Search results for: android; data visualization
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 25646

Search results for: android; data visualization

776 Social Factors That Contribute to Promoting and Supporting Resilience in Children and Youth following Environmental Disasters: A Mixed Methods Approach

Authors: Caroline McDonald-Harker, Julie Drolet

Abstract:

Abstract— In the last six years Canada In the last six years Canada has experienced two major and catastrophic environmental disasters– the 2013 Southern Alberta flood and the 2016 Fort McMurray, Alberta wildfire. These two disasters resulted in damages exceeding 12 billion dollars, the costliest disasters in Canadian history. In the aftermath of these disasters, many families faced the loss of homes, places of employment, schools, recreational facilities, and also experienced social, emotional, and psychological difficulties. Children and youth are among the most vulnerable to the devastating effects of disasters due to the physical, cognitive, and social factors related to their developmental life stage. Yet children and youth also have the capacity to be resilient and act as powerful catalyst for change in their own lives and wider communities following disaster. Little is known, particularly from a sociological perspective, about the specific factors that contribute to resilience in children and youth, and effective ways to support their overall health and well-being. This paper focuses on the voices and experiences of children and youth residing in these two disaster-affected communities in Alberta, Canada and specifically examines: 1) How children and youth’s lives are impacted by the tragedy, devastation, and upheaval of disaster; 2) Ways that children and youth demonstrate resilience when directly faced with the adversarial circumstances of disaster; and 3) The cumulative internal and external factors that contribute to bolstering and supporting resilience among children and youth post-disaster. This paper discusses the characteristics associated with high levels of resilience in 183 children and youth ages 5 to 17 based on quantitative and qualitative data obtained through a mix methods approach. Child and youth participants were administered the Children and Youth Resilience Measure (CYRM-28) in order to examine factors that influence resilience processes including: individual, caregiver, and context factors. The CYRM-28 was then supplemented with qualitative interviews with children and youth to contextualize the CYRM-28 resiliency factors and provide further insight into their overall disaster experience. Findings reveal that high levels of resilience among child and youth participants is associated with both individual factors and caregiver factors, specifically positive outlook, effective communication, peer support, and physical and psychological caregiving. Individual and caregiver factors helped mitigate the negative effects of disaster, thus bolstering resilience in children and youth. This paper discusses the implications that these findings have for understanding the specific mechanisms that support the resiliency processes and overall recovery of children and youth following disaster; the importance of bridging the gap between children and youth’s needs and the services and supports provided to them post-disaster; and the need to develop resiliency processes and practices that empower children and youth as active agents of change in their own lives following disaster. These findings contribute to furthering knowledge about pragmatic and representative changes to resources, programs, and policies surrounding disaster response, recovery, and mitigation.

Keywords: children and youth, disaster, environment, resilience

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775 Forced Migrants in Israel and Their Impact on the Urban Structure of Southern Neighborhoods of Tel Aviv

Authors: Arnon Medzini, Lilach Lev Ari

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Migration, the driving force behind increased urbanization, has made cities much more diverse places to live in. Nearly one-fifth of all migrants live in the world’s 20 largest cities. In many of these global cities, migrants constitute over a third of the population. Many of contemporary migrants are in fact ‘forced migrants,’ pushed from their countries of origin due to political or ethnic violence and persecution or natural disasters. During the past decade, massive numbers of labor migrants and asylum seekers have migrated from African countries to Israel via Egypt. Their motives for leaving their countries of origin include ongoing and bloody wars in the African continent as well as corruption, severe conditions of poverty and hunger, and economic and political disintegration. Most of the African migrants came to Israel from Eritrea and Sudan as they saw Israel the closest natural geographic asylum to Africa; soon they found their way to the metropolitan Tel-Aviv area. There they concentrated in poor neighborhoods located in the southern part of the city, where they live under conditions of crowding, poverty, and poor sanitation. Today around 45,000 African migrants reside in these neighborhoods, and yet there is no legal option for expelling them due to dangers they might face upon returning to their native lands. Migration of such magnitude to the weakened neighborhoods of south Tel-Aviv can lead to the destruction of physical, social and human infrastructures. The character of the neighborhoods is changing, and the local population is the main victim. These local residents must bear the brunt of the failure of both authorities and the government to handle the illegal inhabitants. The extremely crowded living conditions place a heavy burden on the dilapidated infrastructures in the weakened areas where the refugees live and increase the distress of the veteran residents of the neighborhoods. Some problems are economic and some stem from damage to the services the residents are entitled to, others from a drastic decline in their standard of living. Even the public parks no longer serve the purpose for which they were originally established—the well-being of the public and the neighborhood residents; they have become the main gathering place for the infiltrators and a center of crime and violence. Based on secondary data analysis (for example: The Israel’s Population, Immigration and Border Authority, the hotline for refugees and migrants), the objective of this presentation is to discuss the effects of forced migration to Tel Aviv on the following tensions: between the local population and the immigrants; between the local population and the state authorities, and between human rights groups vis-a-vis nationalist local organizations. We will also describe the changes which have taken place in the urban infrastructure of the city of Tel Aviv, and discuss the efficacy of various Israeli strategic trajectories when handling human problems arising in the marginal urban regions where the forced migrant population is concentrated.

Keywords: African asylum seekers, forced migrants, marginal urban regions, urban infrastructure

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774 Risk Factors Associated with Increased Emergency Department Visits and Hospital Admissions Among Child and Adolescent Patients

Authors: Lalanthica Yogendran, Manassa Hany, Saira Pasha, Benjamin Chaucer, Simarpreet Kaur, Christopher Janusz

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Children and adolescent patients visit the Psychiatric Emergency Department (ED) for multiple reasons. Visiting the Psychiatric ED itself can be a traumatic experience that can affect an adolescents mental well-being, regardless of a history of mental illness. Despite this, limited research exists in this domain. Prospective studies have correlated adverse psychosocial determinants among adolescents to risk factors for poor well-being and unfavorable behavior outcomes. Studies have also shown that physiological stress is a contributor in the development of health problems and an increase in substance abuse in adolescents. This study aimed to retrospectively determine which psychosocial factors are associated with an increase in psychiatric ED visits. 600 charts of patients who had a psychiatric ED and inpatient admission visit from January 2014 through December 2014 were reviewed. Sociodemographics, diagnoses, ED visits and inpatient admissions were collected. Descriptive statistics, chi-square tests and independent t-test analyses were utilized to examine differences in the sample to determine which factors affected ED visits and admissions. The sample was 50% female, 35.2% self-identified black, and had a mean age of 13 years. The majority, 85%, went to public school and 17% were in special education. Attention Deficit Hyperactivity Disorder was the most common admitting diagnosis, found in 132(23%) responders. Most patients came from single parent household 305 (53%). The mean ages of patients that were sexually active, with legal issues, and reporting marijuana substance abuse were 15, 14.35, and 15 years respectively. Patients from two biological parent households had significantly fewer ED visits (1.2 vs. 1.7, p < 0.01) and admissions (0.09 vs. 0.26, p < 0.01). Among social factors, those who reported sexual, physical or emotional abuse had a significantly greater number of ED visits (2.1 vs. 1.5, p < 0.01) and admissions (0.61 vs. 0.14, p < 0.01) than those who did not. Patients that were sexually active or had legal issues or substance abuse with marijuana had a significantly greater number of admissions (0.43 vs. 0.17, p < 0.01), (0.54 vs. .18, p < 0.01) and (0.46 vs. 0.18, p < 0.01) respectively. This data supports the theory of the stability of a two parent home. Dual parenting plays a role in creating a safe space where a child can develop; this is shown by subsequent decreases in psychiatric ED visits and admissions. This may highlight the psychological protective role of a two parent household. Abuse can exacerbate existing psychiatric illness or initiate the onset of new disease. Substance abuse and legal issues result in early induction to the criminal system. Results show that this causes an increase in frequency of visits and severity of symptoms. Only marijuana, but not other illicit substances, correlated with higher incidence of psychiatric ED visits. This may speak to the psychotropic nature of tetrahydrocannabinols and their role in mental illness. This study demonstrates the array of psychosocial factors that lead to increased ED visits and admissions in children and adolescents.

