Search results for: gender and migration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3459

Search results for: gender and migration

699 Shoulder-Arm Mobility and Upper and Lower Extremity Muscle Function are Impaired in Patients with Systemic Sclerosis

Authors: F. Bringby, A. Nordin, L. Björnådal, E. Svenungsson, C. Boström, H Alexanderson

Abstract:

Patients with systemic sclerosis (SSc) have reduced hand function and self-reported limitations in daily activities. Few studies have explored limitations in shoulder-arm mobility and muscle function, or if there are differences in physical function between diffuse cutaneous (dcSSc) and limited cutaneous (lcSSc) SSc. The purpose of this study was to describe objectively assessed shoulder-arm mobility, lower extremity muscle function and muscle endurance in SSc and evaluate possible differences between lcSSc and dcSSc. 121 patients with SSc were included in this cross sectional study. Shoulder-arm mobility were examined using the Shoulder Function Assessment Scale (SFA) including 5 tasks ,lower extremity muscle function was measured by Timed stands test (TST) and muscle endurance in shoulder- and hip flexors were assessed by the Functional Index 2 (FI-2). Patients with dcSSc had median SFA hand to back score 5 (4-6) and median “hand to seat” score of 5 (4-6) compared to patients with lcSSc with corresponding median values of 6 (4-6) and 6 (5-6) respectively (p<0.01-p<0.05). 50% of both patientsgroups had lower muscle function assessed by the TST compared to age- and gender matched reference values but there were no differences in TST between the two patient groups. There was no difference in FI-2 scores between dcSSc and lcSSc. The whole group had 40 (28-83) % and 38 (32-72) % of maximal FI-2 shoulder flexion score on the right and left sides, and 40 (23-63) % and 37 (23-62) % of maximal FI-2 hip flexion score on the right and left sides. Reference values for the FI-2 indicate that healthy individuals perform in mean 100 % of maximal score. Patients with dcSSc were more limited than patients with lcSSc. Patients with SSc have reduced muscle function compared to reference values. These results highlights the importance of assessing shoulder-arm mobility and muscle function as well as a need for further research to identify exercise interventions to target these limitations.

Keywords: diffuse, limited, mobility, muscle function, physical therapy, systemic sclerosis

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698 Analyzing the Association between Physical Activity and Sleep Quality in College Students: Cross-Sectional Study

Authors: Fildzah Badzlina, Mega Puspa Sari

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To rest the body after a full day of activities, the body needs sleep. During sleep, the body's response to external stimuli will be reduced and relatively inactive so that it is used to optimize the body's biological functions that cannot be done when awake. College students often experience poor sleep quality because of the dense activities carried out during the day. In addition, the level of physical activity of college students is also relatively low. Based on previous research, college students who have low physical activity have poor sleep quality. Therefore, the purpose of this study was to determine the relationship between physical activity and sleep quality in college students of the University of Muhammadiyah Prof. Dr. Hamka. This study used a cross-sectional research design with 107 respondents as research subjects. Samples were taken using the purposive sampling technique. The data was taken using a google form which was distributed to all college students in September 2021. The statistical test used was Chi-square. The results of this study showed that 85 (79.4%) college students experienced poor sleep quality during the Covid-19 Pandemic Period. Most respondents were 96 women (89.7%) and 32.7% (35 people) aged 20 years. In the pocket money category, most college students (71%) got pocket money less than 500.000 rupiahs per month. A total of 52 respondents (48.6%) had a moderate level of physical activity category. Poor sleep quality was more common in male students (90.9%) compared to female students (78.1%) (p>0.05). In the group with poor sleep quality, 88.9% of students were categorized in Rp. 500.001 to Rp. 1.000.000 for pocket money, 80.3% of students included in the category Rp. 500.000 or less, and 61.5% of students are included in the category of Rp. 1.000.000 or more. Poor sleep quality was more common among students in the age category 20 years (84.1%), compared to students in the age category > 20 years (71.1%). For the level of physical activity in the poor sleep quality group, 87% were included in the category of heavy physical activity, 82.7% included in the moderate level of physical activity, and 68.8% included in the category of low-level physical activity. There was no significant relationship between gender, pocket money, age, and physical activity with sleep quality (p>0.05).

Keywords: college students, physical activity, sleep quality, university students

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697 Comparison of Computed Tomography Dose Index, Dose Length Product and Effective Dose Among Male and Female Patients From Contrast Enhanced Computed Tomography Pancreatitis Protocol

Authors: Babina Aryal

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Background: The diagnosis of pancreatitis is generally based on clinical and laboratory findings; however, Computed Tomography (CT) is an imaging technique of choice specially Contrast Enhanced Computed Tomography (CECT) shows morphological characteristic findings that allow for establishing the diagnosis of pancreatitis and determining the extent of disease severity which is done along with the administration of appropriate contrast medium. The purpose of this study was to compare Computed Tomography Dose Index (CTDI), Dose Length Product (DLP) and Effective Dose (ED) among male and female patients from Contrast Enhanced Computed Tomography (CECT) Pancreatitis Protocol. Methods: This retrospective study involved data collection based on clinical/laboratory/ultrasonography diagnosis of Pancreatitis and has undergone CECT Abdomen pancreatitis protocol. data collection involved detailed information about a patient's Age and Gender, Clinical history, Individual Computed Tomography Dose Index and Dose Length Product and effective dose. Results: We have retrospectively collected dose data from 150 among which 127 were males and 23 were females. The values obtained from the display of the CT screen were measured, calculated and compared to determine whether the CTDI, DLP and ED values were similar or not. CTDI for females was more as compared to males. The differences in CTDI values for females and males were 32.2087 and 37.1609 respectively. DLP values and Effective dose for both the genders did not show significant differences. Conclusion: This study concluded that there were no more significant changes in the DLP and ED values among both the genders however we noticed that female patients had more CTDI than males.

Keywords: computed tomography, contrast enhanced computed tomography, computed tomography dose index, dose length product, effective dose

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696 Between Fiction and Reality: Reading the Silences in Partition History

Authors: Shazia Salam

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This paper focuses on studying the literary reactions of selected Muslim women writers to the event of Partition of India in the north western region. It aims to explore how Muslim women experienced the Partition and how that experience was articulated through their writing. There is a serious dearth of research on the experience of Muslim women who had to witness the momentous event of the subcontinent. Since scholars have often questioned the silence around the historiography related to the experiences of Muslim women, this paper aims to explore if literature could provide insights that may be less readily available in other modes of narration. Using literature as an archival source, it aims to delve into the arenas of history that have been cloistered and closed. Muslim women have been silent about their experiences of Partition which at the cost of essentializing could be attributed to patriarchal constraints, and taboos, on speaking of intimate matters. These silences have consigned the question of their experience to a realm of anonymity. The lack of ethnographic research has in a way been compensated in the realm of literature, mainly poetry and fiction. Besides reportage, literature remains an important source of social history about Partition and how Muslim women lived through it. Where traditional history fails to record moments of rupture and dislocation, literature serves the crucial purpose. The central premise in this paper is that there is a need to revise the history of partition owing to the gaps in historiography. It looks into if literature can serve as a ground for developing new approaches to history since the question of the representation always confronts us--between what a text represents and how it represents it since imagination of the writer plays a great role in the construction of any text. With this approach as an entry point, this paper aims to unpack the questions of representation, the coalescing of history /literature and the gendered nature of partition history. It concludes that the gaps in the narratives of Partition and the memory of Partition can be addressed by way of suing literary as a source to fill in the cracks and fissures.

