Search results for: source of competitive advantage in people’s development (socaipd)
Commenced in January 2007
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Edition: International
Paper Count: 26103

Search results for: source of competitive advantage in people’s development (socaipd)

5133 Evolving Convolutional Filter Using Genetic Algorithm for Image Classification

Authors: Rujia Chen, Ajit Narayanan

Abstract:

Convolutional neural networks (CNN), as typically applied in deep learning, use layer-wise backpropagation (BP) to construct filters and kernels for feature extraction. Such filters are 2D or 3D groups of weights for constructing feature maps at subsequent layers of the CNN and are shared across the entire input. BP as a gradient descent algorithm has well-known problems of getting stuck at local optima. The use of genetic algorithms (GAs) for evolving weights between layers of standard artificial neural networks (ANNs) is a well-established area of neuroevolution. In particular, the use of crossover techniques when optimizing weights can help to overcome problems of local optima. However, the application of GAs for evolving the weights of filters and kernels in CNNs is not yet an established area of neuroevolution. In this paper, a GA-based filter development algorithm is proposed. The results of the proof-of-concept experiments described in this paper show the proposed GA algorithm can find filter weights through evolutionary techniques rather than BP learning. For some simple classification tasks like geometric shape recognition, the proposed algorithm can achieve 100% accuracy. The results for MNIST classification, while not as good as possible through standard filter learning through BP, show that filter and kernel evolution warrants further investigation as a new subarea of neuroevolution for deep architectures.

Keywords: neuroevolution, convolutional neural network, genetic algorithm, filters, kernels

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5132 Seven Years Assessment on the Suitability of Cocoa Clones Cultivation in High-Density Planting and Its Management in Malaysia

Authors: O. Rozita, N. M. Nik Aziz

Abstract:

High-density planting is usually recommended for a small area of planting in order to increase production. The normal planting distance for cocoa (Theobroma cacao L.) in Malaysia is 3 m x 3 m. The study was conducted at Cocoa Research and Development Centre, Malaysia Cocoa Board, Jengka, Pahang with the objectives to evaluate the suitability of seven cocoa clones under four different planting densities and to study the interaction between cocoa clones and planting densities. The study was arranged in the split plot with randomized complete block design and replicated three times. The cocoa clone was assigned as the main plot and planting density was assigned as a subplot. The clones used in this study were PBC 123, PBC 112, MCBC4, MCBC 5, QH 1003, QH 22, and BAL 244. The planting distance were 3 m x 3 m (1000 stands/ha), 3 m x 1.5 m (2000 stands/ha), 3 m x 1 m (3000 stands/ha) and (1.5 m x 1.5 m) x 3 m (3333 stands/ha). Evaluation on yield performance was carried out for seven years. Clones of PBC 123, QH 1003, and QH 22 obtained the higher yield, meanwhile MCBC 4, MCBC 5, and BAL 244 obtained the lowest yield. In general, high-density planting can increase cocoa production with good management practices. Among the cocoa management practices, the selection of suitable clones with small branching habits and moderately vigorous and proper pruning activity were the most important factor in high-density planting.

Keywords: clones, management, planting density, Theobroma cacao, yield

Procedia PDF Downloads 360
5131 Efficient Liquid Desiccant Regeneration for Fresh Air Dehumidification Application

Authors: M. V. Rane, Tareke Tekia

Abstract:

Fresh Air Dehumidifier having a capacity of 1 TR has been developed by Heat Pump Laboratory at IITB. This fresh air dehumidifier is based on potassium formate liquid desiccant. The regeneration of the liquid desiccant can be done in two stages. The first stage of liquid desiccant regeneration involves the boiling of liquid desiccant inside the evacuated glass type solar thermal collectors. Further regeneration of liquid desiccant can be achieved using Low Temperature Regenerator, LTR. The coefficient of performance of the fresh air dehumidifier greatly depends on the performance of the major components such as high temperature regenerator, low temperature regenerator, fresh air dehumidifier, and solution heat exchangers. High effectiveness solution heat exchanger has been developed and tested. The solution heat exchanger is based on a patented aluminium extrusion with special passage geometry to enhance the heat transfer rate. Effectiveness up to 90% was achieved. Before final testing of the dehumidifier, major components have been tested individually. Testing of the solar thermal collector as hot water and steam generator reveals that efficiency up to 55% can be achieved. In this paper, the development of 1 TR fresh air dehumidifier with special focus on solution heat exchangers and solar thermal collector performance is presented.

Keywords: solar, liquid desiccant, dehumidification, air conditioning, regeneration, coefficient of performance

Procedia PDF Downloads 178
5130 Computational Agent-Based Approach for Addressing the Consequences of Releasing Gene Drive Mosquito to Control Malaria

Authors: Imran Hashmi, Sipkaduwa Arachchige Sashika Sureni Wickramasooriya

Abstract:

Gene-drive technology has emerged as a promising tool for disease control by influencing the population dynamics of disease-carrying organisms. Various gene drive mechanisms, derived from global laboratory experiments, aim to strategically manage and prevent the spread of targeted diseases. One prominent strategy involves population replacement, wherein genetically modified mosquitoes are introduced to replace the existing local wild population. To enhance our understanding and aid in the design of effective release strategies, we employ a comprehensive mathematical model. The utilized approach employs agent-based modeling, enabling the consideration of individual mosquito attributes and flexibility in parameter manipulation. Through the integration of an agent-based model and a meta-population spatial approach, the dynamics of gene drive mosquito spreading in a released site are simulated. The model's outcomes offer valuable insights into future population dynamics, providing guidance for the development of informed release strategies. This research significantly contributes to the ongoing discourse on the responsible and effective implementation of gene drive technology for disease vector control.