Keywords: adolescent, child psychiatry, emergency department, substance abuse

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773 Vision and Challenges of Developing VR-Based Digital Anatomy Learning Platforms and a Solution Set for 3D Model Marking

Authors: Gizem Kayar, Ramazan Bakir, M. Ilkay Koşar, Ceren U. Gencer, Alperen Ayyildiz

Abstract:

Anatomy classes are crucial for general education of medical students, whereas learning anatomy is quite challenging and requires memorization of thousands of structures. In traditional teaching methods, learning materials are still based on books, anatomy mannequins, or videos. This results in forgetting many important structures after several years. However, more interactive teaching methods like virtual reality, augmented reality, gamification, and motion sensors are becoming more popular since such methods ease the way we learn and keep the data in mind for longer terms. During our study, we designed a virtual reality based digital head anatomy platform to investigate whether a fully interactive anatomy platform is effective to learn anatomy and to understand the level of teaching and learning optimization. The Head is one of the most complicated human anatomy structures, with thousands of tiny, unique structures. This makes the head anatomy one of the most difficult parts to understand during class sessions. Therefore, we developed a fully interactive digital tool with 3D model marking, quiz structures, 2D/3D puzzle structures, and VR support so as to integrate the power of VR and gamification. The project has been developed in Unity game engine with HTC Vive Cosmos VR headset. The head anatomy 3D model has been selected with full skeletal, muscular, integumentary, head, teeth, lymph, and vein system. The biggest issue during the development was the complexity of our model and the marking of it in the 3D world system. 3D model marking requires to access to each unique structure in the counted subsystems which means hundreds of marking needs to be done. Some parts of our 3D head model were monolithic. This is why we worked on dividing such parts to subparts which is very time-consuming. In order to subdivide monolithic parts, one must use an external modeling tool. However, such tools generally come with high learning curves, and seamless division is not ensured. Second option was to integrate tiny colliders to all unique items for mouse interaction. However, outside colliders which cover inner trigger colliders cause overlapping, and these colliders repel each other. Third option is using raycasting. However, due to its own view-based nature, raycasting has some inherent problems. As the model rotate, view direction changes very frequently, and directional computations become even harder. This is why, finally, we studied on the local coordinate system. By taking the pivot point of the model into consideration (back of the nose), each sub-structure is marked with its own local coordinate with respect to the pivot. After converting the mouse position to the world position and checking its relation with the corresponding structure’s local coordinate, we were able to mark all points correctly. The advantage of this method is its applicability and accuracy for all types of monolithic anatomical structures.

Keywords: anatomy, e-learning, virtual reality, 3D model marking

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772 Evaluation of Bagh Printing Motifs and Processes of Madhya Pradesh: From Past to Contemporary

Authors: Kaveri Dutta, Ratna Sharma

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Indian traditional textile is a synthesis of various cultures. Art and crafts of a country showcases the rich cultural and artistic history of that nation. Prehistorically Indian handicrafts were basically made for day to day use; the yearning for aesthetic application soon saw the development of flooding designs and motifs. Similarly, Bagh print a traditional hand block Print with natural colours an Indian handicraft practiced in Bagh, Madhya Pradesh(India). Bagh print has its roots in Sindh, which is now a part of Pakistan. The present form of Bagh printing actually started in 1962 when the craftsmen migrated from Manavar to the neighboring town of Bagh situated in Madhya Pradesh and hence Bagh has always been associated with this printing style. Bagh printing basically involved blocks that are carved onto motifs that represent flora such as Jasmine, Mushroom leheriya and so on. There are some prints that were inspired by the jaali work that embellished the Taj Mahal and various other forts. Inspiration is also drawn from the landscapes and geometrical figures. The motifs evoke various moods in the serenity of the prints and that is the catchy element of Bagh prints. The development in this traditional textile is as essential as in another field. Nowadays fashion trends are fragile and innovative changes over existing fashion field in the short span is the demand of times. We must make efforts to preserve this cultural heritage of arts and crafts and this is done either by documenting the various ancient traditions or by making a blend of it. Since this craft is well known over the world, but the need is to document the original motif, fabric, technology and colors used in contemporary fashion. Hence keeping above points in mind this study on bagh print textiles of Madhya Pradesh work has been formulated. The information incorporated in the paper was based on secondary data taken from relevant books, journals, museum visit and articles. Besides for the demographic details and working profile of the artisans dealt with printing, an interview schedule was carried out in three regions of Madhya Pradesh. This work of art was expressed in Cotton fabric. For this study selected traditional motifs for Bang printing was used. Some of the popular traditional Bagh motifs are Jasmine, Mushroom leheriya, geometrical figures and jaali work. The Bagh printed cotton fabrics were developed into a range of men’s ethic wear in combination with embroideries from Rajasthan. Products developed were bandhgala jackets, kurtas, serwani and dupattas. From the present study, it can be observed that the embellished traditional Bang printed range of ethnic men’s wear resulted in the fresh and colourful pattern. The embroidered Bagh printed cotton fabric also created a huge change in a positive way among artisans of the three regions.

Keywords: art and craft of Madhya Pradesh, evolution of printing in India, history of Bagh printing, sources of inspiration

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771 A Sociological Study of the Potential Role of Retired Soldiers in the Post War Development and Reconstruction in Sri Lanka

Authors: Amunupura Kiriwandeiye Gedara, Asintha Saminda Gnanaratne

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The security forces can be described as a workforce that goes beyond the role of ensuring the national security and contributes to the development process of the country. Soldiers are following combatant training courses during their tenure, they are equipped with a variety of vocational training courses to satisfy the needs of the army, to equip them with vocational training capabilities to achieve the development and reconstruction goals of the country as well as for the betterment of society in the event of emergencies. But with retirement, their relationship with the military is severed, and they are responsible for the future of their lives. The main purpose of this study was to examine how such professional capabilities can contribute to the development of the country, the current socio-economic status of the retired soldiers, and the current application of the vocational training skills they have mastered in the army to develop and rebuild the country in an effective manner. After analyzing the available research literature related to this field, a conceptual framework was developed and according to qualitative research methodology, and data obtained from Case studies and interviews are analyzed by using thematic analysis. Factors influencing early retirement include a lack of understanding of benefits, delays in promotions, not being properly evaluated for work, getting married on hasty decisions, and not having enough time to spend on family and household chores. Most of the soldiers are not aware about various programs and benefits available to retirees. They do not have a satisfactory attitude towards the retirement guidance they receive from the army at the time of retirement. Also, due to the lack of understanding about how to use their vocational capabilities successfully pursue their retirement life, the majority of people are employed in temporary jobs, and some are successful in post-retirement life due to their successful use of training received. Some live on pensions without engaging in any income-generating activities, and those who retire after 12 years of service are facing severe economic hardships as they do not get pensions. Although they have received training in various fields, they do not use them for their benefit due to lack of proper guidance. Although the government implements programs, they are not clearly aware of them. Barriers to utilization of training include an absence of a system to identify the professional skills of retired soldiers, interest in civil society affairs, exploration of opportunities in the civil and private sectors, and politicization of services. If they are given the opportunity, they will be able to contribute to the development and reconstruction process. The findings of the study further show that it has many social, economic, political, and psychological benefits not only for individuals but also for a country. Entrepreneurship training for all retired soldiers, improving officers' understanding, streamlining existing mechanisms, creating new mechanisms, setting up a separate unit for retirees, and adapting them to civil society, private and non-governmental contributions, and training courses can be identified as potential means to improve the current situation.

Keywords: development, reconstruction, retired soldiers, vocational capabilities

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770 Development of a Risk Governance Index and Examination of Its Determinants: An Empirical Study in Indian Context

Authors: M. V. Shivaani, P. K. Jain, Surendra S. Yadav

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Risk management has been gaining extensive focus from international organizations like Committee of Sponsoring Organizations and Financial Stability Board, and, the foundation of such an effective and efficient risk management system lies in a strong risk governance structure. In view of this, an attempt (perhaps a first of its kind) has been made to develop a risk governance index, which could be used as proxy for quality of risk governance structures. The index (normative framework) is based on eleven variables, namely, size of board, board diversity in terms of gender, proportion of executive directors, executive/non-executive status of chairperson, proportion of independent directors, CEO duality, chief risk officer (CRO), risk management committee, mandatory committees, voluntary committees and existence/non-existence of whistle blower policy. These variables are scored on a scale of 1 to 5 with the exception of the variables, namely, status of chairperson and CEO duality (which have been scored on a dichotomous scale with the score of 3 or 5). In case there is a legal/statutory requirement in respect of above-mentioned variables and there is a non-compliance with such requirement a score of one has been envisaged. Though there is no legal requirement, for the larger part of study, in context of CRO, risk management committee and whistle blower policy, still a score of 1 has been assigned in the event of their non-existence. Recognizing the importance of these variables in context of risk governance structure and the fact that the study basically focuses on risk governance, the absence of these variables has been equated to non-compliance with a legal/statutory requirement. Therefore, based on this the minimum score is 15 and the maximum possible is 55. In addition, an attempt has been made to explore the determinants of this index. For this purpose, the sample consists of non-financial companies (429) that constitute S&P CNX500 index. The study covers a 10 years period from April 1, 2005 to March 31, 2015. Given the panel nature of data, Hausman test was applied, and it suggested that fixed effects regression would be appropriate. The results indicate that age and size of firms have significant positive impact on its risk governance structures. Further, post-recession period (2009-2015) has witnessed significant improvement in quality of governance structures. In contrast, profitability (positive relationship), leverage (negative relationship) and growth (negative relationship) do not have significant impact on quality of risk governance structures. The value of rho indicates that about 77.74% variation in risk governance structures is due to firm specific factors. Given the fact that each firm is unique in terms of its risk exposure, risk culture, risk appetite, and risk tolerance levels, it appears reasonable to assume that the specific conditions and circumstances that a company is beset with, could be the biggest determinants of its risk governance structures. Given the recommendations put forth in the paper (particularly for regulators and companies), the study is expected to be of immense utility in an important yet neglected aspect of risk management.

