Search results for: primary immuno deficiency

Authors: Ghada M. AlSwayied, Anas N. AlHumaid

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Smoking has been linked to thousands of deaths worldwide. Around three million adults continue to use tobacco each day in Saudi Arabia; a sign that smoking is prevalent among Saudi population and obviously considered as a public health threat. Although the awareness against smoking is continuously running, it can be observed that smoking behavior increases noticeably as common practice especially among young adults across the world. Therefore, it was an essential step to guess what does motivate smokers to think about quit smoking. Can a graphic and emotional ad that is focusing on health consequences do really make a difference? A case study has been conducted on the Annual Anti-Smoking National Campaign, which was provided by Saudi Ministry of Health in the period of May 2017. To assess campaign’s effects on the number of calls, the number of visits and online access to health messages during and after the campaign period from May to August compared with the previous campaign in 2016. The educational video was selected as a primary tool to deliver the smoking health message. The Minister of Health who is acting as a role model for young adults was used to deliver a direct message to smokers with an avoidance of smoking cues usage. Due to serious consequences of smoking, the Minister of Health delivered the news of canceling the media campaign and directing the budget to smoking cessation clinics. It was shown that the positive responses and interactions on the campaign were obviously remarkable; achieving a high rate of recall and recognition. During the campaign, the number of calls to book for a visit reached 45880 phone calls, and the total online views ran to 1,253,879. Whereas, clinic visit raised up to 213 cumulative percent. Interestingly, a total number of 15,192 patients visited the clinics along three months compared with the last year campaign’s period, which was merely 4850 patients. Furthermore, around half of patients who visited the clinics were in the age from 26 to 40-year-old. There was a great progress in enhancing public awareness on: 'where to go' to assist smokers in making a quit attempt. With regard to the stages of change theory, it was predicted that by following direct-message technique; the proportion of patients in the contemplation and preparation stages would be increased. There was no process evaluation obtained to assess implementation of the campaigns’ activities.

Keywords: smoking, health promotion, role model, educational material, intervention, community health

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Authors: Zenah Gheblawi, Susan Armijo-Olivo, Elisa B. Pelai, Vaishali Sharma, Musa Tashfeen, Angela Fung, Francisca Claveria

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Due to physiological differences between men and women, pain is experienced differently between the two sexes. Chronic pain disorders, notably temporomandibular disorders (TMDs), disproportionately affect women in diagnosis, and pain severity in opposition of their male counterparts. TMDs are a type of musculoskeletal disorder that target the masticatory muscles, temporalis muscle, and temporomandibular joints, causing considerable orofacial pain which can usually be referred to the neck and back. Therapeutic methods are scarce, and are not TMD-centered, with the latest research suggesting that subjects with chronic musculoskeletal pain disorders have abnormal alterations in the grey matter of their brains which can be remedied with exercise, and thus, decreasing the pain experienced. The aim of the study is to investigate the effects of exercise therapy in TMD female patients experiencing chronic jaw pain and to assess the consequential effects on brain activity. In a randomized controlled trial, the effectiveness of an exercise program to improve brain alterations and clinical outcomes in women with TMD pain will be tested. Women with chronic TMD pain will be randomized to either an intervention arm or a placebo control group. Women in the intervention arm will receive 8 weeks of progressive exercise of motor control training using visual feedback (MCTF) of the cervical muscles, twice per week. Women in the placebo arm will receive innocuous transcutaneous electrical nerve stimulation during 8 weeks as well. The primary outcomes will be changes in 1) pain, measured with the Visual Analogue Scale, 2) brain structure and networks, measured by fractional anisotropy (brain structure) and the blood-oxygen level dependent signal (brain networks). Outcomes will be measured at baseline, after 8 weeks of treatment, and 4 months after treatment ends and will determine effectiveness of MCTF in managing TMD, through improved clinical outcomes. Results will directly inform and guide clinicians in prescribing more effective interventions for women with TMD. This study is underway, and no results are available at this point. The results of this study will have substantial implications on the advancement in understanding the scope of plasticity the brain has in regards with pain, and how it can be used to improve the treatment and pain of women with TMD, and more generally, other musculoskeletal disorders.

