Search results for: access funding

Authors: Ambra Giovannelli, Coriolano Salvini

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Many efforts have been spent in the design and development of Concentrated Solar Power (CPS) Plants worldwide. Most of them are for on-grid electricity generation and they are large plants which can benefit from the economies of scale. Nevertheless, several potential applications for Small and Medium-Scale CSP plants can be relevant in the industrial sector as well as for off-grid purposes (i.e. in rural contexts). In a wide range of industrial processes, CSP technologies can be used for heat generation replacing conventional primary sources. For such market, proven technologies (usually hybrid solutions) already exist: more than 100 installations, especially in developing countries, are in operation and performance can be verified. On the other hand, concerning off-grid applications, solar technologies are not so mature. Even if the market offers a potential deployment of such systems, especially in countries where the access to grid is strongly limited, optimized solutions have not been developed yet. In this context, steam power plants can be taken into consideration for medium scale installations, due to the recent results achieved with direct steam generation systems based on paraboloidal dish or Fresnel lens solar concentrators. Steam at 4.0-4.5 MPa and 500°C can be produced directly by means of innovative solar receivers (some prototypes already exist). Although it could seem a promising technology, presently, steam turbines commercially available do not cover the required cycle specifications. In particular, while low-pressure turbines already exist on the market, high-pressure groups, necessary for the abovementioned applications, are not available. The present paper deals with the preliminary design of a high-pressure steam turbine group for a medium-scale CSP plant (200-1000 kWe). Such a group is arranged in a single geared package composed of four radial expander wheels. Such wheels have been chosen on the basis of automotive turbocharging technology and then modified to take the new requirements into account. Results related to the preliminary geometry selection and to the analysis of the high-pressure turbine group performance are reported and widely discussed.

Keywords: concentrated solar power (CSP) plants, steam turbine, radial turbine, medium-scale power plants

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Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

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Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

Procedia PDF Downloads 84

Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

Procedia PDF Downloads 279

Authors: Julius Y Asamoah

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Mobile money has seen faster adoption in the decade. Its emergence serves as an essential driver of financial inclusion and an innovative financial service delivery channel, especially to the unbanked population. The rising importance of mobile money services has caught policymakers and regulators' attention, seeking to understand the many issues emerging from this context. At the same time, it is unlocking the potential of knowledge of this new technology. Regulatory responses and support are essential, requiring significant changes to current regulatory practices in Ghana. The article aims to answer the following research questions: "What risk does an unregulated mobile money service pose to consumers and the financial system? "What factors stimulate and hinder the introduction of mobile payments in developing countries? The sample size used was 250 respondents selected from the study area. The study has adopted an analytical approach comprising a combination of qualitative and quantitative data collection methods. Actor-network theory (ANT) is used as an interpretive lens to analyse this process. ANT helps analyse how actors form alliances and enrol other actors, including non-human actors (i.e. technology), to secure their interests. The study revealed that government regulatory policies impact mobile money as critical to mobile money services in developing countries. Regulatory environment should balance the needs of advancing access to finance with the financial system's stability and draw extensively from Kenya's work as the best strategies for the system's players. Thus, regulators need to address issues related to the enhancement of supportive regulatory frameworks. It recommended that the government involve various stakeholders, such as mobile phone operators. Moreover, the national regulatory authority creates a regulatory environment that promotes fair practices and competition to raise revenues to support a business-enabling environment's key pillars as infrastructure.

Keywords: actor-network theory (ANT), cashless future, Developing countries, Ghana, Mobile Money

Procedia PDF Downloads 138

Authors: Guillaume P. Fernandez

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Individual language use is a matter of choice in particular interactions. The paper proposes a conceptual and theoretical framework with methodological consideration to develop how language produced in dyadic relations is to be considered and situated in the larger social configuration the interaction is embedded within. An integrated and comprehensive view is taken: social interactions are expected to be ruled by a normative context, defined by the chain of interdependences that structures the personal network. In this approach, the determinants of discursive practices are not only constrained by the moment of production and isolated from broader influences. Instead, the position the individual and the dyad have in the personal network influences the discursive practices in a twofold manner: on the one hand, the network limits the access to linguistic resources available within it, and, on the other hand, the structure of the network influences the agency of the individual, by the social control inherent to particular network characteristics. Concretely, we investigate how and to what extent consistent ego is from one interaction to another in his or her use of adverbs. To do so, social network analysis (SNA) methods are mobilized. Participants (N=130) are college students recruited in the french speaking part of Switzerland. The personal network of significant ones of each individual is created using name generators and edge interpreters, with a focus on social support and conflict. For the linguistic parts, respondents were asked to record themselves with five of their close relations. From the recordings, we computed an average similarity score based on the adverb used across interactions. In terms of analyses, two are envisaged: First, OLS regressions including network-level measures, such as density and reciprocity, and individual-level measures, such as centralities, are performed to understand the tenets of linguistic similarity from one interaction to another. The second analysis considers each social tie as nested within ego networks. Multilevel models are performed to investigate how the different types of ties may influence the likelihood to use adverbs, by controlling structural properties of the personal network. Primary results suggest that the more cohesive the network, the less likely is the individual to change his or her manner of speaking, and social support increases the use of adverbs in interactions. While promising results emerge, further research should consider a longitudinal approach to able the claim of causality.

