Search results for: middle Byzantine architecture
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3366

Search results for: middle Byzantine architecture

876 Local Governments Supporting Environmentally Sustainable Meals to Protect the Planet and People

Authors: Magdy Danial Riad

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Introduction: The ability of our world to support the expanding population after 2050 is at risk due to the food system's global role in poor health, climate change, and resource depletion. Healthy, equitable, and sustainable food systems must be achieved from the point of production through consumption in order to meet several of the sustainable development goals (SDG) targets. There is evidence that changing the local food environment can effectively change dietary habits in a community. The purpose of this article is to outline the policy initiatives taken by local governments to support environmentally friendly eating habits. Methods: Five databases were searched for peer-reviewed articles that described local government authorities' implementation of environmentally sustainable eating habits, were located in cities that had signed the Milan Urban Food Policy Pact, were published after 2015, were available in English, and described policy interventions. Data extraction was a two-step approach that started with extracting information from the included study and ended with locating information unique to policies in the grey literature. Results: 45 papers that described a variety of policy initiatives from low-, middle-, and high-income countries met the inclusion criteria. A variety of desired dietary behaviors were the focus of policy action, including reducing food waste, procuring food locally and in season, boosting breastfeeding, avoiding overconsumption, and consuming more plant-based meals and fewer items derived from animals. Conclusions: In order to achieve SDG targets, local governments are under pressure to implement evidence-based interventions. This study can help direct local governments toward evidence-based policy measures to improve regional food systems and support ecologically friendly eating habits.

Keywords: meals, planet, poor health, eating habits

Procedia PDF Downloads 52
875 A Grey-Box Text Attack Framework Using Explainable AI

Authors: Esther Chiramal, Kelvin Soh Boon Kai

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Explainable AI is a strong strategy implemented to understand complex black-box model predictions in a human-interpretable language. It provides the evidence required to execute the use of trustworthy and reliable AI systems. On the other hand, however, it also opens the door to locating possible vulnerabilities in an AI model. Traditional adversarial text attack uses word substitution, data augmentation techniques, and gradient-based attacks on powerful pre-trained Bidirectional Encoder Representations from Transformers (BERT) variants to generate adversarial sentences. These attacks are generally white-box in nature and not practical as they can be easily detected by humans e.g., Changing the word from “Poor” to “Rich”. We proposed a simple yet effective Grey-box cum Black-box approach that does not require the knowledge of the model while using a set of surrogate Transformer/BERT models to perform the attack using Explainable AI techniques. As Transformers are the current state-of-the-art models for almost all Natural Language Processing (NLP) tasks, an attack generated from BERT1 is transferable to BERT2. This transferability is made possible due to the attention mechanism in the transformer that allows the model to capture long-range dependencies in a sequence. Using the power of BERT generalisation via attention, we attempt to exploit how transformers learn by attacking a few surrogate transformer variants which are all based on a different architecture. We demonstrate that this approach is highly effective to generate semantically good sentences by changing as little as one word that is not detectable by humans while still fooling other BERT models.

Keywords: BERT, explainable AI, Grey-box text attack, transformer

Procedia PDF Downloads 137
874 Update Mosquito Species Composition and Distribution in Qatar

Authors: Fatima Alkhayat, Abu Hassan Ahmed

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Qatar as the one of Middle East and Gulf country is growing rapidly due to urbanization. Urbanization, population’s movement and goods transportation in addition to climatic change all together create suitable environments for remerging and/or introduction of new disease vectors species. Unfortunately, knowledge on mosquito species composition and their geographical distribution in Qatar is extremely limited. The objective of present study is to provide update information on species composition and distribution. Mosquito larval survey carried out in six sentinel sites in Qatar. The collection was made on monthly basis in period from October 2013 to May 2015 using dipping techniques and identified to species level using appropriate pictorial keys. In total about 3,085 mosquito larvae were collected and identified to species compromising three mosquito genera, Culex 87.4% (n=2697), Ochlerotatus 9.9% (n= 305) and Anopheles 2.6% (n= 81). Among Culex genera; Culex quinquefasciatus represent 87.8% (n= 2369), Cx. pipiens 8.7% (n=237), and Cx. mattinglyi 3.4% (n=91). Culex quinquefasciatus was the most commonly collected species, representing 93.5% in Alwakra (n= 2216) which was observed in November, December, March, April and May when reached the peak. 6.4% in Nuaija (n= 151) was found in February and March and reached the peak in March. 0.1% in Alkaraana (n=2) only observed in April. Cx. pipiens was observed 50.2% in Rwdat Alfaras (n=120) and 48.9% in Hazm Almurkhiya (n=117). While in Rowdat Alfaras it was observed in Oct-May and in Hazm Almurkhiya from Oct-April. Cx. mattinglyi (n= 91) was only found in Nuaija from October to December. Ochlerotatus genera account 1 species Oc. dorsalis (n=305). The majority of Oc. dorsalis were observed in March and May, 98% in Nuaija (n= 299), followed by 2% in Alkhor (n=6) which was observed in January and February. Anopheles was only represented by An. stephensi which was found 69% in Alwakra (n= 56) in November, December, April and May, while 25.9% in Hazm Almurkhiya (n=21) and found in May and November. 6.2% in Rwadat Alfaras and was observed only in November and 1.2% in Nuaija (n=1) and observed in October. Further investigation is required on the composition and distribution of mosquito for implementing a surveillance program and control of mosquito-borne diseases in Qatar.

