Search results for: physical activity level

Authors: Folajinmi Oluwasina, Towolawi Adetayo, Kate Ssamula, Penninah Iutung, Daniel Reijer

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Objective: Routine HIV screening has been promoted as an essential component of efforts to reduce incidence, morbidity, and mortality. The objectives of this study were to identify the optimal annual volume needed to realize the public health goals of HIV screening in the AIDS Healthcare Foundation supported hospitals and establish an implementation process to realize that optimal annual volume. Methods: Starting in 2011 a program was established to routinize HIV screening within communities and government hospitals. In 2016 Five-years of HIV screening data were reviewed to identify the optimal annual proportions of age-eligible patients screened to realize the public health goals of reducing new diagnoses and ending late-stage diagnosis (tracked as concurrent HIV/AIDS diagnosis). Analysis demonstrated that rates of new diagnoses level off when 42% of age-eligible patients were screened, providing a baseline for routine screening efforts; and concurrent HIV/AIDS diagnoses reached statistical zero at screening rates of 70%. Annual facility based targets were re-structured to meet these new target volumes. Restructuring efforts focused on right-sizing HIV screening programs to align and transition programs to integrated HIV screening within standard medical care and treatment. Results: Over one million patients were screened for HIV during the five years; 16, 033 new HIV diagnoses and access to care and treatment made successfully for 82 % (13,206), and concurrent diagnosis rates went from 32.26% to 25.27%. While screening rates increased by 104.7% over the 5-years, volume analysis demonstrated that rates need to further increase by 62.52% to reach desired 20% baseline and more than double to reach optimal annual screening volume. In 2011 facility targets for HIV screening were increased to reflect volume analysis, and in that third year, 12 of the 19 facilities reached or exceeded new baseline targets. Conclusions and Recommendation: Quantifying targets against routine HIV screening goals identified optimal annual screening volume and allowed facilities to scale their program size and allocate resources accordingly. The program transitioned from utilizing non-evidence based annual volume increases to establishing annual targets based on optimal volume analysis. This has allowed efforts to be evaluated on the ability to realize quantified goals related to the public health value of HIV screening. Optimal volume analysis helps to determine the size of an HIV screening program. It is a public health tool, not a tool to determine if an individual patient should receive screening.

Keywords: HIV screening, optimal volume, HIV diagnosis, routine

Procedia PDF Downloads 263

Authors: Mohammad Nazri Mustafa, Sh Norliza Sy Salim, Pedram Hatami Abdullah

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Civil and structural assets normally have an average of more than 30 years of design life. Adding to this advantage, the assets are normally subjected to slow degradation process. Due to the fact that repair and strengthening work for these assets are normally not dependent on plant shut down, the maintenance and integrity restoration of these assets are mostly done based on “as required” and “run to failure” basis. However unlike other industries, the exposure in oil and gas environment is harsher as the result of corrosive soil and groundwater, chemical spill, frequent wetting and drying, icing and de-icing, steam and heat, etc. Due to this type of exposure and the increasing level of structural defects and rectification in line with the increasing age of plants, assets integrity assessment requires a more defined scope and procedures that needs to be based on risk and assets criticality. This leads to the establishment of risk based inspection and proactive maintenance procedure for civil and structural assets. To date there is hardly any procedure and guideline as far as integrity assessment and systematic inspection and maintenance of civil and structural assets (onshore) are concerned. Group Technical Solutions has developed a procedure and guideline that takes into consideration credible failure scenario, assets risk and criticality from process safety and structural engineering perspective, structural importance, modeling and analysis among others. Detailed inspection that includes destructive and non-destructive tests (DT & NDT) and structural monitoring is also being performed to quantify defects, assess severity and impact on integrity as well as identify the timeline for integrity restoration. Each defect and its credible failure scenario is assessed against the risk on people, environment, reputation and production loss. This technical paper is intended to share on the established procedure and guideline and their execution in oil & gas plants. In line with the overall roadmap, the procedure and guideline will form part of specialized solutions to increase production and to meet the “Operational Excellence” target while extending service life of civil and structural assets. As the result of implementation, the management of civil and structural assets is now more systematically done and the “fire-fighting” mode of maintenance is being gradually phased out and replaced by a proactive and preventive approach. This technical paper will also set the criteria and pose the challenge to the industry for innovative repair and strengthening methods for civil & structural assets in oil & gas environment, in line with safety, constructability and continuous modification and revamp of plant facilities to meet production demand.

Keywords: assets criticality, credible failure scenario, proactive and preventive maintenance, risk based inspection

Procedia PDF Downloads 404

Authors: Siddhartha Khare, Nitish Kr Boro, Omm Animesh Mishra

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Recent food price hikes may signal the end of an era of predictable global grain crop plenty due to climate change, population expansion, and dietary changes. Food consumption will treble in 20 years, requiring enormous production expenditures. Climate and the atmosphere changed owing to rainfall and seasonal cycles in the past decade. India's tropical agricultural relies on evapotranspiration and monsoons. In places with limited resources, the global environmental change affects agricultural productivity and farmers' capacity to adjust to changing moisture patterns. Motivated by these difficulties, satellite remote sensing might be combined with near-surface imaging data (smartphones, UAVs, and PhenoCams) to enable phenological monitoring and fast evaluations of field-level consequences of extreme weather events on smallholder agriculture output. To accomplish this technique, we must digitally map all communities agricultural boundaries and crop kinds. With the improvement of satellite remote sensing technologies, a geo-referenced database may be created for rural Indian agriculture fields. Using AI, we can design digital agricultural solutions for individual farms. Main objective is to Geo-enable each farm along with their seasonal crop information by combining Artificial Intelligence (AI) with satellite and near-surface data and then prepare long term crop monitoring through in-depth field analysis and scanning of fields with satellite derived vegetation indices. We developed an AI based algorithm to understand the timelapse based growth of vegetation using PhenoCam or Smartphone based images. We developed an android platform where user can collect images of their fields based on the android application. These images will be sent to our local server, and then further AI based processing will be done at our server. We are creating digital boundaries of individual farms and connecting these farms with our smart phone application to collect information about farmers and their crops in each season. We are extracting satellite-based information for each farm from Google earth engine APIs and merging this data with our data of tested crops from our app according to their farm’s locations and create a database which will provide the data of quality of crops from their location.

Keywords: artificial intelligence, satellite remote sensing, crop monitoring, android and web application

Procedia PDF Downloads 100

Authors: Mohamed Gaafar, Evan Davies

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Many municipalities within Canada and abroad use chloramination to disinfect drinking water so as to avert the production of the disinfection by-products (DBPs) that result from conventional chlorination processes and their consequential public health risks. However, the long-lasting monochloramine disinfectant (NH2Cl) can pose a significant risk to the environment. As, it can be introduced into stormwater sewers, from different water uses, and thus freshwater sources. Little research has been undertaken to monitor and characterize the decay of NH2Cl and to study the parameters affecting its decomposition in stormwater networks. Therefore, the current study was intended to investigate this decay starting by building a stormwater model and validating its hydraulic and hydrologic computations, and then modelling water quality in the storm sewers and examining the effects of different parameters on chloramine decay. The presented work here is only the first stage of this study. The 30th Avenue basin in Southern Edmonton was chosen as a case study, because the well-developed basin has various land-use types including commercial, industrial, residential, parks and recreational. The City of Edmonton has already built a MIKE-URBAN stormwater model for modelling floods. Nevertheless, this model was built to the trunk level which means that only the main drainage features were presented. Additionally, this model was not calibrated and known to consistently compute pipe flows higher than the observed values; not to the benefit of studying water quality. So the first goal was to complete modelling and updating all stormwater network components. Then, available GIS Data was used to calculate different catchment properties such as slope, length and imperviousness. In order to calibrate and validate this model, data of two temporary pipe flow monitoring stations, collected during last summer, was used along with records of two other permanent stations available for eight consecutive summer seasons. The effect of various hydrological parameters on model results was investigated. It was found that model results were affected by the ratio of impervious areas. The catchment length was tested, however calculated, because it is approximate representation of the catchment shape. Surface roughness coefficients were calibrated using. Consequently, computed flows at the two temporary locations had correlation coefficients of values 0.846 and 0.815, where the lower value pertained to the larger attached catchment area. Other statistical measures, such as peak error of 0.65%, volume error of 5.6%, maximum positive and negative differences of 2.17 and -1.63 respectively, were all found in acceptable ranges.

