Search results for: Indigenous methodology
2283 Use of Triclosan-Coated Sutures Led to Cost Saving in Public and Private Setting in India across Five Surgical Categories: An Economical Model Assessment
Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli
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Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures
Procedia PDF Downloads 3982282 Attitude of Staff Nurses on Nursing Research and Its Utilization
Authors: Y. N. Shashidhara, B. S. Shakuntala
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Introduction: Nursing practice is undergoing tremendous changes and challenges. In order to meet social challenges and needs, nursing practice must be research based. Research is needed to evaluate the effectiveness of nursing treatment modalities, to determine the impact of nursing care on the health of the patients or to test the theory of nursing practice. Objective of the study to explore the attitude of staff nurses on Nursing research and its utilization Methodology: The descriptive study design was adopted and 300 staff nurses were selected by systematic random sampling technique from eight hospitals. The attitude on nursing research was assessed by validated and reliable self-administered attitude scale which consists of 40 items. Results: The overall attitude mean score 130.2 (SD 11.5) regarding attitude on Nursing research and its utilization. Some of the findings are the majority of staff nurses (51% agreed and 18.3% strongly agreed) that they have all the motivation to use research findings if they get support. Nearly 25.3 percent of staff nurses agreed and 10.7 percent strongly agreed that they do not have time to conduct research. The majority of staff nurses 53.7 percent agreed that research will help in updating Nursing profession. Nearly 32.6 percent of staff nurses agreed and 20.5 percent strongly agreed that being able to use will make them better nurses. About 45.3 percent and 17.3 percent agreed and strongly agreed that knowledge gained through experience is more useful than research. Most (40%) of nurses agreed that thy do not have the authority to change the patient care practice. The majority of staff nurses (45.7 percent agreed and 13 percent strongly agreed) feel the research will consume their personal time. Majority, 50 percent of staff nurses agreed and 16.7 percent strongly agreed that to conduct and utilize research findings requires financial support. Majority 50 percent of staff nurses agreed and 12 percent strongly agreed that physicians will cooperate and value nursing research findings. Majority 67.3 percent of staff nurses had moderate positive and 32.7 percent of staff nurses had highly positive attitude towards Nursing research and its utilization. Conclusion: With this study we understanding that, the staff nurses have positive attitude regarding nursing research. If the nurses are supported and motivated for research utilization we can improve the patient care.Keywords: nurses, attitude, nursing research, research utilization
Procedia PDF Downloads 2602281 Assessment of Nurse's Knowledge Toward Infection Control for Wound Care in Governmental Hospital at Amran City-Yemen
Authors: Fares Mahdi
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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals
Procedia PDF Downloads 952280 Changing Dynamics of Women Entrepreneurship: A Literature Review of a Decade
Authors: Viral Nagori, Preeti Shroff, Prathana Dodia
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The paper presents the study on women entrepreneurship over the last decade in Indian and Global Context. This research study has its basis primarily in the literature review. The research methodology classifies the literature review paper based on different parameters of women entrepreneurship. The literature review relies on research papers in journals, articles in periodicals, and books published on women entrepreneurship. To accomplish this, the criteria included finding the most relevant, recent, and cited studies on women entrepreneurship over the last decade. It aims to evaluate the issues and challenges faced by women entrepreneurs. The finding suggested that there are several common obstacles, which hinders the pathway to success towards being a successful woman entrepreneur. The paper also describes such common obstacles like the level of education, family responsibilities, lack of business information, religious and cultural constraints, limited mobility, exposure, lack of working capital, and more. The in-depth analysis of literature review indicates that despite the numerous barriers, the arrival of social media has played a crucial role in enabling women to start and scale up their enterprises. Further, technology innovation has given them access to have relevant market information, increase reach and network with the customers. It enabled them to achieve work life balance and pursuing entrepreneur in them. The paper also describes the Government and Nongovernmental initiatives for promotion of women entrepreneurship. At the end, the study provides insights into the changing dynamics of women entrepreneurship in the current scenario and future prospects.Keywords: changing dynamics, government initiatives, literature review, social media, technology innovation, women entrepreneurship
Procedia PDF Downloads 1562279 African Women in Power: An Analysis of the Representation of Nigerian Business Women in Television
Authors: Ifeanyichukwu Valerie Oguafor
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Women generally have been categorized and placed under the chain of business industry, sometimes highly regarded and other times merely. The social construction of womanhood does not in all sense support a woman going into business, let alone succeed in it because it is believed that it a man’s world. In a typical patriarchal setting, a woman is expected to know nothing more domestic roles. For some women, this is not the case as they have been able to break these barriers to excel in business amidst these social setting and stereotypes. This study examines media representation of Nigerians business women, using content analysis of TV interviews as media text, framing analysis as an approach in qualitative methodology, The study further aims to analyse media frames of two Nigerian business women: FolorunshoAlakija, a business woman in the petroleum industry with current net worth 1.1 billion U.S dollars, emerging as the richest black women in the world 2014. MosunmolaAbudu, a media magnate in Nigeria who launched the first Africa’s global black entertainment and lifestyle network in 2013. This study used six predefined frames: the business woman, the myth of business women, the non-traditional woman, women in leading roles, the family woman, the religious woman, and the philanthropist woman to analyse the representation of Nigerian business women in the media. The analysis of the aforementioned frames on TV interviews with these women reveals that the media perpetually reproduces existing gender stereotype and do not challenge patriarchy. Women face challenges in trying to succeed in business while trying to keep their homes stable. This study concludes that the media represent and reproduce gender stereotypes in spite of the expectation of empowering women. The media reduces these women’s success insignificant rather than a role model for women in society.Keywords: representation of business women in the media, business women in Nigeria, framing in the media, patriarchy, women's subordination