Keywords: corporate governance, ERM, risk governance, risk management

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769 Validation of an Educative Manual for Patients with Breast Cancer Submitted to Radiation Therapy

Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis

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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.

Keywords: oncology nursing, nursing care, validation studies, educational technology

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768 Waveguiding in an InAs Quantum Dots Nanomaterial for Scintillation Applications

Authors: Katherine Dropiewski, Michael Yakimov, Vadim Tokranov, Allan Minns, Pavel Murat, Serge Oktyabrsky

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InAs Quantum Dots (QDs) in a GaAs matrix is a well-documented luminescent material with high light yield, as well as thermal and ionizing radiation tolerance due to quantum confinement. These benefits can be leveraged for high-efficiency, room temperature scintillation detectors. The proposed scintillator is composed of InAs QDs acting as luminescence centers in a GaAs stopping medium, which also acts as a waveguide. This system has appealing potential properties, including high light yield (~240,000 photons/MeV) and fast capture of photoelectrons (2-5ps), orders of magnitude better than currently used inorganic scintillators, such as LYSO or BaF2. The high refractive index of the GaAs matrix (n=3.4) ensures light emitted by the QDs is waveguided, which can be collected by an integrated photodiode (PD). Scintillation structures were grown using Molecular Beam Epitaxy (MBE) and consist of thick GaAs waveguiding layers with embedded sheets of modulation p-type doped InAs QDs. An AlAs sacrificial layer is grown between the waveguide and the GaAs substrate for epitaxial lift-off to separate the scintillator film and transfer it to a low-index substrate for waveguiding measurements. One consideration when using a low-density material like GaAs (~5.32 g/cm³) as a stopping medium is the matrix thickness in the dimension of radiation collection. Therefore, luminescence properties of very thick (4-20 microns) waveguides with up to 100 QD layers were studied. The optimization of the medium included QD shape, density, doping, and AlGaAs barriers at the waveguide surfaces to prevent non-radiative recombination. To characterize the efficiency of QD luminescence, low temperature photoluminescence (PL) (77-450 K) was measured and fitted using a kinetic model. The PL intensity degrades by only 40% at RT, with an activation energy for electron escape from QDs to the barrier of ~60 meV. Attenuation within the waveguide (WG) is a limiting factor for the lateral size of a scintillation detector, so PL spectroscopy in the waveguiding configuration was studied. Spectra were measured while the laser (630 nm) excitation point was scanned away from the collecting fiber coupled to the edge of the WG. The QD ground state PL peak at 1.04 eV (1190 nm) was inhomogeneously broadened with FWHM of 28 meV (33 nm) and showed a distinct red-shift due to self-absorption in the QDs. Attenuation stabilized after traveling over 1 mm through the WG, at about 3 cm⁻¹. Finally, a scintillator sample was used to test detection and evaluate timing characteristics using 5.5 MeV alpha particles. With a 2D waveguide and a small area of integrated PD, the collected charge averaged 8.4 x10⁴ electrons, corresponding to a collection efficiency of about 7%. The scintillation response had 80 ps noise-limited time resolution and a QD decay time of 0.6 ns. The data confirms unique properties of this scintillation detector which can be potentially much faster than any currently used inorganic scintillator.

Keywords: GaAs, InAs, molecular beam epitaxy, quantum dots, III-V semiconductor

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767 The Professionalization of Teachers in the Context of the Development of a Future-Oriented Technical and Vocational Education and Training System in Egypt

Authors: Sherin Ahmed El-Badry Sadek

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In this research, it is scientifically examined what contribution the professionalization of teachers can make to the development of a future-oriented vocational education and training system in Egypt. For this purpose, a needs assessment of the Egyptian vocational training system with the central actors and prevailing structures forms the foundation of the study, which theoretically underpinned with the attempt to resolve to some extent the tension between Luhmann's systems theory approach and the actor-centered theory of professional teacher competence. The vocational education system, in particular, must be adaptable and flexible due to the rapidly changing qualification requirements. In view of the pace of technological progress and the associated market changes, vocational training is no longer to be understood only as an educational tool aimed at those who achieve poorer academic performance or are not motivated to take up a degree. Rather, it is to be understood as a cornerstone for the development of society, and international experience shows that it is the core of lifelong learning. But to what extent have the education systems been able to react to these changes in their political, social, and technological systems? And how effective and sustainable are these changes actually? The vocational training system, in particular, has a particular impact on other social systems, which is why the appropriate parameters with the greatest leverage must be identified and adapted. Even if systems and structures are highly relevant, teachers must not hide behind them and must instead strive to develop further and to constantly learn. Despite numerous initiatives and programs to reform vocational training in Egypt, including the EU-funded Technical and Vocational Education and Training (TVET) reform phase I and phase II, the fit of the skilled workers to the needs of the labor market is still insufficient. Surveys show that the majority of employers are very dissatisfied with the graduates that the vocational training system produces. The data was collected through guideline-based interviews with experts from the education system and relevant neighboring systems, which allowed me to reconstruct central in-depth structures, as well as patterns of action and interpretation, in order to subsequently feed these into a matrix of recommendations for action. These recommendations are addressed to different decision-makers and stakeholders and are intended to serve as an impetus for the sustainable improvement of the Egyptian vocational training system. The research findings have shown that education, and in particular vocational training, is a political field that is characterized by a high degree of complexity and which is embedded in a barely manageable, highly branched landscape of structures and actors. At the same time, the vocational training system is not only determined by endogenous factors but also increasingly shaped by the dynamics of the environment and the neighboring social subsystems, with a mutual dependency relationship becoming apparent. These interactions must be taken into account in all decisions, even if prioritization of measures and thus a clear sequence and process orientation are of great urgency.

Keywords: competence orientation, educational policies, education systems, expert interviews, globalization, organizational development, professionalization, systems theory, teacher training, TVET system, vocational training

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766 Modeling Driving Distraction Considering Psychological-Physical Constraints

Authors: Yixin Zhu, Lishengsa Yue, Jian Sun, Lanyue Tang

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Modeling driving distraction in microscopic traffic simulation is crucial for enhancing simulation accuracy. Current driving distraction models are mainly derived from physical motion constraints under distracted states, in which distraction-related error terms are added to existing microscopic driver models. However, the model accuracy is not very satisfying, due to a lack of modeling the cognitive mechanism underlying the distraction. This study models driving distraction based on the Queueing Network Human Processor model (QN-MHP). This study utilizes the queuing structure of the model to perform task invocation and switching for distracted operation and control of the vehicle under driver distraction. Based on the assumption of the QN-MHP model about the cognitive sub-network, server F is a structural bottleneck. The latter information must wait for the previous information to leave server F before it can be processed in server F. Therefore, the waiting time for task switching needs to be calculated. Since the QN-MHP model has different information processing paths for auditory information and visual information, this study divides driving distraction into two types: auditory distraction and visual distraction. For visual distraction, both the visual distraction task and the driving task need to go through the visual perception sub-network, and the stimuli of the two are asynchronous, which is called stimulus on asynchrony (SOA), so when calculating the waiting time for switching tasks, it is necessary to consider it. In the case of auditory distraction, the auditory distraction task and the driving task do not need to compete for the server resources of the perceptual sub-network, and their stimuli can be synchronized without considering the time difference in receiving the stimuli. According to the Theory of Planned Behavior for drivers (TPB), this study uses risk entropy as the decision criterion for driver task switching. A logistic regression model is used with risk entropy as the independent variable to determine whether the driver performs a distraction task, to explain the relationship between perceived risk and distraction. Furthermore, to model a driver’s perception characteristics, a neurophysiological model of visual distraction tasks is incorporated into the QN-MHP, and executes the classical Intelligent Driver Model. The proposed driving distraction model integrates the psychological cognitive process of a driver with the physical motion characteristics, resulting in both high accuracy and interpretability. This paper uses 773 segments of distracted car-following in Shanghai Naturalistic Driving Study data (SH-NDS) to classify the patterns of distracted behavior on different road facilities and obtains three types of distraction patterns: numbness, delay, and aggressiveness. The model was calibrated and verified by simulation. The results indicate that the model can effectively simulate the distracted car-following behavior of different patterns on various roadway facilities, and its performance is better than the traditional IDM model with distraction-related error terms. The proposed model overcomes the limitations of physical-constraints-based models in replicating dangerous driving behaviors, and internal characteristics of an individual. Moreover, the model is demonstrated to effectively generate more dangerous distracted driving scenarios, which can be used to construct high-value automated driving test scenarios.