Keywords: gene drive, agent-based modeling, disease-carrying organisms, malaria

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5129 Problem, Policy and Polity in Agenda Setting: Analyzing Safe Motherhood Program in India

Authors: Vanita Singh

Abstract:

In developing countries, there are conflicting political agendas; policy makers have to prioritize issues from a list of issues competing for the limited resources. Thus, it is imperative to understand how some issues gain attention, and others lose in the policy circles. Multiple-Streams Theory of Kingdon (1984) is among the influential theories that help to understand the public policy process and is utilitarian for health policy makers to understand how certain health issues emerge on the policy agendas. The issue of maternal mortality was long standing in India and was linked with high birth rate thus the focus of maternal health policy was on family planning since India’s independence. However, a paradigm shift was noted in the maternal health policy in the year 1992 with the launch of Safe Motherhood Programme and then in the year 2005, when the agenda of maternal health policy became universalizing institutional deliveries and phasing-out of Traditional Birth Attendants (TBAs) from the health system. There were many solutions proposed by policy communities other than universalizing of institutional deliveries, including training of TBAs and improving socio-economic conditions of pregnant women. However, Government of India favored medical community, which was advocating for the policy of universalizing institutional delivery, and neglected the solutions proposed by other policy communities. It took almost 15 years for the advocates of institutional delivery to transform their proposed solution into a program - the Janani Suraksha Yojana (JSY), a safe-motherhood program promoting institutional delivery through cash incentives to pregnant women. Thus, the case of safe motherhood policy in India is worth studying to understand how certain issues/problems gain political attention and how advocacy work in policy circles. This paper attempts to understand the factors that favored the agenda of safe-motherhood in the policy circle in India, using John Kingdon’s Multiple-Stream model of agenda-setting. Through document analysis and literature review, the paper traces the evolution of safe motherhood program and maternal health policy. The study has used open source documents available on the website of Ministry of Health and Family Welfare, media reports (Times of India Archive) and related research papers. The documents analyzed include National health policy-1983, National Health Policy-2002, written reports of Ministry of Health and Family Welfare Department, National Rural Health Mission (NRHM) document, documents related to Janani Suraksha Yojana and research articles related to maternal health programme in India. The study finds that focusing events and credible indicators coupled with media attention has the potential to recognize a problem. The political elites favor clearly defined and well-accepted solutions. The trans-national organizations affect the agenda-setting process in a country through conditional resource provision. The closely-knit policy communities and political entrepreneurship are required for advocating solutions high on agendas. The study has implications for health policy makers in identifying factors that have the potential to affect the agenda-setting process for a desired policy agenda and identify the challenges in generating political priorities.

Keywords: agenda-setting, focusing events, Kingdon’s model, safe motherhood program India

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5128 Review and Evaluation of Trending Canonical Correlation Analyses-Based Brain Computer Interface Methods

Authors: Bayar Shahab

Abstract:

The fast development of technology that has advanced neuroscience and human interaction with computers has enabled solutions to various problems, and issues of this new era have been found and are being found like no other time in history. Brain-computer interface so-called BCI has opened the door to several new research areas and have been able to provide solutions to critical and important issues such as supporting a paralyzed patient to interact with the outside world, controlling a robot arm, playing games in VR with the brain, driving a wheelchair or even a car and neurotechnology enabled the rehabilitation of the lost memory, etc. This review work presents state-of-the-art methods and improvements of canonical correlation analyses (CCA), which is an SSVEP-based BCI method. These are the methods used to extract EEG signal features or, to be said in a different way, the features of interest that we are looking for in the EEG analyses. Each of the methods from oldest to newest has been discussed while comparing their advantages and disadvantages. This would create a great context and help researchers to understand the most state-of-the-art methods available in this field with their pros and cons, along with their mathematical representations and usage. This work makes a vital contribution to the existing field of study. It differs from other similar recently published works by providing the following: (1) stating most of the prominent methods used in this field in a hierarchical way (2) explaining pros and cons of each method and their performance (3) presenting the gaps that exist at the end of each method that can open the understanding and doors to new research and/or improvements.

Keywords: BCI, CCA, SSVEP, EEG

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5127 Physical Aggression and Language Skills among Children with Mild Intellectual Disabilities

Authors: Maryam Razmjoee

Abstract:

Physical aggression is one of the most common behavioural problems among children with intellectual disabilities. Behaviours such as hitting, kicking, and threatening with the intent to harm others are examples of physical aggression. Identified language delays are related to physically aggressive behaviours, as children with poor language skills are often frustrated by socially interactions with their peers, leaving them at risk engaging in acts of physical aggression. As a result of this concern, physical aggression and language skills of children with mild intellectual disabilities was investigated. In the current study, 102 students, from years 1-3, with mild intellectual disabilities (51 girls and 51 boys) have been recruited from five educational centres which cater for children with mild intellectual disabilities in the city of Shiraz (a major city in Iran). The Test of Language Development-Primary: 3rd Edition (TOLD-3) and Overt and Relational Aggression Questionnaire were used to assess these children. Results showed that physical aggression had a significant negative association with expressive (p = 0.008), and receptive (p = 0.019) language skills. In addition, boys demonstrated more physically aggressive behaviours than girls (p = 0.014). No difference was found in expressive and receptive language skills between girls and boys with mild intellectual disabilities. The overall findings suggest that improving the language skills of children with intellectual disabilities experiencing language delays will help them to avoid exhibiting antisocial behaviours in social interactions.