Keywords: stormwater, urban drainage, simulation, validation, MIKE URBAN

Procedia PDF Downloads 297

Authors: J. D. Cabral, E. Murray, P. Turner, E. Hewitt, A. Ali, M. McConnell

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Worldwide demand for organ replacement and tissue regeneration is progressively increasing. Three-dimensional (3D) bioprinting, where a physical construct is produced using computer-aided design, is a promising tool to advance the tissue engineering and regenerative medicine fields. In this paper we describe two different approaches to developing 3D bioprinted constructs for use in tissue regeneration. Bioink development is critical in achieving the 3D biofabrication of functional, regenerative tissues. Hydrogels, cross-linked macromolecules that absorb large amounts of water, have received widespread interest as bioinks due to their relevant soft tissue mechanics, biocompatibility, and tunability. In turn, not only is bioink optimisation crucial, but the creation of vascularized tissues remains a key challenge for the successful fabrication of thicker, more clinically relevant bioengineered tissues. Among the various methodologies, cell-laden hydrogels are regarded as a favorable approach; and when combined with novel core/shell 3D bioprinting technology, an innovative strategy towards creating new vessel-like structures. In this work, we investigate this cell-based approach by using human umbilical endothelial cells (HUVECs) entrapped in a viscoelastic chitosan/dextran (CD)-based core hydrogel, printed simulataneously along with a gelatin methacrylate (GelMA) shell. We have expanded beyond our previously reported FDA approved, commercialised, post-surgical CD hydrogel, Chitogel®, by functionalizing it with cell adhesion and proteolytic peptides in order to promote bone marrow-derived mesenchymal stem cell (immortalized BMSC cell line, hTERT) and HUVECs growth. The biocompatibility and biodegradability of these cell lines in a 3D bioprinted construct is demonstrated. Our studies show that particular peptide combinations crosslinked within the CD hydrogel was found to increase in vitro growth of BMSCs and HUVECs by more than two-fold. These gels were then used as a core bioink combined with the more mechanically robust, UV irradiated GelMA shell bioink, to create 3D regenerative, vessel-like scaffolds with high print fidelity. As well, microporous MEW scaffolds made from milk proteins blended with PCL were found to show promising bioactivity, exhibiting a significant increase in keratinocyte (HaCaTs) and fibroblast (normal human dermal fibroblasts, NhDFs) cell migration and proliferation when compared to PCL only scaffolds. In conclusion, our studies indicate that a peptide functionalized CD hydrogel bioink reinforced with a GelMA shell is biocompatible, biodegradable, and an appropriate cell delivery vehicle in the creation of regenerative 3D constructs. In addition, a novel 3D printing technique, melt electrowriting (MEW), which allows fabrication of micrometer fibre meshes, was used to 3D print polycaprolactone (PCL) and bioactive milk protein, lactorferrin (LF) and whey protein (WP), blended scaffolds for potential skin regeneration applications. MEW milk protein/PCL scaffolds exhibited high porosity characteristics, low overall biodegradation, and rapid protein release. Human fibroblasts and keratinocyte cells were seeded on to the scaffolds. Scaffolds containing high concentrations of LF and combined proteins (LF+WP) showed improved cell viability over time as compared to PCL only scaffolds. This research highlights two scaffolds made using two different 3D printing techniques using a combination of both natural and synthetic biomaterial components in order to create regenerative constructs as potential chronic wound treatments.

Keywords: biomaterials, hydrogels, regenerative medicine, 3D bioprinting

Procedia PDF Downloads 270

Authors: Wilai Masanga, Chirapha Tannanonta, Sangutid Thongsawad, Sasikarn Chamchod, Todsaporn Fuangrod

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The major factors of radiotherapy for head and neck (HN) cancers include patient’s anatomical changes and tumour shrinkage. These changes can significantly affect the planned dose distribution that causes the treatment plan deterioration. A measured transit EPID images compared to a predicted EPID images using gamma analysis has been clinically implemented to verify the dose accuracy as part of adaptive radiotherapy protocol. However, a global gamma analysis dose not sensitive to some critical organ changes as the entire treatment field is compared. The objective of this feasibility study is to evaluate the dosimetric response to patient anatomical changes during the treatment course in HN IMRT (Head and Neck Intensity-Modulated Radiation Therapy) using a novel comparison method; organ-of-interest gamma analysis. This method provides more sensitive to specific organ change detection. Random replanned 5 HN IMRT patients with causes of tumour shrinkage and patient weight loss that critically affect to the parotid size changes were selected and evaluated its transit dosimetry. A comprehensive physics-based model was used to generate a series of predicted transit EPID images for each gantry angle from original computed tomography (CT) and replan CT datasets. The patient structures; including left and right parotid, spinal cord, and planning target volume (PTV56) were projected to EPID level. The agreement between the transit images generated from original CT and replanned CT was quantified using gamma analysis with 3%, 3mm criteria. Moreover, only gamma pass-rate is calculated within each projected structure. The gamma pass-rate in right parotid and PTV56 between predicted transit of original CT and replan CT were 42.8%( ± 17.2%) and 54.7%( ± 21.5%). The gamma pass-rate for other projected organs were greater than 80%. Additionally, the results of organ-of-interest gamma analysis were compared with 3-dimensional cone-beam computed tomography (3D-CBCT) and the rational of replan by radiation oncologists. It showed that using only registration of 3D-CBCT to original CT does not provide the dosimetric impact of anatomical changes. Using transit EPID images with organ-of-interest gamma analysis can provide additional information for treatment plan suitability assessment.

Keywords: re-plan, anatomical change, transit electronic portal imaging device, EPID, head, and neck

Procedia PDF Downloads 216

Authors: I. Cerrillo, A. Carrillo-Vico, M. A. Ortega, B. Escudero-López, N. Álvarez-Sánchez, F. Martín, M. S. Fernández-Pachón

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Melatonin is a bioactive compound involved in multiple biological activities such as glucose tolerance, circadian rhythm regulation, antioxidant defense or immune system action. In elderly subjects the intake of foods and drinks rich in melatonin is very important due to its endogenous level decreases with age. Alcoholic fermentation is a process carried out in fruits, vegetables and legumes to obtain new products with improved bioactive compounds profile in relation to original substrates. Alcoholic fermentation process carried out by Saccharomycetaceae var. Pichia kluyveri induces an important synthesis of melatonin in orange juice. A novel beverage derived of fermented orange juice could be a promising source of this bioactive compound. The aim of the present study was to determine whether the acute intake of fermented orange juice increase the levels of urinary 6-sulfatoxymelatonin in healthy humans. Nine healthy volunteers (7 women and 2 men), aged between 20 and 25 years old and BMI of 21.1  2.4 kg/m2, were recruited. On the study day, participants ingested 500 mL of fermented orange juice. The first urine collection was made before fermented orange juice consumption (basal). The rest of urine collections were made in the following time intervals after fermented orange juice consumption: 0-2, 2-5, 5-10, 10- 15 and 15-24 hours. During the experimental period only the consumption of water was allowed. At lunch time a meal was provided (60 g of white bread, two slices of ham, a slice of cheese, 125 g of sweetened natural yoghurt and water). The subjects repeated the protocol with orange juice following a 2-wk washout period between both types of beverages. The levels of 6-sulfatoxymelatonin (6-SMT) were measured in urine recollected at different time points using the Melatonin-Sulfate Urine ELISA (IBL International GMBH, Hamburg, Germany). Levels of 6-SMT were corrected to those of creatinine for each sample. A significant (p < 0.05) increase in urinary 6-SMT levels was observed between 2-5 hours after fermented orange juice ingestion with respect to basal values (increase of 67,8 %). The consumption of orange juice did not induce any significant change in urinary 6-SMT levels. In addition, urinary 6-SMT levels obtained between 2-5 hours after fermented orange juice ingestion (115,6 ng/mg) were significantly different (p < 0.05) from those of orange juice (42,4 ng/mg). The enhancement of urinary 6-SMT after the ingestion of 500 mL of fermented orange juice in healthy humans compared to orange juice could be an important advantage of this novel product as an excellent source of melatonin. Fermented orange juice could be a new functional food, and its consumption could exert a potentially positive effect on health in both the maintenance of health status and the prevention of chronic diseases.

