Search results for: citizen services quality
9937 Community Re-Integrated Soldiers’ Perceptions of Barriers and Facilitators to A Home-Based Physical Rehabilitation Programme Following Lower-Limb Amputation
Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana
Abstract:
Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative
Procedia PDF Downloads 1699936 Knowledge, Attitude and Practice Towards the Attendance of Antenatal Care Services at Mukono General Hospital
Authors: Nabaweesi Josephine, Namwanje Regina Germina
Abstract:
Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.Keywords: ANC- antenatal care, contacts, mortality, morbidity
Procedia PDF Downloads 1099935 Response of Onion to FTM and Inorganic Fertilizers Application on Growth, Yield and Nutrient Uptake in Lateritic Soil of Konkan
Authors: Rupali Thorat, S. B. Dodake, V. N. Palsande, S. D. Patil
Abstract:
A field experiment was conducted to study the “Response of onion to FYM and inorganic fertilizers application on growth, yield and nutrient uptake in lateritic soil of Konkan” at the farm of Pangari block of Irrigation of Scheme, Central Experimentation Station, Wakawali during Rabi 2009-10. There were 12 treatment combinations, comprising of 3 levels of NPK fertilizers (C1 ,C2-125 kg N, 62.5 kg P205 and 62.5 kg K20 ha-1 and C3-150 kg N, 75 kg P205 and 75 kg K20 ha-1) and 4 levels of FYM (F1-10 t FYM ha-1, F2 - 15 t FYM ha-1, F3-20 t FYM ha-1, F4-25 t FYM ha-1) replicated thrice using Factorial Randomized Block Design. The observations on plant height, number of leaves, girth of plant, polar and equatorial diameter of bulb as well as dry matter yield, onion bulb yield recorded during the course of field study were subjected to statistical analysis. Similarly nutrient content and uptake, quality parameters of bulb and soil properties were also determined and their data were also analyzed statistically. It is revealed from the study that the growth attributes, dry matter yield, onion bulb yield, nutrient content, nutrient uptake, quality parameters were improved significantly due to application of NPK @ 150:75:75 kg ha-1 along with FYM @ 20 t ha-1(C3F3). Application of NPK @ 150:75:75 kg ha-1 along with FYM @ 20 t ha-1 (C3F3) registered highest onion bulb yield (t ha-1). The quality of onion as well as availability of N, P, K, Fe, Mn, Zn and Cu in the soil was improved due to application of NPK @ 150:75:75 kg ha-1 and FYM @ 20 t ha-1.Keywords: onion, FYM, yield, nutrient uptake and fertilizer
Procedia PDF Downloads 4879934 Examination of Indoor Air Quality of Naturally Ventilated Dwellings During Winters in Mega-City Kolkata
Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya
Abstract:
The US Environmental Protection Agency defines indoor air quality as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. The built environment can affect health directly and indirectly through immediate or long-term exposure to indoor air pollutants. Health effects associated with indoor air pollutants include eye/nose/throat irritation, respiratory diseases, heart disease, and even cancer. This study attempts to demonstrate the causal relationship between the indoor air quality and its determining aspects. Detailed indoor air quality audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavorable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses indoor air quality based on factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.Keywords: indoor air quality, occupant health, urban housing, air pollution, natural ventilation, architecture, urban issues
Procedia PDF Downloads 1229933 Variance-Aware Routing and Authentication Scheme for Harvesting Data in Cloud-Centric Wireless Sensor Networks
Authors: Olakanmi Oladayo Olufemi, Bamifewe Olusegun James, Badmus Yaya Opeyemi, Adegoke Kayode
Abstract:
The wireless sensor network (WSN) has made a significant contribution to the emergence of various intelligent services or cloud-based applications. Most of the time, these data are stored on a cloud platform for efficient management and sharing among different services or users. However, the sensitivity of the data makes them prone to various confidentiality and performance-related attacks during and after harvesting. Various security schemes have been developed to ensure the integrity and confidentiality of the WSNs' data. However, their specificity towards particular attacks and the resource constraint and heterogeneity of WSNs make most of these schemes imperfect. In this paper, we propose a secure variance-aware routing and authentication scheme with two-tier verification to collect, share, and manage WSN data. The scheme is capable of classifying WSN into different subnets, detecting any attempt of wormhole and black hole attack during harvesting, and enforcing access control on the harvested data stored in the cloud. The results of the analysis showed that the proposed scheme has more security functionalities than other related schemes, solves most of the WSNs and cloud security issues, prevents wormhole and black hole attacks, identifies the attackers during data harvesting, and enforces access control on the harvested data stored in the cloud at low computational, storage, and communication overheads.Keywords: data block, heterogeneous IoT network, data harvesting, wormhole attack, blackhole attack access control
Procedia PDF Downloads 849932 A Conceptual Analysis of Right of Taxpayers to Claim Refund in Nigeria
Authors: Hafsat Iyabo Sa'adu
Abstract:
A salient feature of the Nigerian Tax Law is the right of the taxpayer to demand for a refund where excess tax is paid. Section 23 of the Federal Inland Revenue Service (Establishment) Act, 2007 vests Federal Inland Revenue Services with the power to make tax refund as well as set guidelines and requirements for refund process from time to time. In addition, Section 61 of the Federal Inland Revenue Service (Establishment) Act, 2007, empowers the Federal Inland Revenue Services to issue information circular to acquaint stakeholders with the policy on the refund process. A Circular was issued to that effect to correct the position that until after the annual audit of the Service before such excess can be paid to the claimant/taxpayer. But it is amazing that such circular issuance does not feature under the states’ laws. Hence, there is an inconsistencies in the tax paying system in Nigeria. This study, therefore, sets an objective, to examine the trending concept of tax refund in Nigeria. In order to achieve this set objective, a doctrinal study went under way, wherein both federal and states laws were consulted including journals and textbooks. At the end of the research, it was revealed that the law should be specific as to the time frame within which to make the refund. It further revealed that it is essential to put up a legal framework for the tax system to recognize excess payment as debt due from the state. This would provide a foundational framework for the relationship between taxpayers and Federal Inland Revenue Service as well as promote effective tax administration in all the states of the federation. Several Recommendations were made especially relating to legislative passage of ‘’Refund Circular Bill at the states levels’ pursuant to the Federal Inland Revenue Service (Establishment) Act, 2007.Keywords: claim, Nigeria, refund, right
