lithuania, on a population level, secular trends in physical fitness were regularly observed each ten years for the last two decades for 11-18 years old students. However, there is apparently a lack of such epidemiological studies among primary school students. Assessing and monitoring physical fitness from an early age is of particular importance seeking to develop and strengthen physical abilities of youths for future health benefits. The goal of the current study was to indicate age and gender differences in anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children. Methods: The study included 3456 1-4th grade students from 6 to 10 years. The data reliably represents the population of primary school children in Lithuania. Among them, 1721 (49.8 percent) were boys. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues (2011). Height and weight were measured and body mass index was calculated. Student t test evaluated differences in physical fitness between boys and girls, ANOVA was performed to indicate differences across age. Results: All anthropometric and fitness means that were identified as significantly different were better in boys than in girls and in older than younger students (p < .05). Among anthropometric measures, height was higher in boys aged 7 through 9 years. Weight and BMI differed among boys and girls only at 8 years old. Means of height and weight increased significantly across all ages. Among musculoskeletal fitness tests, means of standing broad jump, throwing a tennis ball and pushing a medicine ball were different between genders within each age group and across all ages. Differences between genders were less likely in motor fitness than in musculoskeletal or cardiorespiratory fitness. Differences in means of shuttle run 10 x 5 test between genders occurred at age 6, 9 and 10 years; running 20 m at age 6 and 9 years, and climbing wall bars at age 9 and 10. Means of Reduced Cooper test representing cardiorespiratory fitness were different between genders within each age group but did not differ among age 6 and 8 as well as 7 and 8 years in boys, and among age 7 and 8 years in girls. Conclusion: In general, the current study confirms gender differences in musculoskeletal, motor and cardiorespiratory fitness found in other studies across the world in primary school and older children. Observed gender differences might be explained by higher physical activity in boys rather than girls. As it is explained by previous literature, older boys and girls had better performances than younger ones, because of the components of fitness change as a function of growth, maturation, development, and interactions among the three processes.

Keywords: primary school children, motor fitness, musculoskeletal fitness, cardiovascular fitness

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1103 Decentralized Forest Policy for Natural Sal (Shorea robusta) Forests Management in the Terai Region of Nepal

Authors: Medani Prasad Rijal

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The study outlines the impacts of decentralized forest policy on natural Sal (shorea robusta) forests in the Terai region of Nepal. The government has implemented community forestry program to manage the forest resources and improve the livelihood of local people collectively. The forest management authorities such as conserve, manage, develop and use of forest resources were shifted to the local communities, however, the ownership right of the forestland retained by the government. Local communities took the decision on harvesting, distribution, and sell of forest products by fixing the prices independently. The local communities were putting the low value of forest products and distributed among the user households on the name of collective decision. The decision of low valuation is devaluating the worth of forest products. Therefore, the study hypothesized that decision-making capacities are equally prominent next to the decentralized policy and program formulation. To accomplish the study, individual to group level discussions and questionnaire survey methods were applied with executive committee members and user households. The study revealed that the local intuition called Community Forest User Group (CFUG) committee normally took the decisions on consensus basis. Considering to the access and affording capacity of user households having poor economic backgrounds, low pricing mechanism of forest products has been practiced, even though the Sal timber is far expensive in the local market. The local communities thought that low pricing mechanism is accessible to all user households from poor to better off households. However, the analysis of forest products distribution opposed the assumption as most of the Sal timber, which is the most valuable forest product of community forest only purchased by the limited households of better economic conditions. Since the Terai region is heterogeneous by socio-economic conditions, better off households always have higher affording capacity and possibility of taking higher timber benefits because of low price mechanism. On the other hand, the minimum price rate of forest products has poor contribution in community fund collection. Consequently, it has poor support to carry out poverty alleviation activities to poor people. The local communities have been fixed Sal timber price rate around three times cheaper than normal market price, which is a strong evidence of forest product devaluation itself. Finally, the study concluded that the capacity building of local executives as the decision-makers of natural Sal forests is equally indispensable next to the policy and program formulation for effective decentralized forest management. Unilateral decentralized forest policy may devaluate the forest products rather than devolve of power to the local communities and empower to them.

