Search results for: online health information
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5297

Search results for: online health information

107 Curriculum Development of Successful Intelligence Promoting for Nursing Students

Authors: Saranya Chularee, Tawa Chularee

Abstract:

Successful intelligence (SI) is the integrated set of the ability needed to attain success in life, within individual-s sociocultural context. People are successfully intelligent by recognizing their strengths and weaknesses. They will find ways to strengthen their weakness and maintain their strength or even improve it. SI people can shape, select, and adapt to the environments by using balance of higher-ordered thinking abilities including; critical, creative, and applicative. Aims: The purposes of this study were to; 1) develop curriculum that promotes SI for nursing students, and 2) study the effectiveness of the curriculum development. Method: Research and Development was a method used for this study. The design was divided into two phases; 1) the curriculum development which composed of three steps (needs assessment, curriculum development and curriculum field trail), and 2) the curriculum implementation. In this phase, a pre-experimental research design (one group pretest-posttest design) was conducted. The sample composed of 49 sophomore nursing students of Boromarajonani College of Nursing, Surin, Thailand who enrolled in Nursing care of Health problem course I in 2011 academic year. Data were carefully collected using 4 instruments; 1) Modified essay questions test (MEQ) 2) Nursing Care Plan evaluation form 3) Group processing observation form (α = 0.74) and 4) Satisfied evaluation form of learning (α = 0.82). Data were analyzed using descriptive statistics and content analysis. Results: The results revealed that the sample had post-test average score of SI higher than pre-test average score (mean difference was 5.03, S.D. = 2.84). Fifty seven percentages of the sample passed the MEQ posttest at the criteria of 60 percentages. Students demonstrated the strategies of how to develop nursing care plan. Overall, students- satisfaction on teaching performance was at high level (mean = 4.35, S.D. = 0.46). Conclusion: This curriculum can promote the attribute of characteristic of SI person and was highly required to be continued.

Keywords: Curriculum Development, Nursing Education, Successful Intelligence, Thinking ability.

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106 Offline Parameter Identification and State-of-Charge Estimation for Healthy and Aged Electric Vehicle Batteries Based on the Combined Model

Authors: Xiaowei Zhang, Min Xu, Saeid Habibi, Fengjun Yan, Ryan Ahmed

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Recently, Electric Vehicles (EVs) have received extensive consideration since they offer a more sustainable and greener transportation alternative compared to fossil-fuel propelled vehicles. Lithium-Ion (Li-ion) batteries are increasingly being deployed in EVs because of their high energy density, high cell-level voltage, and low rate of self-discharge. Since Li-ion batteries represent the most expensive component in the EV powertrain, accurate monitoring and control strategies must be executed to ensure their prolonged lifespan. The Battery Management System (BMS) has to accurately estimate parameters such as the battery State-of-Charge (SOC), State-of-Health (SOH), and Remaining Useful Life (RUL). In order for the BMS to estimate these parameters, an accurate and control-oriented battery model has to work collaboratively with a robust state and parameter estimation strategy. Since battery physical parameters, such as the internal resistance and diffusion coefficient change depending on the battery state-of-life (SOL), the BMS has to be adaptive to accommodate for this change. In this paper, an extensive battery aging study has been conducted over 12-months period on 5.4 Ah, 3.7 V Lithium polymer cells. Instead of using fixed charging/discharging aging cycles at fixed C-rate, a set of real-world driving scenarios have been used to age the cells. The test has been interrupted every 5% capacity degradation by a set of reference performance tests to assess the battery degradation and track model parameters. As battery ages, the combined model parameters are optimized and tracked in an offline mode over the entire batteries lifespan. Based on the optimized model, a state and parameter estimation strategy based on the Extended Kalman Filter (EKF) and the relatively new Smooth Variable Structure Filter (SVSF) have been applied to estimate the SOC at various states of life.

Keywords: Lithium-Ion batteries, genetic algorithm optimization, battery aging test, and parameter identification.

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105 Trapping Efficiency of Diesel Particles Through a Square Duct

Authors: Francis William S, Imtiaz Ahmed Choudhury, Ananda Kumar Eriki, A. John Rajan

Abstract:

Diesel Engines emit complex mixtures of inorganic and organic compounds in the form of both solid and vapour phase particles. Most of the particulates released are ultrafine nanoparticles which are detrimental to human health and can easily enter the body by respiration. The emissions standards on particulate matter release from diesel engines are constantly upgraded within the European Union and with future regulations based on the particles numbers released instead of merely mass, the need for effective aftertreatment devices will increase. Standard particulate filters in the form of wall flow filters can have problems with high soot accumulation, producing a large exhaust backpressure. A potential solution would be to combine the standard filter with a flow through filter to reduce the load on the wall flow filter. In this paper soot particle trapping has been simulated in different continuous flow filters of monolithic structure including the use of promoters, at laminar flow conditions. An Euler Lagrange model, the discrete phase model in Ansys used with user defined functions for forces acting on particles. A method to quickly screen trapping of 5 nm and 10 nm particles in different catalysts designs with tracers was also developed. Simulations of square duct monoliths with promoters show that the strength of the vortices produced are not enough to give a high amount of particle deposition on the catalyst walls. The smallest particles in the simulations, 5 and 10 nm particles were trapped to a higher extent, than larger particles up to 1000 nm, in all studied geometries with the predominant deposition mechanism being Brownian diffusion. The comparison of the different filters designed with a wall flow filter does show that the options for altering a design of a flow through filter, without imposing a too large pressure drop penalty are good.

Keywords: Diesel Engine trap, thermophoresis, Exhaust pipe, PM-Simulation modeling.

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104 Lean Production to Increase Reproducibility and Work Safety in the Laser Beam Melting Process Chain

Authors: C. Bay, A. Mahr, H. Groneberg, F. Döpper

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Additive Manufacturing processes are becoming increasingly established in the industry for the economic production of complex prototypes and functional components. Laser beam melting (LBM), the most frequently used Additive Manufacturing technology for metal parts, has been gaining in industrial importance for several years. The LBM process chain – from material storage to machine set-up and component post-processing – requires many manual operations. These steps often depend on the manufactured component and are therefore not standardized. These operations are often not performed in a standardized manner, but depend on the experience of the machine operator, e.g., levelling of the build plate and adjusting the first powder layer in the LBM machine. This lack of standardization limits the reproducibility of the component quality. When processing metal powders with inhalable and alveolar particle fractions, the machine operator is at high risk due to the high reactivity and the toxic (e.g., carcinogenic) effect of the various metal powders. Faulty execution of the operation or unintentional omission of safety-relevant steps can impair the health of the machine operator. In this paper, all the steps of the LBM process chain are first analysed in terms of their influence on the two aforementioned challenges: reproducibility and work safety. Standardization to avoid errors increases the reproducibility of component quality as well as the adherence to and correct execution of safety-relevant operations. The corresponding lean method 5S will therefore be applied, in order to develop approaches in the form of recommended actions that standardize the work processes. These approaches will then be evaluated in terms of ease of implementation and their potential for improving reproducibility and work safety. The analysis and evaluation showed that sorting tools and spare parts as well as standardizing the workflow are likely to increase reproducibility. Organizing the operational steps and production environment decreases the hazards of material handling and consequently improves work safety.