Keywords: personal network, adverbs, interactions, social influence

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Authors: Tamara Roma, Emma Capulli

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Pregnancy and fertility, in other words, reproduction, has become, in the last half of the century, increasingly and globally controlled, medicalized, and regulated. The reflection proposed starts from the consequences of the inscription of reproduction into the neoliberal economic paradigm. The new biotechnologies developments have raised a new patriarchal justification for State’s control of uterus bodies and a new construction of knowledge about reproductive health. Moral discussion and juridification remove reproduction and non-reproduction from their personal and intimate context and frame them under words like “duties”, “rights”, “family planning”, “demography”, and “population policy”, reinvent them as “States business” and ultimately help to re/confirm a specific construct of fertility, motherhood, and family. Moreover, the interaction between the neoliberal economy and medical biotechnologies brought about a new formulation of the connection between feminine generative potential and value production. The widespread and contemporary debates on Medically Assisted Reproduction (MAR), surrogacy and abortion suggest the need for a “feminist/queer global bioethical discourse” capable of inserting itself into the official bioethical debate characterized by the traditional dichotomy of laic bioethics/Catholic bioethics. The contribution moves from a feminist bioethics perspective on reproductive technologies to introduce a feminist/queer global bioethics point of view on reproductive health. The comparison between reproduction and non-reproduction debates is useful to analyze and demonstrate how restrictive legislations, dichotomic bioethical discussion and medical control confirm and strengthens gender injustice in reproductive life. In fact, MAR, surrogacy, and abortion restrictions stem from a shared social and legal paradigm that depends on traditional gender roles revealing how the stratification of reproduction is based on multiple discrimination along the lines of gender, race, and class. In conclusion, the perspective of feminist/queer global bioethics tries to read the concept of universal reproductive justice, introducing an original point of view on reproductive health access.

Keywords: queer bioethics, reproductive health, reproductive justice, reproductive technologies

Procedia PDF Downloads 124

Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

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Authors: Marie-Claude Richard, Amelie Bolduc-Mokhtar, Mathieu Parent

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People who have experienced maltreatment in childhood subsequently face many parenting issues of their own, in particular when it comes to distancing themselves from the abusive behaviors they were exposed and had access to positive role models. Few studies have explored the factors explaining the ability to break the generational cycle of child maltreatment. However, deeper knowledge of the factors associated with intergenerational discontinuity could facilitate the development of innovative interventions and increase the preventive potential of existing programs. This poster presentation will be about a better understanding of the intergenerational transmission of maltreatment (IGTM) from the perspective of both youth protection workers and parents receiving child protection services. The data used to meet this goal were collected from a group interview with eight youth protection workers whose caseloads involved IGTM situations and through semi-structured interviews with four parents with a history of child protection services and who were currently receiving such services for at least one of their children. In the view of the youth protection workers, the IGTM refers to everything that is transmitted and not transmitted from one generation to the next within a family. The study participants painted quite a bleak portrait of the families affected by IGTM. However, three main avenues of intervention were mentioned by the participants: working within the network, favoring long-term interventions and being empathic. The results also show that the mothers were in a trajectory of intergenerational discontinuity in child maltreatment. Support from their families and friends as well as from formal support services brought out some possible explanatory factors for intergenerational discontinuity in child maltreatment. From a prevention perspective, developing meaningful and trusting relationships seems a source of resilience for parents who were placed in the care of the child protection system as children. The small number of participants limits the generalizability of these results. The difficulty of recruiting parents is a substantial challenge regarding gaining knowledge on the intergenerational transmission of child maltreatment. Future studies should examine this question and seek to develop effective strategies to help recruit study participants.

Keywords: child maltreatment, intergenerational transmission, prevention, qualitative data

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Authors: James Boag

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The needs of people with a diagnosis of dementia and their carers and families are physical, psychosocial, and psychological and begin at the time of diagnosis. There is frequently a lack of emotional support and counselling. Care- giving support is required from the presentation of the first symptoms of dementia until death. Alzheimer's disease begins decades before the clinical symptoms begin to appear, and in many cases, it remains undiagnosed, or diagnosed too late for any possible interventions to have any effect. However, if an incorrect diagnosis is given, it may result in a person being treated, without effect, for a type of dementia they do not have and delaying the interventions they should have received. Being diagnosed with dementia can cause emotional distress to the person, and physical and emotional support is needed, which will become more important as the disease progresses. The severity of the patient's dementia and their symptoms has a bearing of the impact on the carer and the support needed. A lack of insight and /or a denial of the diagnosis, grief, reacting to anticipated future losses, and coping methods to maximise the disease outcome, are things that should be addressed. Because of the stigma, it is important for carers not to lose contact with family and others because social isolation leads to depression and burnout. The impact on a carer's well- being and quality of life can be influenced by the severity of the illness, its type of dementia, its symptoms, healthcare support, financial and social status, career, age, health, residential setting, and relationship to the patient. Carer burnout due to lack of support leads to people diagnosed with dementia being put into residential care prematurely. Often dementia is not recognised as a terminal illness, limiting the ability of the person diagnosed with dementia and their carers to work on advance care planning and getting access to palliative and other support. Many carers have been satisfied with the physical support they were given in their everyday life, however, it was agreed that there was an immense unmet need for psychosocial support, especially after diagnosis and approaching end of life. Providing continuity and coordination of care is important. Training is necessary for providers to understand that every case is different, and they should understand the complexities. Grief, the emotional response to loss, is suffered during the progression of the disease and long afterwards, and carers should continue to be supported after the death of the person they were caring for.

