Search results for: low vision aids
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1484

Search results for: low vision aids

1184 Driving What’s Next: The De La Salle Lipa Social Innovation in Quality Education Initiatives

Authors: Dante Jose R. Amisola, Glenford M. Prospero

Abstract:

'Driving What’s Next' is a strong campaign of the new administration of De La Salle Lipa in promoting social innovation in quality education. The new leadership directs social innovation in quality education in the institutional directions and initiatives to address real-world challenges with real-world solutions. This research under study aims to qualify the commitment of the institution to extend the Lasallian quality human and Christian education to all, as expressed in the Institution’s new mission-vision statement. The Classic Grounded Theory methodology is employed in the process of generating concepts in reference to the documents, a series of meetings, focus group discussions and other related activities that account for the conceptualization and formulation of the new mission-vision along with the new education innovation framework. Notably, Driving What’s Next is the emergent theory that encapsulates the commitment of giving quality human and Christian education to all. It directs the new leadership in driving social innovation in quality education initiatives. Correspondingly, Driving What’s Next is continually resolved through four interrelated strategies also termed as the institution's four strategic directions, namely: (1) driving social innovation in quality education, (2) embracing our shared humanity and championing social inclusion and justice initiatives, (3) creating sustainable futures and (4) engaging diverse stakeholders in our shared mission. Significantly, the four strategic directions capture and integrate the 17 UN sustainable development goals, making the innovative curriculum locally and globally relevant. To conclude, the main concern of the new administration and how it is continually resolved, provide meaningful and fun learning experiences and promote a new way of learning in the light of the 21st century skills among the members of the academic community including stakeholders and extended communities at large, which are defined as: learning together and by association (collaboration), learning through engagement (communication), learning by design (creativity) and learning with social impact (critical thinking).

Keywords: DLSL four strategic directions , DLSL Lipa mission-vision, driving what's next, social innovation in quality education

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1183 Navigating Life Transitions for Young People with Vision Impairment: A Community-Based Participatory Research Approach to Accessibility and Diversity

Authors: Aikaterini Tavoulari, Michael Proulx, Karin Petrini

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Objective: This study aims to explore the unique challenges faced by young individuals with vision impairment (VI) during key life transitions, utilizing a community-based participatory research (CBPR) approach to identify limitations and positive aspects of existing support systems, with a focus on accessibility and diversity. Design: The study employs a qualitative CBPR design, engaging young participants with VI through online and in-person working groups over six months, prioritizing their active involvement and diverse perspectives. Methods: Twenty-one young individuals with VI from across the UK and with different VI conditions were recruited to participate in the study via a climbing and virtual reality event and stakeholders’ support. Data collection methods included open discussions, forum exchanges, and qualitative questionnaires. The data were analyzed with NVivo using inductive thematic analysis to identify key themes and patterns related to the challenges and experiences of life transitions for this diverse population. Results: The analysis revealed barriers to accessibility, such as assumptions about what a person with VI can do, inaccessibility to material, noisy environments, and insufficient training with assistive technologies. Enablers included guidance from diverse professionals and peers, multisensory approaches (beyond tactile), and peer collaborations. This study underscores the need for developing accessible and tailored strategies together with these young people to address the specific needs of this diverse population during critical life transitions (e.g., to independent living, employment and higher education). Conclusion: Engaging and co-designing effective approaches and tools with young people with VI is key to tackling the specific accessibility barriers they encounter. These approaches should be targeted at different transitional periods of their life journey, promoting diversity and inclusion.

Keywords: vision impairement, life transitions, qualitative research, community-based participatory design, accessibility

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1182 Effect of Yeast Selenium on CD4 T Cell and WAZ of HIV1 Positive Children in Nyamasaria in Kisumu Kenya

Authors: S. B. Otieno1, F. Were, A. Afullo, K. Waza

Abstract:

Background: Multi drug resistance HIV has emerged rendering the current conventional treatment of HIV ineffective. There is a need for new treatment regime which is cheap, effective and not prone to resistance development by HIV. Methods: In randomized clinical study of 68 HIV positive children 3 – 15 years to asses the efficacy of yeast selenium in HIV/AIDS patients, 50μ yeast selenium was administered to 34 children while in matched control of 34 were put on placebo. Blood samples and weight of the both groups which were taken every 3 months intervals up to 6 months, were analyzed by ELIZA for CD4T cells, the data was analyzed by SPSS version 16, WAZ scores were analyzed by Epi Info version 6. Results: No significant difference in age { χ2 (1, 62) =0.03, p =0.853}, cause of morbidity between test and controls {χ2 (1, 65) = 5.87, p= 0.015} and on condition of foster parents {χ2 ( 1,63) = 5.57, p= 0.0172} was observed. Children on selenium showed progressive improvement of WAZ and significant difference at six months {F (5,12) = =5.758, P=0.006}, and weight gain of up to 4.1 kilograms in six months, and significant CD4 T cell count increase t= -2.943, p<0.05 compared to matched controls t = -1.258 p> 0.05. CD4 T cell count increased among all age groups on test 3-5 years (+ 267.1),5-8 years (+200.3) 9-15 years (+71.2) cells/mm3 and in matched controls a decrease 3-5 years (-71), 5-8 years (-125) and 9-13 years (-10.1) cells/mm3 . No significant difference inCD4 T cell count between boys {F (2, 32) = 1.531 p= 0.232} and between boys {F (2, 49) = 1.040, p= 0.361} on test and between boys and girls {F (5, 81) = 1.379, p= 0.241} on test. Similarly no significant difference between boys and girls were observed {F (5, 86) = 1.168, p= 0.332}.In the test group there was significant positive correlation β =252.23 between weight for age (WAZ), and CD4 T Cell Count p=0.007, R2= 0.252, F< 0.05. In matched controls no significant correlation between weight gain and CD4 T cell count change was observed at six months p > 0.05. No positive correlation β =-138.23 was observed between CD4T Cell count, WAZ, p=0.934, R2 =0.0337 F >0.05. Majority (96.78%) of children on test either remained or progressed to WHO immunological stage I. Conclusion: From this study it can be concluded that yeast Selenium is effective in slowing the progress of HIV 1 in children from WHO clinical stage I by improving CD4 T cell count and hence the immunity.