Keywords: Additive manufacturing, lean production, reproducibility, work safety.

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103 Potential of Croatia as an Attractive Tourist Destination for the Russian Market

Authors: Maja Martinovic, Valentina Zarkovic, Hrvoje Maljak

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Europe is one of the most popular tourist destinations in the world, in which tourism occupies a significant place among the most relevant economic activities, and this applies to the Republic of Croatia as well. Based on this study, the authors intended to encourage and support the creation of an effective tourism policy in Croatia that would be based on the profiling of certain target groups. Another objective was to compare the results obtained from the customer analysis with the market analysis of the tourism industry in Croatia. The objective is to adapt the current tourist offer according to the identified needs and expectations of a particular tourist group in order to increase the attractiveness of Croatia as a tourist destination and motivate greater attendance of the targeted tourist groups. The current research was oriented towards the Russian market as the target group. Therefore, the authors wanted to encourage a discussion on how to attract more Russian guests. Consequently, the intention of the research was a detailed analysis of Russian tourists, in order to gain a better understanding of their travelling motives and tendencies. Furthermore, attention was paid to the expectations of Russian customers and to compare them with the Croatian tourist offer, and to determine whether there is a possibility for an overlap. The method used to obtain the information required was a survey conducted among Russian citizens about their travelling habits. The research was carried out on the basis of 166 participants of different age, gender, profession and income group. The sampling and distribution of the survey took place between May and July 2016. The results provided from the research indicate that Croatian tourism has certain unrealized potential considering the popularization of Croatia as a tourist destination, and there is a capacity for increasing the revenues within the group of Russian tourists. Such a conclusion is based on the fact that the Croatian tourist offer and the preferences of the Russian guests are compatible, i.e. they overlap in many aspects. The results demonstrate that beautiful nature, cultural and historical heritage as well as the sun and sea, play a leading role in attracting more Russian tourists. It is precisely these elements that form the three pillars of the Croatian tourist offer. On the other hand, the profiling revealed that the most desirable destinations for the Russian guests are Italy and Spain, both of which provide the same main tourist attractions as Croatia. Therefore, the focus of the strategic ideas given in the paper shifted to other tourism segments, such as type of accommodation, sales channels, travel motives, additional offer and seasonality etc., in order to gain advantage in the Russian market, the Mediterranean region and tourism in general. The purpose of the research is to serve as a foundation for analysing the attractiveness of the other tourist destinations in the Russian market, as well as to be a general basis for a more detailed profiling of the various specific target groups of the Russian and other tourist groups.

Keywords: Croatia, Russian market, target groups, tourism, tourist destination.

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102 Capacities of Early Childhood Education Professionals for the Prevention of Social Exclusion of Children

Authors: Dejana Bouillet, Vlatka Domović

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Both policymakers and researchers recognize that participating in early childhood education and care (ECEC) is useful for all children, especially for those who are exposed to the high risk of social exclusion. Social exclusion of children is understood as a multidimensional construct including economic, social, cultural, health, and other aspects of disadvantage and deprivation, which individually or combined can have an unfavorable effect on the current life and development of a child, as well as on the child’s development and on disadvantaged life chances in adult life. ECEC institutions should be able to promote educational approaches that portray developmental, cultural, language, and other diversity amongst children. However, little is known about the ways in which Croatian ECEC institutions recognize and respect the diversity of children and their families and how they respond to their educational needs. That is why this paper is dedicated to the analysis of the capacities of ECEC professionals to respond to the demands of educational needs of this very diverse group of children and their families. The results obtained in the frame of the project “Models of response to educational needs of children at risk of social exclusion in ECEC institutions,” funded by the Croatian Science Foundation, will be presented. The research methodology arises from explanations of educational processes and risks of social exclusion as a complex and heterogeneous phenomenon. The preliminary results of the qualitative data analysis of educational practices regarding capacities to identify and appropriately respond to the requirements of children at risk of social exclusion will be presented. The data have been collected by interviewing educational staff in 10 Croatian ECEC institutions (n = 10). The questions in the interviews were related to various aspects of inclusive institutional policy, culture, and practices. According to the analysis, it is possible to conclude that Croatian ECEC professionals are still faced with great challenges in the process of implementation of inclusive policies, culture, and practices. There are several baselines of this conclusion. The interviewed educational professionals are not familiar enough with the whole complexity and diversity of needs of children at risk of social exclusion, and the ECEC institutions do not have enough resources to provide all interventions that these children and their families need.

Keywords: children at risk of social exclusion, ECEC professionals, inclusive policies, culture and practices, interpretative phenomenological analysis

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101 An Introduction to the Concept of Environmental Audit: Indian Context

Authors: Pradip Kumar Das

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Phenomenal growth of population and industry exploits the environment in varied ways. Consequently, the greenhouse effect and other allied problems are threatening mankind the world over. Protection and up gradation of environment have, therefore, become the prime necessity all of mankind for the sustainable development of environment. People in humbler walks of life including the corporate citizens have become aware of the impacts of environmental pollution. Governments of various nations have entered the picture with laws and regulations to correct and cure the effects of present and past violations of environmental practices and to obstruct future violations of good environmental disciplines. In this perspective, environmental audit directs verification and validation to ensure that the various environmental laws are complied with and adequate care has been taken towards environmental protection and preservation. The discipline of environmental audit has experienced expressive development throughout the world. It examines the positive and negative effects of the activities of an enterprise on environment and provides an in-depth study of the company processes any growth in realizing long-term strategic goals. Environmental audit helps corporations assess its achievement, correct deficiencies and reduce risk to the health and improving safety. Environmental audit being a strong management tool should be administered by industry for its own self-assessment. Developed countries all over the globe have gone ahead in environment quantification; but unfortunately, there is a lack of awareness about pollution and environmental hazards among the common people in India. In the light of this situation, the conceptual analysis of this study is concerned with the rationale of environmental audit on the industry and the society as a whole and highlights the emerging dimensions in the auditing theory and practices. A modest attempt has been made to throw light on the recent development in environmental audit in developing nations like India and the problems associated with the implementation of environmental audit. The conceptual study also reflects that despite different obstacles, environmental audit is becoming an increasing aspect within the corporate sectors in India and lastly, conclusions along with suggestions have been offered to improve the current scenario.

Keywords: Environmental audit, environmental hazards, environmental laws, environmental protection, environmental preservation.

