Search results for: chaupadi practice

Authors: Claire Far, Sara Wilkinson, Deborah Ascher Barnstone

Abstract:

Energy issues have been a growing concern in current decades. Limited energy resources and increasing energy consumption from one side and environmental pollution and waste of resources from the other side have substantially affected the future of human life. Around 40 percent of total energy consumption of Australian buildings goes to heating and cooling due to the low thermal performance of the buildings. Thermal performance of buildings determines the amount of energy used for heating and cooling of the buildings which profoundly influences energy efficiency. Therefore, employing sustainable design principles and effective use of construction materials for building envelope can play crucial role in the improvement of energy efficiency of existing dwellings and enhancement of thermal comfort of the occupants. The energy consumption for heating and cooling normally is determined by the quality of the building envelope. Building envelope is the part of building which separates the habitable areas from exterior environment. Building envelope consists of external walls, external doors, windows, roof, ground and the internal walls that separate conditioned spaces from non-condition spaces. The energy loss from the building envelope is the key factor. Heat loss through conduction, convection and radiation from building envelope. Thermal performance of the building envelope can be improved by using different methods of retrofitting depending on the climate conditions and construction materials. Based on the available studies, the importance of employing sustainable design principles has been highlighted among the Australian building professionals. However, the residential building sector still suffers from a lack of having the best practice examples and experience for effective use of construction materials for building envelope. As a result, this study investigates the effectiveness of different energy retrofitting techniques and examines the impact of employing those methods on energy consumption of existing dwellings in Sydney, the most populated city in Australia. Based on the research findings, the best thermal retrofitting methods for increasing thermal comfort and energy efficiency of existing residential dwellings as well as reducing their environmental impact and footprint have been identified and proposed.

Keywords: thermal comfort, energy consumption, residential dwellings, sustainable design principles, thermal retrofit

Procedia PDF Downloads 268

Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

Abstract:

Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

Procedia PDF Downloads 128

Authors: Huseyin Duran, Yesim Benal Oztekin, Kazim Kubilay Vursavus, Ilker Huseyin Celen

Abstract:

There are two main approaches to manufacturing, market and usage of plant protection machinery in Turkey. The first approach is called as ‘Product Safety Approach’ and could be summarized as minimum health and safety requirements of consumer needs on plant protection equipment and machinery products. The second approach is the practices related to the Plant Protection Equipment and Machinery Directive. Product safety approach covers the plant protection machinery product groups within the framework of a new approach directive, Machinery Safety Directive (2006/42 / AT). The new directive is in practice in our country by 03.03.2009, parallel to the revision of the EU Regulation on the Directive (03.03.2009 dated and numbered 27158 published in the Official Gazette). ‘Pesticide Application for Machines’ paragraph is added to the 2006/42 / EC Machinery Safety Directive, which is, in particular, reveals the importance of primary health care and product safety issue, explaining the safety requirements for machines used in the application of plant protection products. The Ministry of Science, Industry and Technology is the authorized organizations in our country for the publication and implementation of this regulation. There is a special regulation, carried out by Ministry of Food, Agriculture and Livestock General Directorate of Food and Control, on the manufacture and sale of plant protection machinery. This regulation, prepared based on 5996 Veterinary Services, Plant Health, Food and Feed Law, is ‘Regulation on Plant Protection Equipment and Machinery’ (published on 02.04.2011 whit number 27893 in the Official Gazette). The purposes of this regulation are practicing healthy and reliable crop production, the preparation, implementation and dissemination of the integrated pest management programs and projects for the development of human health and environmentally friendly pest control methods. This second regulation covers: approval, manufacturing, licensing of Plant Protection Equipment and Machinery; duties and responsibilities of the dealers; principles and procedures related to supply and control of the market. There are no inspection procedures for the application of currently used plant protection machinery in Turkey. In this study, content and application principles of all regulation approaches currently used in Turkey are summarized.

Keywords: plant protection equipment and machinery, product safety, market surveillance, inspection procedures

Procedia PDF Downloads 259

Authors: Anita Bela, Marta Juhasz

Abstract:

Adapting to the always-changing environment comes with complex determinants. The authors are zooming into one aspect only when the current workforce comes with obstacles by being less keen to stay engaged, even short or mid-term, resulting in additional challenges impacting the business performance. Seeing these occurring in practice made the researchers eager to gain a better understanding of the reasons behind. The paper aims to provide an overview of the theoretical background and research methods planned for the different stages of the research. The theoretical part takes the leadership behaviors under lens while the focus is on finding ways to attract and retain those who prefer working under more flexible employment conditions (e.g. contractor, contingent worker, etc.). These are considered as the organizational values and along with the power of people management are having their engaging relevance. The organizational culture (visible or invisible level) is clearly the mirror of the set of shared values guiding all members of the companies towards acceptable behavior. The applied research method, inductive reasoning was selected since the focus and questions raised in this research are results of specific observations made on the employees (various employment types) and leaders of start-ups and corporates. By comparing the similarities and differences, the researchers are hoping to prove the readiness and agility of the start-up culture for the desired leadership behaviours of the current and future workforce against the corporate culture. While exploring the preferences and engaging factors of the 21st-century workforce the data gathering would happen through website analysis – using ATLAS.ti qualitative software – followed by interview sessions where demographics will be collected and preferred leadership behaviors - using the Critical Incident Technique. Moreover, a short engagement survey will be administered to understand the linkage between the organizational culture type and engagement level. To conclude, after gaining theoretical understanding, we will zoom back to the employees to reveal the behaviors to be followed to achieve engagement in an environment where nothing is stable and where the companies always must keep their agile eyes and reactions vivid.

Keywords: leadership behaviours, organizational culture, qualitative analysis, workforce engagement

Procedia PDF Downloads 116

Authors: Janet Modu, Jean-Francois Georgin, Laurent Briancon, Eric Antoinet

Abstract:

The current practice during the repowering phase of wind turbines is deconstruction of existing foundations and construction of new foundations to accept larger wind loads or once the foundations have reached the end of their service lives. The ongoing research project FUI25 FEDRE (Fondations d’Eoliennes Durables et REpowering) therefore serves to propose scalable wind turbine foundation designs to allow reuse of the existing foundations. To undertake this research, numerical models and laboratory-scale models are currently being utilized and implemented in the GEOMAS laboratory at INSA Lyon following instrumentation of a reference wind turbine situated in the Northern part of France. Sensors placed within both the foundation and the underlying soil monitor the evolution of stresses from the foundation’s early age to stresses during service. The results from the instrumentation form the basis of validation for both the laboratory and numerical works conducted throughout the project duration. The study currently focuses on the effect of coupled mechanisms (Thermal-Hydro-Mechanical-Chemical) that induce stress during the early age of the reinforced concrete foundation, and scale factor considerations in the replication of the reference wind turbine foundation at laboratory-scale. Using THMC 3D models on COMSOL Multi-physics software, the numerical analysis performed on both the laboratory-scale and the full-scale foundations simulate the thermal deformation, hydration, shrinkage (desiccation and autogenous) and creep so as to predict the initial damage caused by internal processes during concrete setting and hardening. Results show a prominent effect of early age properties on the damage potential in full-scale wind turbine foundations. However, a prediction of the damage potential at laboratory scale shows significant differences in early age stresses in comparison to the full-scale model depending on the spatial position in the foundation. In addition to the well-known size effect phenomenon, these differences may contribute to inaccuracies encountered when predicting ultimate deformations of the on-site foundation using laboratory scale models.