Keywords: selenium, HIV, AIDS, WAZ

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1181 A Prototype of an Information and Communication Technology Based Intervention Tool for Children with Dyslexia

Authors: Rajlakshmi Guha, Sajjad Ansari, Shazia Nasreen, Hirak Banerjee, Jiaul Paik

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Dyslexia is a neurocognitive disorder, affecting around fifteen percent of the Indian population. The symptoms include difficulty in reading alphabet, words, and sentences. This can be difficult at the phonemic or recognition level and may further affect lexical structures. Therapeutic intervention of dyslexic children post assessment is generally done by special educators and psychologists through one on one interaction. Considering the large number of children affected and the scarcity of experts, access to care is limited in India. Moreover, unavailability of resources and timely communication with caregivers add on to the problem of proper intervention. With the development of Educational Technology and its use in India, access to information and care has been improved in such a large and diverse country. In this context, this paper proposes an ICT enabled home-based intervention program for dyslexic children which would support the child, and provide an interactive interface between expert, parents, and students. The paper discusses the details of the database design and system layout of the program. Along with, it also highlights the development of different technical aids required to build out personalized android applications for the Indian dyslexic population. These technical aids include speech database creation for children, automatic speech recognition system, serious game development, and color coded fonts. The paper also emphasizes the games developed to assist the dyslexic child on cognitive training primarily for attention, working memory, and spatial reasoning. In addition, it talks about the specific elements of the interactive intervention tool that makes it effective for home based intervention of dyslexia.

Keywords: Android applications, cognitive training, dyslexia, intervention

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1180 Automatic Furrow Detection for Precision Agriculture

Authors: Manpreet Kaur, Cheol-Hong Min

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The increasing advancement in the robotics equipped with machine vision sensors applied to precision agriculture is a demanding solution for various problems in the agricultural farms. An important issue related with the machine vision system concerns crop row and weed detection. This paper proposes an automatic furrow detection system based on real-time processing for identifying crop rows in maize fields in the presence of weed. This vision system is designed to be installed on the farming vehicles, that is, submitted to gyros, vibration and other undesired movements. The images are captured under image perspective, being affected by above undesired effects. The goal is to identify crop rows for vehicle navigation which includes weed removal, where weeds are identified as plants outside the crop rows. The images quality is affected by different lighting conditions and gaps along the crop rows due to lack of germination and wrong plantation. The proposed image processing method consists of four different processes. First, image segmentation based on HSV (Hue, Saturation, Value) decision tree. The proposed algorithm used HSV color space to discriminate crops, weeds and soil. The region of interest is defined by filtering each of the HSV channels between maximum and minimum threshold values. Then the noises in the images were eliminated by the means of hybrid median filter. Further, mathematical morphological processes, i.e., erosion to remove smaller objects followed by dilation to gradually enlarge the boundaries of regions of foreground pixels was applied. It enhances the image contrast. To accurately detect the position of crop rows, the region of interest is defined by creating a binary mask. The edge detection and Hough transform were applied to detect lines represented in polar coordinates and furrow directions as accumulations on the angle axis in the Hough space. The experimental results show that the method is effective.

Keywords: furrow detection, morphological, HSV, Hough transform

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1179 Water Efficiency: Greywater Recycling

Authors: Melissa Lubitz

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Water scarcity is one of the crucial challenges of our time. There needs to be a focus on creating a society where people and nature flourish, regardless of climatic conditions. One of the solutions we can look to is decentralized greywater recycling. The vision is simple. Every building has its own water source being greywater from the bath, shower, sink and washing machine. By treating this in the home, you can save 25-45% of potable water use and wastewater production, a reduction in energy consumption and CO2 emissions. This reusable water is clean, and safe to be used for toilet flushing, washing machine, and outdoor irrigation. Companies like Hydraloop have been committed to the greywater recycle-ready building concept for years. This means that drinking water conservation and water reuse are included as standards in the design of all new buildings. Sustainability and renewal go hand in hand. This vision includes not only optimizing water savings and waste reduction but also forging strong partnerships that bring this ambition to life. Together with regulators, municipalities and builders, a sustainable and water-conscious future is pursued. This is an opportunity to be part of a movement that is making a difference. By pushing this initiative forward, we become part of a growing community that resists dehydration, believes in sustainability, and is committed to a living environment at the forefront of change: sustainable living, where saving water is the norm and where we shape the future together.

Keywords: greywater, wastewater treatment, water conservation, circular water society

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1178 Choosing Local Organic Food: Consumer Motivations and Ethical Spaces

Authors: Artur Saraiva, Moritz von Schwedler, Emília Fernandes

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In recent years, the organic sector has increased significantly. However, with the ‘conventionalization’ of these products, it has been questioned whether these products have been losing their original vision. Accordingly, this research based on 31 phenomenological interviews with committed organic consumers in urban and rural areas of Portugal, aims to analyse how ethical motivations and ecological awareness are related to organic food consumption. The content thematic analysis highlights aspects related to society and environmental concerns. On an individual level, the importance of internal coherence, peace of mind and balance that these consumers find in the consumption of local organic products was stressed. For these consumers, local organic products consumption made for significant changes in their lives, aiding in the establishment of a green identity, and involves a certain philosophy of life. This vision of an organic lifestyle is grounded in a political and ecological perspective, beyond the usual organic definition, as a ‘post-organic era’. The paper contributes to better understand how an ideological environmental discourse allows highlighting the relationship between consumers’ environmental concerns and the politics of food, resulting in a possible transition to new sustainable consumption practices.