Keywords: fermented orange juice, functional beverage, healthy human, melatonin

Procedia PDF Downloads 405

Authors: Amit Kumar Bardhan, Barnali Nag, Chandra Sekhar Mishra

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Microfinance is considered as one of the key drivers of financial inclusion and pro-poor financial growth. Microfinance in India became popular through Self Help Group (SHG) movement initiated by NABARD. In terms of outreach and loan portfolio, SHG Bank Linkage programme (SHG-BLP) has emerged as the largest microfinance initiative in the world. The success of financial inclusion lies in the successful implementation of SHG-BLP. SHGs are generally promoted by social welfare organisations like NGOs, welfare societies, government agencies, Co-operatives etc. and even banks are also involved in SHG formation. Thus, the pro-poor implementation of the scheme largely depends on the credibility of the SHG Promoting Institutions (SHPIs). The rural poor lack education, skills and financial literacy and hence need continuous support and proper training right from planning to implementation. In this study, we have made an attempt to inspect the reasons behind low penetration of SHG financing to the poorest of the poor both from demand and supply side perspective. Banks, SHPIs, and SHGs are three key essential stakeholders in SHG-BLP programmes. All of them have a vital role in programme implementation. The objective of this paper is to find out the drivers and hurdles in the path of financial inclusion through SHG-BLP and the role of SHPIs in reaching out to the ultra poor. We try to address questions like 'what are the challenges faced by SHPIs in targeting the poor?' and, 'what are factors behind the low credit linkage of SHGs?' Our work is based on a qualitative study of SHG programmes in semi-urban towns in the states of West Bengal and Odisha in India. Data are collected through unstructured questionnaire and in-depth interview from the members of SHGs, SHPIs and designated banks. The study provides some valuable insights about the programme and a comprehensive view of problems and challenges faced by SGH, SHPIs, and banks. On the basis of our understanding from the survey, some findings and policy recommendations that seem relevant are: increasing level of non-performing assets (NPA) of commercial banks and wilful default in expectation of loan waiver and subsidy are the prime reasons behind low rate of credit linkage of SHGs. Regular changes in SHG schemes and no incentive for after linkage follow up results in dysfunctional SHGs. Government schemes are mostly focused on creation of SHG and less on livelihood promotion. As a result, in spite of increasing (YoY) trend of number of SHGs promoted, there is no real impact on welfare growth. Government and other SHPIs should focus on resource based SHG promotion rather only increasing the number of SHGs.

Keywords: financial inclusion, inclusive growth, microfinance, Self-Help Group (SHG), Self-Help Group Promoting Institution (SHPI)

Procedia PDF Downloads 215

Authors: Shari S. C. Shang, Lynn S. L. Chiu

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In the digital payment market, some consumers use only one payment wallet while many others play multi-homing with a variety of payment services. With the diffusion of new payment systems, we examined the determinants of the adoption of multi-homing behavior. This study aims to understand how a digital payment provider dynamically expands business touch points with cross-business strategies to enrich the digital ecosystem and avoid the trap of multi-homing in customers. By synthesizing platform ecosystem literature, we constructed a two-dimensional research framework with one determinant of user digital behavior from offline to online intentions and the other determinant of digital payment touch points from convenient accessibility to cross-business platforms. To explore on a broader scale, we selected 12 digital payments from 5 countries of UK, US, Japan, Korea, and Taiwan. With the interplays of user digital behaviors and payment touch points, we group the study cases into four types: (1) Channel Initiated: users originated from retailers with high access to in-store shopping with face-to-face guidance for payment adoption. Providers offer rewards for customer loyalty and secure the retailer’s efficient cash flow management. (2) Social Media Dependent: users usually are digital natives with high access to social media or the internet who shop and pay digitally. Providers might not own physical or online shops but are licensed to aggregate money flows through virtual ecosystems. (3) Early Life Engagement: digital banks race to capture the next generation from popularity to profitability. This type of payment aimed to give children a taste of financial freedom while letting parents track their spending. Providers are to capitalize on the digital payment and e-commerce boom and hold on to new customers into adulthood. (4) Traditional Banking: plastic credit cards are purposely designed as a control group to track the evolvement of business strategies in digital payments. Traditional credit card users may follow the bank’s digital strategy to land on different types of digital wallets or mostly keep using plastic credit cards. This research analyzed business growth models and inter-firms’ coopetition strategies of the selected cases. Results of the multiple case analysis reveal that channel initiated payments bundled rewards with retailer’s business discount for recurring purchases. They also extended other financial services, such as insurance, to fulfill customers’ new demands. Contrastively, social media dependent payments developed new usages and new value creation, such as P2P money transfer through network effects among the virtual social ties, while early life engagements offer virtual banking products to children who are digital natives but overlooked by incumbents. It has disrupted the banking business domains in preparation for the metaverse economy. Lastly, the control group of traditional plastic credit cards has gradually converted to a BaaS (banking as a service) model depending on customers’ preferences. The multi-homing behavior is not avoidable in digital payment competitions. Payment providers may encounter multiple waves of a multi-homing threat after a short period of success. A dynamic cross-business collaboration strategy should be explored to continuously evolve the digital ecosystems and allow users for a broader shopping experience and continual usage.

Keywords: digital payment, digital ecosystems, multihoming users, cross business strategy, user digital behavior intentions

Procedia PDF Downloads 158

Authors: Rhommel Grutas, Ishmael Narag, Harley Lacbawan

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Construction of high-rise buildings is a means to address the increasing population in Metro Manila, Philippines. The existence of the Valley Fault System within the metropolis and other nearby active faults poses threats to a densely populated city. The distant, shallow and large magnitude earthquakes have the potential to generate slow and long-period vibrations that would affect medium-to-high rise buildings. Heavy damage and building collapse are consequences of prolonged shaking of the structure. If the ground and the building have almost the same period, there would be a resonance effect which would cause the prolonged shaking of the building. Microzoning the long-period ground response would aid in the seismic design of medium to high-rise structures. The shear-wave velocity structure of the subsurface is an important parameter in order to evaluate ground response. Borehole drilling is one of the conventional methods of determining shear-wave velocity structure however, it is an expensive approach. As an alternative geophysical exploration, microtremor array measurements can be used to infer the structure of the subsurface. Microtremor array measurement system was used to survey fifty sites around Metro Manila including some municipalities of Rizal and Cavite. Measurements were carried out during the day under good weather conditions. The team was composed of six persons for the deployment and simultaneous recording of the microtremor array sensors. The instruments were laid down on the ground away from sewage systems and leveled using the adjustment legs and bubble level. A total of four sensors were deployed for each site, three at the vertices of an equilateral triangle with one sensor at the centre. The circular arrays were set up with a maximum side length of approximately four kilometers and the shortest side length for the smallest array is approximately at 700 meters. Each recording lasted twenty to sixty minutes. From the recorded data, f-k analysis was applied to obtain phase velocity curves. Inversion technique is applied to construct the shear-wave velocity structure. This project provided a microzonation map of the metropolis and a profile showing the long-period response of the deep sedimentary basin underlying Metro Manila which would be suitable for local administrators in their land use planning and earthquake resistant design of medium to high-rise buildings.

Keywords: earthquake, ground motion, microtremor, seismic microzonation

Procedia PDF Downloads 468

Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

Procedia PDF Downloads 208

Authors: Pratima Pokharel

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When sewer overflow due to rainfall in urban areas, this leads to public health risks when an individual is exposed to that contaminated floodwater. Nevertheless, it is still unclear the extent to which the infections pose a risk to public health. This study analyzed reported diarrheal cases by month and age in Bangkok, Thailand. The results showed that the cases are reported higher in the wet season than in the dry season. It was also found that in Bangkok, the probability of infection with diarrheal diseases in the wet season is higher for the age group between 15 to 44. However, the probability of infection is highest for kids under 5 years, but they are not influenced by wet weather. Further, this study introduced a vulnerability that leads to health risks from urban flooding. This study has found some vulnerability variables that contribute to health risks from flooding. Thus, for vulnerability analysis, the study has chosen two variables, economic status, and age, that contribute to health risk. Assuming that the people's economic status depends on the types of houses they are living in, the study shows the spatial distribution of economic status in the vulnerability maps. The vulnerability map result shows that people living in Sukhumvit have low vulnerability to health risks with respect to the types of houses they are living in. In addition, from age the probability of infection of diarrhea was analyzed. Moreover, a field survey was carried out to validate the vulnerability of people. It showed that health vulnerability depends on economic status, income level, and education. The result depicts that people with low income and poor living conditions are more vulnerable to health risks. Further, the study also carried out 1D Hydrodynamic Advection-Dispersion modelling with 2-year rainfall events to simulate the dispersion of fecal coliform concentration in the drainage network as well as 1D/2D Hydrodynamic model to simulate the overland flow. The 1D result represents higher concentrations for dry weather flows and a large dilution of concentration on the commencement of a rainfall event, resulting in a drop of the concentration due to runoff generated after rainfall, whereas the model produced flood depth, flood duration, and fecal coliform concentration maps, which were transferred to ArcGIS to produce hazard and risk maps. In addition, the study also simulates the 5-year and 10-year rainfall simulations to show the variation in health hazards and risks. It was found that even though the hazard coverage is very high with a 10-year rainfall events among three rainfall events, the risk was observed to be the same with a 5-year and 10-year rainfall events.

