Search results for: tactile aids
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 531

Search results for: tactile aids

171 Bacteremia Caused by Nontoxigenic Vibrio cholerae in an Immunocompromised Patient in Istanbul, Turkey

Authors: Fatma Koksal Çakirlar, Si̇nem Ozdemir, Selcan Akyol, Revazi̇ye Gulesen, Murat Gunaydin, Nevri̇ye Gonullu, Belkis Levent, Nuri̇ Kiraz

Abstract:

Vibrio cholerae O1 and O139 are the causative agent of epidemic or pandemic cholera. V. cholerae O1 is generally accepted as a non-invasive enterotoxigenic organism causing gastroenteritis of various severities. Non-O1 V. cholerae can cause small outbreaks of diarrhea due to consumption of contaminated food and water. Particularly, the patients with achlorydria have a risk for vibrio infections. There are numerous case reports of bacteremia caused by vibrio in patients with predisposing conditions like cirrhosis, nephrotic syndrome, diabetes, hematologic malignancy, gastrectomy, and AIDS. We described in this study the first case of nontoxigenic, non-01/non-O139 V. cholerae isolated from the blood culture of a 77-year-old female patient with hipertension, diabetes, coronary artery disease, gout and about 9 years ago migrated breast cancer history. The patient with complaints of shortness of breath, fever and malaise admitted to our emergency clinic were evaluated. There was no diarrhea or abdominal symptoms in the patient. No growth in her urine culture, but blood culture (BACTEC 9120 system, Becton Dickinson, USA) was positive for non-01/non-O139 V. cholerae that was identified by conventional methods and Phoenix automated system (BD Diagnostic Systems, Sparks, MD). It does not secrete the cholera toxin. The agglutination test was negative with polyvalent O1 antisera and O139 antiserum. Empirically ceftriaxone was administered to the patient and she was discharged with improvement in general condition. In this study we report bacteremia by non-01/non-O139 V. cholerae that is rare in the worldwide and first in Turkey.

Keywords: bacteremia, blood culture, immunocompromised patient, Non-O1 vibrio cholerae

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170 Business Program Curriculum with Industry-Recognized Certifications: An Empirical Study of Exam Results and Program Curriculum

Authors: Thomas J. Bell III

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Pursuing a business degree is fraught with perplexing questions regarding the rising tuition cost and the immediate value of earning a degree. Any decision to pursue an undergraduate business degree is perceived to have value if it facilitates post-graduate job placement. Business programs have decreased value in the absence of innovation in business programs that close the skills gap between recent graduates and employment opportunities. Industry-based certifications are seemingly becoming a requirement differentiator among job applicants. Texas Wesleyan University offers a Computer Information System (CIS) program with an innovative curriculum that integrates industry-recognized certification training into its traditional curriculum with core subjects and electives. This paper explores a culture of innovation in the CIS business program curriculum that creates sustainable stakeholder value for students, employers, the community, and the university. A quantitative research methodology surveying over one-hundred students in the CIS program will be used to examine factors influencing the success or failure of students taking certification exams. Researchers will analyze control variables to identify specific correlations between practice exams, teaching pedagogy, study time, age, work experience, etc. This study compared various exam preparation techniques to corresponding exam results across several industry certification exams. The findings will aid in understanding control variables with correlations that positively and negatively impact exam results. Such discovery may provide useful insight into pedagogical impact indicators that positively contribute to certification exam success and curriculum enhancement.

Keywords: taking certification exams, exam training, testing skills, exam study aids, certification exam curriculum

Procedia PDF Downloads 65
169 A Mega-Analysis of the Predictive Power of Initial Contact within Minimal Social Network

Authors: Cathal Ffrench, Ryan Barrett, Mike Quayle

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It is accepted in social psychology that categorization leads to ingroup favoritism, without further thought given to the processes that may co-occur or even precede categorization. These categorizations move away from the conceptualization of the self as a unique social being toward an increasingly collective identity. Subsequently, many individuals derive much of their self-evaluations from these collective identities. The seminal literature on this topic argues that it is primarily categorization that evokes instances of ingroup favoritism. Apropos to these theories, we argue that categorization acts to enhance and further intergroup processes rather than defining them. More accurately, we propose categorization aids initial ingroup contact and this first contact is predictive of subsequent favoritism on individual and collective levels. This analysis focuses on Virtual Interaction APPLication (VIAPPL) based studies, a software interface that builds on the flaws of the original minimal group studies. The VIAPPL allows the exchange of tokens in an intra and inter-group manner. This token exchange is how we classified the first contact. The study involves binary longitudinal analysis to better understand the subsequent exchanges of individuals based on who they first interacted with. Studies were selected on the criteria of evidence of explicit first interactions and two-group designs. Our findings paint a compelling picture in support of a motivated contact hypothesis, which suggests that an individual’s first motivated contact toward another has strong predictive capabilities for future behavior. This contact can lead to habit formation and specific favoritism towards individuals where contact has been established. This has important implications for understanding how group conflict occurs, and how intra-group individual bias can develop.

Keywords: categorization, group dynamics, initial contact, minimal social networks, momentary contact

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168 Classification System for Soft Tissue Injuries of Face: Bringing Objectiveness to Injury Severity

Authors: Garg Ramneesh, Uppal Sanjeev, Mittal Rajinder, Shah Sheerin, Jain Vikas, Singla Bhupinder

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Introduction: Despite advances in trauma care, a classification system for soft tissue injuries of the face still needs to be objectively defined. Aim: To develop a classification system for soft tissue injuries of the face; that is objective, easy to remember, reproducible, universally applicable, aids in surgical management and helps to develop a structured data that can be used for future use. Material and Methods: This classification system includes those patients that need surgical management of facial injuries. Associated underlying bony fractures have been intentionally excluded. Depending upon the severity of soft tissue injury, these can be graded from 0 to IV (O-Abrasions, I-lacerations, II-Avulsion injuries with no skin loss, III-Avulsion injuries with skin loss that would need graft or flap cover, and IV-complex injuries). Anatomically, the face has been divided into three zones (Zone 1/2/3), as per aesthetic subunits. Zone 1e stands for injury of eyebrows; Zones 2 a/b/c stand for nose, upper eyelid and lower eyelid respectively; Zones 3 a/b/c stand for upper lip, lower lip and cheek respectively. Suffices R and L stand for right or left involved side, B for presence of foreign body like glass or pellets, C for extensive contamination and D for depth which can be graded as D 1/2/3 if depth is still fat, muscle or bone respectively. I is for damage to facial nerve or parotid duct. Results and conclusions: This classification system is easy to remember, clinically applicable and would help in standardization of surgical management of soft tissue injuries of face. Certain inherent limitations of this classification system are inability to classify sutured wounds, hematomas and injuries along or against Langer’s lines.