Keywords: organic consumption, localism, content thematic analysis, pro-environmental discourse, political consumption, Portugal

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1177 Interrogating the Theoretical Basis of the Freedom Charter in South Africa

Authors: Sibonginkosi Mazibuko

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The “adoption” of the Freedom Charter in 1955 at Kliptown south of Johannesburg, South Africa represented a desire to create a society that is based on common citizenship, and democracy. The architects of the Charter had a vision of a society that lived in peace with itself. Today, the Charter is still promoted as the best thing that ever happened to a society ravaged by racism, dispossession, oppression and exploitation – a society divided in all aspects of its life. This paper moves from the understanding that land is fundamental to all life. It interrogates the Charter’s claim on land. At a time when the colonised world sought to free themselves from the chains of colonialism and Africans throughout the continent demanded Africa for the Africans, the Freedom Charter claimed South Africa for all who lived in it. To the extent that this paper problematizes the philosophical underpinnings of the Charter, it uses the methodology of dialectic materialism to understand the theoretical basis of the Freedom Charter. The paper argues that the understanding, desire and the vision of the Freedom Charter were, as they are today, irreconcilable. To that effect and in pursuit of narrow class interests, the Charter justified land dispossession and unsustainable living conditions for the dispossessed majority. The paper then concludes that, by misrepresenting the critically fundamental land question, the Charter tried to reconcile the dispossessed with their dispossession and thus reflected coloniality and whiteness long before colonialism and settler-colonialism came to an end in South Africa.

Keywords: colonialism, contradictions, freedom charter, South Africa

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1176 Rare Diagnosis in Emergency Room: Moyamoya Disease

Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu

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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.

Keywords: headache, Moyamoya disease, stroke, visual loss

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1175 Factors Contributing to the Risk and Vulnerability to HIV Infection among Individuals with Spinal Cord Injuries (SCI) in South Africa

Authors: J. J. Lloyd, J. S. Phillips

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Background: HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (SCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. Objectives: Thus, the overall objective of this study was to assess the factors that exacerbate the risk and vulnerability of individuals with spinal cord injuries to HIV infection in order to develop a more effective HIV intervention. Methodology: This paper reports on the cross-sectional data gathered from individuals with a traumatic spinal cord injury in 4 conveniently selected provinces in South Africa. Data was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; sexual communication, and negotiation skills and Self-efficacy to refuse sex. Results: The majority of the study sample was males (72.7%) with a mean age of 34.6 years. The majority reported lifetime sexual intercourse (92.4%) but only 31.8% reported condom use with last sexual intercourse. Low level of HIV knowledge, and being male were the strongest predictor of risky sexual behaviours in this sample. Conclusion: Significant numbers of individuals with spinal cord injuries are thus engaging in risky sexual behaviours pointing to a need to strengthen comprehensive sexual health education to increase access to HIV testing, promote safe sex and condom use among this group.

Keywords: Human Immunodeficiency Virus (HIV), individuals with spinal cord injuries, risky sexual behaviours, HIV risk factors, sub-saharan Africa

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1174 Image Multi-Feature Analysis by Principal Component Analysis for Visual Surface Roughness Measurement

Authors: Wei Zhang, Yan He, Yan Wang, Yufeng Li, Chuanpeng Hao

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Surface roughness is an important index for evaluating surface quality, needs to be accurately measured to ensure the performance of the workpiece. The roughness measurement based on machine vision involves various image features, some of which are redundant. These redundant features affect the accuracy and speed of the visual approach. Previous research used correlation analysis methods to select the appropriate features. However, this feature analysis is independent and cannot fully utilize the information of data. Besides, blindly reducing features lose a lot of useful information, resulting in unreliable results. Therefore, the focus of this paper is on providing a redundant feature removal approach for visual roughness measurement. In this paper, the statistical methods and gray-level co-occurrence matrix(GLCM) are employed to extract the texture features of machined images effectively. Then, the principal component analysis(PCA) is used to fuse all extracted features into a new one, which reduces the feature dimension and maintains the integrity of the original information. Finally, the relationship between new features and roughness is established by the support vector machine(SVM). The experimental results show that the approach can effectively solve multi-feature information redundancy of machined surface images and provides a new idea for the visual evaluation of surface roughness.

