Search results for: experimental study
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 53093

Search results for: experimental study

30953 Changing Roles for Academic Leaders: A Comparative Study between Sweden and South Africa

Authors: Åse Nygren, Linda du Plessis

Abstract:

Academic leadership has traditionally been associated with collegiality, consensus and a limitation in time. These factors alone have resulted in a complex and fuzzy leadership culture in academia, combined with a strong sense of autonomy among researchers and teachers. A more competitive educational market have resulted in increased audit as well as recent autonomy reforms with higher demands on effectiveness, cost awareness and accountability in higher education. In recent years, with the introduction of new public management, academic leadership has been in a state of transition moving from collegiality towards manergerialism. University reforms and changes, which have gradually taken place in most western countries in the past decade, including Sweden and South-Africa, have contributed to the notion that collegial academic leadership is questioned. Academic leadership is traditionally associated with vice-chancellors, deans and heads of departments. This paper will focus on “outer circle” of academic leaders, consisting of, for example, program directors, directors of disciplines, course coordinators and research leaders. We investigate the meaning of collegiality for these groups of academic leaders in Sweden and South-Africa. The paper rests on a comparative study made on universities both in Sweden and in South-Africa. The aim of the comparison is to achieve a wider scope and to investigate perspectives from both inside and outside of Bologna.

Keywords: academic leadership, new public management, collegiality, consensus

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30952 Meteorological Risk Assessment for Ships with Fuzzy Logic Designer

Authors: Ismail Karaca, Ridvan Saracoglu, Omer Soner

Abstract:

Fuzzy Logic, an advanced method to support decision-making, is used by various scientists in many disciplines. Fuzzy programming is a product of fuzzy logic, fuzzy rules, and implication. In marine science, fuzzy programming for ships is dramatically increasing together with autonomous ship studies. In this paper, a program to support the decision-making process for ship navigation has been designed. The program is produced in fuzzy logic and rules, by taking the marine accidents and expert opinions into account. After the program was designed, the program was tested by 46 ship accidents reported by the Transportation Safety Investigation Center of Turkey. Wind speed, sea condition, visibility, day/night ratio have been used as input data. They have been converted into a risk factor within the Fuzzy Logic Designer application and fuzzy rules set by marine experts. Finally, the expert's meteorological risk factor for each accident is compared with the program's risk factor, and the error rate was calculated. The main objective of this study is to improve the navigational safety of ships, by using the advance decision support model. According to the study result, fuzzy programming is a robust model that supports safe navigation.

Keywords: calculation of risk factor, fuzzy logic, fuzzy programming for ship, safety navigation of ships

Procedia PDF Downloads 189
30951 Prevalence of Methylenetetrahydrofolate Reductase A1298C Variant in Tunisian Childhood Acute Lymphoblastic Leukemia

Authors: Rim Frikha, Maha Ben Jema, Moez Elloumi, Tarek Rebai

Abstract:

Background: Acute lymphoblastic leukemia (ALL); a common blood cancer characterized by the interaction between genetic and environmental factors. Methylenetetrahydrofolate reductase (MTHFR) is an essential folate metabolic enzyme in the processes of DNA synthesis and methylation. A common functional variant of the MTHFR gene, the A1298C, which induces disturbances in folate metabolism, may affect susceptibility to ALL. Objective: The present study aimed to assess the prevalence of MTHFR polymorphism A1298 > C in Tunisian children with ALL. Materials and Methods: A total of 28 Tunisian ALL children were enrolled in this study. Genomic DNA was extracted from whole venous blood collected in ethylenediaminetetraacetic acid (EDTA). Genotyping was carried out with restriction fragment length polymorphism (RFLP) using MboII restriction enzyme. Genotype distribution and allele frequency of MTHFR A1298C was calculated in ALL patients. Results: The A1298C variant of MTHFR was found in 11(19.6%) heterozygous and one homozygous patient (3.5%). Conclusions: This result highlights that A1298C polymorphism of MTHFR is common in Tunisian childhood ALL and suggests that this variant may have a potential role in leukemogenesis. Genotyping of large samples and different ethnicities are required to validate these findings.

Keywords: methylenetetrahydrofolate reductase, acute lymphoblastic leukemia, A1298C variant, prevalence

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30950 Thermal Performance of Fully Immersed Naturally Cooled Server

Authors: Yaser Al-Anii, Abdulmajeed Almaneea, Jonathan L. Summers, Harvey M. Thompson, Nikil Kapur

Abstract:

The natural convection cooling system of a fully immersed server in a dielectric liquid is studied numerically. In the present case study, the dielectric liquid represents working fluid and it is in contact with server inside capsule. The capsule includes electronic component and fluid which can be modeled as saturated porous media. This medium follow Darcy flow regime and assumed to be in balance between its components. The study focus is on role of spatial parameters on thermal behavior of convective heat transfer. Based on server known unit, which is 1U, two parameters Ly and S are changed to test their effect. Meanwhile, wide-range of modified Rayleigh number, which is 0.5 to 300, are covered to better understand thermal performance. Navier-Stokes equations are used to model physical domain. Furthermore, successive over-relaxation and time marching techniques are used to solve momentum and energy equation. From obtained correlation, the in-between distance S is more effective on Nusselt number than distance to edge Ly by approximately 14%. In addition, as S increases, the average Nusselt number of the upper unit increases sharply, whereas the lower one keeps on the same level.