Keywords: exercise therapy, musculoskeletal disorders, physical therapy, rehabilitation, tempomandibular disorders

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Authors: Sittampalam Manoharan, Gary Chai, Sanaul Chowdhury, Andrew Golding

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The primary objective of this paper is to present a simplified approach to develop the structural deterioration model using traffic speed deflectometer data for flexible pavements. Maintaining assets to meet functional performance is not economical or sustainable in the long terms, and it would end up needing much more investments for road agencies and extra costs for road users. Performance models have to be included for structural and functional predicting capabilities, in order to assess the needs, and the time frame of those needs. As such structural modelling plays a vital role in the prediction of pavement performance. A structural condition is important for the prediction of remaining life and overall health of a road network and also major influence on the valuation of road pavement. Therefore, the structural deterioration model is a critical input into pavement management system for predicting pavement rehabilitation needs accurately. The Traffic Speed Deflectometer (TSD) is a vehicle-mounted Doppler laser system that is capable of continuously measuring the structural bearing capacity of a pavement whilst moving at traffic speeds. The device’s high accuracy, high speed, and continuous deflection profiles are useful for network-level applications such as predicting road rehabilitations needs and remaining structural service life. The methodology adopted in this model by utilizing time series TSD maximum deflection (D0) data in conjunction with rutting, rutting progression, pavement age, subgrade strength and equivalent standard axle (ESA) data. Then, regression analyses were undertaken to establish a correlation equation of structural deterioration as a function of rutting, pavement age, seal age and equivalent standard axle (ESA). This study developed a simple structural deterioration model which will enable to incorporate available TSD structural data in pavement management system for developing network-level pavement investment strategies. Therefore, the available funding can be used effectively to minimize the whole –of- life cost of the road asset and also improve pavement performance. This study will contribute to narrowing the knowledge gap in structural data usage in network level investment analysis and provide a simple methodology to use structural data effectively in investment decision-making process for road agencies to manage aging road assets.

Keywords: adjusted structural number (SNP), maximum deflection (D0), equant standard axle (ESA), traffic speed deflectometer (TSD)

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Authors: Bernard Ewuoso

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Introduction: Induction of labor (IOL) usually involves the patient moving between antenatal, labor, and postnatal wards. Delay in IOL has been defined as delay in the time it takes a woman to wait for induction after her cervix is assessed to be favorable. Opinions vary on the acceptable time the patient is allowed to wait for once the cervix is adjudged ripe for induction. What has been considered a benchmark is a delay of up to 12 hours. There is evidence that delay in IOL is associated with adverse outcomes. Aim: To determine the number of women experiencing delay in induction of labor and their outcomes. Method: This audit was retrospective and observational. It included women who had induction of labor in the month of October 2023 in two hospitals. Clinical data was collected from electronic medical records into an Excel sheet for analysis. Women had cervical ripening as inpatient or outpatient. The primary objective was to determine the number of women experiencing delay in induction of labor, while the secondary objective was to outcome these women. Result: 136 women had IOL. The least percentage of data retrieved for any parameter was 80%. The mean gestational age at IOL was 278.26 days. The mean waiting time was 905.34mins. Seventy-five women had their IOL at the Royal Infirmary of Edinburgh (RIE), fifty-seven at St. John’s Hospital (SJH), and three women were transferred from RIE to SJH. The preferred method of cervical ripening was balloon closely followed by prostaglandin. Twenty-seven women did not require cervical ripening and had their process started with amniotomy. Prostaglandin was the method of choice of cervical ripening at RIE, while balloon was preferred in SJH. Of the thirty-five women found to be suitable for outpatient cervical ripening, thirteen had outpatient ripening. There was a significant increase in the number of women undergoing outpatient cervical ripening at RIE from 10.5% in April 2022 to 42.9%. The preferred method for outpatient cervical ripening at the RIE was balloon, while it was prostaglandin for SJH. These were contradictory to the preferred method of inpatient cervical ripening at both centers. The average waiting time for IOL at RIE, 1166.92mins, is more than double that of SJH, 442.93mins, and far exceed 12hours, which is the proposed benchmark. The waiting time tends to be shorter with prostaglandin. Out of the women that had outpatient cervical ripening 63.6% had to wait for more than 12hrs before being induced while it was 36.1% for women that had inpatient cervical ripening. Overall, 38.5% women waited for more than 12 hours before having their induction. A lesser proportion of the women who waited for more than 12 hours had caesarean section, assisted vaginal delivery, and postpartum hemorrhage, whereas a greater proportion had spontaneous vaginal delivery and intrapartum or postpartum infection. Conclusion: A significant number of the women included in the study experienced delay in their induction process, and this was associated with an increased occurrence of intrapartum or postpartum infection. Outpatient cervical ripening contributed to delay.