Keywords: soft tissue injuries, face, avulsion, classification

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167 The Role of Bone Marrow Stem Cells Transplantation in the Repair of Damaged Inner Ear in Albino Rats

Authors: Ahmed Gaber Abdel Raheem, Nashwa Ahmed Mohamed

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Introduction: Sensorineural hearing loss (SNHL) is largely caused by the degeneration of the cochlea. Therapeutic options for SNHL are limited to hearing aids and cochlear implants. The cell transplantation approach to the regeneration of hair cells has gained considerable attention because stem cells are believed to accumulate in the damaged sites and have the potential for the repair of damaged tissues. The aim of the work: was to assess the use of bone marrow transplantation in repair of damaged inner ear hair cells in rats after the damage had been inflicted by Amikacin injection. Material and Methods: Thirty albino rats were used in this study. They were divided into three groups. Each group ten rats. Group I: used as control. Group II: Were given Amikacin- intratympanic injection till complete loss of hearing function. This could be assessed by Distortion product Otoacoustic Emission (DPOAEs) and / or auditory brain stem evoked potential (ABR). GroupIII: were given intra-peritoneal injection of bone marrow stem cell after complete loss of hearing caused by Amikacin. Clinical assessment was done using DPOAEs and / or auditory brain stem evoked potential (ABR), before and after bone marrow injection. Histological assessment of the inner ear was done by light and electron microscope. Also, Detection of stem cells in the inner ear by immunohistochemistry. Results: Histological examination of the specimens showed promising improvement in the structure of cochlea that may be responsible for the improvement of hearing function in rats detected by DPOAEs and / or ABR. Conclusion: Bone marrow stem cells transplantation might be useful for the treatment of SNHL.

Keywords: amikacin, hair cells, sensorineural hearing loss, stem cells

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166 A Retrospective Cross-Sectional Study on the Prevalence and Factors Associated with Virological Non-Suppression among HIV-Positive Adult Patients on Antiretroviral Therapy in Woliso Town, Oromia, Ethiopia

Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: virological non-suppression, HIV-positive, ART, Woliso town, Ethiopia

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165 New Territories: Materiality and Craft from Natural Systems to Digital Experiments

Authors: Carla Aramouny

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Digital fabrication, between advancements in software and machinery, is pushing practice today towards more complexity in design, allowing for unparalleled explorations. It is giving designers the immediate capacity to apply their imagined objects into physical results. Yet at no time have questions of material knowledge become more relevant and crucial, as technological advancements approach a radical re-invention of the design process. As more and more designers look towards tactile crafts for material know-how, an interest in natural behaviors has also emerged trying to embed intelligence from nature into the designed objects. Concerned with enhancing their immediate environment, designers today are pushing the boundaries of design by bringing in natural systems, materiality, and advanced fabrication as essential processes to produce active designs. New Territories, a yearly architecture and design course on digital design and materiality, allows students to explore processes of digital fabrication in intersection with natural systems and hands-on experiments. This paper will highlight the importance of learning from nature and from physical materiality in a digital design process, and how the simultaneous move between the digital and physical realms has become an essential design method. It will detail the work done over the course of three years, on themes of natural systems, crafts, concrete plasticity, and active composite materials. The aim throughout the course is to explore the design of products and active systems, be it modular facades, intelligent cladding, or adaptable seating, by embedding current digital technologies with an understanding of natural systems and a physical know-how of material behavior. From this aim, three main themes of inquiry have emerged through the varied explorations across the three years, each one approaching materiality and digital technologies through a different lens. The first theme involves crossing the study of naturals systems as precedents for intelligent formal assemblies with traditional crafts methods. The students worked on designing performative facade systems, starting from the study of relevant natural systems and a specific craft, and then using parametric modeling to develop their modular facades. The second theme looks at the cross of craft and digital technologies through form-finding techniques and elastic material properties, bringing in flexible formwork into the digital fabrication process. Students explored concrete plasticity and behaviors with natural references, as they worked on the design of an exterior seating installation using lightweight concrete composites and complex casting methods. The third theme brings in bio-composite material properties with additive fabrication and environmental concerns to create performative cladding systems. Students experimented in concrete composites materials, biomaterials and clay 3D printing to produce different cladding and tiling prototypes that actively enhance their immediate environment. This paper thus will detail the work process done by the students under these three themes of inquiry, describing their material experimentation, digital and analog design methodologies, and their final results. It aims to shed light on the persisting importance of material knowledge as it intersects with advanced digital fabrication and the significance of learning from natural systems and biological properties to embed an active performance in today’s design process.

Keywords: digital fabrication, design and craft, materiality, natural systems

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164 Determination of the CCR5Δ32 Frequency in Emiratis and Tunisians and Screening of the CCR5 Gene for Novel Alleles in Emiratis

Authors: Sara A. Al-Jaberi, Salma Ben-Salem, Meriam Messedi, Fatma Ayadi, Lihadh Al-Gazali, Bassam R. Ali