Keywords: gender, history, literature, partition

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695 Factors Afecting the Academic Performance of In-Service Students in Science Educaction

Authors: Foster Chilufya

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This study sought to determine factors that affect academic performance of mature age students in Science Education at University of Zambia. It was guided by Maslow’s Hierarchy of Needs. The theory provided relationship between achievement motivation and academic performance. A descriptive research design was used. Both Qualitative and Quantitative research methods were used to collect data from 88 respondents. Simple random and purposive sampling procedures were used to collect from the respondents. Concerning factors that motivate mature-age students to choose Science Education Programs, the following were cited: need for self-actualization, acquisition of new knowledge, encouragement from friends and family members, good performance at high school and diploma level, love for the sciences, prestige and desire to be promoted at places of work. As regards factors that affected the academic performance of mature-age students, both negative and positive factors were identified. These included: demographic factors such as age and gender, psychological characteristics such as motivation and preparedness to learn, self-set goals, self esteem, ability, confidence and persistence, student prior academic performance at high school and college level, social factors, institutional factors and the outcomes of the learning process. In order to address the factors that negatively affect academic performance of mature-age students, the following measures were identified: encouraging group discussions, encouraging interactive learning process, providing a conducive learning environment, reviewing Science Education curriculum and providing adequate learning materials. Based on these factors, it is recommended that, the School of Education introduces a program in Science Education specifically for students training to be teachers of science. Additionally, introduce majors in Physics Education, Biology Education, Chemistry Education and Mathematics Education relevant to what is taught in high schools.

Keywords: academic, performance, in-service, science

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694 Mapping the Metamorphosis of the Nigerian Female: A Womanist Approach to the Novels of Chimamanda Ngozi Adichie

Authors: Vidhya R

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The claim of feminists that women are made and not born is neither to set women on par with men nor to discriminate one from the other, but to establish and reiterate the fact that both the sexes have to understand, recognize and appreciate each other’s ability and responsibility thus to contribute to the peaceful co-existence of both, leading to the creation of a better and brave new world, which is neither patriarchal nor matriarchal. But history has repeatedly recorded the relegation of women to the secondary position consummated through the highly biased cultural, ritualistic and customary practices across the globe. In Africa, bracing herself against many odds through generations, the African woman who has been facing multiple jeopardy promulgated by racial, cultural, economic and gender discrimination has slowly started moving from the margins towards the center. The African woman was able to undertake the journey from the margins to the center bravely only because of her grit, grace, courage, confidence, and spirituality. This journey has resulted in the metamorphosis of the African woman’s psyche. Economic independence fortified with education has empowered the African woman. The various stages of metamorphosis are well delineated in the works of the contemporary Nigerian writer Chimamanda Ngozi Adichie. The objective of this research paper is to study the above said metamorphosis, the female protagonists undergo in Adichie’s novels. The approaches on which the study is based on are the Africana Womanist theory propounded by Clenora Hudson –Weems and African feminism of Carole Boyce Davies. The findings of this study lead towards establishing the proposition that the emergence and evolution of the Nigerian woman has resulted in the birth of a new breed of women – the Emphatic Female, manifested in the power packed portrayal of the female protagonists of Purple Hibiscus, Half of a Yellow Sun and Americanah by Chimamanda Ngozi Adichie.

Keywords: Africana womanism, African feminism, chimamanda ngozi adichie, metamorphosis, the emphatic female

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693 Proactive Business Approaches in Human Rights: The Implications of Corporate Social Responsibility

Authors: Fatemeh Jalalvand

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The critical human rights problems such as extreme poverty, hunger, inequalities and gender discrimination need to be addressed by powerful and influential actors in the world. In today’s globalization, corporations have become one of the potent agents in the society. They are capable of generating economic growth, reducing poverty, and increasing the well-being of individuals, thereby contributing to the betterment of a broad spectrum of human rights. However, the discussion on how business can contribute to human rights has primarily focused on not violating them (reactive approach) rather than improving the conditions and solving the problems of human rights (proactive approach). In particular, the role of corporate social responsibility (CSR) in bringing proactivity of business in human rights has gained less attention. This paper develops a conceptual framework to examine the role of different categories of CSR, including discretionary, ethical, legal, instrumental and political CSR in encouraging the proactive contribution of corporations to the betterment of human rights. The five propositions, related to the conceptual framework, outline the relationships between five categories of CSR and proactivity of corporations in human rights. The findings indicate that discretionary CSR with voluntary nature might not be able to motivate any contribution of business in human rights. Moreover, ethical CSR and legal CSR might lead to reactive strategies of business toward human rights. Meanwhile, the economic incentives behind the notion of instrumental CSR could result in partial proactive engagement of corporations in human rights. Finally, the internal motives as profit and power besides the external duties might lead to the highest level of proactivity of corporations in human rights under the context of political CSR. The model developed offers a map for business to adopt proactive human rights strategies more systematically maintaining key profit-drivers like power and profit. In sum, instrumental and political categories of CSR might lead corporations to improve the conditions of human rights proactively.

Keywords: CSR, human rights, proactive approach, reactive approach

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692 Alternative General Formula to Estimate and Test Influences of Early Diagnosis on Cancer Survival

Authors: Li Yin, Xiaoqin Wang

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Background and purpose: Cancer diagnosis is part of a complex stochastic process, in which patients' personal and social characteristics influence the choice of diagnosing methods, diagnosing methods, in turn, influence the initial assessment of cancer stage, the initial assessment, in turn, influences the choice of treating methods, and treating methods in turn influence cancer outcomes such as cancer survival. To evaluate diagnosing methods, one needs to estimate and test the causal effect of a regime of cancer diagnosis and treatments. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to estimate and test these causal effects via point effects. The purpose of the work is to estimate and test causal effects under various regimes of cancer diagnosis and treatments via point effects. Challenges and solutions: The cancer stage has influences from earlier diagnosis as well as on subsequent treatments. As a consequence, it is highly difficult to estimate and test the causal effects via standard parameters, that is, the conditional survival given all stationary covariates, diagnosing methods, cancer stage and prognosis factors, treating methods. Instead of standard parameters, we use the point effects of cancer diagnosis and treatments to estimate and test causal effects under various regimes of cancer diagnosis and treatments. We are able to use familiar methods in the framework of single-point causal inference to accomplish the task. Achievements: we have applied this method to stomach cancer survival from a clinical study in Sweden. We have studied causal effects under various regimes, including the optimal regime of diagnosis and treatments and the effect moderation of the causal effect by age and gender.

