Search results for: pediatric primary care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7975

Search results for: pediatric primary care

4615 An Exploratory Study on the Integration of Neurodiverse University Students into Mainstream Learning and Their Performance: The Case of the Jones Learning Center

Authors: George Kassar, Phillip A. Cartwright

Abstract:

Based on data collected from The Jones Learning Center (JLC), University of the Ozarks, Arkansas, U.S., this study explores the impact of inclusive classroom practices on neuro-diverse college students’ and their consequent academic performance having participated in integrative therapies designed to support students who are intellectually capable of obtaining a college degree, but who require support for learning challenges owing to disabilities, AD/HD, or ASD. The purpose of this study is two-fold. The first objective is to explore the general process, special techniques, and practices of the (JLC) inclusive program. The second objective is to identify and analyze the effectiveness of the processes, techniques, and practices in supporting the academic performance of enrolled college students with learning disabilities following integration into mainstream university learning. Integrity, transparency, and confidentiality are vital in the research. All questions were shared in advance and confirmed by the concerned management at the JLC. While administering the questionnaire as well as conducted the interviews, the purpose of the study, its scope, aims, and objectives were clearly explained to all participants prior starting the questionnaire / interview. Confidentiality of all participants assured and guaranteed by using encrypted identification of individuals, thus limiting access to data to only the researcher, and storing data in a secure location. Respondents were also informed that their participation in this research is voluntary, and they may withdraw from it at any time prior to submission if they wish. Ethical consent was obtained from the participants before proceeding with videorecording of the interviews. This research uses a mixed methods approach. The research design involves collecting, analyzing, and “mixing” quantitative and qualitative methods and data to enable a research inquiry. The research process is organized based on a five-pillar approach. The first three pillars are focused on testing the first hypothesis (H1) directed toward determining the extent to the academic performance of JLC students did improve after involvement with comprehensive JLC special program. The other two pillars relate to the second hypothesis (H2), which is directed toward determining the extent to which collective and applied knowledge at JLC is distinctive from typical practices in the field. The data collected for research were obtained from three sources: 1) a set of secondary data in the form of Grade Point Average (GPA) received from the registrar, 2) a set of primary data collected throughout structured questionnaire administered to students and alumni at JLC, and 3) another set of primary data collected throughout interviews conducted with staff and educators at JLC. The significance of this study is two folds. First, it validates the effectiveness of the special program at JLC for college-level students who learn differently. Second, it identifies the distinctiveness of the mix of techniques, methods, and practices, including the special individualized and personalized one-on-one approach at JLC.

Keywords: education, neuro-diverse students, program effectiveness, Jones learning center

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4614 Health Literacy in Jordan: Obstacles for Doctors and Quality Patient Care

Authors: Etaf Alkhlaifat

Abstract:

This study drew conceptually on Communication Accommodation Theory to describe and analyze conversations between doctors and patients to examine the extent to which patients’ level of literacy represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. A thematic qualitative approach was employed to interpret the phenomena under study, which required direct observation and interviews with doctors (n=6) and patients (n=15) in natural Jordanian medical settings. This generated a comprehensive corpus of audio and videotaped data, which revealed that most doctors expressed dissatisfaction with patients’ ability to express themselves and comprehend them as a result of a lack of medical awareness and limited health education. The significance of this study rests on its detailed investigation of the impact of health literacy on patients’ health outcomes and while providing unique insights into how low health literacy could contribute to misunderstanding and potential ill-health.

Keywords: doctor-patient communication, health literacy, medical knowledge, communication accommodation theory, qualitative research

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4613 The Impact of Gestational Weight Gain on Subclinical Atherosclerosis, Placental Circulation and Neonatal Complications

Authors: Marina Shargorodsky

Abstract:

Aim: Gestational weight gain (GWG) has been related to altering future weight-gain curves and increased risks of obesity later in life. Obesity may contribute to vascular atherosclerotic changes as well as excess cardiovascular morbidity and mortality observed in these patients. Noninvasive arterial testing, such as ultrasonographic measurement of carotid IMT, is considered a surrogate for systemic atherosclerotic disease burden and is predictive of cardiovascular events in asymptomatic individuals as well as recurrent events in patients with known cardiovascular disease. Currently, there is no consistent evidence regarding the vascular impact of excessive GWG. The present study was designed to investigate the impact of GWG on early atherosclerotic changes during late pregnancy, using intima-media thickness, as well as placental vascular circulation and inflammatory lesions and pregnancy outcomes. Methods: The study group consisted of 59 pregnant women who gave birth and underwent a placental histopathological examination at the Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Israel, in 2019. According to the IOM guidelines the study group has been divided into two groups: Group 1 included 32 women with pregnancy weight gain within recommended range; Group 2 included 27 women with excessive weight gain during pregnancy. The IMT was measured from non-diseased intimal and medial wall layers of the carotid artery on both sides, visualized by high-resolution 7.5 MHz ultrasound (Apogee CX Color, ATL). Placental histology subdivided placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion according to the criteria of the Society for Pediatric Pathology, subdividing placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion, as well as the inflammatory response of maternal and fetal origin. Results: IMT levels differed between groups and were significantly higher in Group 1 compared to Group 2 (0.7+/-0.1 vs 0.6+/-0/1, p=0.028). Multiple linear regression analysis of IMT included variables based on their associations in univariate analyses with a backward approach. Included in the model were pre-gestational BMI, HDL cholesterol and fasting glucose. The model was significant (p=0.001) and correctly classified 64.7% of study patients. In this model, pre-pregnancy BMI remained a significant independent predictor of subclinical atherosclerosis assessed by IMT (OR 4.314, 95% CI 0.0599-0.674, p=0.044). Among placental lesions related to fetal vascular malperfusion, villous changes consistent with fetal thrombo-occlusive disease (FTOD) were significantly higher in Group 1 than in Group 2, p=0.034). In Conclusion, the present study demonstrated that excessive weight gain during pregnancy is associated with an adverse effect on early stages of subclinical atherosclerosis, placental vascular circulation and neonatal complications. The precise mechanism for these vascular changes, as well as the overall clinical impact of weight control during pregnancy on IMT, placental vascular circulation as well as pregnancy outcomes, deserves further investigation.

