Search results for: institutional pension facilities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2784

Search results for: institutional pension facilities

624 The Extent of Virgin Olive-Oil Prices' Distribution Revealing the Behavior of Market Speculators

Authors: Fathi Abid, Bilel Kaffel

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The olive tree, the olive harvest during winter season and the production of olive oil better known by professionals under the name of the crushing operation have interested institutional traders such as olive-oil offices and private companies such as food industry refining and extracting pomace olive oil as well as export-import public and private companies specializing in olive oil. The major problem facing producers of olive oil each winter campaign, contrary to what is expected, it is not whether the harvest will be good or not but whether the sale price will allow them to cover production costs and achieve a reasonable margin of profit or not. These questions are entirely legitimate if we judge by the importance of the issue and the heavy complexity of the uncertainty and competition made tougher by a high level of indebtedness and the experience and expertise of speculators and producers whose objectives are sometimes conflicting. The aim of this paper is to study the formation mechanism of olive oil prices in order to learn about speculators’ behavior and expectations in the market, how they contribute by their industry knowledge and their financial alliances and the size the financial challenge that may be involved for them to build private information hoses globally to take advantage. The methodology used in this paper is based on two stages, in the first stage we study econometrically the formation mechanisms of olive oil price in order to understand the market participant behavior by implementing ARMA, SARMA, GARCH and stochastic diffusion processes models, the second stage is devoted to prediction purposes, we use a combined wavelet- ANN approach. Our main findings indicate that olive oil market participants interact with each other in a way that they promote stylized facts formation. The unstable participant’s behaviors create the volatility clustering, non-linearity dependent and cyclicity phenomena. By imitating each other in some periods of the campaign, different participants contribute to the fat tails observed in the olive oil price distribution. The best prediction model for the olive oil price is based on a back propagation artificial neural network approach with input information based on wavelet decomposition and recent past history.

Keywords: olive oil price, stylized facts, ARMA model, SARMA model, GARCH model, combined wavelet-artificial neural network, continuous-time stochastic volatility mode

Procedia PDF Downloads 338
623 Thermal Instability in Solid under Irradiation

Authors: P. Selyshchev

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Construction materials for nuclear facilities are operated under extreme thermal and radiation conditions. First of all, they are nuclear fuel, fuel assemblies, and reactor vessel. It places high demands on the control of their state, stability of their state, and their operating conditions. An irradiated material is a typical example of an open non-equilibrium system with nonlinear feedbacks between its elements. Fluxes of energy, matter and entropy maintain states which are far away from thermal equilibrium. The links that arise under irradiation are inherently nonlinear. They form the mechanisms of feed-backs that can lead to instability. Due to this instability the temperature of the sample, heat transfer, and the defect density can exceed the steady-state value in several times. This can lead to change of typical operation and an accident. Therefore, it is necessary to take into account the thermal instability to avoid the emergency situation. The point is that non-thermal energy can be accumulated in materials because irradiation produces defects (first of all these are vacancies and interstitial atoms), which are metastable. The stored energy is about energy of defect formation. Thus, an annealing of the defects is accompanied by releasing of non-thermal stored energy into thermal one. Temperature of the material grows. Increase of temperature results in acceleration of defect annealing. Density of the defects drops and temperature grows more and more quickly. The positive feed-back is formed and self-reinforcing annealing of radiation defects develops. To describe these phenomena a theoretical approach to thermal instability is developed via formalism of complex systems. We consider system of nonlinear differential equations for different components of microstructure and temperature. The qualitative analysis of this non-linear dynamical system is carried out. Conditions for development of instability have been obtained. Points of bifurcation have been found. Convenient way to represent obtained results is a set of phase portraits. It has been shown that different regimes of material state under irradiation can develop. Thus degradation of irradiated material can be limited by means of choice appropriate kind of evolution of materials under irradiation.

Keywords: irradiation, material, non-equilibrium state, nonlinear feed-back, thermal instability

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622 Prevalence of Disability among Children Two to Fourteen Years at Selected Districts in Greater Accra Region of Ghana

Authors: Yvonne Nanaama Brew, Bismark Jampim Abrokwah

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Children with disabilities in Ghana are not routinely registered, and this can imply that they may be neglected in national policy planning since global estimates may not be near the exact numbers. Although there are some studies with reports on the prevalence of disability among children in Ghana, reliable information on the prevalence, types of disability in children, and children who die with disabilities in the Greater Accra region are lacking. The current study seeks to investigate the incidence of disability among children two to fourteen years at selected districts in the Greater Accra region of Ghana. A cross-sectional design is adapted with a quantitative method for this study. Parents with disabled children who access child welfare clinics at the Greater Accra regional hospital, Maamobi hospital, Ga west, and Ga south district hospitals will be selected through purposive sampling for the study. An adapted UNICEF structured Ten Questions will be used to collect relevant data about participants. The responses to the questions will be either 'Yes' or 'No'. Parents with children who answer 'Yes' to a disability and purposively sampled parents with children who answer 'No' to disability will be invited to Child Health Clinic at the Greater Accra regional hospital for a free clinical assessment. Data will be entered into Microsoft Office Excel 2013 and imported into STATA version 15 for analysis. The study is expected to provide reliable disaggregated data on less than fourteen years of children with disabilities in the Greater Accra region. The findings and recommendations of the study will demonstrate the importance of early detection of disability and facilitate more quality and holistic planning of appropriate programmes that best safeguard the rights of children with disabilities in Ghana. It will help in policy and decision-making on children less than fourteen years with disabilities in Ghana. Also, findings will be useful for health facilities in Ghana to plan services for disabled children. Finally, the study is expected to add to the guides for the National Council of Persons with Disabilities to fulfill its legal mandate for disabled persons in Ghana.