Keywords: urban flooding, risk, hazard, vulnerability, health risk, framework

Procedia PDF Downloads 75

Authors: Zhao Luqian, Wang Yafei

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Participation in music activities is beneficial for enhancing wellbeing, especially for aged people (Creech, 2013). Looking at percussion group in particular, it can facilitate a sense of belonging, relaxation, energy, and productivity, learning, enhanced mood, humanising, seems of accomplishment, escape from trauma, and emotional expression (Newman, 2015). In health literatures, group drumming is effective in reducing stress and improving multiple domains of social-motional behaviors (Ho et al., 2011; Maschi et al., 2010) because it offers a creative and mutual learning space that allows patients to establish a positive peer interaction (Mungas et al., 2014; Perkins, 2016). However, very few studies have investigated the effect of group drumming from the aspect of patients’ needs. Therefore, this study focuses on the discussion of patients' specific needs within mental health and explores how group percussion may meet their needs. Seligman’s (2011) five core elements of mental health were applied as patients’ needs in this study: (1) Positive emotions; (2) Engagement; (3) Relationships; (4) Meaning and (5) Accomplishment. 12 participants aged 57- 80 years were interviewed individually. The researcher also had observation in four drumming groups simultaneously. The results reveal that group drumming could improve participants’ mental wellbeing. First, it created a therapeutic health care environment extending beyond the elimination of boredom, and patients could focus on positive emotions during the session of group drumming. Secondly, it was effective in satisfying patients’ level of engagement. Thirdly, this study found that joining a percussion group would require patients to work on skills such as turn-taking and sharing. This equal relationship is helpful for releasing patients’ negative mood and thus forming tighter relationships between and among them. Fourthly, group drumming was found to meet patients’ meaning needs through offering them a place of belonging and a place for sharing. Its leaner-oriented approach engaged patients by a sense of belonging, accepting, connecting, and ownership. Finally, group drumming could meet patients’ needs for accomplishment through the learning process. The inclusive learning process, which indicates there is no right or wrong throughout the process, allowed patients to make their own decisions. In conclusion, it is difficult for patients to achieve positive emotions, engagement, relationships, meanings, and accomplishments in a hospital setting. Drumming can be practiced for enhancement in terms of reducing patients’ negative emotions and improving their experiences in a hospital through enriched social interaction and sense of accomplishment. Also, it can help patients to enhance social skills in a controlled environment.

Keywords: group drumming, hospital, mental health, music psychology

Procedia PDF Downloads 90

Authors: Mardianto

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Education and learning are now grown rapidly. Synergy of techonology especially instructional technology in the learning activities are very big influence on the effectiveness of learning and creativity to achieve optimal results. But on the other hand there is a education value that is difficult to be articulated through character-forming technology such as honesty, discipline, hard work, heroism, and so forth. Learning strategy and storytelling from the past until today is still an option for teachers to convey the message of character values. With the material was loaded from the local culture (stories folklore), the combination of learning objectives (build character child) strategy, and traditional methods (storytelling and story), and the preservation of local culture (dig tale folklore) is critical to maintaining the nation's culture. In the context of maintaining the nation's culture, then since the age of the child at the level of government elementary school a necessity. Globalization, the internet and technology sometimes feel can displace the role of the teacher in the learning activities. To the oral tradition is a mainstay of storytelling should be maintained and preserved. This research was conducted at the elementary school in the city of Medan, North Sumatra Indonesia, with a random sampling technique, the 27 class teachers were respondents who were randomly assigned to the Madrasah Ibtdaiyah (Islamic Elementary School) both public and private. Research conducted at the beginning of 2014 refers to a curriculum that is being transformed in the environment ministry Republic Religion Indonesia. The results of this study indicate that; the declining skills of teachers to develop storytelling this can be seen from; 74.07% of teachers have never attended a special training storytelling, 85.19% no longer nasakah new stories, only 22.22% are teachers who incorporate methods of stories in the learning plan. Most teachers are no longer concerned with storytelling, among those experiencing difficulty in developing methods because the story; 66.67% of children are more interested in children's cartoons like Bobo boy, Angrybirds and others, 59.26 children prefer other activities than listening to a story. The teachers hope, folklore books should be preserved, storytelling training should be provided by the government through the ministry of religion, race or competition of storytelling should be scheduled, writing a new script-based populist storytelling should be provided immediately. The teachers’ hope certainly not excessive, by realizing the story method becomes articulation as the efforts of child character development based populist, therefore the local knowledge can be a strong fortress facing society in the era of progress as at present, and future.

Keywords: story telling, local wisdom, education, technology development

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Authors: Mahsa Jalili, Essa Ehsan Khan, Signe Dille Lovmo, Augustine Akruwe, Egil Lien, Rolf Erik Olsen, Trygve Sigholt, Atle Magnus Bones

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Data from the Norwegian Directorate of Fisheries reported that >1.2 million tons of Atlantic salmon were produced in Norway aquaculture industry in 2016. Peroxisome proliferator-activated receptors (PPARs) are one of the key transcription factor families that respond to nutritional ligands. Recent studies have shown the connection between PPARs with lipid and carbohydrate metabolism in aquaculture. To our knowledge, there is no published data about the effects of krill meal, soybean meal, Bactocell ® and butyrate feedings compared to control group on PPARs gene and protein expressions in Atlantic salmon. Fish, 1year +postsmolt, average weight 250 gram were cultured for 12 weeks after acclimatization by control commercial feeding in 2 weeks after hatchery. Water oxygen rate, salinity, and temperature were monitored every second day. At the end of the trial, fish were taken from tanks randomly, and four replicates per group were collected and stored in -80 freezers until analysis. Total RNA extracted from posterior part of dorsal fin muscle tissues and Nanodrop and Bioanalyzer was used to check the quality of RNA. Gene expression of PPAR α, β and γ were determined by RT-PCR. The expression of genes of interest was measured relative to control group after normalization to three reference genes. Total protein concentration was calculated by Bradford method, and protein expression was determined with primary PPARγ antibody by western blot. All data were analyzed by ANOVA followed by Benjamini-Hochberg and Bonferroni tests. Probability values <0.05 considered significant. Bactocell® and butyrate groups showed significantly lower PPARα expression. PPARβ and γ were not significantly different among groups. PPARγ mRNA expression was approximately consistent with protein expression pattern, except than butyrate group showed lower mRNA level. The order of PPARγ expression was Bactocell® > soy meal > butyrate > krill meal > control respectively. PPARβ gene expression decreased more in soy meal > butyrate > krill meal > Bactocell® > control groups respectively. In conclusion, the increased expression of PPARγ and α is proposed to represent a reduction tendency of lipid storage in fish fed by Bactocell®, butyrate, soy and krill meal.

Keywords: aquaculture, blotting western, gene expression, krill protein extract, prebiotics, probiotics, Salmo salar

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Authors: Anila Hayat

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Pakistan is one of those developing countries that are least involved in emissions but has the most vulnerable environmental conditions. Pakistan is ranked 8th in most affected countries by climate change on the climate risk index 1992-2011. Pakistan is facing severe water shortages and flooding as a result of changes in rainfall patterns, specifically in the least developed areas such as Tharparkar. Nagarparkar, once an attractive tourist spot located in Tharparkar because of its tropical desert climate, is now facing severe drought conditions for the last few decades. This study investigates the present socio-economic situation of local communities, major impacts of droughts and their underlying causes and current mitigation strategies adopted by local communities. The study uses both secondary (quantitative in nature) and primary (qualitative in nature) methods to understand the impacts and explore causes on the socio-economic life of local communities of the study area. The relevant data has been collected through household surveys using structured questionnaires, focus groups and in-depth interviews of key personnel from local and international NGOs to explore the sensitivity of impacts and adaptation to droughts in the study area. This investigation is limited to four rural communities of union council Pilu of Nagarparkar district, including Bheel, BhojaBhoon, Mohd Rahan Ji Dhani and Yaqub Ji Dhani villages. The results indicate that drought has caused significant economic and social hardships for the local communities as more than 60% of the overall population is dependent on rainfall which has been disturbed by irregular rainfall patterns. The decline in Crop yields has forced the local community to migrate to nearby areas in search of livelihood opportunities. Communities have not undertaken any appropriate adaptive actions to counteract the adverse effect of drought; they are completely dependent on support from the government and external aid for survival. Respondents also reported that poverty is a major cause of their vulnerability to drought. An increase in population, limited livelihood opportunities, caste system, lack of interest from the government sector, unawareness shaped their vulnerability to drought and other social issues. Based on the findings of this study, it is recommended that the local authorities shall create awareness about drought hazards and improve the resilience of communities against drought. It is further suggested to develop, introduce and implement water harvesting practices at the community level to promote drought-resistant crops.