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100 The Cooperation among Insulin, Cortisol and Thyroid Hormones in Morbid Obese Children and Metabolic Syndrome

Authors: Orkide Donma, Mustafa M. Donma

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Obesity, a disease associated with a low-grade inflammation, is a risk factor for the development of metabolic syndrome (MetS). So far, MetS risk factors such as parameters related to glucose and lipid metabolisms as well as blood pressure were considered for the evaluation of this disease. There are still some ambiguities related to the characteristic features of MetS observed particularly in pediatric population. Hormonal imbalance is also important, and quite a lot information exists about the behaviour of some hormones in adults. However, the hormonal profiles in pediatric metabolism have not been cleared yet. The aim of this study is to investigate the profiles of cortisol, insulin, and thyroid hormones in children with MetS. The study population was composed of morbid obese (MO) children without (Group 1) and with (Group 2) MetS components. WHO BMI-for age and sex percentiles were used for the classification of obesity. The values above 99 percentile were defined as morbid obesity. Components of MetS (central obesity, glucose intolerance, high blood pressure, high triacylglycerol levels, low levels of high density lipoprotein cholesterol) were determined. Anthropometric measurements were performed. Ratios as well as obesity indices were calculated. Insulin, cortisol, thyroid stimulating hormone (TSH), free T3 and free T4 analyses were performed by electrochemiluminescence immunoassay. Data were evaluated by statistical package for social sciences program. p<0.05 was accepted as the degree for statistical significance. The mean ages±SD values of Group 1 and Group 2 were 9.9±3.1 years and 10.8±3.2 years, respectively. Body mass index (BMI) values were calculated as 27.4±5.9 kg/m2 and 30.6±8.1 kg/m2, successively. There were no statistically significant differences between the ages and BMI values of the groups. Insulin levels were statistically significantly increased in MetS in comparison with the levels measured in MO children. There was not any difference between MO children and those with MetS in terms of cortisol, T3, T4 and TSH. However, T4 levels were positively correlated with cortisol and negatively correlated with insulin. None of these correlations were observed in MO children. Cortisol levels in both MO as well as MetS group were significantly correlated. Cortisol, insulin, and thyroid hormones are essential for life. Cortisol, called the control system for hormones, orchestrates the performance of other key hormones. It seems to establish a connection between hormone imbalance and inflammation. During an inflammatory state, more cortisol is produced to fight inflammation. High cortisol levels prevent the conversion of the inactive form of the thyroid hormone T4 into active form T3. Insulin is reduced due to low thyroid hormone. T3, which is essential for blood sugar control- requires cortisol levels within the normal range. Positive association of T4 with cortisol and negative association of it with insulin are the indicators of such a delicate balance among these hormones also in children with MetS.

Keywords: Children, cortisol, insulin, metabolic syndrome, thyroid hormones.

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99 Energy Loss Reduction in Oil Refineries through Flare Gas Recovery Approaches

Authors: Majid Amidpour, Parisa Karimi, Marzieh Joda

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For the last few years, release of burned undesirable by-products has become a challenging issue in oil industries. Flaring, as one of the main sources of air contamination, involves detrimental and long-lasting effects on human health and is considered a substantial reason for energy losses worldwide. This research involves studying the implications of two main flare gas recovery methods at three oil refineries, all in Iran as the case I, case II, and case III in which the production capacities are increasing respectively. In the proposed methods, flare gases are converted into more valuable products, before combustion by the flare networks. The first approach involves collecting, compressing and converting the flare gas to smokeless fuel which can be used in the fuel gas system of the refineries. The other scenario includes utilizing the flare gas as a feed into liquefied petroleum gas (LPG) production unit already established in the refineries. The processes of these scenarios are simulated, and the capital investment is calculated for each procedure. The cumulative profits of the scenarios are evaluated using Net Present Value method. Furthermore, the sensitivity analysis based on total propane and butane mole fraction is carried out to make a rational comparison for LPG production approach, and the results are illustrated for different mole fractions of propane and butane. As the mole fraction of propane and butane contained in LPG differs in summer and winter seasons, the results corresponding to LPG scenario are demonstrated for each season. The results of the simulations show that cumulative profit in fuel gas production scenario and LPG production rate increase with the capacity of the refineries. Moreover, the investment return time in LPG production method experiences a decline, followed by a rising trend with an increase in C3 and C4 content. The minimum value of time return occurs at propane and butane sum concentration values of 0.7, 0.6, and 0.7 in case I, II, and III, respectively. Based on comparison of the time of investment return and cumulative profit, fuel gas production is the superior scenario for three case studies.

Keywords: Flare gas reduction, liquefied petroleum gas, fuel gas, net present value method, sensitivity analysis.

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98 Exploring the Spatial Characteristics of Mortality Map: A Statistical Area Perspective

Authors: Jung-Hong Hong, Jing-Cen Yang, Cai-Yu Ou

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The analysis of geographic inequality heavily relies on the use of location-enabled statistical data and quantitative measures to present the spatial patterns of the selected phenomena and analyze their differences. To protect the privacy of individual instance and link to administrative units, point-based datasets are spatially aggregated to area-based statistical datasets, where only the overall status for the selected levels of spatial units is used for decision making. The partition of the spatial units thus has dominant influence on the outcomes of the analyzed results, well known as the Modifiable Areal Unit Problem (MAUP). A new spatial reference framework, the Taiwan Geographical Statistical Classification (TGSC), was recently introduced in Taiwan based on the spatial partition principles of homogeneous consideration of the number of population and households. Comparing to the outcomes of the traditional township units, TGSC provides additional levels of spatial units with finer granularity for presenting spatial phenomena and enables domain experts to select appropriate dissemination level for publishing statistical data. This paper compares the results of respectively using TGSC and township unit on the mortality data and examines the spatial characteristics of their outcomes. For the mortality data between the period of January 1st, 2008 and December 31st, 2010 of the Taitung County, the all-cause age-standardized death rate (ASDR) ranges from 571 to 1757 per 100,000 persons, whereas the 2nd dissemination area (TGSC) shows greater variation, ranged from 0 to 2222 per 100,000. The finer granularity of spatial units of TGSC clearly provides better outcomes for identifying and evaluating the geographic inequality and can be further analyzed with the statistical measures from other perspectives (e.g., population, area, environment.). The management and analysis of the statistical data referring to the TGSC in this research is strongly supported by the use of Geographic Information System (GIS) technology. An integrated workflow that consists of the tasks of the processing of death certificates, the geocoding of street address, the quality assurance of geocoded results, the automatic calculation of statistic measures, the standardized encoding of measures and the geo-visualization of statistical outcomes is developed. This paper also introduces a set of auxiliary measures from a geographic distribution perspective to further examine the hidden spatial characteristics of mortality data and justify the analyzed results. With the common statistical area framework like TGSC, the preliminary results demonstrate promising potential for developing a web-based statistical service that can effectively access domain statistical data and present the analyzed outcomes in meaningful ways to avoid wrong decision making.

Keywords: Mortality map, spatial patterns, statistical area, variation.

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97 Creating Smart and Healthy Cities by Exploring the Potentials of Emerging Technologies and Social Innovation for Urban Efficiency: Lessons from the Innovative City of Boston

Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando

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The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

Keywords: Smart city, social innovation, eHealth, innovation hubs, emerging technologies, equitable healthcare, healthy cities.