Keywords: convective cooling of server, Darcy flow, liquid-immersed server, porous media

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30949 Prevalence and Characteristics of Consumption of Nutraceuticals: The Case Study of Undergraduate Students of Medellin- Colombia, 2013

Authors: Gloria Inés Martínez Domínguez, Lina María Martínez Sánchez, María de los Ángeles Rodríguez Gázquez, Juan Guillermo Jiménez Jiménez, Johan Sebastián Lopera Valle, Natalia Vargas Grisales, Sara Rojas Jiménez, Alejandra Uribe Ocampo, Sara Correa Pérez, Natalia Perilla Hernández, Juan Sebastián Marín Cárdenas

Abstract:

The relationship between diet and chronic or degenerative diseases has led to the development of functional foods such as nutraceuticals. Objective: To determine the prevalence and characteristics of consumption of nutraceuticals in undergraduate students. Methodology: Cross-sectional study. It was a simple random sampling with the Statcalc EpiInfo software vr 6.04. It was designed an instrument for collection of demographic data and consumption of nutraceuticals. Statistical analysis used the SPSS program. Results: 427 students, average age 20.8 years (SD 3.1), 56.1% were women. The life prevalence of nutraceuticals consumption was 66.3% and the annual 51.8%. The main reasons for consumption were as food complement 32.8% and prevent diseases 20.1%. Conclusion: The high prevalence of nutraceuticals observed is comparable to that reported in the literature, which suggests an increasing trend in the habit of consumption of dietary supplement which have a preventive or protective effect on health.

Keywords: dietary supplements, food, health, functional food, Colombia

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30948 Efficacy of Botulinum Toxin in Alleviating Pain Syndrome in Stroke Patients with Upper Limb Spasticity

Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

Abstract:

Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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30947 Effect of Perceived Importance of a Task in the Prospective Memory Task

Authors: Kazushige Wada, Mayuko Ueda

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In the present study, we reanalyzed lapse errors in the last phase of a job, by re-counting near lapse errors and increasing the number of participants. We also examined the results of this study from the perspective of prospective memory (PM), which concerns future actions. This study was designed to investigate whether perceiving the importance of PM tasks caused lapse errors in the last phase of a job and to determine if such errors could be explained from the perspective of PM processing. Participants (N = 34) conducted a computerized clicking task, in which they clicked on 10 figures that they had learned in advance in 8 blocks of 10 trials. Participants were requested to click the check box in the start display of a block and to click the checking off box in the finishing display. This task was a PM task. As a measure of PM performance, we counted the number of omission errors caused by forgetting to check off in the finishing display, which was defined as a lapse error. The perceived importance was manipulated by different instructions. Half the participants in the highly important task condition were instructed that checking off was very important, because equipment would be overloaded if it were not done. The other half in the not important task condition was instructed only about the location and procedure for checking off. Furthermore, we controlled workload and the emotion of surprise to confirm the effect of demand capacity and attention. To manipulate emotions during the clicking task, we suddenly presented a photo of a traffic accident and the sound of a skidding car followed by an explosion. Workload was manipulated by requesting participants to press the 0 key in response to a beep. Results indicated too few forgetting induced lapse errors to be analyzed. However, there was a weak main effect of the perceived importance of the check task, in which the mouse moved to the “END” button before moving to the check box in the finishing display. Especially, the highly important task group showed more such near lapse errors, than the not important task group. Neither surprise, nor workload affected the occurrence of near lapse errors. These results imply that high perceived importance of PM tasks impair task performance. On the basis of the multiprocess framework of PM theory, we have suggested that PM task performance in this experiment relied not on monitoring PM tasks, but on spontaneous retrieving.

Keywords: prospective memory, perceived importance, lapse errors, multi process framework of prospective memory.

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30946 Assessment of the Growth Enhancement Support Scheme in Adamawa State, Nigeria

Authors: Oto J. Okwu, Ornan Henry, Victor A. Otene

Abstract:

The agricultural sector contributes a great deal to the sustenance of Nigeria’s food security and economy, with an attendant impact on rural development. In spite of the relatively high number of farmers in the country, self-sufficiency in food production is still a challenge. Farmers are faced with myriad problems which hinder their production efficiency, one of which is their access to agricultural inputs required for optimum production. To meet the challenges faced by farmers, the government at the federal level has come up with many agricultural policies, one of which is the Agricultural Transformation Agenda (ATA). The Growth Enhancement Support Scheme (GESS) is one of the critical components of ATA, which is aimed at ensuring the effective distribution of agricultural inputs delivered directly to farmers, and at a regulated cost. After about 8 years of launching this policy, it will be necessary to carry out an assessment of GESS and determine the impact it has made on rural farmers with respect to their access to farm inputs. This study was carried out to assess the Growth Enhancement Support Scheme (GESS) in Adamawa State, Nigeria. Crop farmers who registered under the GESS in Adamawa State, Nigeria, formed the population for the study. Primary data for the study were obtained through a survey, and the use of a structured questionnaire. A sample size of 167 respondents was selected using multi-stage, purposive, and random sampling techniques. The validity and reliability of the research instrument (questionnaire) were obtained through pilot testing and test-retest method, respectively. The objectives of the study were to determine the difference in the level of access to agricultural inputs before and after GESS, determine the difference in cost of agricultural inputs before and after GESS, and to determine the challenges faced by rural farmers in accessing agricultural inputs through GESS. Both descriptive and inferential statistics were used in analyzing the collected data. Specifically, Mann-Whitney, student t-test, and factor analysis were used to test the stated hypotheses. Research findings revealed there was a significant difference in the level of access to farm inputs after the introduction of GESS (Z=14.216). Also, there was a significant difference in the cost of agro-inputs after the introduction of GESS (Pr |T| > |t|= 0.0000). The challenges faced by respondents in accessing agro-inputs through GESS were administrative and technical in nature. Based on the findings of the research, it was recommended that efforts be made by the government to sustain the GESS, as it has significantly improved the level of farmers’ access to agricultural inputs and has reduced the cost of agro-inputs, while administrative challenges faced by the respondents in accessing inputs be addressed by the government, and extension agents assist the farmers to overcome the technical challenges they face in accessing inputs.