Keywords: delay in induction of labor, inpatient, outpatient, intrapartum, postpartum, infection

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Authors: David A. Scott, Michelle G. Scott

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The problem of juvenile crime, school suspensions and oppositional behaviors indicates a need for a wide range of intervention programs for at-risk youth. Juvenile court systems and mental health agencies are examining alternative ways to deal with at-risk youth that will allow the adolescent to live within their home community. The previous trend that treatment away from home is more effective than treatment near one's community has shifted. Research now suggests that treatment be close to home for several reasons, such as increased treatment success, parental involvement, and reduced costs. Treatment options consist of a wide range of interventions, including outpatient, inpatient, and community-based services (therapeutic group homes, foster care and in-home preservation services). The juvenile justice system, families and other mental health agencies continue to seek the most effective treatment for at-risk youth in their communities. This research examines two possible treatment modalities, a multi-systemic outpatient program and a residential program. Research examining effective, evidence- based counseling will be discussed during this presentation. The presenter recently completed a three-year research grant examining effective treatment modalities for at-risk youth participating in a multi-systemic program. The presenter has also been involved in several research activities gathering data on effective techniques used in residential programs. The data and discussion will be broken down into two parts, each discussing one of the treatment modalities mentioned above. Data on the residential programs was collected on both a sample of 740 at- risk youth over a five-year period and also a sample of 63 participants during a one-year period residing in a residential programs. The effectiveness of these residential services was measured in three ways: services are evaluated by primary referral sources; follow-up data is obtained at various intervals after program participation to measure recidivism (what percentage got back into trouble with the Department of Juvenile Justice); and a more sensitive, "Offense Seriousness Score", has been computed and analyzed prior to, during and after treatment in the residential program. Data on the multi-systemic program was gathered over the past three years on 190 participants. Research will discuss pre and post test results, recidivism rates, academic performance, parental involvement, and effective counseling treatment modalities.

Keywords: at-risk youth, group homes, therapeutic group homes, recidivism rates

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Authors: Lucas Peries, Rolla Monib

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The construction industry plays a vital role in the global economy, contributing billions of dollars annually. However, the industry has been struggling with persistently low productivity levels for years, unlike other sectors that have shown significant improvements. Modular and prefabricated construction methods have been identified as potential solutions to boost productivity in the construction industry. These methods offer time advantages over traditional construction methods. Despite their potential benefits, modular and prefabricated construction face hindrances and limitations that are not present in traditional building systems. Building information modelling (BIM) has the potential to address some of these hindrances, but barriers are preventing its widespread adoption in the construction industry. This research aims to enhance understanding of the shortcomings of modular and prefabricated building systems and develop BIM-based solutions to alleviate or eliminate these hindrances. The research objectives include identifying and analysing key issues hindering the use of modular and prefabricated building systems, investigating the current state of BIM adoption in the construction industry and factors affecting its successful implementation, proposing BIM-based solutions to address the issues associated with modular and prefabricated building systems, and assessing the effectiveness of the developed solutions in removing barriers to their use. The research methodology involves conducting a critical literature review to identify the key issues and challenges in modular and prefabricated construction and BIM adoption. Additionally, an online questionnaire will be used to collect primary data from construction industry professionals, allowing for feedback and evaluation of the proposed BIM-based solutions. The data collected will be analysed to evaluate the effectiveness of the solutions and their potential impact on the adoption of modular and prefabricated building systems. The main findings of the research indicate that the identified issues from the literature review align with the opinions of industry professionals, and the proposed BIM-based solutions are considered effective in addressing the challenges associated with modular and prefabricated construction. However, the research has limitations, such as a small sample size and the need to assess the feasibility of implementing the proposed solutions. In conclusion, this research contributes to enhancing the understanding of modular and prefabricated building systems' limitations and proposes BIM-based solutions to overcome these limitations. The findings are valuable to construction industry professionals and BIM software developers, providing insights into the challenges and potential solutions for implementing modular and prefabricated construction systems in future projects. Further research should focus on addressing the limitations and assessing the feasibility of implementing the proposed solutions from technical and legal perspectives.