Keywords: cancer diagnosis, causal effect, point effect, G-formula, sequential causal effect

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691 A Study on Wage Discrimination Between Young and Middle-Aged Workers in Indian Informal Sector: Evidence from Periodic Labour Force Survey

Authors: Dharshini S.

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India is currently experiencing a shift in wage discrimination from gender, caste and religion to different age groups in both formal and informal sectors. In this milieu, this study examines wage discrimination in the informal labour market between young people (15-29 years) and middle-aged people (30-59 years) among regular and casual employees in the Indian informal sector. The data was collected using periodic labour force (PLFS), and the original data was extracted from the National Sample Survey Office (NSSO) under the Ministry of Statistics and Programme Implementation (MOSPI), Government of India. The OLS regression model explores the determinants of wages for both regular and casual employees. Moreover, the Blinder Oaxaca decomposition method is used to explore the explained and unexplained components of this wage discrimination. The younger people (regular and casual employees) get lower wages as compared to middle-aged employees in the informal sector. The regression result follows the human capital theory, where education, job experience and higher occupation help to raise the wage rate of middle-aged people more than young-aged people in regular work. Furthermore, we found the rising trend of wage discrimination between the above groups over the years from 2017-18 to 2022-23. Unexplained factors (discrimination effects) contribute more to the wage differentiation between the young and middle age groups. It indicates that wage discrimination persists among regular and casual employees in the informal labour market, which is not a good sign for the economy. For the betterment of workers who face discrimination for age, the policies and programs should be implemented like other countries such as the U.S.A to stop age discrimination due to stereotypes in India.

Keywords: wage discrimination, young workers, middle workers, Informal sector, blinder oaxaca decomposition, PLFS.

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690 Application of a Confirmatory Composite Model for Assessing the Extent of Agricultural Digitalization: A Case of Proactive Land Acquisition Strategy (PLAS) Farmers in South Africa

Authors: Mazwane S., Makhura M. N., Ginege A.

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Digitalization in South Africa has received considerable attention from policymakers. The support for the development of the digital economy by the South African government has been demonstrated through the enactment of various national policies and strategies. This study sought to develop an index for agricultural digitalization by applying composite confirmatory analysis (CCA). Another aim was to determine the factors that affect the development of digitalization in PLAS farms. Data on the indicators of the three dimensions of digitalization were collected from 300 Proactive Land Acquisition Strategy (PLAS) farms in South Africa using semi-structured questionnaires. Confirmatory composite analysis (CCA) was employed to reduce the items into three digitalization dimensions and ultimately to a digitalization index. Standardized digitalization index scores were extracted and fitted to a linear regression model to determine the factors affecting digitalization development. The results revealed that the model shows practical validity and can be used to measure digitalization development as measures of fit (geodesic distance, standardized root mean square residual, and squared Euclidean distance) were all below their respective 95%quantiles of bootstrap discrepancies (HI95 values). Therefore, digitalization is an emergent variable that can be measured using CCA. The average level of digitalization in PLAS farms was 0.2 and varied significantly across provinces. The factors that significantly influence digitalization development in PLAS land reform farms were age, gender, farm type, network type, and cellular data type. This should enable researchers and policymakers to understand the level of digitalization and patterns of development, as well as correctly attribute digitalization development to the contributing factors.

Keywords: agriculture, digitalization, confirmatory composite model, land reform, proactive land acquisition strategy, South Africa

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689 Constructing the Cult of the Self: on White, Working-class Males And The Neoliberalisation Of Identities – An Autoethnographic Study

Authors: Dane Morace-Court

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This paper offers a reflective and reflexive examination of the lived experience of a group of young, white, working-class males engaging in secondary-education in England at a time when this population is widely recognised as the lowest attaining ethnic group within British schools. The focus of the paper is an exploration of the development of identities and aspirations, alongside contemporary demographic and ideological shifts in the British population, in their intersection with neoliberal education policies and the emerging ideological conflict between identity conservatism and liberalism. The construction and performance of intersecting social-class, gender, ethnic and national identities is considered as well as the process through which socially constructed narratives inform identities, values, and aspirations. Evocative autoethnography is then employed to offer reflections on working-class habitus and, in particular, classed and gendered codes that underpin expectations of manhood in post-industrial culture within an education system which seemingly requires the abandonment of aspects of a working-class background. Findings from the study identify the emergence of a culture of hyper-individualisation amongst white, working-class males in schools and a belief in the meritocratic ideologies of the New Right. In particular, the breakdown of the social contract, including notions of political and civic responsibility, coupled with the symbolic violence perpetrated against working-class culture and solidarity in British schools, have all informed the construction of a working-class masculinity which values the individual entrepreneur over the collective, and depoliticizes students to an extent where a focus on the spectacle and performance of success has replaced individual and collective investment in community.

Keywords: education, identity, masculinity, neoliberalism, working-class, intersectionality, autoethnography

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688 A Critical Study on Unprecedented Employment Discrimination and Growth of Contractual Labour Engaged by Rail Industry in India

Authors: Munmunlisa Mohanty, K. D. Raju

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Rail industry is one of the model employers in India has separate national legislation (Railways Act 1989) to regulate its vast employment structure, functioning across the country. Indian Railway is not only the premier transport industry of the country; indeed, it is Asia’s most extensive rail network organisation and the world’s second-largest industry functioning under one management. With the growth of globalization of industrial products, the scope of anti-employment discrimination is no more confined to gender aspect only; instead, it extended to the unregularized classification of labour force applicable in the various industrial establishments in India. And the Indian Rail Industry inadvertently enhanced such discriminatory employment trends by engaging contractual labour in an unprecedented manner. The engagement of contractual labour by rail industry vanished the core “Employer-Employee” relationship between rail management and contractual labour who employed through the contractor. This employment trend reduces the cost of production and supervision, discourages the contractual labour from forming unions, and reduces its collective bargaining capacity. So, the primary intention of this paper is to highlight the increasing discriminatory employment scope for contractual labour engaged by Indian Railways. This paper critically analyses the diminishing perspective of anti-employment opportunity practiced by Indian Railways towards contractual labour and demands an urgent outlook on the probable scope of anti-employment discrimination against contractual labour engaged by Indian Railways. The researcher used doctrinal methodology where primary materials (Railways Act, Contract Labour Act and Occupational, health and Safety Code, 2020) and secondary data (CAG Report 2018, Railways Employment Regulation Rules, ILO Report etc.) are used for the paper.