Procedia PDF Downloads 1612278 Development of a Geomechanical Risk Assessment Model for Underground Openings
Authors: Ali Mortazavi
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The main objective of this research project is to delve into a multitude of geomechanical risks associated with various mining methods employed within the underground mining industry. Controlling geotechnical design parameters and operational factors affecting the selection of suitable mining techniques for a given underground mining condition will be considered from a risk assessment point of view. Important geomechanical challenges will be investigated as appropriate and relevant to the commonly used underground mining methods. Given the complicated nature of rock mass in-situ and complicated boundary conditions and operational complexities associated with various underground mining methods, the selection of a safe and economic mining operation is of paramount significance. Rock failure at varying scales within the underground mining openings is always a threat to mining operations and causes human and capital losses worldwide. Geotechnical design is a major design component of all underground mines and basically dominates the safety of an underground mine. With regard to uncertainties that exist in rock characterization prior to mine development, there are always risks associated with inappropriate design as a function of mining conditions and the selected mining method. Uncertainty often results from the inherent variability of rock masse, which in turn is a function of both geological materials and rock mass in-situ conditions. The focus of this research is on developing a methodology which enables a geomechanical risk assessment of given underground mining conditions. The outcome of this research is a geotechnical risk analysis algorithm, which can be used as an aid in selecting the appropriate mining method as a function of mine design parameters (e.g., rock in-situ properties, design method, governing boundary conditions such as in-situ stress and groundwater, etc.).Keywords: geomechanical risk assessment, rock mechanics, underground mining, rock engineering
Procedia PDF Downloads 1452277 The Optimization of the Parameters for Eco-Friendly Leaching of Precious Metals from Waste Catalyst
Authors: Silindile Gumede, Amir Hossein Mohammadi, Mbuyu Germain Ntunka
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Goal 12 of the 17 Sustainable Development Goals (SDGs) encourages sustainable consumption and production patterns. This necessitates achieving the environmentally safe management of chemicals and all wastes throughout their life cycle and the proper disposal of pollutants and toxic waste. Fluid catalytic cracking (FCC) catalysts are widely used in the refinery to convert heavy feedstocks to lighter ones. During the refining processes, the catalysts are deactivated and discarded as hazardous toxic solid waste. Spent catalysts (SC) contain high-cost metal, and the recovery of metals from SCs is a tactical plan for supplying part of the demand for these substances and minimizing the environmental impacts. Leaching followed by solvent extraction, has been found to be the most efficient method to recover valuable metals with high purity from spent catalysts. However, the use of inorganic acids during the leaching process causes a secondary environmental issue. Therefore, it is necessary to explore other alternative efficient leaching agents that are economical and environmentally friendly. In this study, the waste catalyst was collected from a domestic refinery and was characterised using XRD, ICP, XRF, and SEM. Response surface methodology (RSM) and Box Behnken design were used to model and optimize the influence of some parameters affecting the acidic leaching process. The parameters selected in this investigation were the acid concentration, temperature, and leaching time. From the characterisation results, it was found that the spent catalyst consists of high concentrations of Vanadium (V) and Nickel (Ni); hence this study focuses on the leaching of Ni and V using a biodegradable acid to eliminate the formation of the secondary pollution.Keywords: eco-friendly leaching, optimization, metal recovery, leaching
Procedia PDF Downloads 682276 Mutual Fund Anchoring Bias with its Parent Firm Performance: Evidence from Mutual Fund Industry of Pakistan
Authors: Muhammad Tahir
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Purpose The purpose of the study is to find anchoring bias behavior in mutual fund return with its parent firm performance in Pakistan. Research Methodology The paper used monthly returns of equity funds whose parent firm exist from 2011 to 2021, along with parent firm return. Proximity to 52-week highest return calculated by dividing fund return by parent firm 52-week highest return. Control variables are also taken and used pannel regression model to estimate our results. For robust results, we also used feasible generalize least square (FGLS) model. Findings The results showed that there exist anchoring biased in mutual fund return with its parent firm performance. The FGLS results reaffirms the same results as obtained from panner regression results. Proximity to 52-week highest Xc is significant in both models. Research Implication Since most of mutual funds has a parent firm, anchoring behavior biased found in mutual fund with its parent firm performance. Practical Implication Mutual fund investors in Pakistan invest in equity funds in which behavioral bias exist, although there might be better opportunity in market. Originality/Value Addition Our research is a pioneer study to investigate anchoring bias in mutual fund return with its parent firm performance. Research limitations Our sample is limited to only 23 equity funds, which has a parent firm and data was available from 2011 to 2021.Keywords: mutual fund, anchoring bias, 52-week high return, proximity to 52-week high, parent firm performance, pannel regression, FGLS
Procedia PDF Downloads 1192275 Awareness of Drug Interactions among Physicians at Governmental Health Centers in Bahrain
Authors: Yasin I. Tayem, Jamil Ahmed, Mahmood Bahzad, Abdullah Alnama, Fahad Al Asfoor, Mahmood A. Jalil, Mohammed Radhi, Ahmed Alenezi, Khalid A. J. Al-Khaja