Keywords: feature analysis, machine vision, PCA, surface roughness, SVM

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1173 New Test Algorithm to Detect Acute and Chronic HIV Infection Using a 4th Generation Combo Test

Authors: Barun K. De

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Acquired immunodeficiency syndrome (AIDS) is caused by two types of human immunodeficiency viruses, collectively designated HIV. HIV infection is spreading globally particularly in developing countries. Before an individual is diagnosed with HIV, the disease goes through different phases. First there is an acute early phase that is followed by an established or chronic phase. Subsequently, there is a latency period after which the individual becomes immunodeficient. It is in the acute phase that an individual is highly infectious due to a high viral load. Presently, HIV diagnosis involves use of tests that do not detect the acute phase infection during which both the viral RNA and p24 antigen are expressed. Instead, these less sensitive tests detect antibodies to viral antigens which are typically sero-converted later in the disease process following acute infection. These antibodies are detected in both asymptomatic HIV-infected individuals as well as AIDS patients. Studies indicate that early diagnosis and treatment of HIV infection can reduce medical costs, improve survival, and reduce spreading of infection to new uninfected partners. Newer 4th generation combination antigen/antibody tests are highly sensitive and specific for detection of acute and established HIV infection (HIV1 and HIV2) enabling immediate linkage to care. The CDC (Center of Disease Control, USA) recently recommended an algorithm involving three different tests to screen and diagnose acute and established infections of HIV-1 and HIV-2 in a general population. Initially a 4th generation combo test detects a viral antigen p24 and specific antibodies against HIV -1 and HIV-2 envelope proteins. If the test is positive it is followed by a second test known as a differentiation assay which detects antibodies against specific HIV-1 and HIV-2 envelope proteins confirming established infection of HIV-1 or HIV-2. However if it is negative then another test is performed that measures viral load confirming an acute HIV-1 infection. Screening results of a Phoenix area population detected 0.3% new HIV infections among which 32.4% were acute cases. Studies in the U.S. indicate that this algorithm effectively reduces HIV infection through immediate treatment and education following diagnosis.

Keywords: new algorithm, HIV, diagnosis, infection

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1172 Examining the Design of a Scaled Audio Tactile Model for Enhancing Interpretation of Visually Impaired Visitors in Heritage Sites

Authors: A. Kavita Murugkar, B. Anurag Kashyap

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With the Rights for Persons with Disabilities Act (RPWD Act) 2016, the Indian government has made it mandatory for all establishments, including Heritage Sites, to be accessible for People with Disabilities. However, recent access audit surveys done under the Accessible India Campaign by Ministry of Culture indicate that there are very few accessibility measures provided in the Heritage sites for people with disabilities. Though there are some measures for the mobility impaired, surveys brought out that there are almost no provisions for people with vision impairment (PwVI) in heritage sites thus depriving them of a reasonable physical & intellectual access that facilitates an enjoyable experience and enriching interpretation of the Heritage Site. There is a growing need to develop multisensory interpretative tools that can help the PwVI in perceiving heritage sites in the absence of vision. The purpose of this research was to examine the usability of an audio-tactile model as a haptic and sound-based strategy for augmenting the perception and experience of PwVI in a heritage site. The first phase of the project was a multi-stage phenomenological experimental study with visually impaired users to investigate the design parameters for developing an audio-tactile model for PwVI. The findings from this phase included user preferences related to the physical design of the model such as the size, scale, materials, details, etc., and the information that it will carry such as braille, audio output, tactile text, etc. This was followed by the second phase in which a working prototype of an audio-tactile model is designed and developed for a heritage site based on the findings from the first phase of the study. A nationally listed heritage site from the author’s city was selected for making the model. The model was lastly tested by visually impaired users for final refinements and validation. The prototype developed empowers People with Vision Impairment to navigate independently in heritage sites. Such a model if installed in every heritage site, can serve as a technological guide for the Person with Vision Impairment, giving information of the architecture, details, planning & scale of the buildings, the entrances, location of important features, lifts, staircases, and available, accessible facilities. The model was constructed using 3D modeling and digital printing technology. Though designed for the Indian context, this assistive technology for the blind can be explored for wider applications across the globe. Such an accessible solution can change the otherwise “incomplete’’ perception of the disabled visitor, in this case, a visually impaired visitor and augment the quality of their experience in heritage sites.

Keywords: accessibility, architectural perception, audio tactile model , inclusive heritage, multi-sensory perception, visual impairment, visitor experience

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1171 Traffic Analysis and Prediction Using Closed-Circuit Television Systems

Authors: Aragorn Joaquin Pineda Dela Cruz

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Road traffic congestion is continually deteriorating in Hong Kong. The largest contributing factor is the increase in vehicle fleet size, resulting in higher competition over the utilisation of road space. This study proposes a project that can process closed-circuit television images and videos to provide real-time traffic detection and prediction capabilities. Specifically, a deep-learning model involving computer vision techniques for video and image-based vehicle counting, then a separate model to detect and predict traffic congestion levels based on said data. State-of-the-art object detection models such as You Only Look Once and Faster Region-based Convolutional Neural Networks are tested and compared on closed-circuit television data from various major roads in Hong Kong. It is then used for training in long short-term memory networks to be able to predict traffic conditions in the near future, in an effort to provide more precise and quicker overviews of current and future traffic conditions relative to current solutions such as navigation apps.

Keywords: intelligent transportation system, vehicle detection, traffic analysis, deep learning, machine learning, computer vision, traffic prediction

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1170 The Relationship between Knowledge Management Processes and Strategic Thinking at the Organization Level

Authors: Bahman Ghaderi, Hedayat Hosseini, Parviz Kafche

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The role of knowledge management processes in achieving the strategic goals of organizations is crucial. To this end, understanding the relationship between knowledge management processes and different aspects of strategic thinking (followed by long-term organizational planning) should be considered. This research examines the relationship between each of the five knowledge management processes (creation, storage, transfer, audit, and deployment) with each dimension of strategic thinking (vision, creativity, thinking, communication and analysis) in one of the major sectors of the food industry in Iran. In this research, knowledge management and its dimensions (knowledge acquisition, knowledge storage, knowledge transfer, knowledge auditing, and finally knowledge utilization) as independent variables and strategic thinking and its dimensions (creativity, systematic thinking, vision, strategic analysis, and strategic communication) are considered as the dependent variable. The statistical population of this study consisted of 245 managers and employees of Minoo Food Industrial Group in Tehran. In this study, a simple random sampling method was used, and data were collected by a questionnaire designed by the research team. Data were analyzed using SPSS 21 software. LISERL software is also used for calculating and drawing models and graphs. Among the factors investigated in the present study, knowledge storage with 0.78 had the most effect, and knowledge transfer with 0.62 had the least effect on knowledge management and thus on strategic thinking.