Keywords: prevalence, disability, children, Ghana

Procedia PDF Downloads 131
621 Dynamic Web-Based 2D Medical Image Visualization and Processing Software

Authors: Abdelhalim. N. Mohammed, Mohammed. Y. Esmail

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In the course of recent decades, medical imaging has been dominated by the use of costly film media for review and archival of medical investigation, however due to developments in networks technologies and common acceptance of a standard digital imaging and communication in medicine (DICOM) another approach in light of World Wide Web was produced. Web technologies successfully used in telemedicine applications, the combination of web technologies together with DICOM used to design a web-based and open source DICOM viewer. The Web server allowance to inquiry and recovery of images and the images viewed/manipulated inside a Web browser without need for any preinstalling software. The dynamic site page for medical images visualization and processing created by using JavaScript and HTML5 advancements. The XAMPP ‘apache server’ is used to create a local web server for testing and deployment of the dynamic site. The web-based viewer connected to multiples devices through local area network (LAN) to distribute the images inside healthcare facilities. The system offers a few focal points over ordinary picture archiving and communication systems (PACS): easy to introduce, maintain and independently platforms that allow images to display and manipulated efficiently, the system also user-friendly and easy to integrate with an existing system that have already been making use of web technologies. The wavelet-based image compression technique on which 2-D discrete wavelet transform used to decompose the image then wavelet coefficients are transmitted by entropy encoding after threshold to decrease transmission time, stockpiling cost and capacity. The performance of compression was estimated by using images quality metrics such as mean square error ‘MSE’, peak signal to noise ratio ‘PSNR’ and compression ratio ‘CR’ that achieved (83.86%) when ‘coif3’ wavelet filter is used.

Keywords: DICOM, discrete wavelet transform, PACS, HIS, LAN

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620 Informal Green Infrastructure as Mobility Enabler in Informal Settlements of Quito

Authors: Ignacio W. Loor

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In the context of informal settlements in Quito, this paper provides evidence that slopes and deep ravines typical of Andean cities, around which marginalized urban communities sit, constitute a platform for green infrastructure that supports mobility for pedestrians in an incremental fashion. This is informally shaped green infrastructure that provides connectivity to other mobility infrastructures such as roads and public transport, which permits relegated dwellers reach their daily destinations and reclaim their rights to the city. This is relevant in that walking has been increasingly neglected as a viable mean of transport in Latin American cities, in favor of rather motorized means, for which the mobility benefits of green infrastructure have remained invisible to policymakers, contributing to the progressive isolation of informal settlements. This research leverages greatly on an ecological rejuvenation programme led by the municipality of Quito and the Andean Corporation for Development (CAN) intended for rehabilitating the ecological functionalities of ravines. Accordingly, four ravines in different stages of rejuvenation were chosen, in order to through ethnographic methods, capture the practices they support to dwellers of informal settlements across different stages, particularly in terms of issues of mobility. Then, by presenting fragments of interviews, description of observed phenomena, photographs and narratives published in institutional reports and media, the production process of mobility infrastructure over unoccupied slopes and ravines, and the roles that this infrastructure plays in the mobility of dwellers and their quotidian practices are explained. For informal settlements, which normally feature scant urban infrastructure, mobility embodies an unfavourable driver for the possibilities of dwellers to actively participate in the social, economic and political dimensions of the city, for which their rights to the city are widely neglected. Nevertheless, informal green infrastructure for mobility provides some alleviation. This infrastructure is incremental, since its features and usability gradually evolves as users put into it knowledge, labour, devices, and connectivity to other infrastructures in different dimensions which increment its dependability. This is evidenced in the diffusion of knowledge of trails and routes of footpaths among users, the implementation of linking stairs and bridges, the improved access by producing public spaces adjacent to the ravines, the illuminating of surrounding roads, and ultimately, the restoring of ecological functions of ravines. However, the perpetuity of this type of infrastructure is also fragile and vulnerable to the course of urbanisation, densification, and expansion of gated privatised spaces.

Keywords: green infrastructure, informal settlements, urban mobility, walkability

Procedia PDF Downloads 163
619 Analysis of Eco-Efficiency and the Determinants of Family Agriculture in Southeast Spain

Authors: Emilio Galdeano-Gómez, Ángeles Godoy-Durán, Juan C. Pérez-Mesa, Laura Piedra-Muñoz

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Eco-efficiency is receiving ever-increasing interest as an indicator of sustainability, as it links environmental and economic performances in productive activities. In agriculture, these indicators and their determinants prove relevant due to the close relationships in this activity between the use of natural resources, which is generally limited, and the provision of basic goods to society. In this context, various analyses have focused on eco-efficiency by considering individual family farms as the basic production unit. However, not only must the measure of efficiency be taken into account, but also the existence of a series of factors which constitute socio-economic, political-institutional, and environmental determinants. Said factors have been studied to a lesser extent in the literature. The present work analyzes eco-efficiency at a micro level, focusing on small-scale family farms as the main decision-making units in horticulture in southeast Spain, a sector which represents about 30% of the fresh vegetables produced in the country and about 20% of those consumed in Europe. The objectives of this study are a) to obtain a series of eco-efficiency indicators by estimating several pressure ratios and economic value added in farming, b) to analyze the influence of specific social, economic and environmental variables on the aforementioned eco-efficiency indicators. The present work applies the method of Data Envelopment Analysis (DEA), which calculates different combinations of environmental pressures (water usage, phytosanitary contamination, waste management, etc.) and aggregate economic value. In a second stage, an analysis is conducted on the influence of the socio-economic and environmental characteristics of family farms on the eco-efficiency indicators, as endogeneous variables, through the use of truncated regression and bootstrapping techniques, following Simar-Wilson methodology. The results reveal considerable inefficiency in aspects such as waste management, while there is relatively little inefficiency in water usage and nitrogen balance. On the other hand, characteristics, such as product specialization, the adoption of quality certifications and belonging to a cooperative do have a positive impact on eco-efficiency. These results are deemed to be of interest to agri-food systems structured on small-scale producers, and they may prove useful to policy-makers as regards managing public environmental programs in agriculture.

Keywords: data envelopment analysis, eco-efficiency, family farms, horticulture, socioeconomic features

Procedia PDF Downloads 193
618 The Role of Home Composting in Waste Management Cost Reduction

Authors: Nahid Hassanshahi, Ayoub Karimi-Jashni, Nasser Talebbeydokhti

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Due to the economic and environmental benefits of producing less waste, the US Environmental Protection Agency (EPA) introduces source reduction as one of the most important means to deal with the problems caused by increased landfills and pollution. Waste reduction involves all waste management methods, including source reduction, recycling, and composting, which reduce waste flow to landfills or other disposal facilities. Source reduction of waste can be studied from two perspectives: avoiding waste production, or reducing per capita waste production, and waste deviation that indicates the reduction of waste transfer to landfills. The present paper has investigated home composting as a managerial solution for reduction of waste transfer to landfills. Home composting has many benefits. The use of household waste for the production of compost will result in a much smaller amount of waste being sent to landfills, which in turn will reduce the costs of waste collection, transportation and burial. Reducing the volume of waste for disposal and using them for the production of compost and plant fertilizer might help to recycle the material in a shorter time and to use them effectively in order to preserve the environment and reduce contamination. Producing compost in a home-based manner requires very small piece of land for preparation and recycling compared with other methods. The final product of home-made compost is valuable and helps to grow crops and garden plants. It is also used for modifying the soil structure and maintaining its moisture. The food that is transferred to landfills will spoil and produce leachate after a while. It will also release methane and greenhouse gases. But, composting these materials at home is the best way to manage degradable materials, use them efficiently and reduce environmental pollution. Studies have shown that the benefits of the sale of produced compost and the reduced costs of collecting, transporting, and burying waste can well be responsive to the costs of purchasing home compost machine and the cost of related trainings. Moreover, the process of producing home compost may be profitable within 4 to 5 years and as a result, it will have a major role in reducing waste management.