Keywords: anti-employment, CAG Report, contractual labour, discrimination, Indian Railway, principal employer

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687 Factors Associated with Acute Kidney Injury in Multiple Trauma Patients with Rhabdomyolysis

Authors: Yong Hwang, Kang Yeol Suh, Yundeok Jang, Tae Hoon Kim

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Introduction: Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle constituents into the circulation. Acute kidney injury is a potential complication of severe rhabdomyolysis and the prognosis is substantially worse if renal failure develops. We try to identify the factors that were predictive of AKI in severe trauma patients with rhabdomyolysis. Methods: This retrospective study was conducted at the emergency department of a level Ⅰ trauma center. Patients enrolled that initial creatine phosphokinase (CPK) levels were higher than 1000 IU with acute multiple trauma, and more than 18 years older from Oct. 2012 to June 2016. We collected demographic data (age, gender, length of hospital day, and patients’ outcome), laboratory data (ABGA, lactate, hemoglobin. hematocrit, platelet, LDH, myoglobin, liver enzyme, and BUN/Cr), and clinical data (Injury Mechanism, RTS, ISS, AIS, and TRISS). The data were compared and analyzed between AKI and Non-AKI group. Statistical analyses were performed using IMB SPSS 20.0 statistics for Window. Results: Three hundred sixty-four patients were enrolled that AKI group were ninety-six and non-AKI group were two hundred sixty-eight. The base excess (HCO3), AST/ALT, LDH, and myoglobin in AKI group were significantly higher than non-AKI group from laboratory data (p ≤ 0.05). The injury severity score (ISS), revised Trauma Score (RTS), Abbreviated Injury Scale 3 and 4 (AIS 3 and 4) were showed significant results in clinical data. The patterns of CPK level were increased from first and second day, but slightly decreased from third day in both group. Seven patients had received hemodialysis treatment despite the bleeding risk and were survived in AKI group. Conclusion: We recommend that HCO3, CPK, LDH, and myoglobin should be checked and be concerned about ISS, RTS, AIS with injury mechanism at the early stage of treatment in the emergency department.

Keywords: acute kidney injury, emergencies, multiple trauma, rhabdomyolysis

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686 Three-Dimensional Measurement and Analysis of Facial Nerve Recess

Authors: Kang Shuo-Shuo, Li Jian-Nan, Yang Shiming

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Purpose: The three-dimensional anatomical structure of the facial nerve recess and its relationship were measured by high-resolution temporal bone CT to provide imaging reference for cochlear implant operation. Materials and Methods: By analyzing the high-resolution CT of 160 cases (320 pleural ears) of the temporal bone, the following parameters were measured at the axial window niche level: 1. The distance between the facial nerve and chordae tympani nerve d1; 2. Distance between the facial nerve and circular window niche d2; 3. The relative Angle between the facial nerve and the circular window niche a; 4. Distance between the middle point of the face recess and the circular window niche d3; 5. The relative angle between the middle point of the face recess and the circular window niche b. Factors that might influence the anatomy of the facial recess were recorded, including the patient's sex, age, and anatomical variation (e.g., vestibular duct dilation, mastoid gas type, mothoid sinus advancement, jugular bulbar elevation, etc.), and the correlation between these factors and the measured facial recess parameters was analyzed. Result: The mean value of face-drum distance d1 is (3.92 ± 0.26) mm, the mean value of face-niche distance d2 is (5.95 ± 0.62) mm, the mean value of face-niche Angle a is (94.61 ± 9.04) °, and the mean value of fossa - niche distance d3 is (6.46 ± 0.63) mm. The average fossa-niche Angle b was (113.47 ± 7.83) °. Gender, age, and anterior sigmoid sinus were the three factors affecting the width of the opposite recess d1, the Angle of the opposite nerve relative to the circular window niche a, and the Angle of the facial recess relative to the circular window niche b. Conclusion: High-resolution temporal bone CT before cochlear implantation can show the important anatomical relationship of the facial nerve recess, and the measurement results have clinical reference value for the operation of cochlear implantation.

Keywords: cochlear implantation, recess of facial nerve, temporal bone CT, three-dimensional measurement

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685 Lifespan Assessment of the Fish Crossing System of Itaipu Power Plant (Brazil/Paraguay) Based on the Reaching of Its Sedimentological Equilibrium Computed by 3D Modeling and Churchill Trapping Efficiency

Authors: Anderson Braga Mendes, Wallington Felipe de Almeida, Cicero Medeiros da Silva

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This study aimed to assess the lifespan of the fish transposition system of the Itaipu Power Plant (Brazil/Paraguay) by using 3D hydrodynamic modeling and Churchill trapping effiency in order to identify the sedimentological equilibrium configuration in the main pond of the Piracema Channel, which is part of a 10 km hydraulic circuit that enables fish migration from downstream to upstream (and vice-versa) the Itaipu Dam, overcoming a 120 m water drop. For that, bottom data from 2002 (its opening year) and 2015 were collected and analyzed, besides bed material at 12 stations to the purpose of identifying their granulometric profiles. The Shields and Yalin and Karahan diagrams for initiation of motion of bed material were used to determine the critical bed shear stress for the sedimentological equilibrium state based on the sort of sediment (grain size) to be found at the bottom once the balance is reached. Such granulometry was inferred by analyzing the grosser material (fine and medium sands) which inflows the pond and deposits in its backwater zone, being adopted a range of diameters within the upper and lower limits of that sand stratification. The software Delft 3D was used in an attempt to compute the bed shear stress at every station under analysis. By modifying the input bathymetry of the main pond of the Piracema Channel so as to the computed bed shear stress at each station fell within the intervals of acceptable critical stresses simultaneously, it was possible to foresee the bed configuration of the main pond when the sedimentological equilibrium is reached. Under such condition, 97% of the whole pond capacity will be silted, and a shallow water course with depths ranging from 0.2 m to 1.5 m will be formed; in 2002, depths ranged from 2 m to 10 m. Out of that water path, the new bottom will be practically flat and covered by a layer of water 0.05 m thick. Thus, in the future the main pond of the Piracema Channel will lack its purpose of providing a resting place for migrating fish species, added to the fact that it may become an insurmountable barrier for medium and large sized specimens. Everything considered, it was estimated that its lifespan, from the year of its opening to the moment of the sedimentological equilibrium configuration, will be approximately 95 years–almost half of the computed lifespan of Itaipu Power Plant itself. However, it is worth mentioning that drawbacks concerning the silting in the main pond will start being noticed much earlier than such time interval owing to the reasons previously mentioned.