Keywords: building information modelling, modularisation, prefabrication, technology

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Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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Authors: Nozar Kishi, Babak Kamrani, Filmon Habte

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Natural hazards such as earthquakes and tropical storms, are very frequent and highly destructive in Japan. Japan experiences, every year on average, more than 10 tropical cyclones that come within damaging reach, and earthquakes of moment magnitude 6 or greater. We have developed stochastic catastrophe models to address the risk associated with the entire suite of damaging events in Japan, for use by insurance, reinsurance, NGOs and governmental institutions. KCC’s (Karen Clark and Company) catastrophe models are procedures constituted of four modular segments: 1) stochastic events sets that would represent the statistics of the past events, hazard attenuation functions that could model the local intensity, vulnerability functions that would address the repair need for local buildings exposed to the hazard, and financial module addressing policy conditions that could estimates the losses incurring as result of. The events module is comprised of events (faults or tracks) with different intensities with corresponding probabilities. They are based on the same statistics as observed through the historical catalog. The hazard module delivers the hazard intensity (ground motion or wind speed) at location of each building. The vulnerability module provides library of damage functions that would relate the hazard intensity to repair need as percentage of the replacement value. The financial module reports the expected loss, given the payoff policies and regulations. We have divided Japan into regions with similar typhoon climatology, and earthquake micro-zones, within each the characteristics of events are similar enough for stochastic modeling. For each region, then, a set of stochastic events is developed that results in events with intensities corresponding to annual occurrence probabilities that are of interest to financial communities; such as 0.01, 0.004, etc. The intensities, corresponding to these probabilities (called CE, Characteristics Events) are selected through a superstratified sampling approach that is based on the primary uncertainty. Region specific hazard intensity attenuation functions followed by vulnerability models leads to estimation of repair costs. Extensive economic exposure model addresses all local construction and occupancy types, such as post-linter Shinand Okabe wood, as well as concrete confined in steel, SRC (Steel-Reinforced Concrete), high-rise.

Keywords: typhoon, earthquake, Japan, catastrophe modelling, stochastic modeling, stratified sampling, loss model, ERM

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Authors: Po-Chien Li

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Despite the extant literature has hosted a wide-range of knowledge about trade shows, this knowledge base deserves to be further expanded and extended because there exist many unclear issues and overlooked topics. One area that needs much research attention is regarding the behavior and performance of booth workers at the exhibition site. Booth staffs play many key roles in interacting with booth visitors. Their exhibiting-related attitudes and motivations might have significant consequences on a firm’s exhibition results. However, to date, little research, if any, has studied how booth workers are affected and behave in the context of trade fair. The primary purpose of the current study is to develop and test a research model, derived from role theory and resource-based viewpoint, that depicts the effects of a firm’s pre-exhibition resource investment behavior on booth staff’s role perceptions and work behavior during the exhibition period. The author collects data with two survey questionnaires at two trade shows in 2016. One questionnaire is given to the booth head of an exhibiting company, asking about the firm’s resource commitment behavior prior to the exhibition period. In contrast, another questionnaire is provided for a booth worker of the same firm, requesting the individual staff to report his/her own role perceptions, degree of exhibition goal acceptance, and level of work effort during the exhibition period. The study has utilized the following analytic methods, including descriptive statistics, exploratory factor analysis, reliability analysis, and regression analysis. The results of a set of regression analyses show that a firm’s pre-exhibition resource investment behavior has significant effects on a booth staff’s exhibiting perceptions and attitudes. Specifically, an exhibitor’s resource investment behavior has impacts on the factors of booth staff’s role clarity and role conflict. In addition, a booth worker’s role clarity is related to the degree of exhibition goal acceptance, but his/her role conflict is not. Finally, a booth worker’s exhibiting effort is significantly related to the individual’s role clarity, role conflict and goal acceptance. In general, the major contribution of the current research is that it offers insight into and early evidence on the links between an exhibiting firm’s resource commitment behavior and the work perceptions and attitudes of booth staffs during the exhibition period. The current research’s results can benefit the extant literature of exhibition marketing.