Keywords: dementia, caring, challenges, needs

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Authors: Sandeep Mehmi, Harsh Verma, A. L. Sangal

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Ever since the idea of using computing services as commodity that can be delivered like other utilities e.g. electric and telephone has been floated, the scientific fraternity has diverted their research towards a new area called utility computing. New paradigms like cluster computing and grid computing came into existence while edging closer to utility computing. With the advent of internet the demand of anytime, anywhere access of the resources that could be provisioned dynamically as a service, gave rise to the next generation computing paradigm known as cloud computing. Today, cloud computing has become one of the most aggressively growing computer paradigm, resulting in growing rate of applications in area of IT outsourcing. Besides catering the computational and storage demands, cloud computing has economically benefitted almost all the fields, education, research, entertainment, medical, banking, military operations, weather forecasting, business and finance to name a few. Smart grid is another discipline that direly needs to be benefitted from the cloud computing advantages. Smart grid system is a new technology that has revolutionized the power sector by automating the transmission and distribution system and integration of smart devices. Cloud based smart grid can fulfill the storage requirement of unstructured and uncorrelated data generated by smart sensors as well as computational needs for self-healing, load balancing and demand response features. But, security issues such as confidentiality, integrity, availability, accountability and privacy need to be resolved for the development of smart grid cloud. In recent years, a number of intrusion prevention techniques have been proposed in the cloud, but hackers/intruders still manage to bypass the security of the cloud. Therefore, precise intrusion detection systems need to be developed in order to secure the critical information infrastructure like smart grid cloud. Considering the success of artificial neural networks in building robust intrusion detection, this research proposes an artificial neural network based model for detecting attacks in smart grid cloud.

Keywords: artificial neural networks, cloud computing, intrusion detection systems, security issues, smart grid

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Authors: Tanjil Sowgat, Shamim Kobir

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World is now experiencing the consequences of climate change such as increased heat stress due to high temperature rise. In the context of changing climate, this study intends to find out the planning interventions necessary to adapt to the current heat stress in the planned residential areas of Khulna city. To carry out the study Sonadanga residential area (phase I) of Khulna city has been taken as the study site. This residential neighbourhood covering an area of 30 acres has 206 residential plots. The study area comprises twelve access roads, one park, one playfield, one water body and two street furniture’s. This study conducts visual analysis covering green, open space, water body, footpath, drainage and street trees and furniture and questionnaire survey deals with socio-economic, housing tenancy, experience of heat stress and urban design interventions. It finds that the current state that accelerates the heat stress condition such as lack of street trees and inadequate shading, maximum uses are not within ten minutes walking distance, no footpath for the pedestrians and lack of well-maintained street furniture. It proposes that to adapt to the heat stress pedestrian facilities, buffer sidewalk with landscaping, street trees and open spaces, soft scape, natural and man-made water bodies, green roofing could be effective urban design interventions. There are evidences of limited number of heat stress adaptive planned residential area. Since current sub-division planning practice focuses on rigid land use allocation, it partly addresses the climatic concerns through creating open space and street trees. To better respond to adapt to the heat stress, urban design considerations in the context of sub-division practice would bring more benefits.

Keywords: climate change, urban design, adaptation, heat stress, water-logging

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Authors: Daria Karasalihovic Sedlar, Lucija Jukic, Ivan Smajla, Marija Macenic

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This paper analyses possible geothermal energy production from a mature oil reservoir based on exploitation of underlying aquifer thermal energy for the purpose of heating public buildings. Research was conducted based on the case study of the City of Ivanic-Grad public buildings energy demand and Ivanic oil filed that is situated in the same area. Since the City of Ivanic is one of the few cities in the EU where hydrocarbon exploitation has been taking place for decades almost entirely in urban area, decommissioning of oil wells is inevitable; therefore, the research goal was to investigate how to extend the life-time of the reservoir by exploiting geothermal brine beneath the oil reservoir in an environmental friendly manner. This kind of a project is extremely complex in all segments, from documentation preparation, implementation of technological solutions, and providing ecological measures for environmentally acceptable geothermal energy production and utilization. New mining activities that will be needed for the development of geothermal project at the observed Hydrocarbon Exploitation Field Ivanic will be carried out in order to prepare wells for increasing geothermal brine production. These operations involve the conversion of existing wells (well completion for conversion of the observation wells to production ones) along with workover activities, installation of new heat exchangers, and pipelines. Since the wells are in the urban area of the City of Ivanic-Grad in high density populated area, the inhabitants will be exposed to the different environmental impacts during preparation phase of the project. For the purpose of performing workovers, it will be necessary to secure access to wellheads of existing wells. This paper gives guidelines for describing potential impacts on environment components that could occur during geothermal production preparation on existing mature oil filed, recommends possible protection measures to mitigate these impacts, and gives recommendations for environmental monitoring.