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Background: The chemokine receptor components play crucial roles in the immune system and some of them serve as co-receptors for the HIV virus. Several studies have documented those variants in chemokine receptors are correlated with susceptibility and resistance to infection with HIV virus. For example, mutations in the chemokine receptor 5 gene (CCR5) resulting in loss-of-function (such as the homozygous CCR5Δ32) confer high degree of resistance to HIV infection. Heterozygotes for these variants exhibit slow progression to AIDS. The prevalence of CCR5 polymorphisms varies among ethnic and geographical groups. For example, the CCR5 Δ32 variant is present in 10–15% of north Europeans but is rarely encountered among Africans. This study aims to identify the prevalence of some CCR5 variants in two geographically distant Arab populations (namely Emiratis and Tunisians). Methodology: The prevalence of CCR5 gene variants including CCR5Δ32, FS299, C101X, A29S and C178R has been determined using PCR and direct DNA sequencing. A total of 403 unrelated healthy individuals (253 Emiratis and 150 Tunisians) were genotyped for the CCR5Δ32 variant using PCR amplification and gel electrophoresis. In addition, 200 Emiratis have been screened for other SNPs using Sanger DNA sequencing. Results: Among Emiratis, the allele frequency of the CCR5Δ32 variant has been found to be 0.002. In addition, two variants L55Q and A159 were found at a frequency of 0.002.Moreover, the prevalence of the CCR5Δ32 variant in Tunisians was estimated to be 0.013 which is relatively higher than its frequency in Emiratis but lower than Europeans. Conclusion: We conclude that the allele frequency of the most critical CCR5 polymorphism (Δ32) is extremely low among Emiratis compared to other Arabs and North Europeans. In addition, very low allele frequencies of other CCR5 polymorphisms have been detected among Emiratis.

Keywords: chemokine receptors, CCR5Δ32, CCR5 polymorphisms, Emiratis, Arab populations

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163 A Robust System for Foot Arch Type Classification from Static Foot Pressure Distribution Data Using Linear Discriminant Analysis

Authors: R. Periyasamy, Deepak Joshi, Sneh Anand

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Foot posture assessment is important to evaluate foot type, causing gait and postural defects in all age groups. Although different methods are used for classification of foot arch type in clinical/research examination, there is no clear approach for selecting the most appropriate measurement system. Therefore, the aim of this study was to develop a system for evaluation of foot type as clinical decision-making aids for diagnosis of flat and normal arch based on the Arch Index (AI) and foot pressure distribution parameter - Power Ratio (PR) data. The accuracy of the system was evaluated for 27 subjects with age ranging from 24 to 65 years. Foot area measurements (hind foot, mid foot, and forefoot) were acquired simultaneously from foot pressure intensity image using portable PedoPowerGraph system and analysis of the image in frequency domain to obtain foot pressure distribution parameter - PR data. From our results, we obtain 100% classification accuracy of normal and flat foot by using the linear discriminant analysis method. We observe there is no misclassification of foot types because of incorporating foot pressure distribution data instead of only arch index (AI). We found that the mid-foot pressure distribution ratio data and arch index (AI) value are well correlated to foot arch type based on visual analysis. Therefore, this paper suggests that the proposed system is accurate and easy to determine foot arch type from arch index (AI), as well as incorporating mid-foot pressure distribution ratio data instead of physical area of contact. Hence, such computational tool based system can help the clinicians for assessment of foot structure and cross-check their diagnosis of flat foot from mid-foot pressure distribution.

Keywords: arch index, computational tool, static foot pressure intensity image, foot pressure distribution, linear discriminant analysis

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162 A Step Magnitude Haptic Feedback Device and Platform for Better Way to Review Kinesthetic Vibrotactile 3D Design in Professional Training

Authors: Biki Sarmah, Priyanko Raj Mudiar

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In the modern world of remotely interactive virtual reality-based learning and teaching, including professional skill-building training and acquisition practices, as well as data acquisition and robotic systems, the revolutionary application or implementation of field-programmable neurostimulator aids and first-hand interactive sensitisation techniques into 3D holographic audio-visual platforms have been a coveted dream of many scholars, professionals, scientists, and students. Integration of 'kinaesthetic vibrotactile haptic perception' along with an actuated step magnitude contact profiloscopy in augmented reality-based learning platforms and professional training can be implemented by using an extremely calculated and well-coordinated image telemetry including remote data mining and control technique. A real-time, computer-aided (PLC-SCADA) field calibration based algorithm must be designed for the purpose. But most importantly, in order to actually realise, as well as to 'interact' with some 3D holographic models displayed over a remote screen using remote laser image telemetry and control, all spatio-physical parameters like cardinal alignment, gyroscopic compensation, as well as surface profile and thermal compositions, must be implemented using zero-order type 1 actuators (or transducers) because they provide zero hystereses, zero backlashes, low deadtime as well as providing a linear, absolutely controllable, intrinsically observable and smooth performance with the least amount of error compensation while ensuring the best ergonomic comfort ever possible for the users.

Keywords: haptic feedback, kinaesthetic vibrotactile 3D design, medical simulation training, piezo diaphragm based actuator

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161 Librarian Liaisons: Facilitating Multi-Disciplinary Research for Academic Advancement

Authors: Tracey Woods

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In the ever-evolving landscape of academia, the traditional role of the librarian has undergone a remarkable transformation. Once considered as custodians of books and gatekeepers of information, librarians have the potential to take on the vital role of facilitators of cross and inter-disciplinary projects. This shift is driven by the growing recognition of the value of interdisciplinary collaboration in addressing complex research questions in pursuit of novel solutions to real-world problems. This paper shall explore the potential of the academic librarian’s role in facilitating innovative, multi-disciplinary projects, both recognising and validating the vital role that the librarian plays in a somewhat underplayed profession. Academic libraries support teaching, the strengthening of knowledge discourse, and, potentially, the development of innovative practices. As the role of the library gradually morphs from a quiet repository of books to a community-based information hub, a potential opportunity arises. The academic librarian’s role is to build knowledge across a wide span of topics, from the advancement of AI to subject-specific information, and, whilst librarians are generally not offered the research opportunities and funding that the traditional academic disciplines enjoy, they are often invited to help build research in support of the academic. This identifies that one of the primary skills of any 21st-century librarian must be the ability to collaborate and facilitate multi-disciplinary projects. In universities seeking to develop research diversity and academic performance, there is an increasing awareness of the need for collaboration between faculties to enable novel directions and advancements. This idea has been documented and discussed by several researchers; however, there is not a great deal of literature available from recent studies. Having a team based in the library that is adept at creating effective collaborative partnerships is valuable for any academic institution. This paper outlines the development of such a project, initiated within and around an identified library-specific need: the replication of fragile special collections for object-based learning. The research was developed as a multi-disciplinary project involving the faculties of engineering (digital twins lab), architecture, design, and education. Centred around methods for developing a fragile archive into a series of tactile objects furthers knowledge and understanding in both the role of the library as a facilitator of projects, chairing and supporting, alongside contributing to the research process and innovating ideas through the bank of knowledge found amongst the staff and their liaising capabilities. This paper shall present the method of project development from the initiation of ideas to the development of prototypes and dissemination of the objects to teaching departments for analysis. The exact replication of artefacts is also balanced with the adaptation and evolutionary speculations initiated by the design team when adapted as a teaching studio method. The dynamic response required from the library to generate and facilitate these multi-disciplinary projects highlights the information expertise and liaison skills that the librarian possesses. As academia embraces this evolution, the potential for groundbreaking discoveries and innovative solutions across disciplines becomes increasingly attainable.