Keywords: agricultural policy, agro-inputs, assessment, growth enhancement support scheme, rural farmers

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30945 Genetic Diversity of Norovirus Strains in Outpatient Children from Rural Communities of Vhembe District, South Africa, 2014-2015

Authors: Jean Pierre Kabue, Emma Meader, Afsatou Ndama Traore, Paul R. Hunter, Natasha Potgieter

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Norovirus is now considered the most common cause of outbreaks of nonbacterial gastroenteritis. Limited data are available for Norovirus strains in Africa, especially in rural and peri-urban areas. Despite the excessive burden of diarrhea disease in developing countries, Norovirus infections have been to date mostly reported in developed countries. There is a need to investigate intensively the role of viral agents associated with diarrhea in different settings in Africa continent. To determine the prevalence and genetic diversity of Norovirus strains circulating in the rural communities in the Limpopo Province, South Africa and investigate the genetic relationship between Norovirus strains, a cross-sectional study was performed on human stools collected from rural communities. Between July 2014 and April 2015, outpatient children under 5 years of age from rural communities of Vhembe District, South Africa, were recorded for the study. A total of 303 stool specimens were collected from those with diarrhea (n=253) and without (n=50) diarrhea. NoVs were identified using real-time one-step RT-PCR. Partial Sequence analyses were performed to genotype the strains. Phylogenetic analyses were performed to compare identified NoVs genotypes to the worldwide circulating strains. Norovirus detection rate was 41.1% (104/253) in children with diarrhea. There was no significant difference (OR=1.24; 95% CI 0.66-2.33) in Norovirus detection between symptomatic and asymptomatic children. Comparison of the median CT values for NoV in children with diarrhea and without diarrhea revealed significant statistical difference of estimated GII viral load from both groups, with a much higher viral burden in children with diarrhea. To our knowledge, this is the first study reporting on the differences in estimated viral load of GII and GI NoV positive cases and controls. GII.Pe (n=9) were the predominant genotypes followed by GII.Pe/GII.4 Sydney 2012 (n=8) suspected recombinant and GII.4 Sydney 2012 variants(n=7). Two unassigned GII.4 variants and an unusual RdRp genotype GII.P15 were found. With note, the rare GIIP15 identified in this study has a common ancestor with GIIP15 strain from Japan previously reported as GII/untypeable recombinant strain implicated in a gastroenteritis outbreak. To our knowledge, this is the first report of this unusual genotype in the African continent. Though not confirmed predictive of diarrhea disease in this study, the high detection rate of NoV is an indication of subsequent exposure of children from rural communities to enteric pathogens due to poor sanitation and hygiene practices. The results reveal that the difference between asymptomatic and symptomatic children with NoV may possibly be related to the NoV genogroups involved. The findings emphasize NoV genetic diversity and predominance of GII.Pe/GII.4 Sydney 2012, indicative of increased NoV activity. An uncommon GII.P15 and two unassigned GII.4 variants were also identified from rural settings of the Vhembe District/South Africa. NoV surveillance is required to help to inform investigations into NoV evolution, and to support vaccine development programmes in Africa.

Keywords: asymptomatic, common, outpatients, norovirus genetic diversity, sporadic gastroenteritis, South African rural communities, symptomatic

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30944 Sensitivity and Uncertainty Analysis of Hydrocarbon-In-Place in Sandstone Reservoir Modeling: A Case Study

Authors: Nejoud Alostad, Anup Bora, Prashant Dhote

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Kuwait Oil Company (KOC) has been producing from its major reservoirs that are well defined and highly productive and of superior reservoir quality. These reservoirs are maturing and priority is shifting towards difficult reservoir to meet future production requirements. This paper discusses the results of the detailed integrated study for one of the satellite complex field discovered in the early 1960s. Following acquisition of new 3D seismic data in 1998 and re-processing work in the year 2006, an integrated G&G study was undertaken to review Lower Cretaceous prospectivity of this reservoir. Nine wells have been drilled in the area, till date with only three wells showing hydrocarbons in two formations. The average oil density is around 300API (American Petroleum Institute), and average porosity and water saturation of the reservoir is about 23% and 26%, respectively. The area is dissected by a number of NW-SE trending faults. Structurally, the area consists of horsts and grabens bounded by these faults and hence compartmentalized. The Wara/Burgan formation consists of discrete, dirty sands with clean channel sand complexes. There is a dramatic change in Upper Wara distributary channel facies, and reservoir quality of Wara and Burgan section varies with change of facies over the area. So predicting reservoir facies and its quality out of sparse well data is a major challenge for delineating the prospective area. To characterize the reservoir of Wara/Burgan formation, an integrated workflow involving seismic, well, petro-physical, reservoir and production engineering data has been used. Porosity and water saturation models are prepared and analyzed to predict reservoir quality of Wara and Burgan 3rd sand upper reservoirs. Subsequently, boundary conditions are defined for reservoir and non-reservoir facies by integrating facies, porosity and water saturation. Based on the detailed analyses of volumetric parameters, potential volumes of stock-tank oil initially in place (STOIIP) and gas initially in place (GIIP) were documented after running several probablistic sensitivity analysis using Montecalro simulation method. Sensitivity analysis on probabilistic models of reservoir horizons, petro-physical properties, and oil-water contacts and their effect on reserve clearly shows some alteration in the reservoir geometry. All these parameters have significant effect on the oil in place. This study has helped to identify uncertainty and risks of this prospect particularly and company is planning to develop this area with drilling of new wells.