Keywords: 3D hydrodynamic modeling, Churchill trapping efficiency, fish crossing system, Itaipu power plant, lifespan, sedimentological equilibrium

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684 Comparison of College Students and Full-Time Employees on Emerging Adulthood Dimensions and Identity Statuses in Turkey

Authors: Ebru Ergi̇n, Funda Kutlu

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Emerging adulthood is a developmental period and the formation of identity is crucial task of emerging adults in this period. In this frame, the main aim of the study was to compare college students and full-time workers on emerging adulthood dimensions and identity statuses in relation to some demographic variables in Turkey. The participants of the study were university students studying in Ankara and the employees working full-time in Ankara and Bursa. The mean age of the sample was 20.84 (sd=1.84), ranging from 18 to 25. The measurement instruments of the study were Inventory of Dimensions of Emerging Adulthood and Extended Objective Measure of Ego Identity Status (EOMEIS-II). The participants’ data (N=313) were analyzed to test the research questions and hypotheses of the study. A series of MANOVA were performed to test the group differences for some demographic characteristics (such as: employee/student, male/female, living with family/living apart from family) on scores of emerging adulthood dimensions and identity status. The results of the MANOVAs indicated that students, females and participants who live apart from their families had higher scores on emerging adulthood dimensions. The results of the identity status scores differences depending on the demographic characteristic pointed out that there were a significant group differences for identity foreclosure identity scores between employees and students. Employees’ foreclosure identity scores were higher than students. Furthermore, the identity scores were differed significantly according to gender of the participants. Male participants had higher scores in moratorium and foreclosure identity and female participants have higher achievement identity scores than males. Also, the participants who live with their family scored higher in foreclosure identity and the participants who live apart from their family scored higher in identity achievement status.

Keywords: college students, emerging adulthood, full-time employees, identity statuses

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683 A Deluge of Disaster, Destruction, Death and Deception: Negative News and Empathy Fatigue in the Digital Age

Authors: B. N. Emenyeonu

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Initially identified as sensationalism in the eras of yellow journalism and tabloidization, the inclusion of news which shocks or provokes strong emotional responses among readers, viewers, and browsers has not only remained a persistent feature of journalism but has also seemingly escalated in the current climate of digital and social media. Whether in the relentless revelation of scandals in high places, profiles on people displaced by sporadic wars or natural disasters, gruesome accounts of trucks plowing into pedestrians in a city centre, or the coverage of mourners paying tributes to victims of a mass shooting, mainstream, and digital media are often awash with tragedy, tears, and trauma. While it may aim at inspiring sympathy, outrage, or even remedial reactions, it would appear that the deluge of grief and misery in the news merely generates in the audience a feeling that borders on hearing or seeing too much to care or act. This feeling also appears to be accentuated by the dizzying diffusion of social media news and views, most of whose authenticity is not easily verifiable. Through a survey of 400 regular consumers of news and an in-depth interview of 10 news managers in selected media organizations across the Middle East, this study therefore investigates public attitude to the profusion of bad news in mainstream and digital media. Among other targets, it examines whether the profusion of bad news generates empathy fatigue among the audience and, if so, whether there is any association between biographic variables (profession, age, and gender) and an inclination to empathy fatigue. It also seeks to identify which categories of bad news and media are most likely to drag the audience into indifference. In conclusion, the study discusses the implications of the findings for mass-mediated advocacies such as campaigns against conflicts, corruption, nuclear threats, terrorism, gun violence, sexual crimes, and human trafficking, among other threats to humanity.

Keywords: digital media, empathy fatigue, media campaigns, news selection

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682 Electronic Physical Activity Record (EPAR): Key for Data Driven Physical Activity Healthcare Services

Authors: Rishi Kanth Saripalle

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Medical experts highly recommend to include physical activity in everyone’s daily routine irrespective of gender or age as it helps to improve various medical issues or curb potential issues. Simultaneously, experts are also diligently trying to provide various healthcare services (interventions, plans, exercise routines, etc.) for promoting healthy living and increasing physical activity in one’s ever increasing hectic schedules. With the introduction of wearables, individuals are able to keep track, analyze, and visualize their daily physical activities. However, there seems to be no common agreed standard for representing, gathering, aggregating and analyzing an individual’s physical activity data from disparate multiple sources (exercise pans, multiple wearables, etc.). This issue makes it highly impractical to develop any data-driven physical activity applications and healthcare programs. Further, the inability to integrate the physical activity data into an individual’s Electronic Health Record to provide a wholistic image of that individual’s health is still eluding the experts. This article has identified three primary reasons for this potential issue. First, there is no agreed standard, both structure and semantic, for representing and sharing physical activity data across disparate systems. Second, various organizations (e.g., LA fitness, Gold’s Gym, etc.) and research backed interventions and programs still primarily rely on paper or unstructured format (such as text or notes) to keep track of the data generated from physical activities. Finally, most of the wearable devices operate in silos. This article identifies the underlying problem, explores the idea of reusing existing standards, and identifies the essential modules required to move forward.

Keywords: electronic physical activity record, physical activity in EHR EIM, tracking physical activity data, physical activity data standards

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681 Proposed Organizational Development Interventions in Managing Occupational Stressors for Business Schools in Batangas City

Authors: Marlon P. Perez

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The study intended to determine the level of occupational stress that was experienced by faculty members of private and public business schools in Batangas City with the end in view of proposing organizational development interventions in managing occupational stressors. Stressors such as factors intrinsic to the job, role in the organization, relationships at work, career development and organizational structure and climate were used as determinants of occupational stress level. Descriptive method of research was used as its research design. There were only 64 full-time faculty members coming from private and public business schools in Batangas City – University of Batangas, Lyceum of the Philippines University-Batangas, Golden Gate Colleges, Batangas State University and Colegio ng Lungsod ng Batangas. Survey questionnaire was used as data gathering instrument. It was found out that all occupational stressors were assessed stressful when grouped according to its classification of tertiary schools while response of subject respondents differs on their assessment of occupational stressors. Age variable has become significantly related to respondents’ assessments on factors intrinsic to the job and career development; however, it was not significantly related to role in the organization, relationships at work and organizational structure and climate. On the other hand, gender, marital status, highest educational attainment, employment status, length of service, area of specialization and classification of tertiary school were revealed to be not significantly related to all occupational stressors. Various organizational development interventions have been proposed to manage the occupational stressors that are experienced by business faculty members in the institution.

Keywords: occupational stress, business school, organizational development, intervention, stressors, faculty members, assessment, manage

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680 Credibility and Personal Social Media Use of Health Professionals: A Field Study

Authors: Abrar Al-Hasan

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Objectives: There is ongoing discourse regarding the potential risks to health professionals' reputations and credibility arising from their personal social media use. However, the specific impacts on professional credibility and the health professional-client relationship remain largely unexplored. This study aims to investigate the type and frequency of the content posted by health professionals on their Instagram accounts and its influence on their credibility and the professional-client relationship. Methodology: In a controlled field study, participants reviewed randomly assigned mock Instagram profiles of health professionals. Mock profiles were constructed according to gender (female/male), social media usage (high/low), and social media richness (high/ low), with richness increasing from posts to stories to reels and personal content type (high /low). Participants then rated the profile owners’ credibility on a visual analog scale. An analysis of variance compared these ratings, and mediation analyses assessed the influence of credibility ratings on participants' willingness to become clients of the mock health professional. Results: Results from 315 participants showed that health professionals with personal Instagram profiles displaying high social media richness were perceived as more credible than those with lower social media richness. Low social media usage is perceived as more credible than high social media usage. Personal content type is perceived as less credible as compared to those with low personal content type. Contributions: These findings provide initial evidence of the impact of health professionals' personal online disclosures on credibility and the health professional-client relationship. Understanding public perceptions of professionalism and credibility is essential for informing e-professionalism guidelines and promoting best practices in social media use among health professionals.