Procedia PDF Downloads 1199931 Study on the Experiences and Emotions Associated with Happiness among High School Students
Authors: Khishig-Undrakh Mijgee, Yerkyejan Amanbyek, Yilina, Bayarkhuu Agvaanbayar, Anudari Chingiskhuu
Abstract:
The study of happiness focuses on how people perceive their well-being, the ways they seek happiness, and the factors that affect their feelings of happiness, including self-esteem, depression, satisfaction, and the quality of life. Researchers also aim to explore the relationship between happiness, self-esteem, depression, satisfaction, and quality of life, with the goal of assessing people's sense of achievement. Happiness is strongly linked to an individual's sense of achievement and overall life satisfaction. In this article, we will discuss the findings of a study that examines the feelings of happiness and the factors that influence them among 562 high school students.Keywords: happiness, high school students, feelings of happiness, happiness level
Procedia PDF Downloads 539930 Allied Health Students Health-Related Quality of Life and Its Musculoskeletal and Mental Stress Predictors
Authors: Khader A. Almhdawi, Saddam F. Kanaan
Abstract:
Background: Allied health (AH) students, including rehabilitation sciences students, are subjected to significant levels of physical and mental stressors, which could affect their education. This study aimed to study physical and mental of Health-related Quality of Life (HR-QoL) levels along with their predictors among students of nine AH majors. Methods: Students filled validated anonymous surveys covering demographics and life style, Nordic Musculoskeletal Questionnaire, 12-item Short-Form Health Survey (SF-12), and Depression Anxiety Stress Scale (DASS- 42). SF-12 Mental (MCS) and Physical (PCS) summary scores were compared between academic majors and gender. Multiple linear regression models were conducted to examine potential predictors of PCS and MCS scores. Results: 838 students (77.4% females) participated in this study. Participants’ PCS mean score was 45.64±7.93 and found statistically different between the nine academic majors (P < 0.001). Additionally, participants’’ MCS mean score was 39.45±10.86 and significantly greater in males (P < 0.001). Significant PCS scores predictors included hip and upper back musculoskeletal pain, anxiety score, diet self-evaluation, and GPA. Finally, MCS scores were statistically associated with neck musculoskeletal pain, stress score, depression score, number of weekly clinical training hours, gender, university year, GPA, sleep quality self-evaluation, and diet self-evaluation. Conclusion: Clinical educators of AH need to account for students’ low levels of HR-QoL and their academic-related, health-related, and lifestyle-related associated factors. More studies are recommended to investigate the progression of HR-QoL throughout university years and to create effective interventions to improve HR-QoL among healthcare students.Keywords: medical education, quality of life, stress, anxiety, depression
Procedia PDF Downloads 1269929 Contextual Factors of Innovation for Improving Commercial Banks' Performance in Nigeria
Authors: Tomola Obamuyi
Abstract:
The banking system in Nigeria adopted innovative banking, with the aim of enhancing financial inclusion, and making financial services readily and cheaply available to majority of the people, and to contribute to the efficiency of the financial system. Some of the innovative services include: Automatic Teller Machines (ATMs), National Electronic Fund Transfer (NEFT), Point of Sale (PoS), internet (Web) banking, Mobile Money payment (MMO), Real-Time Gross Settlement (RTGS), agent banking, among others. The introduction of these payment systems is expected to increase bank efficiency and customers' satisfaction, culminating in better performance for the commercial banks. However, opinions differ on the possible effects of the various innovative payment systems on the performance of commercial banks in the country. Thus, this study empirically determines how commercial banks use innovation to gain competitive advantage in the specific context of Nigeria's finance and business. The study also analyses the effects of financial innovation on the performance of commercial banks, when different periods of analysis are considered. The study employed secondary data from 2009 to 2018, the period that witnessed aggressive innovation in the financial sector of the country. The Vector Autoregression (VAR) estimation technique forecasts the relative variance of each random innovation to the variables in the VAR, examine the effect of standard deviation shock to one of the innovations on current and future values of the impulse response and determine the causal relationship between the variables (VAR granger causality test). The study also employed the Multi-Criteria Decision Making (MCDM) to rank the innovations and the performance criteria of Return on Assets (ROA) and Return on Equity (ROE). The entropy method of MCDM was used to determine which of the performance criteria better reflect the contributions of the various innovations in the banking sector. On the other hand, the Range of Values (ROV) method was used to rank the contributions of the seven innovations to performance. The analysis was done based on medium term (five years) and long run (ten years) of innovations in the sector. The impulse response function derived from the VAR system indicated that the response of ROA to the values of cheques transaction, values of NEFT transactions, values of POS transactions was positive and significant in the periods of analysis. The paper also confirmed with entropy and range of value that, in the long run, both the CHEQUE and MMO performed best while NEFT was next in performance. The paper concluded that commercial banks would enhance their performance by continuously improving on the services provided through Cheques, National Electronic Fund Transfer and Point of Sale since these instruments have long run effects on their performance. This will increase the confidence of the populace and encourage more usage/patronage of these services. The banking sector will in turn experience better performance which will improve the economy of the country. Keywords: Bank performance, financial innovation, multi-criteria decision making, vector autoregression,Keywords: Bank performance, financial innovation, multi-criteria decision making, vector autoregression