Keywords: migration, vulnerability, awareness, Drought

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Authors: Remi Szauer

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Introductory, Background, and Importance of the Study: For many years, religiosity in Poland remained at a stable level of religious practice. When the symptoms of secularization and privatization processes appeared in Poland, it was not clearly felt but rather related to the decline in compulsory practices carried out in public, the growing distance of respondents to catholic ethic, and the lack of acceptance regarding the intervention of the Church in legislation and policy. The basic indicators observed over the years kept the picture: more religious women - less religious men. By carrying out own research in the field of religious and moral attitudes in 2019-2021, it was noticed that a reversal of the trend preserved over the years could be observed. The data showed that women under 40 are radically different in their responses than women older than them - especially those over 50: in terms of practices or ties with the Church and many more specific aspects. This became the basis for a careful examination of the responses in the under 40 age cohorts among women. This study is significant because it shows completely new perspectives of women's perception of religiosity and allows us to notice clearly the aspects of social changes mapped in the minds of the surveyed women. Research Methodology: The original survey was carried out using the quantitative method among 2,346 respondents in northern Poland, 1,349 of whom were women. The findings from these observations led to deepening the topic of beliefs of women under 40 compared to other age cohorts of women. Hence, studies were carried out on the general population of women in Poland, which constituted a comparative sample. These were panel studies. The selection of the sample among women was random, respecting the age amounts so that the two statistical groups could be compared. The designated research parameters included: declarations of religious faith, declarations of religious practice, bond with the Church, acceptance of Mariological dogmas, attitude towards the image of women in the Church, and acceptance of selected issues in Catholic ethics. Main Research Findings: Among women under 40, the decline in declarations not only concerning compulsory public practices but also private practices and declarations of religious faith is more pronounced. Not only is the range of indifferent religious attitudes increasing, but also attitudes directly declaring religious disbelief, for which there are important justifications. Women under 40 years of age strongly distance themselves from the institutions of the Church and from accepting Mariological dogmas. Moreover, they note that the image of a woman is marked by stereotyping, favoring the intensification of violence against women, as well as disregarding her potential and agency. Concluding Statement: By analyzing the answers of the female respondents and the data obtained in the research, it can be observed a reevaluation of women's beliefs, which opens the perspective of analyzing the role of religion and the Church in Poland as well as religious socialization.

Keywords: religiosity, morality, gender, feminism, social change

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Authors: Abdolrasoul Daneshjoo

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Introduction: Soccer is a game which draws more attention in different countries especially in Brazil. Kicking among different skills in soccer and soccer players is an excellent role for the success and preference of a team. The way of point gaining in this game is passing the ball over the goal lines which are gained by shoot skill in attack time and or during the penalty kicks.Regarding the above assumption, identifying the effective factors in instep kicking in different distances shoot with maximum force and high accuracy or pass and penalty kick, may assist the coaches and players in raising qualitative level of performing the skill. Purpose: The aim of the present study was to study of a few kinematical parameters in instep kicking from 3 and 5 meter distance among the male and female elite soccer players. Methods: 24 right dominant lower limb subjects (12 males and 12 females) among Tehran elite soccer players with average and the standard deviation (22.5 ± 1.5) & (22.08± 1.31) years, height of (179.5 ± 5.81) & (164.3 ± 4.09) cm, weight of (69.66 ± 4.09) & (53.16 ± 3.51) kg, %BMI (21.06 ± .731) & (19.67 ± .709), having playing history of (4 ± .73) & (3.08 ± .66) years respectively participated in this study. They had at least two years of continuous playing experience in Tehran soccer league.For sampling player's kick; Kinemetrix Motion analysis with three cameras with 500 Hz was used. Five reflective markers were placed laterally on the kicking leg over anatomical points (the iliac crest, major trochanter, lateral epicondyle of femur, lateral malleolus, and lateral aspect of distal head of the fifth metatarsus). Instep kick was filmed, with one step approach and 30 to 45 degrees angle from stationary ball. Three kicks were filmed, one kick selected for further analyses. Using Kinemetrix 3D motion analysis software, the position of the markers was analyzed. Descriptive statistics were used to describe the mean and standard deviation, while the analysis of variance, and independent t-test (P < 0.05) were used to compare the kinematic parameters between two genders. Results and Discussion: Among the evaluated parameters, the knee acceleration, the thigh angular velocity, the angle of knee proportionately showed significant relationship with consequence of kick. While company performance on 5m in 2 genders, significant differences were observed in internal – external displacement of toe, ankle, hip and the velocity of toe, ankle and the acceleration of toe and the angular velocity of pelvic, thigh and before time contact. Significant differences showed the internal – external displacement of toe, the ankle, the knee and the hip, the iliac crest and the velocity of toe, the ankle and acceleration of ankle and angular velocity of the pelvic and the knee.

Keywords: biomechanics, kinematics, soccer, instep kick, male, female

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Authors: Khawla Almulla

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It is noticed that many Arab intellectuals have called to the need and the importance of enlightenment and its application in their communities, such as Saudi Arabia. To every Islamic state, the Kingdom of Saudi Arabia represents a strategic cornerstone, since it is considered the cradle of Islam. It is the Land of the Two Holy Mosques: the Holy Mosque in Makkah surrounding the Kaaba, towards which all Muslims around the world turn while performing daily prayers and even travel to if possible in order to perform the Hajj (Pilgrimage). It also has the Prophet'ـ‘s Holy Mosque in Al-Madinah Al-Munawarah, which contains the tomb of Prophet Muhammad (pbuh). Therefore, Saudi Arabia occupies an eminent position among Arab and Islamic countries on a religious level. Saudi Arabia has become the most influential country in the Arab world, since it has one-third of the oil resources outside Central Asia, China and Russia .It is the world’s largest producer and exporter of oil. Discovering oil in Saudi Arabia converted it from an important country for Muslims-only to an important country for the major industrial countries and also the developing countries, as well. For various reasons, the diversity of intellectual currents can play a significant role in each community by way of cultural improvement, the development of civilization and the education of people until they become accustomed to accepting or rejecting opinions or ideas which differ from or oppose their own. In addition, the intellectual pluralism and cultural diversity can play a variety of roles. This helps promote dialogue and understanding between different groups or schools of thought. It can also develop cognitive skills, by exchanging ideas and views between different schools and intellectual currents. However, in Saudi Arabia there is much to oppose this plurality. The situation today shows that having a variety of ideologies and differences of cultures are not considered a reasonable way to develop intellectually as an individual or as a country. Rather the opposite is recommended, such that the ideologies of different groups are enough to bring out intellectual conflict and then to the segregation of society. As a consequence, extremism of thought from the different currents in Saudi Arabia has become apparent. This research is of great importance in its exploration of two significant themes. First, it highlights the Saudi Arabian background, in particular the historical, religious and social contexts, in order to understand the background of each religious or liberal movement and find the core of the intellectual differences between them. In addition, the aim of this research is to show the importance of moderation in Islamic thought in Saudi Arabia by tracing the thoughts and views of Dr Salman Al-Odah, whom he has considered to be the most important moderate thinker in Saudi Arabia.