Keywords: cement hydration, early age behavior, reinforced concrete, shrinkage, THMC 3D models, wind turbines

Procedia PDF Downloads 175

Authors: G. T. Ntuli

Abstract:

This paper critically examines the gender dynamics of a Zulu girl child in her religio-cultural context from the postcolonial feminist perspective. As one of the former colonized ethnic groups in the South African context, the Zulu tribe used to have particular and contextual religio-cultural ways of a girl’s upbringing. This included traditional and cultural norms that any member of the community could not infringe without serious repercussions from the community members. However, the postcolonial social position of a girl child within this community became ambiguous and unpredictable due to colonial changes that enhanced gender dynamics that propelled tribal communities into deeper patriarchal structures. In the empirical study conducted within the Zulu context, which investigated the retrieval of ubuntombi (virginity) as a Zulu cultural heritage, identity and sex education as a path to adulthood, it was found that a Zulu girl child’s social position is geared towards double oppression due to gender dynamics that she experiences in her lifetime. It is these gender dynamics that are examined in this paper from the postcolonial feminist perspective. These gender dynamics are at play from the birth of a girl child, developmental stage to puberty and marriage rituals. These rituals and religio-cultural practices are meant to shape and mold a ‘good woman’ in the Zulu cultural context but social gender inequality that elevates males over females propel women social status into life denying peripheral positions. Consequently, in the place of a ‘good woman’ in the communal view, an oppressed and dehumanized woman becomes the outcome of such gender dynamics, more often treated with contempt, despised and violated in many demeaning ways. These do not only leave women economically and socio-politically impoverished, but also having to face violence of all kinds such as domestic, emotional, sexual and gender-based violence that are increasingly becoming a scourge in some of the sub-Saharan African countries including South Africa. It is for this reason that this paper becomes significant, not only within the Zulu context where the research was conducted, but also in all the countries that practice and promote patriarchal tendencies in the name of religio-cultural practices. There is a need for a different outlook as to what it means to be a ‘good woman’ in the cultural context, because if the goodness of a woman is determined by life denying cultural practices, such practices need to be deconstructed and discarded.

Keywords: feminist, gender dynamics, postcolonial, religio-cultural, Zulu girl child

Procedia PDF Downloads 156

Authors: Girija Jha

Abstract:

This paper investigates the need of cotton to integrate sustainability. The methodology used in the paper is to do secondary research to find out the various environmental implications of cotton as textile material across its life cycle and try to look at ways and possibilities of minimizing its ecological footprint. Cotton is called ‘The Fabric of Our Lives’. History is replete with examples where this fabric used to be more than a fabric of lives. It used to be a miracle fabric, a symbol India’s pride and social Movement of Swaraj, Gandhijee’s clarion call to self reliance. Cotton is grown in more than 90 countries across the globe on 2.5 percent of the world's arable land in countries like China, India, United States, etc. accounting for almost three fourth of global production. But cotton as a raw material has come under the scanner of sustainability experts because of myriad reasons a few have been discussed here. It may take more than 20,000 liters of water to produce 1kg of cotton. Cotton harvest is primarily done from irrigated land which leads to Salinization and depletion of local water reservoirs, e.g., Drying up of Aral Sea. Cotton is cultivated on 2.4% of total world’s crop land but accounts for 24% usage of insecticide and shares the blame of 11% usage of pesticides leading to health hazards and having an alarmingly dangerous impact on the ecosystem. One of the possible solutions to these problems as proposed was GM, Genetically Modified cotton crop. However, use of GM cotton is still debatable and has many ethical issues. The practice of mass production and increasing consumerism and especially fast fashion has been major culprits to disrupt this delicate balance. Disposable fashion or fast fashion is on the rise and cotton being one of the major choices adds on to the problem. Denims – made of cotton and have a strong fashion statement and the washes being an integral part of their creation they share a lot of blame. These are just a few problems listed. Today Sustainability is the need of the hour and it is inevitable to incorporate have major changes in the way we cultivate and process cotton to make it a sustainable choice. The answer lies in adopting minimalism and boycotting fast fashion, in using Khadi, in saying no to washed denims and using selvedge denims or using better methods of finishing the washed out fabric so that the environment does not bleed blue. Truly, the answer lies in integrating state of art technology with age old sustainable practices so that the synergy of the two may help us come out of the vicious circle.

Keywords: cotton, sustainability, denim, Khadi

Procedia PDF Downloads 156

Authors: Sami W. Tabsh

Abstract:

The strength of reinforced concrete depends on the member dimensions and material properties. The properties of concrete and steel materials are not constant but random variables. The variability of concrete strength is due to batching errors, variations in mixing, cement quality uncertainties, differences in the degree of compaction and disparity in curing. Similarly, the variability of steel strength is attributed to the manufacturing process, rolling conditions, characteristics of base material, uncertainties in chemical composition, and the microstructure-property relationships. To account for such uncertainties, codes of practice for reinforced concrete design impose resistance factors to ensure structural reliability over the useful life of the structure. In this investigation, the effects of reductions in concrete and reinforcing steel strengths from the nominal values, beyond those accounted for in the structural design codes, on the structural reliability are assessed. The considered limit states are flexure, shear and axial compression based on the ACI 318-11 structural concrete building code. Structural safety is measured in terms of a reliability index. Probabilistic resistance and load models are compiled from the available literature. The study showed that there is a wide variation in the reliability index for reinforced concrete members designed for flexure, shear or axial compression, especially when the live-to-dead load ratio is low. Furthermore, variations in concrete strength have minor effect on the reliability of beams in flexure, moderate effect on the reliability of beams in shear, and sever effect on the reliability of columns in axial compression. On the other hand, changes in steel yield strength have great effect on the reliability of beams in flexure, moderate effect on the reliability of beams in shear, and mild effect on the reliability of columns in axial compression. Based on the outcome, it can be concluded that the reliability of beams is sensitive to changes in the yield strength of the steel reinforcement, whereas the reliability of columns is sensitive to variations in the concrete strength. Since the embedded target reliability in structural design codes results in lower structural safety in beams than in columns, large reductions in material strengths compromise the structural safety of beams much more than they affect columns.