Keywords: computational cognitive model, driving distraction, microscopic traffic simulation, psychological-physical constraints

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765 The Effect of Whole-Body Vertical Rhythm Training on Fatigue, Physical Activity, and Quality of Life to the Middle-Aged and Elderly with Hemodialysis Patients

Authors: Yen-Fen Shen, Meng-Fan Li

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The study aims to investigate the effect of full-body vertical rhythmic training on fatigue, physical activity, and quality of life among middle-aged and elderly hemodialysis patients. The study adopted a quasi-experimental research method and recruited 43 long-term hemodialysis patients from a medical center in northern Taiwan, with 23 and 20 participants in the experimental and control groups, respectively. The experimental group received full-body vertical rhythmic training as an intervention, while the control group received standard hemodialysis care without any intervention. Both groups completed the measurements by using "Fatigue Scale", "Physical Activity Scale" and "Chinese version of the Kidney Disease Quality of Life Questionnaire" before and after the study. The experimental group underwent a 10-minute full-body vertical rhythmic training three times per week, which lasted for eight weeks before receiving regular hemodialysis treatment. The data were analyzed by SPSS 25 software, including descriptive statistics such as frequency distribution, percentages, means, and standard deviations, as well as inferential statistics, including chi-square, independent samples t-test, and paired samples t-test. The study results are summarized as follows: 1. There were no significant differences in demographic variables, fatigue, physical activity, and quality of life between the experimental and control groups in the pre-test. 2. After the intervention of the “full-body vertical rhythmic training,” the experimental group showed significantly better results in the category of "feeling tired and fatigued in the lower back", "physical functioning role limitation", "bodily pain", "social functioning", "mental health", and "impact of kidney disease on life quality." 3. The paired samples t-test results revealed that the control group experienced significant differences between the pre-test and post-test in the categories of feeling tired and fatigued in the lower back, bodily pain, social functioning mental health, and impact of kidney disease on life quality, with scores indicating a decline in life quality. Conversely, the experimental group only showed a significant worsening in bodily pain" and the impact of kidney disease on life quality, with lower change values compared to the control group. Additionally, there was an improvement in the condition of "feeling tired and fatigued in the lower back" for the experimental group. Conclusion: The intervention of the “full-body vertical rhythmic training” had a certain positive effect on the quality of life of the experimental group. While it may not entirely enhance patients' quality of life, it can mitigate the negative impact of kidney disease on certain aspects of the body. The study provides clinical practice, nursing education, and research recommendations based on the results and discusses the limitations of the research.

Keywords: hemodialysis, full-body vertical rhythmic training, fatigue, physical activity, quality of life

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764 Reflections on the Trajectory of an Online Literature Cafe through Its Music and Arts Activities

Authors: Mariko Hara, Mari Aoki, Takako Ito, Masao Sugita

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Social distancing measures due to the COVID-19 crisis had a severe impact on music and art practices based in community settings. They had to re-think how to connect with their dispersed community using online tools. As the social distancing continues, there is an urgent need to investigate the possibilities of online community music and art practices. Are they sustainable actions that can have positive impacts on the community and the quality of lives of people over time? The Online Lindgren Café (hereafter ‘OLC’) is a monthly online literature event which started in June 2020. In the OLC, up to 14 members meet online to discuss the works of Astrid Lindgren and similar authors. Members come from various places in Japan and Norway, with a variety of expertise from music therapy, music education, psychotherapy, music sociology, storytelling, and theatre, and their family members join them. In these meetings, music and arts activities emerged in response to interests among the members. The resources and experiences of the members helped to develop these activities further. This paper first introduces one of the music and art activities in one specific event, a collaborative picture book-making with music, which was initiated and led by the second author. The third author chose the music, and the activity itself was recorded. This is followed by the description of a reflecting event, where the recording of the collaborative picture book-making activity was shared to facilitate further creations (drawings, haiku, and fabric weaving) as well as group reflections on the trajectories of the Online Lindgren Café. Finally, we will discuss the preliminary findings using the data collected at the reflecting event. Key findings suggest that the resource-driven approach of the OLC leveled the relationships among the intergenerational, multi-cultural, and interdisciplinary members. This enabled the members to set aside their professional and/or predominant identities, which allowed them to discover their own and others’ resources. The relaxed, unstructured, and liminal phenomenon at OLC can be regarded as a form of communitas, where members gain a sense of liberation and belonging in a different way from in-person communications. Participation from one’s home, as well as a video conferencing function that allowed the members to position themselves among the other participants in equal-sized windows, seems to have enabled members to feel safe to express themselves openly at the same time feel a sense of belonging. Furthermore, in the OLC, music and arts activities acted to inclusively connect and re-connect dispersed, intergenerational members with each other. For instance, in a music and drawing activity, music acted as a means for each member to engage in their own ‘drawing space’ while still feeling connected with the others. The positive experiences from these activities inspired the members to use similar approaches outside of the OLC. The finding suggests that, because of its resource-driven approach supported by the music and arts activities, the OLC could be developed further as a permeable and sustainable action even after any current social distancing measures are lifted.

Keywords: communitas, COVID-19, musical affordances, online community of practices, resource-driven approach

Procedia PDF Downloads 135
763 Fischer Tropsch Synthesis in Compressed Carbon Dioxide with Integrated Recycle

Authors: Kanchan Mondal, Adam Sims, Madhav Soti, Jitendra Gautam, David Carron

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Fischer-Tropsch (FT) synthesis is a complex series of heterogeneous reactions between CO and H2 molecules (present in the syngas) on the surface of an active catalyst (Co, Fe, Ru, Ni, etc.) to produce gaseous, liquid, and waxy hydrocarbons. This product is composed of paraffins, olefins, and oxygenated compounds. The key challenge in applying the Fischer-Tropsch process to produce transportation fuels is to make the capital and production costs economically feasible relative to the comparative cost of existing petroleum resources. To meet this challenge, it is imperative to enhance the CO conversion while maximizing carbon selectivity towards the desired liquid hydrocarbon ranges (i.e. reduction in CH4 and CO2 selectivities) at high throughputs. At the same time, it is equally essential to increase the catalyst robustness and longevity without sacrificing catalyst activity. This paper focuses on process development to achieve the above. The paper describes the influence of operating parameters on Fischer Tropsch synthesis (FTS) from coal derived syngas in supercritical carbon dioxide (ScCO2). In addition, the unreacted gas and solvent recycle was incorporated and the effect of unreacted feed recycle was evaluated. It was expected that with the recycle, the feed rate can be increased. The increase in conversion and liquid selectivity accompanied by the production of narrower carbon number distribution in the product suggest that higher flow rates can and should be used when incorporating exit gas recycle. It was observed that this process was capable of enhancing the hydrocarbon selectivity (nearly 98 % CO conversion), reducing improving the carbon efficiency from 17 % to 51 % in a once through process and further converting 16 % CO2 to liquid with integrated recycle of the product gas stream and increasing the life of the catalyst. Catalyst robustness enhancement has been attributed to the absorption of heat of reaction by the compressed CO2 which reduced the formation of hotspots and the dissolution of waxes by the CO2 solvent which reduced the blinding of active sites. In addition, the recycling the product gas stream reduced the reactor footprint to one-fourth of the once through size and product fractionation utilizing the solvent effects of supercritical CO2 were realized. In addition to the negative CO2 selectivities, methane production was also inhibited and was limited to less than 1.5%. The effect of the process conditions on the life of the catalysts will also be presented. Fe based catalysts are known to have a high proclivity for producing CO2 during FTS. The data of the product spectrum and selectivity on Co and Fe-Co based catalysts as well as those obtained from commercial sources will also be presented. The measurable decision criteria were the increase in CO conversion at H2:CO ratio of 1:1 (as commonly found in coal gasification product stream) in supercritical phase as compared to gas phase reaction, decrease in CO2 and CH4 selectivity, overall liquid product distribution, and finally an increase in the life of the catalysts.