Keywords: compost, home compost, reducing waste, waste management

Procedia PDF Downloads 424
617 Significant Factor of Magnetic Resonance for Survival Outcome in Rectal Cancer Patients Following Neoadjuvant Combined Chemotherapy and Radiation Therapy: Stratification of Lateral Pelvic Lymph Node

Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

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Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

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616 A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program

Authors: Jacqueline M. Dias, Amina A Khowaja

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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.

Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum

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615 Risk Factors Associated with Outbreak of Cerebrospinal Meningitis in Kano State- Nigeria, March-May 2017

Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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614 A Geographical Study of Women Status in an Emerging Urban Industrial Economy: Experiences from the Asansol Sub-Division and Durgapur Sub-Division of West Bengal, India

Authors: Mohana Basu, Snehamanju Basu

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Urbanization has an immense impact on the holistic development of a region. In that same context, the level of women empowerment plays a significant role in the development of any region, particularly a region belonging to a developing country. The present study investigates the status of women empowerment in the Asansol Durgapur Planning Area of the state of West Bengal, India by investigating the status of women and their access to various facilities and awareness about the various governmental and non-governmental schemes meant for their elevation. Through this study, an attempt has been to made to understand the perception of the respondents on the context of women's empowerment. The study integrates multiple sources of qualitative and quantitative data collected from various reports, field-based measurements, questionnaire survey and community based participatory appraisals. Results reveal that women of the rural parts of the region are relatively disempowered due to the various restrictions imposed on them and enjoy lower socioeconomic clout than their male counterparts in spite of the several remedial efforts taken by the government and NGOs to elevate their position in the society. A considerable gender gap still exists regarding access to education, employment and decision-making power in the family and significant differences in attitude towards women are observable in the rural and urban areas. Freedom of women primarily vary according to their age group, educational level, employment and income status and also on the degree of urbanization. Asansol Durgapur Planning Area is primarily an industrial region where huge employment generation scope exists. But these disparities are quite alarming and indicate that economic development does not always usher in socially justifiable rights and access to resources for both men and women alike in its awake. In this backdrop, this study will attempt to forward relevant suggestions which can be followed for betterment of the status of women.

Keywords: development, disempowered, economic development, urbanization, women empowerment

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613 (Mis) Communication across the Borders: Politics, Media, and Public Opinion in Turkey

Authors: Banu Baybars Hawks

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To date, academic attention in social sciences remains inadequate with regard to research and analysis of public opinion in Turkey. Most of the existing research has assessed the public opinion during political election periods. Therefore, it is of great interest to find out what the public thinks about current issues in Turkey, and how to interpret the results to be able to reveal whether they may have any reflections on social, political, and cultural structure of the country. Accordingly, the current study seeks to fill the gap in the social sciences literature in English regarding Turkey’s social and political stand which may be perceived to be very different by other nations. Without timely feedback from public surveys, various programs for improving different services and institutions functioning in the country might not achieve their expected goal, nor can decisions about which programs to implement be made rationally. Additionally, the information gathered may not only yield important insights into public’s opinion regarding current agenda in Turkey, but also into the correlates shaping public policies. Agenda-setting studies including agenda-building, agenda melding, reversed agenda-setting and information diffusion studies will be used to explain the roles of factors and actors in the formation of public opinion in Turkey. Knowing the importance of public agenda in the agenda setting and building process, this paper aims to reveal the social and political tendencies of the Turkish public. For that purpose, a survey will be carried out in December of 2014 to determine the social and political trends in Turkey for that same year. The subjects for the study, which utilize a questionairre in one-on-one interviews, will include 1,000 individuals aged 18 years and older from 26 cities representing general population. A stratified random sampling frame will be used. The topics covered by the survey include: The most important current problem in Turkey; the Economy; Terror; Approaches to the Kurdish Issue; Evaluations of the Government and Opposition Parties; Evaluations of Institutional Efficiency; Foreign Policy; the Judicial System/Constitution; Democracy and the Media; and, Social Relations/Life in Turkey. Since the beginning of the 21st century, Turkey has been undergoing a rapid transformation. The reflections of the changes can be seen in all areas from economics to politics. It is my hope that findings of this study may shed light on the important aspects of institutions, variables setting the agenda, and formation process of public opinion in Turkey.

Keywords: public opinion, media, agenda setting, information diffusion, government, freedom, Turkey

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612 Highway Waste Management in Zambia Policy Preparedness and Remedies: The Case of Great East Road

Authors: Floyd Misheck Mwanza, Paul Boniface Majura

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The paper looked at highways/ roadside waste generation, disposal and the consequent environmental impacts. The dramatic increase in vehicular and paved roads in the recent past in Zambia, has given rise to the indiscriminate disposal of litter that now poses a threat to health and the environment. Primary data was generated by carrying out oral interviews and field observations for holistic and in–depth assessment of the environment and the secondary data was obtained from desk review method, information on effects of roadside wastes on environment were obtained from relevant literatures. The interviews were semi structured and a purposive sampling method was adopted and analyzed descriptively. The results of the findings showed that population growth and unplanned road expansion has exceeded the expected limit in recent time with resultant poor system of roadside wastes disposal. Roadside wastes which contain both biodegradable and non-biodegradable roadside wastes are disposed at the shoulders of major highways in temporary dumpsites and are never collected by a road development agency (RDA). There is no organized highway to highway or street to street collection of the wastes in Zambia by the key organization the RDA. The study revealed that roadside disposal of roadside wastes has serious impacts on the environment. Some of these impacts include physical nuisance of the wastes to the environment, the waste dumps also serve as hideouts for rodents and snakes which are dangerous. Waste are blown around by wind making the environment filthy, most of the wastes are also been washed by overland flow during heavy downpour to block drainage channels and subsequently lead to flooding of the environment. Most of the non- biodegradable wastes contain toxic chemicals which have serious implications on the environmental sustainability and human health. The paper therefore recommends that Government/ RDA should come up with proper orientation and environmental laws should be put in place for the general public and also to provide necessary facilities and arrange for better methods of collection of wastes.