Keywords: Liaison librarian, multi-disciplinary collaborations, library innovations, librarian stakeholders

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160 Mapping of Risks and Opportunities for Adolescents Girls’ Sexual and Reproductive Health in Peri-Urban Setting in Mwanza, Tanzania

Authors: Soori Nnko, Zaina Mchome, John Dusabe, Angela Obasi

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In sub-Saharan Africa, adolescent girls living in urban and periurban settings are among the groups at increased risk of getting sexually transmitted infections. One of the challenges to improve uptake of sexual and reproductive health (SRH) services among adolescents is linked to little appreciation about their vulnerability and the knowledge on availability of the SRH services. Objective: This study assesses adolescents’ perceptions on risks for SRH problems and the availability of services to prevent against SRH problems. Methodology: The study was conducted in March 2011 in Mwanza region, Tanzania. Data collection techniques included 18 Participatory Group Discussions and 17 In-depth Interviews with adolescents and young mothers aged 15-20 years. Results: Adolescents indicated that risk places included their homes, bushes, commercial centers, roadsides as well as school settings. Risk for having unprotected sex varied depending on where you are, and the time of the day. For example, collection of firewood in the bushes or water from the wells exposed girls to men who forced or lured them to have sex. The girls reported to encounter motorcyclists who offered the ride in exchange for sex. Girls also knew myriads places to seek SRH services, including public and private clinics, drug shops and traditional healers. Despite being aware of risky environment, and places to seek the services, access to SRH services were limited due to the stigma and negative attitude of community regarding adolescents’ utilization of SRH services. Conclusion: Adolescents are exposed to various risky environments, yet due to social stigma they have difficult to access the available SRH services.

Keywords: adolescent girls, sexual and reproductive health, AIDS, risk, opportunities, interventions, sub Saharan africa

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159 Book Exchange System with a Hybrid Recommendation Engine

Authors: Nilki Upathissa, Torin Wirasinghe

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This solution addresses the challenges faced by traditional bookstores and the limitations of digital media, striking a balance between the tactile experience of printed books and the convenience of modern technology. The book exchange system offers a sustainable alternative, empowering users to access a diverse range of books while promoting community engagement. The user-friendly interfaces incorporated into the book exchange system ensure a seamless and enjoyable experience for users. Intuitive features for book management, search, and messaging facilitate effortless exchanges and interactions between users. By streamlining the process, the system encourages readers to explore new books aligned with their interests, enhancing the overall reading experience. Central to the system's success is the hybrid recommendation engine, which leverages advanced technologies such as Long Short-Term Memory (LSTM) models. By analyzing user input, the engine accurately predicts genre preferences, enabling personalized book recommendations. The hybrid approach integrates multiple technologies, including user interfaces, machine learning models, and recommendation algorithms, to ensure the accuracy and diversity of the recommendations. The evaluation of the book exchange system with the hybrid recommendation engine demonstrated exceptional performance across key metrics. The high accuracy score of 0.97 highlights the system's ability to provide relevant recommendations, enhancing users' chances of discovering books that resonate with their interests. The commendable precision, recall, and F1score scores further validate the system's efficacy in offering appropriate book suggestions. Additionally, the curve classifications substantiate the system's effectiveness in distinguishing positive and negative recommendations. This metric provides confidence in the system's ability to navigate the vast landscape of book choices and deliver recommendations that align with users' preferences. Furthermore, the implementation of this book exchange system with a hybrid recommendation engine has the potential to revolutionize the way readers interact with printed books. By facilitating book exchanges and providing personalized recommendations, the system encourages a sense of community and exploration within the reading community. Moreover, the emphasis on sustainability aligns with the growing global consciousness towards eco-friendly practices. With its robust technical approach and promising evaluation results, this solution paves the way for a more inclusive, accessible, and enjoyable reading experience for book lovers worldwide. In conclusion, the developed book exchange system with a hybrid recommendation engine represents a progressive solution to the challenges faced by traditional bookstores and the limitations of digital media. By promoting sustainability, widening access to printed books, and fostering engagement with reading, this system addresses the evolving needs of book enthusiasts. The integration of user-friendly interfaces, advanced machine learning models, and recommendation algorithms ensure accurate and diverse book recommendations, enriching the reading experience for users.

Keywords: recommendation systems, hybrid recommendation systems, machine learning, data science, long short-term memory, recurrent neural network

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158 Simulation-Based Validation of Safe Human-Robot-Collaboration

Authors: Titanilla Komenda

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Human-machine-collaboration defines a direct interaction between humans and machines to fulfil specific tasks. Those so-called collaborative machines are used without fencing and interact with humans in predefined workspaces. Even though, human-machine-collaboration enables a flexible adaption to variable degrees of freedom, industrial applications are rarely found. The reasons for this are not technical progress but rather limitations in planning processes ensuring safety for operators. Until now, humans and machines were mainly considered separately in the planning process, focusing on ergonomics and system performance respectively. Within human-machine-collaboration, those aspects must not be seen in isolation from each other but rather need to be analysed in interaction. Furthermore, a simulation model is needed that can validate the system performance and ensure the safety for the operator at any given time. Following on from this, a holistic simulation model is presented, enabling a simulative representation of collaborative tasks – including both, humans and machines. The presented model does not only include a geometry and a motion model of interacting humans and machines but also a numerical behaviour model of humans as well as a Boole’s probabilistic sensor model. With this, error scenarios can be simulated by validating system behaviour in unplanned situations. As these models can be defined on the basis of Failure Mode and Effects Analysis as well as probabilities of errors, the implementation in a collaborative model is discussed and evaluated regarding limitations and simulation times. The functionality of the model is shown on industrial applications by comparing simulation results with video data. The analysis shows the impact of considering human factors in the planning process in contrast to only meeting system performance. In this sense, an optimisation function is presented that meets the trade-off between human and machine factors and aids in a successful and safe realisation of collaborative scenarios.