Procedia PDF Downloads 1219928 Quality Function Deployment Application in Sewer Pipeline Assessment
Authors: Khalid Kaddoura, Tarek Zayed
Abstract:
Infrastructure assets are essential in urban cities; their purpose is to facilitate the public needs. As a result, their conditions and states shall always be monitored to avoid any sudden malfunction. Sewer systems, one of the assets, are an essential part of the underground infrastructure as they transfer sewer medium to designated areas. However, their conditions are subject to deterioration due to ageing. Therefore, it is of great significance to assess the conditions of pipelines to avoid sudden collapses. Current practices of sewer pipeline assessment rely on industrial protocols that consider distinct defects and grades to conclude the limited average or peak score of the assessed assets. This research aims to enhance the evaluation by integrating the Quality Function Deployment (QFD) and the Decision-Making Trial and Evaluation Laboratory (DEMATEL) methods in assessing the condition of sewer pipelines. The methodology shall study the cause and effect relationship of the systems’ defects to deduce the relative influence weights of each defect. Subsequently, the overall grade is calculated by aggregating the WHAT’s and HOW’s of the House of Quality (HOQ) using the computed relative weights. Thus, this study shall enhance the evaluation of the assets to conclude informative rehabilitation and maintenance plans for decision makers.Keywords: condition assessment, DEMATEL, QFD, sewer pipelines
Procedia PDF Downloads 4349927 Internet Impulse Buying: A Study Based on Stimulus-Organism-Response Theory
Authors: Pui-Lai To, Yi-Jing Tsai
Abstract:
As the advance of e-commerce technologies, the consumers buying behavior have changed. The focus on consumer buying behavior has already shifted from physical space to the cyberspace, which impulse buying is a major issue of concern. This study examines the stimulus effect of web environment on the consumer's emotional states, and in turn, affecting the urge of impulse buying based on a stimulus-organism-response (S-O-R) theory. Website ambiance and website service quality are the two stimulus variables. The study also explores the effects and the moderator effects of contextual variables and individual characteristic variables on the web environment, the emotional states and the urge of impulse buying. A total of 328 valid questionnaires were collected. Structural equation modeling was used to test the research hypothesis. This study found that both website ambiance and website service quality have a positive effect on consumer emotion, which in turn positively affect the urge of impulse buying. Consumer’s trait of impulse buying has a positive effect on the urge of impulse buying. Consumer’s hedonic motivation has a positive effect on both emotion state and the urge of impulse buying. On the other hand, the study found that money available for the consumer would positively affect consumer's emotion state and time available for the consumer would negatively affect the relationship between website service quality and consumer emotion. The result of this study validates Internet impulse buying behavior based on the S-O-R theory. This study also suggests that having a good website atmosphere and service quality is important to influencing consumers’ emotion and increasing the likelihood of consumer purchasing. The study could serve as a basis for the future research regarding online consumer behavior.Keywords: emotion state, impulse buying, stimulus-organism-response, the urge of impulse buying
Procedia PDF Downloads 2359926 Design of Ka-Band Satellite Links in Indonesia
Authors: Zulfajri Basri Hasanuddin
Abstract:
There is an increasing demand for broadband services in Indonesia. Therefore, the answer is the use of Ka-Band which has some advantages such as wider bandwidth, the higher transmission speeds, and smaller size of antenna in the ground. However, rain attenuation is the primary factor in the degradation of signal at the Kaband. In this paper, the author will determine whether the Ka-band frequency can be implemented in Indonesia which has high intensity of rainfall.Keywords: Ka-band, link budget, link availability, BER, Eb/No, C/N
Procedia PDF Downloads 4229925 Variations in Water Supply and Quality in Selected Groundwater Sources in a Part of Southwest Nigeria
Authors: Samuel Olajide Babawale, O. O. Ogunkoya
Abstract:
The study mapped selected wells in Inisa town, Osun state, in the guinea savanna region of southwest Nigeria, and determined the water quality considering certain elements. It also assessed the variation in the elevation of the water table surface to depth of the wells in the months of August and November. This is with a view to determine the level of contamination of the water with respect to land use and anthropogenic activities, and also to determine the variation that occurs in the quantity of well water in the rainy season and the start of the dry season. Results show a random pattern of the distribution of the mapped wells and shows that there is a shallow water table in the study area. The temporal changes in the elevation show that there are no significant variations in the depth of the water table surface over the period of study implying that there is a sufficient amount of water available to the town all year round. It also shows a high concentration of sodium in the water sample analyzed compared to other elements that were considered, which include iron, copper, calcium, and lead. This is attributed majorly to anthropogenic activities through the disposal of waste in landfill sites. There is a low concentration of lead which is a good indication of a reduced level of pollution.Keywords: anthropogenic activities, land use, temporal changes, water quality