Keywords: composition, distribution, mosquito, Qatar

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873 Regional Variation of Cancer Incidence in Nepal

Authors: Rudra Prasad Khanal

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Introduction: Non-communicable disease, such as cancer, has spread all over the world for some last decades. However, every nation has experienced a burden from the development of technology. In the context of Nepal, 10 to 15 thousand new cancer incidences are being registered in different hospitals for treatment. Since the date of starting nuclear medicine at Bir Hospital in 1998, cancer patients have been getting treatment regularly. According to the data of the population-based cancer registry, approximately 60% of the population having a middle-class income is being affected by cancer in Nepal. Methods and Materials: The study is aimed to find out the particular place where the population density of new cancer incidence is highest in Nepal and to inform the concerned regulatory body that is working on cancer screening and early detection for the proper treatment from the beginning. In order to identify the areas with the highest population density of new cancer incidence, all the data of cancer patients were collected from five different renowned hospitals and also from the population-based cancer registry center and then analyzed the data. The history of cancer patients was studied from 2003 to 2020, but here the data are analyzed from 2015 to 2020 only to find the latest trend in cancer incidence. Results: In the five major hospitals in Nepal, the total new cancer incidence was 61783 from 2015 to 2020. Out of those, 34617 were female, and 27176 were male. This research shows that female cancer patients were more every year. In the male, lung cancer patients more than cancer of other organs, but in females, the number of breast cancer patients was greatest. The age-adjusted mortality rate for males in Kathmandu valley was 36.3, and for females was 27.0 per 100,000 population. The cancer incidence and mortality rate were slightly lesser in other districts of Nepal. This rate increased with the increase in the age of people. Over 60 years, cancer incidence and mortality rates have been found to increase rapidly. Conclusion: This research supports conducting the program of cancer screening and early detection at Kathmandu valley with high priority and then Morang, Rukum, SSDM, etc., to control cancer.

Keywords: cancer incidence, research scholar, Tribhuvan University, Bhaktapur Cancer Hospital, Nepal

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872 The Semiosis of 'We' Narrative: Examining Collectivity in Tahrir Memoir

Authors: May Al Sahib

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This paper draws together an analysis of two autobiographical writings; Ahdaf Soueif’s Cairo: My City, Our Revolution (2012), Radwa Ashour’s Heavier than Radwa (2013), and Revolution is My Name: An Egyptian Woman’s Diary from Eighteen Days in Tahrir (2015). Soueif, Ashour, and Prince are Egyptian authors, activists, and cultural commentators who are fully aware that being a ‘third world’ citizen constrains the writer into taking a specific pattern in writing. However, this paper will analyze the choice of literary form in writing the 2011 January revolution. All texts give factual accounts of the revolution with all its contesting powers lingering with mixed references of anxiety and merriment that accentuates their sense of communal solidarity against social corruption and political positioning. Through shifting between the pronouns ‘I’ and ‘we’, these narratives do not solely engage with the personal life of the memorialist; but rather give an account of the collective. Both writers take us to the heart of high-spirited Tahrir Square in 2011 while millions are ranting to oust Hosni Mubarak, the 30 years ruling dictator. By utilizing the instrumentality of collective memory for expressing textual collectivity in their non-fictional writings, these writers are depicting the people power of Egyptians and the historical civil-resistance against governmental unfairness and establishing a certain type of patriotism that elevates and priorities itself from minor conflicts. Their de-individualizing type of life narrative represents the Arabic nation through vital socio-political situations that perpetuate the politics of resistance and collectivity with a constant fear of betraying it and erupts historical moments aiming for an improved future. The texts incorporate an explicit set of reported political series of thought that shape an overall public argument and representational ideas.

Keywords: resistance narrative, life-writing, Tahrir memoir, Middle Eastern literature

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871 Improving Cheon-Kim-Kim-Song (CKKS) Performance with Vector Computation and GPU Acceleration

Authors: Smaran Manchala

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Homomorphic Encryption (HE) enables computations on encrypted data without requiring decryption, mitigating data vulnerability during processing. Usable Fully Homomorphic Encryption (FHE) could revolutionize secure data operations across cloud computing, AI training, and healthcare, providing both privacy and functionality, however, the computational inefficiency of schemes like Cheon-Kim-Kim-Song (CKKS) hinders their widespread practical use. This study focuses on optimizing CKKS for faster matrix operations through the implementation of vector computation parallelization and GPU acceleration. The variable effects of vector parallelization on GPUs were explored, recognizing that while parallelization typically accelerates operations, it could introduce overhead that results in slower runtimes, especially in smaller, less computationally demanding operations. To assess performance, two neural network models, MLPN and CNN—were tested on the MNIST dataset using both ARM and x86-64 architectures, with CNN chosen for its higher computational demands. Each test was repeated 1,000 times, and outliers were removed via Z-score analysis to measure the effect of vector parallelization on CKKS performance. Model accuracy was also evaluated under CKKS encryption to ensure optimizations did not compromise results. According to the results of the trail runs, applying vector parallelization had a 2.63X efficiency increase overall with a 1.83X performance increase for x86-64 over ARM architecture. Overall, these results suggest that the application of vector parallelization in tandem with GPU acceleration significantly improves the efficiency of CKKS even while accounting for vector parallelization overhead, providing impact in future zero trust operations.