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Drug-drug interactions (DDIs) represent a significant cause of patient’s morbidity and mortality. The rate of DDIs is rapidly increasing worldwide with the increasing proportion of ageing population and frequent requirement of polypharmacy-prescription of multiple drugs to treat comorbidities. Prescribing physicians are responsible for checking their prescriptions for the presence and severity of DDIs. However, since a large number of new drugs are approved and marketed every year, new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely only upon their previous knowledge of medicine to avoid potential DDIs. The aim of this study was to explore the perceptions of physicians working at primary healthcare centers in Bahrain towards DDIs and how they manage them during their practice. Methodology: In this cross-sectional study, physicians working at all governmental primary healthcare centers in Bahrain were invited to voluntarily, privately and anonymously respond to a self-administered questionnaire. The questionnaire aims to assess their self-reported knowledge of DDIs and how they check for them in their practice. The participants were requested to provide socio demographic data and information related to their attitudes towards DDIs including strategies they employ for detecting and managing them, and their awareness of drugs which commonly cause DDIs. At the end of the questionnaire, an open-ended item was added to allow participants to further add any comment. Findings and Conclusions: The study is going on currently, and the results and conclusions will be presented at the conference.Keywords: awareness, drug interactions, health centres, physicians
Procedia PDF Downloads 2442274 Benefits of PRP in Third Molar Surgery - A Review of the Literature
Authors: Nitesh Kumar, Adel Elrasheed, Antonio Gagliardilugo
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Introduction and aims: PRP has been increasing in popularity over the past decade. It is used in many facets of medicine and dentistry such as osteoarthritis, hair loss, skin rejunavation, healing of tendons after injury. Due to the increasing popularity of PRP in third molar surgery in dentistry, this study aims to identify the role of platelet rich plasma and its function in third molar surgery. Methodology: Three databases were chosen to source the articles for review: pubmed, science direct, and Cochrane. The keywords “platelet rich plasma”, “third molar extraction” and “wisdom tooth extraction” and literature review were used to search for relevant articles. Articles that were not in English were omitted and only systematic reviews relevant to the study were collected. All systematic reviews abstracts pertinent to the study were read by two reviewers to avoid bias. Results/statistics: 20 review articles were obtained of which 13 fulfilled the criteria. The Amstar tool validified the strength of these review articles. There is strong evidence in the literature that PRP in third molar surgery decreases post op pain, swelling and recovery time. 20 review articles were obtained of which 13 fulfilled the criteria. The Amstar tool validified the strength of these review articles. There is strong evidence in the literature that PRP in third molar surgery decreases post op pain, swelling and recovery time. Conclusions/clinical relevance: Platelet rich plasma plays a crucial role in patient recovery following the extraction of third molars and should be considered and offered as a routine part of third molar therapy.Keywords: PRP, third molar, extractions, wisdom teeth
Procedia PDF Downloads 622273 Ultrasound-Assisted Extraction of Bioactive Compounds from Cocoa Shell and Their Encapsulation in Gum Arabic and Maltodextrin: A Technology to Produce Functional Food Ingredients
Authors: Saeid Jafari, Khursheed Ahmad Sheikh, Randy W. Worobo, Kitipong Assatarakul
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In this study, the extraction of cocoa shell powder (CSP) was optimized, and the optimized extracts were spray-dried for encapsulation purposes. Temperature (45-65 ◦C), extraction time (30–60 min), and ethanol concentration (60–100%) were the extraction parameters. The response surface methodology analysis revealed that the model was significant (p ≤ 0.05) in interactions between all variables (total phenolic compound, total flavonoid content, and antioxidant activity as measured by 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP assays), with a lack of fit test for the model being insignificant (p > 0.05). Temperature (55 ◦C), time (45 min), and ethanol concentration (60%) were found to be the optimal extraction conditions. For spray-drying encapsulation, some quality metrics (e.g., water solubility, water activity) were insignificant (p > 0.05). The microcapsules were found to be spherical in shape using a scanning electron microscope. Thermogravimetric and differential thermogravimetric measurements of the microcapsules revealed nearly identical results. The gum arabic + maltodextrin microcapsule (GMM) showed potential antibacterial (zone of inhibition: 11.50 mm; lower minimum inhibitory concentration: 1.50 mg/mL) and antioxidant (DPPH: 1063 mM trolox/100g dry wt.) activities (p ≤ 0.05). In conclusion, the microcapsules in this study, particularly GMM, are promising antioxidant and antibacterial agents to be fortified as functional food ingredients for the production of nutraceutical foods with health-promoting properties.Keywords: functional foods, coco shell powder, antioxidant activity, encapsulation, extraction
Procedia PDF Downloads 572272 Experimental Investigation of Mechanical Friction Influence in Semi-Hydraulic Clutch Actuation System Over Mileage
Authors: Abdul Azarrudin M. A., Pothiraj K., Kandasamy Satish
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In the current automobile scenario, there comes a demand on more sophistication and comfort drive feel on passenger segments. The clutch pedal effort is one such customer touch feels in manual transmission vehicles, where the driver continuous to operate the clutch pedal in his entire the driving maneuvers. Hence optimum pedal efforts at green condition and over mileage to be ensured for fatigue free the driving. As friction is one the predominant factor and its tendency to challenge the technicality by causing the function degradation. One such semi-hydraulic systems shows load efficiency of about 70-75% over lifetime only due to the increase in friction which leads to the increase in pedal effort and cause fatigue to the vehicle driver. This work deals with the study of friction with different interfaces and its influence in the fulcrum points over mileage, with the objective of understanding the trend over mileage and determining the alternative ways of resolving it. In that one way of methodology is the reduction of friction by experimental investigation of various friction reduction interfaces like metal-to-metal interface and it has been tried out and is detailed further. Also, the specific attention has been put up considering the fulcrum load and its contact interfaces to move on with this study. The main results of the experimental data with the influence of three different contact interfaces are being presented with an ultimate intention of ending up into less fatigue with longer consistent pedal effort, thus smoothens the operation of the end user. The Experimental validation also has been done through rig-level test setup to depict the performance at static condition and in-parallel vehicle level test has also been performed to record the additional influences if any.Keywords: automobile, clutch, friction, fork