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96 Measuring the Effect of Ventilation on Cooking in Indoor Air Quality by Low-Cost Air Sensors

Authors: Andres Gonzalez, Adam Boies, Jacob Swanson, David Kittelson

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The concern of the indoor air quality (IAQ) has been increasing due to its risk to human health. The smoking, sweeping, and stove and stovetop use are the activities that have a major contribution to the indoor air pollution. Outdoor air pollution also affects IAQ. The most important factors over IAQ from cooking activities are the materials, fuels, foods, and ventilation. The low-cost, mobile air quality monitoring (LCMAQM) sensors, is reachable technology to assess the IAQ. This is because of the lower cost of LCMAQM compared to conventional instruments. The IAQ was assessed, using LCMAQM, during cooking activities in a University of Minnesota graduate-housing evaluating different ventilation systems. The gases measured are carbon monoxide (CO) and carbon dioxide (CO2). The particles measured are particle matter (PM) 2.5 micrometer (µm) and lung deposited surface area (LDSA). The measurements are being conducted during April 2019 in Como Student Community Cooperative (CSCC) that is a graduate housing at the University of Minnesota. The measurements are conducted using an electric stove for cooking. The amount and type of food and oil using for cooking are the same for each measurement. There are six measurements: two experiments measure air quality without any ventilation, two using an extractor as mechanical ventilation, and two using the extractor and windows open as mechanical and natural ventilation. 3The results of experiments show that natural ventilation is most efficient system to control particles and CO2. The natural ventilation reduces the concentration in 79% for LDSA and 55% for PM2.5, compared to the no ventilation. In the same way, CO2 reduces its concentration in 35%. A well-mixed vessel model was implemented to assess particle the formation and decay rates. Removal rates by the extractor were significantly higher for LDSA, which is dominated by smaller particles, than for PM2.5, but in both cases much lower compared to the natural ventilation. There was significant day to day variation in particle concentrations under nominally identical conditions. This may be related to the fat content of the food. Further research is needed to assess the impact of the fat in food on particle generations.

Keywords: Cooking, indoor air quality, low-cost sensor, ventilation.

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95 Neighborhood Sustainability Assessment Tools: A Conceptual Framework for Their Use in Building Adaptive Capacity to Climate Change

Authors: Sally Naji, Julie Gwilliam

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Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

Keywords: Adaptive capacity, climate change, NSA tools, resilience, vulnerability.

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94 Life Cycle Datasets for the Ornamental Stone Sector

Authors: Isabella Bianco, Gian Andrea Blengini

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The environmental impact related to ornamental stones (such as marbles and granites) is largely debated. Starting from the industrial revolution, continuous improvements of machineries led to a higher exploitation of this natural resource and to a more international interaction between markets. As a consequence, the environmental impact of the extraction and processing of stones has increased. Nevertheless, if compared with other building materials, ornamental stones are generally more durable, natural, and recyclable. From the scientific point of view, studies on stone life cycle sustainability have been carried out, but these are often partial or not very significant because of the high percentage of approximations and assumptions in calculations. This is due to the lack, in life cycle databases (e.g. Ecoinvent, Thinkstep, and ELCD), of datasets about the specific technologies employed in the stone production chain. For example, databases do not contain information about diamond wires, chains or explosives, materials commonly used in quarries and transformation plants. The project presented in this paper aims to populate the life cycle databases with specific data of specific stone processes. To this goal, the methodology follows the standardized approach of Life Cycle Assessment (LCA), according to the requirements of UNI 14040-14044 and to the International Reference Life Cycle Data System (ILCD) Handbook guidelines of the European Commission. The study analyses the processes of the entire production chain (from-cradle-to-gate system boundaries), including the extraction of benches, the cutting of blocks into slabs/tiles and the surface finishing. Primary data have been collected in Italian quarries and transformation plants which use technologies representative of the current state-of-the-art. Since the technologies vary according to the hardness of the stone, the case studies comprehend both soft stones (marbles) and hard stones (gneiss). In particular, data about energy, materials and emissions were collected in marble basins of Carrara and in Beola and Serizzo basins located in the province of Verbano Cusio Ossola. Data were then elaborated through an appropriate software to build a life cycle model. The model was realized setting free parameters that allow an easy adaptation to specific productions. Through this model, the study aims to boost the direct participation of stone companies and encourage the use of LCA tool to assess and improve the stone sector environmental sustainability. At the same time, the realization of accurate Life Cycle Inventory data aims at making available, to researchers and stone experts, ILCD compliant datasets of the most significant processes and technologies related to the ornamental stone sector.

Keywords: LCA datasets, life cycle assessment, ornamental stone, stone environmental impact.

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93 Improving the Management Systems of the Ownership Risks in Conditions of Transformation of the Russian Economy

Authors: Mikhail V. Khachaturyan

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The article analyzes problems of improving the management systems of the ownership risks in the conditions of the transformation of the Russian economy. Among the main sources of threats business owners should highlight is the inefficiency of the implementation of business models and interaction with hired managers. In this context, it is particularly important to analyze the relationship of business models and ownership risks. The analysis of this problem appears to be relevant for a number of reasons: Firstly, the increased risk appetite of the owner directly affects the business model and the composition of his holdings; secondly, owners with significant stakes in the company are factors in the formation of particular types of risks for owners, for which relations have a significant influence on a firm's competitiveness and ultimately determines its survival; and thirdly, inefficient system of management ownership of risk is one of the main causes of mass bankruptcies, which significantly affects the stable operation of the economy as a whole. The separation of the processes of possession, disposal and use in modern organizations is the cause of not only problems in the process of interaction between the owner and managers in managing the organization as a whole, but also the asymmetric information about the kinds and forms of the main risks. Managers tend to avoid risky projects, inhibit the diversification of the organization's assets, while owners can insist on the development of such projects, with the aim not only of creating new values for themselves and consumers, but also increasing the value of the company as a result of increasing capital. In terms of separating ownership and management, evaluation of projects by the ratio of risk-yield requires preservation of the influence of the owner on the process of development and making management decisions. It is obvious that without a clearly structured system of participation of the owner in managing the risks of their business, further development is hopeless. In modern conditions of forming a risk management system, owners are compelled to compromise between the desire to increase the organization's ability to produce new value, and, consequently, increase its cost due to the implementation of risky projects and the need to tolerate the cost of lost opportunities of risk diversification. Improving the effectiveness of the management of ownership risks may also contribute to the revitalization of creditors on implementation claims to inefficient owners, which ultimately will contribute to the efficiency models of ownership control to exclude variants of insolvency. It is obvious that in modern conditions, the success of the model of the ownership of risk management and audit is largely determined by the ability and willingness of the owner to find a compromise between potential opportunities for expanding the firm's ability to create new value through risk and maintaining the current level of new value creation and an acceptable level of risk through the use of models of diversification.