Keywords: CKKS scheme, runtime efficiency, fully homomorphic encryption (FHE), GPU acceleration, vector parallelization

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870 Land Degradation Assessment through Spatial Data Integration in Eastern Chotanagpur Plateau, India

Authors: Avijit Mahala

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Present study is primarily concerned with the physical processes and status of land degradation in a tropical plateau fringe. Chotanagpur plateau is one of the most water erosion related degraded areas of India. The granite gneiss geological formation, low to medium developed soil cover, undulating lateritic uplands, high drainage density, low to medium rainfall (100-140cm), dry tropical deciduous forest cover makes the Silabati River basin a truly representative of the tropical environment. The different physical factors have been taken for land degradation study includes- physiographic formations, hydrologic characteristics, and vegetation cover. Water erosion, vegetal degradation, soil quality decline are the major processes of land degradation in study area. Granite-gneiss geological formation is responsible for developing undulating landforms. Less developed soil profile, low organic matter, poor structure of soil causes high soil erosion. High relief and sloppy areas cause unstable environment. The dissected highland causes topographic hindrance in productivity. High drainage density and frequency in rugged upland and intense erosion in sloppy areas causes high soil erosion of the basin. Decreasing rainfall and increasing aridity (low P/PET) threats water stress condition. Green biomass cover area is also continuously declining. Through overlaying the different physical factors (geological formation, soil characteristics, geomorphological characteristics, etc.) of considerable importance in GIS environment the varying intensities of land degradation areas has been identified. Middle reaches of Silabati basin with highly eroded laterite soil cover areas are more prone to land degradation.

Keywords: land degradation, tropical environment, lateritic upland, undulating landform, aridity, GIS environment

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869 Automatic Generation of Census Enumeration Area and National Sampling Frame to Achieve Sustainable Development Goals

Authors: Sarchil H. Qader, Andrew Harfoot, Mathias Kuepie, Sabrina Juran, Attila Lazar, Andrew J. Tatem

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The need for high-quality, reliable, and timely population data, including demographic information, to support the achievement of the sustainable development goals (SDGs) in all countries was recognized by the United Nations' 2030 Agenda for sustainable development. However, many low and middle-income countries lack reliable and recent census data. To achieve reliable and accurate census and survey outputs, up-to-date census enumeration areas and digital national sampling frames are critical. Census enumeration areas (EAs) are the smallest geographic units for collection, disseminating, and analyzing census data and are often used as a national sampling frame to serve various socio-economic surveys. Even for countries that are wealthy and stable, creating and updating EAs is a difficult yet crucial step in preparing for a national census. Such a process is commonly done manually, either by digitizing small geographic units on high-resolution satellite imagery or walking the boundaries of units, both of which are extremely expensive. We have developed a user-friendly tool that could be employed to generate draft EA boundaries automatically. The tool is based on high-resolution gridded population and settlement datasets, GPS household locations, building footprints and uses publicly available natural, man-made and administrative boundaries. Initial outputs were produced in Burkina Faso, Paraguay, Somalia, Togo, Niger, Guinea, and Zimbabwe. The results indicate that the EAs are in line with international standards, including boundaries that are easily identifiable and follow ground features, have no overlaps, are compact and free of pockets and disjoints, and the boundaries are nested within administrative boundaries.

Keywords: enumeration areas, national sampling frame, gridded population data, preEA tool

Procedia PDF Downloads 144
868 Economic Integration in Eurasia: Modeling of the Current and Future Architecture

Authors: M. G. Shilina

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The prospects for political and economic development of the Eurasian space are currently discussed at both governmental and expert levels. New concepts actively proposed by the Eurasian governments require the analysis and search for effective implementation options. In the paper, an attempt to identify effective solutions to the problems surrounding the current economic integration of the Eurasian states is given on the basis of an interdisciplinary, comprehensive, structured analysis. The phenomenon is considered through the prism of the international law, world economy and politics, combined with the study of existing intergovernmental practice. The modeling method was taken as the basis for the research and is supplemented by legal and empirical methods. The detailed multi-level model of practical construction the 'Great Eurasia' (the GE) concept is proposed, the option for building a phased interaction in Eurasia is given through the prism of construction by the Eurasian Economic Union (the EAEU) as the main tool. The Shanghai Cooperation Organization (the SCO) is seen as the most promising element of the model. The SCO is capable of streamlining the formation of the GE and determine the transformation of Eurasia into a common economic space. Effective development of the economic integration between Eurasian states on the framework of the SCO is optimal. The SCO+ could be used as a platform for integration-integration processes formation. The creation of stable financial ties could become the basis for the possible formation of an expanded transregional integration platform. The paper concludes that the implementation of the proposed model could entail a gradual economic rapprochement of Eurasia and beyond.

Keywords: economic integration, The Eurasian Economic Union, The European Union, The Shanghai Cooperation Organization, the silk road economic belt

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867 The Impact of Artificial Intelligence on Digital Construction

Authors: Omil Nady Mahrous Maximous

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The construction industry is currently experiencing a shift towards digitisation. This transformation is driven by adopting technologies like Building Information Modelling (BIM), drones, and augmented reality (AR). These advancements are revolutionizing the process of designing, constructing, and operating projects. BIM, for instance, is a new way of communicating and exploiting technology such as software and machinery. It enables the creation of a replica or virtual model of buildings or infrastructure projects. It facilitates simulating construction procedures, identifying issues beforehand, and optimizing designs accordingly. Drones are another tool in this revolution, as they can be utilized for site surveys, inspections, and even deliveries. Moreover, AR technology provides real-time information to workers involved in the project. Implementing these technologies in the construction industry has brought about improvements in efficiency, safety measures, and sustainable practices. BIM helps minimize rework and waste materials, while drones contribute to safety by reducing workers' exposure to areas. Additionally, AR plays a role in worker safety by delivering instructions and guidance during operations. Although the digital transformation within the construction industry is still in its early stages, it holds the potential to reshape project delivery methods entirely. By embracing these technologies, construction companies can boost their profitability while simultaneously reducing their environmental impact and ensuring safer practices.