Keywords: community forestry program, decentralized forest policy, Nepal, Sal forests, Terai

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1102 Awareness and Perception of Food Safety, Nutrition and Food Security among Omani Women

Authors: Abeer Al Kalbani

Abstract:

Oman is a sub-tropical country with limited water resources, harsh weather and limited soil fertility, constraining food production. Therefore, it largely depends on international markets to assure supply of food. In the light of these circumstances, food security in Oman is defined as the ability of the country to grant the staple food needs of people (e.g. rice, wheat, lentil, sugar, dates, dairy products, fish and plant or vegetable oils). It also involves exporting local goods with high production rates to exchange them with required food products. This concept of food security includes the availability of food through production and/or importing, stability of the market prices during all circumstances, and the ability of people to meet their needs within their income capabilities. As a result, most of the food security work is focused on availability and access dimensions of the issue. Not much research is focused on the utilization aspect of food security in Oman. Although women play a vital role in food security, there is limited research on women’s role in food security neither in Oman nor in neighboring Gulf countries. Women play an important role not only by carrying the responsibility of feeding their families but also by setting the consumption model for the household. Therefore, the research aims to contribute to the work done on food security in Oman and similar regions of the world by studying the role women play at the utilization level. Methods used in this research include Qualitative unstructured interviews, focus groups, survey questionnaire and an experimental study. Based on the FAO definition of food security, it consists of availability, access, utilization and sustainability. Results from a pilot study conducted for this research on two groups of women in Oman; urban and rural women, showed that women in Oman are responsible for achieving these four pillars at the household level. Moreover, awareness of women increased as their educational level increased. Urban women showed more awareness and openness to adopt healthier and proper food related choices than rural women. Urban women seem also more open than rural women to new ideas and concepts and ways to healthier food. However, both urban and rural women claim that no training and educational programs are available for them and awareness of food security in general remains relatively low in both groups. In the light of these findings, this research attempts to further investigate the social beliefs, practices and attitudes women adopt in relation to food purchase, storage, preparation and consumption as considered as important parts of the food system. It also seeks to examine the effect of educational training programs and media on the level of women awareness on the issue.

Keywords: food security, household food security, utilization, role of women

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1101 Investigation of the Usability of Biochars Obtained from Olive Pomace and Smashed Olive Seeds as Additives for Bituminous Binders

Authors: Muhammed Ertugrul Celoglu, Beyza Furtana, Mehmet Yilmaz, Baha Vural Kok

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Biomass, which is considered to be one of the largest renewable energy sources in the world, has a potential to be utilized as a bitumen additive after it is processed by a wide variety of thermochemical methods. Furthermore, biomasses are renewable in short amounts of time, and they possess a hydrocarbon structure. These characteristics of biomass promote their usability as additives. One of the most common ways to create materials with significant economic values from biomasses is the processes of pyrolysis. Pyrolysis is defined as the process of an organic matter’s thermochemical degradation (carbonization) at a high temperature and in an anaerobic environment. The resultant liquid substance at the end of the pyrolysis is defined as bio-oil, whereas the resultant solid substance is defined as biochar. Olive pomace is the resultant mildly oily pulp with seeds after olive is pressed and its oil is extracted. It is a significant source of biomass as the waste of olive oil factories. Because olive pomace is waste material, it could create problems just as other waste unless there are appropriate and acceptable areas of utilization. The waste material, which is generated in large amounts, is generally used as fuel and fertilizer. Generally, additive materials are used in order to improve the properties of bituminous binders, and these are usually expensive materials, which are produced chemically. The aim of this study is to investigate the usability of biochars obtained after subjecting olive pomace and smashed olive seeds, which are considered as waste materials, to pyrolysis as additives in bitumen modification. In this way, various ways of use will be provided for waste material, providing both economic and environmental benefits. In this study, olive pomace and smashed olive seeds were used as sources of biomass. Initially, both materials were ground and processed through a No.50 sieve. Both of the sieved materials were subjected to pyrolysis (carbonization) at 400 ℃. Following the process of pyrolysis, bio-oil and biochar were obtained. The obtained biochars were added to B160/220 grade pure bitumen at 10% and 15% rates and modified bitumens were obtained by mixing them in high shear mixtures at 180 ℃ for 1 hour at 2000 rpm. Pure bitumen and four different types of bitumen obtained as a result of the modifications were tested with penetration, softening point, rotational viscometer, and dynamic shear rheometer, evaluating the effects of additives and the ratios of additives. According to the test results obtained, both biochar modifications at both ratios provided improvements in the performance of pure bitumen. In the comparison of the test results of the binders modified with the biochars of olive pomace and smashed olive seed, it was revealed that there was no notable difference in their performances.