Keywords: exhibition resource investment, role perceptions, goal acceptance, work effort

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Authors: Tahzeeb Mahreen

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Distance education refers to giving instruction in which students are remote from the institution and once in a while go to formal demonstration classes, and teaching sessions. Segments of media, for example, radio, TV, PC and Internet and so on are the assets and method for correspondence being utilized as a part of learning material by many open and distance learning institutions. Media has a great part in maximizing the learning opportunities thus enabling distance education, a mode of increased literacy rate of the country. This study goes for analyzing how media had affected distance education through its different mediums. The objectives of the study were (i) to determine the direct impact of media on distance education? (ii) To know how media effects distance education pedagogy (iii) To find out how media works to increase student’s achievement. Literature-based methodology was used, and books, peer-reviewed articles, press reports and internet-based materials were studied as a result. By using descriptive qualitative research analysis, the researcher has interpreted that distance education programs are progressively utilizing mixes of media to convey training that has a positive impact on learning along with a few challenges. In addition, the perception of the researcher varied depending on the programs of distance learning but generally believed that electronic media were moderately more supportive in enhancing the overall performance of the learners. It was concluded that the intellectual style, identity qualities, and self-expectations are the three primary enhanced areas in a student’s educational life in distance education programs. It was portrayed that a comprehension of how individual learners approach learning may make it workable for the distance educator to see an example of learning styles and arrange or modify course presentations through media. Moreover, it is noticed that teaching in distance education address the developing role of the instructor, the requirement for diminishing resistance as conventional teachers utilize remove conveyance frameworks lastly, staff state of mind toward the utilization of innovation. Furthermore, the results showed that media had assumed its part to make distance learning educators more dynamic, capable and concerned about their individual works. The study also indicated a high positive relationship between the media available at study centers and media used by the distance education. The challenge pointed out by the researcher was the clash of distance and time with communication as the life situations of every learner are varied. Recommendations included the realization of the duty of distance learning instructor to help students understand the effective use of media for their study lessons and also to develop online learning communities to be in instant connection with the students.

Keywords: distance education, education, media, teaching and learning

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Authors: Ellis Kofi Akwaa-Sekyi, Jordi Moreno Gené

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Managerial actions which negatively profile banks and impair corporate reputation are addressed through effective internal control systems. Disregard for acceptable standards and procedures for granting credit have affected bank loan portfolios and could be cited for the crises in some European countries. The study intends to determine the effectiveness of internal control systems, investigate whether perceived agency problems exist on the part of board members and to establish the relationship between internal controls and credit risk among listed banks in the European Union. Drawing theoretical support from the behavioural compliance and agency theories, about seventeen internal control variables (drawn from the revised COSO framework), bank-specific, country, stock market and macro-economic variables will be involved in the study. A purely quantitative approach will be employed to model internal control variables covering the control environment, risk management, control activities, information and communication and monitoring. Panel data from 2005-2014 on listed banks from 28 European Union countries will be used for the study. Hypotheses will be tested and the Generalized Least Squares (GLS) regression will be run to establish the relationship between dependent and independent variables. The Hausman test will be used to select whether random or fixed effect model will be used. It is expected that listed banks will have sound internal control systems but their effectiveness cannot be confirmed. A perceived agency problem on the part of the board of directors is expected to be confirmed. The study expects significant effect of internal controls on credit risk. The study will uncover another perspective of internal controls as not only an operational risk issue but credit risk too. Banks will be cautious that observing effective internal control systems is an ethical and socially responsible act since the collapse (crisis) of financial institutions as a result of excessive default is a major contagion. This study deviates from the usual primary data approach to measuring internal control variables and rather models internal control variables in a quantitative approach for the panel data. Thus a grey area in approaching the revised COSO framework for internal controls is opened for further research. Most bank failures and crises could be averted if effective internal control systems are religiously adhered to.