Procedia PDF Downloads 1242271 Restructuring and Revitalising School Leadership Philosophy in Nepal: Embracing Contextual and Equitable Approaches
Authors: Shankar Dhakal, Andrew Jones, Geoffrey W. Lummis
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The Federal Democratic Republic of Nepal is a linguistically, culturally, and ethnically diverse country with approximately 123 different spoken languages that represent several ethnic, cultural, and religious groups of people. With a population of about 30 million, long-standing disparities and inequalities in access and achievement in education have constantly been challenging to provide equitable educational opportunities for all students. While the new constitution of federal Nepal (2015) stipulates that all schools serve the interests of diverse communities, leadership practices have failed to adopt local contextual sensitivities, leading to traditional, authoritarian approaches and entrenched inequalities. However, little is known about how Nepali secondary school principals can adapt and implement context-responsive and equitable strategies to ensure equity and inclusiveness in its enormously diverse socio-cultural contexts. To fill this gap, this study explores how educational leadership approaches and philosophies are transformed using a multi-case automated/ethnographic research methodology underpinned by the paradigm of critical constructivism. This paper reconstructs to see if school leadership in Nepal can produce more equitable and contextual outcomes. The results of this study highlight the need for a paradigm shift and the adoption of innovative leadership approaches that foster humility, empathy, and compassion in school leaders to achieve better school outcomes. This research provides valuable insights into existing literary gaps and provides guidance for future school leadership policies and practices at the personal, cultural, and political levels.Keywords: school leadership, auto/ethnography, equitable and context-responsive leadership, Nepal
Procedia PDF Downloads 742270 ILearn, a Pathway to Progress
Authors: Reni Francis
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Learning has transcended the classroom boundaries to create a learner centric, interactive, and integrative teaching learning environment. This study analysed the impact of iLearn on the teaching, learning, and evaluation among 100 teacher trainees. The objectives were to cater to the different learning styles of the teacher trainees, to incorporate innovative teaching learning activities, to assist in peer tutoring, to implement different evaluation processes. i: Identifying the learning styles among the teacher trainees through VARK Learning style checklist was followed by planning the teaching-learning process to meet the learning styles of the teacher trainees. L: Leveraging innovations in teaching- learning by planning and creating modules incorporating innovative teaching learning and hence the concept based year plan was prepared. E: Engage learning through constructivism using different teaching methodology to engage the teacher trainees in the learning process through Workshop, Round Robin, Gallery walk, Co-Operative learning, Think-Pair-Share, EDMODO, Course Networking, Concept Map, Brainstorming Sessions, Video Clippings. A: Assessing the learning through an Open Book assignment, Closed book assignment, and Multiple Choice Questions and Seminar presentation. R: Remediation through peer tutoring through Mentor-mentee approach in the tutorial groups, Group work, Library Hours. N: Norming new standards. This was done in the form of extended remediation and tutorials to understand the need of the teacher trainee and support them for further achievements in learning through Face to face interaction, Supervised Study Circle, Mobile (Device) learning. The findings of the study revealed the positive impact of iLearn towards student achievement and enhanced social skills.Keywords: academic achievement, innovative strategy, learning styles, social skills
Procedia PDF Downloads 3562269 Aeronautical Noise Management inside an Aerodrome: Analysis of Sound Exposure on Aviation Professional’s Health
Authors: Rafael Felipe Guatura da Silva, José Luis Gomes da Silva, Luiz Antonio, Ferreira Perrone de Brito
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Noise can cause serious damage to human health, such as hearing loss, stress, irritability, fatigue, and others. Aviation is a place where your entire process should be work out with the utmost attention and commitment of human resources, thus the need to study the effects of noise in this sector, as aeronautical noise levels are high. This study aimed to evaluate the impact of noise pollution on the performance of professionals regarding the fatigue generated by aeronautical noise and time to noise exposure. The methodology used consists of measurements of sound pressure levels at 42 points of the aerodrome. The selected points are located inside the hangars and outside the airfield hangars. All points chosen are close to the professionals' work areas, seeking to identify the sound pressure levels to which they submitted. The other part of the research used the principle on the application of a self-report questionnaire to a sample of 207 people working inside the aerodrome. The 207 professionals surveyed consist of aircraft mechanics, pilots, maintenance managers, and administrative professionals. The questionnaire was intended to evaluate the knowledge that professionals have about health risks caused by sound exposure as well as to identify diseases that professionals have, and that may be associated with exposure to high levels of sound pressure. Preliminary results identify points with sound pressure levels of up to 91.7 dB, thus highlighting the need for the use of personal protective equipment that reduces noise exposure. It was also identified a large number of professionals who are bothered by the sound exposure and approximately 25% of professionals interviewed reported having a hearing disorder.Keywords: aeronautical noise, fatigue, noise and health, noise management