Procedia PDF Downloads 1349924 Socioeconomic Burden of a Diagnosis of Cervical Cancer in Women in Rural Uganda: Findings from a Phenomenological Study
Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni
Abstract:
Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic
Procedia PDF Downloads 2179923 Comparing Community Health Agents, Physicians and Nurses in Brazil's Family Health Strategy
Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta
Abstract:
Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care
Procedia PDF Downloads 2299922 In Case of Possible Disaster Management with Geographic Information System in Konya
Authors: Savaş Durduran, Ceren Yağci
Abstract:
The nature of the events going on in the world, when people’s lives are considered significantly affects natural disasters. Considering thousands of years of earth history, it is seen that many natural disasters, particularly earthquakes located in our country. Behaving cautious, without occurring hazards, after being disaster is much easier and cost effective than returning to the normal life. The four phases of disaster management in the whole world has been described as; pre-disaster preparedness and mitigation, post-disaster response and rehabilitation studies. Pre-disaster and post-disaster phases has half the weight of disaster management. How much would be prepared for disaster, no matter how disaster damage reducing work gives important, we will be less harm from material and spiritual sense. To do this in a systematic way we use the Geographic Information Systems (GIS). The execution of the emergency services to be on time and emergency control mechanism against the development the most appropriate decision Geographic Information System GIS) can be useful. The execution of the emergency services to be on time and emergency control mechanism towards for developing to be the most appropriate decision Geographic Information System (GIS) can be useful. The results obtained by using products with GIS analysis of seismic data to the city, manager of the city required information and data that can be more healthy and satisfies the appropriate policy decisions can be produced. In this study, using ArcGIS software and benefiting reports of the earthquake that occurred in the Konya city, spatial and non-spatial data consisting databases created, by the help of this database a potential disaster management aimed in the city of Konya regard to urban earthquake, GIS-aided analyzes were performed.Keywords: geographic information systems (GIS), disaster management, emergency control mechanism, Konya
Procedia PDF Downloads 4739921 Automatic Segmentation of 3D Tomographic Images Contours at Radiotherapy Planning in Low Cost Solution
Authors: D. F. Carvalho, A. O. Uscamayta, J. C. Guerrero, H. F. Oliveira, P. M. Azevedo-Marques
Abstract:
The creation of vector contours slices (ROIs) on body silhouettes in oncologic patients is an important step during the radiotherapy planning in clinic and hospitals to ensure the accuracy of oncologic treatment. The radiotherapy planning of patients is performed by complex softwares focused on analysis of tumor regions, protection of organs at risk (OARs) and calculation of radiation doses for anomalies (tumors). These softwares are supplied for a few manufacturers and run over sophisticated workstations with vector processing presenting a cost of approximately twenty thousand dollars. The Brazilian project SIPRAD (Radiotherapy Planning System) presents a proposal adapted to the emerging countries reality that generally does not have the monetary conditions to acquire some radiotherapy planning workstations, resulting in waiting queues for new patients treatment. The SIPRAD project is composed by a set of integrated and interoperabilities softwares that are able to execute all stages of radiotherapy planning on simple personal computers (PCs) in replace to the workstations. The goal of this work is to present an image processing technique, computationally feasible, that is able to perform an automatic contour delineation in patient body silhouettes (SIPRAD-Body). The SIPRAD-Body technique is performed in tomography slices under grayscale images, extending their use with a greedy algorithm in three dimensions. SIPRAD-Body creates an irregular polyhedron with the Canny Edge adapted algorithm without the use of preprocessing filters, as contrast and brightness. In addition, comparing the technique SIPRAD-Body with existing current solutions is reached a contours similarity at least 78%. For this comparison is used four criteria: contour area, contour length, difference between the mass centers and Jaccard index technique. SIPRAD-Body was tested in a set of oncologic exams provided by the Clinical Hospital of the University of Sao Paulo (HCRP-USP). The exams were applied in patients with different conditions of ethnology, ages, tumor severities and body regions. Even in case of services that have already workstations, it is possible to have SIPRAD working together PCs because of the interoperability of communication between both systems through the DICOM protocol that provides an increase of workflow. Therefore, the conclusion is that SIPRAD-Body technique is feasible because of its degree of similarity in both new radiotherapy planning services and existing services.Keywords: radiotherapy, image processing, DICOM RT, Treatment Planning System (TPS)
Procedia PDF Downloads 2969920 The Construction Technology of Dryer Silo Materials to Grains Made from Webbing Bamboo: A Drying Technology Solutions to Empowerment Farmers in Yogyakarta, Indonesia
Authors: Nursigit Bintoro, Abadi Barus, Catur Setyo Dedi Pamungkas
Abstract:
Indonesia is an agrarian country have almost population work as farmers. One of the popular agriculture commodity in Indonesia is paddy and corn. Production of paddy and corn are increased, but not balanced to the development of appropriate technology to farmers. Methods of drying applied with farmers still using sunshine. Drying by this method has some drawbacks, such as differences moisture content of corn grains, time used to dry around 3 days, and less quality of the products obtained. Beside it, the method of drying by using sunshine can’t do when the rainy season arrives. On this season the product obtained has less quality. One solution to the above problems is to create a dryer with simple technology. That technology is made silo dryer from webbing bamboo and wood. This technology is applicable to be applied to farmers' groups as well as the creation technology is quite cheap. The experiment material used in this research will be obtained from the corn grains. The equipment used are woven bamboo with a height of 3 meters and have capacity of up to 900 kgs as a silo, gas, burner, blower, bucket elevators, thermocouple, Arduino microcontroller 2560. This tools automatically records all the data of temperature and relative humidity. During on drying, each 30 minutes take 9 sample for measuring moisture content with moisture meter. By using this technology, farmers can save time, energy, and cost to the drying their agriculture product. In addition, by using this technology have good quality moisture content of grains and have a longer shelf life because the temperature when the heating process is controlled. Therefore, this technology is applicable to be applied to the public because the materials used to make the dryer easier to find, cheaper, and manufacture of the dryer made simple with good quality.Keywords: grains, dryer, moisture content, appropriate technology
Procedia PDF Downloads 3589919 The Use of Synthetic Soil for The Vegetables Cultivation in Conditions of Limited Water Consumption
Authors: Italo Luigi de Paoli
Abstract:
The use of synthetic soil for the vegetables cultivation in conditions of limited water consumption The separate collection of urban organic waste and green waste for the countries of the European Union averages 100 kg / inhabitant x year with an annual growth of about 10%. The production of quality compost averages 38% - 40% of the production of organic waste material. Most of the compost produced is used as an organic soil improver in those nutrient-poor soils in order to improve its quality. This study seeks to enhance the production of quality compost by creating a synthetic soil, where the percentages of compost on average oscillate between 50% and 60% in which, with appropriate precautions, different species of horticultural can be grown in conditions of high environmental safety without the use of pesticides and with a consumption of water used for irrigation limited to the actual evaporation of the plants. The project started in 2018 and is still ongoing, confirms its validity through a series of different horticultural productions, especially if this technology is applied where the availability of land suitable for the cultivation of vegetables is limited and where the use of water for irrigation represents a cultural criticality. Furthermore, the creation of "open field" crops, together with their automation, represents a further possibility in the concrete development of such technologies, giving the final product organoleptic characteristics equal if not superior to what the market offers today for human nutrition.Keywords: water scarcity, compost, vegetable foods, syntetic soil
Procedia PDF Downloads 1739918 Validating the Contract between Microservices
Authors: Parveen Banu Ansari, Venkatraman Chinnappan, Paramasivam Shankar
Abstract:
Contract testing plays a pivotal role in the current landscape of microservices architecture. Testing microservices at the initial stages of development helps to identify and rectify issues before they escalate to higher levels, such as UI testing. By validating microservices through contract testing, you ensure the integration quality of APIs, enhancing the overall reliability and performance of the application. Contract testing, being a collaborative effort between testers and developers, ensures that the microservices adhere to the specified contracts or agreements. This proactive approach significantly reduces defects, streamlines the development process, and contributes to the overall efficiency and robustness of the application. In the dynamic and fast-paced world of digital applications, where microservices are the building blocks, embracing contract testing is indeed a strategic move for ensuring the quality and reliability of the entire system.Keywords: validation, testing, contract, agreement, microservices
Procedia PDF Downloads 579917 Evaluation of Nutrition Supplement on Body Composition during Catch-Up Growth, in a Pre-Clinical Model of Growth Restriction
Authors: Bindya Jacob
Abstract:
The aim of the present study was to assess the quality of catchup growth induced by Oral Nutrition Supplement (ONS), in animal model of growth restriction due to under nutrition. Quality of catch-up growth was assessed by proportion of lean body mass (LBM) and fat mass (FM). Young SD rats were food restricted at 70% of normal caloric intake for 4 weeks; and re-fed at 120% of normal caloric intake for 4 weeks. Refeeding diet had 50% calories from animal diet and 50% from ONS formulated for optimal growth. After refeeding, the quantity and quality of catch-up growth were measured including weight, length, LBM and FM. During nutrient restriction, body weight and length of animals was reduced compared to healthy controls. Both LBM and FM were significantly lower than healthy controls (p < 0.001). Refeeding with ONS resulted in increase of weight and length, with significant catch-up growth compared to baseline (p < 0.001). Detailed examination of body composition showed that the catch-up in body weight was due to proportionate increase of LBM and FM, resulting in a final body composition similar to healthy controls. This data supports the use of well-designed ONS for recovery from growth restriction due to under nutrition, and return to normal growth trajectory characterized by normal ratio of lean and fat mass.Keywords: catch up growth, body composition, nutrient restriction, healthy growth
Procedia PDF Downloads 4389916 Determinants of Quality of Life and Mental Health in Medical Students During Two Years Observation
Authors: Szymon Szemik, Małgorzata Kowalska
Abstract:
Objective: Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK (POLski LEKarz, eng. Polish Physician) study aims to identify and evaluate the quality of life, mental health status, and ever-recognized chronic diseases by simultaneously assessing their determinants in Polish medical students during long-term observation. Material and Methods: The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results: The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. Obtained results confirmed that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domains. Moreover, we observed a significant increase in self-declared scoring of somatic symptoms year by year (from M=4.75 at T1 to M=8.06 at T2, p<0.001) in the GHQ-28 questionnaire survey. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the first year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in meat consumption. Conclusions: The QoL in medical students and selected determinants of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.Keywords: quality of life, mental health, medical students, follow-up study