Keywords: Risk management, ownership risks, economic transformation, Russian economy, management systems.

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92 Client Satisfaction: Does Private or Public Health Sector Make a Difference? Results from Secondary Data Analysis in Sindh, Pakistan

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

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Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset on 3133 women. Ten different multivariate models were made. to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92, 95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29). Discussion: Public sector has successfully attained substantial satisfaction levels with respect to provision of contraceptives, but it contrasts previous literature from a multi country studies. Our study though in is concordance with a study from Tanzania where public sector was more likely to offer family planning services to clients as compared to private facilities. Conclusion: In majority of the developing countries, public sector is more involved in FP service provision; however, in Pakistan clients’ satisfaction in private sector is more, which opens doors for public-private partnerships and collaboration in the near future. 

Keywords: Client satisfaction, Family Planning, Public private partnership, Quality of care

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91 Description of Reported Foodborne Diseases in Selected Communities within the Greater Accra Region-Ghana: Epidemiological Review of Surveillance Data

Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson

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Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.

Keywords: Accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance.

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90 The Digital Microscopy in Organ Transplantation: Ergonomics of the Tele-Pathological Evaluation of Renal, Liver and Pancreatic Grafts

Authors: C. S. Mammas, A. Lazaris, A. S. Mamma-Graham, G. Kostopanagiotou, C. Lemonidou, J. Mantas, E. Patsouris

Abstract:

Introduction: The process to build a better safety culture, methods of error analysis, and preventive measures, starts with an understanding of the effects when human factors engineering refer to remote microscopic diagnosis in surgery and specially in organ transplantation for the remote evaluation of the grafts. It has been estimated that even in well-organized transplant systems an average of 8% to 14% of the grafts (G) that arrive at the recipient hospitals may be considered as diseased, injured, damaged or improper for transplantation. Digital microscopy adds information on a microscopic level about the grafts in Organ Transplant (OT), and may lead to a change in their management. Such a method will reduce the possibility that a diseased G, will arrive at the recipient hospital for implantation. Aim: Ergonomics of Digital Microscopy (DM) based on virtual slides, on Telemedicine Systems (TS) for Tele-Pathological (TPE) evaluation of the grafts (G) in organ transplantation (OT). Material and Methods: By experimental simulation, the ergonomics of DM for microscopic TPE of Renal Graft (RG), Liver Graft (LG) and Pancreatic Graft (PG) tissues is analyzed. In fact, this corresponded to the ergonomics of digital microscopy for TPE in OT by applying Virtual Slide (VS) system for graft tissue image capture, for remote diagnoses of possible microscopic inflammatory and/or neoplastic lesions. Experimentation included: a. Development of an OTE-TS similar Experimental Telemedicine System (Exp.-TS), b. Simulation of the integration of TS with the VS based microscopic TPE of RG, LG and PG applying DM. Simulation of the DM based TPE was performed by 2 specialists on a total of 238 human Renal Graft (RG), 172 Liver Graft (LG) and 108 Pancreatic Graft (PG) tissues digital microscopic images for inflammatory and neoplastic lesions on four electronic spaces of the four used TS. Results: Statistical analysis of specialist‘s answers about the ability to diagnose accurately the diseased RG, LG and PG tissues on the electronic space among four TS (A,B,C,D) showed that DM on TS for TPE in OT is elaborated perfectly on the ES of a Desktop, followed by the ES of the applied Exp.-TS. Tablet and Mobile-Phone ES seem significantly risky for the application of DM in OT (p<.001). Conclusion: To make the largest reduction in errors and adverse events referring to the quality of the grafts, it will take application of human factors engineering to procurement, design, audit, and aware ness-raising activities. Consequently, it will take an investment in new training, people, and other changes to management activities for DM in OT. The simulating VS based TPE with DM of RG, LG and PG tissues after retrieval; seem feasible and reliable and dependable on the size of the electronic space of the applied TS, for remote prevention of diseased grafts from being retrieved and/or sent to the recipient hospital and for post-grafting and pre-transplant planning.

Keywords: Organ Transplantation, Tele-Pathology, Digital Microscopy, Virtual Slides.

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89 Association of Phosphorus and Magnesium with Fat Indices in Children with Metabolic Syndrome

Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a disease associated with obesity. It is a complicated clinical problem possibly affecting body composition as well as macrominerals. These parameters gain further attention particularly in pediatric population. The aim of this study is to investigate the amount of discrete body composition fractions in groups that differ in the severity of obesity. Also, the possible associations with calcium (Ca), phosphorus (P), magnesium (Mg) will be examined. The study population was divided into four groups. 28, 29, 34 and 34 children were involved in Group 1 (healthy), Group 2 (obese), Group 3 (morbid obese) and Group 4 (MetS), respectively. Institutional Ethical Committee approved the study protocol. Informed consent forms were obtained from the parents of the participants. The classification of obese groups was performed based upon the recommendations of World Health Organization. MetS components were defined. Serum Ca, P, Mg concentrations were measured. Within the scope of body composition, fat mass, fat-free mass, protein mass, mineral mass were determined by body composition monitor using bioelectrical impedance analysis technology. Weight, height, waist circumference, hip circumference, head circumference and neck circumference values were recorded. Body mass index, diagnostic obesity notation model assessment index, fat mass index and fat-free mass index values were calculated. Data were statistically evaluated and interpreted. There was no statistically significant difference among the groups in terms of Ca and P concentrations. Magnesium concentrations differed between Group 1 and Group 4. Strong negative correlations were detected between P as well as Mg and fat mass index as well as diagnostic obesity notation model assessment index in Group 4, which comprised morbid obese children with MetS. This study emphasized unique associations of P and Mg minerals with diagnostic obesity notation model assessment index and fat mass index during the evaluation of morbid obese children with MetS. It was also concluded that diagnostic obesity notation model assessment index and fat mass index were more proper indices in comparison with body mass index and fat-free mass index for the purpose of defining body composition in children.

Keywords: Children, fat mass, fat-free mass, macrominerals, obesity.

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88 Factors Militating the Organization of Intramural Sport Programs in Secondary Schools: A Case Study of the Ekiti West Local Government Area of Ekiti State, Nigeria

Authors: Adewole Taiwo Adelabu

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The study investigated the factors militating the organization of intramural sports programs in secondary schools in Ekiti State, Nigeria. The purpose of the study was to identify the factors affecting the organization of sports in secondary schools and also to proffer possible solutions to these factors. The study employed the inferential statistics of chi-square (x2). Five research hypotheses were formulated. The population for the study was all the students in the government-owned secondary schools in Ekiti West Local Government of Ekiti State Nigeria. The sample for the study was 60 students in three schools within the local government selected through simple random sampling techniques. The instrument used for the study was a self-developed questionnaire by the researcher for data collection. The instrument was presented to experts and academicians in the field of Human Kinetics and Health Education for construct and content validation. A reliability test was conducted which involves 10 students who are not part of the study. The test-retest coefficient of 0.74 was obtained which attested to the fact that the instrument was reliable enough for the study. The validated questionnaire was administered to the students in their various schools by the researcher with the help of two research assistants; the questionnaires were filled and returned to the researcher immediately. The data collected were analyzed using the descriptive statistics of frequency count, percentage and mean to analyze demographic data in section A of the questionnaire, while inferential statistics of chi-square was used to test the hypotheses at 0.05 alpha level. The results of the study revealed that personnel, fund, schedule (time) were significant factors that affect the organization of intramural sport programs among students in secondary schools in Ekiti West Local Government Area of the State. The study also revealed that organization of intramural sports programs among students of secondary schools will improve and motivate students’ participation in sports beyond the local level. However, facilities and equipment is not a significant factor affecting the organization of intramural sports among secondary school students in Ekiti West Local Government Area.