Keywords: code, flexure, limit states, random variables, reinforced concrete, reliability, reliability index, shear, structural safety

Procedia PDF Downloads 430

Authors: Marina Petrova

Abstract:

Language policy issues related to the preservation and development of the native languages of the Russian peoples and the state languages of the national republics are increasingly becoming the focus of recent attention of educators and parents, public and national figures. Is it legal to teach the national language or the mother tongue as the state language? Due to that dispute language phobia moods easily evolve into xenophobia among the population. However, a civilized, intelligent multicultural personality can only be formed if the country develops bilingualism and multilingualism, and languages as a political tool help to find ‘keys’ to sufficiently closed national communities both within a poly-ethnic state and in internal relations of multilingual countries. The purpose of this study is to design and theoretically substantiate an efficient model of language education in the innovatively developing Republic of Sakha. 800 participants from different educational institutions of Yakutia worked at developing a multilingual model of education. This investigation is of considerable practical importance because researchers could build a methodical system designed to create conditions for the formation of a cultural language personality and the development of the multilingual communicative competence of Yakut youth, necessary for communication in native, Russian and foreign languages. The selected methodology of humane-personal and competence approaches is reliable and valid. Researchers used a variety of sources of information, including access to related scientific fields (philosophy of education, sociology, humane and social pedagogy, psychology, effective psychotherapy, methods of teaching Russian, psycholinguistics, socio-cultural education, ethnoculturology, ethnopsychology). Of special note is the application of theoretical and empirical research methods, a combination of academic analysis of the problem and experienced training, positive results of experimental work, representative series, correct processing and statistical reliability of the obtained data. It ensures the validity of the investigation’s findings as well as their broad introduction into practice of life-long language education.

Keywords: intercultural communication, language policy, multilingual and multicultural education, the Sakha Republic of Yakutia

Procedia PDF Downloads 222

Authors: Neşe Alkan

Abstract:

Purpose: The point that applied/clinical psychology, which is the practice and research discipline of the mental health field, has reached today can be summarized as the necessity of handling the psychological well-being of people from multiple perspectives and the goal of moving it to a higher level. Clients' subjective assessment of their own condition and wellbeing is an integral part of evidence-based interventions. There is a need for tools through which clients can evaluate the effectiveness of the psychotherapy/intervention performed with them and their contribution to the wellbeing and wellbeing of this process in a valid and reliable manner. The aim of this research is to meet this need, to test the reliability and validity of the index in Turkish, and explore its usability in the practices of both researchers and psychotherapists. Method: A total of 213 adults aged between 18-54, 69.5% working and 29.5% university students, were included in the study. Along with their demographic information, the participants were administered a set of scales: wellbeing, life satisfaction, spiritual satisfaction, shopping addiction, and loneliness, namely via an online platform. The construct validity of the wellbeing scale was tested with exploratory and confirmatory factor analyses, convergent and discriminant validity were tested with two-way full and partial correlation analyses and, measurement invariance was tested with one-way analysis of variance. Results: Factor analyzes showed that the scale consisted of six dimensions as it is in its original structure. The internal consistency of the scale was found to be Cronbach α = .82. Two-way correlation analyzes revealed that the wellbeing scale total score was positively correlated with general life satisfaction (r = .62) and spiritual satisfaction (r = .29), as expected. It was negatively correlated with loneliness (r = -.51) and shopping addiction (r = -.15). While the scale score did not vary by gender, previous illness, or nicotine addiction, it was found that the total wellbeing scale scores of the participants who had used antidepressant medication during the past year were lower than those who did not use antidepressant medication (F(1,204) = 7.713, p = .005). Conclusion: It has been concluded that the 12-item wellbeing scale consisting of six dimensions can be used in research and health sciences practices as a valid and reliable measurement tool. Further research which examines the reliability and validity of the scale in different widely used languages such as Spanish and Chinese is recommended.

Keywords: wellbeing, intervention effectiveness, reliability and validity, effectiveness

Procedia PDF Downloads 180

Authors: Jamie E. Banker

Abstract:

For many families, pregnancy and the postpartum time are filled with both anticipation and change. For some pregnant or postpartum women, this time is marked by the onset of a mood or anxiety disorder. Experiencing a mood or anxiety disorders during this time of life differs from depression or anxiety at other times of life. Not only because of the physical changes occurring in the mother’s body but also the mental and physical preparation necessary to redefine family roles, responsibilities, and develop new identities in the life transition. The presence of a mood or anxiety disorder can influence the way in which a mother defines herself and can complicate her understanding of her abilities and competencies as a mother. The complexity of experiencing a mood or anxiety disorder in the midst of these changes necessitates specific treatment interventions to match both the symptomatology and psychological adjustments. This study explores the use of narrative family therapy techniques when treating a mother who is experiencing postpartum depression. Externalization is a common technique used in narrative family therapy and can help client’s separate their identity from the problems they are experiencing. This is crucial to a new mom who is in the middle of defining her identity during her transition to parenthood. The goal of this study is to examine how the use of externalization techniques help postpartum women separate their mood and anxiety symptoms from their identity as a mother. An exploratory case study design was conducted in a single setting, private practice therapy office, and explored how a narrative family therapy approach can be used to treat perinatal mood and anxiety disorders. The therapy sessions were audio recorded and transcribed. Constructivism and narrative theory are used as theoretical frameworks and data from the therapy sessions, and a follow-up survey was triangulated and analyzed. During the course of the treatment, the participant reports using the new externalizing labels for her symptoms. Within one month of treatment, the participant reports that she could stop herself from thinking the harmful thoughts faster, and within three months, the harmful thoughts went away. The main themes in this study were building courage and less self-blame. This case highlights the role narrative family therapy can play in the treatment of perinatal mood and anxiety disorders and the importance of separating a women’s mood from her identity as a mother. This conceptual framework was beneficial to the postpartum mother when treating perinatal mood and anxiety disorder symptoms.