Keywords: carbon efficiency, Fischer Tropsch synthesis, low GHG, pressure tunable fractionation

Procedia PDF Downloads 240
762 Sand Production Modelled with Darcy Fluid Flow Using Discrete Element Method

Authors: M. N. Nwodo, Y. P. Cheng, N. H. Minh

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In the process of recovering oil in weak sandstone formations, the strength of sandstones around the wellbore is weakened due to the increase of effective stress/load from the completion activities around the cavity. The weakened and de-bonded sandstone may be eroded away by the produced fluid, which is termed sand production. It is one of the major trending subjects in the petroleum industry because of its significant negative impacts, as well as some observed positive impacts. For efficient sand management therefore, there has been need for a reliable study tool to understand the mechanism of sanding. One method of studying sand production is the use of the widely recognized Discrete Element Method (DEM), Particle Flow Code (PFC3D) which represents sands as granular individual elements bonded together at contact points. However, there is limited knowledge of the particle-scale behavior of the weak sandstone, and the parameters that affect sanding. This paper aims to investigate the reliability of using PFC3D and a simple Darcy flow in understanding the sand production behavior of a weak sandstone. An isotropic tri-axial test on a weak oil sandstone sample was first simulated at a confining stress of 1MPa to calibrate and validate the parallel bond models of PFC3D using a 10m height and 10m diameter solid cylindrical model. The effect of the confining stress on the number of bonds failure was studied using this cylindrical model. With the calibrated data and sample material properties obtained from the tri-axial test, simulations without and with fluid flow were carried out to check on the effect of Darcy flow on bonds failure using the same model geometry. The fluid flow network comprised of every four particles connected with tetrahedral flow pipes with a central pore or flow domain. Parametric studies included the effects of confining stress, and fluid pressure; as well as validating flow rate – permeability relationship to verify Darcy’s fluid flow law. The effect of model size scaling on sanding was also investigated using 4m height, 2m diameter model. The parallel bond model successfully calibrated the sample’s strength of 4.4MPa, showing a sharp peak strength before strain-softening, similar to the behavior of real cemented sandstones. There seems to be an exponential increasing relationship for the bigger model, but a curvilinear shape for the smaller model. The presence of the Darcy flow induced tensile forces and increased the number of broken bonds. For the parametric studies, flow rate has a linear relationship with permeability at constant pressure head. The higher the fluid flow pressure, the higher the number of broken bonds/sanding. The DEM PFC3D is a promising tool to studying the micromechanical behavior of cemented sandstones.

Keywords: discrete element method, fluid flow, parametric study, sand production/bonds failure

Procedia PDF Downloads 324
761 Mobile Phones, (Dis) Empowerment and Female Headed Households: Trincomalee, Sri Lanka

Authors: S. A. Abeykoon

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This study explores the empowerment potential of the mobile phone, the widely penetrated and greatly affordable communication technology in Sri Lanka, for female heads of households in Trincomalee District, Sri Lanka-an area recovering from the effects of a 30-year civil war and the 2004 Boxing Day Tsunami. It also investigates how the use of mobile phones by these women is shaped and appropriated by the gendered power relations and inequalities in their respective communities and by their socio-economic factors and demographic characteristics. This qualitative study is based on the epistemology of constructionism; interpretivist, functionalist and critical theory approaches; and the process of action research. The data collection was conducted from September 2014 to November 2014 in two Divisional Secretaries of the Trincomalee District, Sri Lanka. A total of 30 semi-structured depth interviews and six focus groups with the female heads of households of Sinhalese, Tamil and Muslim ethnicities were conducted using purposive, representative and snowball sampling methods. The Grounded theory method was used to analyze transcribed interviews, focus group discussions and field notes that were coded and categorized in accordance with the research questions and the theoretical framework of the study. The findings of the study indicated that the mobile phone has mainly enabled the participants to balance their income earning activities and family responsibilities and has been useful in maintaining their family and social relationships, occupational duties and in making decisions. Thus, it provided them a higher level of security, safety, reassurance and self-confidence in carrying out their daily activities. They also practiced innovative strategies for the effective and efficient use of their mobile expenses. Although participants whose husbands or relatives have migrated were more tended to use smart phones, mobile literacy level of the majority of the participants was at a lower level limited to making and receiving calls and using SMS (Short Message Service) services. However, their interaction with the mobile phone was significantly shaped by the gendered power relations and their multiple identities based on their ethnicity, religion, class, education, profession and age. Almost all the participants were precautious of giving their mobile numbers to and have been harassed with ‘nuisance calls’ from men. For many, ownership and use of their mobile phone was shaped and influenced by their children and migrated husbands. Although these practices limit their use of the technology, there were many instances that they challenged these gendered harassments. While man-made and natural destructions have disempowered and victimized the women in the Sri Lankan society, they have also liberated women making them stronger and transforming their agency and traditional gender roles. Therefore, their present position in society is reflected in their mobile phone use as they assist such women to be more self-reliant and liberated, yet making them disempowered at some time.

Keywords: mobile phone, gender power relations, empowerment, female heads of households

Procedia PDF Downloads 338
760 Analytical, Numerical, and Experimental Research Approaches to Influence of Vibrations on Hydroelastic Processes in Centrifugal Pumps

Authors: Dinara F. Gaynutdinova, Vladimir Ya Modorsky, Nikolay A. Shevelev

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The problem under research is that of unpredictable modes occurring in two-stage centrifugal hydraulic pump as a result of hydraulic processes caused by vibrations of structural components. Numerical, analytical and experimental approaches are considered. A hypothesis was developed that the problem of unpredictable pressure decrease at the second stage of centrifugal pumps is caused by cavitation effects occurring upon vibration. The problem has been studied experimentally and theoretically as of today. The theoretical study was conducted numerically and analytically. Hydroelastic processes in dynamic “liquid – deformed structure” system were numerically modelled and analysed. Using ANSYS CFX program engineering analysis complex and computing capacity of a supercomputer the cavitation parameters were established to depend on vibration parameters. An influence domain of amplitudes and vibration frequencies on concentration of cavitation bubbles was formulated. The obtained numerical solution was verified using CFM program package developed in PNRPU. The package is based on a differential equation system in hyperbolic and elliptic partial derivatives. The system is solved by using one of finite-difference method options – the particle-in-cell method. The method defines the problem solution algorithm. The obtained numerical solution was verified analytically by model problem calculations with the use of known analytical solutions of in-pipe piston movement and cantilever rod end face impact. An infrastructure consisting of an experimental fast hydro-dynamic processes research installation and a supercomputer connected by a high-speed network, was created to verify the obtained numerical solutions. Physical experiments included measurement, record, processing and analysis of data for fast processes research by using National Instrument signals measurement system and Lab View software. The model chamber end face oscillated during physical experiments and, thus, loaded the hydraulic volume. The loading frequency varied from 0 to 5 kHz. The length of the operating chamber varied from 0.4 to 1.0 m. Additional loads weighed from 2 to 10 kg. The liquid column varied from 0.4 to 1 m high. Liquid pressure history was registered. The experiment showed dependence of forced system oscillation amplitude on loading frequency at various values: operating chamber geometrical dimensions, liquid column height and structure weight. Maximum pressure oscillation (in the basic variant) amplitudes were discovered at loading frequencies of approximately 1,5 kHz. These results match the analytical and numerical solutions in ANSYS and CFM.

Keywords: computing experiment, hydroelasticity, physical experiment, vibration

Procedia PDF Downloads 246
759 Thermal Energy Storage Based on Molten Salts Containing Nano-Particles: Dispersion Stability and Thermal Conductivity Using Multi-Scale Computational Modelling

Authors: Bashar Mahmoud, Lee Mortimer, Michael Fairweather

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New methods have recently been introduced to improve the thermal property values of molten nitrate salts (a binary mixture of NaNO3:KNO3in 60:40 wt. %), by doping them with minute concentration of nanoparticles in the range of 0.5 to 1.5 wt. % to form the so-called: Nano-heat-transfer-fluid, apt for thermal energy transfer and storage applications. The present study aims to assess the stability of these nanofluids using the advanced computational modelling technique, Lagrangian particle tracking. A multi-phase solid-liquid model is used, where the motion of embedded nanoparticles in the suspended fluid is treated by an Euler-Lagrange hybrid scheme with fixed time stepping. This technique enables measurements of various multi-scale forces whose characteristic (length and timescales) are quite different. Two systems are considered, both consisting of 50 nm Al2O3 ceramic nanoparticles suspended in fluids of different density ratios. This includes both water (5 to 95 °C) and molten nitrate salt (220 to 500 °C) at various volume fractions ranging between 1% to 5%. Dynamic properties of both phases are coupled to the ambient temperature of the fluid suspension. The three-dimensional computational region consists of a 1μm cube and particles are homogeneously distributed across the domain. Periodic boundary conditions are enforced. The particle equations of motion are integrated using the fourth order Runge-Kutta algorithm with a very small time-step, Δts, set at 10-11 s. The implemented technique demonstrates the key dynamics of aggregated nanoparticles and this involves: Brownian motion, soft-sphere particle-particle collisions, and Derjaguin, Landau, Vervey, and Overbeek (DLVO) forces. These mechanisms are responsible for the predictive model of aggregation of nano-suspensions. An energy transport-based method of predicting the thermal conductivity of the nanofluids is also used to determine thermal properties of the suspension. The simulation results confirms the effectiveness of the technique. The values are in excellent agreement with the theoretical and experimental data obtained from similar studies. The predictions indicates the role of Brownian motion and DLVO force (represented by both the repulsive electric double layer and an attractive Van der Waals) and its influence in the level of nanoparticles agglomeration. As to the nano-aggregates formed that was found to play a key role in governing the thermal behavior of nanofluids at various particle concentration. The presentation will include a quantitative assessment of these forces and mechanisms, which would lead to conclusions about nanofluids, heat transfer performance and thermal characteristics and its potential application in solar thermal energy plants.