Keywords: human-machine-system, human-robot-collaboration, safety, simulation

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157 Efficacy of the Use of Different Teaching Approaches of Math Teachers

Authors: Nilda San Miguel, Elymar Pascual

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The main focus of this study is exploring the effective approaches in teaching Mathematics that is being applied in public schools, s.y. 2018-2019. This research was written as connected output to the district-wide School Learning Action Cell (DISLAC) on Math teaching approaches which was recently conducted in Victoria, Laguna. Fifty-four math teachers coming from 17 schools in Victoria became the respondents of this study. Qualitative method of doing research was applied. Teachers’ responses to the following concerns were gathered, analyzed and interpreted: (1) evaluation of the recently conducted DISLAC, (2) status of the use of different approaches, (3) perception on the effective use of approaches, (4) preference of approach to explore in classroom sessions, (5) factors affecting the choice of approach, (6) difficulties encountered, (7) and perceived benefit to learners. Results showed that the conduct of DISLAC was very highly satisfactory (mean 4.41). Teachers looked at collaborative approach as very highly effective (mean 4.74). Fifty-two percent of the teachers is using collaborative approach, 17% constructivist, 11% integrative, 11% inquiry-based, and 9% reflective. Reflective approach was chosen to be explored by most of the respondents (29%) in future sessions. The difficulties encountered by teachers in using the different approaches are: (1) learners’ difficulty in following instructions, (2) lack of focus, (3) lack of willingness and cooperation, (4) teachers’ lack of mastery in using different approaches, and (5) lack of time of doing visual aids because of time mismanagement. Teachers deemed the use of various teaching approaches can help the learners to have (1) mastery of competency, (2) increased communication, (3) improved confidence, (4) facility in comprehension, and (5) better academic output. The result obtained from this study can be used as an input for SLACs. Recommendations at the end of the study were given to school/district heads and future researchers.

Keywords: approaches, collaborative, constructivism, inquiry-based, integrative, reflective

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156 Anaphora and Cataphora on the Selected State of the City Addresses of the Mayor of Dapitan

Authors: Mark Herman Sumagang Potoy

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State of the City Address (SOCA) is a speech, modelled after the State of the Nation Address, given not as mandated by law but usually a matter of practice or tradition delivered before the chief executive’s constituents. Through this, the general public is made to know the performance of the local government unit and its agenda for the coming year. Therefore, it is imperative for SOCAs to clearly convey its message and carry out the myriad function of enlightening its readers which could be achieved through the proper use of reference. Anaphora and cataphora are the two major types of reference; the former refer back to something that has already been mentioned while the latter points forward to something which is yet to be said. This paper seeks to identify the types of reference employed on the SOCAs from 2014 to 2016 of Hon. Rosalina Garcia Jalosjos, Mayor of Dapitan City and look into how the references contribute to the clarity of the message of the text. The qualitative method of research is used in this study through an in-depth analysis of the corpus. As soon as the copies of the SOCAs are secured from the Office of the City Mayor, they are then analyzed using documentary technique categorizing the types of reference as to anaphora and cataphora, counting each of these types and describing the implications of the dominant types used in the addresses. After a thorough analysis, it is found out that the two reference types namely, anaphora and cataphora are both employed on the three SOCAs, the former being used more frequently than the latter accounting to 80% and 20% of actual usage, respectively. Moreover, the use of anaphors and cataphora on the three addresses helps in conveying the message clearly because they primarily become aids to avoid the repetition of the same element in the text especially when there wasn’t a need to emphasize a point. Finally, it is recommended that writers of State of the City Addresses should have a vast knowledge on how reference should be used and the functions they take in the text since this is a vital tool to clearly transmit a message. Moreover, English teachers should explicitly teach the proper usage of anaphora and cataphora, as instruments to develop cohesion in written discourse, to enable students to write not only with sense but also with fluidity in tying utterances together.

Keywords: anaphora, cataphora, reference, State of the City Address

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155 Assessment of HIV/Hepatitis B Virus Co-Infection among Patients Living with HIV in Northern and Southern Region of Nigeria

Authors: Folajinmi Oluwasina, Greg Abiaziem, Moses Luke, Mobolaji Kolawole, Nancy Yibowei, Anne Taiwo

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Background: Occurrence of HIV infection has an adverse effect on the natural causes of Hepatitis B Viral (HBV) infection, faster progression of hepatic fibrosis demonstrated in patients with co-infection. This study was carried out to determine the incidence of HBV infection among HIV-positive patients, and to retrospectively evaluate laboratory characteristics of patients with HIV/HBV co-infection. Methods: A retrospective analysis of patient files for all HIV-infected cases followed-up and treated at 52 health facilities. Among HIV-infected cases, those with HBsAg positivity and HIV/Hepatitis B co-infection were determined. Socio demographic, alcohol or substance use, ART, CD4, Viral Load levels and treatment durations were retrospectively evaluated. Results: Of the 125 HIV-infected patients evaluated retrospectively, 17 (13.6%) had HBsAg positivity. Of these 17 cases were 11(64.7%) male and 6 (35.3%) female, with a mean age of 48.7 years. No patients had a history of alcohol or substance use. The mean duration of follow up was 28 months. 9 (52.9%) patients had negative HBV DNA at presentation while 8(47%) had positive HBV DNA, with normal ALT levels in all subjects. Among the 9 cases with negative HBV DNA who had no indication for the treatment of chronic hepatitis B. In five cases, treatment was commenced since HBV DNA was elevated in conjunction with low CD4. One patient in whom treatment was not indicated based on HBV DNA and CD4 levels in conjunction with the absence of AIDS defining clinical picture was currently being followed-up without treatment. Of the patients receiving HAART therapy, the average CD4 count at presentation was 278 cells/mm3 vs. 466 cells/mm3 at the end of 12 months. In three subjects with positive HBV DNA, a decrease in HBV DNA was noted after initiation of treatment. In four patients with negative DNA who received treatment, the HBV DNA negative status was found to remain, while one patient who did not receive treatment had elevated HBV DNA and decreased CD4 levels. Conclusion: It was shown that this group of patients with HIV/HBV co-infection, HAART was found to be associated with a decrease in HBV DNA in HBV DNA positive cases, absence of transition to positivity among those with negative HBV DNA, and with increased CD4 in all subjects.