Procedia PDF Downloads 409915 Discovering Semantic Links Between Synonyms, Hyponyms and Hypernyms
Authors: Ricardo Avila, Gabriel Lopes, Vania Vidal, Jose Macedo
Abstract:
This proposal aims for semantic enrichment between glossaries using the Simple Knowledge Organization System (SKOS) vocabulary to discover synonyms, hyponyms and hyperonyms semiautomatically, in Brazilian Portuguese, generating new semantic relationships based on WordNet. To evaluate the quality of this proposed model, experiments were performed by the use of two sets containing new relations, being one generated automatically and the other manually mapped by the domain expert. The applied evaluation metrics were precision, recall, f-score, and confidence interval. The results obtained demonstrate that the applied method in the field of Oil Production and Extraction (E&P) is effective, which suggests that it can be used to improve the quality of terminological mappings. The procedure, although adding complexity in its elaboration, can be reproduced in others domains.Keywords: ontology matching, mapping enrichment, semantic web, linked data, SKOS
Procedia PDF Downloads 2179914 Healthcare Social Entrepreneurship: A Positive Theory Applied to the Case of YOU Foundation in Nepal
Authors: Simone Rondelli, Damiano Rondelli, Bishesh Poudyal, Juan Jose Cabrera-Lazarini
Abstract:
One of the main obstacles for Social Entrepreneurship is to find a business model that is financially sustainable. In other words, the captured value generates enough cash flow to ensure business continuity and reinvestment for growth. Providing Health Services in poor countries for the uninsured population affected by a high-cost chronical disease is not the exception for this challenge. As a prime example, cancer has become a high impact on a global disease not only because of the high morbidity but also of the financial impact on both the patient family and health services in underdeveloped countries. Therefore, it is relevant to find a Social Entrepreneurship Model that provides affordable treatment for this disease while maintaining healthy finances not only for the patient but also for the organization providing the treatment. Using the methodology of Constructive Research, this paper applied a Positive Theory and four business models of Social Entrepreneurship to a case of a Private Foundation model whose mission is to address the challenge previously described. It was found that the Foundation analyzed, in this case, is organized as an Embedded Business Model and complies with the four propositions of the Positive Theory considered. It is recommended for this Private Foundation to explore implementing the Integrated Business Model to ensure more robust sustainability in the long term. It evolves as a scalable model that can attract investors interested in contributing to expanding this initiative globally.Keywords: affordable treatment, global healthcare, social entrepreneurship theory, sustainable business model
Procedia PDF Downloads 1459913 A Gauge Repeatability and Reproducibility Study for Multivariate Measurement Systems
Authors: Jeh-Nan Pan, Chung-I Li
Abstract:
Measurement system analysis (MSA) plays an important role in helping organizations to improve their product quality. Generally speaking, the gauge repeatability and reproducibility (GRR) study is performed according to the MSA handbook stated in QS9000 standards. Usually, GRR study for assessing the adequacy of gauge variation needs to be conducted prior to the process capability analysis. Traditional MSA only considers a single quality characteristic. With the advent of modern technology, industrial products have become very sophisticated with more than one quality characteristic. Thus, it becomes necessary to perform multivariate GRR analysis for a measurement system when collecting data with multiple responses. In this paper, we take the correlation coefficients among tolerances into account to revise the multivariate precision-to-tolerance (P/T) ratio as proposed by Majeske (2008). We then compare the performance of our revised P/T ratio with that of the existing ratios. The simulation results show that our revised P/T ratio outperforms others in terms of robustness and proximity to the actual value. Moreover, the optimal allocation of several parameters such as the number of quality characteristics (v), sample size of parts (p), number of operators (o) and replicate measurements (r) is discussed using the confidence interval of the revised P/T ratio. Finally, a standard operating procedure (S.O.P.) to perform the GRR study for multivariate measurement systems is proposed based on the research results. Hopefully, it can be served as a useful reference for quality practitioners when conducting such study in industries. Measurement system analysis (MSA) plays an important role in helping organizations to improve their product quality. Generally speaking, the gauge repeatability and reproducibility (GRR) study is performed according to the MSA handbook stated in QS9000 standards. Usually, GRR study for assessing the adequacy of gauge variation needs to be conducted prior to the process capability analysis. Traditional MSA only considers a single quality characteristic. With the advent of modern technology, industrial products have become very sophisticated with more than one quality characteristic. Thus, it becomes necessary to perform multivariate GRR analysis for a measurement system when collecting data with multiple responses. In this paper, we take the correlation coefficients among tolerances into account to revise the multivariate precision-to-tolerance (P/T) ratio as proposed by Majeske (2008). We then compare the performance of our revised P/T ratio with that of the existing ratios. The simulation results show that our revised P/T ratio outperforms others in terms of robustness and proximity to the actual value. Moreover, the optimal allocation of several parameters such as the number of quality characteristics (v), sample size of parts (p), number of operators (o) and replicate measurements (r) is discussed using the confidence interval of the revised P/T ratio. Finally, a standard operating procedure (S.O.P.) to perform the GRR study for multivariate measurement systems is proposed based on the research results. Hopefully, it can be served as a useful reference for quality practitioners when conducting such study in industries.Keywords: gauge repeatability and reproducibility, multivariate measurement system analysis, precision-to-tolerance ratio, Gauge repeatability