Keywords: thermal energy storage, molten salt, nano-fluids, multi-scale computational modelling

Procedia PDF Downloads 194
758 Information and Communication Technology (ICT) Education Improvement for Enhancing Learning Performance and Social Equality

Authors: Heichia Wang, Yalan Chao

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Social inequality is a persistent problem. One of the ways to solve this problem is through education. At present, vulnerable groups are often less geographically accessible to educational resources. However, compared with educational resources, communication equipment is easier for vulnerable groups. Now that information and communication technology (ICT) has entered the field of education, today we can accept the convenience that ICT provides in education, and the mobility that it brings makes learning independent of time and place. With mobile learning, teachers and students can start discussions in an online chat room without the limitations of time or place. However, because liquidity learning is quite convenient, people tend to solve problems in short online texts with lack of detailed information in a lack of convenient online environment to express ideas. Therefore, the ICT education environment may cause misunderstanding between teachers and students. Therefore, in order to better understand each other's views between teachers and students, this study aims to clarify the essays of the analysts and classify the students into several types of learning questions to clarify the views of teachers and students. In addition, this study attempts to extend the description of possible omissions in short texts by using external resources prior to classification. In short, by applying a short text classification, this study can point out each student's learning problems and inform the instructor where the main focus of the future course is, thus improving the ICT education environment. In order to achieve the goals, this research uses convolutional neural network (CNN) method to analyze short discussion content between teachers and students in an ICT education environment. Divide students into several main types of learning problem groups to facilitate answering student problems. In addition, this study will further cluster sub-categories of each major learning type to indicate specific problems for each student. Unlike most neural network programs, this study attempts to extend short texts with external resources before classifying them to improve classification performance. In short, by applying the classification of short texts, we can point out the learning problems of each student and inform the instructors where the main focus of future courses will improve the ICT education environment. The data of the empirical process will be used to pre-process the chat records between teachers and students and the course materials. An action system will be set up to compare the most similar parts of the teaching material with each student's chat history to improve future classification performance. Later, the function of short text classification uses CNN to classify rich chat records into several major learning problems based on theory-driven titles. By applying these modules, this research hopes to clarify the main learning problems of students and inform teachers that they should focus on future teaching.

Keywords: ICT education improvement, social equality, short text analysis, convolutional neural network

Procedia PDF Downloads 129
757 Navigating Top Management Team Characteristics for Ambidexterity in Small and Medium-Sized African Businesses: The Key to Unlocking Success

Authors: Rumbidzai Sipiwe Zimvumi

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The study aimed to identify the top management team attributes for ambidexterity in small and medium-sized enterprises by utilizing the upper echelons theory. The conventional opinion holds that an organization's ability to pursue both exploitative and explorative innovation methods at the same time is reflected in its ambidexterity. Top-level managers are critical to this matrix because they forecast and explain strategic choices that guarantee success by improving organizational performance. Since the focus of the study was on the unique characteristics of TMTs that can facilitate ambidexterity, the primary goal was to comprehend how TMTs in SMEs can better manage ambidexterity. The study used document analysis to collect information on ambidexterity and TMT traits. Finding, choosing, assessing, and synthesizing data from peer-reviewed publications allowed for the review and evaluation of papers. The fact that SMEs will perform better if they can achieve a balance between exploration and exploitation cannot be overstated. Unfortunately, exploitation is the main priority for most SMEs. The results showed that some of the noteworthy TMT traits that support ambidexterity in SMEs are age diversity, shared responsibility, leadership impact, psychological safety, and self-confidence. It has been shown that most SMEs confront significant obstacles in recruiting people, including formalizing their management and assembling executive teams with seniority. Small and medium-sized enterprises (SMEs) are often held by families or people who neglect to keep their personal lives apart from the firm, which eliminates the opportunity for management and staff to take the initiative. This helps to explain why exploitative strategies, which preserve present success, are used rather than explorative strategies, which open new economic opportunities and dimensions. It is evident that psychological safety deteriorates, and creativity is hindered in the process. The study makes the case that TMTs who are motivated to become ambidextrous can exist. According to the report, small- and medium-sized business owners should value the opinions of all parties involved and provide their managers and regular staff the freedom to think creatively and in a safe environment. TMTs who experience psychological safety are more likely to be inventive, creative, and productive. A team's collective perception that it is acceptable to take chances, voice opinions and concerns, ask questions, and own up to mistakes without fear of unfavorable outcomes is known as team psychological safety. Thus, traits like age diversity, leadership influence, learning agility, psychological safety, and self-assurance are critical to the success of SMEs. As a solution to ensuring ambidexterity is attained, the study suggests a clear separation of ownership and control, the adoption of technology to stimulate creativity, team spirit and excitement, shared accountability, and good management of diversity. Among the suggestions for the SME's success are resource allocation and important collaborations.

Keywords: navigating, ambidexterity, top management team, small and medium enterprises

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756 Role of Vitamin-D in Reducing Need for Supplemental Oxygen Among COVID-19 Patients

Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

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Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

Procedia PDF Downloads 156
755 The Relationship between Body Fat Percent and Metabolic Syndrome Indices in Childhood Morbid Obesity

Authors: Mustafa Metin Donma

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Metabolic syndrome (MetS) is characterized by a series of biochemical, physiological and anthropometric indicators and is a life-threatening health problem due to its close association with chronic diseases such as diabetes mellitus, hypertension, cancer and cardiovascular diseases. The syndrome deserves great interest both in adults and children. Central obesity is the indispensable component of MetS. Particularly, children, who are morbidly obese have a great tendency to develop the disease, because they are under the threat in their future lives. Preventive measures at this stage should be considered. For this, investigators seek for an informative scale or an index for the purpose. So far, several, but not many suggestions come into the stage. However, the diagnostic decision is not so easy and may not be complete particularly in the pediatric population. The aim of the study was to develop a MetS index capable of predicting MetS, while children are at the morbid obesity stage. This study was performed on morbid obese (MO) children, which were divided into two groups. Morbid obese children, who do not possess MetS criteria comprised the first group (n=44). The second group was composed of children (n=42) with MetS diagnosis. Parents were informed about the signed consent forms, which are required for the participation of their children in the study. The approval of the study protocol was taken from the institutional ethics committee of Tekirdag Namik Kemal University. Helsinki Declaration was accepted prior to and during the study. Anthropometric measurements including weight, height, waist circumference (WC), hip C, head C, neck C, biochemical tests including fasting blood glucose (FBG), insulin (INS), triglycerides (TRG), high density lipoprotein cholesterol (HDL-C) and blood pressure measurements (systolic (SBP) and diastolic (DBP)) were performed. Body fat percentage (BFP) values were determined by TANITA’s Bioelectrical Impedance Analysis technology. Body mass index and MetS indices were calculated. The equations for MetS index (MetSI) and advanced Donma MetS index (ADMI) were [(INS/FBG)/(HDL-C/TRG)]*100 and MetSI*[(SBP+DBP/Height)], respectively. Descriptive statistics including median values, compare means tests, correlation-regression analysis were performed within the scope of data evaluation using the statistical package program, SPSS. Statistically significant mean differences were determined by a p value smaller than 0.05. Median values for MetSI and ADMI in MO (MetS-) and MO (MetS+) groups were calculated as (25.9 and 36.5) and (74.0 and 106.1), respectively. Corresponding mean±SD values for BFPs were 35.9±7.1 and 38.2±7.7 in groups. Correlation analysis of these two indices with corresponding general BFP values exhibited significant association with ADMI, close to significance with MetSI in MO group. Any significant correlation was found with neither of the indices in MetS group. In conclusion, important associations observed with MetS indices in MO group were quite meaningful. The presence of these associations in MO group was important for showing the tendency towards the development of MetS in MO (MetS-) participants. The other index, ADMI, was more helpful for predictive purpose.