Keywords: Hepatitis B, DNA, anti retroviral therapy, co-infection

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154 A Novel Study Contrasting Traditional Autopsy with Post-Mortem Computed Tomography in Falls Leading to Death

Authors: Balaji Devanathan, Gokul G., Abilash S., Abhishek Yadav, Sudhir K. Gupta

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Background: As an alternative to the traditional autopsy, a virtual autopsy is carried out using scanning and imaging technologies, mainly post-mortem computed tomography (PMCT). This facility aims to supplement traditional autopsy results and reduce or eliminate internal dissection in subsequent autopsies. For emotional and religious reasons, the deceased's relatives have historically disapproved such interior dissection. The non-invasive, objective, and preservative PMCT is what friends and family would rather have than a traditional autopsy. Additionally, it aids in the examination of the technologies and the benefits and drawbacks of each, demonstrating the significance of contemporary imaging in the field of forensic medicine. Results: One hundred falls resulting in fatalities was analysed by the writers. Before the autopsy, each case underwent a PMCT examination using a 16-slice Multi-Slice CT spiral scanner. By using specialised software, MPR and VR reconstructions were carried out following the capture of the raw images. The accurate detection of fractures in the skull, face bones, clavicle, scapula, and vertebra was better observed in comparison to a routine autopsy. The interpretation of pneumothorax, Pneumoperitoneum, pneumocephalus, and hemosiuns are much enhanced by PMCT than traditional autopsy. Conclusion. It is useful to visualise the skeletal damage in fall from height cases using a virtual autopsy based on PMCT. So, the ideal tool in traumatising patients is a virtual autopsy based on PMCT scans. When assessing trauma victims, PMCT should be viewed as an additional helpful tool to traditional autopsy. This is because it can identify additional bone fractures in body parts that are challenging to examine during autopsy, such as posterior regions, which helps the pathologist reconstruct the victim's life and determine the cause of death.

Keywords: PMCT, fall from height, autopsy, fracture

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153 Employability Potential of Differently Abled in the Indian Apparel Industry

Authors: Gunjita Shami, Noopur Anand

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The pilot run of 50 days was undertaken to test employability potential of people with visual and hearing & speech impairment. Various roles in an apparel manufacturing set up like spreading of fabric for cutting, folding, sealing and labeling cartons, pasting size barcode stickers on packed garments, removing tickets from the garments in the finishing stage were studied. Their performance was quantified basis timesheets for all the days and improvement per day was quantified. Their final day output was compared to that of the able-bodied worker. For example in the carton making activity on day one visually impaired worker was making one box every three minutes which improved to four boxes per minute on day 28 displaying 91.6% improvement compared or an improvement of 3.6% per day which was comparable to the able-bodied seasoned workers, who were making 5 boxes per minute. The performance of persons with hearing and speech impairment in the finishing department was 10% higher than that of able-bodied seasoned workers in the same process. Overall in all the activities the differently abled showed day to day improvement of 65% while able bodied displayed improvement of 52%. On the first day performance of able-bodied worker was 75% better than that of differently abled while on the 50th day it was only 20% better. Therefore the performance of persons with disabilities was found comparable to the able bodied person. The results, though on a small scale, showed a big promise of employment of persons with disability in the apparel industry. Armed with the promising result a full-scale study has been undertaken to identify the roles suitable for certain kind of disability in apparel production, work-aids required to assist the differently abled to improve performance and measures to be undertaken to make production floor 'friendlier' for them. The results have been discussed in this paper which opens doors for integrating differently abled into the world projected and assumed for only able-bodied.

Keywords: apparel sector, differently abled, employability, performance, work-aid

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152 Project Based Learning in Language Lab: An Analysis in ESP Learning Context

Authors: S. Priya

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A project based learning assignment in English for Specific Purposes (ESP) context based on Communicative English as prescribed in the university syllabus for engineering students and its learning outcome from ESP context is the focus of analysis through this paper. The task based on Project Based Learning (PBL) was conducted in the digital language lab which had audio visual aids to support the team presentation. The total strength of 48 students of Mechanical Branch were divided into 6 groups, each consisting of 8 students. The group members were selected on random numbering basis. They were given a group task to represent a power point presentation on a topic related to their core branch. They had to discuss the issue and choose their topic and represent in a given format. It provided the individual role of each member in the presentation. A brief overview of the project and the outcome of its technical aspects were also had to be included. Each group had to highlight the contributions of that innovative technology through their presentation. The power point should be provided in a CD format. The variations in the choice of subjects, their usage of digital technologies, co-ordination for competition, learning experience of first time stage presentation, challenges of team cohesiveness were some criteria observed as their learning experience. For many other students undergoing the stages of planning, preparation and practice as steps for presentation had been the learning outcomes as given through their feedback form. The evaluation pattern is distributed for individual contribution and group effectiveness which promotes quality of presentation. The evaluated skills are communication skills, group cohesiveness, and audience response, quality of technicality and usage of technical terms. This paper thus analyses how project based learning improves the communication, life skills and technical skills in English for Specific learning context through PBL.