Keywords: geothermal energy production, mature oil filed, environmental impact assessment, underlying aquifer thermal energy

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Authors: Nardjes Hamini, Mohamed Bachir Yagoubi

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Precision agriculture has revolutionized farming by enabling farmers to monitor their crops remotely in real-time. By utilizing technologies such as sensors, farmers can detect the state of growth, hydration levels, and nutritional status and even identify diseases affecting their crops. With this information, farmers can make informed decisions regarding irrigation, fertilization, and pesticide application. Automated agricultural tasks, such as plowing, seeding, planting, and harvesting, are carried out by autonomous robots and have helped reduce costs and increase production. Despite the advantages of precision agriculture, its high cost makes it inaccessible to small and medium-sized farms. To address this issue, this paper presents an open-source guidance system for an autonomous planter robot. The system is composed of a Raspberry Pi-type nanocomputer equipped with Wi-Fi, a GPS module, a gyroscope, and a power supply module. The accompanying application allows users to enter and calibrate maps with at least four coordinates, enabling the localized contour of the parcel to be captured. The application comprises several modules, such as the mission entry module, which traces the planting trajectory and points, and the action plan entry module, which creates an ordered list of pre-established tasks such as loading, following the plan, returning to the garage, and entering sleep mode. A remote control module enables users to control the robot manually, visualize its location on the map, and use a real-time camera. Wi-Fi coverage is provided by an outdoor access point, covering a 2km circle. This open-source system offers a low-cost alternative for small and medium-sized farms, enabling them to benefit from the advantages of precision agriculture.

Keywords: autonomous robot, guidance system, low-cost, medium farms, open-source system, planter robot, precision agriculture, real-time monitoring, remote control, small farms

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Authors: Telma Fontao de Castro, Kylee Miller, Maria Xavier Araújo, Isabel Brandao, Sandra Torres

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Objective: There is a dearth of research investigating the long-term emotional functioning of individuals recovered from anorexia nervosa (AN). This 15-year longitudinal study aimed to examine whether difficulties in cognitive processing of emotions persisted after long-term AN recovery and its link to anxiety and depression. Method: Twenty-four females, who were tested longitudinally during their acute and recovered AN phases, and 24 healthy control (HC) women, were screened for anxiety, depression, alexithymia, and emotion regulation difficulties (ER; only assessed in recovery phase). Results: Anxiety, depression, and alexithymia levels decreased significantly with AN recovery. However, scores on anxiety and difficulty in identifying feelings (alexithymia factor) remained high when compared to the HC group. Scores on emotion regulation difficulties were also lower in HC group. The abovementioned differences between AN recovered group and HC group in difficulties in identifying and accepting feelings and lack of emotional clarity were no longer present when the effect of anxiety and depression was controlled. Conclusions: Findings suggest that emotional dysfunction tends to decrease in AN recovered phase. However, using an HC group as a reference, we conclude that several emotional difficulties are still increased after long-term AN recovery, in particular, limited access to emotion regulation strategies, and difficulty controlling impulses and engaging in goal-directed behavior, thus suggesting to be a trait vulnerability. In turn, competencies related to emotional clarity and acceptance of emotional responses seem to be state-dependent phenomena linked to anxiety and depression. In sum, managing emotions remains a challenge for individuals recovered from AN. Under this circumstance, maladaptive eating behavior can serve as an affect regulatory function, increasing the risk of relapse. Emotional education and stabilization of depressive and anxious symptomatology after recovery emerge as an important avenue to protect from long-term AN relapse.

Keywords: alexithymia, anorexia nervosa, emotion recognition, emotion regulation

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Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

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Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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Authors: Valentina Talu, Giulia Tola

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Current researches and applications aimed at exploring the role of spatial configuration as a means for improving the autonomy of people with ASD (Autism Spectrum Disorder), almost exclusively focus on the definition of criteria for the design of closed, separated, private spaces devoted only to people - mainly children - with ASD. In fact, very few researches specifically investigate the relation between the city and people with autism, focusing on their sensory experiences related to the interaction with the urban environment. The growing incidence of ASD and the need to guarantee during adulthood the actual opportunity to exercise the achieved level of autonomy and independency, emphasizes the necessity to ‘broaden’ the research perspective by investigating also the specific contribution of urban mobility policies and urban design to the enhancement of the quality of life of people with ASD. Starting from these considerations, the paper describes an ongoing research focused on the relation between the city and people with autism spectrum disorder, with the specific aim of promoting their possibility of walking across the city at the neighborhood scale, thus making the access to relevant urban spaces and services possible. In the first part, the paper proposes a framework for illustrating the commonly recurring problems that people with ASD face in their daily life when they interact with the urban environment (with reference to the capability approach). Subsequently, with the support of an in depth analysis of existing contributions (researches and projects) and an exchange with different experts (neuropsychiatrists, teachers, parents), are identified two urban requirements, then 'translated' into an integrated system of urban mobility policies and extra-small tactical project aimed at enhancing the actual possibility for people with ASD of walking through the city autonomously and safely. According to this vision, the promotion of the autonomy of people with ASD through the adoption of mobility policies and micro tactical urban projects can represent an opportunity for promoting and improving the overall quality of urban life.