Procedia PDF Downloads 1472268 Shared Decision-Making in Holistic Healthcare: Integrating Evidence-Based Medicine and Values-Based Medicine
Authors: Ling-Lang Huang
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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare
Procedia PDF Downloads 522267 Quality of Care of Medical Male Circumcisions: A Non-Negotiable for Right to Care
Authors: Nelson Igaba, C. Onaga, S. Hlongwane
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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement
Procedia PDF Downloads 1762266 Credible Autopsy Report for Investigators and Judiciary
Authors: Sudhir K. Gupta
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Introduction: When a forensic doctor determines that a suspicious death is a suicide, homicide, or accident, the decision virtually becomes incontestable by the investigating police officer, and it becomes an issue whether the medical opinion was created with necessary checks and balances on the other probabilities of the case. It is suggested that the opinion of Forensic Medical experts is conventional, mutable, and shifting from one expert to another. The determination of suicide, accident, or homicide is mandatorily required, which is the Gold Standard for conducting death investigations. Forensic investigations serve many audiences, but the court is by far the most critical. The likely questions on direct and cross-examination determine how forensic doctors gather and handle evidence and what conclusions they reach. Methodology: The author interacted with the investigative authority, and a crime scene visit was also done along with the perusal of the Postmortem report, subsequent opinion, and crime scene photographs and statements of the witness and accused. Further analysis of all relevant scientific documents and opinions of other forensic doctors, forensic scientists, and ballistic experts involved in these cases was done to arrive at an opinion with scientific justification. Findings: The opinions arrived at by the author and how they helped the judiciary in delivering justice in these cases have been discussed in this article. This can help the readers to understand the process involved in formulating a credible forensic medical expert opinion for investigators and the judiciary. Conclusion: A criminal case might be won or lost over doubt cast on the chain of custody. Medically trained forensic doctors, therefore, learn to practice their profession in legally appropriate ways, and opinions must be based on medical justifications with credible references.Keywords: forensic doctor, professional credibility, investigation, expert opinion
Procedia PDF Downloads 762265 Recognition of Arrest Patients and Application of Basic Life Support by Bystanders in the Field
Authors: Behcet Al, Mehmet Murat Oktay, Suat Zengin, Mustafa Sabak, Cuma Yildirim
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Objective: Th Recognition of arrest patients and application of basic life support (BLS) by bystanders in the field and the activation of emergency serves were evaluated in present study. Methodology: The present study was carried out by Emergency Department of Medicine Faculty of Gaziantep University at 33 of Emergency Health center in Gaziantep between December 2012- April 2014 prospectively. Of 539 arrested patients, 171 patients were included in study. Results: 118 (69%) male, and 53 31(%) female with a totlay of 171 patients were included in this study. Of patients, 32.2% had syncope and 24% had shorth breathing just befor being arrested. The majority of arrest cases had occured at home (61.4%) and rural area (11.7%) respectively. Of asking help, %48.5 were constructed by family members. Of announcement, only 15.2% occured within first minute of arrest. The BLS ratio that was applied by bystanders was 22.2%. Of bystanders, 47.4% had a course experience of BLS. The emergency serve had reached to the field with a mean of 8.43 min. Of cases, 55% (n=94) were evaluated as exitus firstly bu emergency staff. The most noticed rythim was asystol (73.1%). BLS and advanced life support (ALS) were applied to 98.8% and 60% respectively at the field. 10.5% (n=18) of cases were defibrilated, and 45 (26.3%) were intubated endotrecealy. The majority (48.5%) of staff who applied BLS and ALS at the fied were emergency medicine technicians. CPR was performed to 86.5% (n=148) cases in ambulance while they were transported. The mean arrival time to mergency department was 9.13 min. When the patients arrived to ED 15.2% needed defirlitation. 91.2% (n =156) of patients resulted in exitus in ED. 15 (8.8%) patients were discharged (9 with recovery, six patients with damage). Conclusion: The ratio of inntervention for arrest patients by bystanders is still low. To optain a high percentage of survival, BLS training should be widened among the puplic especiallyamong the caregivers.Keywords: arrest patients, cardiopulmonary resuscitation, bystanders, chest compressions, prehospital
Procedia PDF Downloads 3892264 Exploring the Safety of Sodium Glucose Co-Transporter-2 Inhibitors at the Imperial College London Diabetes Centre, UAE
Authors: Raad Nari, Maura Moriaty, Maha T. Barakat
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Introduction: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs with a unique mechanism of action. They are used to improve glycaemic control in adults with type 2 diabetes by enhancing urinary glucose excretion. In the UAE, there has been certainly an increased use of these medications. As with any new medication, there are safety considerations related to their use in patients with type two diabetes. A retrospective study was conducted at the three main centres of the Imperial College London Diabetes Centre. Methodology: All patients in electronic database (Diamond) from October 2014 to October 2017 were included with a minimum of six months usage of sodium glucose co-transporter inhibitors that comprise canagliflozin, dapagliflozin and empagliflozin. There were 15 paired sample biochemical and clinical correlations. The analysis was done at the start of the study, three months and six months apart. SPSS version 24 was used for this study. Conclusion: This study of sodium glucose co-transporter-2 inhibitors used showed significant reductions in weight, glycated haemoglobin A1C, systolic and diastolic blood pressures. As the case with systematic reviews, there were similar changes in liver enzymes, raised total cholesterol, low density lipopoptein and high density lipoprotein. There was slight improvement in estimated glomerular filtration rate too. Our analysis also showed that they increased in the incidence of urinary tract symptoms and incidence of urinary tract infections.Keywords: SGLT2 inhibitors dapagliflozin empagliflozin canagliflozin, adverse effects, amputation diabetic ketoacidosis DKA, urinary tract infection