Keywords: obesity, pregnancy, complications, weight gain

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4612 Hybrid Fuzzy Weighted K-Nearest Neighbor to Predict Hospital Readmission for Diabetic Patients

Authors: Soha A. Bahanshal, Byung G. Kim

Abstract:

Identification of patients at high risk for hospital readmission is of crucial importance for quality health care and cost reduction. Predicting hospital readmissions among diabetic patients has been of great interest to many researchers and health decision makers. We build a prediction model to predict hospital readmission for diabetic patients within 30 days of discharge. The core of the prediction model is a modified k Nearest Neighbor called Hybrid Fuzzy Weighted k Nearest Neighbor algorithm. The prediction is performed on a patient dataset which consists of more than 70,000 patients with 50 attributes. We applied data preprocessing using different techniques in order to handle data imbalance and to fuzzify the data to suit the prediction algorithm. The model so far achieved classification accuracy of 80% compared to other models that only use k Nearest Neighbor.

Keywords: machine learning, prediction, classification, hybrid fuzzy weighted k-nearest neighbor, diabetic hospital readmission

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4611 The Power-Knowledge Relationship in the Italian Education System between the 19th and 20th Century

Authors: G. Iacoviello, A. Lazzini

Abstract:

This paper focuses on the development of the study of accounting in the Italian education system between the 19th and 20th centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. From a political perspective, the period was characterized by two dominant movements - liberalism (1861-1922) and fascism (1922-1945) - that deeply influenced accounting practices and the entire Italian education system. The materials used in the study include both primary and secondary sources. The primary sources used to inform this study are numerous original documents issued from 1890-1935 by the government and maintained in the Historical Archive of the State in Rome. The secondary sources have supported both the development of the theoretical framework and the definition of the historical context. This paper assigns to the educational system the role of cultural producer. Foucauldian analysis identifies the problem confronted by the critical intellectual in finding a way to deploy knowledge through a 'patient labour of investigation' that highlights the contingency and fragility of the circumstances that have shaped current practices and theories. Education can be considered a powerful and political process providing students with values, ideas, and models that they will subsequently use to discipline themselves, remaining as close to them as possible. It is impossible for power to be exercised without knowledge, just as it is impossible for knowledge not to engender power. The power-knowledge relationship can be usefully employed for explaining how power operates within society, how mechanisms of power affect everyday lives. Power is employed at all levels and through many dimensions including government. Schools exercise ‘epistemological power’ – a power to extract a knowledge of individuals from individuals. Because knowledge is a key element in the operation of power, the procedures applied to the formation and accumulation of knowledge cannot be considered neutral instruments for the presentation of the real. Consequently, the same institutions that produce and spread knowledge can be considered part of the ‘power-knowledge’ interrelation. Individuals have become both objects and subject in the development of knowledge. If education plays a fundamental role in shaping all aspects of communities in the same way, the structural changes resulting from economic, social and cultural development affect the educational systems. Analogously, the important changes related to social and economic development required legislative intervention to regulate the functioning of different areas in society. Knowledge can become a means of social control used by the government to manage populations. It can be argued that the evolution of Italy’s education systems is coherent with the idea that power and knowledge do not exist independently but instead are coterminous. This research aims to reduce such a gap by analysing the role of the state in the development of accounting education in Italy.

Keywords: education system, government, knowledge, power

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4610 Improving Sales through Inventory Reduction: A Retail Chain Case Study

Authors: M. G. Mattos, J. E. Pécora Jr, T. A. Briso

Abstract:

Today's challenging business environment, with unpredictable demand and volatility, requires a supply chain strategy that handles uncertainty and risks in the right way. Even though inventory models have been previously explored, this paper seeks to apply these concepts on a practical situation. This study involves the inventory replenishment problem, applying techniques that are mainly based on mathematical assumptions and modeling. The primary goal is to improve the retailer’s supply chain processes taking store differences when setting the various target stock levels. Through inventory review policy, picking piece implementation and minimum exposure definition, we were able not only to promote the inventory reduction as well as improve sales results. The inventory management theory from literature review was then tested on a single case study regarding a particular department in one of the largest Latam retail chains.