Keywords: behaviour, language skills, mild intellectual disabilities, physical aggression, primary school students

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5126 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

Abstract:

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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5125 Role of Physiotherapist: How Their Job and Working Area Could Be Known

Authors: Juan Pablo Hervas-Perez, Jesus Guodemar-Perez, Montserrat Ruiz-Lopez, Elena Sonsoles Rodriguez-Lopez, Noemi Mayoral-Gonzalo, Eduardo Cimadevilla Fernandez-Pola, Mario Caballero-Corella

Abstract:

Physiotherapy is a healthcare discipline that covers many fields of action within the recovery and prevention of health. Some are well known, but others, such as working with newborns and premature children are not so. Physical therapist functions are well defined, but the impression of the population is that there are other professionals who can develop them, and a large part are unknown. Objective: To evaluate the level of knowledge of the sample on the role of the physiotherapist in general, and more specifically in the neonatal intensive care (NICU) units, and estimate your level of notions on the development centered care (DCC). Method: A descriptive, transversal, observational and prospective study developed on a 125 participants' sample. Results: From the sample studied, 87.2% had already had contact with physiotherapy previously. An 80.9% believed that the physiotherapist intervention was decisive for the cure, and 84.0% would recommend physiotherapy treatment to others. Of the total surveyed, 98.0% felt that the physiotherapist is who should run the physiotherapeutic treatments, but shares with other professions 71.0% of votes. The field's best-known work is rehabilitation (94.0%); Neonatology is on the 4th place (66.0% of votes). Conclusions: Many areas of work of physical therapy are unknown to a big part of the population, including the own health workers. Less than half of the sample meets the DCC, and only 58% of the interviewed physiotherapists know them.

Keywords: functions of physiotherapist, neonatal intensive care, physiotherapy, prematurity

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5124 Driver of Migration and Appropriate Policy Concern Considering the Southwest Coastal Part of Bangladesh

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

Abstract:

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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5123 Evaluation of Acetylcholinesterase, Glutathione S-Transferase and Catalase Activities in the Land Snail Helix aspersa Exposed to Thiamethoxam

Authors: Ait Hamlet Smina, Bensoltane Samira, Djekoun Mohamed, Berrebbah Houria

Abstract:

In Algeria, the use of insecticides and other phytosanitary products are considerably spreading with the development of agriculture. But, the analyses of the residues of pesticides are not systematically made. In this context, we estimated through an experimental study, the effect of a neonicotinoid insecticide, the thiamethoxam which is used as a commercial preparation on the land snail Helix aspersa. This snail is one of the most abundant gastropod in North-East Algeria. Little information is available in the literature concerning the study of the biochemical markers of mollusks which are exposed to insecticides and especially, thiamethoxam.In this work, adult snails Helix aspersa were used to estimate the effect of a neonicotinoid insecticide (thiamethoxam) on the acetylcholinesterase (AChE), glutathione S-transferase (GST) and catalase (CAT) activities in this gastropod after a treatment of 6 weeks. During this period, snails were exposed by ingestion and contact to fresh lettuce leaves which were soaked with an insecticide solution. The thiamethoxam test solutions were 0, 25, 50, 100 and 200 mg/L, which are lower or equal to the concentrations that are applied in field. The results showed that the enzymatic activities of AChE and GST and CAT increased significantly with a dose-dependent manner. These results confirmed the toxic effect of thiamethoxam on snails exposed to the lettuce contaminated with this neonicotinoid insecticide, likely to be used as biomarker of exposure, at first to thiamethoxam then to other insecticides belonging to the same chemical family, currently present in the environment.

Keywords: helix aspersa, insecticide, thiamethoxam, AChE, GST, CAT

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5122 Metal Contamination in an E-Waste Recycling Community in Northeastern Thailand

Authors: Aubrey Langeland, Richard Neitzel, Kowit Nambunmee

Abstract:

Electronic waste, ‘e-waste’, refers generally to discarded electronics and electrical equipment, including products from cell phones and laptops to wires, batteries and appliances. While e-waste represents a transformative source of income in low- and middle-income countries, informal e-waste workers use rudimentary methods to recover materials, simultaneously releasing harmful chemicals into the environment and creating a health hazard for themselves and surrounding communities. Valuable materials such as precious metals, copper, aluminum, ferrous metals, plastic and components are recycled from e-waste. However, persistent organic pollutants such as polychlorinated biphenyls (PCBs) and some polybrominated diphenyl ethers (PBDEs), and heavy metals are toxicants contained within e-waste and are of great concern to human and environmental health. The current study seeks to evaluate the environmental contamination resulting from informal e-waste recycling in a predominantly agricultural community in northeastern Thailand. To accomplish this objective, five types of environmental samples were collected and analyzed for concentrations of eight metals commonly associated with e-waste recycling during the period of July 2016 through July 2017. Rice samples from the community were collected after harvest and analyzed using inductively coupled plasma mass spectrometry (ICP-MS) and gas furnace atomic spectroscopy (GF-AS). Soil samples were collected and analyzed using methods similar to those used in analyzing the rice samples. Surface water samples were collected and analyzed using absorption colorimetry for three heavy metals. Environmental air samples were collected using a sampling pump and matched-weight PVC filters, then analyzed using Inductively Coupled Argon Plasma-Atomic Emission Spectroscopy (ICAP-AES). Finally, surface wipe samples were collected from surfaces in homes where e-waste recycling activities occur and were analyzed using ICAP-AES. Preliminary1 results indicate that some rice samples have concentrations of lead and cadmium significantly higher than limits set by the United States Department of Agriculture (USDA) and the World Health Organization (WHO). Similarly, some soil samples show levels of copper, lead and cadmium more than twice the maximum permissible level set by the USDA and WHO, and significantly higher than other areas of Thailand. Surface water samples indicate that areas near e-waste recycling activities, particularly the burning of e-waste products, result in increased levels of cadmium, lead and copper in surface waters. This is of particular concern given that many of the surface waters tested are used in irrigation of crops. Surface wipe samples measured concentrations of metals commonly associated with e-waste, suggesting a danger of ingestion of metals during cooking and other activities. Of particular concern is the relevance of surface contamination of metals to child health. Finally, air sampling showed that the burning of e-waste presents a serious health hazard to workers and the environment through inhalation and deposition2. Our research suggests a need for improved methods of e-waste recycling that allows workers to continue this valuable revenue stream in a sustainable fashion that protects both human and environmental health. 1Statistical analysis to be finished in October 2017 due to follow-up field studies occurring in July and August 2017. 2Still awaiting complete analytic results.