Procedia PDF Downloads 2292263 Numerical Simulations of Acoustic Imaging in Hydrodynamic Tunnel with Model Adaptation and Boundary Layer Noise Reduction
Authors: Sylvain Amailland, Jean-Hugh Thomas, Charles Pézerat, Romuald Boucheron, Jean-Claude Pascal
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The noise requirements for naval and research vessels have seen an increasing demand for quieter ships in order to fulfil current regulations and to reduce the effects on marine life. Hence, new methods dedicated to the characterization of propeller noise, which is the main source of noise in the far-field, are needed. The study of cavitating propellers in closed-section is interesting for analyzing hydrodynamic performance but could involve significant difficulties for hydroacoustic study, especially due to reverberation and boundary layer noise in the tunnel. The aim of this paper is to present a numerical methodology for the identification of hydroacoustic sources on marine propellers using hydrophone arrays in a large hydrodynamic tunnel. The main difficulties are linked to the reverberation of the tunnel and the boundary layer noise that strongly reduce the signal-to-noise ratio. In this paper it is proposed to estimate the reflection coefficients using an inverse method and some reference transfer functions measured in the tunnel. This approach allows to reduce the uncertainties of the propagation model used in the inverse problem. In order to reduce the boundary layer noise, a cleaning algorithm taking advantage of the low rank and sparse structure of the cross-spectrum matrices of the acoustic and the boundary layer noise is presented. This approach allows to recover the acoustic signal even well under the boundary layer noise. The improvement brought by this method is visible on acoustic maps resulting from beamforming and DAMAS algorithms.Keywords: acoustic imaging, boundary layer noise denoising, inverse problems, model adaptation
Procedia PDF Downloads 3352262 Nutritional Wellness at the Workplace
Authors: Siveshnee Devar
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Background: The rate of absenteeism and prevalence of NCDs in South Africa is extremely high. This is consistent with other educational institutions and workplaces around the globe. In most cases the absence of health and the presence of one or more non communicable diseases coupled with the lack of physical exercise is a major factor in absenteeism. Absenteeism at the workplace comes at a huge cost to the employer and the country as a whole. Aim: Findings from this study was to develop a suitable nutritional wellness program for the workplace. Methodology: A needs analysis in the form of 24-hour recall, food frequency, health and socio demographic questionnaires was undertaken to determine the need for a wellness program for the institution. Anthropometric indices such as BMI, waist circumference and blood pressure were also undertaken to determine the state of health of the staff. Results: This study has found that obesity, central obesity, hypertension as well as deficiencies in nutrients and minerals were prevalent in this group. Fruit and vegetable consumption was also below the WHO recommendation. This study showed a link between diet, physical activity and diseases of lifestyle. There were positive correlations between age and systolic blood pressure, waist circumference and systolic blood pressure, waist circumference and diastolic blood pressure and waist-to-height ratio and BMI. Conclusion: The results indicated the need for immediate intervention in the form of a wellness program. Nutrition education is important for both the workplace and out. Education and knowledge are important factors for lifestyle changes. The proposed intervention is aimed at improving presenteeism and decreasing the incidence of non- communicable diseases. Presenteeism and good health are important factors for quality education at all educational institutions.Keywords: absenteeism, non-communicable diseases, nutrition, wellness
Procedia PDF Downloads 5772261 Exploring the Potential of Phase Change Materials in Construction Environments
Authors: A. Ait Ahsene F., B. Boughrara S.
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The buildings sector accounts for a significant portion of global energy consumption, with much of this energy used to heat and cool indoor spaces. In this context, the integration of innovative technologies such as phase change materials (PCM) holds promising potential to improve the energy efficiency and thermal comfort of buildings. This research topic explores the benefits and challenges associated with the use of PCMs in buildings, focusing on their ability to store and release thermal energy to regulate indoor temperature. We investigated the different types of PCM available, their thermal properties, and their potential applications in various climate zones and building types. To evaluate and compare the performance of PCMs, our methodology includes a series of laboratory and field experiments. In the laboratory, we measure the thermal storage capacity, melting and solidification temperatures, latent heat, and thermal conductivity of various PCMs. These measurements make it possible to quantify the capacity of each PCM to store and release thermal energy, as well as its capacity to transfer this energy through the construction materials. Additionally, field studies are conducted to evaluate the performance of PCMs in real-world environments. We install PCM systems in real buildings and monitor their operation over time, measuring energy savings, occupant thermal comfort, and material durability. These empirical data allow us to compare the effectiveness of different types of PCMs under real-world use conditions. By combining the results of laboratory and field experiments, we provide a comprehensive analysis of the advantages and limitations of PCMs in buildings, as well as recommendations for their effective application in practice.Keywords: energy saving, phase change materials, material sustainability, buildings sector
Procedia PDF Downloads 412260 The Utilization of Tea Extract within the Realm of the Food Industry
Authors: Raana Babadi Fathipour