Keywords: externalizing techniques, narrative family therapy, perinatal mood and anxiety disorders, postpartum depression

Procedia PDF Downloads 274

Authors: I. Dangeard, S. Meineri, M. Dupré

Abstract:

large body of research on energy consumption reveals that regular information on energy consumption produces a positive effect on behavior. The present research aims to test this feedback paradigm on waste management. A small-scale experiment on residual household waste was performed in a large french urban area, in partnership with local authorities, as part of the development of larger-scale project. A two-step door-to-door recruitment scheme led to 85 households answering a questionnaire. Among them, 54 accepted to participate in a study on waste (second step). Participants were then randomly assigned to one of the 3 experimental conditions : self-reported feedback on curbside waste, external feedback on waste weight based on information technologies, and no feedback for the control group. An additional control group was added, including households who were not requested to answer the questionnaire. Household residual waste was collected every week, and tags on curbside bins fed a database with waste weight of households. The feedback period lasted 14 weeks (february-may 2014). Quantitative data on waste weight were analysed, including these 14 weeks and the 7 previous weeks. Households were then contacted by phone in order to confirm the quantitative results. Regarding the recruitment questionnaire, results revealed high pro-environmental attitude on the NEP scale, high recycling behavior level and moderate level of source reduction behavior on the adapted 3R scale, but no statistical difference between the 3 experimental groups. Regarding the feedback manipulation paradigm, waste weight reveals important differences between households, but doesn't prove any statistical difference between the experimental conditions. Qualitative phone interviews confirm that recycling is a current practice among participants, whereas source reduction of waste is not, and mainly appears as a producer problem of packaging limitation. We conclude that triggering waste prevention behaviors among recycling households involves long-term feedback and should promote benchmarking, in order to clearly set waste reduction as an objective to be managed through feedback figures.

Keywords: eco-feedback, household waste, waste reduction, experimental research

Procedia PDF Downloads 392

Authors: Alice Huffman, Joseph Hartland, Sam Gibbs

Abstract:

Dermatology is often a neglected specialty in low-resource settings, despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV positive patients. African countries have the highest HIV infection rates and skin conditions are frequently misdiagnosed and mismanaged, because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV positive patients. A literature search within Embase, Medline and Google scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff a list of 15 skin conditions was included and a booklet created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff, alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: dermatology, HIV, Malawi, skin disease

Procedia PDF Downloads 204

Authors: Ekaterina Reznikova

Abstract:

The paper provides an overview of the comparative analysis of legal novelties on telework in Portugal and Spain from a gender perspective. Telework, defined as the practice of working remotely using information and communication technologies, has gained increased attention in recent years, particularly in the context of the COVID-19 pandemic. As countries implement legal frameworks to regulate telework, it is essential to assess their gender implications and their impact on promoting gender equality in the workplace. In Portugal, legal novelties on telework have been introduced through various legislative measures, including the Telework Regulation Act (Lei do Teletrabalho) enacted in 2018. This legislation aims to provide a framework for telework arrangements, outlining rights and obligations for both employers and employees. However, the gender perspective in Portugal's telework regulations remains somewhat limited, with few explicit provisions addressing gender disparities in telework participation or the unequal distribution of caregiving responsibilities. In contrast, Spain has taken a more proactive approach to addressing gender equality in telework through its legal novelties. The Spanish government passed the Royal Decree-Law 28/2020, which introduced significant reforms to telework regulations in response to the COVID-19 pandemic. This legislation includes provisions aimed at promoting gender equality in telework, such as measures to ensure work-life balance and prevent discrimination based on gender in telework arrangements. Additionally, Spain has implemented initiatives to encourage "joint responsibility" at home, emphasizing the importance of shared caregiving duties between men and women. By comparing the legal novelties on telework in Portugal and Spain from a gender perspective, this study aims to identify best practices and areas for improvement in promoting gender equality in telework arrangements. Through a comprehensive analysis of the legal frameworks, this study will assess the extent to which Portugal and Spain's telework regulations address gender disparities and support the advancement of women in the workforce. The findings of this comparative analysis will have significant implications for policymakers, employers, and other stakeholders involved in shaping telework policies. By identifying effective strategies for promoting gender equality in telework, this study seeks to contribute to the development of inclusive and sustainable work environments that benefit all employees, regardless of gender.

Keywords: telework, labour law, digitalization, gender

Procedia PDF Downloads 60

Authors: Frank Fan

Abstract:

PharmD (Doctor of Pharmacy) education has confronted an increasing challenge — curricular overload, a phenomenon resulting from the expansion of curricular requirements, as PharmD education strives to produce graduates who are practice-ready. The aftermath of the global pandemic has amplified the need for healthcare professionals, leading to a growing trend of assigning more responsibilities to them to address the global healthcare shortage. For instance, the pharmacist’s role has expanded to include not only compounding and distributing medication but also providing clinical services, including minor ailments management, patient counselling and vaccination. Consequently, PharmD programs have responded by continually expanding their curricula adding more requirements. While these changes aim to enhance the education and training of future professionals, they have also led to unintended consequences, including curricular overload, student burnout, and a potential decrease in program quality. To address the issue and ensure program quality, there is a growing need for evidence-based curriculum reforms. My research seeks to integrate Cognitive Load Theory, emerging machine learning algorithms within artificial intelligence (AI), and statistical approaches to develop a quantitative framework for optimizing curriculum design within the PharmD program at the University of Toronto, the largest PharmD program within Canada, to provide quantification and measurement of issues that currently are only discussed in terms of anecdote rather than data. This research will serve as a guide for curriculum planners, administrators, and educators, aiding in the comprehension of how the pharmacy degree program compares to others within and beyond the field of pharmacy. It will also shed light on opportunities to reduce the curricular load while maintaining its quality and rigor. Given that pharmacists constitute the third-largest healthcare workforce, their education shares similarities and challenges with other health education programs. Therefore, my evidence-based, data-driven curriculum analysis framework holds significant potential for training programs in other healthcare professions, including medicine, nursing, and physiotherapy.

Keywords: curriculum, curriculum analysis, health professions education, reflective writing, machine learning

Procedia PDF Downloads 61

Authors: Titinan Pothong, Prasit Wangpakapattanawong, Stephen Elliott

Abstract:

Shifting cultivation is an indigenous agricultural practice among upland people and has long been one of the major land-use systems in Southeast Asia. As a result, fallows and secondary forests have come to cover a large part of the region. However, they are increasingly being replaced by monocultures, such as corn cultivation. This is believed to be a main driver of deforestation and forest degradation, and one of the reasons behind the recurring winter smog crisis in Thailand and around Southeast Asia. Accurate biomass estimation of trees is important to quantify valuable carbon stocks and changes to these stocks in case of land use change. However, presently, Thailand lacks proper tools and optimal equations to quantify its carbon stocks, especially for secondary evergreen forests, including fallow areas after shifting cultivation and smaller trees with a diameter at breast height (DBH) of less than 5 cm. Developing new allometric equations to estimate biomass is urgently needed to accurately estimate and manage carbon storage in tropical secondary forests. This study established new equations using a destructive method at three study sites: approximately 50-year-old secondary forest, 4-year-old fallow, and 7-year-old fallow. Tree biomass was collected by harvesting 136 individual trees (including coppiced trees) from 23 species, with a DBH ranging from 1 to 31 cm. Oven-dried samples were sent for carbon analysis. Wood density was calculated from disk samples and samples collected with an increment borer from 79 species, including 35 species currently missing from the Global Wood Densities database. Several models were developed, showing that aboveground biomass (AGB) was strongly related to DBH, height (H), and wood density (WD). Including WD in the model was found to improve the accuracy of the AGB estimation. This study provides insights for reforestation management, and can be used to prepare baseline data for Thailand’s carbon stocks for the REDD+ and other carbon trading schemes. These may provide monetary incentives to stop illegal logging and deforestation for monoculture.