Keywords: city and people with ASD, quality of urban life of disadvantaged people, urban capabilities, urban design

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Authors: Muhammad Yayat Afianto, Darmawan, Agung Putra Utama, Hari Kushardanto

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Fish Forever, Rare’s innovative coastal fisheries program, combined community-based conservation management approach with spatial management to restore and protect Indonesia’s small-scale fisheries by establishing Fishing Managed Access Area. A ‘TURF-Reserve’ is a fishery management approach that positions fishers at the center of fisheries management, empowering them to take care of and make decisions about the future of their fishery. After two years of the program, social marketing campaigns succeeded in changing their behavior by adopting the new conservation behavior. The Pride-TURF-R campaigns developed an overarching hypothesis of impact that captured the knowledge, attitude and behavior changes needed to reduce threats and achieve conservation results. Rare help Batu Belah fishers to develop their group, developed with their roles, sustainable fisheries plan, and the budget plan. On 12th February 2017, the Head of Loka Kawasan Konservasi Perairan Nasional (LKKPN) which is a Technical Implementation Unit for National Marine Conservation Areas directly responsible to the Directorate General for Marine Spatial Management in the Ministry of Marine Affairs and Fisheries had signed a Partnership Agreement with the Head of Batu Belah Village to manage a TURF+Reserve area as wide as 909 hectares. The fishers group have been collecting the catch and submitting the report monthly, initiated the installation of the buoy markers for the No Take Zone, and formed the Pokmaswas (community-based surveillance group). Prior to this behavior adoption, they don’t have any fisheries data, no group of fishers, and they have still fishing inside the No Take Zone. This is really a new behavior adoption for them. This paper will show the process and success story of the social marketing campaign to conserve marine habitat in Anambas through Pride-TURF-R program.

Keywords: behavior adoption, community participation, no take zone, pride-TURF-R

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Authors: Şenay Güngör, Emre Elbaşi, Beyda Sadikoğlu, Utku Eren Bağci, Ömer Uzunel

Abstract:

One of the first places that comes to mind when it comes to tourism in Turkey is the Cappadocia Region. Due to its rich geological and geomorphological heritage, Cappadocia is one of the most visited destinations in the world. In fact, in the first half of 2023, the number of international tourists visiting Cappadocia exceeded 2 million. Considering that the economy of the Cappadocia region is largely based on tourism, it is understood that the quality and technology integration levels of the touristic services offered in the region are of great importance. In this context; as a result of the observations made in Kızılçukur, Meskendir, Güllüdere 1 and Güllüdere 2 valleys, where the important hiking routes of the Cappadocia Region are located, it has been observed that the digital level of the routes is insufficient. It has been observed that the telephone networks in the area are very low or have completely lost their signal strength. In addition, it was determined that the materials such as maps and brochures used by tourism agencies to introduce the valleys are simple and incomplete. It is thought that this situation negatively affects the tourists' orientation and touristic experience in the field. Eliminating these deficiencies identified in the field, improving the digital level of the above-mentioned hiking routes and increasing the added value in destinations are among the main objectives of our study. Within the scope of the study, a mobile application that can work both online and offline on hiking routes has been prepared. 3D modeling of Kızılçukur, Meskendir, Güllüdere 1 and Güllüdere 2 valleys were made using Geographical Information Systems (GIS). In addition, a website has been created to enable tourists to easily access all the above-mentioned information, visuals and technological applications related to the routes. As it is known, the effective use of information and communication technologies in touristic regions not only increases the satisfaction levels of tourists, but also positively affects the attraction of qualified tourists to the region. When the tangible and intangible outputs of this study are evaluated, it is thought that it will serve the social and economic development of the region and set an example for the digital transformation of other routes in the region.

Keywords: nevşehir, cappadocia, cappadocia valleys, trekking route

Procedia PDF Downloads 62

Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

Abstract:

Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

Procedia PDF Downloads 355

Authors: Sasiwan Tassana-iem, Sumattana Glangkarn

Abstract:

Diabetic nephropathy is a major complication in diabetic patients whom as the glomerular filtration rate falls. The affects their quality of life and results in loss of money for kidney replacement therapy costs. There is an existing intervention, but the prevalence remains high, thus this research aims to study lessons learned in implementing programs to delay diabetic nephropathy management in primary health care. Method: The target settings are, 24 sub-district health promoting hospital in Sakon Nakhon province. Participants included the health care professionals, head of the sub-district health promoting hospital and the person responsible for managing diabetic nephropathy in each hospital (n= 50). There are 400 patients with diabetes mellitus in an area. Data were collected using questionnaires, patient records data, interviews and focus groups and analyzed by statistics and content analysis. Result: Reflection of participants that the interventions to delay diabetic nephropathy management in each area, the Ministry of Public Health has a policy to screen and manage this disease. The implementing programs aimed to provide health education, innovative teaching media used in communication to educate. Patients and caregivers had misunderstanding about the actual causes and prevention of this disease and how to apply knowledge suitable for daily life. Conclusion: The obstacles to the success of the implementing programs to delay diabetic nephropathy management in primary health care were most importantly, the patient needs self-care and should be evaluated for health literacy. This is crucial to promote health literacy; to access and understand health information as well to decide their health-related choices based on health information which will promote and maintain a good health. This preliminary research confirms that situation of diabetic nephropathy still exists. The results of this study will lead to the development of delay in diabetic nephropathy implementation among patients in the province studied.