Keywords: original oil-in-place, sensitivity, uncertainty, sandstone, reservoir modeling, Monte-Carlo simulation

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30943 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

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Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

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30942 Gammarus: Asellus Ratio as an Index of Organic Pollution: A Case Study in Markeaton, Kedleston Hall, and Allestree Park Lakes Derby, UK

Authors: Usman Bawa

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Macro-invertebrates have been used to monitor organic pollution in rivers and streams. Several biotic indices based on macro-invertebrates have been developed over the years including the Biological Monitoring Working Party (BMWP). A new biotic index, the Gammarus:Asellus ratio has been recently proposed as an index of organic pollution. This study tested the validity of the Gammarus:Asellus ratio as an index of organic pollution, by examining the relationship between the Gammarus:Asellus ratio and physical-chemical parameters, and other biotic indices such as BMWP and, Average Score Per Taxon (ASPT) from lakes and streams at Markeaton Park, Allestree Park, and Kedleston Hall, Derbyshire. Macro invertebrates were sampled using the standard five-minute kick sampling techniques physical and chemical environmental variables were obtained based on standard sampling techniques. Eighteen sites were sampled, six sites from Markeaton Park (three sites across the stream and three sites across the lake). Six sites each were also sampled from Allestree Park and Kedleston Hall lakes. The Gammarus:Asellus ratio showed an opposite significant positive correlations with parameters indicative of organic pollution such as the level of nitrates, phosphates, and calcium and also revealed a negatively significant correlations with other biotic indices (BMWP/ASPT). The BMWP score correlated positively significantly with some water quality parameters such as dissolved oxygen and flow rate, but revealed no correlations with other chemical environmental variables. The BMWP score was significantly higher in the stream than the lake in Markeaton Park, also The ASPT scores appear to be significantly higher in the upper Lakes than the middle and lower lakes. This study has further strengthened the use of BMWP/ASPT score as an index of organic pollution. But, additional application is required to validate the use of Gammarus:Asellus as a rapid bio monitoring tool.

Keywords: Asellus, biotic index, Gammarus, macro invertebrates, organic pollution

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30941 Signal Processing of Barkhausen Noise Signal for Assessment of Increasing Down Feed in Surface Ground Components with Poor Micro-Magnetic Response

Authors: Tanmaya Kumar Dash, Tarun Karamshetty, Soumitra Paul

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The Barkhausen Noise Analysis (BNA) technique has been utilized to assess surface integrity of steels. But the BNA technique is not very successful in evaluating surface integrity of ground steels that exhibit poor micro-magnetic response. A new approach has been proposed for the processing of BN signal with Fast Fourier transforms while Wavelet transforms has been used to remove noise from the BN signal, with judicious choice of the ‘threshold’ value, when the micro-magnetic response of the work material is poor. In the present study, the effect of down feed induced upon conventional plunge surface grinding of hardened bearing steel has been investigated along with an ultrasonically cleaned, wet polished and a sample ground with spark out technique for benchmarking. Moreover, the FFT analysis has been established, at different sets of applied voltages and applied frequency and the pattern of the BN signal in the frequency domain is analyzed. The study also depicts the wavelet transforms technique with different levels of decomposition and different mother wavelets, which has been used to reduce the noise value in BN signal of materials with poor micro-magnetic response, in order to standardize the procedure for all BN signals depending on the frequency of the applied voltage.

Keywords: barkhausen noise analysis, grinding, magnetic properties, signal processing, micro-magnetic response

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30940 Management Support, Role Ambiguity and Role Ambiguity among Professional Nurses at National Health Insurance Pilot Sites in South Africa: An Interpretive Phenomenology

Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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30939 Toxic Heavy Metal Accumulation by Algerian Malva sylvestris L. Depending on Location Variation

Authors: Souhila Terfi, Fatma Hassaine-Sadi

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In the present study, wet digestion with HCl and HNO3 mixture was used to extract the heavy metals (copper (Cu), chromium (Cr), zinc (Zn), lead (Pb) and cadmium (Cd)) from the leaves, the stems and the roots of Malva sylvestris L., which were subsequently analyzed by AAS. The samples (soil and parts of species) were collected from different sites: the industrial area (IA) (Rouiba), the rubbish dump area (RDA) (Boudouaou), the residential area (RA) with large open fields and construction activities (Blida), the Montaigne area (MA) (Chrea) and the high plateau area (HPA) (Berouaguia). The study showed differences in metal concentrations according to the analysed parts and the different sampling locations. In the contaminated site of the industrial area (IA), high content of the toxic heavy metals (Cd: 3.18 µg/g DW and Pb: 34.48 µg/g DW) were found in the leaves of Malva sylvestris L. This finding suggests that the consumers of this species could be exposed to a risk associated with this higher level of these toxic metals. It was found that Malva sylvestris L. is rich by Zn and Cu in some sites, which are considered to be the essential elements for the human health. The obtained results with the control site (Montaigne area) suggest that this species can be applicable in both the health and food, feasible alternatives as medicinal plant without any risk.