Keywords: Saudi Arabia, intellectual movements, religious movements, extremism, moderation, Salafism, liberalism, Salman Al-Odah

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Authors: Ashoke Priyadarshana Premananda

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As per the suggestions of previously conducted research in Counseling Psychology, the necessity of forming culture- friendly approaches has been strongly emphasized by a number of scholars in the field. In response to that, Multicultural-model of Buddhist Based Cognitive Behavioral Therapy (MMBCBT) has been formed as a culture-friendly therapeutic approach to address psychological disturbances (depression) in late adulthood. Elderly population in the world is on the rise by leaps and bounds, and forming a culture-based therapeutic model which is blended with Buddhist teachings has been the major objective of the study. Buddhist teachings and cultural applications, which were mapped onto Cognitive Behavioral Therapy (CBT) in the West, ultimately resulted in MMBCBT. Therefore, MMBCBT is a blend of cultural therapeutic techniques and the essence of certain Buddhist teachings extracted from five crucial suttas, which include CBT principles. In the process of mapping, MeghiyaSutta, GirimānandaSutta, SallekhaSutta, DvedhāvitakkaSutta, and Vitakka- SaṇṭhānaSutta have been taken into consideration mainly because of their cognitive behavioral content. The practical components of Vitakka- Saṇṭhānasutta (Aññanimittapabbaṃ) and Sallekhasutta (SallekhaPariyāya and CittuppādaPariyāya) have been used in the model while mindfulness of breathing was also carried out with the participants. Basically, multi-cultural therapeutic approaches of MMBCBT aim at modifying behavior (behavioral modification), whereas the rest is centered to the cognitive restructuring process. Therefore, MMBCBT is endowed with Behavioral Therapy (BT) and Cognitive Therapy(CT). In order to find out the validation of MMBCBT as a newly formed approach, it was then followed by mixed research (quantitative and qualitative research) with a sample selected from the elderly population following the purposive sampling technique. 40 individuals were selected from three elderly homes as per the purposive sampling technique. Elderly people identified to be depressed via Geriatric Depression Scale underwent MMBCBT for two weeks continuously while action research was being conducted simultaneously. Additionally, a Focus Group interview was carried out to support the action research. As per the research findings, people who identified depressed prior to the exposure to MMBCBT were found to be showing positive changes after they were exposed to the model. “Paired Sample t test” showed that the Multicultural Model of Buddhist based Cognitive Behavioral Therapy reduced depression of elderly people (The mean value (x̄) of the sample (level of depression) before the model was 10.7 whereas the mean value after the model was 7.5.). Most importantly, MMBCBT has been found to be effectively used with people from all walks of life despite religious diversities.

Keywords: buddhist psychotherapy, cognitive behavioral therapy in buddhism, counseling in cultural context, gerontology, and buddhism

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Authors: Majed A. Alsalem

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Universal Design for Learning (UDL) is common theme in education across the US and an influential model and framework that enables students in general and particularly students who are deaf and hard of hearing (DHH) to access the general education curriculum. UDL helps teachers determine how information will be presented to students and how to keep students engaged. Moreover, UDL helps students to express their understanding and knowledge to others. UDL relies on technology to promote students' interaction with content and their communication of knowledge. This study included 120 DHH students who received daily instruction based on UDL principles. This study presents the results of the study and discusses its implications for the integration of UDL in day-to-day practice as well as in the country's education policy. UDL is a Western concept that began and grew in the US, and it has just begun to transfer to other countries such as Saudi Arabia. It will be very important to researchers, practitioners, and educators to see how UDL is being implemented in a new place with a different culture. UDL is a framework that is built to provide multiple means of engagement, representation, and action and expression that should be part of curricula and lessons for all students. The purpose of this study is to investigate the variables associated with the implementation of UDL in Saudi Arabian schools and identify the barriers that could prevent the implementation of UDL. Therefore, this study used a mixed methods design that use both quantitative and qualitative methods. More insights will be gained by including both quantitative and qualitative rather than using a single method. By having methods that different concepts and approaches, the databases will be enriched. This study uses levels of collecting date through two stages in order to insure that the data comes from multiple ways to mitigate validity threats and establishing trustworthiness in the findings. The rationale and significance of this study is that it will be the first known research that targets UDL in Saudi Arabia. Furthermore, it will deal with UDL in depth to set the path for further studies in the Middle East. From a perspective of content, this study considers teachers’ implementation knowledge, skills, and concerns of implementation. This study deals with effective instructional designs that have not been presented in any conferences, workshops, teacher preparation and professional development programs in Saudi Arabia. Specifically, Saudi Arabian schools are challenged to design inclusive schools and practices as well as to support all students’ academic skills development. The total participants in stage one were 336 teachers of DHH students. The results of the intervention indicated significant differences among teachers before and after taking the training sessions associated with their understanding and level of concern. Teachers have indicated interest in knowing more about UDL and adopting it into their practices; they reported that UDL has benefits that will enhance their performance for supporting student learning.

Keywords: deaf and hard of hearing, professional development, Saudi Arabia, universal design for learning

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Authors: Pui Hong Chung, Cyrus Leung, Jun Li, Kin On Kwok, Ek Yeoh

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Introduction: Studies for TB control in intermediate tuberculosis burden countries (IBCs) comprise a relatively small proportion in TB control literature, as compared to the effort put in high and low burden counterparts. It currently lacks of consensus in the optimal weapons and strategies we can use to combat TB in IBCs; guidelines of TB control are inadequate and thus posing a great obstacle in eliminating TB in these countries. To fill-in the research and services gap, we need to summarize the findings of the effort in this regard and to seek consensus in terms of policy making for TB control, we have devised a series of scoping and Delphi studies for these purposes. Method: The scoping and Delphi studies are conducted in parallel to feed information for each other. Before the Delphi iterations, we have invited three local experts in TB control in Hong Kong to participate in the pre-assessment round of the Delphi study to comments on the validity, relevance, and clarity of the Delphi questionnaire. Result: Two scoping studies, regarding LTBI control in health care workers in IBCs and TB control in elderly of IBCs respectively, have been conducted. The result of these two studies is used as the foundation for developing the Delphi questionnaire, which tapped on seven areas of question, namely: characteristics of IBCs, adequacy of research and services in LTBI control in IBCs, importance and feasibility of interventions for TB control and prevention in hospital, screening and treatment of LTBI in community, reasons of refusal to/ default from LTBI treatment, medical adherence of LTBI treatment, and importance and feasibility of interventions for TB control and prevention in elderly in IBCs. The local experts also commented on the two scoping studies conducted, thus act as the sixth phase of expert consultation in Arksey and O’Malley framework of scoping studies, to either nourish the scope and strategies used in these studies or to supplement ideas for further scoping or systematic review studies. In the subsequent stage, an international expert panel, comprised of 15 to 20 experts from IBCs in Western Pacific Region, will be recruited to join the two-round anonymous Delphi iterations. Four categories of TB control experts, namely clinicians, policy makers, microbiologists/ laboratory personnel, and public health clinicians will be our target groups. A consensus level of 80% is used to determine the achievement of consensus on particular issues. Key messages: 1. Scoping review and Delphi method are useful to identify gaps and then achieve consensus in research. 2. Lots of resources are put in the high burden countries now. However, the usually neglected intermediate-burden countries with TB is an indispensable part for achieving the ambitious WHO End TB 2035 target.

Keywords: dephi questionnaire, tuberculosis, WHO, latent TB infection

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Authors: Nick Woodier, Iain Moppett

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Background: It is estimated that one in ten patients admitted to hospital will suffer an adverse event in their care. While the majority of these will result in low harm, patients are being significantly harmed by the processes meant to help them. Healthcare, therefore, seeks to make improvements in patient safety by taking learning from other industries that are perceived to be more mature in their management of safety events. Of particular interest to healthcare are ‘near misses,’ those events that almost happened but for an intervention. Healthcare does not have any guidance as to how best to manage and learn from near misses to reduce the chances of harm to patients. The authors, as part of a larger study of near-miss management in healthcare, sought to learn from the UK nuclear sector to develop principles for how healthcare can identify, report, and learn from near misses to improve patient safety. The nuclear sector was chosen as an exemplar due to its status as an ultra-safe industry. Methods: A Grounded Theory (GT) methodology, augmented by a scoping review, was used. Data collection included interviews, scenario discussion, field notes, and the literature. The review protocol is accessible online. The GT aimed to develop theories about how nuclear manages near misses with a focus on defining them and clarifying how best to support reporting and analysis to extract learning. Near misses related to radiation release or exposure were focused on. Results: Eightnuclear interviews contributed to the GT across nuclear power, decommissioning, weapons, and propulsion. The scoping review identified 83 articles across a range of safety-critical industries, with only six focused on nuclear. The GT identified that nuclear has a particular focus on precursors and low-level events, with regulation supporting their management. Exploration of definitions led to the recognition of the importance of several interventions in a sequence of events, but that do not solely rely on humans as these cannot be assumed to be robust barriers. Regarding reporting and analysis, no consistent methods were identified, but for learning, the role of operating experience learning groups was identified as an exemplar. The safety culture across nuclear, however, was heard to vary, which undermined reporting of near misses and other safety events. Some parts of the industry described that their focus on near misses is new and that despite potential risks existing, progress to mitigate hazards is slow. Conclusions: Healthcare often sees ‘nuclear,’ as well as other ultra-safe industries such as ‘aviation,’ as homogenous. However, the findings here suggest significant differences in safety culture and maturity across various parts of the nuclear sector. Healthcare can take learning from some aspects of management of near misses in nuclear, such as how they are defined and how learning is shared through operating experience networks. However, healthcare also needs to recognise that variability exists across industries, and comparably, it may be more mature in some areas of safety.