Keywords: aboveground biomass, allometric equation, carbon stock, secondary forest

Procedia PDF Downloads 284

Authors: Deirdre Mc Grath, Joanne Reid

Abstract:

Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

Procedia PDF Downloads 186

Authors: H. S. Niroshani, W. M. Ediri Arachchi, R. Tudugala, U. J. M. A. L. Jayasinghe, U. M. U. J. Jayasekara, P. B. Hewavithana

Abstract:

Mammography is used as a screening tool for early diagnosis of breast cancer. It is also useful in refining the diagnosis of breast cancer either by assessment or work up after a suspicious area in the breast has been detected. In order to detect breast cancer accurately and at the earliest possible stage, the image must have an optimum contrast to reveal mass densities and spiculated fibrous structures radiating from them. In addition, the spatial resolution must be adequate to reveal the suffusion of micro calcifications and their shape. The above factors can be optimized by implementing an effective QA programme to enhance the accurate diagnosis of mammographic imaging. Therefore, the radiographer’s knowledge on QA is greatly instrumental in routine mammographic practice. The aim of this study was to assess the radiographer’s knowledge on Quality Assurance and Quality Control programmes in relation to mammographic procedures. A cross-sectional study was carried out among all radiographers working in each mammography setting in Sri Lanka. Pre-tested, anonymous self-administered questionnaires were circulated among the study population and duly filled questionnaires returned within a period of three months were taken into the account. The data on demographical information, knowledge on QA programme and associated QC tests, overall knowledge on QA and QC programmes were obtained. Data analysis was performed using IBM SPSS statistical software (version 20.0). The total response rate was 59.6% and the average knowledge score was 54.15±11.29 SD out of 100. Knowledge was compared on the basis of education level, special training of mammography, and the years of working experience in a mammographic setting of the individuals. Out of 31 subjects, 64.5% (n=20) were graduate radiographers and 35.5% (n=11) were diploma holders while 83.9% (n=26) of radiographers have been specially trained for mammography and 16.1% (n=5) have not been attended for any special training for mammography. It is also noted that 58.1% (n=18) of individuals possessed their experience of less than one year and rest 41.9% (n=13) of them were greater than that. Further, the results found that there is a significant difference (P < 0.05) in the knowledge of QA and overall knowledge on QA and QC programme in the categories of education level and working experience. Also, results imply that there was a significant difference (P < 0.05) in the knowledge of QC test among the groups of trained and non-trained radiographers. This study reveals that education level, working experience and the training obtained particularly in the field of mammography have a significant impact on their knowledge on QA and QC in mammography.

Keywords: knowledge, mammography, quality assurance, quality control

Procedia PDF Downloads 330

Authors: Rodziana M. Razali, Tamara J. Duraisingham

Abstract:

Malaysia is not a signatory to the 1951 Refugee Convention and its 1967 Protocol despite receiving the largest share of refugee inflows in Southeast Asia aside from Thailand. In Peninsular Malaysia, the majority of refugees and asylum seekers are from Myanmar, with Rohingya refugees recording the highest number compared to all other ethnicities. In the eastern state of Sabah, the presence of refugees who have long established themselves in the state is connected to those who escaped military persecution in southern Philippines in the 1970’s and 1980’s. A combination of legal and non-legal factors has created and sustained an adverse atmosphere of deprivation of legal identity for children of migrants including refugees born in Malaysia. This paper aims to qualitatively analyse the barriers to birth registration as the cornerstone of every person’s legal identity for children of refugees born in this country, together with the associated human rights implications. Data obtained through semi-structured interviews with refugees in Kota Kinabalu, Sabah and Rohingya refugees in Peninsular Malaysia shall be studied alongside secondary sources. Results show that births out of medical facilities, suspension of birth records, illiteracy, lack of awareness on the importance and procedures of birth registration, inability to meet documentary requirements, as well as fear of immigration enforcement, are the key factors hindering birth registration. These challenges exist against the backdrop of restrictive integration policy to avoid destabilising demographic and racial balance, political sentiment stirring xenophobic prejudices, as well as other economic and national security considerations. With no proof of their legal identity, the affected children grow up in a legal limbo, facing multiple human rights violations across generations. This research concludes that the country’s framework and practice concerning birth registration is in need of serious reform and improvement to reflect equality and universality of access to its birth registration system. Such would contribute significantly towards meeting its commitments to the post-2015 sustainable development agenda that pledges to 'Leave no one behind', as well as its recently announced National Human Rights Action Plan.

Keywords: birth registration, children, Malaysia, refugees

Procedia PDF Downloads 172

Authors: Devyani Shete, Sudeep Rai

Abstract:

Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

Procedia PDF Downloads 149

Authors: Szilvia Halmos

Abstract:

Hungary was one of the first countries to sign and ratify the UN Convention on the Rights of Persons with Disabilities (hereinafter: CRPD). Consequently, Hungary assumed an obligation under international law to review the national law in the light of the Article 12 of the CRPD requiring the States parties to guarantee the equality of persons with disabilities in terms of legal capacity, and to replace the regimes of substitute decision-making by the instruments of supported decision-making. This article is often characterized as one of the key norms of the CRPD, since the legal autonomy of the persons with disabilities is an essential precondition of their participation in the social life on an equal basis with others, envisaged by the social paradigm of disability. This paper examines the impact of the CRPD on the relevant Hungarian national legal norms, with special focus on the relevant rules of the recently codified Civil Code. The employed research methodologies include (1) the specification of the implementation requirements imposed by the Article 12 of the CRPD, (2) the determination of the indicators of the appropriate implementation, (3) the critical analysis of compliance of the relevant Hungarian legal regulation with the indicators, (4) with respect to the relevant case law of the Hungarian Constitutional Court and ordinary courts, the European Court of Human Rights and the Committee of Rights of Persons with Disabilities and (5) to the available empirical figures on the functioning of substitute and supported decision-making regimes. It will be established that the new Civil Code has made large steps toward the equality of persons with disabilities in terms of legal capacity and the support model of decision-making by the introduction of some specific instruments of supported decision-making and the restriction of the application of guardianship. Nevertheless, the regulation currently in effect fails to represent some crucial principles of the Article 12 of the CRPD, such as the non-discrimination of persons with psycho-social disabilities, the support of the articulation of the will and preferences of the individual instead of his/her best interest in the course of decision-making. The changes in the practice of the substitute and the support model brought about by the new legal norms can also be assessed as significant, however, so far unsatisfactory. The number of registered supporters is rather low, and the preconditions of the effective functioning of the support (e.g. the proper training of the supporters) are not ensured.