Keywords: knowledge management, strategic thinking, knowledge management processes, food industry

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1169 The Lived Experience of Thai Mothers Living with HIV in Southern Thailand

Authors: Dusanee Suwankhong, Pranee Liamputtong

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Mothers living with HIV tend to experience stigma and discrimination which has an impact on their psychological and social well-being and their human rights. This paper explores the lived experience of Thai mothers with HIV in their family. In-depth interviewing and drawing methods were employed to gain a deep understanding on the experience of 30 HIV-positive mothers in the southern community of Thailand. The data was analyzed using thematic analysis method. We found that the majority of HIV-positive mothers learned about their HIV status through blood test services during their antenatal care, but some decided to visit a doctor when their partner became chronically frail and showed some signs indicating HIV/AIDS. Learning about their HIV gave them a great shock, and they could not believe that they were infected with HIV/AIDS. They feared that their illness would be disclosed and hence attempted to keep their HIV secret. This was due to the fact that people in their community would blame and labeled them as a ‘disgusting person’. Besides, they would be separated from social contacts and networks, their individual rights would be disregarded, and their potential roles would be restricted. Although participants suggested that people had more positive view on HIV-infected person nowadays, all still wanted to keep it secret because of fear of stigma and discrimination. Thai health care has provided various kinds of support programs, but many mothers chose not to participate due to the fear of disclosure. However, the women attempted to seek some strategies to live a life which would be more acceptable by the community. We conclude that HIV is still seen as a stigmatised disease in rural community of southern Thailand. Local health care providers and relevant sectors in the locality should create suitable programs to enhance self-worth among those HIV-positive mothers because this could increase a quality of life of this vulnerable mothers. Providing sufficient and appropriate supports for better emotional wellbeing is an essential role of health professionals so that the feeling of isolation among these women could be eliminated and positive social justice can be achieved.

Keywords: HIV-positive mothers, lived experience, southern Thailand, stigma and discrimination

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1168 Autonomous Kuka Youbot Navigation Based on Machine Learning and Path Planning

Authors: Carlos Gordon, Patricio Encalada, Henry Lema, Diego Leon, Dennis Chicaiza

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The following work presents a proposal of autonomous navigation of mobile robots implemented in an omnidirectional robot Kuka Youbot. We have been able to perform the integration of robotic operative system (ROS) and machine learning algorithms. ROS mainly provides two distributions; ROS hydro and ROS Kinect. ROS hydro allows managing the nodes of odometry, kinematics, and path planning with statistical and probabilistic, global and local algorithms based on Adaptive Monte Carlo Localization (AMCL) and Dijkstra. Meanwhile, ROS Kinect is responsible for the detection block of dynamic objects which can be in the points of the planned trajectory obstructing the path of Kuka Youbot. The detection is managed by artificial vision module under a trained neural network based on the single shot multibox detector system (SSD), where the main dynamic objects for detection are human beings and domestic animals among other objects. When the objects are detected, the system modifies the trajectory or wait for the decision of the dynamic obstacle. Finally, the obstacles are skipped from the planned trajectory, and the Kuka Youbot can reach its goal thanks to the machine learning algorithms.

Keywords: autonomous navigation, machine learning, path planning, robotic operative system, open source computer vision library

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1167 Automatic Detection of Sugarcane Diseases: A Computer Vision-Based Approach

Authors: Himanshu Sharma, Karthik Kumar, Harish Kumar

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The major problem in crop cultivation is the occurrence of multiple crop diseases. During the growth stage, timely identification of crop diseases is paramount to ensure the high yield of crops, lower production costs, and minimize pesticide usage. In most cases, crop diseases produce observable characteristics and symptoms. The Surveyors usually diagnose crop diseases when they walk through the fields. However, surveyor inspections tend to be biased and error-prone due to the nature of the monotonous task and the subjectivity of individuals. In addition, visual inspection of each leaf or plant is costly, time-consuming, and labour-intensive. Furthermore, the plant pathologists and experts who can often identify the disease within the plant according to their symptoms in early stages are not readily available in remote regions. Therefore, this study specifically addressed early detection of leaf scald, red rot, and eyespot types of diseases within sugarcane plants. The study proposes a computer vision-based approach using a convolutional neural network (CNN) for automatic identification of crop diseases. To facilitate this, firstly, images of sugarcane diseases were taken from google without modifying the scene, background, or controlling the illumination to build the training dataset. Then, the testing dataset was developed based on the real-time collected images from the sugarcane field from India. Then, the image dataset is pre-processed for feature extraction and selection. Finally, the CNN-based Visual Geometry Group (VGG) model was deployed on the training and testing dataset to classify the images into diseased and healthy sugarcane plants and measure the model's performance using various parameters, i.e., accuracy, sensitivity, specificity, and F1-score. The promising result of the proposed model lays the groundwork for the automatic early detection of sugarcane disease. The proposed research directly sustains an increase in crop yield.