Keywords: biodegradable, disposal, environment, impacts

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611 Voices from Inside and the Power of Art to Transform and Restore

Authors: Karen Miner-Romanoff

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Few art programs for incarcerated juveniles exist; however, evaluation results indicate decreased recidivism and behavior problems. This paper reports on an on-going study of a promising art program for incarcerated adolescents with community exhibits and charitable sale of their work. Voices from Inside, a partnership between Franklin University and the Ohio Department of Youth Services, sponsored three exhibits in 2012, 2013, and 2014. In 2013, youth exhibitor survey results (response rate 47%, 16 of 34) showed that 81% cited as benefits cooperation with others, task completion, and increased self-esteem from public recognition and art sales. Community attendee survey results (response rate 29.5%, 59 of 200) showed positive attitude changes toward juvenile offenders, from 40% to 53%. Qualitative responses were similarly positive. The 2014 youth exhibitor sample was larger (response rate 58%, 29 of 50) and showed that 93% cited positive benefits including increase in self-esteem, decrease in stress, pride or recognition of the ability to reach a goal from completing, exhibiting and selling their art to benefit a charity for at-risk youth. This year, the research was able to conduct ten one-on-one interviews inside of the youth facilities, and qualitative responses were even more positive with one youth explaining, “This art represents my joy, my tears, my pain and my hope.” Community attendee survey results (response rate 50%, 86 of 170) were transformative in that that they indicated significant impression on attitudes toward juvenile offenders and their rehabilitative needs with one attendee stating that the event had an, “Immense impact for me bringing into focus the humanity and value these youth still have for us and society.” Future research indicates a need for a correlation study to determine the extent to which these art programs reduce behavioral incidents inside of the facility and long-term reduction in reoffending rates. Generally, further study of juvenile offenders’ art for rehabilitation and restorative justice, the power of art to transform, and university-community partnerships implementing art programs for juvenile offenders should continue.

Keywords: art, juvenile, incarcerated, restorative justice

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610 Equity, Bonds, Institutional Debt and Economic Growth: Evidence from South Africa

Authors: Ashenafi Beyene Fanta, Daniel Makina

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Economic theory predicts that finance promotes economic growth. Although the finance-growth link is among the most researched areas in financial economics, our understanding of the link between the two is still incomplete. This is caused by, among others, wrong econometric specifications, using weak proxies of financial development, and inability to address the endogeneity problem. Studies on the finance growth link in South Africa consistently report economic growth driving financial development. Early studies found that economic growth drives financial development in South Africa, and recent studies have confirmed this using different econometric models. However, the monetary aggregate (i.e. M2) utilized used in these studies is considered a weak proxy for financial development. Furthermore, the fact that the models employed do not address the endogeneity problem in the finance-growth link casts doubt on the validity of the conclusions. For this reason, the current study examines the finance growth link in South Africa using data for the period 1990 to 2011 by employing a generalized method of moments (GMM) technique that is capable of addressing endogeneity, simultaneity and omitted variable bias problems. Unlike previous cross country and country case studies that have also used the same technique, our contribution is that we account for the development of bond markets and non-bank financial institutions rather than being limited to stock market and banking sector development. We find that bond market development affects economic growth in South Africa, and no similar effect is observed for the bank and non-bank financial intermediaries and the stock market. Our findings show that examination of individual elements of the financial system is important in understanding the unique effect of each on growth. The observation that bond markets rather than private credit and stock market development promotes economic growth in South Africa induces an intriguing question as to what unique roles bond markets play that the intermediaries and equity markets are unable to play. Crucially, our results support observations in the literature that using appropriate measures of financial development is critical for policy advice. They also support the suggestion that individual elements of the financial system need to be studied separately to consider their unique roles in advancing economic growth. We believe that our understanding of the channels through which bond market contribute to growth would be a fertile ground for future research.

Keywords: bond market, finance, financial sector, growth

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609 Profile of the Renal Failure Patients under Haemodialysis at B. P. Koirala Institute of Health Sciences Nepal

Authors: Ram Sharan Mehta, Sanjeev Sharma

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Introduction: Haemodialysis (HD) is a mechanical process of removing waste products from the blood and replacing essential substances in patients with renal failure. First artificial kidney developed in Netherlands in 1943 AD First successful treatment of CRF reported in 1960AD, life-saving treatment begins for CRF in 1972 AD. In 1973 AD Medicare took over financial responsibility for many clients and after that method become popular. BP Koirala institute of health science is the only center outside the Kathmandu, where HD service is available. In BPKIHS PD started in Jan.1998, HD started in August 2002 till September 2003 about 278 patients received HD. Day by day the number of HD patients is increasing in BPKIHS as with institutional growth. No such type of study was conducted in past hence there is lack of valid & reliable baseline data. Hence, the investigators were interested to conduct the study on " Profile of the Renal Failure patients under Haemodialysis at B.P. Koirala Institute of Health Sciences Nepal". Objectives: The objectives of the study were: to find out the Socio-demographic characteristics of the patients, to explore the knowledge of the patients regarding disease process and Haemodialysis and to identify the problems encountered by the patients. Methods: It is a hospital-based exploratory study. The population of the study was the clients under HD and the sampling method was purposive. Fifty-four patients undergone HD during the period of 17 July 2012 to 16 July 2013 of complete one year were included in the study. Structured interview schedule was used for collect data after obtaining validity and reliability. Results: Total 54 subjects had undergone for HD, having age range of 5-75 years and majority of them were male (74%) and Hindu (93 %). Thirty-one percent illiterate, 28% had agriculture their occupation, 80% of them were from very poor community, and about 30% subjects were unaware about the disease they suffering. Majority of subjects reported that they had no complications during dialysis (61%), where as 20% reported nausea and vomiting, 9% Hypotension, 4% headache and 2%chest pain during dialysis. Conclusions: CRF leading to HD is a long battle for patients, required to make major and continuous adjustment, both physiologically and psychologically. The study suggests that non-compliance with HD regimen were common. The socio-demographic and knowledge profile will help in the management and early prevention of disease and evaluate aspects that will influence care and patients can select mode of treatment themselves properly.