Keywords: Article 12 of the UN CRPD, Hungarian law on legal capacity, persons with intellectual and psycho-social disabilities, supported decision-making

Procedia PDF Downloads 289

Authors: Muhammad Umar Usman

Abstract:

This study investigates the entrepreneurial intentions, drivers and challenges of starting a business among final year students in Jigawa State polytechnic. Nigeria. Final year students of Jigawa State Polytechnic from the department of accounting, business administration and management and public administration were used as a case study. The study became necessary due to the alarming rate of graduate unemployment in Nigeria. The study adopted a holistic case study approach involving a multiple methods of questionnaires involving (182) Higher National Diploma (HND) and National Diploma (ND) final year students and a telephone interview with two lecturers teaching entrepreneurship in the college. The findings clearly indicate that exposer to entrepreneurship education increases students’ entrepreneurial intentions. The result found that desire for independence, confidence and strong intention are the most important factors that influence students’ entrepreneurial intention. The study identified 3 key drivers of students’ entrepreneurial intentions. These are to earn a living, to seek job security and provision of employment. The result again identified 4 factors namely lack of support, finance, insecurity and erratic power supply as the major challenges in starting a business in Nigeria. It was also revealed that the current entrepreneurship education programme prepares students on how to open up a business not becoming an entrepreneur. The study concluded entrepreneurship helps students toward building and driving their intention to venture into business. However, the challenges of entrepreneurship in Nigeria need to be addressed in order to enable individuals to become an entrepreneur and create employment opportunities that will lead to the development of Nigerian economy. Thus, the government should provide adequate support particularly the issue of infrastructures. The Federal Government of Nigeria in collaboration with the National Board for Technical Education should fashion out the curriculum thereby making it more practically-oriented so that students may become more interested. Polytechnics should develop an internship programme for students to work in firms so as to put theory learnt in the class to practice. Students should try to align the theory learnt in college with the practical application in dynamic economic environment. Hence, this will help in building their capabilities toward entrepreneurship development in Nigeria.

Keywords: entrepreneurial intention, entrepreneurial drivers, challenges, entrepreneurial education

Procedia PDF Downloads 301

Authors: Rehan Ullah

Abstract:

The primary purpose of the study is to observe the relationship that exists between the organizational information technology (IT) capabilities and the organizational performance in China and Pakistan. Nations like China and Pakistan utilize modern techno-how to enhance their production endeavors. Therefore, making a wide-ranging comparison of the manufacturing services between China and Pakistan was chosen due to numerous reasons. One reason for carrying out this comparison is to determine how IT of the two countries enhances organizational competency on small and medium-sized manufacturing enterprises (SMEs). The study hypothesized that organizational IT capabilities (IT infrastructure, IT competence) have a positive influence on organizational performance and the strategic benefits of IT have a mediating effect on the relationship between IT capability and organizational performance. To investigate the relationship between IT capabilities and organizational performance, surveys were sent to managers of small, medium-sized manufacturing organizations located in the southwestern region, Sichuan province of China, and Pakistani companies, which are located in Islamabad, Lahore, and Karachi. These cities were selected as typical representatives of each country. Organizational performance has been measured in terms of profitability, organizational success, growth, market share, and innovativeness. Out of 400 surveys distributed to different manufacturing organizations, 303 usable and valid responses were received that are analyzed in this research. The data were examined using SPSS and Smart PLS computer software. The results of the study, including the descriptive statistics of each variable, are used. The outer model has been measured with considerations to content validity, discriminant validity, and convergent validity. The path coefficients among the constructs were also computed when analyzing the structural model using the bootstrapping technique. The analysis of data from both China and Pakistan yields an identical but unique result. The results show that IT infrastructure, IT competence, strategic benefits of IT are all correlated to the performance of the organizations. Moreover, strategic benefits of IT have been proved to mediate the relationship between IT capabilities and organization performance. The author, concerning the role of IT on the performance of an organization, highlights the different aspects as well as its benefits in an organization. The overall study concludes several implications for both managers and academicians. It also provides the limitations of the study and offers recommendations for future studies and practice.

Keywords: organizational performance, IT capabilities, IT infrastructure, IT competence, strategic benefits of IT, China, Pakistan

Procedia PDF Downloads 94

Authors: Mojtaba Eshraghi Arani

Abstract:

According to the international conventions for the carriage of goods by sea, the consignee is the person who is entitled to take delivery of the cargo from the carrier. Such a person is usually named in the relevant box of the bill of lading unless the latter is issued “To Order” or “To Bearer”. However, there are some cases in which the apparent consignee, as above, was not intended to take delivery of cargo, like the L/C issuing bank or the freight forwarder who are named as consignee only for the purpose of security or acceleration of transit process. In such cases as well as the BL which is issued “To Order”, the so-called “real consignee” can be found out in the “Notify Party” box. The dispute revolves around the choice between apparent consignee and real consignee for being entitled not only to take delivery of the cargo but also to sue the carrier for any damages or loss. While it is a generally accepted rule that only the apparent consignee shall be vested with such rights, some courts like France’s Cour de Cassation have declared that the “Notify Party”, as the real consignee, was entitled to sue the carrier and in some cases, the same court went far beyond and permitted the real consignee to take suit even where he was not mentioned on the BL as a “Notify Party”. The main argument behind such reasoning is that the real consignee is the person who suffered the loss and thus had a legitimate interest in bringing action; of course, the real consignee must prove that he incurred a loss. It is undeniable that the above-mentioned approach is contrary to the position of the international conventions on the express definition of consignee. However, international practice has permitted the use of BL in a different way to meet the business requirements of banks, freight forwarders, etc. Thus, the issue is one of striking a balance between the international conventions on the one hand and existing practices on the other hand. While the latest convention applicable for sea transportation, i.e., the Rotterdam Rules, dealt with the comparable issue of “shipper” and “documentary shipper”, it failed to cope with the matter being discussed. So a new study is required to propose the best solution for amending the current conventions for carriage of goods by sea. A qualitative method with the concept of interpretation of data collection has been used in this article. The source of the data is the analysis of domestic and international regulations and cases. It is argued in this manuscript that the judge is not allowed to recognize any one as real consignee, other than the person who is mentioned in the “Consingee” box unless the BL is issued “To Order” or “To Bearer”. Moreover, the contract of carriage is independent of the sale contract and thus, the consignee must be determined solely based on the facts of the BL itself, like “Notify Party” and not any other contract or document.