Keywords: Malva sylvestris L., toxic heavy metal, medicinal plant, impact on human health

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30938 A Corpus-Based Diachronic Study on Indefinite Pronominal Anaphora in English

Authors: Qiong Hu

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From old English to modern English, the gender category has changed from grammatical gender system to natural gender system. The word classes that reflected gender has changed from pronouns, adjectives, and numerals in old English to only pronouns in modern English. In present-day English, the third person singular pronouns are the only paradigm that keeps an intact gender. 'He' and 'they' used as epicene pronouns are one of the two commonest phenomena of gender disagreement (the other being those against the natural gender). Considering the convenience of corpus concordance, epicene pronoun usage is selected in this study in which the anaphors are restricted to possessives (eg. his, their), and the antecedents are restricted to compound indefinite pronouns (eg. someone, somebody). Factors like writing form (eg. someone vs. some one), the semantics of the prefixes (eg. some- vs. any-), and suffixes (eg. -one vs. -body), as well as frequency, are taken into consideration. Statistics indicate that 'their' is increasingly used as the epicene pronoun compared with the decline of 'his' (when both writing forms are considered). This is influenced by social factors such as feminist movement, as well as the semantics and frequency of antecedents. Their (plural) used in anaphoric reference to various indefinite pronouns (singular in form) can also be treated as number variation in third person pronouns, and the trend that 'their' in place of his can also be treated as a change in number category. Among different candidates for the gender-neutral function, 'their' is proven to be the most promising one based on the diachronic data. This does not reject any new competitors in the future which still remains to be seen.

Keywords: language variation and change, epicene pronouns, gender, number

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30937 Optimum Locations for Intercity Bus Terminals with the AHP Approach: Case Study of the City of Esfahan

Authors: Mehrdad Arabi, Ehsan Beheshtitabar, Bahador Ghadirifaraz, Behrooz Forjanizadeh

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Interaction between human, location and activity defines space. In the framework of these relations, space is a container for current specifications in relations of the 3 mentioned elements. The change of land utility considered with average performance range, urban regulations, society requirements etc. will provide welfare and comfort for citizens. From an engineering view it is fundamental that choosing a proper location for a specific civil activity requires evaluation of locations from different perspectives. The debate of desirable establishment of municipal service elements in urban regions is one of the most important issues related to urban planning. In this paper, the research type is applicable based on goal, and is descriptive and analytical based on nature. Initially existing terminals in Esfahan are surveyed and then new locations are presented based on evaluated criteria. In order to evaluate terminals based on the considered factors, an AHP model is used at first to estimate weight of different factors and then existing and suggested locations are evaluated using Arc GIS software and AHP model results. The results show that existing bus terminals are located in fairly proper locations. Further results of this study suggest new locations to establish terminals based on urban criteria.

Keywords: Arc GIS, Esfahan city, optimum locations, terminals

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30936 Assessing the Impact of Frailty in Elderly Patients Undergoing Emergency Laparotomies in Singapore

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

Abstract:

Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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30935 Lifelong Learning in Applied Fields (LLAF) Tempus Funded Project: A Case Study of Problem-Based Learning

Authors: Nirit Raichel, Dorit Alt

Abstract:

Although university teaching is claimed to have a special task to support students in adopting ways of thinking and producing new knowledge anchored in scientific inquiry practices, it is argued that students' habits of learning are still overwhelmingly skewed toward passive acquisition of knowledge from authority sources rather than from collaborative inquiry activities. In order to overcome this critical inadequacy between current educational goals and instructional methods, the LLAF consortium is aimed at developing updated instructional practices that put a premium on adaptability to the emerging requirements of present society. LLAF has created a practical guide for teachers containing updated pedagogical strategies based on the constructivist approach for learning, arranged along Delors’ four theoretical ‘pillars’ of education: Learning to know, learning to do, learning to live together, and learning to be. This presentation will be limited to problem-based learning (PBL), as a strategy introduced in the second pillar. PBL leads not only to the acquisition of technical skills, but also allows the development of skills like problem analysis and solving, critical thinking, cooperation and teamwork, decision- making and self-regulation that can be transferred to other contexts. This educational strategy will be exemplified by a case study conducted in the pre-piloting stage of the project. The case describes a three-fold process implemented in a postgraduate course for in-service teachers, including: (1) learning about PBL (2) implementing PBL in the participants' classes, and (3) qualitatively assessing the contributions of PBL to students' outcomes. An example will be given regarding the ways by which PBL was applied and assessed in civic education for high-school students. Two 9th-grade classes have participated the study; both included several students with learning disability. PBL was applied only in one class whereas traditional instruction was used in the other. Results showed a robust contribution of PBL to students' affective and cognitive outcomes as reflected in their motivation to engage in learning activities, and to further explore the subject. However, students with learning disability were less favorable with this "active" and "annoying" environment. Implications of these findings for the LLAF project will be discussed.

Keywords: problem-based learning, higher education, pedagogical strategies

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30934 Comparative Proximate Composition of Selected Edible Vegetables Harvested from Farmland Nearby Oil Impacted Sites in Rivers State, Nigeria

Authors: K. O. Igwe, E. N. Onyeike, A. A. Uwakwe

Abstract:

Comparative proximate composition of selected edible vegetables (Abelmoschus esculentus, Telfairia occidentalis, vernonia amygdalina and Talinum triangulare ) harvested in farmland nearby oil impacted sites in Rivers State was investigated. The result obtained was compared to the proximate composition of similar edible vegetables harvested from non oil producing areas in Imo State. Values from the study areas indicated vegetables with high moisture levels (highest values in Abelmoschus esculentus and Telfairia occidentalis; 6.07±0.11% and 4.10±0.12%) low ash contents (lowest value in Telfairia occidentalis 9.80±0.08%) low crude protein (lowest value in Talinum triangulare 8.15±0.06 %) high lipid content (highest value in Talinum triangulare 4.12± 0.20%) lower crude fibre (lowest value in Abelmoschus esculentus 9.58±0.08 %) and higher Carbohydrate contents (highest value in vernonia amygdalina 62.18± 0.67%). Values obtained indicated vegetables with lower quality in the study areas.