Keywords: profile, haemodialysis, Nepal, patients, treatment

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608 Practical Skill Education for Doctors in Training: Economical and Efficient Methods for Students to Receive Hands-on Experience

Authors: Nathaniel Deboever, Malcolm Breeze, Adrian Sheen

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Basic surgical and suturing techniques are a fundamental requirement for all doctors. In order to gain confidence and competence, doctors in training need to obtain sufficient teaching and just as importantly: practice. Young doctors with an apt level of expertise on these simple surgical skills, which are often used in the Emergency Department, can help alleviate some pressure during a busy evening. Unfortunately, learning these skills can be quite difficult during medical school or even during junior doctor years. The aim of this project was to adequately train medical students attending University of Sydney’s Nepean Clinical School through a series of workshops highlighting practical skills, with hopes to further extend this program to junior doctors in the hospital. The sessions instructed basic skills via tutorials, demonstrations, and lastly, the sessions cemented these proficiencies with practical sessions. During such an endeavor, it is fundamental to employ models that appropriately resemble what students will encounter in the clinical setting. The sustainability of workshops is similarly important to the continuity of such a program. To address both these challenges, the authors have developed models including suturing platforms, knot tying, and vessel ligation stations, as well as a shave and punch biopsy models and ophthalmologic foreign body device. The unique aspect of this work is that we utilized hands-on teaching sessions, to address a gap in doctors-in-training and junior doctor curriculum. Presented to you through this poster are our approaches to creating models that do not employ animal products and therefore do not necessitate particular facilities or discarding requirements. Covering numerous skills that would be beneficial to all young doctors, these models are easily replicable and affordable. This exciting work allows for countless sessions at low cost, providing enough practice for students to perform these skills confidently as it has been shown through attendee questionnaires.

Keywords: medical education, surgical models, surgical simulation, surgical skills education

Procedia PDF Downloads 155
607 Mindful Self-Compassion Training to Alleviate Work Stress and Fatigue in Community Workers: A Mixed Method Evaluation

Authors: Catherine Begin, Jeanne Berthod, Manon Truchon

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In Quebec, there are more than 8,000 community organizations throughout the province, representing more than 72,000 jobs. Working in a community setting involves several particularities (e.g., contact with the suffering of users, feelings of powerlessness, institutional pressure, unstable funding, etc.), which can put workers at risk of fatigue, burnout, and psychological distress. A 2007 study shows that 52% of community workers surveyed have a high psychological distress index. The Ricochet project, founded in 2019, is an initiative aimed at providing various care and services to community workers in the Quebec City region, with a global health approach. Within this program, mindful self-compassion training (MSC) is offered at a low cost. MSC is one of the effective strategies proposed in the literature to help prevent and reduce burnout. Self-compassion is the recognition that suffering, failure, and inadequacies are inherent in the human experience and that everyone, including oneself, deserves compassion. MSC training targets several behavioral, cognitive, and emotional learnings (e.g., motivating oneself with caring, better managing difficult emotions, promoting resilience, etc.). A mixed-method evaluation was conducted with the participants in order to explore the effects of the training on community workers in the Quebec City region. The participants were community workers (management or caregiver). 15 participants completed satisfaction and perceived impact surveys, and 30 participated in structured interviews. Quantitative results showed that participants were generally completely satisfied or satisfied with the training (94%) and perceived that the training allowed them to develop new strategies for dealing with stress (87%). Participants perceived effects on their mood (93%), their contact with others (80%), and their stress level (67%). Some of the barriers raised were scheduling constraints, length of training, and guilt about taking time for oneself. The qualitative results show that individuals experienced long-term benefits, as they were able to apply the tools they received during the training in their daily lives. Some barriers were noted, such as difficulty in getting away from work or problems with the employer, which prevented enrollment. Overall, the results of this evaluation support the use of MSC (mindful self-compassion) training among community workers. Future research could support this evaluation by using a rigorous design and developing innovative ways to overcome the barriers raised.

Keywords: mindful self-compassion, community workers, work stres, burnout, wellbeing at work

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606 Managing Sunflower Price Risk from a South African Oil Crushing Company’s Perspective

Authors: Daniel Mokatsanyane, Johnny Jansen Van Rensburg

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The integral role oil-crushing companies play in sunflower oil production is often overlooked to offer high-quality oil to refineries and end consumers. Sunflower oil crushing companies in South Africa are exposed to price fluctuations resulting from the local and international markets. Hedging instruments enable these companies to hedge themselves against unexpected prices spikes and to ensure sustained profitability. A crushing company is a necessary middleman, and as such, these companies have exposure to the purchasing and selling sides of sunflower. Sunflower oil crushing companies purchase sunflower seeds from farmers or agricultural companies that provide storage facilities. The purchasing price is determined by the supply and demand of sunflower seed, both national and international. When the price of sunflower seeds in South Africa is high but still below import parity, then the crush margins realised by these companies are reduced or even negative at times. There are three main products made by sunflower oil crushing companies, oil, meal, and shells. Profits are realised from selling three products, namely, sunflower oil, meal and shells. However, when selling sunflower oil to refineries, sunflower oil crushing companies needs to hedge themselves against a reduction in vegetable oil prices. Hedging oil prices is often done via futures and is subject to specific volume commitments before a hedge position can be taken in. Furthermore, South African oil-crushing companies hedge sunflower oil with international, Over-the-counter contracts as South Africa is a price taker of sunflower oil and not a price maker. As such, South Africa provides a fraction of the world’s sunflower oil supply and, therefore, has minimal influence on price changes. The advantage of hedging using futures ensures that the sunflower crushing company will know the profits they will realise, but the downside is that they can no longer benefit from a price increase. Alternative hedging instruments like options might pose a solution to the opportunity cost does not go missing and that profit margins are locked in at the best possible prices for the oil crushing company. This paper aims to investigate the possibility of employing options alongside futures to simulate different scenarios to determine if options can bridge the opportunity cost gap.