Keywords: body fat percentage, child, index, metabolic syndrome, obesity

Procedia PDF Downloads 60
754 Disaster Management Approach for Planning an Early Response to Earthquakes in Urban Areas

Authors: Luis Reynaldo Mota-Santiago, Angélica Lozano

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Determining appropriate measures to face earthquakesarea challenge for practitioners. In the literature, some analyses consider disaster scenarios, disregarding some important field characteristics. Sometimes, software that allows estimating the number of victims and infrastructure damages is used. Other times historical information of previous events is used, or the scenarios’informationis assumed to be available even if it isnot usual in practice. Humanitarian operations start immediately after an earthquake strikes, and the first hours in relief efforts are important; local efforts are critical to assess the situation and deliver relief supplies to the victims. A preparation action is prepositioning stockpiles, most of them at central warehouses placed away from damage-prone areas, which requires large size facilities and budget. Usually, decisions in the first 12 hours (standard relief time (SRT)) after the disaster are the location of temporary depots and the design of distribution paths. The motivation for this research was the delay in the reaction time of the early relief efforts generating the late arrival of aid to some areas after the Mexico City 7.1 magnitude earthquake in 2017. Hence, a preparation approach for planning the immediate response to earthquake disasters is proposed, intended for local governments, considering their capabilities for planning and for responding during the SRT, in order to reduce the start-up time of immediate response operations in urban areas. The first steps are the generation and analysis of disaster scenarios, which allow estimatethe relief demand before and in the early hours after an earthquake. The scenarios can be based on historical data and/or the seismic hazard analysis of an Atlas of Natural Hazards and Risk as a way to address the limited or null available information.The following steps include the decision processes for: a) locating local depots (places to prepositioning stockpiles)and aid-giving facilities at closer places as possible to risk areas; and b) designing the vehicle paths for aid distribution (from local depots to the aid-giving facilities), which can be used at the beginning of the response actions. This approach allows speeding up the delivery of aid in the early moments of the emergency, which could reduce the suffering of the victims allowing additional time to integrate a broader and more streamlined response (according to new information)from national and international organizations into these efforts. The proposed approachis applied to two case studies in Mexico City. These areas were affectedby the 2017’s earthquake, having limited aid response. The approach generates disaster scenarios in an easy way and plans a faster early response with a short quantity of stockpiles which can be managed in the early hours of the emergency by local governments. Considering long-term storage, the estimated quantities of stockpiles require a limited budget to maintain and a small storage space. These stockpiles are useful also to address a different kind of emergencies in the area.

Keywords: disaster logistics, early response, generation of disaster scenarios, preparation phase

Procedia PDF Downloads 111
753 Techno-Economic Assessments of Promising Chemicals from a Sugar Mill Based Biorefinery

Authors: Kathleen Frances Haigh, Mieke Nieder-Heitmann, Somayeh Farzad, Mohsen Ali Mandegari, Johann Ferdinand Gorgens

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Lignocellulose can be converted to a range of biochemicals and biofuels. Where this is derived from agricultural waste, issues of competition with food are virtually eliminated. One such source of lignocellulose is the South African sugar industry. Lignocellulose could be accessed by changes to the current farming practices and investments in more efficient boilers. The South African sugar industry is struggling due to falling sugar prices and increasing costs and it is proposed that annexing a biorefinery to a sugar mill will broaden the product range and improve viability. Process simulations of the selected chemicals were generated using Aspen Plus®. It was envisaged that a biorefinery would be annexed to a typical South African sugar mill. Bagasse would be diverted from the existing boilers to the biorefinery and mixed with harvest residues. This biomass would provide the feedstock for the biorefinery and the process energy for the biorefinery and sugar mill. Thus, in all scenarios a portion of the biomass was diverted to a new efficient combined heat and power plant (CHP). The Aspen Plus® simulations provided the mass and energy balance data to carry out an economic assessment of each scenarios. The net present value (NPV), internal rate of return (IRR) and minimum selling price (MSP) was calculated for each scenario. As a starting point scenarios were generated to investigate the production of ethanol, ethanol and lactic acid, ethanol and furfural, butanol, methanol, and Fischer-Tropsch syncrude. The bypass to the CHP plant is a useful indicator of the energy demands of the chemical processes. An iterative approach was used to identify a suitable bypass because increasing this value had the combined effect of increasing the amount of energy available and reducing the capacity of the chemical plant. Bypass values ranged from 30% for syncrude production to 50% for combined ethanol and furfural production. A hurdle rate of 15.7% was selected for the IRR. The butanol, combined ethanol and furfural, or the Fischer-Tropsch syncrude scenarios are unsuitable for investment with IRRs of 4.8%, 7.5% and 11.5% respectively. This provides valuable insights into research opportunities. For example furfural from sugarcane bagasse is an established process although the integration of furfural production with ethanol is less well understood. The IRR for the ethanol scenario was 14.7%, which is below the investment criteria, but given the technological maturity it may still be considered for investment. The scenarios which met the investment criteria were the combined ethanol and lactic acid, and the methanol scenarios with IRRs of 20.5% and 16.7%, respectively. These assessments show that the production of biochemicals from lignocellulose can be commercially viable. In addition, this assessment have provided valuable insights for research to improve the commercial viability of additional chemicals and scenarios. This has led to further assessments of the production of itaconic acid, succinic acid, citric acid, xylitol, polyhydroxybutyrate, polyethylene, glucaric acid and glutamic acid.

Keywords: biorefineries, sugar mill, methanol, ethanol

Procedia PDF Downloads 197
752 Monitoring and Improving Performance of Soil Aquifer Treatment System and Infiltration Basins Performance: North Gaza Emergency Sewage Treatment Plant as Case Study

Authors: Sadi Ali, Yaser Kishawi

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As part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely cover the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is to find non-conventional water resource from treated wastewater to irrigate 1500 hectares and serves over 100,000 inhabitants. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & 9 infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, phase A is functioning since Apr 2009. Since Apr 2009, a monitoring plan is conducted to monitor the infiltration rate (I.R.) of the 9 basins. Nearly 23 million m3 of partially treated wastewater were infiltrated up to Jun 2014. It is important to maintain an acceptable rate to allow the basins to handle the coming quantities (currently 10,000 m3 are pumped an infiltrated daily). The methodology applied was to review and analysis the collected data including the I.R.s, the WW quality and the drying-wetting schedule of the basins. One of the main findings is the relation between the Total Suspended Solids (TSS) at BLWWTP and the I.R. at the basins. Since April 2009, the basins scored an average I.R. of about 2.5 m/day. Since then the records showed a decreasing pattern of the average rate until it reached the lower value of 0.42 m/day in Jun 2013. This was accompanied with an increase of TSS (mg/L) concentration at the source reaching above 200 mg/L. The reducing of TSS concentration directly improved the I.R. (by cleaning the WW source ponds at Biet Lahia WWTP site). This was reflected in an improvement in I.R. in last 6 months from 0.42 m/day to 0.66 m/day then to nearly 1.0 m/day as the average of the last 3 months of 2013. The wetting-drying scheme of the basins was observed (3 days wetting and 7 days drying) besides the rainfall rates. Despite the difficulty to apply this scheme accurately a control of flow to each basin was applied to improve the I.R. The drying-wetting system affected the I.R. of individual basins, thus affected the overall system rate which was recorded and assessed. Also the ploughing activities at the infiltration basins as well were recommended at certain times to retain a certain infiltration level. This breaks the confined clogging layer which prevents the infiltration. It is recommended to maintain proper quality of WW infiltrated to ensure an acceptable performance of IBs. The continual maintenance of settling ponds at BLWWTP, continual ploughing of basins and applying soil treatment techniques at the IBs will improve the I.R.s. When the new WWTP functions a high standard effluent quality (TSS 20mg, BOD 20 mg/l and TN 15 mg/l) will be infiltrated, thus will enhance I.R.s of IBs due to lower organic load.

Keywords: SAT, wastewater quality, soil remediation, North Gaza

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751 Nutritional Genomics Profile Based Personalized Sport Nutrition

Authors: Eszter Repasi, Akos Koller

Abstract:

Our genetic information determines our look, physiology, sports performance and all our features. Maximizing the performances of athletes have adopted a science-based approach to the nutritional support. Nowadays genetics studies have blended with nutritional sciences, and a dynamically evolving, new research field have appeared. Nutritional genomics is needed to be used by nutritional experts. This is a recent field of nutritional science, which can provide a solution to reach the best sport performance using correlations between the athlete’s genome, nutritions, molecules, included human microbiome (links between food, microbiome and epigenetics), nutrigenomics and nutrigenetics. Nutritional genomics has a tremendous potential to change the future of dietary guidelines and personal recommendations. Experts need to use new technology to get information about the athletes, like nutritional genomics profile (included the determination of the oral and gut microbiome and DNA coded reaction for food components), which can modify the preparation term and sports performance. The influence of nutrients on the genes expression is called Nutrigenomics. The heterogeneous response of gene variants to nutrients, dietary components is called Nutrigenetics. The human microbiome plays a critical role in the state of health and well-being, and there are more links between food or nutrition and the human microbiome composition, which can develop diseases and epigenetic changes as well. A nutritional genomics-based profile of athletes can be the best technic for a dietitian to make a unique sports nutrition diet plan. Using functional food and the right food components can be effected on health state, thus sports performance. Scientists need to determine the best response, due to the effect of nutrients on health, through altering genome promote metabolites and result changes in physiology. Nutritional biochemistry explains why polymorphisms in genes for the absorption, circulation, or metabolism of essential nutrients (such as n-3 polyunsaturated fatty acids or epigallocatechin-3-gallate), would affect the efficacy of that nutrient. Controlled nutritional deficiencies and failures, prevented the change of health state or a newly discovered food intolerance are observed by a proper medical team, can support better sports performance. It is important that the dietetics profession informed on gene-diet interactions, that may be leading to optimal health, reduced risk of injury or disease. A special medical application for documentation and monitoring of data of health state and risk factors can uphold and warn the medical team for an early action and help to be able to do a proper health service in time. This model can set up a personalized nutrition advice from the status control, through the recovery, to the monitoring. But more studies are needed to understand the mechanisms and to be able to change the composition of the microbiome, environmental and genetic risk factors in cases of athletes.