Keywords: automatic classification, computer vision, convolutional neural network, image processing, sugarcane disease, visual geometry group

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1166 Integrated Risk Management as a Framework for Organisational Success

Authors: Olakunle Felix Adekunle

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Risk management is recognised as an essential tool to tackle the inevitable uncertainty associated with business and projects at all levels. But it frequently fails to meet expectations, with projects continuing to run late, over budget or under performing, and business is not gaining the expected benefits. The evident disconnect which often occurs between strategic vision and tactical project delivery typically arises from poorly defined project objectives and inadequate attention to the proactive management of risks that could affect those objectives. One of the main failings in the traditional approach to risk management arises from a narrow focus on the downside, restricted to the technical or operational field, addressing tactical threats to processes, performance or people. This shortcoming can be overcome by widening the scope of risk management to encompass both strategic risks and upside opportunities, creating an integrated approach which can bridge the gap between strategy and tactics. Integrated risk management addresses risk across a variety of levels in the organisation, including strategy and tactics, and covering both opportunity and threat. Effective implementation of integrated risk management can produce a number of benefits to the organisation which are not available from the typical limited-scope risk process. This paper explores how to expand risk management to deliver strategic advantage while retaining its use as a tactical tool.

Keywords: risk management, success, organization, strategy, project, tactis, vision

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1165 Design and Development of Multi-Functional Intelligent Robot Arm Gripper

Authors: W. T. Asheber, L. Chyi-Yeu

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An intelligent robot arm is expected to recognize the desired object, grasp it with appropriate force without dropping or damaging it, and also manipulate and deliver the object to the desired destination safely. This paper presents an intelligent multi-finger robot arm gripper design along with vision, proximity, and tactile sensor for efficient grasping and manipulation tasks. The generic design of the gripper makes it convenient for improved parts manipulation, multi-tasking and ease for components assembly. The proposed design emulates the human’s hand fingers structure using linkages and direct drive through power screw like transmission. The actuation and transmission mechanism is designed in such a way that it has non-back-drivable capability, which makes the fingers hold their position when even unpowered. The structural elements are optimized for a finest performance in motion and force transmissivity of the gripper fingers. The actuation mechanisms is designed specially to drive each finger and also rotate two of the fingers about the palm to form appropriate configuration to grasp various size and shape objects. The gripper has an automatic tool set fixture incorporated into its palm, which will reduce time wastage and do assembling in one go. It is equipped with camera-in-hand integrated into its palm; subsequently an image based visual-servoing control scheme is employed.

Keywords: gripper, intelligent gripper, transmissivity, vision sensor

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1164 Automatic Identification and Monitoring of Wildlife via Computer Vision and IoT

Authors: Bilal Arshad, Johan Barthelemy, Elliott Pilton, Pascal Perez

Abstract:

Getting reliable, informative, and up-to-date information about the location, mobility, and behavioural patterns of animals will enhance our ability to research and preserve biodiversity. The fusion of infra-red sensors and camera traps offers an inexpensive way to collect wildlife data in the form of images. However, extracting useful data from these images, such as the identification and counting of animals remains a manual, time-consuming, and costly process. In this paper, we demonstrate that such information can be automatically retrieved by using state-of-the-art deep learning methods. Another major challenge that ecologists are facing is the recounting of one single animal multiple times due to that animal reappearing in other images taken by the same or other camera traps. Nonetheless, such information can be extremely useful for tracking wildlife and understanding its behaviour. To tackle the multiple count problem, we have designed a meshed network of camera traps, so they can share the captured images along with timestamps, cumulative counts, and dimensions of the animal. The proposed method takes leverage of edge computing to support real-time tracking and monitoring of wildlife. This method has been validated in the field and can be easily extended to other applications focusing on wildlife monitoring and management, where the traditional way of monitoring is expensive and time-consuming.

Keywords: computer vision, ecology, internet of things, invasive species management, wildlife management

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1163 Measurement and Modelling of HIV Epidemic among High Risk Groups and Migrants in Two Districts of Maharashtra, India: An Application of Forecasting Software-Spectrum

Authors: Sukhvinder Kaur, Ashok Agarwal

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Background: For the first time in 2009, India was able to generate estimates of HIV incidence (the number of new HIV infections per year). Analysis of epidemic projections helped in revealing that the number of new annual HIV infections in India had declined by more than 50% during the last decade (GOI Ministry of Health and Family Welfare, 2010). Then, National AIDS Control Organisation (NACO) planned to scale up its efforts in generating projections through epidemiological analysis and modelling by taking recent available sources of evidence such as HIV Sentinel Surveillance (HSS), India Census data and other critical data sets. Recently, NACO generated current round of HIV estimates-2012 through globally recommended tool “Spectrum Software” and came out with the estimates for adult HIV prevalence, annual new infections, number of people living with HIV, AIDS-related deaths and treatment needs. State level prevalence and incidence projections produced were used to project consequences of the epidemic in spectrum. In presence of HIV estimates generated at state level in India by NACO, USIAD funded PIPPSE project under the leadership of NACO undertook the estimations and projections to district level using same Spectrum software. In 2011, adult HIV prevalence in one of the high prevalent States, Maharashtra was 0.42% ahead of the national average of 0.27%. Considering the heterogeneity of HIV epidemic between districts, two districts of Maharashtra – Thane and Mumbai were selected to estimate and project the number of People-Living-with-HIV/AIDS (PLHIV), HIV-prevalence among adults and annual new HIV infections till 2017. Methodology: Inputs in spectrum included demographic data from Census of India since 1980 and sample registration system, programmatic data on ‘Alive and on ART (adult and children)’,‘Mother-Baby pairs under PPTCT’ and ‘High Risk Group (HRG)-size mapping estimates’, surveillance data from various rounds of HSS, National Family Health Survey–III, Integrated Biological and Behavioural Assessment and Behavioural Sentinel Surveillance. Major Findings: Assuming current programmatic interventions in these districts, an estimated decrease of 12% points in Thane and 31% points in Mumbai among new infections in HRGs and migrants is observed from 2011 by 2017. Conclusions: Project also validated decrease in HIV new infection among one of the high risk groups-FSWs using program cohort data since 2012 to 2016. Though there is a decrease in HIV prevalence and new infections in Thane and Mumbai, further decrease is possible if appropriate programme response, strategies and interventions are envisaged for specific target groups based on this evidence. Moreover, evidence need to be validated by other estimation/modelling techniques; and evidence can be generated for other districts of the state, where HIV prevalence is high and reliable data sources are available, to understand the epidemic within the local context.