Keywords: diabetic nephropathy, chronic kidney disease, primary health care, implementation

Procedia PDF Downloads 200

Authors: Mustapha Ouardouz, Mina Amharref, Abdessamed Bernoussi

Abstract:

The future energy, for limited energy resources countries, goes through renewable energies (solar, wind etc.). The renewable energies constitute a major component of the energy strategy to cover a substantial part of the growing needs and contribute to environmental protection by replacing fossil fuels. Indeed, sustainable development involves the promotion of renewable energy and the preservation of the environment by the use of clean energy technologies to limit emissions of greenhouse gases and reducing the pressure exerted on the forest cover. So the impact studies, of the energy use on the environment and farm-related risks are necessary. For that, a global approach integrating all the various sectors involved in such project seems to be the best approach. In this paper we present an approach based on the multi criteria analysis and the realization of one pilot to achieve the development of an innovative geo-intelligent environmental platform. An implementation of this platform will collect, process, analyze and manage environmental data in connection with the nature of used energy in the studied region. As an application we consider a region in the north of Morocco characterized by intense agricultural and industrials activities and using diverse renewable energy. The strategic goals of this platform are; the decision support for better governance, improving the responsiveness of public and private companies connected by providing them in real time with reliable data, modeling and simulation possibilities of energy scenarios, the identification of socio-technical solutions to introduce renewable energies and estimate technical and implantable potential by socio-economic analyzes and the assessment of infrastructure for the region and the communities, the preservation and enhancement of natural resources for better citizenship governance through democratization of access to environmental information, the tool will also perform simulations integrating environmental impacts of natural disasters, particularly those linked to climate change. Indeed extreme cases such as floods, droughts and storms will be no longer rare and therefore should be integrated into such projects.

Keywords: renewable energies, decision aided tool, environment, simulation

Procedia PDF Downloads 459

Authors: Chijindu D. Mgbemere

Abstract:

Mass killing also known as genocide is the systematic killing of people from national, ethnic, or religious group, or an attempt to do so. The act has been there before 1948, when it was officially recognized for what it is. From then, the world has continued to witness genocide in diverse forms- negating different measures by the United Nations and its agencies to curb it. So far, all the studies and documentations on this subject are biased in favor of radio and the print. This paper therefore extended the interrogation of genocide, drumming its devastating effects, using the film medium; and in doing so devised innovative and pragmatic approach to genocide scholarship. It further centered attention on the factors and impacts of genocide, with a view to determine how effective film can be in such a study. The study is anchored on Bateson’s Framing Theory. Four films- Hotel Rwanda, Half of a Yellow Sun, Attack on Darfur, and sarafina, were analyzed, based on background, factors/causes, impacts, and development of genocide, via Content Analysis. The study discovered that: as other continents strive towards peace, acts of genocide are on the increase in African. Bloodletting stereotypes give Africa negative image in the global society. Difficult political frameworks, the trauma of postcolonial state, aggravated by ethnic and religious intolerance, and limited access to resources are responsible for high cases of genocide in Africa. The media, international communities, and peace agencies often abet other than prevent genocide or mass killings in Africa. High human casualty and displacement, children soldering, looting, hunger, rape, sex-slavery and abuse, mental and psychosomatic stress disorders are some of the impacts of genocide. Genocidaires are either condemned or killed. Grievances can be vented using civil resistance, negotiation, adjudication, arbitration, and mediation. The cinema is an effective means of studying and documenting genocide. Africans must factor the image laundering of their continent into consideration. Punishment of genocidaires without an attempt to de-radicalize them is counterproductive.

Keywords: African film, genocide, framing theory, mass murder

Procedia PDF Downloads 118

Authors: Hend Albassam, Nouf Alrumaih

Abstract:

Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

Procedia PDF Downloads 304

Authors: Cristina Gutiérrez Carranza

Abstract:

Digital nomadism is a trend and lifestyle which combines work and traveling. This tourism tendency is motivated by the desire to have a fixed source of financial income while becoming independent from a specific work location. This study contextualizes Costa Rica and its potential prospects to take advantage of this tourism market niche. It explores the dynamics of digital nomadism in the context of Costa Rica, analyzing the current scenario, challenges, and opportunities related to this global phenomenon. The research covers several areas, including the conceptualization of digital nomadism, its historical background, and contemporary manifestations. The investigation delves into the present state of digital nomadism, evaluating the extent of digitalization in Costa Rica, mobile phone coverage, and fixed internet access. As part of the strategies implemented, as the study develops, mapping the most common destinations of digital nomads is a key factor, bringing a sight on the aspects that make Costa Rica an attractive location for this emerging tourist group. Additionally, the paper draws insights from hosting entrepreneurs and digital nomads with work visas in Costa Rica, offering a comprehensive understanding of the experiences and perspectives from both sides. Hence, the study includes data from a sample of 20 digital nomads holding visas for Costa Rica, offering a detailed analysis of their professional activities, experiences and needs as remote workers in the country. As well it adds in perceptions from 10 entrepreneurs engaged in providing accommodation services to digital nomads contribute to a degree of understanding of the way they have faced this growing movement. This research provides significant insights on the dynamics of digital nomadism in Costa Rica by integrating data from specific sources. Policymakers, entrepreneurs, and other stakeholders are anticipated to gain valuable data from the findings regarding the opportunities and challenges of hosting and accommodating digital nomads, which will ultimately aid in the creation of plans to capitalize on this worldwide trend for the nation's socioeconomic development.