Keywords: e-waste, environmental contamination, informal recycling, metals

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5121 Automated Irrigation System with Programmable Logic Controller and Photovoltaic Energy

Authors: J. P. Reges, L. C. S. Mazza, E. J. Braga, J. A. Bessa, A. R. Alexandria

Abstract:

This paper proposes the development of control and automation of irrigation system located sunflower harvest in the Teaching Unit, Research and Extension (UEPE), the Apodi Plateau in Limoeiro do Norte. The sunflower extraction, which in turn serves to get the produced oil from its seeds, animal feed, and is widely used in human food. Its nutritional potential is quite high what makes of foods produced from vegetal, very rich and healthy. The focus of research is to make the autonomous irrigation system sunflower crop from programmable logic control energized with alternative energy sources, solar photovoltaics. The application of automated irrigation system becomes interesting when it provides convenience and implements new forms of managements of the implementation of irrigated cropping systems. The intended use of automated addition to irrigation quality and consequently brings enormous improvement for production of small samples. Addition to applying the necessary and sufficient features of water management in irrigation systems, the system (PLC + actuators + Renewable Energy) will enable to manage the quantitative water required for each crop, and at the same time, insert the use of sources alternative energy. The entry of the automated collection will bring a new format, and in previous years, used the process of irrigation water wastage base and being the whole manual irrigation process.

Keywords: automation, control, sunflower, irrigation, programming, renewable energy

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5120 Problems concerning Legal Regulation of Electronic Governance in Georgia

Authors: Giga Phartenadze

Abstract:

In the legal framework of regulation of electronic governance, those norms are considered which include measures for improvement of functions of public institutions and a complex of actions for raising their standard such as websites of public institutions, online services, some forms of internet interactions and higher level of internet services. An important legal basis for electronic governance in Georgia is Georgian Law about Electronic Communications which defines legal and economic basis for utilizing electronic communication systems in Georgia. As for single electronic basis for e-governance regulation, it can be said that it does not exist at all. The official websites of public institutions do not have standards for proactive spreading of information. At the same time, there is no common legal norm which would make all public institutions have an official website for public relations, accountability, publicity, and raising information quality. Electronic governance in Georgia needs comprehensive legal regulation. Public administration in electronic form is on the initial stage of development. Currently existing legal basis has a low quality for public institutions and officials as well as citizens and business. Services of e-involvement and e-consultation have also low quality. So far there is no established legal framework for e-governance. Therefore, a single legislative system of e-governance should be created which will help develop effective, comprehensive and multi component electronic systems in the country (central, regional, local levels). Such comprehensive legal framework will provide relevant technological, institutional, and informational conditions.

Keywords: law, e-government, public administration, Georgia

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5119 Strategic Thinking to Enhance Critical Transport Infrastructure and Build Resilience

Authors: Jayantha Withanaarachchi, Sujeeva Setunge, Sara Moridpour

Abstract:

Gaps in strategic thinking and planning lead to critical transport infrastructure resilience. These gaps in strategic transport and land use development planning have an impact on communities and cities. Natural and man-induced disasters can be catastrophic to communities. After a disaster, many types of critical infrastructure, including transport infrastructure gets un-usable or gets damaged. This paper examines strategic thinking behind the resilience and protection of Critical Transport Infrastructure (CI) within transport networks by investigating the impact of disasters such as bushfires, hurricanes and earthquakes. A detailed analysis of three case studies have been conducted to identify the gaps in strategic transport planning and strategic decision making processes required to mitigate the impacts of disasters. Case studies will be analysed to identify existing gaps in road design, transport planning and decision making. This paper examines the effect of road designing, transport corridors and decision making during transport planning stages and how it impacts transport infrastructure as well as community resilience. A set of recommendations to overcome the shortcomings of existing strategic planning and designing process are presented. This research paper reviews transport infrastructure planning issues and presents the common approach suitable for future strategic thinking and planning which could be adopted in practices.

Keywords: community resilience, decision making , infrastructure resilience, strategic transport planning, transport infrastructure

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5118 Integrative Analysis of Urban Transportation Network and Land Use Using GIS: A Case Study of Siddipet City

Authors: P. Priya Madhuri, J. Kamini, S. C. Jayanthi

Abstract:

Assessment of land use and transportation networks is essential for sustainable urban growth, urban planning, efficient public transportation systems, and reducing traffic congestion. The study focuses on land use, population density, and their correlation with the road network for future development. The scope of the study covers inventory and assessment of the road network dataset (line) at the city, zonal, or ward level, which is extracted from very high-resolution satellite data (spatial resolution < 0.5 m) at 1:4000 map scale and ground truth verification. Road network assessment is carried out by computing various indices that measure road coverage and connectivity. In this study, an assessment of the road network is carried out for the study region at the municipal and ward levels. In order to identify gaps, road coverage and connectivity were associated with urban land use, built-up area, and population density in the study area. Ward-wise road connectivity and coverage maps have been prepared. To assess the relationship between road network metrics, correlation analysis is applied. The study's conclusions are extremely beneficial for effective road network planning and detecting gaps in the road network at the ward level in association with urban land use, existing built-up, and population.