Keywords: edible vegetables, proximate composition, oil spill, farmland

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30933 Investigation of Genetic Variation for Agronomic Traits among the Recombinant Inbred Lines of Wheat from the Norstar × Zagross Cross under Water Stress Condition

Authors: Mohammad Reza Farzami Pour

Abstract:

Determination of genetic variation is useful for plant breeding and hence production of more efficient plant species under different conditions, like drought stress. In this study, a sample of 28 recombinant inbred lines (RILs) of wheat developed from the cross of Norstar and Zagross varieties, together with their parents, were evaluated for two years (2010-2012) under normal and water stress conditions using split plot design with three replications. Main plots included two irrigation treatments of 70 and 140 mm evaporation from Class A pan and sub-plots consisted of 30 genotypes. The effect of genotypes and interaction of genotypes with years and water regimes were significant for all characters. Significant genotypic effect implies the existence of genetic variation among the lines under study. Heritability estimates were high for 1000 grain weight (0.87). Biomass and grain yield showed the lowest heritability values (0.42 and 0.50, respectively). Highest genotypic and phenotypic coefficients of variation (GCV and PCV) belonged to harvest index. Moderate genetic advance for most of the traits suggested the feasibility of selection among the RILs under investigation. Some RILs were higher yielding than either parent at both environments.

Keywords: wheat, genetic gain, heritability, recombinant inbred lines

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30932 The Poetics of Space through the Prism of Geography: The Case of La Honte by Annie Ernaux

Authors: Neda Mozaffari

Abstract:

This study represents an investigation into the poetics of space within Annie Ernaux's autobiographical work La honte, highlighting the intricate interplay among space, the individual, and society. The research aims to dissect the spatial dimension of the town Yvetot, the referential locale of the author's childhood, drawing upon the frameworks of geocriticism and geopoetics. Our analysis exposes a profound dialectical tension fundamentally predicated on the binaries of "interior/exterior" and "here/there," emphasizing how space and its occupants may reciprocally influence each other. This endeavor aspires to attribute meaning to space in Ernaux's writing in La honte and to forge a connection between spatial elements and the author's autobiographical perspective, heavily imprinted by social dynamics. Ernaux's approach fluctuates between certain binaries that segment space according to the collective perception of social hierarchy, thus unveiling the author's preoccupation with social distancing. Consequently, space transforms into a structured milieu that transfers fear and insecurity to the child, where spatial and architectural segregation further cements class divisions in terms of the language employed by its inhabitants. Ernaux's depiction of space serves both as a repository of collective memory and an instrument of social distinction, where her autobiographical perception echoes within a collective geography marked by class determinism and culture.

Keywords: geocriticism, literary study, social class, social space, spatial analysis

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30931 Controlled Conductivity of Poly (3,4-Ethylenedioxythiophene): Poly (4-Styrene Sulfonate) Composites with Polyester

Authors: Kazui Sasakii, Seira Mormune-Moriya, Hiroaki Tanahashi, Shigeji Kongaya

Abstract:

Poly (3.4-ethylenedioxythiophene) doped with poly (4-styrene sulfonate) (PEDOT: PSS) attracted a great deal of attention because of its unique characteristics of flexibility, optical properties, heat resistance and colloidal dispersion in water. It is well known that when high boiling solvents such as ethylene glycol or dimethyl sulfoxide are added as a secondary dopant to the micellar structure, PEDOT microcrystallizes and becomes highly conductive. In previous study bis(4-hydroxyphenyl) sulfone (BPS) was used as a secondary dopant for PEDOT:PSS and the enhancement of the conductivity was revealed. However, ductility is one of the serious issues which limited the application of PEDOT:PSS/BPS. So far, the composition with polymer binders has been conducted, however, polymer binders decrease the conductivity of the materials. In this study, PEDOT: PSS composites with polyester (PEs) were prepared by a simple aqueous process using PEs emulsion. The structural studies revealed that PEDOT:PSS and PEs were homogeneously distributed in the composites. It was found that the properties of PEDOT:PSS were remarkably enhanced by the incorporation of PEs. According to the tensile test, the ductility of PEDOT:PSS was remarkably improved. Interestingly, the conductivity of PEDOT:PSS/PEs composites was higher than that of neat PEDOT:PSS. For example, the conductivity increased by 8% at PEs content of 25 wt%. Since PEDOT:PSS were homogeneously dispersed on the surface of PEs particles, it was assumed that the conductive pathway was constructed by PEs particles in the nanocomposites. Therefore, a significant increase in conductivity was achieved.

Keywords: polymer composites, conductivity, PEDOT:PSS, polyester

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30930 Removing Barriers in Assessment and Feedback for Blind Students in Open Distance Learning

Authors: Sindile Ngubane-Mokiwa

Abstract:

This paper addresses two questions: (1) what barriers do the blind students face with assessment and feedback in open distance learning contexts? And (2) How can these barriers be removed? The paper focuses on the distance education through which most students with disabilities elevate their chances of accessing higher education. Lack of genuine inclusion is also evident in the challenges the blind students face during the assessment. These barriers are experienced at both formative and summative stages. The insights in this paper emanate from a case study that was carried out through qualitative approaches. The data was collected through in-depth interview, life stories, and telephonic interviews. The paper provides a review of local, continental and international views on how best assessment barriers can be removed. A group of five blind students, comprising of two honours students, two master's students and one doctoral student participated in this study. The data analysis was done through thematic analysis. The findings revealed that (a) feedback to the assignment is often inaccessible; (b) the software used is incompatible; (c) learning and assessment are designed in exclusionary approaches; (d) assessment facilities are not conducive; and (e) lack of proactive innovative assessment strategies. The article concludes by recommending ways in which barriers to assessment can be removed. These include addressing inclusive assessment and feedback strategies in professional development initiatives.