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Tea, a beverage widely cherished across the globe, has captured the interest of scholars with its recent acknowledgement for possessing noteworthy health advantages. Of particular significance is its proven ability to ward off ailments such as cancer and cardiovascular afflictions. Moreover, within the realm of culinary creations, lipid oxidation poses a significant challenge for food product development. In light of these aforementioned concerns, this present discourse turns its attention towards exploring diverse methodologies employed in extracting polyphenols from various types of tea leaves and examining their utility within the vast landscape of the ever-evolving food industry. Based on the discoveries unearthed in this comprehensive investigation, it has been determined that the fundamental constituents of tea are polyphenols possessed of intrinsic health-enhancing properties. This includes an assortment of catechins, namely epicatechin, epigallocatechin, epicatechin gallate, and epigallocatechin gallate. Moreover, gallic acid, flavonoids, flavonols and theaphlavins have also been detected within this aromatic beverage. Of these myriad components examined vigorously in this study's analysis, catechin emerges as particularly beneficial. Multiple techniques have emerged over time to successfully extract key compounds from tea plants, including solvent-based extraction methodologies, microwave-assisted water extraction approaches and ultrasound-assisted extraction techniques. In particular, consideration is given to microwave-assisted water extraction method as a viable scheme which effectively procures valuable polyphenols from tea extracts. This methodology appears adaptable for implementation within sectors such as dairy production along with meat and oil industries alike.Keywords: camellia sinensis, extraction, food application, shelf life, tea
Procedia PDF Downloads 702259 Sharing Tacit Knowledge: The Essence of Knowledge Management
Authors: Ayesha Khatun
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In 21st century where markets are unstable, technologies rapidly proliferate, competitors multiply, products and services become obsolete almost overnight and customers demand low cost high value product, leveraging and harnessing knowledge is not just a potential source of competitive advantage rather a necessity in technology based and information intensive industries. Knowledge management focuses on leveraging the available knowledge and sharing the same among the individuals in the organization so that the employees can make best use of it towards achieving the organizational goals. Knowledge is not a discrete object. It is embedded in people and so difficult to transfer outside the immediate context that it becomes a major competitive advantage. However, internal transfer of knowledge among the employees is essential to maximize the use of knowledge available in the organization in an unstructured manner. But as knowledge is the source of competitive advantage for the organization it is also the source of competitive advantage for the individuals. People think that knowledge is power and sharing the same may lead to lose the competitive position. Moreover, the very nature of tacit knowledge poses many difficulties in sharing the same. But sharing tacit knowledge is the vital part of knowledge management process because it is the tacit knowledge which is inimitable. Knowledge management has been made synonymous with the use of software and technology leading to the management of explicit knowledge only ignoring personal interaction and forming of informal networks which are considered as the most successful means of sharing tacit knowledge. Factors responsible for effective sharing of tacit knowledge are grouped into –individual, organizational and technological factors. Different factors under each category have been identified. Creating a positive organizational culture, encouraging personal interaction, practicing reward system are some of the strategies that can help to overcome many of the barriers to effective sharing of tacit knowledge. Methodology applied here is completely secondary. Extensive review of relevant literature has been undertaken for the purpose.Keywords: knowledge, tacit knowledge, knowledge management, sustainable competitive advantage, organization, knowledge sharing
Procedia PDF Downloads 3982258 Beneficiation of Pulp and Paper Mill Sludge for the Generation of Single Cell Protein for Fish Farming
Authors: Lucretia Ramnath
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Fishmeal is extensively used for fish farming but is an expensive fish feed ingredient. A cheaper alternate to fishmeal is single cell protein (SCP) which can be cultivated on fermentable sugars recovered from organic waste streams such as pulp and paper mill sludge (PPMS). PPMS has a high cellulose content, thus is suitable for glucose recovery through enzymatic hydrolysis but is hampered by lignin and ash. To render PPMS amenable for enzymatic hydrolysis, the PPMS waspre-treated to produce a glucose-rich hydrolysate which served as a feed stock for the production of fungal SCP. The PPMS used in this study had the following composition: 72.77% carbohydrates, 8.6% lignin, and 18.63% ash. The pre-treatments had no significant effect on lignin composition but had a substantial effect on carbohydrate and ash content. Enzymatic hydrolysis of screened PPMS was previously optimized through response surface methodology (RSM) and 2-factorial design. The optimized protocol resulted in a hydrolysate containing 46.1 g/L of glucose, of which 86% was recovered after downstream processing by passing through a 100-mesh sieve (38 µm pore size). Vogel’s medium supplemented with 10 g/L hydrolysate successfully supported the growth of Fusarium venenatum, conducted using standard growth conditions; pH 6, 200 rpm, 2.88 g/L ammonium phosphate, 25°C. A maximum F. venenatum biomass of 45 g/L was produced with a yield coefficient of 4.67. Pulp and paper mill sludge hydrolysate contained approximately five times more glucose than what was needed for SCP production and served as a suitable carbon source. We have shown that PPMS can be successfully beneficiated for SCP production.Keywords: pulp and paper waste, fungi, single cell protein, hydrolysate
Procedia PDF Downloads 2072257 Technical Non-Destructive Evaluation of Burnt Bridge at CH. 57+450 Along Abuja-Abaji-Lokoja Road, Nigeria
Authors: Abraham O. Olaniyi, Oluyemi Oke, Atilade Otunla
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The structural performance of bridges decreases progressively throughout their service life due to many contributing factors (fatigue, carbonation, fire incidents etc.). Around the world, numerous bridges have attained their estimated service life and many have approached this limit. The structural integrity assessment of the burnt composite bridge located at CH57+450, Koita village along Abuja-Abaji-Lokoja road, Nigeria, is presented as a case study and shall be forthwith referred to as the 'Koita bridge' in this paper. From the technical evaluation, the residual compressive strength of the concrete piers was found to be below 16.0 N/mm2. This value is very low compared to the expected design value of 30.0 N/mm2. The pier capping beam at pier location 1 has a very low residual compressive strength. The cover to the reinforcement of certain capping beams has an outline of reinforcement which signifies poor concrete cover and the mean compressive strength is also less than 20.0 N/mm2. The steel girder indicated black colouration as a result of the fire incident without any significant structural defect like buckling or warping of the steel section. This paper reviews the structural integrity assessment and repair methodology of the Koita bridge; a composite bridge damaged by fire, highlighting the various challenges of limited obtainable guidance documents about the bridge. The objectives are to increase the understanding of processes and versatile equipment required to test and assess a fire-damaged bridge in order to improve the quality of structural appraisal and rehabilitation; thus, eliminating the prejudice associated with current visual inspection techniques.Keywords: assessment, bridge, rehabilitation, sustainability