Keywords: inventory, distribution, retail, risk, safety stock, sales, uncertainty

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4609 Multitemporal Satellite Images for Agriculture Change Detection in Al Jouf Region, Saudi Arabia

Authors: Ali A. Aldosari

Abstract:

Change detection of Earth surface features is extremely important for better understanding of our environment in order to promote better decision making. Al-Jawf is remarkable for its abundant agricultural water where there is fertile agricultural land due largely to underground water. As result, this region has large areas of cultivation of dates, olives and fruits trees as well as other agricultural products such as Alfa Alfa and wheat. However this agricultural area was declined due to the reduction of government supports in the last decade. This reduction was not officially recorded or measured in this region at large scale or governorate level. Remote sensing data are primary sources extensively used for change detection in agriculture applications. This study is applied the technology of GIS and used the Normalized Difference Vegetation Index (NDVI) which can be used to measure and analyze the spatial and temporal changes in the agriculture areas in the Aljouf region.

Keywords: spatial analysis, geographical information system, change detection

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4608 Leveraging Reasoning through Discourse: A Case Study in Secondary Mathematics Classrooms

Authors: Cory A. Bennett

Abstract:

Teaching and learning through the use of discourse support students’ conceptual understanding by attending to key concepts and relationships. One discourse structure used in primary classrooms is number talks wherein students mentally calculate, discuss, and reason about the appropriateness and efficiency of their strategies. In the secondary mathematics classroom, the mathematics understudy does not often lend itself to mental calculations yet learning to reason, and articulate reasoning, is central to learning mathematics. This qualitative case study discusses how one secondary school in the Middle East adapted the number talk protocol for secondary mathematics classrooms. Several challenges in implementing ‘reasoning talks’ became apparent including shifting current discourse protocols and practices to a more student-centric model, accurately recording and probing student thinking, and specifically attending to reasoning rather than computations.

Keywords: discourse, reasoning, secondary mathematics, teacher development

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4607 The Web Site Development for E-Commerce Trading in Thailand Customers View

Authors: Ladaporn Pithuk

Abstract:

The purposes of the study were to ascertain the customer requirement, to identify the factors related to online business in Thailand. The sample of this study consisted of 400 customers who are purchasing product and service on E-commerce. To get primary sources, a questionnaire consisting of 31 questions was designed and adapted from previous studies. The data from the questionnaires were collected and analyzed in descriptive forms and (ONE-WAY ANOVA) was conducted. The majority of the respondents showed customer requirement by stating “moderately agree” for questions asking them about customization, connection, content, commerce, context, communication and community, however, they also displayed negative attitudes by identifying “moderately disagree” for security concerns and after-sales services. These important issues need to be improved immediately since it can encourage customers to buy goods and services through the Internet or discourage them, and businesses should offer more channels of payment methods for customers for instance, e-payment.

Keywords: customer requirement, customization, connection, online business

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4606 Dynamical Analysis of the Fractional-Order Mathematical Model of Hashimoto’s Thyroiditis

Authors: Neelam Singha

Abstract:

The present work intends to analyze the system dynamics of Hashimoto’s thyroiditis with the assistance of fractional calculus. Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis is an autoimmune disorder in which the immune system attacks the thyroid gland, which gradually results in interrupting the normal thyroid operation. Consequently, the feedback control of the system gets disrupted due to thyroid follicle cell lysis. And, the patient perceives life-threatening clinical conditions like goiter, hyperactivity, euthyroidism, hyperthyroidism, etc. In this work, we aim to obtain the approximate solution to the posed fractional-order problem describing Hashimoto’s thyroiditis. We employ the Adomian decomposition method to solve the system of fractional-order differential equations, and the solutions obtained shall be useful to provide information about the effect of medical care. The numerical technique is executed in an organized manner to furnish the associated details of the progression of the disease and to visualize it graphically with suitable plots.

Keywords: adomian decomposition method, fractional derivatives, Hashimoto's thyroiditis, mathematical modeling

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4605 Methods Used to Perform Requirements Elicitation for Healthcare Software Development

Authors: Tang Jiacheng, Fang Tianyu, Liu Yicen, Xiang Xingzhou

Abstract:

The proportion of healthcare services is increasing throughout the globe. The convergence of mobile technology is driving new business opportunities, innovations in healthcare service delivery and the promise of a better life tomorrow for different populations with various healthcare needs. One of the most important phases for the combination of health care and mobile applications is to elicit requirements correctly. In this paper, four articles from different research directions with four topics on healthcare were detailed analyzed and summarized. We identified the underlying problems in guidance to develop mobile applications to provide healthcare service for Older adults, Women in menopause, Patients undergoing covid. These case studies cover several elicitation methods: survey, prototyping, focus group interview and questionnaire. And the effectiveness of these methods was analyzed along with the advantages and limitations of these methods, which is beneficial to adapt the elicitation methods for future software development process.

Keywords: healthcare, software requirement elicitation, mobile applications, prototyping, focus group interview

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4604 Mechanical Tension Control of Winding Systems for Paper Webs

Authors: Glaoui Hachemi

Abstract:

In this paper, a scheme based on multi-input multi output Fuzzy Sliding Mode control (MIMO-FSMC) for linear speed regulation of winding system is proposed. Once the uncoupled model of the winding system was obtained, a smooth control function with a threshold was selected to indicate how far away the case was from the sliding surface. nevertheless, this control function depends closely on the higher bound of the uncertainties, which generates overlap. So, this size has to be chosen with broad care to obtain high performances. Usually, the upper bound of uncertainties is difficult to know before motor operation, so, a Fuzzy Sliding Mode controller is investigated to resolve this problem, a simple Fuzzy inference mechanism is used to decrease the chattering phenomenon by simple adjustments. A simulation study is achieved and that the indicate fuzzy sliding mode controllers have great potential for use as an alternative to the conventional sliding mode control.