Keywords: HIV sentinel surveillance, high risk groups, projections, new infections

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1162 Deep Learning Application for Object Image Recognition and Robot Automatic Grasping

Authors: Shiuh-Jer Huang, Chen-Zon Yan, C. K. Huang, Chun-Chien Ting

Abstract:

Since the vision system application in industrial environment for autonomous purposes is required intensely, the image recognition technique becomes an important research topic. Here, deep learning algorithm is employed in image system to recognize the industrial object and integrate with a 7A6 Series Manipulator for object automatic gripping task. PC and Graphic Processing Unit (GPU) are chosen to construct the 3D Vision Recognition System. Depth Camera (Intel RealSense SR300) is employed to extract the image for object recognition and coordinate derivation. The YOLOv2 scheme is adopted in Convolution neural network (CNN) structure for object classification and center point prediction. Additionally, image processing strategy is used to find the object contour for calculating the object orientation angle. Then, the specified object location and orientation information are sent to robotic controller. Finally, a six-axis manipulator can grasp the specific object in a random environment based on the user command and the extracted image information. The experimental results show that YOLOv2 has been successfully employed to detect the object location and category with confidence near 0.9 and 3D position error less than 0.4 mm. It is useful for future intelligent robotic application in industrial 4.0 environment.

Keywords: deep learning, image processing, convolution neural network, YOLOv2, 7A6 series manipulator

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1161 Hear Me: The Learning Experience on “Zoom” of Students With Deafness or Hard of Hearing Impairments

Authors: H. Weigelt-Marom

Abstract:

Over the years and up to the arousal of the COVID-19 pandemic, deaf or hard of hearing students studying in higher education institutions, participated lectures on campus using hearing aids and strategies adapted for frontal learning in a classroom. Usually, these aids were well known to them from their earlier study experience in school. However, the transition to online lessons, due to the latest pandemic, led deaf or hard of hearing students to study outside of their physical, well known learning environment. The change of learning environment and structure rose new challenges for these students. The present study examined the learning experience, limitations, challenges and benefits regarding learning online with lecture and classmates via the “Zoom” video conference program, among deaf or hard of hearing students in academia setting. In addition, emotional and social aspects related to learning in general versus the “Zoom” were examined. The study included 18 students diagnosed as deaf or hard of hearing, studying in various higher education institutions in Israel. All students had experienced lessons on the “Zoom”. Following allocation of the group study by the deaf and hard of hearing non-profit organization “Ma’agalei Shema”, and receiving the participants inform of consent, students were requested to answer a google form questioner and participate in an interview. The questioner included background information (e.g., age, year of studying, faculty etc.), level of computer literacy, and level of hearing and forms of communication (e.g., lip reading, sign language etc.). The interviews included a one on one, semi-structured, in-depth interview, conducted by the main researcher of the study (interview duration: up to 60 minutes). The interviews were held on “ZOOM” using specific adaptations for each interviewee: clear face screen of the interviewer for lip and face reading, and/ or professional sign language or live text transcript of the conversation. Additionally, interviewees used their audio devices if needed. Questions regarded: learning experience, difficulties and advantages studying using “Zoom”, learning in a classroom versus on “Zoom”, and questions concerning emotional and social aspects related to learning. Thematic analysis of the interviews revealed severe difficulties regarding the ability of deaf or hard of hearing students to comprehend during ”Zoom“ lessons without adoptive aids. For example, interviewees indicated difficulties understanding “Zoom” lessons due to their inability to use hearing devices commonly used by them in the classroom (e.g., FM systems). 80% indicated that they could not comprehend “Zoom” lessons since they could not see the lectures face, either because lectures did not agree to open their cameras or, either because they did not keep a straight forward clear face appearance while teaching. However, not all descriptions regarded learning via the “zoom” were negative. For example, 20% reported the recording of “Zoom” lessons as a main advantage. Enabling then to repeatedly watch the lessons at their own pace, mostly assisted by friends and family to translate the audio output into an accessible input. These finding and others regarding the learning experience of the group study on the “Zoom”, as well as their recommendation to enable deaf or hard of hearing students to study inclusively online, will be presented at the conference.

Keywords: deaf or hard of hearing, learning experience, Zoom, qualitative research

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1160 Floodnet: Classification for Post Flood Scene with a High-Resolution Aerial Imaginary Dataset

Authors: Molakala Mourya Vardhan Reddy, Kandimala Revanth, Koduru Sumanth, Beena B. M.