Keywords: architectural education, construction industry, digital learning environments, immersive learning BIM, digital construction, construction technologies, digital transformation artificial intelligence, collaboration, digital architecture, digital design theory, material selection, space construction

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866 Assessing the Impact of Quinoa Cultivation Adopted to Produce a Secure Food Crop and Poverty Reduction by Farmers in Rural Pakistan

Authors: Ejaz Ashraf, Raheel Babar, Muhammad Yaseen, Hafiz Khurram Shurjeel, Nosheen Fatima

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Main purpose of this study was to assess adoption level of farmers for quinoa cultivation after they had been taught through training and visit extension approach. At this time of the 21st century, population structure, climate change, food requirements and eating habits of people are changing rapidly. In this scenario, farmers must play their key role in sustainable crop development and production through adoption of new crops that may also be helpful to overcome the issue of food insecurity as well as reducing poverty in rural areas. Its cultivation in Pakistan is at the early stages and there is a need to raise awareness among farmers to grow quinoa crops. In the middle of the 2015, a training and visit extension approach was used to raise awareness and convince farmers to grow quinoa in the area. During training and visit extension program, 80 farmers were randomly selected for the training of quinoa cultivation. Later on, these farmers trained 60 more farmers living into their neighborhood. After six months, a survey was conducted with all 140 farmers to assess the impact of the training and visit program on adoption level of respondents for the quinoa crop. The survey instrument was developed with the help of literature review and other experts of the crop. Validity and reliability of the instrument were checked before complete data collection. The data were analyzed by using SPSS. Multiple regression analysis was used for interpretation of the results from the survey, which indicated that factors like information/ training, change in agronomic and plant protection practices play a key role in the adoption of quinoa cultivation by respondents. In addition, the model explains more than 50% of variation in the adoption level of respondents. It is concluded that farmers need timely information for improved knowledge of agronomic and plant protection practices to adopt cultivation of the quinoa crop in the area.

Keywords: farmers, quinoa, adoption, contact, training and visit

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865 Use of Serum Creatinine as an Incentive to Increase Prep Uptake Among Key Population Groups in South-South Nigeria

Authors: Akhigbe Mark, Abang Roger, Mwoltu Nanaribet, Edet Blessing

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Introduction.: The introduction of pre- exposure prophylaxis (PrEP) as a biomedical prevention method for HIV/AIDS has been around for more than a decade since the first confirmed evidence of its effectiveness when used daily as an oral pill. It is now a very valuable addition for people who are at higher risk of contracting HIV. Although globalacceptanceof PrEP hasincreased, PrEP is still highly concentrated in a small number of countries and within a small sub-population, with Kenya and South Africa accounting for only 19% of people who have received PrEP in Africa region, there is still a significant regionGap in PrEP availability and use, with only 28% of the target of 3 million in low-and middle countries currently using PrEP. Description: The purpose of this study is to find out if serum creatinine could be used as an incentive to improve PrEP uptake among Key population.Numerous approaches to increasing the uptake ofPrEP as a prevention mechanism for HIV in KPs has beenemployed, and one of them is serum creatinine. This approach is a biomarker of renal function, which was used in study as an incentive to increase PrEP uptake among key population groups (female sex workers, men who have sex with men, persons who inject drugs, transgender) in 3 states from South-South Nigeria. Whole blood samples are collected from clients, analysis of the samples is done using the clinical chemistry analyzer before they are initiated onto PrEP. Lessons learned and Recommendations: Secondary data was extracted from 3 states of HALG Implementing facilities in Southern part of Nigeria, PrEP uptake before and afterthe introduction of serum creatinine between March 2020 and August 2020 among key populationsin Nigeria. A total of 5664 patients were initiated on PrEP before, and after the introduction of serum creatinine, the PrEP uptake rate before (March 2020 to May 2020) introduction of serum creatinine accounted for only 5% of the total onset, and after (June 2020 to August 2020) introduction of serum creatinine, the uptake rate accounted for 95% of the total onset. These finding shows that increased uptake of PrEP before/after serum creatineindicates that serum creatine may be an effective stimulus for promoting PrEP in key populations.

Keywords: serum creatinine, incentives, PrEP, key populations, Nigeria

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864 Fashion Performing/Fashioning Performances: Catwalks as Communication Tools between Market, Branding and Performing Art

Authors: V. Linfante

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Catwalks are one of the key moments in fashion: the first and most relevant display where brands stage their collections, products, ideas, and style. The garment is 'the star' of the catwalk and must show itself not just as a product but as a result of a design process endured for several months. All contents developed within this process become ingredients for connecting scenography, music, lights, and direction into a unique fashion narrative. According to the spirit of different ages, fashion shows have been transformed and shaped into peculiar formats: from Pandoras to presentations organized by Parisian couturiers, across the 'marathons' typical of the beginning of modern fashion system, coming up to the present structure of fashion weeks, with their complex organization and related creative and technical businesses. The paper intends to introduce the evolution of the fashion system through its unique process of seasonally staging and showing its production. The paper intends to analyse the evolution of the fashion shows from the intimacy of ballrooms at the beginning of the 20th century, passing through the enthusiasm attitude typical from the '70s and the '80s, to finally depict our present. In this last scenario, catwalks are not anymore a standard collections presentation but become one of the most exciting expression of contemporary culture (and sub-cultures), going from sophisticated performances (as Karl Lagerfeld's Chanel shows) to real artistic happenings (as the events of Victor&Rolf, Alexander McQueen, OFF_WHITE, Vetements, and Martin Margiela), often involving contemporary architecture, digital world, technology, social media, performing art and artists.