Keywords: Challenge, militating, intramural sport, programs.

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87 The Application of Dynamic Network Process to Environment Planning Support Systems

Authors: Wann-Ming Wey

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In recent years, in addition to face the external threats such as energy shortages and climate change, traffic congestion and environmental pollution have become anxious problems for many cities. Considering private automobile-oriented urban development had produced many negative environmental and social impacts, the transit-oriented development (TOD) has been considered as a sustainable urban model. TOD encourages public transport combined with friendly walking and cycling environment designs, however, non-motorized modes help improving human health, energy saving, and reducing carbon emissions. Due to environmental changes often affect the planners’ decision-making; this research applies dynamic network process (DNP) which includes the time dependent concept to promoting friendly walking and cycling environmental designs as an advanced planning support system for environment improvements.

This research aims to discuss what kinds of design strategies can improve a friendly walking and cycling environment under TOD. First of all, we collate and analyze environment designing factors by reviewing the relevant literatures as well as divide into three aspects of “safety”, “convenience”, and “amenity” from fifteen environment designing factors. Furthermore, we utilize fuzzy Delphi Technique (FDT) expert questionnaire to filter out the more important designing criteria for the study case. Finally, we utilized DNP expert questionnaire to obtain the weights changes at different time points for each design criterion. Based on the changing trends of each criterion weight, we are able to develop appropriate designing strategies as the reference for planners to allocate resources in a dynamic environment. In order to illustrate the approach we propose in this research, Taipei city as one example has been used as an empirical study, and the results are in depth analyzed to explain the application of our proposed approach.

Keywords: Environment Planning Support Systems, Walking and Cycling, Transit-oriented Development (TOD), Dynamic Network Process (DNP).

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86 Beginning Physics Experiments Class Using Multi Media in National University of Laos

Authors: T. Nagata, S. Xaphakdy, P. Souvannavong, P. Chanthamaly, K. Sithavong, C. H. Lee, S. Phommathat, V. Srithilat, P. Sengdala, B. Phetarnousone, B. Siharath, X. Chemcheng, T. Yamaguchi, A. Suenaga, S. Kashima

Abstract:

National University of Laos (NUOL) requested Japan International Cooperation Agency (JICA) volunteers to begin a physics experiments class using multi media. However, there are issues. NUOL had no physics experiment class, no space for physics experiments, experiment materials were not used for many years and were scattered in various places, and there is no projector and laptop computer in the unit. This raised the question: How do authors begin the physics experiments class using multimedia? To solve this problem, the JICA took some steps, took stock of what was available and reviewed the syllabus. The JICA then revised the experiment materials to assess what was available and then developed textbooks for experiments using them; however, the question remained, what about the multimedia component of the course? Next, the JICA reviewed Physics teacher Pavy Souvannavong’s YouTube channel, where he and his students upload video reports of their physics classes at NUOL using their smartphones. While they use multi-media, almost all the videos recorded were of class presentations. To improve the multimedia style, authors edited the videos in the style of another YouTube channel, “Science for Lao,” which is a science education group made up of Japan Overseas Cooperation Volunteers (JOCV) in Laos. They created the channel to enhance science education in Laos, and hold regular monthly meetings in the capital, Vientiane, and at teacher training colleges in the country. They edit the video clips in three parts, which are the materials and procedures part including pictures, practice footage of the experiment part, and then the result and conclusion part. Then students perform experiments and prepare for presentation by following the videos. The revised experiment presentation reports use PowerPoint presentations, material pictures and experiment video clips. As for providing textbooks and submitting reports, the students use the e-Learning system of “Moodle” of the Information Technology Center in Dongdok campus of NUOL. The Korean International Cooperation Agency (KOICA) donated those facilities. The authors have passed the process of the revised materials, developed textbooks, the PowerPoint slides presented by students, downloaded textbooks and uploaded reports, to begin the physics experiments class using multimedia. This is the practice research report for beginning a physics experiments class using multimedia in the physics unit at the Department of Natural Science, Faculty of Education, at the NUOL.

Keywords: NUOL, JICA, KOICA, Physics experiment materials, smart phone, Moodle, IT center, Science for Lao.

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85 Snails and Fish as Pollution Biomarkers in Lake Manzala and Laboratory B: Lake Manzala Fish

Authors: Hanaa M. M. El-Khayat, Hanan S. Gaber, Hoda Abdel-Hamid, Kadria M. A. Mahmoud, Hoda M. A. Abu Taleb

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This work aimed to examine Oreochromis niloticus fish from Lake Manzala in Port Said, Dakahlya and Damietta governorates, Egypt, as a bio-indicator for the lake water pollution through recording alterations in their hematological, physiological, and histopathological parameters. All fish samples showed a significant increase in levels of alkaline phosphatase (ALP), creatinine and glutathione-S-transferase (GST); only Dakahlya samples showed a significant increase (p<0.01) in aspartate aminotransferase (AST) level and most Dakahlya and Damietta samples showed reversed albumin and globulin ratio and a significant increase in γ-glutamyltransferase (GGT) level. Port-Said and Damietta samples showed a significant decrease of hemoglobin (Hb) while Dakahlya samples showed a significant decrease in white blood cell (WBC) count. Histopathological investigation for different fish organs showed that Port-Said and Dakahlya samples were more altered than Damietta. The muscle and gill followed by intestine were the most affected organs. The muscle sections showed severe edema, neoplasia, necrotic change, fat vacuoles and splitting of muscle fiber. The gill sections showed dilated blood vessels of the filaments, curling of gill lamellae, severe hyperplasia, edema and blood vessels congestion of filaments. The intestine sections revealed degeneration, atrophy, dilation in blood vessels and necrotic changes in sub-mucosa and mucosa with edema in between. The recorded significant alterations, in most of the physiological and histological parameters in O. niloticus samples from Lake Manzala, were alarming for water pollution impacts on lake fish community, which constitutes the main diet and the main source of income for the people inhabiting these areas, and were threatening their public health and economy. Also, results evaluate the use of O. niloticus fish as important bio-indicator for their habitat stressors.

Keywords: Lake Manzala, Oreochromis niloticus fish, water pollution, physiological, hematological and histopathological parameters.