Keywords: bituminous binders, biochar, biomass, olive pomace, pomace, pyrolysis

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1100 The Role of High Schools in Saudi Arabia in Supporting Young Adults with Intellectual Disabilities with Their Transition to Post-secondary Education

Authors: Sohil I. Alqazlan

Abstract:

Introduction and Objectives: There is limited research focusing on young adults with intellectual disabilities (ID) and their experiences after finishing compulsory education, especially in the Middle Eastern/Arab countries. This paper aims to further understand the lives of young adults with ID in Riyadh [the capital city of Saudi Arabia], particularly as they go on to access Post-Secondary Education [PSE]. As part of this study, it is important to understand the roles of high schools in Riyadh in terms of preparing their students for post-school life. To achieve this, the researcher has asked Saudi Arabia’s Ministry of Education to provide student transition plans (TPs) for post-school opportunities. However, and unfortunately, high schools in Riyadh do not use transition plans for their students. Therefore, the researcher has requested individual education plans (IEPs) for students with ID in their final year at high school to find the type of support the students had regarding both their long- and short-term goals that might help them access PSE or the labour market. Methods: The researcher analysed 10 IEPs of students in their final year at high school. To achieve the aim of the study, the researcher compared these IEPs with expectations set out in the official IEP framework of the MoE in Saudi Arabia, such as collaboration on the IEP sample and the focus on adult life. By analysing the students’ IEPs in terms of various goals, this study attempts to highlight skills that might offer students more independence after finishing compulsory education and going on to PSE. Results: Unfortunately, communication between IEP team members proved persistently absent in the sample. This was clear from the fact that none of the team members, apart from the SEN teachers, had signed any of the IEPs. Thus, none of the daily or weekly goals outlined were sent to parents to review at home. As a result of this, there were no goals in the IEPs that clearly referred to PSE. However, some long-term goals were set which might help those with ID become more independent in their adult life. For example, in the IEPs, which dealt with computer skills, the student had goals related to using Microsoft Word. Finally, just one goal of these IEPs set an important independent skill for the young adults with ID: “the student will learn how to use public transportation”. Conclusions: From analysing the ten IEPs, it was clear that SEN teachers in Riyadh schools were working without any help from other professionals. The students with ID, as well as their families, were not consulted on their views on important goals. Therefore, more work needs to be done with the students regarding their transition to PSE, perhaps by building partnerships between high schools and potential PSE institutions. Finally, more PSE programmes and a higher level of employer awareness could help create a bridge for students transferring from high school to PSE. Schools could also focus their IEP goals towards specific PSE programmes the student might attend, which could increase their chances of success.

Keywords: high school, post-secondary education, PSE, students with intellectual disabilities

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1099 Automated Computer-Vision Analysis Pipeline of Calcium Imaging Neuronal Network Activity Data

Authors: David Oluigbo, Erik Hemberg, Nathan Shwatal, Wenqi Ding, Yin Yuan, Susanna Mierau

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Introduction: Calcium imaging is an established technique in neuroscience research for detecting activity in neural networks. Bursts of action potentials in neurons lead to transient increases in intracellular calcium visualized with fluorescent indicators. Manual identification of cell bodies and their contours by experts typically takes 10-20 minutes per calcium imaging recording. Our aim, therefore, was to design an automated pipeline to facilitate and optimize calcium imaging data analysis. Our pipeline aims to accelerate cell body and contour identification and production of graphical representations reflecting changes in neuronal calcium-based fluorescence. Methods: We created a Python-based pipeline that uses OpenCV (a computer vision Python package) to accurately (1) detect neuron contours, (2) extract the mean fluorescence within the contour, and (3) identify transient changes in the fluorescence due to neuronal activity. The pipeline consisted of 3 Python scripts that could both be easily accessed through a Python Jupyter notebook. In total, we tested this pipeline on ten separate calcium imaging datasets from murine dissociate cortical cultures. We next compared our automated pipeline outputs with the outputs of manually labeled data for neuronal cell location and corresponding fluorescent times series generated by an expert neuroscientist. Results: Our results show that our automated pipeline efficiently pinpoints neuronal cell body location and neuronal contours and provides a graphical representation of neural network metrics accurately reflecting changes in neuronal calcium-based fluorescence. The pipeline detected the shape, area, and location of most neuronal cell body contours by using binary thresholding and grayscale image conversion to allow computer vision to better distinguish between cells and non-cells. Its results were also comparable to manually analyzed results but with significantly reduced result acquisition times of 2-5 minutes per recording versus 10-20 minutes per recording. Based on these findings, our next step is to precisely measure the specificity and sensitivity of the automated pipeline’s cell body and contour detection to extract more robust neural network metrics and dynamics. Conclusion: Our Python-based pipeline performed automated computer vision-based analysis of calcium image recordings from neuronal cell bodies in neuronal cell cultures. Our new goal is to improve cell body and contour detection to produce more robust, accurate neural network metrics and dynamic graphs.

Keywords: calcium imaging, computer vision, neural activity, neural networks

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1098 Lateral Retroperitoneal Transpsoas Approach: A Practical Minimal Invasive Surgery Option for Treating Pyogenic Spondylitis of the Lumbar Vertebra

Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

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