Keywords: Winding system, induction machine, Mechanical tension, Proportional-integral (PI), sliding mode control, Fuzzy logic

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4603 The Political Economy of Police Corruption in Nigeria

Authors: Tosin Osasona

Abstract:

The Nigeria Police Force bears the constitutional mandate as the primary policing agency for the protection of life and property within Nigeria; however, the police have an historical ill-reputation for corruption, ineptitude and impunity. Using the institutional theory of police as the framework of analysis, the paper argues that the performance of the police in Nigeria mirrors the dominant political, social and economic institutions and the structural environment of the Nigerian state. The article puts in perspective the deliberate political decision to underfund the police, leaving officers of the force the extra task of foraging for funds to undertake the duty that the Nigeria state primarily exists for; the article further explores the nexus between corruption in the police in Nigeria and the issue of funding. The article finds that the Nigerian state, by deliberately under-funding the police, while expecting the agency to perform its duties, has indirectly sanctioned the corruption of the force and approved the cooption of the institution of police and policing for private use in Nigeria.

Keywords: Police Corruption, Funding , Informal Taxation, POlice Checkpoint

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4602 Automated Prepaid Billing Subscription System

Authors: Adekunle K. O, Adeniyi A. E, Kolawole E

Abstract:

One of the most dramatic trends in the communications market in recent years has been the growth of prepaid services. Today, prepaid no longer constitutes the low-revenue, basic-service segment. It is driven by a high margin, value-add service customers who view it as a convenient way of retaining control over their usage and communication spending while expecting high service levels. To service providers, prepaid services offer the advantage of reducing bad accounts while allowing them to predict usage and plan network resources. Yet, the real-time demands of prepaid services require a scalable, real-time platform to manage customers through their entire life cycle. It delivers integrated real-time rating, voucher management, recharge management, customer care and service provisioning for the generation of new prepaid services. It carries high scalability that can handle millions of prepaid customers in real-time through their entire life cycle.

Keywords: prepaid billing, voucher management, customers, automated, security

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4601 Locating the Role of Informal Urbanism in Building Sustainable Cities: Insights from Ghana

Authors: Gideon Abagna Azunre

Abstract:

Informal urbanism is perhaps the most ubiquitous urban phenomenon in sub-Saharan Africa (SSA) and Ghana specifically. Estimates suggest that about two-fifths of urban dwellers (37.9%) in Ghana live in informal settlements, while two-thirds of the working labour force are within the informal economy. This makes Ghana invariably an ‘informal country.’ Informal urbanism involves economic and housing activities that are – in law or in practice – not covered (or insufficiently covered) by formal regulations. Many urban folks rely on informal urbanism as a survival strategy due to limited formal waged employment opportunities or rising home prices in the open market. In an era of globalizing neoliberalism, this struggle to survive in cities resonates with several people globally. For years now, there have been intense debates on the utility of informal urbanism – both its economic and housing dimensions – in developing sustainable cities. While some scholars believe that informal urbanism is beneficial to the sustainable city development agenda, others argue that it generates unbearable negative consequences and it symbolizes lawlessness and squalor. Consequently, the main aim of this research was to dig below the surface of the narratives to locate the role of informal urbanism in the quest for sustainable cities. The research geographically focused on Ghana and its burgeoning informal sector. Also, both primary and secondary data were utilized for the analysis; Secondary data entailed a synthesis of the fragmented literature on informal urbanism in Ghana, while primary data entailed interviews with informal stakeholders (such as informal settlement dwellers), city authorities, and planners. These two data sets were weaved together to discover the nexus between informal urbanism and the tripartite dimensions of sustainable cities – economic, social, and environmental. The results from the research showed a two-pronged relationship between informal urbanism and the three dimensions of sustainable city development. In other words, informal urbanism was identified to both positively and negatively affect the drive for sustainable cities. On the one hand, it provides employment (particularly to women), supplies households’ basic needs (shelter, health, water, and waste management), and enhances civic engagement. However, on the other hand, it perpetuates social and gender inequalities, insecurity, congestion, and pollution. The research revealed that a ‘black and white’ interpretation and policy approach is incapable of capturing the complexities of informal urbanism. Therefore, trying to eradicate or remove it from the urbanscape because it exhibits some negative consequences means cities will lose their positive contributions. The inverse also holds true. A careful balancing act is necessary to maximize the benefits and minimize the costs. Overall, the research presented a de-colonial theorization of informal urbanism and thus followed post-colonial scholars’ clarion call to African cities to embrace the paradox of informality and find ways to integrate it into the city-building process.