Keywords: road connectivity, road coverage, road network, urban land use, transportation analysis

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5117 Expectation-Confirmation Model of Information System Continuance: A Meta-Analysis

Authors: Hui-Min Lai, Chin-Pin Chen, Yung-Fu Chang

Abstract:

The expectation-confirmation model (ECM) is one of the most widely used models for evaluating information system continuance, and this model has been extended to other study backgrounds, or expanded with other theoretical perspectives. However, combining ECM with other theories or investigating the background problem may produce some disparities, thus generating inaccurate conclusions. Habit is considered to be an important factor that influences the user’s continuance behavior. This paper thus critically examines seven pairs of relationships from the original ECM and the habit variable. A meta-analysis was used to tackle the development of ECM research over the last 10 years from a range of journals and conference papers published in 2005–2014. Forty-six journal articles and 19 conference papers were selected for analysis. The results confirm our prediction that a high effect size for the seven pairs of relationships was obtained (ranging from r=0.386 to r=0.588). Furthermore, a meta-analytic structural equation modeling was performed to simultaneously test all relationships. The results show that habit had a significant positive effect on continuance intention at p<=0.05 and that the six other pairs of relationships were significant at p<0.10. Based on the findings, we refined our original research model and an alternative model was proposed for understanding and predicting information system continuance. Some theoretical implications are also discussed.

Keywords: Expectation-confirmation theory, Expectation-confirmation model, Meta-analysis, meta-analytic structural equation modeling.

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5116 Investigation of an Alkanethiol Modified Au Electrode as Sensor for the Antioxidant Activity of Plant Compounds

Authors: Dana A. Thal, Heike Kahlert, Fritz Scholz

Abstract:

Thiol molecules are known to easily form self-assembled monolayers (SAM) on Au surfaces. Depending on the thiol’s structure, surface modifications via SAM can be used for electrode sensor development. In the presented work, 1-decanethiol coated polycrystalline Au electrodes were applied to indirectly assess the radical scavenging potential of plant compounds and extracts. Different plant compounds with reported antioxidant properties as well as an extract from the plant Gynostemma pentaphyllum were tested for their effectiveness to prevent SAM degradation on the sensor electrodes via photolytically generated radicals in aqueous media. The SAM degradation was monitored over time by differential pulse voltammetry (DPV) measurements. The results were compared to established antioxidant assays. The obtained data showed an exposure time and concentration dependent degradation process of the SAM at the electrode’s surfaces. The tested substances differed in their capacity to prevent SAM degradation. Calculated radical scavenging activities of the tested plant compounds were different for different assays. The presented method poses a simple system for radical scavenging evaluation and, considering the importance of the test system in antioxidant activity evaluation, might be taken as a bridging tool between in-vivo and in-vitro antioxidant assay in order to obtain more biologically relevant results in antioxidant research.

Keywords: alkanethiol SAM, plant antioxidant, polycrystalline Au, radical scavenger

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5115 Determining the Functionality of Urban Wildlife with Large Megafauna: A Case Study from Chobe District, Northern Botswana

Authors: Tempe S. F. Adams, Michael J. Chase, Tracey L. Rogers, Keith E. A. Leggett

Abstract:

Transfrontier wildlife corridors can be successful conservation tools, connecting protected areas and reducing the impact of habitat fragmentation on mobile species. Urban wildlife corridors have been proposed as a potential mitigation tool to facilitate the passage of elephants through towns without causing conflict with urban communities. However, because such corridors are typically narrow and close to human development, wildlife (particularly large mammals) may be less likely to use them. We used remote-sensor camera traps and global positioning system collars to identify the movement patterns of African elephants Loxondonta africana through narrow, urban corridors in Botswana. The corridors were in three types of human-dominated land-use designations with varying levels of human activity: agricultural, industrial and open space recreational land. We found that elephants used the corridors within all three land-use designations and we identified, using a model selection approach, that season, time of day and rainfall were important factors in determining the presence of elephants in the corridors. Elephants moved more slowly through the narrow corridors compared with their movement patterns through broader, wide-ranging corridors. Our results indicate that urban wildlife corridors are useful for facilitating elephants to pass through urban areas.

Keywords: camera traps, conservation, human-elephant coexistence, land management, urban wildlife corridors

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5114 Development of a Work-Related Stress Management Program Guaranteeing Fitness-For-Duty for Human Error Prevention

Authors: Hyeon-Kyo Lim, Tong-Il Jang, Yong-Hee Lee

Abstract:

Human error is one of the most dreaded factors that may result in unexpected accidents, especially in nuclear power plants. For accident prevention, it is quite indispensable to analyze and to manage the influence of any factor which may raise the possibility of human errors. Out of lots factors, stress has been reported to have a significant influence on human performance. Therefore, this research aimed to develop a work-related stress management program which can guarantee Fitness-for-Duty (FFD) of the workers in nuclear power plants, especially those working in main control rooms. Major stress factors were elicited through literal surveys and classified into major categories such as demands, supports, and relationships. To manage those factors, a test and intervention program based on 4-level approaches was developed over the whole employment cycle including selection and screening of workers, job allocation, and job rotation. In addition, a managerial care program was introduced with the concept of Employee-Assistance-Program (EAP) program. Reviews on the program conducted by ex-operators in nuclear power plants showed responses in the affirmative, and suggested additional treatment to guarantee high performance of human workers, not in normal operations but also in emergency situations.

Keywords: human error, work performance, work stress, Fitness-For-Duty (FFD), Employee Assistance Program (EAP)

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5113 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi

Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

Abstract:

Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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5112 Overview of Multi-Chip Alternatives for 2.5 and 3D Integrated Circuit Packagings

Authors: Ching-Feng Chen, Ching-Chih Tsai

Abstract:

With the size of the transistor gradually approaching the physical limit, it challenges the persistence of Moore’s Law due to the development of the high numerical aperture (high-NA) lithography equipment and other issues such as short channel effects. In the context of the ever-increasing technical requirements of portable devices and high-performance computing, relying on the law continuation to enhance the chip density will no longer support the prospects of the electronics industry. Weighing the chip’s power consumption-performance-area-cost-cycle time to market (PPACC) is an updated benchmark to drive the evolution of the advanced wafer nanometer (nm). The advent of two and half- and three-dimensional (2.5 and 3D)- Very-Large-Scale Integration (VLSI) packaging based on Through Silicon Via (TSV) technology has updated the traditional die assembly methods and provided the solution. This overview investigates the up-to-date and cutting-edge packaging technologies for 2.5D and 3D integrated circuits (ICs) based on the updated transistor structure and technology nodes. The author concludes that multi-chip solutions for 2.5D and 3D IC packagings are feasible to prolong Moore’s Law.