Keywords: derivatives, hedging, price risk, sunflower, sunflower oil, South Africa

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605 Tourism Development and Planning in Rwanda

Authors: Ntachobazi bosco

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Tourism Development and Planning in Rwanda: Rwanda, a small landlocked country located in the heart of Africa, has experienced significant growth in its tourism industry in recent years. The country’s stunning natural beauty, rich cultural heritage, and warm hospitality have made it an attractive destination for travelers from around the world. However, to ensure sustainable tourism development and planning, the Rwandan government has implemented various strategies and policies to promote responsible tourism practices. Infrastructure Development: To support the growth of the tourism industry, the Rwandan government has invested heavily in infrastructure development. This includes the construction of new hotels, resorts, and lodges, as well as the upgrading of existing facilities. The government has also improved the country’s transportation network, including the construction of new airports and the upgrading of existing ones. Conservation Efforts: Rwanda is home to several national parks and reserves, including the famous Volcanoes National Park, which is known for its mountain gorilla populations. To protect these natural wonders, the Rwandan government has implemented conservation efforts, such as the establishment of protected areas and the development of sustainable tourism practices. Community-Based Tourism: Community-based tourism is a key component of Rwanda’s tourism development strategy. The government has established several community-based tourism programs, which aim to involve local communities in the tourism industry and provide them with economic benefits. These programs include homestays, village tours, and cultural performances. Sustainable Tourism Practices: To promote sustainable tourism practices, the Rwandan government has implemented several initiatives, such as the use of eco-friendly accommodations and the promotion of responsible wildlife viewing practices. The government has also established the Rwanda Tourism Board, which is responsible for promoting and regulating the tourism industry. Challenges and Opportunities: Despite the growth of the tourism industry in Rwanda, several challenges need to be addressed, such as the lack of skilled labor and the need for more infrastructure development. However, there are also several opportunities for the industry, such as the potential for ecotourism and the growth of the meetings, incentives, conventions, and exhibitions (MICE) market.

Keywords: tourism, in rwanda, developent, in africa

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604 Computer Modeling and Plant-Wide Dynamic Simulation for Industrial Flare Minimization

Authors: Sujing Wang, Song Wang, Jian Zhang, Qiang Xu

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Flaring emissions during abnormal operating conditions such as plant start-ups, shut-downs, and upsets in chemical process industries (CPI) are usually significant. Flare minimization can help to save raw material and energy for CPI plants, and to improve local environmental sustainability. In this paper, a systematic methodology based on plant-wide dynamic simulation is presented for CPI plant flare minimizations under abnormal operating conditions. Since off-specification emission sources are inevitable during abnormal operating conditions, to significantly reduce flaring emission in a CPI plant, they must be either recycled to the upstream process for online reuse, or stored somewhere temporarily for future reprocessing, when the CPI plant manufacturing returns to stable operation. Thus, the off-spec products could be reused instead of being flared. This can be achieved through the identification of viable design and operational strategies during normal and abnormal operations through plant-wide dynamic scheduling, simulation, and optimization. The proposed study includes three stages of simulation works: (i) developing and validating a steady-state model of a CPI plant; (ii) transiting the obtained steady-state plant model to the dynamic modeling environment; and refining and validating the plant dynamic model; and (iii) developing flare minimization strategies for abnormal operating conditions of a CPI plant via a validated plant-wide dynamic model. This cost-effective methodology has two main merits: (i) employing large-scale dynamic modeling and simulations for industrial flare minimization, which involves various unit models for modeling hundreds of CPI plant facilities; (ii) dealing with critical abnormal operating conditions of CPI plants such as plant start-up and shut-down. Two virtual case studies on flare minimizations for start-up operation (over 50% of emission savings) and shut-down operation (over 70% of emission savings) of an ethylene plant have been employed to demonstrate the efficacy of the proposed study.

Keywords: flare minimization, large-scale modeling and simulation, plant shut-down, plant start-up

Procedia PDF Downloads 318
603 An Anthropometric Index Capable of Differentiating Morbid Obesity from Obesity and Metabolic Syndrome in Children

Authors: Mustafa Metin Donma

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Circumference measurements are important because they are easily obtained values for the identification of the weight gain without determining body fat. They may give meaningful information about the varying stages of obesity. Besides, some formulas may be derived from a number of body circumference measurements to estimate body fat. Waist (WC), hip (HC) and neck (NC) circumferences are currently the most frequently used measurements. The aim of this study was to develop a formula derived from these three anthropometric measurements, each giving a valuable information independently, to question whether their combined power within a formula was capable of being helpful for the differential diagnosis of morbid obesity without metabolic syndrome (MetS) from MetS. One hundred and eighty seven children were recruited from the pediatrics outpatient clinic of Tekirdag Namik Kemal University Faculty of Medicine. The parents of the participants were informed about asked to fill and sign the consent forms. The study was carried out according to the Helsinki Declaration. The study protocol was approved by the institutional non-interventional ethics committee. The study population was divided into four groups as normal-body mass index (N-BMI), obese (OB), morbid obese (MO) and MetS, which were composed of 35, 44, 75 and 33 children, respectively. Age- and gender-adjusted BMI percentile values were used for the classification of groups. The children in MetS group were selected based upon the nature of the MetS components described as MetS criteria. Anthropometric measurements, laboratory analysis and statistical evaluation confined to study population were performed. Body mass index values were calculated. A circumference index, advanced Donma circumference index (ADCI) was introduced as WC*HC/NC. The statistical significance degree was chosen as p value smaller than 0.05. Body mass index values were 17.7±2.8, 24.5±3.3, 28.8±5.7, 31.4±8.0 kg/m2, for N-BMI, OB, MO, MetS groups, respectively. The corresponding values for ADCI were 165±35, 240±42, 270±55, and 298±62. Significant differences were obtained between BMI values of N-BMI and OB, MO, MetS groups (p=0.001). Obese group BMI values also differed from MO group BMI values (p=0.001). However, the increase in MetS group compared to MO group was not significant (p=0.091). For the new index, significant differences were obtained between N-BMI and OB, MO, MetS groups (p=0.001). Obese group ADCI values also differed from MO group ADCI values (p=0.015). A significant difference between MO and MetS groups was detected (p=0.043). The correlation coefficient value and the significance check of the correlation was found between BMI and ADCI as r=0.0883 and p=0.001 upon consideration of all participants. In conclusion, in spite of the strong correlation between BMI and ADCI values obtained when all groups were considered, ADCI, but not BMI, was the index, which was capable of differentiating cases with morbid obesity from cases with morbid obesity and MetS.