Abstract:

Emergency response and recovery operations are severely hampered by natural catastrophes, especially floods. Understanding post-flood scenarios is essential to disaster management because it facilitates quick evaluation and decision-making. To this end, we introduce FloodNet, a brand-new high-resolution aerial picture collection created especially for comprehending post-flood scenes. A varied collection of excellent aerial photos taken during and after flood occurrences make up FloodNet, which offers comprehensive representations of flooded landscapes, damaged infrastructure, and changed topographies. The dataset provides a thorough resource for training and assessing computer vision models designed to handle the complexity of post-flood scenarios, including a variety of environmental conditions and geographic regions. Pixel-level semantic segmentation masks are used to label the pictures in FloodNet, allowing for a more detailed examination of flood-related characteristics, including debris, water bodies, and damaged structures. Furthermore, temporal and positional metadata improve the dataset's usefulness for longitudinal research and spatiotemporal analysis. For activities like flood extent mapping, damage assessment, and infrastructure recovery projection, we provide baseline standards and evaluation metrics to promote research and development in the field of post-flood scene comprehension. By integrating FloodNet into machine learning pipelines, it will be easier to create reliable algorithms that will help politicians, urban planners, and first responders make choices both before and after floods. The goal of the FloodNet dataset is to support advances in computer vision, remote sensing, and disaster response technologies by providing a useful resource for researchers. FloodNet helps to create creative solutions for boosting communities' resilience in the face of natural catastrophes by tackling the particular problems presented by post-flood situations.

Keywords: image classification, segmentation, computer vision, nature disaster, unmanned arial vehicle(UAV), machine learning.

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1159 Analyzing the Causes of Amblyopia among Patients in Tertiary Care Center: Retrospective Study in King Faisal Specialist Hospital and Research Center

Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

Abstract:

Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

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1158 Machine Learning and Deep Learning Approach for People Recognition and Tracking in Crowd for Safety Monitoring

Authors: A. Degale Desta, Cheng Jian

Abstract:

Deep learning application in computer vision is rapidly advancing, giving it the ability to monitor the public and quickly identify potentially anomalous behaviour from crowd scenes. Therefore, the purpose of the current work is to improve the performance of safety of people in crowd events from panic behaviour through introducing the innovative idea of Aggregation of Ensembles (AOE), which makes use of the pre-trained ConvNets and a pool of classifiers to find anomalies in video data with packed scenes. According to the theory of algorithms that applied K-means, KNN, CNN, SVD, and Faster-CNN, YOLOv5 architectures learn different levels of semantic representation from crowd videos; the proposed approach leverages an ensemble of various fine-tuned convolutional neural networks (CNN), allowing for the extraction of enriched feature sets. In addition to the above algorithms, a long short-term memory neural network to forecast future feature values and a handmade feature that takes into consideration the peculiarities of the crowd to understand human behavior. On well-known datasets of panic situations, experiments are run to assess the effectiveness and precision of the suggested method. Results reveal that, compared to state-of-the-art methodologies, the system produces better and more promising results in terms of accuracy and processing speed.

Keywords: action recognition, computer vision, crowd detecting and tracking, deep learning

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1157 Positioning Mama Mkubwa Indigenous Model into Social Work Practice through Alternative Child Care in Tanzania: Ubuntu Perspective

Authors: Johnas Buhori, Meinrad Haule Lembuka

Abstract:

Introduction: Social work expands its boundary to accommodate indigenous knowledge and practice for better competence and services. In Tanzania, Mama Mkubwa Mkubwa (MMM) (Mother’s elder sister) is an indigenous practice of alternative child care that represents other traditional practices across African societies known as Ubuntu practice. Ubuntu is African Humanism with values and approaches that are connected to the social work. MMM focuses on using the elder sister of a deceased mother or father, a trusted elder woman from the extended family or indigenous community to provide alternative care to an orphan or vulnerable child. In Ubuntu's perspective, it takes a whole village or community to raise a child, meaning that every person in the community is responsible for child care. Methodology: A desk review method guided by Ubuntu theory was applied to enrich the study. Findings: MMM resembles the Ubuntu ideal of traditional child protection of those in need as part of alternative child care throughout Tanzanian history. Social work practice, along with other formal alternative child care, was introduced in Tanzania during the colonial era in 1940s and socio-economic problems of 1980s affected the country’s formal social welfare system, and suddenly HIV/AIDS pandemic triggered the vulnerability of children and hampered the capacity of the formal sector to provide social welfare services, including alternative child care. For decades, AIDS has contributed to an influx of orphans and vulnerable children that facilitated the re-emerging of traditional alternative child care at the community level, including MMM. MMM strongly practiced in regions where the AIDS pandemic affected the community, like Njombe, Coastal region, Kagera, etc. Despite of existing challenges, MMM remained to be the remarkably alternative child care practiced in both rural and urban communities integrated with social welfare services. Tanzania envisions a traditional mechanism of family or community environment for alternative child care with the notion that sometimes institutionalization care fails to offer children all they need to become productive members of society, and later, it becomes difficult to reconnect in the society. Implications to Social Work: MMM is compatible with social work by using strengths perspectives; MMM reflects Ubuntu's perspective on the ground of humane social work, using humane methods to achieve human goals. MMM further demonstrates the connectedness of those who care and those cared for and the inextricable link between them as Ubuntu-inspired models of social work that view children from family, community, environmental, and spiritual perspectives. Conclusion: Social work and MMM are compatible at the micro and mezzo levels; thus, application of MMM can be applied in social work practice beyond Tanzania when properly designed and integrated into other systems. When MMM is applied in social work, alternative care has the potential to support not only children but also empower families and communities. Since MMM is a community-owned and voluntary base, it can relieve the government, social workers, and other formal sectors from the annual burden of cost in the provision of institutionalized alternative child care.

Keywords: ubuntu, indigenous social work, african social work, ubuntu social work, child protection, child alternative care

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1156 Predictors of Lost to Follow-Up among HIV Patients Attending Anti-Retroviral Therapy Treatment Centers in Nigeria

Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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1155 Cost Effectiveness Analysis of a Community Intervention for Anti-Retroviral Therapy Delivery in Cambodia

Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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