Keywords: informal urbanism, sustainable city development, economic sustainability, social sustainability, environmental sustainability, Ghana

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4600 Servant Leadership and Organisational Climate in South African Private Schools: A Qualitative Study

Authors: Christo Swart, Lidia Pottas, David Maree

Abstract:

Background: It is a sine qua non that the South African educational system finds itself in a profound crisis and that traditional school leadership styles are outdated and hinder quality education. New thinking is mandatory to improve the status quo and school leadership has an immense role to play to improve the current situation. It is believed that the servant leadership paradigm, when practiced by school leadership, may have a significant influence on the school environment in totality. This study investigates the private school segment in search of constructive answers to assist with the educational crises in South Africa. It is assumed that where school leadership can augment a supportive and empowering environment for teachers to constructively engage in their teaching and learning activities - then many challenges facing by school system may be subjugated in a productive manner. Aim: The aim of this study is fourfold. To outline the constructs of servant leadership which are perceived by teachers of private schools as priorities to enhance a successful school environment. To describe the constructs of organizational climate which are observed by teachers of private schools as priorities to enhance a successful school environment. To investigate whether the participants perceived a link between the constructs of servant leadership and organizational climate. To consider the process to be followed to introduce the constructs of SL and OC the school system in general as perceived by participants. Method: This study utilized a qualitative approach to explore the mediation between school leadership and the organizational climate in private schools in the search for amicable answers. The participants were purposefully selected for the study. Focus group interviews were held with participants from primary and secondary schools and a focus group discussion was conducted with principals of both primary and secondary schools. The interview data were transcribed and analyzed and identical patterns of coded data were grouped together under emerging themes. Findings: It was found that the practice of servant leadership by school leadership indeed mediates a constructive and positive school climate. It was found that the constructs of empowerment, accountability, humility and courage – interlinking with one other - are prominent of servant leadership concepts that are perceived by teachers of private schools as priorities for school leadership to enhance a successful school environment. It was confirmed that the groupings of training and development, communication, trust and work environment are perceived by teachers of private schools as prominent features of organizational climate as practiced by school leadership to augment a successful school environment. It can be concluded that the participants perceived several links between the constructs of servant leadership and organizational climate that encourage a constructive school environment and that there is a definite positive consideration and motivation that the two concepts be introduced to the school system in general. It is recommended that school leadership mentors and guides teachers to take ownership of the constructs of servant leadership as well as organizational climate and that public schools be researched and consider to implement the two paradigms. The study suggests that aspirant teachers be exposed to leadership as well as organizational paradigms during their studies at university.

Keywords: empowering environment for teachers and learners, new thinking required, organizational climate, school leadership, servant leadership

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4599 Future trends of MED-TVC Desalination Technology

Authors: Irfan Wazeer

Abstract:

Desalination has become one of the major water treatment process in several countries around the world where shortage of water is a serious problem. Energy consumption is a vital economic factor in selecting the type of desalination processes because current desalination processes require large amount of energy which is costly. Multi-effect desalination system with thermal vapor compression (MED-TVC) is particularly more attractive than other thermal desalination systems due to its low energy consumption. MED-TVC is characterized by high performance ratio (PR), easier operation, low maintenance requirements and simple geometry. These attractive features make MED-TVC highly competitive to other well established desalination techniques that include the reverse osmosis (RO) and multi-stage flash desalination (MSF). The primary goal of this paper is to present a preview of some aspects related with the theory of the technology, parametric study of the MED-TVC systems and its development. It will analyzed the current and future aspects of the MED-TVC technology in view of latest installed plants.

Keywords: MED-TVC, parallel feed, performance ratio, GOR

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4598 Food Insecurity and Other Correlates of Individual Components of Metabolic Syndrome in Women Living with HIV (WLWH) in the United States

Authors: E. Wairimu Mwangi, Daniel Sarpong

Abstract:

Background: Access to effective antiretroviral therapy in the United States has resulted in the rise in longevity in people living with HIV (PLHIV). Despite the progress, women living with HIV (WLWH) experience increasing rates of cardiometabolic disorders compared with their HIV-negative counterparts. Studies focusing on the predictors of metabolic disorders in this population have largely focused on the composite measure of metabolic syndrome (METs). This study seeks to identify the predictors of composite and individual METs factors in a nationally representative sample of WLWH. In particular, the study also examines the role of food security in predicting METs. Methods: The study comprised 1800 women, a subset of participants from the Women’s Interagency HIV Study (WIHS). The primary exposure variable, food security, was measured using the U.S. 10-item Household Food Security Survey Module. The outcome measures are the five metabolic syndrome indicators (elevated blood pressure [systolic BP > 130 mmHg and diastolic BP ≥ 85 mmHg], elevated fasting glucose [≥ 110 mg/dL], elevated fasting triglyceride [≥ 150 mg/dL], reduced HDL cholesterol [< 50 mg/dL], and waist circumference > 88 cm) and the composite measure - Metabolic Syndrome (METs) Status. Each metabolic syndrome indicator was coded one if yes and 0 otherwise. The values of the five indicators were summed, and participants with a total score of 3 or greater were classified as having metabolic syndrome. Participants classified as having metabolic syndrome were assigned a code of 1 and 0 otherwise for analysis. The covariates accounted for in this study fell into sociodemographic factors and behavioral and health characteristics. Results: The participants' mean (SD) age was 47.1 (9.1) years, with 71.4% Blacks and 10.9% Whites. About a third (33.1%) had less than a high school (HS) diploma, 60.4% were married, 32.8% were employed, and 53.7% were low-income. The prevalence of worst dietary diversity, low, moderate, and high food security were 24.1%, 26.6%, 17.0%, and 56.4%, respectively. The correlate profile of the five individual METs factors plus the composite measure of METs differ significantly, with METs based on HDL having the most correlates (Age, Education, Drinking Status, Low Income, Body Mass Index, and Health Perception). Additionally, metabolic syndrome based on waist circumference was the only metabolic factor where food security was significantly correlated (Food Security, Age, and Body Mass Index). Age was a significant predictor of all five individual METs factors plus the composite METs measure. Except for METs based on Fasting Triglycerides, body mass index (BMI) was a significant correlate of the various measures of metabolic syndrome. Conclusion: High-density Lipoprotein (HDL) cholesterol significantly correlated with most predictors. BMI was a significant predictor of all METs factors except Fasting Triglycerides. Food insecurity, the primary predictor, was only significantly associated with waist circumference.