Keywords: real consignee, cargo, delivery, to order, notify the party

Procedia PDF Downloads 79

Authors: T. Holecki, J. Wozniak-Holecka, P. Romaniuk

Abstract:

Due to the highly centralized model of financing health care in Poland, local self-government rarely undertook their own initiatives in the field of public health, particularly health promotion. However, since 2017 the possibility of applying for a subsidy to health policy programs has been allowed, with the additional resources to be retrieved from the National Health Fund, which is the dominant payer in the health system. The amount of subsidy depends on the number of inhabitants in a given unit and ranges about 40% of the total cost of the program. The aim of this paper is to assess the impact of newly implemented solutions in financing health policy on the management of public finances, as well as on the activity provided by local self-government in health promotion. An effort to estimate the amount of expenses that both local governments, and the National Health Fund, spent on local health policy programs while implementing the new solutions. The research method is the analysis of financial data obtained from the National Health Fund and from local government units, as well as reports published by the Agency for Health Technology Assessment and Pricing, which holds substantive control over the health policy programs, and releases permission for their implementation. The study was based on a comparative analysis of expenditures on the implementation of health programs in Poland in years 2010-2018. The presentation of the results includes the inclusion of average annual expenditures of local government units per 1 inhabitant, the total number of positively evaluated applications and the percentage share in total expenditures of local governments (16 voivodships areas). The most essential purpose is to determine whether the assumptions of the subsidy program are working correctly in practice, and what are the real effects of introducing legislative changes into local government levels in the context of public health tasks. The assumption of the study was that the use of a new motivation tool in the field of public management would result in multiplication of resources invested in the provision of health policy programs. Preliminary conclusions show that financial expenditures changed significantly after the introduction of public funding at the level of 40%, obtaining an increase in funding from own funds of local governments at the level of 80 to 90%.

Keywords: health care system, health policy programs, local self-governments, public health management

Procedia PDF Downloads 156

Authors: Pampita Chakraborty, Sukumar Mukherjee

Abstract:

Diabetes Mellitus (DM) is commonly encountered metabolic disorder in clinical practice. An estimated 25 percent of DM patients develop foot problems. Foot ulceration and infection are one of the major causes of morbidity, hospitalization or even amputation. Objective: To isolate and identify bacterial pathogens in Diabetic Foot Ulcer (DFU) and to observe its antimicrobial sensitivity pattern. Methodology: A prospective study was conducted for a period of 9 months at the Department of Microbiology, GD Hospital & Diabetes Institute, Kolkata. 75 DFU patients were recruited in the study. Specimens for microbiological studies obtained from ulcer base were examined as gram stained smear and was cultured aerobically on Nutrient agar, Blood agar and MacConkey agar plates. Antimicrobial sensitivity test was performed by disc diffusion techniques according to CLSI guidelines. Result: In this study out of 75cases, 73% (55/75) were male and 27% (20/75) were females with mean (SD) age of 51.11(±10) years. Out of 75 pus cultures, 63(84%) showed growth of microorganism making total of 81 bacterial isolates with 71.42% of monomicrobial infection and 28.57% of polymicrobial infection. Out of 81 isolates 53(65.43%) were gram negative and 21(25.92%) were gram positive. E.coli was relatively common isolate 21(26%) followed by Staphylococcus aureus 15(18.5%), Klebsiella pneumonia 14(17.28%), Pseudomonas aeruginosa 12 (14.81%), Proteus spp. 3 (3.70%), and Enterococcus faecalis 6 (7.40%). 75% of Gram-negative microorganism were extended Beta-lactamase enzyme (ESBL) producer and around 20 % of Klebsiella and Proteus spp. were carbapenemase enzyme producer. Among Gram positive, around 50% of S.aureus was MRSA, sensitive only to Vancomycin, Teicoplanin & Linezolid. Conclusion: More prevalence of monomicrobial gram-negative bacteria than gram-positive bacteria in DFU was observed. This study emphasizes that Beta-Lactam group of antibiotics should not be the empirical treatment of choice for Gram-negative isolates; instead alternatives like Carbapenems, Amikacin could be a better option. On the other hand, Vancomycin and Linezolid are preferred for most of the infection with gram-positive aerobes. Continuous surveillance of resistant bacteria is required for empiric therapy.

Keywords: antibiotic resistant, antimicrobial susceptibility, diabetic foot ulcer, surveillance

Procedia PDF Downloads 369

Authors: Evangelia-Chrysanthi Kouklari, Evdokia Tagkouli, Vassiliki Ntre, Artemios Pehlivanidis, Stella Tsermentseli, Gerasimos Kolaitis, Katerina Papanikolaou

Abstract:

Executive Function (EF) is a set of goal-directed cognitive skills essentially needed in problem-solving and social behavior. Developmental EF research has indicated that EF emerges early in life and marks dramatic changes before the age of 5. Research evidence has suggested that it may continue to develop up to adolescence as well, following the development of the prefrontal cortex. Over the last decade, research evidence has suggested distinguished domains of cool and hot EF, but traditionally the development of EF in Autism Spectrum Disorder (ASD) has been examined mainly with tasks that address the “cool” cognitive aspects of EF. Thus, very little is known about the development of “hot” affective EF processes and whether the cross-sectional developmental pathways of cool and hot EF present similarities in ASD. Cool EF has also been proven to have a strong correlation with Theory of Mind (ToM) in young and middle childhood in typical development and in ASD, but information about the relationship of hot EF to ToM skills is minimal. The present study’s objective was to explore the age-related changes of cool and hot EF in ASD participants from middle childhood to adolescence, as well as their relationship to ToM. This study employed an approach of cross-sectional developmental trajectories to investigate patterns of cool and hot EF relative to chronological age within ASD. Eighty-two participants between 7 and 16 years of age were recruited to undertake measures that assessed cool EF (working memory, cognitive flexibility, planning & inhibition), hot EF (affective decision making & delay discounting) and ToM (false belief and mental state/emotion recognition). Results demonstrated that trajectories of all cool EF presented age-related changes in ASD (improvements with age). With regards to hot EF, affective decision-making presented age-related changes, but for delay discounting, there were no statistically significant changes found across younger and older ASD participants. ToM was correlated only to cool EF. Theoretical implications are discussed as the investigation of the cross-sectional developmental trajectories of the broader EF (cool and hot domains) may contribute to better defining cognitive phenotypes in ASD. These findings highlight the need to examine developmental trajectories of both hot and cool EF in research and clinical practice as they may aid in enhancing diagnosis or better-informed intervention programs.