Keywords: credibility, consumer behavior, social media, media richness, healthcare professionals

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679 The Effect of Rice Husk Ash on the Mechanical and Durability Properties of Concrete

Authors: Binyamien Rasoul

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Portland cement is one of the most widely used construction materials in the world today; however, manufacture of ordinary Portland cement (OPC) emission significant amount of CO2 resulting environmental impact. On the other hand, rice husk ash (RHA), which is produce as by product material is generally considered to be an environmental issue as a waste material. This material (RHA) consists of non-crystalline silicon dioxide with high specific surface area and high pozzolanic reactivity. These RHA properties can demonstrate a significant influence in improving the mechanical and durability properties of mortar and concrete. Furthermore, rice husk ash can provide a cost effective and give concrete more sustainability. In this paper, chemical composition, reactive silica and fineness effect was assessed by examining five different types of RHA. Mortars and concrete specimens were molded with 5% to 50% of ash, replacing the Portland cement, and measured their compressive and tensile strength behavior. Beyond it, another two parameters had been considered: the durability of concrete blended RHA, and effect of temperature on the transformed of amorphous structure to crystalline form. To obtain the rice husk ash properties, these different types were subjected to X-Ray fluorescence to determine the chemical composition, while pozzolanic activity obtained by using X-Ray diffraction test. On the other hand, finesses and specific surface area were obtained by used Malvern Mastersizer 2000 test. The measured parameters properties of fresh mortar and concrete obtained by used flow table and slump test. While, for hardened mortar and concrete the compressive and tensile strength determined pulse the chloride ions penetration for concrete using NT Build 492 (Nord Test) – non-steady state migration test (RMT Test). The obtained test results indicated that RHA can be used as a cement replacement material in concrete with considerable proportion up to 50% percentages without compromising concrete strength. The use of RHA in the concrete as blending materials improved the different characteristics of the concrete product. The paper concludes that to exhibits a good compressive strength of OPC mortar or concrete with increase RHA replacement ratio rice husk ash should be consist of high silica content with high pozzolanic activity. Furthermore, with high amount of carbon content (12%) could be improve the strength of concrete when the silica structure is totally amorphous. As well RHA with high amount of crystalline form (25%) can be used as cement replacement when the silica content over 90%. The workability and strength of concrete increased by used of superplasticizer and it depends on the silica structure and carbon content. This study therefore is an investigation of the effect of partially replacing Ordinary Portland cement (OPC) with Rice hush Ash (RHA) on the mechanical properties and durability of concrete. This paper gives satisfactory results to use RHA in sustainable construction in order to reduce the carbon footprint associated with cement industry.

Keywords: OPC, ordinary Portland cement, RHA rice husk ash, W/B water to binder ratio, CO2, carbon dioxide

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678 Utilization of Family Planning Methods and Associated Factors among Women of Reproductive Age Group in Sunsari, Nepal

Authors: Punam Kumari Mandal, Namita Yangden, Bhumika Rai, Achala Niraula, Sabitra Subedi

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introduction: Family planning not only improves women’s health but also promotes gender equality, better child health, and improved education outcomes, including poverty reduction. The objective of this study is to assess the utilization of family planning methods and associated factors in Sunsari, Nepal. methodology: A cross-sectional analytical study was conducted among women of the reproductive age group (15-49 years) in Sunsari in 2020. Nonprobability purposive sampling was used to collect information from 212 respondents through face-to-face interviews using a Semi-structured interview schedule from ward no 1 of Barju rural municipality. Data processing was done by using SPSS “statistics for windows, version 17.0(SPSS Inc., Chicago, III.USA”). Descriptive analysis and inferential analysis (binary logistic regression) were used to find the association of the utilization of family planning methods with selected demographic variables. All the variables with P-value <0.1 in bivariate analysis were included in multivariate analysis. A P-value of <0.05 was considered to indicate statistical significance at a level of significance of 5%. results: This study showed that the mean age and standard deviation of the respondents were 26±7.03, and 91.5 % of respondent’s age at marriage was less than 20 years. Likewise, 67.5% of respondents use any methods of family planning, and 55.2% of respondents use family planning services from the government health facility. Furthermore, education (AOR 1.579, CI 1.013-2.462)., husband’s occupation (AOR 1.095, CI 0.744-1.610)., type of family (AOR 2.741, CI 1.210-6.210)., and no of living son (AOR 0.259 CI 0.077-0.872)are the factors associated with the utilization of family planning methods. conclusion: This study concludes that two-thirds of reproductive-age women utilize family planning methods. Furthermore, education, the husband’s occupation, the type of family, and no of living sons are the factors associated with the utilization of family planning methods. This reflects that awareness through mass media, including behavioral communication, is needed to increase the utilization of family planning methods.

Keywords: family planning methods, utilization. factors, women, community

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677 Investigating Relationship between Body Size and Physical Fitness Factors among University Students

Authors: Allahyar Arabmomeni, Hojjatollah Alaei

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Background: The objectives of this study was to investigate effect of anthropometric variables and body composition on physical capabilities among male and female students. Materials and Methods: The study had a descriptive correlation method. The statistical population consisted of all students of Islamic Azad University, Khomeinishahr Branch, from 2011 to 2013, which was about 7000 students. The statistical sample included 300 male and 300 female students who were randomly selected from among university students in proportion to frequency of students in each faculty. Descriptive statistical methods, t-test and Pearson correlation coefficient were used for data analysis. Results: Results of this research showed that body size of male students in the studied variables was more than that of female students (p<0.05). Moreover, there was significant difference between all the variables based on significance level of the table. Also, the results taken from the Pearson correlation of this study's variables showed a positive relationship between height and leg and hand length and sit-up, full-ups bar and vertical jump tests (p<0/01). Besides, there was a positive correlation between hand length, sit-up, full-ups bar and vertical jump tests. As far as tests of length of legs and vertical jump were concerned, a highly positive correlation was observed between them. Additionally, results of this study indicated a significant correlation at alpha level of 0.05 between age and height of the students; but, there was a negative correlation between age, sit-up and 1600-m tests (p<0.05). Conclusion: The results of this study indicated a relationship between size of weight, height, length of hands and legs and some physical fitness tests. Therefore, it is required to consider anthropometric factors in addition to gender and age while preparing norms of physical fitness since variables of height and length of hands also affect physical fitness evaluation.