Keywords: culture, definitions, near miss, nuclear safety, patient safety

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Authors: Radhika Jain

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The nursing community in India face unique challenges ranging from lack of adequate career progression, low social status attached to the profession, poor nurse-to-patient ratio leading to heavy workload resulting in stress and burnout, lack of general recognition and the responsibility of often having to deal with the ire of the patients and their families. This study explores how a combination of Playback Theatre and Expressive Arts could be used as a very powerful tool to understand the concerns, and consequently as a self-care tool to bring about the sense of well-being and emotional awareness for the nurses. For the purpose of this study, Playback Theatre was used as an entry tool to understand the thoughts, feelings and concerns. Playback theatre is a unique improvisational form of theatre developed by Jonathan Fox and Jo Salas in 1975, in which audience share their own stories from their lives and the performers play them back through a range of improv techniques such as metaphor, poetry, music and movement. Playback Theatre helped in first warming them up to the idea of sharing and then gave them the confidence of a safe space to collectively go deeper into their emotional experiences. As the next step, structured sessions of Expressive Arts were conducted with the same set of nurses, for them to work on the issues and concerns they have (and which they shared during the Playback performance). These sessions were to enable longer engagements as many of the concerns expressed were related to perceptions and beliefs that have been ingrained over a period of time and hence it needs a longer engagement to be worked on in detail. The Expressive Art sessions helped in this regard. Expressive arts therapy combines psychology and the creative process to promote emotional growth and healing. The study was conducted at two places: one a geriatric centre and the other, a palliative care centre. The study revealed that concerns and challenges would not be identical across the nursing community or across similar types of health care organizations but would be specific to each organization or centre as the circumstances and set-up at each place would be different. At the geriatric centre, stress and burnout emerged as the main concerns while at the palliative care centre, the main concern that came up was around the difficulty the nurses faced in expressing emotions and in communicating their feelings. The objective analysis of the results of the study indicated how longer-term engagements using Expressive Arts as the modality helped the nurses have better awareness of their emotions and helped them develop tools of self-care tools while also tapping into their emotions to express and experience. The process of eliciting the main concerns from the nurses using a Playback Theatre performance and then following that with subsequent sessions of expressive arts helped the nurses in the way nurses approached their job and the reduced level of overwhelm that they felt.

Keywords: palliative care, nurses, self-care, expressive arts, playback theatre

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Authors: Hetvi Trivedi

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Technological escalation cannot be negated. The same is true for the benefits of technology. However, such escalation has interfered with the traditional theories of protection under Intellectual Property Rights. Out of the many trends that have disrupted the old-school understanding of Intellectual Property Rights, one is hashtags. What began modestly in the year 2007 has now earned a remarkable status, and coupled with the unprecedented rise in social media the hashtag culture has witnessed a monstrous growth. A tiny symbol on the keypad of phones or computers is now a major trend which also serves companies as a critical investment measure in establishing their brand in the market. Due to this a section of the Intellectual Property Rights- Trademarks is undergoing a humungous transformation with hashtags like #icebucket, #tbt or #smilewithacoke, getting trademark protection. So, as the traditional theories of IP take on the modern trends, it is necessary to understand the change and challenge at a theoretical and proportional level and where need be, question the change. Traditionally, Intellectual Property Rights serves the societal need for intellectual productions that ensure its holistic development as well as cultural, economic, social and technological progress. In a two-pronged effort at ensuring continuity of creativity, IPRs recognize the investment of individual efforts that go into creation by way of offering protection. Commonly placed under two major theories- Utilitarian and Natural, IPRs aim to accord protection and recognition to an individual’s creation or invention which serve as an incentive for further creations or inventions, thus fully protecting the creative, inventive or commercial labour invested in the same. In return, the creator by lending the public the access to the creation reaps various benefits. This way Intellectual Property Rights form a ‘social contract’ between the author and society. IPRs are similarly attached to a social function, whereby individual rights must be weighed against competing rights and to the farthest limit possible, both sets of rights must be treated in a balanced manner. To put it differently, both the society and the creator must be put on an equal footing with neither party’s rights subservient to the other. A close look through doctrinal research, at the recent trend of trademark protection, makes the social function of IPRs seem to be moving far from the basic philosophy. Thus, where technology interferes with the philosophies of law, it is important to check and allow such growth only in moderation, for none is superior than the other. The human expansionist nature may need everything under the sky that can be tweaked slightly to be counted and protected as Intellectual Property- like a common parlance word transformed into a hashtag, however IP in order to survive on its philosophies needs to strike a balance. A unanimous global decision on the judicious use of IPR recognition and protection is the need of the hour.

Keywords: hashtag trademarks, intellectual property, social function, technology

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Authors: Asfaw Gezae Daful, Mohsen Alimandagari, Kathleen Haigh, Somayeh Farzad, Eugene Van Rensburg, Johann F. Görgens

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The sugar industry has to 're-invent' itself to ensure long-term economic survival and opportunities for job creation and enhanced community-level impacts, given increasing pressure from fluctuating and low global sugar prices, increasing energy prices and sustainability demands. We propose biorefineries for re-vitalisation of the sugar industry using low value lignocellulosic biomass (sugarcane bagasse, leaves, and tops) annexed to existing sugar mills, producing a spectrum of high value platform chemicals along with biofuel, bioenergy, and electricity. Opportunity is presented for greener products, to mitigate climate change and overcome economic challenges. Xylose from labile hemicellulose remains largely underutilized and the conversion to value-add products a major challenge. Insight is required on pretreatment and/or extraction to optimize production of cellulosic ethanol together with lactic acid, furfural or biopolymers from sugarcane bagasse, leaves, and tops. Experimental conditions for alkaline and pressurized hot water extraction dilute acid and steam explosion pretreatment of sugarcane bagasse and harvest residues were investigated to serve as a basis for developing various process scenarios under a sugarcane biorefinery scheme. Dilute acid and steam explosion pretreatment were optimized for maximum hemicellulose recovery, combined sugar yield and solids digestibility. An optimal range of conditions for alkaline and liquid hot water extraction of hemicellulosic biopolymers, as well as conditions for acceptable enzymatic digestibility of the solid residue, after such extraction was established. Using data from the above, a series of energy efficient biorefinery scenarios are under development and modeled using Aspen Plus® software, to simulate potential factories to better understand the biorefinery processes and estimate the CAPEX and OPEX, environmental impacts, and overall viability. Rigorous and detailed sustainability assessment methodology was formulated to address all pillars of sustainability. This work is ongoing and to date, models have been developed for some of the processes which can ultimately be combined into biorefinery scenarios. This will allow systematic comparison of a series of biorefinery scenarios to assess the potential to reduce negative impacts on and maximize the benefits of social, economic, and environmental factors on a lifecycle basis.