Keywords: language lab, ESP context, communicative skills, life skills

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151 Thermo-Oxidative Degradation of Esterified Starch (with Lauric Acid) -Plastic Composite Assembled with Pro-Oxidants and Elastomers

Authors: R. M. S. Sachini Amararathne

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This research is striving to develop a thermo degradable starch plastic compound/ masterbatch for industrial packaging applications. A native corn starch-modified with an esterification reaction of lauric acid is melt blent with an unsaturated elastomer (styrene-butadiene-rubber/styrene-butadiene-styrene). A trace amount of metal salt is added into the internal mixer to study the effect of pro-oxidants in a thermo oxidative environment. Then the granulated polymer composite which is consisted with 80-86% of polyolefin (LLDP/LDPE/PP) as the pivotal agent; is extruded with processing aids, antioxidants and some other additives in a co-rotating twin-screw extruder. The pelletized composite is subjected to compression molding/ Injection molding or blown film extrusion processes to acquire the samples/specimen for tests. The degradation process is explicated by analyzing the results of fourier transform infrared spectroscopy (FTIR) measurements, thermo oxidative aging studies (placing the dumb-bell specimen in an air oven at 70 °C for four weeks of exposure.) governed by tensile and impact strength test reports. Furthermore, the samples were elicited into manifold outdoors to inspect the degradation process. This industrial process is implemented to reduce the volume of fossil-based garbage by achieving the biodegradability and compostability in the natural cycle. Hence the research leads to manufacturing a degradable plastic packaging compound which is now available in the Sri Lankan market.

Keywords: blown film extrusion, compression moulding, polyolefin, pro-oxidant, styrene-butadine-rubber, styrene-butadiene-styrene, thermo oxidative aging, unsaturated elastomer

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150 Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North-Western Nigeria

Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

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Haemoglobin (HB) indicates anaemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like zidovudine are known to cause anaemia in People living with HIV/AIDS (PLWHA). A cross-sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December 2009 and July 2011 to assess the effect of zidovudine on haematologic and RNA viral load of female sex workers receiving antiretroviral treatment in north-western Nigeria. Anaemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anaemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anaemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that out of 218 patients, 26 with haemoglobin count between 5.1–10 g/dl were observed to have the highest viral load count of 300,000–350,000 copies/ml. It was also observed that most patients (190) with HB of 10.1–15.0 g/dl had viral load count of 200,000–250,000 copies/ml. An inverse relationship therefore exists, i.e. the lower the haemoglobin level, the higher the viral load count, even though the test statistics did not show any significance between the two (P=0.206). This shows that multivariate logistic regression analysis demonstrated that anaemia was associated with a CD4+ cell count below 50/µL in female sex workers with a viral load above 100,000 copies/mL who use zidovudine. Severe anaemia was less prevalent in this study population than in historical comparators; however, mild to moderate anaemia rates remain high. The study, therefore, recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: anaemia, female sex worker, haemoglobin, Zidovudine

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149 Healthcare Workers' Attitudes Towards People Living With Hiv And Drug Users

Authors: Delband Yekta Moazami

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Background: For proper care and treatment of HIV patients and drug users, the medical staff and physicians must have a correct and positive attitude and knowledge towards such patients. We aimed to assess the attitudes in a sample of health care workers (HCW) working in different hospitals and clinics and medical students in Georgia towards HIV infected people and drug users in Tbilisi. Method: We conducted a cross-sectional study to assess attitudes of health care workers towards people living with HIV and drug users in hospitals and clinics in Tbilisi. The study was carried out from 1st of May 2020 till 30th of September 2020. Data were collected using a self-administered structured online questionnaire. With this tool we evaluated four facets of attitudes: Discrimination, Acceptance of HIV/AIDS patients, Acceptance of drug users and Fear. All data were imported and analyzed with the software SPSS 22 for windows. Results: In total data was collected from168 respondents, that among them 107 (65%) were women and majority of the participants were medical doctors. Women had more acceptance attitudes rather than men towards drug abusers. We found significant differences regarding expressing negative attitudes among HCW who were more than 50 years old comparing with other age groups in all four aspects. Medical doctors expressed more acceptances towards people with HIV and drug users comparing two other groups. Also our study revealed that the group with working experience 21 years and more, showed more discriminatory attitudes comparing other groups. Conclusion: Based on our study findings, there are significant differences regarding respondent’s attitudes based on gender, medical specialty and working experience in health care system. People struggling with HIV and drug use need nonjudgmental and positive behaviors from health care workers and physicians in order to help them for harm reduction and receiving appropriate treatment.

Keywords: hiv, addiction, attitudes, healthcare workers

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148 Shear Capacity of Rectangular Duct Panel Experiencing Internal Pressure

Authors: K. S. Sivakumaran, T. Thanga, B. Halabieh

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The end panels of a large rectangular industrial duct, which experience significant internal pressures, also experience considerable transverse shear due to transfer of gravity loads to the supports. The current design practice of such thin plate panels for shear load is based on methods used for the design of plate girder webs. The structural arrangements, the loadings and the resulting behavior associated with the industrial duct end panels are, however, significantly different than those of the web of a plate girder. The large aspect ratio of the end panels gives rise to multiple bands of tension fields, whereas the plate girder web design is based on one tension field. In addition to shear, the industrial end panels are subjected to internal pressure which in turn produces significant membrane action. This paper reports a study which was undertaken to review the current industrial analysis and design methods and to propose a comprehensive method of designing industrial duct end panels for shear resistance. In this investigation, a nonlinear finite element model was developed to simulate the behavior of industrial duct end panel subjected to transverse shear and internal pressures. The model considered the geometric imperfections and constitutive relations for steels. Six scale independent dimensionless parameters that govern the behavior of such end panel were identified and were then used in an extensive parametric study. It was concluded that the plate slenderness dominates the shear strength of stockier end panels, and whereas, the aspect ratio and plate slenderness influence the shear strength of slender end panels. Based on these studies, this paper proposes design aids for estimating the shear strength of rectangular duct end panels.