Keywords: anthropometric variables, physical fitness factors, students, body composition

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676 Hyperelastic Constitutive Modelling of the Male Pelvic System to Understand the Prostate Motion, Deformation and Neoplasms Location with the Influence of MRI-TRUS Fusion Biopsy

Authors: Muhammad Qasim, Dolors Puigjaner, Josep Maria López, Joan Herrero, Carme Olivé, Gerard Fortuny

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Computational modeling of the human pelvis using the finite element (FE) method has become extremely important to understand the mechanics of prostate motion and deformation when transrectal ultrasound (TRUS) guided biopsy is performed. The number of reliable and validated hyperelastic constitutive FE models of the male pelvis region is limited, and given models did not precisely describe the anatomical behavior of pelvis organs, mainly of the prostate and its neoplasms location. The motion and deformation of the prostate during TRUS-guided biopsy makes it difficult to know the location of potential lesions in advance. When using this procedure, practitioners can only provide roughly estimations for the lesions locations. Consequently, multiple biopsy samples are required to target one single lesion. In this study, the whole pelvis model (comprised of the rectum, bladder, pelvic muscles, prostate transitional zone (TZ), and peripheral zone (PZ)) is used for the simulation results. An isotropic hyperelastic approach (Signorini model) was used for all the soft tissues except the vesical muscles. The vesical muscles are assumed to have a linear elastic behavior due to the lack of experimental data to determine the constants involved in hyperelastic models. The tissues and organ geometry is taken from the existing literature for 3D meshes. Then the biomechanical parameters were obtained under different testing techniques described in the literature. The acquired parametric values for uniaxial stress/strain data are used in the Signorini model to see the anatomical behavior of the pelvis model. The five mesh nodes in terms of small prostate lesions are selected prior to biopsy and each lesion’s final position is targeted when TRUS probe force of 30 N is applied at the inside rectum wall. Code_Aster open-source software is used for numerical simulations. Moreover, the overall effects of pelvis organ deformation were demonstrated when TRUS–guided biopsy is induced. The deformation of the prostate and neoplasms displacement showed that the appropriate material properties to organs altered the resulting lesion's migration parametrically. As a result, the distance traveled by these lesions ranged between 3.77 and 9.42 mm. The lesion displacement and organ deformation are compared and analyzed with our previous study in which we used linear elastic properties for all pelvic organs. Furthermore, the visual comparison of axial and sagittal slices are also compared, which is taken for Magnetic Resource Imaging (MRI) and TRUS images with our preliminary study.

Keywords: code-aster, magnetic resonance imaging, neoplasms, transrectal ultrasound, TRUS-guided biopsy

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675 Analyzing Habits of Brushing Teeth in Yuzawa Town, Japan

Authors: Takeo Shibata, Arihito Endo, Akemi Kunimatsu, Chika Hiraga, Yoko Shimizu

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Introduction: Yuzawa Town, located in the Niigata prefecture of Japan, is famous for its hot springs. A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. We evaluated the profiles of brushing teeth in adults. Subjects: 368 questionnaires were corrected from people who live in Yuzawa town. The range of age was between nineteen and sixty-four years old. Methods: Mann-Whitney’s U test and Kruskal-Wallis test were used to evaluate significant differences in frequencies of brushing teeth per a day. Chi-square test and the adjusted residuals were used to evaluate when they brush their teeth. Results: Women showed greater frequencies of brushing teeth per a day than men. No difference was shown by age. Construction workers showed fewer frequencies of brushing teeth. Specialized technicians, clerical workers, and housewives showed greater frequencies. People who know Yuzawa family health plan, take a regular life, or take a breakfast every day showed greater frequencies. People who think not healthy, don’t care a balance of foods, don’t take yearly health check-up, or smoke showed fewer frequencies. After breakfast, women and specialized technicians showed greater frequencies, and construction workers and self-employed workers showed fewer frequencies. After lunch, clerical workers and specialized technicians showed greater frequencies. There was no significant difference at after waking up, after dinner, and before going to bed. Construction workers showed a lower rate of having a marital partner and having information of health. Conclusion: Gender and occupational differences were shown in frequencies of brushing teeth per a day. A promotion of teeth brushing for male, especially construction workers and self-employed workers, is needed.

Keywords: health promotion, Yuzawa family health plan, brushing teeth, occupational difference

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674 The Three-Dimensional Kinematics of the Sprint Start in Young Elite Sprinters

Authors: Saeed Ilbeigi, Bart Van Gheluwe

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The purpose of this study was to identify the three-dimensional kinematics of the sprint start during the start phase of the sprint. The purpose of this study was to identify the three-dimensional kinematics of the sprint start during the start phase of the sprint. Moreover, the effect of anthropometrical factors such as skeletal muscle mass, thigh girth, and calf girth also were considered on the kinematics of the sprint start. Among all young sprinters involved in the national Belgium league, sixty sprinters (boys: 14.7 ± 1.8 years and girls: 14.8±1.5 years) were randomly selected. The kinematics data of the sprint start were collected with a Vicon® 620 motion analysis system equipped with 12 infrared cameras running at 250 Hz and running the Vicon Data Station software. For statistical analysis, T-tests and ANOVA׳s with Scheffé post hoc test were used and the significant level was set as p≤0.05. The results showed that the angular positions of the lower joints of the young sprinters in the set position were comparable with adult figures from literature, however, with a greater range of joint extension. The most significant difference between boys and girls was found in the set position, where the boys presented a more dorsiflexed ankle. No further gender effect was observed during the leaving the blocks and contact phase. The sprinters with a higher age, skeletal muscle mass, thigh girth, and calf girth displayed a better angular position of the lower joints (e.g. ankle, knee, hip) in the set position, a more optimal angular position for the foot and knee for absorbing impact forces at foot contact and finally a higher range of flexion/extension motion to produce force and power when leaving the blocks.

Keywords: anthropometry, kinematics, sprint start, young elite sprinters

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673 Personality Profiles, Emotional Disturbance and Health-Related Quality of Life in Patients with Epilepsy

Authors: Usha Barahmand, Ruhollah Heydari Sheikh Ahmad, Sara Alaie Khoraem

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Introduction: The association of epilepsy with several psychological disorders and reduced quality of life has long been recognized. The present study aimed at comparing the personality profiles, quality of life and symptomatology of anxiety and depression in patients with epilepsy and healthy controls. Materials and Methods: Forty seven patients (29 men and 18 women) with diagnosed epilepsy participated in this study. Forty seven healthy controls who matched the patients in age and gender were also recruited. The participants’ personality and psychological profiles were assessed using the Depression, Anxiety, and Stress Scale (DASS-21), the Short-Form Health Survey (SF-36) and the HEXACO Personality Inventory (HEXACO-PI). Scoring algorithms were applied to the SF-36 produce the physical and mental component scores (PCS and MCS). Results: There were statistically significant differences in the total SF-36 score, anxiety, depression and stress scores of the DASS-21 between patients and controls. Anxiety, stress and depression scores significantly correlated inversely with the PCS and MCS. Data analysis showed that females had higher depression scores than males in both patients and controls, while males in both groups scored higher on stress. Patients’ personality scores were also different from those reported by controls on emotional, agreeableness and extroversion. Patients scored higher on emotionality, and lower on agreeableness and extraversion. Patients also scored lower on indices of quality of life. Regression analysis revealed that emotionality, anxiety, stress and MCS accounted for a significant proportion of the variance in severity of epileptic seizures. Conclusion: Stressful situations and psychological conditions as well as the personality trait of neuroticism were related to the occurrence of recurrent epileptic seizures.