Keywords: assessment design, barriers, disabilities, blind students, feedback, universal design for learning

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30929 The General Trend of FDI and the Effects of These Investments for Countries: 2000-2013

Authors: Esra Cebeci

Abstract:

As a result of acceleration of globalization in the 21st century economic boundaries are removed. With liberalization of capital and foreign trade, not only developed countries but also developing countries get into rapid growth efforts. In developing countries, one of the most important problem is insufficient capital accumulation. For reduce this deficit, one of the general approaches that is offered increasing amount of foreign direct investments. Also, in developing countries saving rates are low. So, foreign direct investments make possible an increase for domestic savings. In this regard, the multinational corporations are capable of these investments have importance. By providing micro-macro effects for countries, demand for these firms are many. These effects in general positive, some negative effects may able to come into being especially for developing countries. Foreign direct investments are performed buying an existing corporation, merging or greenfield investments. In recent, foreign direct investments are performed as a green field investments for developing countries. The study aims to analysis foreign direct investment trends for 2000-2013 years. In the first part of this study, the importance of foreign direct investments and their determinants are explained. In the second part, the article also shows that comparative analysis of the inward and outward investments for developing and developed countries. In conclusion, while developed countries can stand competition against other countries with these investments, developing countries can provide a sustainable growth with capital inflows.

Keywords: foreign direct investments, multinational corporations, determinants of FDI, FDI trend

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30928 Solar Wind Turbulence and the Role of Circularly Polarized Dispersive Alfvén Wave

Authors: Swati Sharma, R. P. Sharma

Abstract:

We intend to study the nonlinear evolution of the parallel propagating finite frequency Alfvén wave (also called Dispersive Alfvén wave/Hall MHD wave) propagating in the solar wind regime of the solar region when a perpendicularly propagating magnetosonic wave is present in the background. The finite frequency Alfvén wave behaves differently from the usual non-dispersive behavior of the Alfvén wave. To study the nonlinear processes (such as filamentation) taking place in the solar regions such as solar wind, the dynamical equation of both the waves are derived. Numerical simulation involving finite difference method for the time domain and pseudo spectral method for the spatial domain is then performed to analyze the transient evolution of these waves. The power spectra of the Dispersive Alfvén wave is also investigated. The power spectra shows the distribution of the magnetic field intensity of the Dispersive Alfvén wave over different wave numbers. For DAW the spectra shows a steepening for scales larger than the proton inertial length. This means that the wave energy gets transferred to the solar wind particles as the wave reaches higher wave numbers. This steepening of the power spectra can be explained on account of the finite frequency of the Alfvén wave. The obtained results are consistent with the observations made by CLUSTER spacecraft.

Keywords: solar wind, turbulence, dispersive alfven wave

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30927 Grouping Pattern, Habitat Assessment and Overlap Analysis of Five Ungulates Species in Different Altitudinal Gradients of Western Himalaya, Uttarakhand, India

Authors: Kaleem Ahmed, Jamal A. Khan

Abstract:

Grouping patterns, habitat use, and overlap studies were conducted on five sympatric ungulate species sambar (Cervus unicolor), chital (Axis axis), muntjac (Muntiacus muntjac), goral (Nemorhaedus goral), and serow (Capricornis sumatraensis) in the Dabka watershed area within Indian West Himalayan range. Data on age, sex composition, group size, and various ecological and topographical factors governing the presence/absence of species within the study area were collected using a 250 km of a trail walk, 95 permanent circular plots of 10 m radius, and 3 vantage points with 58 scannings. The highest mean group size was recorded for chital (6.35 ± 0.50), followed by sambar (1.35 ± 0.10), goral (1.25 ±0.63), muntjac (1.12 ± 0.05), and serow (1.00 ± 0.00). Grouping pattern significantly varied among sympatric species (F = 85.10, df. = 6, P = 0.000). The highest mean pellet group density (/ha ± SE) was recorded for sambar (41.56 ± 3.51), followed by goral (23.31 ± 3.45), chital (19.21 ± 3.51), muntjac (7.43 ± 1.21), and serow (1.02 ± 0.10). Two-way variance analysis showed a significant difference in the density of the pellet group of all ungulate species across different study area habitats (F = 6.38, df = 4, P = 0.027). The availability-utilization (AU) analysis reveals that goral was mostly sighted in steep slopes, preferred > 2100 m altitudinal range with low shrub understory, avoided dense forest, and relatively more southern aspects were used. Chital had used a wide range of tree and shrub coverings with a preference towards moderate cover range (26-50%), preferred areas with low slope category ( < 25), avoided areas of high altitude > 900 m. Sambar avoided less tree cover (0-25), preferred slope category (26-500), altitudes between 1600-2100 m, and preferred dense forest with northern aspects. Muntjac used all elevation ranges in the study area with a preference towards the dense forest and northern aspects. Serow preferred high tree cover > 75%, avoided low shrub cover (0-25%), preferred high shrub cover 51-75%, utilized higher elevation > 2100 m, avoided low elevation range and northern aspects. All species occupied similar habitat types, forest or scrub, except for the goral, which preferred open spaces. Between muntjac and sambar, the highest overlap was found (65%), and there was no overlap between chital and serow, chital and goral. Aspect, slope, altitude, and vegetation characteristics were found to be important factors for the overlap of ungulate sympatric species. One major reason for their ecological separation at the fine-scale level is the differential use of altitude by ungulates in the present study. This is confirmed by the avoidance by chital of altitudes > 900 m and serow of < 2100 m.