Keywords: gene-diet interaction, multidisciplinary team, microbiome, diet plan

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750 Assessing the Socio-Economic Problems and Environmental Implications of Green Revolution In Uttar Pradesh, India

Authors: Naima Umar

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Mid-1960’s has been landmark in the history of Indian agriculture. It was in 1966-67 when a New Agricultural Strategy was put into practice to tide over chronic shortages of food grains in the country. This strategy adopted was the use High-Yielding Varieties (HYV) of seeds (wheat and rice), which was popularly known as the Green Revolution. This phase of agricultural development has saved us from hunger and starvation and made the peasants more confident than ever before, but it has also created a number of socio-economic and environmental implications such as the reduction in area under forest, salinization, waterlogging, soil erosion, lowering of underground water table, soil, water and air pollution, decline in soil fertility, silting of rivers and emergence of several diseases and health hazards. The state of Uttar Pradesh in the north is bounded by the country of Nepal, the states of Uttrakhand on the northwest, Haryana on the west, Rajasthan on the southwest, Madhya Pradesh on the south and southwest, and Bihar on the east. It is situated between 23052´N and 31028´N latitudes and 7703´ and 84039´E longitudes. It is the fifth largest state of the country in terms of area, and first in terms of population. Forming the part of Ganga plain the state is crossed by a number of rivers which originate from the snowy peaks of Himalayas. The fertile plain of the Ganga has led to a high concentration of population with high density and the dominance of agriculture as an economic activity. Present paper highlights the negative impact of new agricultural technology on health of the people and environment and will attempt to find out factors which are responsible for these implications. Karl Pearson’s Correlation coefficient technique has been applied by selecting 1 dependent variable (i.e. Productivity Index) and some independent variables which may impact crop productivity in the districts of the state. These variables have categorized as: X1 (Cropping Intensity), X2 (Net irrigated area), X3 (Canal Irrigated area), X4 (Tube-well Irrigated area), X5 (Irrigated area by other sources), X6 (Consumption of chemical fertilizers (NPK) Kg. /ha.), X7 (Number of wooden plough), X8 (Number of iron plough), X9 (Number of harrows and cultivators), X10 (Number of thresher machines), X11(Number of sprayers), X12 (Number of sowing instruments), X13 (Number of tractors) and X14 (Consumption of insecticides and pesticides (in Kg. /000 ha.). The entire data during 2001-2005 and 2006- 2010 have been taken and 5 years average value is taken into consideration, based on secondary sources obtained from various government, organizations, master plan report, economic abstracts, district census handbooks and village and town directories etc,. put on a standard computer programmed SPSS and the results obtained have been properly tabulated.

Keywords: agricultural technology, environmental implications, health hazards, socio-economic problems

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749 Gender, Social Media Usage, and Type of Gym Activity on Body Image Among Urban Emerging Adults

Authors: Pranav Saxena

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This study examines the influence of social media usage, gym activities (weightlifting vs. cardiovascular exercise), and gender on body image perceptions among urban emerging adults in India. The research aimed to assess how these factors interact to shape body esteem, a crucial aspect of psychological well-being in a society increasingly influenced by media portrayals of idealized bodies. A purposive sample of 317 participants aged 18–27 years (167 male, 150 female) was recruited through snowball sampling across diverse urban areas. Body esteem was measured using the Body-Esteem Scale for Adolescents and Adults (BESAA), which evaluates perceptions related to appearance, weight, and how individuals perceive others’ view their bodies. Data was collected via online surveys, and Mann-Whitney U tests were used to examine differences in body esteem scores based on the type of gym activity, gender, and social media usage. Results revealed that participants who engaged in cardiovascular activities had significantly higher body esteem compared to those who participated in weightlifting (p = 0.020). Gender differences were also notable, with females reporting higher body esteem than males (p = 0.01). These findings suggest that women may experience more positive body perceptions, possibly influenced by the broader body positivity movement. Contrary to expectations, social media usage was found to be significantly associated with the drive for thinness (p = 0.030) but not with overall body esteem scores (p = 0.329). This suggests that while social media may contribute to specific body dissatisfaction related to thinness, it does not appear to be a major factor influencing overall body esteem in this sample. These results underscore the significant role of physical activity and gender in shaping body image perceptions while challenging the view that social media is the primary driver of negative body image in emerging adults. The findings indicate that physical activity, particularly cardiovascular exercise, may have a protective effect on body esteem, whereas weightlifting could potentially contribute to body dissatisfaction, especially among males. The study also highlights the need for a nuanced understanding of social media's role in shaping body image, suggesting that its impact may be less pronounced than previously thought when compared to other social factors such as gender and physical activity. This study contributes to the growing body of literature on body image in emerging adults, particularly in the context of urban India, where media and fitness culture heavily influence perceptions of the ideal body. It calls for further research into the long-term effects of social media on body image, the role of specific fitness cultures, and how gender norms continue to shape body image concerns. The findings have important implications for designing mental health and fitness interventions that are tailored to address the unique challenges faced by young adults, especially those who may experience heightened dissatisfaction with their bodies due to societal pressures or media portrayals.

Keywords: body image, gender, gym activity, social media usage

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748 Impact of Climate Change on Irrigation and Hydropower Potential: A Case of Upper Blue Nile Basin in Western Ethiopia

Authors: Elias Jemal Abdella

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The Blue Nile River is an important shared resource of Ethiopia, Sudan and also, because it is the major contributor of water to the main Nile River, Egypt. Despite the potential benefits of regional cooperation and integrated joint basin management, all three countries continue to pursue unilateral plans for development. Besides, there is great uncertainty about the likely impacts of climate change in water availability for existing as well as proposed irrigation and hydropower projects in the Blue Nile Basin. The main objective of this study is to quantitatively assess the impact of climate change on the hydrological regime of the upper Blue Nile basin, western Ethiopia. Three models were combined, a dynamic Coordinated Regional Climate Downscaling Experiment (CORDEX) regional climate model (RCM) that is used to determine climate projections for the Upper Blue Nile basin for Representative Concentration Pathways (RCPs) 4.5 and 8.5 greenhouse gas emissions scenarios for the period 2021-2050. The outputs generated from multimodel ensemble of four (4) CORDEX-RCMs (i.e., rainfall and temperature) were used as input to a Soil and Water Assessment Tool (SWAT) hydrological model which was setup, calibrated and validated with observed climate and hydrological data. The outputs from the SWAT model (i.e., projections in river flow) were used as input to a Water Evaluation and Planning (WEAP) water resources model which was used to determine the water resources implications of the changes in climate. The WEAP model was set-up to simulate three development scenarios. Current Development scenario was the existing water resource development situation, Medium-term Development scenario was planned water resource development that is expected to be commissioned (i.e. before 2025) and Long-term full Development scenario were all planned water resource development likely to be commissioned (i.e. before 2050). The projected change of mean annual temperature for period (2021 – 2050) in most of the basin are warmer than the baseline (1982 -2005) average in the range of 1 to 1.4oC, implying that an increase in evapotranspiration loss. Subbasins which already distressed from drought may endure to face even greater challenges in the future. Projected mean annual precipitation varies from subbasin to subbasin; in the Eastern, North Eastern and South western highland of the basin a likely increase of mean annual precipitation up to 7% whereas in the western lowland part of the basin mean annual precipitation projected to decrease by 3%. The water use simulation indicates that currently irrigation demand in the basin is 1.29 Bm3y-1 for 122,765 ha of irrigation area. By 2025, with new schemes being developed, irrigation demand is estimated to increase to 2.5 Bm3y-1 for 277,779 ha. By 2050, irrigation demand in the basin is estimated to increase to 3.4 Bm3y-1 for 372,779 ha. The hydropower generation simulation indicates that 98 % of hydroelectricity potential could be produced if all planned dams are constructed.

Keywords: Blue Nile River, climate change, hydropower, SWAT, WEAP

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747 Budget Impact Analysis of a Stratified Treatment Cascade for Hepatitis C Direct Acting Antiviral Treatment in an Asian Middle-Income Country through the Use of Compulsory and Voluntary Licensing Options

Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

Abstract:

Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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