Procedia PDF Downloads 3662256 Applied Spatial Mapping and Monitoring of Illegal Landfills for Deprived Urban Areas in Romania
Authors: Șercăianu Mihai, Aldea Mihaela, Iacoboaea Cristina, Luca Oana, Nenciu Ioana
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The rise and mitigation of unauthorized illegal waste dumps are a significant global issue within waste management ecosystems, impacting disadvantaged communities. Globally, including in Romania, many individuals live in houses without legal recognition, lacking ownership or construction permits, in areas known as "informal settlements." An increasing number of regions and cities in Romania are struggling to manage their illegal waste dumps, especially in the context of increasing poverty and lack of regulation related to informal settlements. One such informal settlement is located at the end of Bistra Street in Câlnic, within the Reșița Municipality of Caras Severin County. The article presents a case study that focuses on employing remote sensing techniques and spatial data to monitor and map illegal waste practices, with subsequent integration into a geographic information system tailored for the Reșița community. In addition, the paper outlines the steps involved in devising strategies aimed at enhancing waste management practices in disadvantaged areas, aligning with the shift toward a circular economy. Results presented in the paper contain a spatial mapping and visualization methodology calibrated with in situ data collection applicable for identifying illegal landfills. The emergence and neutralization of illegal dumps pose a challenge in the field of waste management. These approaches, which prove effective where conventional solutions have failed, need to be replicated and adopted more wisely.Keywords: informal settlements, GIS, waste dumps, waste management, monitoring
Procedia PDF Downloads 872255 Causes for the Precession of the Perihelion in the Planetary Orbits
Authors: Kwan U. Kim, Jin Sim, Ryong Jin Jang, Sung Duk Kim
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It is Leverrier that discovered the precession of the perihelion in the planetary orbits for the first time in the world, while it is Einstein that explained the astronomical phenomenom for the first time in the world. The amount of the precession of the perihelion for Einstein’s theory of gravitation has been explained by means of the inverse fourth power force(inverse third power potential) introduced totheory of gravitation through Schwarzschild metric However, the methodology has a serious shortcoming that it is impossible to explain the cause for the precession of the perihelion in the planetary orbits. According to our study, without taking the cause for the precession of the perihelion, 6 methods can explain the amount of the precession of the perihelion discovered by Leverrier. Therefore, the problem of what caused the perihelion to precess in the planetary orbits must be solved for physics because it is a profound scientific and technological problem for a basic experiment in construction of relativistic theory of gravitation. The scientific solution to the problem proved that Einstein’s explanation for the planetary orbits is a magic made by the numerical expressions obtained from fictitious gravitation introduced to theory of gravitation and wrong definition of proper time The problem of the precession of the perihelion seems solved already by means of general theory of relativity, but, in essence, the cause for the astronomical phenomenon has not been successfully explained for astronomy yet. The right solution to the problem comes from generalized theory of gravitation. Therefore, in this paper, it has been shown that by means of Schwarzschild field and the physical quantities of relativistic Lagrangian redflected in it, fictitious gravitation is not the main factor which can cause the perihelion to precess in the planetary orbits. In addition to it, it has been shown that the main factor which can cause the perihelion to precess in the planetary orbits is the inverse third power force existing really in the relativistic region in the Solar system.Keywords: inverse third power force, precession of the perihelion, fictitious gravitation, planetary orbits
Procedia PDF Downloads 132254 Real-Time Land Use and Land Information System in Homagama Divisional Secretariat Division
Authors: Kumara Jayapathma J. H. M. S. S., Dampegama S. D. P. J.
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Lands are valuable & limited resource which constantly changes with the growth of the population. An efficient and good land management system is essential to avoid conflicts associated with lands. This paper aims to design the prototype model of a Mobile GIS Land use and Land Information System in real-time. Homagama Divisional Secretariat Division situated in the western province of Sri Lanka was selected as the study area. The prototype model was developed after reviewing related literature. The methodology was consisted of designing and modeling the prototype model into an application running on a mobile platform. The system architecture mainly consists of a Google mapping app for real-time updates with firebase support tools. Thereby, the method of implementation consists of front-end and back-end components. Software tools used in designing applications are Android Studio with JAVA based on GeoJSON File structure. Android Studio with JAVA in GeoJSON File Synchronize to Firebase was found to be the perfect mobile solution for continuously updating Land use and Land Information System (LIS) in real-time in the present scenario. The mobile-based land use and LIS developed in this study are multiple user applications catering to different hierarchy levels such as basic users, supervisory managers, and database administrators. The benefits of this mobile mapping application will help public sector field officers with non-GIS expertise to overcome the land use planning challenges with land use updated in real-time.Keywords: Android, Firebase, GeoJSON, GIS, JAVA, JSON, LIS, Mobile GIS, real-time, REST API
Procedia PDF Downloads 229