Keywords: autism spectrum disorder, developmental trajectories, executive function, theory of mind

Procedia PDF Downloads 148

Authors: Deddi Nordiawan

Abstract:

Effective public policy creation required a strong budget system, both in terms of design and implementation. Performance-based Budget is an evolutionary approach with two substantial characteristics; first, the strong integration between budgeting and planning, and second, its existence as guidance so that all activities and expenditures refer to measurable performance targets. There are four processes in the government that should be followed in order to make the budget become performance-based. These four processes consist of the preparation of a vision according to the bold aspiration, the formulation of outcome, the determination of output based on the analysis of organizational resources, and the formulation of Value Creation Map that contains a series of programs and activities. This is consistent with the concept of logic model which revealed that the budget performance should be placed within a relational framework of resources, activities, outputs, outcomes and impacts. Through the issuance of Law 17/2003 regarding State Finance, local governments in Indonesia have to implement performance-based budget. Central Government then issued Government Regulation 58/2005 which contains the detail guidelines how to prepare local governments budget. After a decade, implementation of performance budgeting in local government is still not fully meet expectations, though the guidance is completed, socialization routinely performed, and trainings have also been carried out at all levels. Accordingly, this study views the practice of performance-based budget at local governments as a problematic situation. This condition must be approached with a system approach that allows the solutions from many point of views. Based on the fact that the infrastructure of budgeting has already settled, the study then considering the situation as complexity. Therefore, the intervention needs to be done in the area of human activity system. Using Soft Systems Methodology, this research will reconstruct the process of performance-based budget at local governments is area of human activity system. Through conceptual models, this study will invite all actors (central government, local government, and the parliament) for dialogue and formulate interventions in human activity systems that systematically desirable and culturally feasible. The result will direct central government in revise the guidance to local government budgeting process as well as a reference to build the capacity building strategy.

Keywords: soft systems methodology, performance-based budgeting, Indonesia, public policy

Procedia PDF Downloads 252

Authors: Ivan M. Taremwa, Scholastic Ashaba, Harriet O. Adrama, Carlrona Ayebazibwe, Daniel Omoding, Imelda Kemeza, Jane Yatuha, Thadeus Turuho, Noni E. MacDonald, Robert Hilliard

Abstract:

Background: The burden of malaria in Uganda remains unacceptably high, especially among children and pregnant women. To prevent malaria related complications, household possession and use of Insecticide Treated mosquito Nets (ITNs) has become a common practice in the country. Despite the availability of ITNs, the number of malaria cases has not gone down. We sought to explore knowledge, attitude, and behaviour towards the use of ITNs as a nightly malaria prevention strategy among pregnant women and children under five years of age in rural southwest Uganda. Materials and Methods: This was a community based, descriptive cross-sectional study, in which households with children under 5 years, and/or pregnant women were enrolled. We used a structured questionnaire to collect data on participants’ understanding of the causes, signs and symptoms of malaria; use of ITNs to prevent malaria; attitudes and behaviours towards the use of ITNs. We also conducted key informant interviews (KIIs) to get in-depth understanding of responses from the participants. We analysed quantitative data using STATA version 12. Qualitative findings from the KIIs were transcribed and translated, and manually analysed using thematic content analysis. Results: Of the 369 households enrolled, 98.6% (N=363) households had children under five. Most participants (41.2%, N=152) were in the 21-30 years of age category (mean age; 32.2). 98.6% (N=362) of the respondents considered ITNs a key malaria prevention strategy. The ITN possession rate was 84.0% (N=310), of these, 67.0% (N=205) consistently used them. 39% of the respondents did not have a positive attitude towards ITNs, as they considered more the perceived effects of ITNs. Conclusions: Although 84.0% of the respondents possessed ITNs, many were not consistently using them. There is need to engage all stakeholders (including cultural leaders, community health workers, religious leaders and the government) in the malaria prevention campaigns using ITNs through: a) government’s concerted effort to ensure universal access of good quality ITNs, b) end-user directed education to correct false beliefs and misinformation, c) telling the ITN success stories to improve on the usage.

Keywords: ITNs use, malaria, pregnant women, rural Uganda

Procedia PDF Downloads 355

Authors: Arunas Burinskas, Aurelija Burinskiene

Abstract:

On average, ten percent of drugs - commercial products are not available in pharmacies due to shortage. The shortage event disbalance sales and requires a recovery period, which is too long. Therefore, one of the critical issues that pharmacies do not record potential sales transactions during shortage and recovery periods. The authors suggest estimating outliers during shortage and recovery periods. To shorten the recovery period, the authors suggest using average sales per sales day prediction, which helps to protect the data from being downwards or upwards. Authors use the outlier’s visualization method across different drugs and apply the Grubbs test for significance evaluation. The researched sample is 100 drugs in a one-month time frame. The authors detected that high demand variability products had outliers. Among analyzed drugs, which are commercial products i) High demand variability drugs have a one-week shortage period, and the probability of facing a shortage is equal to 69.23%. ii) Mid demand variability drugs have three days shortage period, and the likelihood to fall into deficit is equal to 34.62%. To avoid shortage events and minimize the recovery period, real data must be set up. Even though there are some outlier detection methods for drug data cleaning, they have not been used for the minimization of recovery period once a shortage has occurred. The authors use Grubbs’ test real-life data cleaning method for outliers’ adjustment. In the paper, the outliers’ adjustment method is applied with a confidence level of 99%. In practice, the Grubbs’ test was used to detect outliers for cancer drugs and reported positive results. The application of the Grubbs’ test is used to detect outliers which exceed boundaries of normal distribution. The result is a probability that indicates the core data of actual sales. The application of the outliers’ test method helps to represent the difference of the mean of the sample and the most extreme data considering the standard deviation. The test detects one outlier at a time with different probabilities from a data set with an assumed normal distribution. Based on approximation data, the authors constructed a framework for scaling potential sales and estimating outliers with Grubbs’ test method. The suggested framework is applicable during the shortage event and recovery periods. The proposed framework has practical value and could be used for the minimization of the recovery period required after the shortage of event occurrence.

Keywords: drugs, Grubbs' test, outlier, shortage event

Procedia PDF Downloads 134