Keywords: digital nomads, tourism, sustainability, digital nomads visa, remote jobs

Procedia PDF Downloads 68

Authors: Şenay Güngör, Emre Elbaşi, Beyda Sadikğlu, Utku Eren Bağci, Ömer Uzunel

Abstract:

One of the first places that comes to mind when it comes to tourism in Turkey is the Cappadocia Region. Due to its rich geological and geomorphological heritage, Cappadocia is one of the most visited destinations in the world. In fact, in the first half of 2023, the number of international tourists visiting Cappadocia exceeded 2 million. Considering that the economy of the Cappadocia region is largely based on tourism, it is understood that the quality and technology integration levels of the touristic services offered in the region are of great importance. In this context; as a result of the observations made in Kızılçukur, Meskendir, Güllüdere 1 and Güllüdere 2 valleys, where the important hiking routes of the Cappadocia Region are located, it has been observed that the digital level of the routes is insufficient. It has been observed that the telephone networks in the area are very low or have completely lost their signal strength. In addition, it was determined that the materials such as maps and brochures used by tourism agencies to introduce the valleys are simple and incomplete. It is thought that this situation negatively affects the tourists' orientation and touristic experience in the field. Eliminating these deficiencies identified in the field, improving the digital level of the above-mentioned hiking routes and increasing the added value in destinations are among the main objectives of our study. Within the scope of the study, a mobile application that can work both online and offline on hiking routes has been prepared. 3D modeling of Kızılçukur, Meskendir, Güllüdere 1 and Güllüdere 2 valleys were made using Geographical Information Systems (GIS). In addition, a website has been created to enable tourists to easily access all the above-mentioned information, visuals and technological applications related to the routes. As it is known, the effective use of information and communication technologies in touristic regions not only increases the satisfaction levels of tourists, but also positively affects the attraction of qualified tourists to the region. When the tangible and intangible outputs of this study are evaluated, it is thought that it will serve the social and economic development of the region and set an example for the digital transformation of other routes in the region.

Keywords: nevşehir, cappadocia, cappadocia valleys, tourism route

Procedia PDF Downloads 56

Authors: Samaneh Abedini, Diana Coholic

Abstract:

The transition from adolescence into adulthood involves many changes that result in increased vulnerability to psychological challenges. This developmental stage can be especially stressful for female youth living in underserviced regions. If mental health problems are left untreated in socially marginalized youth, these challenges can extend into adulthood. We know that a lack of access to mental health services and supports can influence adolescents’ psycho-social development and well-being, while resilience and emotion regulation can help them cope with these challenges. Feasible therapeutic programs can play a significant role in assisting youth in developing these characteristics and skills. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) and Holistic Art-Based Program (HAP) are two examples of mindfulness-based interventions (MBIs) that address emotion regulation, coping strategies, and resilience in marginalized youth. While each program’s beneficial effects have been documented, there is a lack of research comparing MBIs with youth, within underserviced geographical locations, and across different cultures. In this study, the sample was 42 female youth between the ages of 12 and 17 years from Iran. 42 female youth from the Elm o Honar High School, located in rural parts of Iran, Isfahan province, have been enrolled in the study. The participants were assigned to one of the MBIs (three MBCT-C experimental groups (n=20) and three HAP experimental groups (n=22)). All participants completed measures including the Child and Youth Resilience Measure-28 (CYRM-28), Child and Adolescent Mindfulness Measure (CAMM), and Difficulties in Emotion Regulation Scale (DERS) at baseline and post-intervention. At the end of intervention, the MBCT-C and HAP experimental groups showed significant changes in resilience and emotion regulation. However, the changes in resilience in HAP groups were not significant; the participants in MBCT-C experimental groups showed significant improvement in resilience. The study provided initial evidence that mindfulness-based intervention can be potentially beneficial for improving mental health status in marginalized Iranian female youth living in the middle east culture.