Keywords: anthropometry, body mass index, child, circumference, metabolic syndrome, obesity

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602 The Development of Cultural Routes: The Case of Greece

Authors: Elissavet Kosta

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Introduction: In this research, we will propose the methodology, which is required for the planning of the cultural route in order to prepare substantiated proposals for the development and planning of cultural routes in Greece in the near future. Our research has started at 2016. Methodology in our research: Α combination of primary and secondary research will be used as project methodology. Furthermore, this study aims to follow a multidisciplinary approach, using dimensions of qualitative and quantitative data analysis models. Regarding the documentation of the theoretical part of the project, the method of secondary research will be mainly used, yet in combination with bibliographic sources. However, the data collection regarding the research topic will be conducted exclusively through primary research (questionnaires and interviews). Cultural Routes: The cultural route is defined as a brand name touristic product, that is a product of cultural tourism, which is shaped according to a specific connecting element. Given its potential, the cultural route is an important ‘tool’ for the management and development of cultural heritage. Currently, a constant development concerning the cultural routes is observed in an international level during the last decades, as it is widely accepted that cultural tourism has an important role in the world touristic industry. Cultural Routes in Greece: Especially for Greece, we believe, actions have not been taken to the systematic development of the cultural routes yet. The cultural routes that include Greece and have been design in a world scale as well as the cultural routes, which have been design in Greek ground up to this moment are initiations of the Council of Europe, World Tourism Organization UNWTO and ‘Diazoma’ association. Regarding the study of cultural routes in Greece as a multidimensional concept, the following concerns have arisen: Firstly, we are concerned about the general impact of cultural routes at local and national level and specifically in the economic sector. Moreover, we deal with the concerns regarding the natural environment and we delve into the educational aspect of cultural routes in Greece. In addition, the audience we aim at is both specific and broad and we put forward the institutional framework of the study. Finally, we conduct the development and planning of new cultural routes, having in mind the museums as both the starting and ending point of a route. Conclusion: The contribution of our work is twofold and lies firstly on the fact that we attempt to create cultural routes in Greece and secondly on the fact that an interdisciplinary approach is engaged towards realizing our study objective. In particular, our aim is to take advantage of all the ways in which the promotion of a cultural route can have a positive influence on the way of life of society. As a result, we intend to analyze how a cultural route can turn into a well-organized activity that can be used as social intervention to develop tourism, strengthen the economy and improve access to cultural goods in Greece during the economic crisis.

Keywords: cultural heritage, cultural routes, cultural tourism, Greece

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601 Urban Sustainable Development with Flood Crisis Management Approach

Authors: Ali Liaghat, Navid Tavanpour, Nima Tavanpour

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An increase in population and prevalence of urbanity have led plan makers and decision makers put effort into sustainable development of cities at national and local levels. One of the important issues in urban development is compliance with safety issues in cities. Despite natural disasters and unexpected events such as floods, earthquakes, hurricanes, fires, etc., urban development should be regarded as an axiom, or else any form of construction and development is not safe, because it will greatly harm economic growth and development and pose an obstacle to achieving sustainable development, plus a loss to lives and finances of people. Therefore, in line with urban development, it is necessary to identify particular environmental and local issues as determinants and pay attention to them at the top of everything, in that we can call it a good action and factor in urban sustainable developments. Physical structure of each city represents how it has developed or its development shaped and what incidents, changes, natural disasters it has undergone over time. Since any form of development plan should be in accordance with the previous situations of cities, disregarding it, unfortunately, can escalate into uncontrolled urban development, non-resistant and unstable construction against earthquake or invasion of river areas, destruction of agricultural lands or vegetation, periodic floods over time. It has been viewed as serious threats to developing cities, and typically caused destruction of bed and other urban facilities as well as damages to lives and finances. In addition, uncontrolled development has caused cities to look ugly in terms of urban façade, and off and on such unplanned measures caused the country to face countless losses, and it not only vitiates expenses incurred, but it will also impose additional costs of reconstruction, i.e. it is unsustainable development. Thus, in this paper, in addition to a discussion about necessity for a profound attitude toward this subject and making long-term plans, programs for organizing river and its surrounding area, creating open and green urban spaces, retrofitting and flood preventing are presented for sustainable safety and development of cities along with a critique of successful countries.

Keywords: flood, sustainable development, urbanisation, urban management

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600 Case Study: Institutionalization of CSR Activities of MRGC through an NGO (OSDI)

Authors: Aasim Siddiqui

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In a country where 45.6 per cent of the total population lives below the poverty line, according to the Human Development Report 2014 by UNDP, an increasing number of private companies are now dedicating their resources to remedy this situation of chronic poverty. Most corporations in Pakistan now have a separate and dedicated department for Corporate Social Responsibility (CSR), albeit with varying goals and hence different strategies for achieving those goals. Similarly, Marine Group of Companies (MRGC) also has a robust CSR policy which the group implements through a Non-Government Organization (NGO) called Organization for Social Development Initiatives (OSDI). This organization, which operates under the ambit of MRGC’s CSR division, has a concentrated focus on helping the poorest communities in the rural areas of Pakistan to break out of intergenerational poverty. This paper maps the theoretical strategies as well as practical activities undertaken by OSDI for poverty alleviation via rural development in Pakistan. To obtain in-depth information of demographics, livelihood and socio-economic indicators in OSDI’s focused districts; a combination of quantitative and qualitative research methodologies was used during the course of this research. The paper highlights and explains OSDI’s unique three-pronged approach which aims at reducing poverty through income generation via the livelihood assistance program and through the provision of access to the most basic services (including health and education) via the community development and food security programs. Modeled on the concept of capacity building, OSDI’s modus operandi is centered on disbursing timely microcredit facilities to farmers who can benefit from these funds by investing in productive assets to foster financial capability for the future. With a focus on increasing the income of poor farmers, OSDI’s approach is to integrate all the socio-economic facets: education, health and sanitation and food security, to induce a sustained positive impact on their living standards.

Keywords: CSR, poverty, rural, sustainability

Procedia PDF Downloads 246
599 Role of Imaging in Alzheimer's Disease Trials: Impact on Trial Planning, Patient Recruitment and Retention

Authors: Kohkan Shamsi

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Background: MRI and PET are now extensively utilized in Alzheimer's disease (AD) trials for patient eligibility, efficacy assessment, and safety evaluations but including imaging in AD trials impacts site selection process, patient recruitment, and patient retention. Methods: PET/MRI are performed at baseline and at multiple follow-up timepoints. This requires prospective site imaging qualification, evaluation of phantom data, training and continuous monitoring of machines for acquisition of standardized and consistent data. This also requires prospective patient/caregiver training as patients must go to multiple facilities for imaging examinations. We will share our experience form one of the largest AD programs. Lesson learned: Many neurological diseases have a similar presentation as AD or could confound the assessment of drug therapy. The inclusion of wrong patients has ethical and legal issues, and data could be excluded from the analysis. Centralized eligibility evaluation read process will be discussed. Amyloid related imaging abnormalities (ARIA) were observed in amyloid-β trials. FDA recommended regular monitoring of ARIA. Our experience in ARIA evaluations in large phase III study at > 350 sites will be presented. Efficacy evaluation: MRI is utilized to evaluate various volumes of the brain. FDG PET or amyloid PET agents has been used in AD trials. We will share our experience about site and central independent reads. Imaging logistic issues that need to be handled in the planning phase will also be discussed as it can impact patient compliance thereby increasing missing data and affecting study results. Conclusion: imaging must be prospectively planned to include standardizing imaging methodologies, site selection process and selecting assessment criteria. Training should be transparently conducted and documented. Prospective patient/caregiver awareness of imaging requirement is essential for patient compliance and reduction in missing imaging data.