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84 A Risk Assessment Tool for the Contamination of Aflatoxins on Dried Figs based on Machine Learning Algorithms

Authors: Kottaridi Klimentia, Demopoulos Vasilis, Sidiropoulos Anastasios, Ihara Diego, Nikolaidis Vasileios, Antonopoulos Dimitrios

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Aflatoxins are highly poisonous and carcinogenic compounds produced by species of the genus Aspergillus spp. that can infect a variety of agricultural foods, including dried figs. Biological and environmental factors, such as population, pathogenicity and aflatoxinogenic capacity of the strains, topography, soil and climate parameters of the fig orchards are believed to have a strong effect on aflatoxin levels. Existing methods for aflatoxin detection and measurement, such as high-performance liquid chromatography (HPLC), and enzyme-linked immunosorbent assay (ELISA), can provide accurate results, but the procedures are usually time-consuming, sample-destructive and expensive. Predicting aflatoxin levels prior to crop harvest is useful for minimizing the health and financial impact of a contaminated crop. Consequently, there is interest in developing a tool that predicts aflatoxin levels based on topography and soil analysis data of fig orchards. This paper describes the development of a risk assessment tool for the contamination of aflatoxin on dried figs, based on the location and altitude of the fig orchards, the population of the fungus Aspergillus spp. in the soil, and soil parameters such as pH, saturation percentage (SP), electrical conductivity (EC), organic matter, particle size analysis (sand, silt, clay), concentration of the exchangeable cations (Ca, Mg, K, Na), extractable P and trace of elements (B, Fe, Mn, Zn and Cu), by employing machine learning methods. In particular, our proposed method integrates three machine learning techniques i.e., dimensionality reduction on the original dataset (Principal Component Analysis), metric learning (Mahalanobis Metric for Clustering) and K-nearest Neighbors learning algorithm (KNN), into an enhanced model, with mean performance equal to 85% by terms of the Pearson Correlation Coefficient (PCC) between observed and predicted values.

Keywords: aflatoxins, Aspergillus spp., dried figs, k-nearest neighbors, machine learning, prediction

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83 Financial Burden of Family for the Children with Autism Spectrum Disorder

Authors: M. R. Bhuiyan, S. M. M. Hossain, M. Z. Islam

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Autism Spectrum Disorder (ASD) is the fastest growing serious developmental disorder characterized by social deficits, communicative difficulties, and repetitive behaviors. ASD is an emerging public health issue globally which is associated with huge financial burden to the family, community and the nation. The aim of this study was to assess the financial burden of family for the children with Autism spectrum Disorder. This cross-sectional study was carried out from July 2015 to June 2016 among 154 children with ASD to assess the financial burden of family. Data were collected by face-to-face interview with semi-structured questionnaire following systematic random sampling technique. Majority (73.4%) children were male and mean (±SD) age was 6.66 ± 2.97 years. Most (88.8%) of the children were from urban areas with average monthly family income Tk. 41785.71±23936.45. Average monthly direct cost of the children was Tk.17656.49 ± 9984.35, while indirect cost was Tk. 13462.90 ± 9713.54 and total treatment cost was Tk. 23076.62 ± 15341.09. Special education cost (Tk. 4871.00), cost of therapy (Tk. 4124.07) and travel cost (Tk. 3988.31) were the major types of direct cost, while loss of income (Tk.14570.18) was the chief indirect cost incurred by the families. The study found that majority (59.8%) of the children attended special schools were incurred Tk.20001-78700 as total treatment cost, which were statistically significant (p<0.001). Again, families with higher monthly family income incurred higher treatment cost (r=0.526, p<0.05). Difference between mean direct and indirect cost was found significant (t=4.190, df=61, p<0.001). According to the analysis of variance, mean difference of father’s educational status among direct cost (F=10.337, p<0.001) and total treatment cost (F=7.841, p<0.001), which were statistically significant. The study revealed that maximum children with ASD were under five years, three-fourth were male. According to monthly family income, maximum family were in middle class. The study recommends cost effective interventions and financial safety-net measures to reduce the financial burden of families for the children with ASD.

Keywords: Autism spectrum disorder, financial burden, direct cost, indirect cost, Special education.

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82 Application of Transportation Models for Analysing Future Intercity and Intracity Travel Patterns in Kuwait

Authors: Srikanth Pandurangi, Basheer Mohammed, Nezar Al Sayegh

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In order to meet the increasing demand for housing care for Kuwaiti citizens, the government authorities in Kuwait are undertaking a series of projects in the form of new large cities, outside the current urban area. Al Mutlaa City located to the north-west of the Kuwait Metropolitan Area is one such project out of the 15 planned new cities. The city accommodates a wide variety of residential developments, employment opportunities, commercial, recreational, health care and institutional uses. This paper examines the application of comprehensive transportation demand modeling works undertaken in VISUM platform to understand the future intracity and intercity travel distribution patterns in Kuwait. The scope of models developed varied in levels of detail: strategic model update, sub-area models representing future demand of Al Mutlaa City, sub-area models built to estimate the demand in the residential neighborhoods of the city. This paper aims at offering model update framework that facilitates easy integration between sub-area models and strategic national models for unified traffic forecasts. This paper presents the transportation demand modeling results utilized in informing the planning of multi-modal transportation system for Al Mutlaa City. This paper also presents the household survey data collection efforts undertaken using GPS devices (first time in Kuwait) and notebook computer based digital survey forms for interviewing representative sample of citizens and residents. The survey results formed the basis of estimating trip generation rates and trip distribution coefficients used in the strategic base year model calibration and validation process.

Keywords: GPS based household surveys, transportation infrastructure, origin-destination trip matrices, traffic forecasts, transportation demand modeling, travel behavior patterns.

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81 Understanding Help Seeking among Black Women with Clinically Significant Posttraumatic Stress Symptoms

Authors: Glenda Wrenn, Juliet Muzere, Meldra Hall, Allyson Belton, Kisha Holden, Chanita Hughes-Halbert, Martha Kent, Bekh Bradley

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Understanding the help seeking decision making process and experiences of health disparity populations with posttraumatic stress disorder (PTSD) is central to development of trauma-informed, culturally centered, and patient focused services. Yet, little is known about the decision making process among adult Black women who are non-treatment seekers as they are, by definition, not engaged in services. Methods: Audiotaped interviews were conducted with 30 African American adult women with clinically significant PTSD symptoms who were engaged in primary care, but not in treatment for PTSD despite symptom burden. A qualitative interview guide was used to elucidate key themes. Independent coding of themes mapped to theory and identification of emergent themes were conducted using qualitative methods. An existing quantitative dataset was analyzed to contextualize responses and provide a descriptive summary of the sample. Results: Emergent themes revealed that active mental avoidance, the intermittent nature of distress, ambivalence, and self-identified resilience as undermining to help seeking decisions. Participants were stuck within the help-seeking phase of ‘recognition’ of illness and retained a sense of “it is my decision” despite endorsing significant social and environmental negative influencers. Participants distinguished ‘help acceptance’ from ‘help seeking’ with greater willingness to accept help and importance placed on being of help to others. Conclusions: Elucidation of the decision-making process from the perspective of non-treatment seekers has implications for outreach and treatment within models of integrated and specialty systems care. The salience of responses to trauma symptoms and stagnation in the help seeking recognition phase are findings relevant to integrated care service design and community engagement.