Keywords: benefits, female, marginalized, mindfulness, youth

Procedia PDF Downloads 89

Authors: Inigo de Miguel Beriain

Abstract:

Genetic data of deceased persons are of great interest for both biomedical research and clinical use. This is due to several reasons. On the one hand, many of our diseases have a genetic component; on the other hand, we share genes with a good part of our biological family. Therefore, it would be possible to improve our response considerably to these pathologies if we could use these data. Unfortunately, at the present moment, the status of data on the deceased is far from being satisfactorily resolved by the EU data protection regulation. Indeed, the General Data Protection Regulation has explicitly excluded these data from the category of personal data. This decision has given rise to a fragmented legal framework on this issue. Consequently, each EU member state offers very different solutions. For instance, Denmark considers the data as personal data of the deceased person for a set period of time while some others, such as Spain, do not consider this data as such, but have introduced some specifically focused regulations on this type of data and their access by relatives. This is an extremely dysfunctional scenario from multiple angles, not least of which is scientific cooperation at the EU level. This contribution attempts to outline a solution to this dilemma through an alternative proposal. Its main hypothesis is that, in reality, health data are, in a sense, a rara avis within data in general because they do not refer to one person but to several. Hence, it is possible to think that all of them can be considered data subjects (although not all of them can exercise the corresponding rights in the same way). When the person from whom the data were obtained dies, the data remain as personal data of his or her biological relatives. Hence, the general regime provided for in the GDPR may apply to them. As these are personal data, we could go back to thinking in terms of a general prohibition of data processing, with the exceptions provided for in Article 9.2 and on the legal bases included in Article 6. This may be complicated in practice, given that, since we are dealing with data that refer to several data subjects, it may be complex to refer to some of these bases, such as consent. Furthermore, there are theoretical arguments that may oppose this hypothesis. In this contribution, it is shown, however, that none of these objections is of sufficient substance to delegitimize the argument exposed. Therefore, the conclusion of this contribution is that we can indeed build a general framework on the processing of personal data of deceased persons in the context of the GDPR. This would constitute a considerable improvement over the current regulatory framework, although it is true that some clarifications will be necessary for its practical application.

Keywords: collective data conceptual issues, data from deceased people, genetic data protection issues, GDPR and deceased people

Procedia PDF Downloads 154

Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

Abstract:

Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

Procedia PDF Downloads 62

Authors: Tsegay Kahsay Gebrekidan, Gebremariam Gebrezgabher Gebremedhin, Abraha Kahsay Weldemariam, Meaza Kidane Teferi

Abstract:

Municipal solid waste management (MSWM) in Ethiopia is a complex issue with institutional, social, political, environmental, and economic dimensions, impacting sustainable development. Effective MSWM planning necessitates understanding the generation rate and composition of waste. This systematic review synthesizes qualitative and quantitative data from various sources to aggregate current knowledge, identify gaps, and provide a comprehensive understanding of municipal solid waste management in Ethiopia. The findings reveal that the generation rate of municipal solid waste in Ethiopia is 0.38 kg/ca/day, with the waste composition being predominantly food waste, followed by ash, dust, and sand, and yard waste. Over 85% of this MSW is either reusable or recyclable, with a significant portion being organic matter (73.13% biodegradable) and 11.78% recyclable materials. Physicochemical analyses reveal that Ethiopian MSW is suitable for composting and biogas production, offering opportunities to reduce environmental pollution, and GHGs, support urban agriculture, and create job opportunities. However; challenges persist, including a lack of political will, weak municipal planning, limited community awareness, and inadequate waste management infrastructure, and only 31.8% of MSW is collected legally, leading to inefficient and harmful disposal practices. To improve MSWM, Ethiopia should focus on public awareness; increased funding, infrastructure investment, private sector partnerships, and implementing the 4 R principles (reduce, reuse, and recycle). An integrated approach involving government, industry, and civil society is essential. Further research on the physicochemical properties and strategic uses of MSW is needed to enhance management practices. Implications: The comprehensive study of municipal solid waste management (MSWM) in Ethiopia reveals the intricate interplay of institutional, social, political, environmental, and economic factors that influence the nation’s sustainable development. The findings underscore the urgent need for tailored, integrated waste management strategies that are informed by a thorough understanding of MSW generation rates, composition, and current management practices. Ethiopia’s lower per capita MSW generation compared to developed countries and the predominantly organic composition of its waste present significant opportunities for sustainable waste management practices such as composting and recycling. These practices can not only minimize the environmental impact but also support urban greening, agriculture, and renewable energy production. The high organic content, suitable physicochemical properties of MSW for composting, and potential for biogas and briquette production highlight pathways for creating employment, reducing waste, and enhancing soil fertility. Despite these opportunities, Ethiopia faces substantial challenges due to inadequate political will, weak municipal planning, limited community awareness, insufficient waste management infrastructure, and poor policy implementation. The high rate of illegal waste disposal further exacerbates environmental and health issues, emphasizing the need for a more effective and integrated MSWM approach. To address these challenges and harness the potential of MSW, Ethiopia must prioritize increasing public awareness; investing in infrastructure, fostering private sector partnerships, and implementing the principles of reduce, reuse, and recycle (3 R). Developing strategies that involve all stakeholders and turning waste into valuable resources is crucial. Government, industry, and civil society must collaborate to implement integrated MSWM systems that focus on waste reduction at the source, alternative material use, and advanced recycling technologies. Further research at both federal and regional levels is essential to optimize the physicochemical analysis and strategic use of MSW. Prompt action is required to transform waste management into a pillar of sustainable urban development, ultimately improving environmental quality and human health in Ethiopia.

Keywords: biodegradable, healthy environment, integrated solid waste management, municipal

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Authors: Joelle Fong

Abstract:

Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.

Keywords: actuarial modeling, cohort analysis, frail elderly, health

Procedia PDF Downloads 244