Keywords: Alzheimer's disease, ARIA, MRI, PET, patient recruitment, retention

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598 The Impact of Coronal STIR Imaging in Routine Lumbar MRI: Uncovering Hidden Causes to Enhanced Diagnostic Yield of Back Pain and Sciatica

Authors: Maysoon Nasser Samhan, Somaya Alkiswani, Abdullah Alzibdeh

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Background: Routine lumbar MRIs for back pain may yield normal results despite persistent symptoms, which means the possibility of other causes for this pain, which was not shown on the routine images. Research suggests including coronal STIR imaging to detect additional pathologies like sacroiliitis. Objectives: This study aims to enhance diagnostic accuracy and aid in determining treatment processes for patients with persistent back pain who have normal routine lumbar MRI (T1 and T2 images) by incorporating coronal STIR into the examination. Methods: A prospectively conducted study involving 274 patients, 115 males and 159 females, with an age range of 6–92 years, reviewed their medical records and imaging data following a lumbar spine MRI. This study included patients with back pain and sciatica as their primary complaints, all of whom underwent lumbar spine MRIs at our hospital to identify potential pathologies. Using a GE Signa HD 1.5T MRI System, each patient received a standard MRI protocol that included T1 and T2 sagittal and axial sequences, as well as a coronal STIR sequence. We collected relevant MRI findings, including abnormalities and structural variations, from radiology reports. We classified these findings into tables and documented them as counts and percentages, using Fisher’s exact test to assess differences between categorical variables. We conducted a statistical analysis using Prism GraphPad software version 10.1.2. The study adhered to ethical guidelines, institutional review board approvals, and patient confidentiality regulations. Results: Exclusion of the coronal STIR sequence led to 83 subjects (30.29%) being classified as within normal limits on MRI examination. 36 patients without abnormalities on T1 and T2 sequences showed abnormalities on the coronal STIR sequence, with 26 cases attributed to spinal pathologies and 10 to non-spinal pathologies. In addition to that, Fisher's exact test demonstrated a significant association between sacroiliitis diagnosis and abnormalities identified solely through the coronal STIR sequence (P < 0.0001). Conclusion: Implementing coronal STIR imaging as part of routine lumbar MRI protocols has the potential to improve patient care by facilitating a more comprehensive evaluation and management of persistent back pain.

Keywords: magnetic resonance imaging, lumber MRI, radiology, neurology

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597 Therapeutic Nihilism: Challenging Aging Diseases in Cameroon

Authors: Chick Loveline Ayoh Epse Ndi

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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.

Keywords: challeng, therapy, agtng, diseases cameroon

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596 Map UI Design of IoT Application Based on Passenger Evacuation Behaviors in Underground Station

Authors: Meng-Cong Zheng

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When the public space is in an emergency, how to quickly establish spatial cognition and emergency shelter in the closed underground space is the urgent task. This study takes Taipei Station as the research base and aims to apply the use of Internet of things (IoT) application for underground evacuation mobility design. The first experiment identified passengers' evacuation behaviors and spatial cognition in underground spaces by wayfinding tasks and thinking aloud, then defined the design conditions of User Interface (UI) and proposed the UI design.  The second experiment evaluated the UI design based on passengers' evacuation behaviors by wayfinding tasks and think aloud again as same as the first experiment. The first experiment found that the design conditions that the subjects were most concerned about were "map" and hoping to learn the relative position of themselves with other landmarks by the map and watch the overall route. "Position" needs to be accurately labeled to determine the location in underground space. Each step of the escape instructions should be presented clearly in "navigation bar." The "message bar" should be informed of the next or final target exit. In the second experiment with the UI design, we found that the "spatial map" distinguishing between walking and non-walking areas with shades of color is useful. The addition of 2.5D maps of the UI design increased the user's perception of space. Amending the color of the corner diagram in the "escape route" also reduces the confusion between the symbol and other diagrams. The larger volume of toilets and elevators can be a judgment of users' relative location in "Hardware facilities." Fire extinguisher icon should be highlighted. "Fire point tips" of the UI design indicated fire with a graphical fireball can convey precise information to the escaped person. "Fire point tips" of the UI design indicated fire with a graphical fireball can convey precise information to the escaped person. However, "Compass and return to present location" are less used in underground space.

Keywords: evacuation behaviors, IoT application, map UI design, underground station

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595 Ethno-Botanical Diversity and Conservation Status of Medicinal Flora at High Terrains of Garhwal (Uttarakhand) Himalaya, India: A Case Study in Context to Multifarious Tourism Growth and Peri-Urban Encroachments

Authors: Aravind Kumar

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The high terrains of Garhwal (Uttarakhand) Himalaya are the niches of a number of rare and endemic plant species of great therapeutic importance. However, the wild flora of the area is still under a constant threat due to rapid upsurge in human interferences, especially through multifarious tourism growth and peri-urban encroachments. After getting the status of a ‘Special State’ of the country since its inception in the year 2000, this newly borne State led to very rapid infrastructural growth and development. Consequently, its townships started expanding in an unmanaged way grabbing nearby agricultural lands and forest areas into peri-urban landscapes. Simultaneously, a boom in tourism and pilgrimage in the state and the infrastructural facilities raised by the government for tourists/pilgrims are destroying its biodiversity. Field survey revealed 242 plant species of therapeutic significance naturally growing in the area and being utilized by local inhabitants as traditional medicines. On conservation scale, 6 species (2.2%) were identified as critically endangered, 19 species (7.1%) as the endangered ones, 8 species (3.0%) under rare category, 17 species (6.4%) as threatened and 14 species (5.2%) as vulnerable. The Government of India has brought mega-biodiversity hot spots of the state under Biosphere Reserve, National Parks, etc. restricting all kinds of human interferences; however, the two most sacred shrines of Hindus and Sikhs viz. Shri Badrinath and Shri Hemkunt Sahib, and two great touristic attractions viz. Valley of Flowers and Auli-Joshimath Skiing Track oblige the government to maintain equilibrium between entries of visitors vis-à-vis biodiversity conservation in high terrains of Uttarakhand Himalaya.

Keywords: biodiversity conservation, ethno-botany, Garhwal (Uttarakhand) Himalaya, peri-urban encroachment, pilgrimage and tourism

Procedia PDF Downloads 224