Keywords: Culture, help-seeking, integrated care, PTSD.

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80 Tools and Techniques in Risk Assessment in Public Risk Management Organisations

Authors: Atousa Khodadadyan, Gabe Mythen, Hirbod Assa, Beverley Bishop

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Risk assessment and the knowledge provided through this process is a crucial part of any decision-making process in the management of risks and uncertainties. Failure in assessment of risks can cause inadequacy in the entire process of risk management, which in turn can lead to failure in achieving organisational objectives as well as having significant damaging consequences on populations affected by the potential risks being assessed. The choice of tools and techniques in risk assessment can influence the degree and scope of decision-making and subsequently the risk response strategy. There are various available qualitative and quantitative tools and techniques that are deployed within the broad process of risk assessment. The sheer diversity of tools and techniques available to practitioners makes it difficult for organisations to consistently employ the most appropriate methods. This tools and techniques adaptation is rendered more difficult in public risk regulation organisations due to the sensitive and complex nature of their activities. This is particularly the case in areas relating to the environment, food, and human health and safety, when organisational goals are tied up with societal, political and individuals’ goals at national and international levels. Hence, recognising, analysing and evaluating different decision support tools and techniques employed in assessing risks in public risk management organisations was considered. This research is part of a mixed method study which aimed to examine the perception of risk assessment and the extent to which organisations practise risk assessment’ tools and techniques. The study adopted a semi-structured questionnaire with qualitative and quantitative data analysis to include a range of public risk regulation organisations from the UK, Germany, France, Belgium and the Netherlands. The results indicated the public risk management organisations mainly use diverse tools and techniques in the risk assessment process. The primary hazard analysis; brainstorming; hazard analysis and critical control points were described as the most practiced risk identification techniques. Within qualitative and quantitative risk analysis, the participants named the expert judgement, risk probability and impact assessment, sensitivity analysis and data gathering and representation as the most practised techniques.

Keywords: Decision-making, public risk management organisations, risk assessment, tools and techniques.

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79 The Characteristics of Static Plantar Loading in the First-Division College Sprint Athletes

Authors: Tong-Hsien Chow

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Background: Plantar pressure measurement is an effective method for assessing plantar loading and can be applied to evaluating movement performance of the foot. The purpose of this study is to explore the sprint athletes’ plantar loading characteristics and pain profiles in static standing. Methods: Experiments were undertaken on 80 first-division college sprint athletes and 85 healthy non-sprinters. ‘JC Mat’, the optical plantar pressure measurement was applied to examining the differences between both groups in the arch index (AI), three regional and six distinct sub-regional plantar pressure distributions (PPD), and footprint characteristics. Pain assessment and self-reported health status in sprint athletes were examined for evaluating their common pain areas. Results: Findings from the control group, the males’ AI fell into the normal range. Yet, the females’ AI was classified as the high-arch type. AI values of the sprint group were found to be significantly lower than the control group. PPD were higher at the medial metatarsal bone of both feet and the lateral heel of the right foot in the sprint group, the males in particular, whereas lower at the medial and lateral longitudinal arches of both feet. Footprint characteristics tended to support the results of the AI and PPD, and this reflected the corresponding pressure profiles. For the sprint athletes, the lateral knee joint and biceps femoris were the most common musculoskeletal pains. Conclusions: The sprint athletes’ AI were generally classified as high arches, and that their PPD were categorized between the features of runners and high-arched runners. These findings also correspond to the profiles of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles appeared to correspond to the symptoms of high-arched runners and PFPS. The findings reflected upon the possible link between high arches and PFPS. The correlation between high-arched runners and PFPS development is worth further studies.

Keywords: Sprint athletes, arch index, plantar pressure distributions, high arches, patellofemoral pain syndrome.

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78 Investigation of Genetic Epidemiology of Metabolic Compromises in ß Thalassemia Minor Mutation: Phenotypic Pleiotropy

Authors: Surajit Debnath, Soma Addya

Abstract:

Human genome is not only the evolutionary summation of all advantageous events, but also houses lesions of deleterious foot prints. A single gene mutation sometimes may express multiple consequences in numerous tissues and a linear relationship of the genotype and the phenotype may often be obscure. ß Thalassemia minor, a transfusion independent mild anaemia, coupled with environment among other factors may articulate into phenotypic pleotropy with Hypocholesterolemia, Vitamin D deficiency, Tissue hypoxia, Hyper-parathyroidism and Psychological alterations. Occurrence of Pancreatic insufficiency, resultant steatorrhoea, Vitamin-D (25-OH) deficiency (13.86 ngm/ml) with Hypocholesterolemia (85mg/dl) in a 30 years old male ß Thal-minor patient (Hemoglobin 11mg/dl with Fetal Hemoglobin 2.10%, Hb A2 4.60% and Hb Adult 84.80% and altered Hemogram) with increased Para thyroid hormone (62 pg/ml) & moderate Serum Ca+2 (9.5mg/ml) indicate towards a cascade of phenotypic pleotropy where the ß Thalassemia mutation ,be it in the 5’ cap site of the mRNA , differential splicing etc in heterozygous state is effecting several metabolic pathways. Compensatory extramedulary hematopoiesis may not coped up well with the stressful life style of the young individual and increased erythropoietic stress with high demand for cholesterol for RBC membrane synthesis may have resulted in Hypocholesterolemia.Oxidative stress and tissue hypoxia may have caused the pancreatic insufficiency, leading to Vitamin D deficiency. This may in turn have caused the secondary hyperparathyroidism to sustain serum Calcium level. Irritability and stress intolerance of the patient was a cumulative effect of the vicious cycle of metabolic compromises. From these findings we propose that the metabolic deficiencies in the ß Thalassemia mutations may be considered as the phenotypic display of the pleotropy to explain the genetic epidemiology. According to the recommendations from the NIH Workshop on Gene-Environment Interplay in Common Complex Diseases: Forging an Integrative Model, study design of observations should be informed by gene-environment hypotheses and results of a study (genetic diseases) should be published to inform future hypotheses. Variety of approaches is needed to capture data on all possible aspects, each of which is likely to contribute to the etiology of disease. Speakers also agreed that there is a need for development of new statistical methods and measurement tools to appraise information that may be missed out by conventional method where large sample size is needed to segregate considerable effect. A meta analytic cohort study in future may bring about significant insight on to the title comment.

Keywords: Genetic disease, Genetic epidemiology, Heterozygous, Phenotype, Pleotropy, ß Thalassemia minor, Metabolic compromises.

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