Keywords: branding, communication, fashion, new media, performing art

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863 Confidence Building Strategies Adopted in an EAP Speaking Course at METU and Their Effectiveness: A Case Study

Authors: Canan Duzan

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For most language learners, mastery of the speaking skill is the proof of the mastery of the foreign language. On the other hand, the speaking skill is considered as the most difficult aspect of language learning to develop for both learners and teachers. Especially in countries like Turkey where exposure to the target language is minimum and resources and opportunities provided for language practice are scarce, teaching and learning to speak the language become a real struggle for teachers and learners alike. Data collected from students, instructors, faculty members and the business sector in needs analysis studies conducted previously at Middle East Technical University (METU) consistently revealed the need for addressing the problem of lack of confidence in speaking English. Action was taken during the design of the only EAP speaking course offered in Modern Languages Department since lack of confidence is considered to be a serious barrier for effective communication and causes learners to suffer from insecurity, uncertainty and fear. “Confidence building” served as the guiding principle in the syllabus design, nature of the tasks created for the course and the assessment procedures to help learners become more confident speakers of English. In order to see the effectiveness of the decisions made during the design phase of the course and whether students become more confident speakers upon completion of the course, a case study was carried out with 100 students at METU. A questionnaire including both Likert-Scale and open-ended items were administered to students to collect data and this data were analyzed using the SPSS program. Group interviews were also carried out to gain more insight into the effectiveness of the course in terms of building speaking confidence. This presentation will explore the specific actions taken to develop students’ confidence based on the findings of program evaluation studies and to what extent the students believe these actions to be effective in improving their confidence. The unique design of this course and strategies adopted for confidence building are highly applicable in other EAP contexts and may yield similar positive results.

Keywords: confidence, EAP, speaking, strategy

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862 Evaluation and Control of Cracking for Bending Rein-forced One-way Concrete Voided Slab with Plastic Hollow Inserts

Authors: Mindaugas Zavalis

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Analysis of experimental tests data of bending one-way reinforced concrete slabs from various articles of science revealed that voided slabs with a grid of hollow plastic inserts inside have smaller mechani-cal and physical parameters compared to continuous cross-section slabs (solid slabs). The negative influence of a reinforced concrete slab is impacted by hollow plastic inserts, which make a grid of voids in the middle of the cross-sectional area of the reinforced concrete slab. A formed grid of voids reduces the slab’s stiffness, which influences the slab’s parameters of serviceability, like deflection and cracking. Prima-ry investigation of data established during experiments illustrates that cracks occur faster in the tensile surface of the voided slab under bend-ing compared to bending solid slab. It means that the crack bending moment force for the voided slab is smaller than the solid slab and the reduction can variate in the range of 14 – 40 %. Reduce of resistance to cracking can be controlled by changing a lot of factors: the shape of the plastic hallow insert, plastic insert height, steps between plastic in-serts, usage of prestressed reinforcement, the diameter of reinforcement bar, slab effective depth, the bottom cover thickness of concrete, effec-tive cross-section of the concrete area about reinforcement and etc. Mentioned parameters are used to evaluate crack width and step of cracking, but existing analytical calculation methods for cracking eval-uation of voided slab with plastic inserts are not so exact and the re-sults of cracking evaluation in this paper are higher than the results of analyzed experiments. Therefore, it was made analytically calculations according to experimental bending tests of voided reinforced concrete slabs with hollow plastic inserts to find and propose corrections for the evaluation of cracking for reinforced concrete voided slabs with hollow plastic inserts.

Keywords: voided slab, cracking, hallow plastic insert, bending, one-way reinforced concrete, serviceability

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861 Debris Flow Mapping Using Geographical Information System Based Model and Geospatial Data in Middle Himalayas

Authors: Anand Malik

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The Himalayas with high tectonic activities poses a great threat to human life and property. Climate change is another reason which triggering extreme events multiple fold effect on high mountain glacial environment, rock falls, landslides, debris flows, flash flood and snow avalanches. One such extreme event of cloud burst along with breach of moraine dammed Chorabri Lake occurred from June 14 to June 17, 2013, triggered flooding of Saraswati and Mandakini rivers in the Kedarnath Valley of Rudraprayag district of Uttrakhand state of India. As a result, huge volume of water with its high velocity created a catastrophe of the century, which resulted into loss of large number of human/animals, pilgrimage, tourism, agriculture and property. Thus a comprehensive assessment of debris flow hazards requires GIS-based modeling using numerical methods. The aim of present study is to focus on analysis and mapping of debris flow movements using geospatial data with flow-r (developed by team at IGAR, University of Lausanne). The model is based on combined probabilistic and energetic algorithms for the assessment of spreading of flow with maximum run out distances. Aster Digital Elevation Model (DEM) with 30m x 30m cell size (resolution) is used as main geospatial data for preparing the run out assessment, while Landsat data is used to analyze land use land cover change in the study area. The results of the study area show that model can be applied with great accuracy as the model is very useful in determining debris flow areas. The results are compared with existing available landslides/debris flow maps. ArcGIS software is used in preparing run out susceptibility maps which can be used in debris flow mitigation and future land use planning.