Keywords: thin plate, transverse shear, tension field, finite element analysis, parametric study, design

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147 Effect of Oxidative Stress on Glutathione Reductase Activity of Escherichia coli Clinical Isolates from Patients with Urinary Tract Infection

Authors: Fariha Akhter Chowdhury, Sabrina Mahboob, Anamika Saha, Afrin Jahan, Mohammad Nurul Islam

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Urinary tract infection (UTI) is frequently experienced by the female population where the prevalence increases with aging. Escherichia coli, one of the most common UTI causing organisms, retains glutathione defense mechanism that aids the organism to withstand the harsh physiological environment of urinary tract, host oxidative immune response and even to affect antibiotic-mediated cell death and the emergence of resistance. In this study, we aimed to investigate the glutathione reductase activity of uropathogenic E. coli (UPEC) by observing the reduced glutathione (GSH) level alteration under stressful condition. Urine samples of 58 patients with UTI were collected. Upon isolation and identification, 88% of the samples presented E. coli as UTI causing organism among which randomly selected isolates (n=9), obtained from urine samples of female patients, were considered for this study. E. coli isolates were grown under normal and stressful conditions where H₂O₂ was used as the stress-inducing agent. GSH level estimation of the isolates in both conditions was carried out based on the colorimetric measurement of 5,5'-dithio-bis (2-nitrobenzoic acid) (DTNB) and GSH reaction product using microplate reader assay. The GSH level of isolated E. coli sampled from adult patients decreased under stress compared to normal condition (p = 0.011). On the other hand, GSH production increased markedly in samples that were collected from elderly subjects (p = 0.024). A significant partial correlation between age and change of GSH level was found as well (p = 0.007). This study may help to reveal ways for better understanding of E. coli pathogenesis of UTI prevalence in elderly patients.

Keywords: Escherichia coli, glutathione reductase activity, oxidative stress, reduced glutathione (GSH), urinary tract infection (UTI)

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146 Female Sex Workers and Their Association with Self-Help Groups in Thane, Maharashtra, India: A Comparative Analysis in the Context of HIV Program Outcome

Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

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Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

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145 Value Gaps Between Patients and Doctors

Authors: Yih-Jer Wu, Ling-Lang Huang

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Shared decision-making (SDM) is a critical aspect of determining optimal medical strategies. However, current patient decision aids (PDAs) often prioritize evidence-based discussions over value-based considerations. Despite its significance, there is limited research addressing the 'value gap' between patients and healthcare providers. To address this gap, we developed the 'Patient-Doctor Relationship Questionnaire,' consisting of 12 questions. To explore potential variations in the patient-doctor value gap across different medical specialties, we conducted interviews with physicians, surgeons, and their respective patients, utilizing the questionnaire. Between 2020 and 2022, we interviewed a total of 144 patients and 19 doctors. Among the 12 questions, physicians demonstrated significant patient-doctor value gaps in 5 questions, while surgeons in 3 questions. Only one question turned out significant gaps in both physicians and surgeons. When asking both doctors and their patients to choose one from the following 6 answers (1. No issue significant; 2. Not knowing how to make a medical decision; 3. Not confident in the doctor’s clinical judgment; 4. Not knowing how to articulate one’s own condition; 5. Unable to afford medical expenses; 6. Not understanding what doctors explain) in response to the question “what the most significant issue is in the medical consultation”, over 50% of doctors chose “Not knowing how to make a medical decision” (physicians vs. patients, 50% vs. 11%, p=0.046; surgeon vs. patients, 83% vs. 29%, p=0.001), while significantly more patients chose “No issue significant” (10% vs. 52%, p=0.002; 0% vs. 33%, p<0.001, respectively). Our findings indicate that value gaps do exist between patients and doctors and that most patients in Taiwan "fully trust" their doctors' recommendations for medical decisions. However, when treatment outcomes are far from ideal, this overinflated "trust" may turn into frustration, which could become the catalyst for medical disputes. Doctors should spend more time having more effective communication with their patients, particularly regarding potentially dissatisfactory treatment outcomes. This study underscores the substantial variability in the patient-doctor value gap, often overlooked in SDM. Patients from different clinical backgrounds may hold values distinct from those of their healthcare providers. Bridging this value gap is imperative for achieving genuine and effective SDM.

Keywords: share-decision making, value gaps, communication, doctor-patient relationship

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144 Better Defined WHO International Classification of Disease Codes for Relapsing Fever Borreliosis, and Lyme Disease Education Aiding Diagnosis, Treatment Improving Human Right to Health

Authors: Mualla McManus, Jenna Luche Thaye

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World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

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143 Family Planning Programming for Youths and Adolescents in Nigeria

Authors: Ashimolowo Olubunmi

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Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

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142 A Correlational Study between Sexual Awareness, Behaviour and Sources of Sexual Knowledge among Youth in Context of Bihar

Authors: Kanika Naresh Singh, Uday Shankar

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Background: Human behaviours are influenced by drives. Sexual drive is one of them. Education regarding sexual behaviour plays a great role in shaping one’s attitude towards it. These days after attaining the age of puberty, adolescents are confused and feel shy to talk about it. In order to get information, they refer to various types of sources and these sources play a greater role in spreading awareness in the mass adolescent population. Sometimes it also leads to the building of myths and misconceptions. Due to increasing incidences of HIV/AIDS, RTIs/STIs and teenage pregnancies, there is a rising need to impart sex education. Aim: The aim of this research was to study the level of sexual awareness among the youth of Bihar and also study their sexual behaviour and sources of influence. It also aims to study the correlation between sexual awareness, behaviour and sources of sexual knowledge among youth in Bihar. Methods: The sample size for the project was 50 youth consisting of both boys and girls, in between the age group of 18 to 23 years from urban and semi-urban areas. The purposive sampling method was used in the research. The tools used were the Sexual Awareness Questionnaire and Sexual Behavior and Sources of Influence (SBSI) scale. The sexual Awareness Questionnaire was developed by Snell, having 35 items. A socio-demographic data sheet was also used. Results: The youth had poor sexual awareness. Internet and Friends were found to be the major source for gathering information. The youth of Bihar were less inclined towards resolving their doubts with their parents. There was a positive correlation between sexual awareness, behaviour and sources of knowledge. Conclusion: The youth of Bihar has poor sexual knowledge. Internet and Friends are major sources of information. Sex Education should be promoted as suggested by various institutions like World Health Organization United Nations. Psychiatrists and psychologists have a key leadership role in introducing these potentially emotionally challenging issues to the youth with consideration of psychosocial and cultural factors.

Keywords: sexual awareness, sexual behavior, sources of influence, youths, Bihar, India

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