Keywords: altitude, grouping pattern, Himalayas, overlap, ungulates

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30926 Health Outcomes and Economic Growth Nexus: Testing for Long-run Relationships and Causal Links in Nigeria

Authors: Haruna Modibbo Usman, Mustapha Muktar, Nasiru Inuwa

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This paper examined the long run relationship between health outcomes and economic growth in Nigeria from 1961 to 2012. Using annual time series data, Augmented Dickey-Fuller (ADF) test is conducted to check the stochastic properties of the variables. Also, the long run relationship among the variables is confirmed based on Johansen Multivariate Cointegration approach whereas the long run and short run dynamics are observed using Vector Error Correction Mechanism (VECM). In addition, VEC Granger causality test is employed to examine the direction of causality among the variables. On the whole, the results obtained revealed the existence of a long run relationship between health outcomes and economic growth in Nigeria and that both life expectancy and crude death rate as measures of health are found to have a long run negative and statistically significant impact on the economic growth over the study period. This is further buttressed by the results of Granger causality test which indicated the existence of unidirectional causality running from life expectancy and crude death rate to economic growth. The study therefore, calls for governments at various levels to create preconditions for health improvements in Nigeria in order to boost the level of health outcomes.

Keywords: cointegration, economic growth, Granger causality, health outcomes, VECM

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30925 Offset Dependent Uniform Delay Mathematical Optimization Model for Signalized Traffic Network Using Differential Evolution Algorithm

Authors: Tahseen Saad, Halim Ceylan, Jonathan Weaver, Osman Nuri Çelik, Onur Gungor Sahin

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A new concept of uniform delay offset dependent mathematical optimization problem is derived as the main objective for this study using a differential evolution algorithm. To control the coordination problem, which depends on offset selection and to estimate uniform delay based on the offset choice in a traffic signal network. The assumption is the periodic sinusoidal function for arrival and departure patterns. The cycle time is optimized at the entry links and the optimized value is used in the non-entry links as a common cycle time. The offset optimization algorithm is used to calculate the uniform delay at each link. The results are illustrated by using a case study and are compared with the canonical uniform delay model derived by Webster and the highway capacity manual’s model. The findings show new model minimizes the total uniform delay to almost half compared to conventional models. The mathematical objective function is robust. The algorithm convergence time is fast.

Keywords: area traffic control, traffic flow, differential evolution, sinusoidal periodic function, uniform delay, offset variable

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30924 An Analytic Cross-Sectional Study on the Association between Social Determinants of Health, Maternal and Child Health-Related Knowledge and Attitudes, and Utilization of Maternal, Newborn, Child Health and Nutrition Strategy-Prescribed Services for M

Authors: Rafael Carlos C. Aniceto, Bryce Abraham M. Anos, Don Christian A. Cornel, Marjerie Brianna S. Go, Samantha Nicole U. Roque, Earl Christian C. Te

Abstract:

Indigenous peoples (IPs) in the Philippines are a vulnerable, marginalized group in terms of health and overall well-being due to social inequities and cultural differences. National standards regarding maternal healthcare are geared towards facility-based delivery with modern medicine, health services, and skilled birth attendants. Standards and procedures of care for pregnant mothers do not take into account cultural differences between indigenous people and the majority of the population. There do exist, however, numerous other factors that cause relatively poorer health outcomes among indigenous peoples (IPs). This analytic cross-sectional study sought to determine the association between social determinants of health (SDH), focusing on status as indigenous peoples, and maternal health-related knowledge and attitudes (KA), and health behavior of the Dumagat-Agta indigenous people of Barangay Catablingan and Barangay San Marcelino, General Nakar, Quezon Province, and their utilization of health facilities for antenatal care, facility-based delivery and postpartum care, which would affect their health outcomes (that were not within the scope of this study). To quantitatively measure the primary/secondary exposures and outcomes, a total of 90 face-to-face interviews with IP and non-IP mothers were done. For qualitative information, participant observation among 6 communities (5 IP and 1 non-IP), 11 key informant interviews (traditional and modern health providers) and 4 focused group discussions among IP mothers were conducted. Primary quantitative analyses included chi-squared, T-test and binary logistic regression, while secondary qualitative analyses involved thematic analysis and triangulation. The researchers spent a total of 15 days in the community to learn the culture and participate in the practices of the Dumagat-Agta more intensively and deeply. Overall, utilization of all MNCHN services measured in the study was lower for IP mothers compared to their non-IP counterparts. After controlling for confounders measured in the study, IP status (primary exposure) was found to be significantly correlated with utilization of and adherence to two MNCHN-prescribed services: number of antenatal care check-ups and place of delivery (secondary outcomes). Findings show that being an indigenous mother leads to unfavorable social determinants of health, and if compounded by a difference in knowledge and attitudes, would then lead to poor levels of utilization of MNCHN-prescribed services. Key themes from qualitative analyses show that factors that affected utilization were: culture, land alienation, social discrimination, socioeconomic status, and relations between IPs and non-IPs, specifically with non-IP healthcare providers. The findings of this study aim to be used to help and guide in policy-making, to provide healthcare that is not only adequate and of quality, but more importantly, that addresses inequities stemming from various social determinants, and which is socio-culturally acceptable to indigenous communities. To address the root causes of health problems of IPs, there must be full recognition and exercise of their collective rights to communal assets, specifically land, and self-determination. This would improve maternal and child health outcomes to one of the most vulnerable and neglected sectors in society today.

Keywords: child health, indigenous people, knowledge-attitudes-practices, maternal health, social determinants of health

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