Keywords: blood pressure, food insecurity, fasting glucose, fasting triglyceride, high-density lipoprotein, metabolic syndrome, waist circumference, women living with HIV

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4597 Studying Roughness Effects on Flow Regimes in Offshore Pipelines

Authors: Mohammad Sadegh Narges, Zahra Ghadampour

Abstract:

Due to the specific condition, offshore pipelines are given careful consideration and care in both design and operation. Most of the offshore pipeline flows are multi-phase. Multi-phase flows construct different pattern or flow regimes (in simultaneous gas-liquid flow, flow regimes like slug flow, wave and …) under different circumstances. One of the influencing factors on the flow regime is the pipeline roughness value. So far, roughness value influences and the sensitivity of the present models to this parameter have not been taken into consideration. Therefore, roughness value influences on the flow regimes in offshore pipelines are discussed in this paper. Results showed that geometry, absolute pipeline roughness value (materials that the pipeline is made of) and flow phases prevailing the system are of the influential parameters on the flow regimes prevailing multi-phase pipelines in a way that a change in any of these parameters results in a change in flow regimes in all or part of the pipeline system.

Keywords: absolute roughness, flow regime, multi-phase flow, offshore pipelines

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4596 India’s Energy Transition, Pathways for Green Economy

Authors: B. Sudhakara Reddy

Abstract:

In modern economy, energy is fundamental to virtually every product and service in use. It has been developed on the dependence of abundant and easy-to-transform polluting fossil fuels. On one hand, increase in population and income levels combined with increased per capita energy consumption requires energy production to keep pace with economic growth, and on the other, the impact of fossil fuel use on environmental degradation is enormous. The conflicting policy objectives of protecting the environment while increasing economic growth and employment has resulted in this paradox. Hence, it is important to decouple economic growth from environmental degeneration. Hence, the search for green energy involving affordable, low-carbon, and renewable energies has become global priority. This paper explores a transition to a sustainable energy system using the socio-economic-technical scenario method. This approach takes into account the multifaceted nature of transitions which not only require the development and use of new technologies, but also of changes in user behaviour, policy and regulation. The scenarios that are developed are: baseline business as usual (BAU) as well as green energy (GE). The baseline scenario assumes that the current trends (energy use, efficiency levels, etc.) will continue in future. India’s population is projected to grow by 23% during 2010 –2030, reaching 1.47 billion. The real GDP, as per the model, is projected to grow by 6.5% per year on average between 2010 and 2030 reaching US$5.1 trillion or $3,586 per capita (base year 2010). Due to increase in population and GDP, the primary energy demand will double in two decades reaching 1,397 MTOE in 2030 with the share of fossil fuels remaining around 80%. The increase in energy use corresponds to an increase in energy intensity (TOE/US $ of GDP) from 0.019 to 0.036. The carbon emissions are projected to increase by 2.5 times from 2010 reaching 3,440 million tonnes with per capita emissions of 2.2 tons/annum. However, the carbon intensity (tons per US$ of GDP) decreases from 0.96 to 0.67. As per GE scenario, energy use will reach 1079 MTOE by 2030, a saving of about 30% over BAU. The penetration rate of renewable energy resources will reduce the total primary energy demand by 23% under GE. The reduction in fossil fuel demand and focus on clean energy will reduce the energy intensity to 0.21 (TOE/US$ of GDP) and carbon intensity to 0.42 (ton/US$ of GDP) under the GE scenario. The study develops new ‘pathways out of poverty’ by creating more than 10 million jobs and thus raise the standard of living of low-income people. Our scenarios are, to a great extent, based on the existing technologies. The challenges to this path lie in socio-economic-political domains. However, to attain a green economy the appropriate policy package should be in place which will be critical in determining the kind of investments that will be needed and the incidence of costs and benefits. These results provide a basis for policy discussions on investments, policies and incentives to be put in place by national and local governments.

Keywords: energy, renewables, green technology, scenario

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4595 Antecedents of Online Trust Towards E-Retailers for Repeat Buyers: An Empirical Study in Indian Context

Authors: Prageet Aeron, Shilpi Jain

Abstract:

The present work explores the trust building mechanisms in the context of e-commerce vendors and reconciles trust as a cognitive as well as a knowledge-based mechanism in the framework which is developed. The paper conducts an empirical examination of the variables integrity, benevolence, and ability with trust as the dependent variable and propensity to trust as the mediating variable. Authors establish ability and integrity as primary antecedents as well as establish the central role of trust propensity in the online context for Indian buyers. Authors further identify that benevolence in the context of Indian buyers online behaviour seems insignificant, and this seems counter-intutive given the role of discounts in the Indian market. Lastly, authors conclude that the role of media and social influencers in building a perception of trust seems of little consequence.