Keywords: anxiety, depression, epilepsy, neuroticism, personality, quality of life, stress

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672 Comparison of the Anthropometric Obesity Indices in Prediction of Cardiovascular Disease Risk: Systematic Review and Meta-analysis

Authors: Saeed Pourhassan, Nastaran Maghbouli

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Statement of the problem: The relationship between obesity and cardiovascular diseases has been studied widely(1). The distribution of fat tissue gained attention in relation to cardiovascular risk factors during lang-time research (2). American College of Cardiology/American Heart Association (ACC/AHA) is widely and the most reliable tool to be used as a cardiovascular risk (CVR) assessment tool(3). This study aimed to determine which anthropometric index is better in discrimination of high CVR patients from low risks using ACC/AHA score in addition to finding the best index as a CVR predictor among both genders in different races and countries. Methodology & theoretical orientation: The literature in PubMed, Scopus, Embase, Web of Science, and Google Scholar were searched by two independent investigators using the keywords "anthropometric indices," "cardiovascular risk," and "obesity." The search strategy was limited to studies published prior to Jan 2022 as full-texts in the English language. Studies using ACC/AHA risk assessment tool as CVR and those consisted at least 2 anthropometric indices (ancient ones and novel ones) are included. Study characteristics and data were extracted. The relative risks were pooled with the use of the random-effect model. Analysis was repeated in subgroups. Findings: Pooled relative risk for 7 studies with 16,348 participants were 1.56 (1.35-1.72) for BMI, 1.67(1.36-1.83) for WC [waist circumference], 1.72 (1.54-1.89) for WHR [waist-to-hip ratio], 1.60 (1.44-1.78) for WHtR [waist-to-height ratio], 1.61 (1.37-1.82) for ABSI [A body shape index] and 1.63 (1.32-1.89) for CI [Conicity index]. Considering gender, WC among females and WHR among men gained the highest RR. The heterogeneity of studies was moderate (α²: 56%), which was not decreased by subgroup analysis. Some indices such as VAI and LAP were evaluated just in one study. Conclusion & significance: This meta-analysis showed WHR could predict CVR better in comparison to BMI or WHtR. Some new indices like CI and ABSI are less accurate than WHR and WC. Among women, WC seems to be a better choice to predict cardiovascular disease risk.

Keywords: obesity, cardiovascular disease, risk assessment, anthropometric indices

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671 Challenges in the Last Mile of the Global Guinea Worm Eradication Program: A Systematic Review

Authors: Getahun Lemma

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Introduction Guinea Worm Disease (GWD), also known as dracunculiasisis, is one of the oldest diseases in the history of mankind. Dracunculiasis is caused by a parasitic nematode, Dracunculus medinensis. Infection is acquired by drinking contaminated water with copepods containing infective Guinea Worm (GW) larvae). Almost one year after the infection, the worm usually emerges out through the skin on a lower, causing severe pain and disabilities. Although there is no effective drug or vaccine against the disease, the chain of transmission can be effectively prevented with simple and cost effective public health measures. Death due to dracunculiasis is very rare. However, it results in a wide range of physical, social and economic sequels. The disease is usually common in the rural, remote places of Sub-Saharan African countries among the marginalized societies. Currently, GWD is one of the neglected tropical diseases, which is on the verge of eradication. The global Guinea Worm Eradication Program (GWEP) was started in 1980. Since then, the program has achieved a tremendous success in reducing the global burden and number of GW case from 3.5 million to only 28 human cases at the end of 2018. However, it has recently been shown that not only humans can become infected, with a total of 1,105 animal infections have been reported at the end of 2018. Therefore, the objective of this study was to identify the existing challenges in the last mile of the GWEP in order To inform Policy makers and stakeholders on potential measures to finally achieve eradication. Method Systematic literature review on articles published from January 1, 2000 until May 30, 2019. Papers listed in Cochrane Library, Google Scholar, ProQuest PubMed and Web of Science databases were searched and reviewed. Results Twenty-five articles met inclusion criteria of the study and were selected for analysis. Hence, relevant data were extracted, grouped and descriptively analyzed. Results showed the main challenges complicating the last mile of global GWEP: 1. Unusual mode of transmission; 2. Rising animal Guinea Worm infection; 3. Suboptimal surveillance; 4. Insecurity; 5. Inaccessibility; 6. Inadequate safe water points; 7. Migration; 8. Poor case containment measures, 9. Ecological changes; and 10. New geographic foci of the disease. Conclusion This systematic review identified that most of the current challenges in the GWEP have been present since the start of the campaign. However, the recent change in epidemiological patterns and nature of GWD in the last remaining endemic countries illustrates a new twist in the global GWEP. Considering the complex nature of the current challenges, there seems to be a need for a more coordinated and multidisciplinary approach of GWD prevention and control measures in the last mile of the campaign. These new strategies would help to make history by eradicating dracunculiasis as the first ever parasitic disease.

Keywords: dracunculiasis, eradication program, guinea worm, last mile

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670 Effects of Tenefovir Disiproxil Fumarate on the Renal Sufficiency of HIV Positive Patients

Authors: Londeka Ntuli, Frasia Oosthuizen

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Background: Tenefovir disiproxil fumarate (TDF) is a nephrotoxic drug and has been proven to contribute to renal insufficiency necessitating intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. TDF is one of the preferred first-line drugs used in combination therapy in most regions. There are estimated 300 000 patients being initiated on the Efavirenz/TDF/Emtricitabine first-line regimen annually in South Africa. It is against this background that this study aims to investigate the effects of TDF on renal sufficiency of HIV positive patients. Methodology: A retrospective quantitative study was conducted, analysing clinical charts of HIV positive patient’s older than 18 years of age and on a TDF-containing regimen for more than 1 year. Data were obtained from the analysis of patient files and was transcribed into Microsoft® Excel® spreadsheet. Extracted data were coded, categorised and analysed using STATA®. Results: A total of 275 patient files were included in this study. Renal function started decreasing after 3 months of treatment (with 93.5% patients having a normal EGFR), and kept on decreasing as time progressed with only 39.6% normal renal function at year 4. Additional risk factors for renal insufficiency included age below 25, female gender, and additional medication. Conclusion: It is clear from this study that the use of TDF necessitates intensive monitoring and management of adverse effects arising from prolonged exposure to the drug. The findings from this study generated pertinent information on the safety profile of the drug TDF in a resource-limited setting of a public health institution. The appropriate management is of tremendous importance in the South African context where the majority of HIV positive individuals are on the TDF containing regimen; thus it is beneficial to ascertain the possible level of toxicities these patients may be experiencing.

Keywords: renal insufficiency, tenefovir, HIV, risk factors

Procedia PDF Downloads 122