Keywords: moore’s law, high numerical aperture, power consumption-performance-area-cost-cycle time to market, 2.5 and 3D- very-large-scale integration, packaging, through silicon via

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5111 Acceptance towards Counselling Services among Flood Victims in Selangor

Authors: Husni Mohd Radzi, Lilie Zahara Ramly, Sapora Sipon, Salhah Abdullah

Abstract:

Malaysia have been experiencing series of huge floods all around the country for the past decades despide planned development done by local authorities. The floods incurred due to factors like natural climate change or man-made disaster. Floods have caused a lot of damages, destructions and losses in term of infrastructure, financial implications and physical health. However, other damaging aspect was not being given much attention are the psychological need of the flood victim. The traumatic impact from the natural disaster like floods may cause serious psychological and spiritual deterioration. Many flood relief shelters in the past did not provide counseling services for flood victims to consult, and as a result, it contributes to added stress among the flood victims, as the issue were not being addressed. Some studies indicates that flood victims did not look for counseling service being offered. A total of 257 flood victim was involved in this study. Main area of the study was Kg Bukit Changgang, Kg. Rancangan Tanah Belia, Kg. Labohan Dagang and Kg.Olak Lempit in Kuala Langat, Selangor. The flood victims have responded to the survey given and the data was analyze using SPSS for descriptive information and other measures. At least 13 victims were reported to have experienced moderate to severe level of stress and anxiety over the flood disaster incidents and a total of 88 respondents admitted to have at least thought and consider getting counseling service.

Keywords: perception, acceptance towards counseling, counseling service for flood victim, disaster

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5110 Inclusive Education in Jordanian Double-Shift Schools: Attitudes of Teacher and Students

Authors: David Ross Cameron

Abstract:

In an attempt to alleviate the educational planning problem, double-shift schools have been created throughout various regions in Jordan, namely communities closer to the Syrian border, where a large portion of the refugee population settled, allowing Jordanians to attend the morning-shift and Syrians to attend the afternoon-shift. Subsequently, overcrowded classrooms have added a significant amount of stress on school facilities and teacher capacities. Established national policies and the implementation of inclusive educational practices have been jeopardized. In particular, teachers’ and student’s attitudes of the importance of inclusive education provisions in the classroom have deteriorated. To have a more comprehensive understanding of the current situation and possible plan for intervention, a focus study was carried out at a double-shift Jordanian/Syrian girls’ public school in Irbid, Jordan. Interviews and surveys of 29 students with physical, learning, emotional and behavioral disabilities, 33 students without any special needs and nine teachers were included with a mixed-method social research approach to highlight the current attitudes that students and teachers held and factors that contributed to shaping their inclinations and beliefs of inclusive education.

Keywords: capacity building, development, double-shift, Irbid, inclusive education, Jordan, pedagogy, planning, policy, refugee, special education, special needs, vulnerable population

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5109 Effect of Cabbage and Cauliflower Emitted Volatile Organic Compounds on Foraging Response of Plutella xylostella

Authors: Sumbul Farhat, Pratyay Vaibhav, Sarah Jain, Kapinder Kumar, Archna Kumar

Abstract:

The Diamondback Moth, Plutella xylostella (Linnaeus), is a major pest of cole crops that causes approximately 50% loss in global production. The utilization of inorganic pesticides is reflected in the development of resistance to this pest. Thus, there is a great need for an eco-friendly, sustainable strategy for the control of this pest. Although this pest, several natural enemies are reported worldwide, none of them can control it efficiently. Therefore, a proposed study is planned to understand the Volatile Organic Compounds (VOCs) mediated signaling interaction mechanism of the plant, pest, and natural enemy. For VOCs collection during different deployment stages of Cabbage POI, Green Ball, Pusa Cabbage, Cabbage Local, Snowball 16, Kanchan Plus, Pusa Meghna, Farm Sona Hybrid F1, and Samridhi F1 Hybrid, the Solid-phase microextraction (SPME) method was employed. Characterization of VOCs was conducted by Gas Chromatography-Mass Spectrometry (GC-MS). The impact of collected VOCs was assessed through Y-Tube Bioassays. The results indicate that the Cabbage variety Green Ball shows maximum repellency for P. xylostella (-100%). The cues present in this variety may be exploited for efficient management of P. xylostella in the cole crop ecosystem.

Keywords: Plutella xylostella, cole crops, volatile organic compounds, GC-MS, Green Ball

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5108 Queer Anti-Urbanism: An Exploration of Queer Space Through Design

Authors: William Creighton, Jan Smitheram

Abstract:

Queer discourse has been tied to a middle-class, urban-centric, white approach to the discussion of queerness. In doing so, the multilayeredness of queer existence has been washed away in favour of palatable queer occupation. This paper uses design to explore a queer anti-urbanist approach to facilitate a more egalitarian architectural occupancy. Scott Herring’s work on queer anti-urbanism is key to this approach. Herring redeploys anti-urbanism from its historical understanding of open hostility, rejection and desire to destroy the city towards a mode of queer critique that counters normative ideals of homonormative metronormative gay lifestyles. He questions how queer identity has been closed down into a more diminutive frame where those who do not fit within this frame are subjected to persecution or silenced through their absence. We extend these ideas through design to ask how a queer anti-urbanist approach facilitates a more egalitarian architectural occupancy. Following a “design as research” methodology, the design outputs allow a vehicle to ask how we might live, otherwise, in architectural space. A design as research methodologically is a process of questioning, designing and reflecting – in a non-linear, iterative approach – establishes itself through three projects, each increasing in scale and complexity. Each of the three scales tackled a different body relationship. The project began exploring the relations between body to body, body to known others, and body to unknown others. Moving through increasing scales was not to privilege the objective, the public and the large scale; instead, ‘intra-scaling’ acts as a tool to re-think how scale reproduces normative ideas of the identity of space. There was a queering of scale. Through this approach, the results were an installation that brings two people together to co-author space where the installation distorts the sensory experience and forces a more intimate and interconnected experience challenging our socialized proxemics: knees might touch. To queer the home, the installation was used as a drawing device, a tool to study and challenge spatial perception, drawing convention, and as a way to process practical information about the site and existing house – the device became a tool to embrace the spontaneous. The final design proposal operates as a multi-scalar boundary-crossing through “private” and “public” to support kinship through communal labour, queer relationality and mooring. The resulting design works to set adrift bodies in a sea of sensations through a mix of pleasure programmes. To conclude, through three design proposals, this design research creates a relationship between queer anti-urbanism and design. It asserts that queering the design process and outcome allows a more inclusive way to consider place, space and belonging. The projects lend to a queer relationality and interdependence by making spaces that support the unsettled, out-of-place, but is it queer enough?

Keywords: queer, queer anti-urbanism, design as research, design

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5107 Philosophy and Value Education for Children in India

Authors: Merina Islam

Abstract:

In this paper, an attempt is made to draw out the contemporary relevance of philosophy in school education of India. This paper attempt is made to inquire into the importance of philosophy for schoolchildren in the Indian cultural context. As education in philosophy for children is useful for teaching the acquisition of knowledge from the information provided, for questioning of rules in different contexts, and for the analysis of facts encountered in daily life. Ethical attitudes can neither be derived from the information provided about the moral rules, nor do they result from a practice of unquestioning obedience It includes some studies done in this field and also reports on philosophy. Many European countries emphasise on the above said theme. There are lots of work and research done by many philosophers on philosophy for children. Indian values system is different from the West and more important than others. Education has become a tool to achieve efficiency in all walks of human life whether social, political, religious or philosophical. Every nation started developing its own specific set of educational values. For India it is very necessary to increase philosophical thinking study and research. Philosophy could make significant contribution, particularly in relation to children's moral development because the Indian curriculum currently neglects this aim. A teacher can play an important role in promoting this discussion because a teacher has the capacity to influence students with their thoughts and personality and engages them in these activities. Philosophy needs to be included in the curriculum and have demonstrated cognitive and social gains in children who were explored to philosophy in their schooling.

Keywords: education, ethical attitude, moral value, philosophy

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5106 Reliability of 2D Motion Analysis System for Sagittal Plane Lower Limb Kinematics during Running

Authors: Seyed Hamed Mousavi, Juha M. Hijmans, Reza Rajabi, Ron Diercks, Johannes Zwerver, Henk van der Worp

Abstract:

Introduction: Running is one of the most popular sports activity among people. Improper sagittal plane ankle, knee and hip kinematics are considered to be associated with the increase of injury risk in runners. Motion assessing smart-phone applications are increasingly used to measure kinematics both in the field and laboratory setting, as they are cheaper, more portable, accessible, and easier to use relative to 3D motion analysis system. The aims of this study are 1) to compare the results of 3D gait analysis system and CE; 2) to evaluate the test-retest and intra-rater reliability of coach’s eye (CE) app for the sagittal plane hip, knee, and ankle angles in the touchdown and toe-off while running. Method: Twenty subjects participated in this study. Sixteen reflective markers and cluster markers were attached to the subject’s body. Subjects were asked to run at a self-selected speed on a treadmill. Twenty-five seconds of running were collected for analyzing kinematics of interest. To measure sagittal plane hip, knee and ankle joint angles at touchdown (TD) and toe off (TO), the mean of first ten acceptable consecutive strides was calculated for each angle. A smartphone (Samsung Note5, android) was placed on the right side of the subject so that whole body was simultaneously filmed with 3D gait system during running. All subjects repeated the task with the same running speed after a short interval of 5 minutes in between. The CE app, installed on the smartphone, was used to measure the sagittal plane hip, knee and ankle joint angles at touchdown and toe off the stance phase. Results: Intraclass correlation coefficient (ICC) was used to assess test-retest and intra-rater reliability. To analyze the agreement between 3D and 2D outcomes, the Bland and Altman plot was used. The values of ICC were for Ankle at TD (TRR=0.8,IRR=0.94), ankle at TO (TRR=0.9,IRR=0.97), knee at TD (TRR=0.78,IRR=0.98), knee at TO (TRR=0.9,IRR=0.96), hip at TD (TRR=0.75,IRR=0.97), hip at TO (TRR=0.87,IRR=0.98). The Bland and Altman plots displaying a mean difference (MD) and ±2 standard deviation of MD (2SDMD) of 3D and 2D outcomes were for Ankle at TD (MD=3.71,+2SDMD=8.19, -2SDMD=-0.77), ankle at TO (MD=-1.27, +2SDMD=6.22, -2SDMD=-8.76), knee at TD (MD=1.48, +2SDMD=8.21, -2SDMD=-5.25), knee at TO (MD=-6.63, +2SDMD=3.94, -2SDMD=-17.19), hip at TD (MD=1.51, +2SDMD=9.05, -2SDMD=-6.03), hip at TO (MD=-0.18, +2SDMD=12.22, -2SDMD=-12.59). Discussion: The ability that the measurements are accurately reproduced is valuable in the performance and clinical assessment of outcomes of joint angles. The results of this study showed that the intra-rater and test-retest reliability of CE app for all kinematics measured are excellent (ICC ≥ 0.75). The Bland and Altman plots display that there are high differences of values for ankle at TD and knee at TO. Measuring ankle at TD by 2D gait analysis depends on the plane of movement. Since ankle at TD mostly occurs in the none-sagittal plane, the measurements can be different as foot progression angle at TD increases during running. The difference in values of the knee at TD can depend on how 3D and the rater detect the TO during the stance phase of running.