Keywords: e-commerce, trust, e-retailers, propensity to trust

Procedia PDF Downloads 356
4594 Perception of Women towards Participation in Employment: A Study on Mumbai Slums Women

Authors: Mukesh Ranjan, Varsha Nagargoje

Abstract:

Applying the exploratory factor analysis (EFA), Women Employment Participation Perception Index (WEPPI) has been made through 13 components. The basic purpose of the WEPPI is to develop an index or search for the latent factors which will capture the attitude or perception of the Mumbai’s slum women towards women’s employment participation in the job market through primary survey based on 160 observations. Majority of the response analyzed under various socio-economic and demographic characteristics falls in the strongly agree or agree category. It means whether it is age wise, marital status-wise, caste, religion or economic dimension-wise women responded that they should participate in employment in Mumbai. Value of KMO test was 0.544 and chronbac’s alpha value was between 0.5-0.6, so the index falls in poor category and can be improved upon by adding more number of items.

Keywords: WEPPI, exploratory factor analysis, KMO test, Chronbac alpha

Procedia PDF Downloads 484
4593 Evaluation of South African Plants with Acaricide Activity against Ticks

Authors: G. Fouché, J. N. Eloff, K. Wellington

Abstract:

Acaricides are commonly used to control ticks but are toxic, harmful to the environment and too expensive to resource-limited farmers. Traditionally, many communities in South Africa rely on a wide range of indigenous practices to keep their livestock healthy. One of these health care practices includes the use of medicinal plants and this offers an alternative to conventional medicine. An investigation was conducted at the CSIR in South Africa, and selected indigenous plants used in communities were scientifically evaluated for the management of ticks in animals. 17 plants were selected from 239 plants used traditionally in South Africa. Two different organic extracts were prepared from the 17 samples, resulting in 34 plant samples. These were tested for efficacy against two tick species, namely Rhipicephalus microplus and Rhipicephalus turanicus. The plant extracts were also screened against Vero cells and most were found to have low cytotoxicity. This study has shown that there is potential for the development of botanicals as natural acaricides against ticks that are non-toxic and environmentally benign.

Keywords: South Africa, ticks, plant extracts, Rhipicephalus (Boophilus) microplus

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4592 Smartphones: Tools for Enhancing Teaching in Nigeria’s Higher Institutions

Authors: Ma'amun Muhammed

Abstract:

The ability of smartphones in enhancing communication, providing access to business and serving as a pool for information retrieval has a far reaching and potentially beneficial impacts on enhancing teaching in higher institutions in the developing countries like Nigeria. Nigeria as one of the fast growing economies in Africa, whose citizens patronize smartphones can utilize this opportunity by inculcating the culture of using smartphones not only for communication, business transaction, banking etc. but also for enhancing teaching in the higher institutions. Smartphones have become part and parcel of our lives, particularly among young people. The primary objective of this paper is to ascertain the use of smartphones in enhancing teaching in Nigeria’s higher institutions, to achieve this, content analysis was used thoroughly. This paper examines the opportunities offered by smartphones to the students of higher institutions of learning, the challenges being faced by lecturers of these institutions in classrooms. Lastly, it offers solution on how some of these critical challenges will be overcame, so as to utilize the technology of these devices.

Keywords: communication, information retrieval, mobile phone, smartphones teaching

Procedia PDF Downloads 423
4591 Global Direct Search Optimization of a Tuned Liquid Column Damper Subject to Stochastic Load

Authors: Mansour H. Alkmim, Adriano T. Fabro, Marcus V. G. De Morais

Abstract:

In this paper, a global direct search optimization algorithm to reduce vibration of a tuned liquid column damper (TLCD), a class of passive structural control device, is presented. The objective is to find optimized parameters for the TLCD under stochastic load from different wind power spectral density. A verification is made considering the analytical solution of an undamped primary system under white noise excitation. Finally, a numerical example considering a simplified wind turbine model is given to illustrate the efficacy of the TLCD. Results from the random vibration analysis are shown for four types of random excitation wind model where the response PSDs obtained showed good vibration attenuation.

Keywords: generalized pattern search, parameter optimization, random vibration analysis, vibration suppression

Procedia PDF Downloads 275
4590 Examining the Impact of De-Escalation Training among Emergency Department Nurses

Authors: Jonathan D. Recchi

Abstract:

Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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4589 Arabic Fables in Contemporary Garbs: Ahmed Shawqī’s Reconstruction of Fables in the Modern Era

Authors: Monia Hejaiej

Abstract:

The fable has lent itself to memorable imitations and reinventions. The writing of fables, in prose and verse, was widely cultivated not only in pre-Islamic Arabia but also in the middle ages, reaching its culmination with the Egyptian poet and man of letters Ahmad Shawqī (1989-1932), who revived the ancient tradition, a relatively minor and unexploited genre in the modern era, and re-wrote rimed fables with an Arab Islamic flavor, articulating a set of modern ethico-political concepts and sensibilities such as a belief in good judgment in governance, individual liberty, democracy, a sense of the brotherhood of man and justice. This essay aims to restore the 20th Century poet to his rightful place in the international pantheon of literary achievement, and offers an examination of the Arabian fabulist tradition as it appears in Arabic literature, and a treatment of this genre re-visiting a few representative samples of Ahmad Shawqī collection of fables and their implications for contemporary politics in the Middle East.