Keywords: debris flow, geospatial data, GIS based modeling, flow-R

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860 Downscaling Seasonal Sea Surface Temperature Forecasts over the Mediterranean Sea Using Deep Learning

Authors: Redouane Larbi Boufeniza, Jing-Jia Luo

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This study assesses the suitability of deep learning (DL) for downscaling sea surface temperature (SST) over the Mediterranean Sea in the context of seasonal forecasting. We design a set of experiments that compare different DL configurations and deploy the best-performing architecture to downscale one-month lead forecasts of June–September (JJAS) SST from the Nanjing University of Information Science and Technology Climate Forecast System version 1.0 (NUIST-CFS1.0) for the period of 1982–2020. We have also introduced predictors over a larger area to include information about the main large-scale circulations that drive SST over the Mediterranean Sea region, which improves the downscaling results. Finally, we validate the raw model and downscaled forecasts in terms of both deterministic and probabilistic verification metrics, as well as their ability to reproduce the observed precipitation extreme and spell indicator indices. The results showed that the convolutional neural network (CNN)-based downscaling consistently improves the raw model forecasts, with lower bias and more accurate representations of the observed mean and extreme SST spatial patterns. Besides, the CNN-based downscaling yields a much more accurate forecast of extreme SST and spell indicators and reduces the significant relevant biases exhibited by the raw model predictions. Moreover, our results show that the CNN-based downscaling yields better skill scores than the raw model forecasts over most portions of the Mediterranean Sea. The results demonstrate the potential usefulness of CNN in downscaling seasonal SST predictions over the Mediterranean Sea, particularly in providing improved forecast products.

Keywords: Mediterranean Sea, sea surface temperature, seasonal forecasting, downscaling, deep learning

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859 Woody Carbon Stock Potentials and Factor Affecting Their Storage in Munessa Forest, Southern Ethiopia

Authors: Mojo Mengistu Gelasso

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The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

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858 Woody Carbon Stock Potentials and Factor Affecting Their Storage in Munessa Forest, Southern Ethiopia

Authors: Mengistu Gelasso Mojo

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The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

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857 Mycobacterium Genome Extraction from Lymph Nodes of Sarcoidosis Cases Using Transbronchial Needle Aspiration: A Cross-Sectional Descriptive Essay On 1223 Patients

Authors: Atefeh Abedini, Pegah Soltani, Arda Kiani

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Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association.

Keywords: mycobacterium tuberculosis, sarcoidosis, genome, DNA, trans-bronchial needle aspiration

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856 A Case Study on Theme-Based Approach in Health Technology Engineering Education: Customer Oriented Software Applications

Authors: Mikael Soini, Kari Björn

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Metropolia University of Applied Sciences (MUAS) Information and Communication Technology (ICT) Degree Programme provides full-time Bachelor-level undergraduate studies. ICT Degree Programme has seven different major options; this paper focuses on Health Technology. In Health Technology, a significant curriculum change in 2014 enabled transition from fragmented curriculum including dozens of courses to a new integrated curriculum built around three 30 ECTS themes. This paper focuses especially on the second theme called Customer Oriented Software Applications. From students’ point of view, the goal of this theme is to get familiar with existing health related ICT solutions and systems, understand business around health technology, recognize social and healthcare operating principles and services, and identify customers and users and their special needs and perspectives. This also acts as a background for health related web application development. Built web application is tested, developed and evaluated with real users utilizing versatile user centred development methods. This paper presents experiences obtained from the first implementation of Customer Oriented Software Applications theme. Student feedback was gathered with two questionnaires, one in the middle of the theme and other at the end of the theme. Questionnaires had qualitative and quantitative parts. Similar questionnaire was implemented in the first theme; this paper evaluates how the theme-based integrated curriculum has progressed in Health Technology major by comparing results between theme 1 and 2. In general, students were satisfied for the implementation, timing and synchronization of the courses, and the amount of work. However there is still room for development. Student feedback and teachers’ observations have been and will be used to develop the content and operating principles of the themes and whole curriculum.

Keywords: engineering education, integrated curriculum, learning and teaching methods, learning experience

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855 Begamat-I-Bhopals': Role in the Development of Female Education under Colonialism

Authors: Munaza Mubeen

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The colonial Urdu literature has played a significant role in uplifting the overall status of the Indians. Taking example of the Bhopal State, the contribution of the Royal ladies holds no match in the contemporary age. Similarly, the efforts of the Begamat-e-Bhopal in the field of education had been acknowledged across the Sub-continent. It had been noticed that with the downfall of the Mughal Empire at the hands of the British Raj, the local culture in the Indian sub-continent in general and in Bhopal State in proper got deteriorated. This led to uncertainty, chaos and an anti-British sentiment which created hatred against them in the entire sub-continent. Likely, in Bhopal State, the role of women in field of education also vanished. However, this change was felt by the ladies in the Royal Household where they struggled for restoration of the status quo with their personal efforts. The prominent contributors from the Royal household included Qudseya Begum, Nawab Sikander Begum, Nawab Shah Jahan Begum and Nawab Sultan Johan-they are known as Begamat-i-Bhopal. They established schools, colleges and universities to impart formal and non-formal education respectively. Their systematic approach and continued efforts constituted a dynamic aspect of women’ empowerment. Focused on the female education, however, one of the by-products of their efforts was an introduction of socio-cultural and politico-religious awareness among the middle class womenfolk. Unfortunately, the role of these Bagamat-i-Bhopal has been left untouched or ignored by the academic scholars. This study critically analyzed the role of Beghamat-i-Bhopal regarding female education in Hindustan in general and in Bhopal in particular. Similarly, the contribution of the contemporary writers in development of female education in Bhopal has also been discussed in this paper. This paper is based on the 'historico-textual' approach following structural reason which has established a justifiable argument. The researcher, therefore, has taken into consideration all the chronological nuances in order to accord greater visibility to the contents. The data has been described, analyzed and interpreted inclusively and in generalized manner.