Procedia PDF Downloads 2629912 Prioritizing the TQM Enablers and IT Resources in the ICT Industry: An AHP Approach
Authors: Suby Khanam, Faisal Talib, Jamshed Siddiqui
Abstract:
Total Quality Management (TQM) is a managerial approach that improves the competitiveness of the industry, meanwhile Information technology (IT) was introduced with TQM for handling the technical issues which is supported by quality experts for fulfilling the customers’ requirement. Present paper aims to utilise AHP (Analytic Hierarchy Process) methodology to priorities and rank the hierarchy levels of TQM enablers and IT resource together for its successful implementation in the Information and Communication Technology (ICT) industry. A total of 17 TQM enablers (nine) and IT resources (eight) were identified and partitioned into 3 categories and were prioritised by AHP approach. The finding indicates that the 17 sub-criteria can be grouped into three main categories namely organizing, tools and techniques, and culture and people. Further, out of 17 sub-criteria, three sub-criteria: Top management commitment and support, total employee involvement, and continuous improvement got highest priority whereas three sub-criteria such as structural equation modelling, culture change, and customer satisfaction got lowest priority. The result suggests a hierarchy model for ICT industry to prioritise the enablers and resources as well as to improve the TQM and IT performance in the ICT industry. This paper has some managerial implication which suggests the managers of ICT industry to implement TQM and IT together in their organizations to get maximum benefits and how to utilize available resources. At the end, conclusions, limitation, future scope of the study are presented.Keywords: analytic hierarchy process, information technology, information and communication technology, prioritization, total quality management
Procedia PDF Downloads 3499911 Evaluation of Railway Network and Service Performance Based on Transportation Sustainability in DKI Jakarta
Authors: Nur Bella Octoria Bella, Ayomi Dita Rarasati
Abstract:
DKI Jakarta is Indonesia's capital city with the 10th highest congestion rate in the world based on the 2019 traffic index. Other than that based on World Air Quality Report in 2019 showed DKI Jakarta's air pollutant concentrate 49.4 µg and the 5th highest air pollutant in the world. In the urban city nowadays, the mobility rate is high enough and the efficiency for sustainability assessment in transport infrastructure development is needed. This efficiency is the important key for sustainable infrastructure development. DKI Jakarta is nowadays in the process of constructing the railway infrastructure to support the transportation system. The problems appearing are the railway infrastructure networks and the service in DKI Jakarta already planned based on sustainability factors or not. Therefore, the aim of this research is to make the evaluation of railways infrastructure networks performance and services in DKI Jakarta regards on the railway sustainability key factors. Further, this evaluation will be used to make the railway sustainability assessment framework and to offer some of the alternative solutions to improve railway transportation sustainability in DKI Jakarta. Firstly a very detailed literature review of papers that have focused on railway sustainability factors and their improvements of railway sustainability, published in the scientific journal in the period 2011 until 2021. Regarding the sustainability factors from the literature review, further, it is used to assess the current condition of railway infrastructure in DKI Jakarta. The evaluation will be using a Likert rate questionnaire and directed to the transportation railway expert and the passenger. Furthermore, the mapping and evaluation rate based on the sustainability factors will be compared to the effect factors using the Analytical Hierarchical Process (AHP). This research offers the network's performance and service rate impact on the sustainability aspect and the passenger willingness for using the rail public transportation in DKI Jakarta.Keywords: transportation sustainability, railway transportation, sustainability, DKI Jakarta
Procedia PDF Downloads 1639910 Floorboards, Whitewalls and Butterflies: Ethnography of a Community Mental Health Cafe
Authors: J. N. Bardi, N. Wright, S. Timmons, P. Crawford
Abstract:
Introduction: In the United Kingdom (UK), the transfer of care from the asylums to the community has meant that some people with mental health problems (MHP) may not have access to suitable or adequate statutory community mental health services (CMHS). However, in addition to statutory CMHS, there are informal CMHS that provide spaces where people with MHP can attend such as faith communities, clubhouses, user-led organisations, day centres including drop-in-centres and community hubs and community mental health cafés (CMHCs). Aim: To qualitatively understand what happens in a community mental health café in relation to the place, people and processes, from the participant's perspective. Methodology: Ethnography Methods: Data collection will be field notes from observations written as thick description and interviews with participants. Data analysis will be thematic and narrative analysis. Relevance: The study seeks to observe what happens in a user-led community mental health café and explore if it provides the services that it claims to offer. Therefore, a literature review was conducted to examine the research evidence related to informal CMHS, focusing on similarities and differences. Results indicated that informal CMHS differ with regards to why, how, who set them up and who funds them, but they are similar because people with MHP who attend them report related psychological, vocational, and social interaction benefits. In addition to the differences listed above, CMHCs differ in their adoption