Keywords: reliability, running, sagittal plane, two dimensional

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5105 Changes in Attitudes of State Towards Orthodox Church: Greek Case after Eurozone Crisis in Alexis Tsipras Era

Authors: Zeynep Selin Balci, Altug Gunal

Abstract:

Religion has always an effect on the policies of states. In the case of religion having a central role in defining identity, especially when becoming an independent state, the bond between religious authority and state cannot easily be broken. As independence of Greece from the Ottoman Empire was acquired at the same time with the creation of its own church under the name of the Church of Greece by declaring its independence from the Greek Orthodox Patriarchate in Istanbul, the new church became an important part of Greek national identity. As the Church has the ability to influence Greeks, its rituals, public appearances, and practices are used to provide support to the state. Although there sometimes have been controversies between church and state, it has always been a fact that church is an integral part of the state, which is proved by that paying the salaries of priest by state payroll and them being naturally civil servants. European Union membership, on the other hand, has a changing impact on this relationship. This impact started to be more visible in 2000 when then government decided to exclude the religion section from identity cards. Church’s reaction was to gather people around recalling their religious identity and followed by redefining the content of nationality, which aspired nationalist fronts. After 2015 when leftist coalition Syriza and its self-described atheist leader came to power, the situation for nationalists and Church became more tangling in addition to the economic crisis started in 2010 and evolved into the Eurozone crisis by affecting not only Greece but also other members. Although the church did not have direct confrontations with the government, the fact that Tsipras refused to take the oath on Bible created tensions because it was not acceptable for a state whose Constitution starts ‘in the name of the Holy, Consubstantial and Indivisible Trinity’. Moreover, austerity measures to overcome the economic crisis, which affected the everyday life of citizens in terms of both prices and salaries, did not harm the church’s economic situation much. Considering church being the second biggest landowner after state and paying no taxes, the fact that church was exempt from austerity measures showed to the government the necessity to find a way to make church contribute to solution for the crisis. In 2018, when the government agreed with the head of the church on cutting off the priests from government payroll automatically meaning to end priests’ civil servant status, it created tensions both for church and in society. As a result of the elections held in July 2019, Tsipras could not have the chance to apply the decision as he left the office. In light of these, this study aims to analyze the position of the church in the economic crisis and its effects on Tsipras term. In order to sufficiently understand this, it is to look at the historical changing points of Church’s influence in Greek’s eyes.

Keywords: Eurozone crisis, Greece, Orthodox Church, Tsipras

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5104 Self-Medication with Antibiotics, Evidence of Factors Influencing the Practice in Low and Middle-Income Countries: A Systematic Scoping Review

Authors: Neusa Fernanda Torres, Buyisile Chibi, Lyn E. Middleton, Vernon P. Solomon, Tivani P. Mashamba-Thompson

Abstract:

Background: Self-medication with antibiotics (SMA) is a global concern, with a higher incidence in low and middle-income countries (LMICs). Despite intense world-wide efforts to control and promote the rational use of antibiotics, continuing practices of SMA systematically exposes individuals and communities to the risk of antibiotic resistance and other undesirable antibiotic side effects. Moreover, it increases the health systems costs of acquiring more powerful antibiotics to treat the resistant infection. This review thus maps evidence on the factors influencing self-medication with antibiotics in these settings. Methods: The search strategy for this review involved electronic databases including PubMed, Web of Knowledge, Science Direct, EBSCOhost (PubMed, CINAHL with Full Text, Health Source - Consumer Edition, MEDLINE), Google Scholar, BioMed Central and World Health Organization library, using the search terms:’ Self-Medication’, ‘antibiotics’, ‘factors’ and ‘reasons’. Our search included studies published from 2007 to 2017. Thematic analysis was performed to identify the patterns of evidence on SMA in LMICs. The mixed method quality appraisal tool (MMAT) version 2011 was employed to assess the quality of the included primary studies. Results: Fifteen studies met the inclusion criteria. Studies included population from the rural (46,4%), urban (33,6%) and combined (20%) settings, of the following LMICs: Guatemala (2 studies), India (2), Indonesia (2), Kenya (1), Laos (1), Nepal (1), Nigeria (2), Pakistan (2), Sri Lanka (1), and Yemen (1). The total sample size of all 15 included studies was 7676 participants. The findings of the review show a high prevalence of SMA ranging from 8,1% to 93%. Accessibility, affordability, conditions of health facilities (long waiting, quality of services and workers) as long well as poor health-seeking behavior and lack of information are factors that influence SMA in LMICs. Antibiotics such as amoxicillin, metronidazole, amoxicillin/clavulanic, ampicillin, ciprofloxacin, azithromycin, penicillin, and tetracycline, were the most frequently used for SMA. The major sources of antibiotics included pharmacies, drug stores, leftover drugs, family/friends and old prescription. Sore throat, common cold, cough with mucus, headache, toothache, flu-like symptoms, pain relief, fever, running nose, toothache, upper respiratory tract infections, urinary symptoms, urinary tract infection were the common disease symptoms managed with SMA. Conclusion: Although the information on factors influencing SMA in LMICs is unevenly distributed, the available information revealed the existence of research evidence on antibiotic self-medication in some countries of LMICs. SMA practices are influenced by social-cultural determinants of health and frequently associated with poor dispensing and prescribing practices, deficient health-seeking behavior and consequently with inappropriate drug use. Therefore, there is still a need to conduct further studies (qualitative, quantitative and randomized control trial) on factors and reasons for SMA to correctly address the public health problem in LMICs.

Keywords: antibiotics, factors, reasons, self-medication, low and middle-income countries (LMICs)

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