Keywords: colonialism, Begamaat e Bhopal, female education, State of Bhopal

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854 Experiencing Daylight in Architectural Spaces: A Case Study of Public Buildings in the Context of Karachi, Pakistan

Authors: Safia Asif, Saadia Bano

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In a world with rapidly depleting resources, using artificial lighting during daytime is an act of human ignorance. Imitated light is the major source of energy consumption in public buildings. Despite, the fact that substantial working hours of these buildings usually persist in natural daylight time; there is a trend of isolated, un-fenestrated and a-contextual interiors majorly dependent on active energy sources. On the contrary, if direct and un-controlled sunlight is allowed inside the building, it will create visual and thermal discomfort. Controlled daylighting with appropriate design mechanisms is one of the important aspects of achieving thermal and visual comfort. The natural sunlight can be utilized intelligently with the help of architectural thermal controlling mechanisms to achieve a healthy and productive environment. This paper is an attempt to investigate and analyze the importance of daylighting with reference to energy efficiency and thermal comfort. For this purpose, three public buildings including two educational institutions and one general post office are selected, as case-studies in the context of Karachi, Pakistan. Various parameters of visual and thermal comfort are analyzed which includes orientation, ceiling heights, overall building profile along with daylight controlling mechanisms in terms of penetration, distribution, protection, and control. In the later part of the research, a questionnaire survey is also conducted to evaluate the user experience in terms of adequate daylighting and thermal comfort.

Keywords: daylight, public buildings, sustainable architecture, visual and thermal comfort

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853 20th-Century River Course Changes and Their Relation to Sediment Carbon Distribution Patterns in the Yellow River Delta

Authors: Dongxue Li, Zhonghua Ning, Yi’na Li, Baoshan Cui, Wasner Daniel, Sebastian Dötterl

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Most of the world's coastal alluvial plains can be significant carbon (C) eservoirs in which upland sediments are deposited and bury former topsoil, thereby contributing to soil C preservation, especially in river-controlled deltas like the Yellow River Delta, China. These deltas are affected by the continuous large amount of sediment transport and strong river dynamics from the upper reaches, which makes the river course in the deltas change frequently. However, the impact of varying river course changes on C stocks in these estuary wetlands is unclear. To investigate this, we drilled five 2 m cores along a sediment deposition sequence of the Yellow River Delta, which shifted its main course flow in the delta several times throughout the 20th century. Covering 80 years of sediment deposition, we explored both soil C stocks and their potential sources, and identified key soil physicochemical and hydrometeorological variables that correlate to C density and deposition rate. Further, the spatiotemporal C distribution and its relationship with these variables was examined. Our results showed that sediments at a soil depth of 200 cm in the main courses of the Yellow River corresponded to deposition ages ranging from 1942 to 1989. The oldest course has the lowest C stocks and showed C-enriched compared with younger courses. Contributions of soil C stemming from fresh particulate organic carbon from deposited upstream sources were significantly higher than local, in-situ vegetation. In addition, the carbon of the oldest and relatively young courses tends to be affected by interaction effects of hydrometeorological and physiochemical varibales, and that of the middle courses tends to be affected by independent variables. Our findings can help prioritize conservation efforts across different river courses and provide quantitative support for global carbon emission reduction by assessing sediment carbon reservoirs.

Keywords: alluvial plains, coastal wetland, core drilling, course diversion, organic carbon, sediment deposition rate, soil deposition

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852 Hypertension and Obesity: A Cross-National Comparison of BMI and Waist-Height Ratio

Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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851 A Single Stage Cleft Rhinoplasty Technique for Primary Unilateral Cleft Lip and Palate 'The Gujrat Technique'

Authors: Diaa Othman, Muhammad Adil Khan, Muhammad Riaz

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Without an early intervention to correct the unilateral complete cleft lip and palate deformity, nasal architecture can progress to an exaggerated cleft nose deformity. We present the results of a modified unilateral cleft rhinoplasty procedure ‘the Gujrat technique’ to correct this deformity. Ninety pediatric and adult patients with non-syndromic unilateral cleft lip underwent primary and secondary composite cleft rhinoplasty using the Gujrat technique as a single stage operation over a 10-year period. The technique involved an open rhinoplasty with Tennison lip repair, and employed a combination of three autologous cartilage grafts, seven cartilage-molding sutures and a prolene mesh graft for alar base support. Post-operative evaluation of nasal symmetry was undertaken using the validated computer program ‘SymNose’. Functional outcome and patient satisfaction were assessed using the NOSE scale and ROE (rhinoplasty outcome evaluation) questionnaires. The single group study design used the non-parametric matching pairs Wilcoxon Sign test (p < 0.001), and showed overall good to excellent functional and aesthetic outcomes, including nasal projection and tip definition, and higher scores of the digital SymNose grading system. Objective assessment of the Gujrat cleft rhinoplasty technique demonstrates its aesthetic appeal and functional versatility. Overall it is a simple and reproducible technique, with no significant complications.