Keywords: fable, politcs, governace, democracy, ethics of care

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4588 Robust Fault Diagnosis for Wind Turbine Systems Subjected to Multi-Faults

Authors: Sarah Odofin, Zhiwei Gao, Sun Kai

Abstract:

Operations, maintenance and reliability of wind turbines have received much attention over the years due to rapid expansion of wind farms. This paper explores early fault diagnosis scale technique based on a unique scheme of a 5MW wind turbine system that is optimized by genetic algorithm to be very sensitive to faults and resilient to disturbances. A quantitative model based analysis is pragmatic for primary fault diagnosis monitoring assessment to minimize downtime mostly caused by components breakdown and exploit productivity consistency. Simulation results are computed validating the wind turbine model which demonstrates system performance in a practical application of fault type examples. The results show the satisfactory effectiveness of the applied performance investigated in a Matlab/Simulink/Gatool environment.

Keywords: disturbance robustness, fault monitoring and detection, genetic algorithm, observer technique

Procedia PDF Downloads 380
4587 Cost Effectiveness and Performance Study of Perpetual Pavement Using ABAQUS

Authors: Mansour Fakhri, Monire Zokaei

Abstract:

Where there are many demolitions on conventional asphalt pavements, heavy costs are paid to repair and reconstruct the pavement roads annually. Recently some research has been done in order to increase the pavement life. Perpetual pavement is regarded as one of them which can improve the pavement life and minimize the maintenance activity and cost. In this research, ABAQUS which is a finite element software is implemented for analyzing and simulation of perpetual pavement. Viscoelastic model of material is used and loading wheel is considered to be dynamic. Effect of different parameters on pavement function has been considered. Because of high primary cost these pavements are not widely used. In this regard, life cost analysis was also carried out to compare perpetual pavement to conventional asphalt concrete pavement. It was concluded that although the initial cost of perpetual pavement is higher than that of conventional asphalt pavement, life cycle cost analysis during 50 years of service life showed that the performance of this pavement is better and the whole life cost of that is less.

Keywords: ABAQUS, lifecycle cost analysis, mechanistic empirical, perpetual pavement

Procedia PDF Downloads 383
4586 Medical Dressing Induced Digital Ischemia in Patient with Congenital Insensitivity to Pain and Anhidrosis

Authors: Abdulwhab Alotaibi, Abdullah Alzahrani, Ziyad Bokhari, Abdulelah Alghamdi

Abstract:

First described in 1975 by Dr. Miller, Medical dressings are uncommon but possible cause of hand digital ischemia due the tourniquet-like effect. The incident of this complication has been reported across wide range of age-groups, yet it seems like that the pediatric population are specifically vulnerable. Multiple dressing types were reported to have caused ischemic injury, such as elastic wrap, tubular gauze, and self-adherent dressings. We present a case of medical dressing induced digital ischemia in patient with Congenital insensitivity to pain and anhidrosis (CIPA), which further challenge the discovery of the condition. An 8-year-old girl known case of CIPA. Brought by her mother to the ER after nail bed injury, which she managed by application of elastic wrap that was left for 24 hours. When the mother found out she immediately removed the elastic band, and noticed the fingertip was black and cold with tense bullae. The color then changed later when she arrived to the ER to dark purple with bluish discoloration on the tip. On examination there was well demarcated tense bullae on the distal right fifth finger. Neurovascular intact, pulse oximetry on distal digit 100%, capillary refill time was delayed. She was seen under Plastic surgery and conservative management recommended, and patient was discharged with safety netting. Two days later the patient came as follow-up visit at which her condition demonstrated significant improvement, the bullae has since ruptured leaving behind sloughed skin, capillary refill and pulse oximetry were both within normal limits, sensory function couldn’t be assessed but her motor function and ROM were normal, topical bacitracin and bandage dressings were applied for the eroded skin. Patient was scheduled for a follow-up in 2 weeks. Preventatively it’s advisable to avoid the commonly implicated dressings such as elastic, tubular gauze or self-adherent wraps in hand or digital injuries when possible, but in cases where the use of these dressings is of necessity the appropriate precautions must be taken, Dr. Makarewich proposed the following 5 measures to help minimize the incidence of the injury: 1-Unwrapping 12 inches of the dressing before rolling the injured finger. 2-Wrapping from distal to proximal with minimal tension to avoid vascular embarrassment. 3-The use of 5-25 inch to overlap the entire wrap. 4-Maintaining light pressure over the wrap to allow adherence of the dressing. 5-Minimization of the number of layers used to wrap the affected digit. Also assessing the capillary refill after the application can help in determining the patency of the supplying blood vessels. It’s also important to selectively determine if the patient is a candidate for conservative management, as tailored approach can help in maximizing the positive outcomes for our patients.

Keywords: congenital insensitivity to pain, digital ischemia, medical dressing, conservative management

Procedia PDF Downloads 64