Keywords: biomass, biorefinery, green economy, sustainability

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Authors: Sakinah Idris, Femke Ten Hoeve, Kirstin Greaves-Lord

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Background: Social skills interventions are considered to be efficacious if social skills are improved as a result of an intervention. Nevertheless, the objective assessment of social skills is hindered by a lack of sensitive and validated measures. To measure the change in social skills after an intervention, questionnaires reported by parents, clinicians and/or teachers are commonly used. Observations are the most ecologically valid method of assessing improvements in social skills after an intervention. For this purpose, The Program for the Educational and Enrichment of Relational Skills (PEERS) was developed for adolescents, in order to teach them the age-appropriate skills needed to participate in society. It is an evidence-based intervention for adolescents with ASD that taught ecologically valid social skills techniques. Objectives: The current study aims to describe the development and psychometric evaluation of the Dutch Contextual Assessment of Social Skills (CASS), an observational outcome measure of social skills for adolescents with Autism Spectrum Disorder (ASD). Methods: 64 adolescents (M = 14.68, SD = 1.41, 71% boys) with ASD performed the CASS before and after a social skills intervention (i.e. PEERS or the active control condition). Each adolescent completed a 3-minute conversation with a confederate. The conversation was prompt as a natural introduction between two-unfamiliar, similar ages, opposite-sex peers who meet for the first time. The adolescent and the confederate completed a brief questionnaire about the conversation (Conversation Rating Scale). Results: Results indicated sufficient psychometric properties. The Dutch CASS has a high level of internal consistency (Cronbach's α coefficients = 0.84). Data supported the convergent validity (i.e., significant correlated with the Social Skills Improvement System (SSiS). The Dutch CASS did not significantly correlate with the autistic mannerism subscale from Social Responsiveness Scale (SRS), thus proved the divergent validity. Based on scorings made by raters who were kept blind to the time points, reliable change index was computed to assess the change in social skills. With regard to the content validity, only the learning objectives of the first two meetings of PEERS about conversational skills relatively matched with rating domains of the CASS. Due to this underrepresentation, we found an existing observational measure (TOPICC) that covers some of the other learning objectives of PEERS. TOPICC covers 22% of the learning objectives of PEERS about conversational skills, meanwhile, CASS is 45%. Unfortunately, 33% of the learning objectives of PEERS was not covered by CASS or TOPICC. Conclusion: Recommendations are made to improve the psychometric properties and content validity of the Dutch CASS.

Keywords: autism spectrum disorder, observational, PEERS, social skills

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Authors: S.K. Bhandari, E. Veneklaas, L. McCaw, R. Mazanec, K. Whitford, M. Renton

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Eucalyptus marginata, E. diversicolor and Corymbia calophylla form widespread forests in south-west Western Australia (SWWA). These forests have economic and ecological importance, and therefore, tree growth and sustainable management are of high priority. This paper aimed to analyse and model the growth of these species at both stand and individual levels, but this presentation will focus on predicting the growth of E. Marginata at the individual tree level. More specifically, the study wanted to investigate how well individual E. marginata tree growth could be predicted by considering the diameter and height of the tree at the start of the growth period, and whether this prediction could be improved by also accounting for the competition from neighbouring trees in different ways. The study also wanted to investigate how many neighbouring trees or what neighbourhood distance needed to be considered when accounting for competition. To achieve this aim, the Pearson correlation coefficient was examined among competition indices (CIs), between CIs and dbh growth, and selected the competition index that can best predict the diameter growth of individual trees of E. marginata forest managed under different thinning regimes at Inglehope in SWWA. Furthermore, individual tree growth models were developed using simple linear regression, multiple linear regression, and linear mixed effect modelling approaches. Individual tree growth models were developed for thinned and unthinned stand separately. The developed models were validated using two approaches. In the first approach, models were validated using a subset of data that was not used in model fitting. In the second approach, the model of the one growth period was validated with the data of another growth period. Tree size (diameter and height) was a significant predictor of growth. This prediction was improved when the competition was included in the model. The fit statistic (coefficient of determination) of the model ranged from 0.31 to 0.68. The model with spatial competition indices validated as being more accurate than with non-spatial indices. The model prediction can be optimized if 10 to 15 competitors (by number) or competitors within ~10 m (by distance) from the base of the subject tree are included in the model, which can reduce the time and cost of collecting the information about the competitors. As competition from neighbours was a significant predictor with a negative effect on growth, it is recommended including neighbourhood competition when predicting growth and considering thinning treatments to minimize the effect of competition on growth. These model approaches are likely to be useful tools for the conservations and sustainable management of forests of E. marginata in SWWA. As a next step in optimizing the number and distance of competitors, further studies in larger size plots and with a larger number of plots than those used in the present study are recommended.

Keywords: competition, growth, model, thinning

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Authors: Sharon K. Mahlangu, Mustapha Mohammed, Felix D. Dakora

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Rural households in Africa depend largely on legumes as a source of high-protein food due to N₂-fixation by rhizobia when they infect plant roots. However, the legume/rhizobia symbiosis can exhibit some level of specificity such that some legumes may be selectively nodulated by only a particular group of rhizobia. In contrast, some legumes are highly promiscuous and are nodulated by a wide range of rhizobia. Little is known about the nodulation promiscuity of bacterial symbionts from wild legumes such as Aspalathus linearis, especially if they can nodulate cultivated grain legumes such as cowpea and Kersting’s groundnut. Determining the host range of the symbionts of wild legumes can potentially reveal novel rhizobial strains that can be used to increase nitrogen fixation in cultivated legumes. In this study, bacteria were isolated and tested for their ability to induce root nodules on their homologous hosts. Seeds were surface-sterilized with alcohol and sodium hypochlorite and planted in sterile sand contained in plastic pots. The pot surface was covered with sterile non-absorbent cotton wool to avoid contamination. The plants were watered with nitrogen-free nutrient solution and sterile water in alternation. Three replicate pots were used per isolate. The plants were grown for 90 days in a naturally-lit glasshouse and assessed for nodulation (nodule number and nodule biomass) and shoot biomass. Seven isolates from each of Kersting’s groundnut and cowpea and two from Rooibos tea plants were tested for their ability to nodulate soybean, mung bean, common bean and Bambara groundnut. The results showed that of the isolates from cowpea, where VUSA55 and VUSA42 could nodulate all test host plants, followed by VUSA48 which nodulated cowpea, Bambara groundnut and soybean. The two isolates from Rooibos tea plants nodulated Bambara groundnut, soybean and common bean. However, isolate L1R3.3.1 also nodulated mung bean. There was a greater accumulation of shoot biomass when cowpea isolate VUSA55 nodulated common bean. Isolate VUSA55 produced the highest shoot biomass, followed by VUSA42 and VUSA48. The two Kersting’s groundnut isolates, MGSA131 and MGSA110, accumulated average shoot biomass. In contrast, the two Rooibos tea isolates induced a higher accumulation of biomass in Bambara groundnut, followed by common bean. The results suggest that inoculating these agriculturally important grain legumes with cowpea isolates can contribute to improved soil fertility, especially soil nitrogen levels.

Keywords: legumes, nitrogen fixation, nodulation, rhizobia

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Authors: Mita Sirait

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Everyday Jakarta produces 7,000 tons of solid waste and only about 5,200 tons delivered to landfill out of the city by 720 trucks, the rest are left yet manageable, as reported by Government of Clean Sector. CLEAN Jakarta Project is aimed at empowering community to achieve healthy environment for children and families in urban slum in Semper Barat and Penjaringan sub-district of North Jakarta that consisted of 20,584 people. The project applies Community Based Total Sanitation, an approach to empowering community to achieve total hygiene and sanitation behaviour by triggering activities. As regulated by Ministry of Health, it has 5 pillars: (1) open defecation free, (2) hand-washing with soaps, (3) drinking-water treatment, (4) solid-waste management and (5) waste-water management; and 3 strategic components: 1) demand creation, 2) supply creation and 3) enabling environment. Demand creation is generated by triggering community’s reaction to their daily sanitation habits by exposing them to their surrounding where they can see faeces, waste and other environmental pollutant to stimulate disgusting, embarrassing and responsibility sense. Triggered people then challenged to commit to improving their hygiene practice such as to stop littering and start waste separation. In order to support this commitment, and for supply creation component, the project initiated waste bank with community working group. It facilitated capacity-building trainings, waste bank system formulation and meetings with local authorities to solicit land permit and waste bank decree. As it is of a general banking system, waste bank has customer service, teller, manager, legal paper and provides saving book and money transaction. In 8 months, two waste banks have established with 148 customers, 17 million rupiah cash, and about 9 million of stored recyclables. Approximately 2.5 tons of 15-35 types of recyclable are managed in both waste banks per week. On enabling environment, the project has initiated sanitation working group in community and multi sectors government level, and advocated both parties. The former is expected to promote behaviour change and monitoring in the community, while the latter is expected to support sanitation with regulations, strategies, appraisal and awards; to coordinate partnering and networking, and to replicate best practices to other areas.

Keywords: urban community, waste management, Jakarta, community based total sanitation (CBTS)

Procedia PDF Downloads 294