Keywords: cleft lip and palate, congenital rhinoplasty, nasal deformity, secondary rhinoplasty

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850 Application of Sustainable Agriculture Based on LEISA in Landscape Design of Integrated Farming

Authors: Eduwin Eko Franjaya, Andi Gunawan, Wahju Qamara Mugnisjah

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Sustainable agriculture in the form of integrated farming with its LEISA (Low External Input Sustainable Agriculture) concept has brought a positive impact on agriculture development and ambient amelioration. But, most of the small farmers in Indonesia did not know how to put the concept of it and how to combine agricultural commodities on the site effectively and efficiently. This research has an aim to promote integrated farming (agrofisheries, etc) to the farmers by designing the agricultural landscape to become integrated farming landscape as medium of education for the farmers. The method used in this research is closely related with the rule of design in the landscape architecture science. The first step is inventarization for the existing condition on the research site. The second step is analysis. Then, the third step is concept-making that consists of base concept, design concept, and developing concept. The base concept used in this research is sustainable agriculture with LEISA. The concept design is related with activity base on site. The developing concept consists of space concept, circulation, vegetation and commodity, production system, etc. The fourth step as the final step is planning and design. This step produces site plan of integrated farming based on LEISA. The result of this research is site plan of integrated farming with its explanation, including the energy flow of integrated farming system on site and the production calendar of integrated farming commodities for education and agri-tourism opportunity. This research become the right way to promote the integrated farming and also as a medium for the farmers to learn and to develop it.

Keywords: integrated farming, LEISA, planning and design, site plan

Procedia PDF Downloads 511
849 Europe's War on Refugees: The Increased Need for International Protection and Promotion of Migrant Rights

Authors: Rai Friedman

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The recent migrant crisis has revealed an unmet demand for increased international protection and promotion of migrant rights. Europe has found itself at the centre of the migration crisis, being the recipient to the largest number of asylum-seekers since the conclusion of the second World War. Rather than impart a unified humanitarian lens of offering legal protections, the Schengen territory is devising new, preventative measures to confront the influx of asylum-seekers. This paper will focus on the refugee crisis in Europe as it relates to the Central Mediterranean route. To do so, it will outline the increased need for international protection for migrant rights through analyzing historic human rights treaties and conventions; the formation of the current composition of the Schengen area; the evolutionary changes in policies and legal landscapes throughout Europe and the Central Mediterranean route; the vernacular transformation surrounding refugees, migrants, and asylum-seekers; and expose the gaps in international protection. It will also discuss Europe’s critical position, both geographically and conceptually, critiquing the notion of European victimization. Lastly, it will discuss the increased harm of preventative border measures and argue for tangible sustainability solutions through economic programming models in highly vulnerable countries. To do so, this paper will observe a case study in Algeria that has conceded to an economic programming model for forced migrants. In 2017 amid worker shortages, Algeria announced it would grant African migrants’ legal status to become agriculturalists and construction workers. Algeria is one of the few countries along the Central Mediterranean route that has adopted a law to govern foreign nationals’ conditions of entry, stay and circulation. Thereafter, it will provide recommendations for solutions for forced migration along the Central Mediterranean route and advocate for strengthened protections under international law.

Keywords: refugees, migrants, human rights, middle east, Africa, mediterranean, international humanitarian law, policy

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848 Investigating Legal Consciousness Among Migrants in Greece: A Study of Migrant’s Views of Hate Crime and their Legal Rights

Authors: Violeta Kapageorgiadou

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Over the past decade, millions of individuals from middle-eastern and African countries have migrated to Europe to seek refuge. The majority of these refugees emigrate from Muslim majority countries and seek to integrate into European societies. Notably, Greece has hosted thousands of individuals seeking asylum since 2015. Many of these individuals have applied for asylum. They have sought to integrate into the Greek society and to navigate their way through the national and European legal systems with regard to their status. This paper, drawn from a PhD thesis project, focuses on the legal consciousness of migrants and the processes open to asylum seekers to assert their rights, notably with regard to incidents of hate crime and including their interactions with the legal authorities in Greece. The research seeks to capture the factors that influence the views and behaviors of migrants towards the law and their legal rights, using legal consciousness as a theoretical framework. The research findings indicate that asylum seekers have developed a multidimensional legal consciousness influenced by their religious and political background, legal knowledge, previous (negative) experiences with the legal system and their socio-economic status in Greece. Asylum seekers, while aware of the rights essential for their survival in the host country (such as applying for asylum to obtain a secure status, claiming for benefits and housing), were unaware of, and less willing to engage with, legal authorities and rights which they did not find essential for their survival. They viewed hate incidents against them as less important, not worth reporting and sometimes did not even consider these incidents as crimes. The research suggests that asylum seekers in Greece are a vulnerable population who need mechanisms to support them and raise their legal consciousness around their rights in order to better integrate, develop and thrive in the host society. Moving forwards, a better understanding of refugees' and asylum seekers’ reactions towards hate crime will help to create future policies and support mechanisms that could improve the lives of these individuals.

Keywords: hate crime, legal consciousness, legal rights, migrations

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847 Development, Evaluation and Scale-Up of a Mental Health Care Plan (MHCP) in Nepal

Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

Procedia PDF Downloads 295