of the commercial café model of social space and some CMHCs claim to address needs of social isolation and loneliness which they assert are not properly addressed by statutory CMHS and some informal CMHS. Therefore, CMHCs explicitly differentiate themselves from statutory CMHS and some informal CMHS such as day centres, hospitals and social services. However, CMHCs were found to be like drop-in-centres and community hubs which are also free for MHP to attend without the need for assessments, membership or appointments. To situate community mental health café within other informal CMHS and provide a rationale for the proposed study a scoping review was conducted to determine the scope of available research evidence on CMHCs. Findings from the scoping review reflected the literature review findings with regards to the benefits of attending informal CMHCs for people with MHP. Of the ten studies included in the scoping review, seven were on CMHCs for people living with dementia and two were on CMHCs for people with a broader range of MHP. The researcher hopes that findings from the proposed PhD study will build on the existing understanding of informal CMHS, extend the research evidence on CMHCs and address any gap in the literature.Keywords: cafe, community, ethnography, mental health
Procedia PDF Downloads 1999909 The Life Skills Project: Client-Centered Approaches to Life Skills Acquisition for Homeless and At-Risk Populations
Authors: Leah Burton, Sara Cumming, Julianne DiSanto
Abstract:
Homelessness is a widespread and complex problem in Canada and around the globe. Many Canadians will face homelessness at least once in their lifetime, with several experiencing subsequent bouts or cyclical patterns of housing precarity. While a Housing First approach to homelessness is a long-standing and widely accepted best practice, it is also recognized that the acquisition of life skills is an effective way to reduce cycles of homelessness. Indeed, when individuals are provided with a range of life skills—such as (but not limited to) financial literacy, household management, interpersonal skills, critical thinking, and resource management—they are given the tools required to maintain long-term Housing for a lifetime; thus reducing a repetitive need for services. However, there is limited research regarding the best ways to teach life skills, a problem that has been further complicated in a post-pandemic world, where services are being delivered online or in a hybrid model of care. More than this, it is difficult to provide life skills on a large scale without losing a client-centered approach to services. This lack of client-centeredness is also seen in the lack of attention to culturally sensitive life skills, which consider the diverse needs of individuals and imbed equity, diversity, and inclusion (EDI) within the skills being taught. This study aims to fill these identified gaps in the literature by employing a community-engaged (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, EDI-informed life skill learning management system. A triangulation methodology was utilized for this research. An environmental scan was conducted for current best practices, and over 100 front-line staff (including workers, managers, and executive directors who work with homeless populations) participated in two separate Creative Problem Solving Sessions. Over 200 individuals with experience in homelessness completed quantitative and open-ended surveys. All sections of this research aimed to discover the areas of skills that individuals need to maintain Housing and to ascertain what a more client-driven EDI approach to life skills training should include. This presentation will showcase the findings on which life skills are deemed essential for homeless and precariously housed individuals.Keywords: homelessness, housing first, life skills, community engaged research, client- centered
Procedia PDF Downloads 1019908 Correlative Study of Serum Interleukin-18 and Disease Activity, Functional Disability and Quality of Life in Rheumatoid Arthritis Patients
Authors: Hamdy Khamis Korayem, Manal Yehia Tayel, Abeer Shawky El Hadedy, Emmanuel Kamal Aziz Saba, Shimaa Badr Abdelnaby Badr
Abstract:
The aim of the current study was to demonstrate whether serum Interleukin-18 (IL-18) is increased in rheumatoid arthritis (RA) and its correlation with disease activity, functional disability and quality of life in RA patients. The study included 30 RA patients and 20 healthy normal control subjects. The RA patients were diagnosed according to the 2010 ACR/EULAR classification criteria for RA with the exclusion of those who had diabetes mellitus, endocrine disorders, associated rheumatologic diseases, viral hepatitis B or C and other diseases with increased serum IL-18 level. All patients were subjected to clinical evaluation of the musculoskeletal system. Disease activity was assessed by disease activity score 28 with 4 variables (DAS 28). Functional disability was assessed by health assessment questionnaire disability index (HAQ-DI). The quality of life was assessed by Short form-36 (SF-36) questionnaire. Radiological assessment of both hands and feet by Sharp/van der Heijde (SvH) scoring method. Laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) were assessed in patients and serum level of IL-18 in both patients and control subjects. There was no statistically significant difference between patient and control group as regards age and sex. Among patients, 29 % were females and the age range was between 25 to 55 years. Extra-articular manifestations were presented in 56.7% of the patients. The mean of DAS 28 score was 5.73±1.46 and that of HAQ-DI was 1.22±0.72 while that of SF-36 was 40.03±13.96. The level of serum IL-18 was significantly higher in patients than in the control subjects (P= 0.030). Serum IL-18 was correlated with ACPA among the patient group. There were no statistically significant correlations between serum IL-18 and DAS28, HAQ-DI, SF-36, total SvH score and the other laboratory results. In conclusion, IL-18 is significantly higher in RA patient than in healthy control subjects and positively correlated with ACPA level. IL-18 is associated with extra-articular manifestations. However, it is not correlated with other laboratory parameters, disease activity, functional disability, quality of life nor radiological severity.Keywords: disease activity score, Interleukin-18, quality of life assessment, rheumatoid arthritis
Procedia PDF Downloads 325