Keywords: agency theory, credit risk, internal controls, revised COSO framework

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Authors: Narayan Bhattarai, Arjun Bhattarai, Kabi Raj Paudyal, Lalu Paudel

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Palung granite is leucocratic, alkali feldspar granite, which is one of the six major granite bodies of the Lesser Himalaya of Nepal. The Cambro-Ordovician granite body has intruded on the Palaeozoic metasedimentary rock of the Kathmandu Complex in Central Nepal. The granite crystallized from magma that was mainly generated by anatexis of the Precambrian continental crust. The magma is heterogeneous with respect to the primary ages and/or metamorphic histories of the magma source rocks. This indicates either a derivation from (meta-) sediments or an intense mixing of different crustally derived magmas. The genesis of the Palung granite is possibly related to an orogeny which affected the Indian shield in lower Paleozoic times. The granite body has been mapped into different zones with visual inspection and petrographical study: i. Quartz rich granite: Quartz is smokey to grayish, euhedral to subherdal, 0.2 to 0.7 cm, and constitutes 30 to 40%. Feldspar is white to brownish, subhedral to euhedral, more than 3 cm, and constitutes 20–30%. Tourmaline is black, 0.1 to 0.2 cm in size, and consists of 10 to 20%. Biotite is black flakes up to o.2 cm, representing 5-8%. ii. Feldspar rich granite: white to grayish, medium to coarse-grained, containing feldspar, quartz, biotite, muscovite and tourmaline. Feldspar porphyritic crystals up to 2.5 cm subherdral represent 50–60%, quartz is smokey transparent and represents 30–40%, biotite is dark brown to black, crystals are irregular, 0.5 cm and represent 8–20%, tourmaline is black fractured, small needles represent 5–10%, and muscovite is white to brown and represents 1-4%. iii. Biotite granite: grey to white, medium to coarse-grained, containing quartz, feldspar, biotite and tourmaline. Feldspar crystals up to 2.5 cm represent 40–50%, quartz is smokey, representing 30–40%, biotite is dark brown to black, crystal size 0.5cm, representing 10–20%, tourmaline is black, small needle, 5–10%, and muscovite is white to brown, representing 3-5%. and iv. Muscovite granite: medium-coarse-grained, brown and gray, containing quartz, feldspar, muscovite and tourmaline. Feldspar is white to brown; crystal sizes 0.2–0.4 cm represents 40–50%; quartz is brown and white, transparent, crystals up to 1 cm represent 35–50%; tourmaline is black, opaque, needle shaped; size up to 7–20%; and muscovite is brownish to white, with flakes up to 0.3 cm representing 5–10%. The xenoliths are very common and are not genetically related. Xenoliths are composed mostly of fine-grained, grayish quartz biotite (muscovite) schist and garnetiferous quartz mica schist.

Keywords: leucocratic granite, cambro-ordovician granite, lesser himalayan granite, pegmatite

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Authors: Linneth Nkateko Mabila, Patrick Hulisani Demana, Tebogo Maria Mothiba

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Background: Sustaining adherence to antiretroviral therapy (ART) over the long term by people, especially children living with Human-Immunodeficiency Virus (HIV), requires accurate and consistent monitoring, and this is a particular challenge for countries in sub-Saharan Africa. However, the regularity and punctuality in monthly antiretroviral treatment collections indicate medication adherence to a certain extent since it has been revealed to be a significant determinant of the outcome of ART. Aim: This study assessed and described the pattern of monthly antiretroviral treatment collections among a cohort of virally unsuppressed HIV-positive children initiated and managed on ART in the rural public clinics of Mopani District, Limpopo, and explored the nurses' perceptions and views of the findings. Methods: A facility-based mixed-methods study was conducted to assess the honoring of scheduled monthly treatment collection practices by a cohort of HIV-positive children under 15 years initiated and managed on ART by Nurse Initiated Management of Antiretroviral Treatment (NIMART)-trained professional nurses (PNs) from 01 January 2015 to 31 December 2015 in public PHC clinics of Mopani District Municipality. This was followed by the exploration of the nurses' perceptions and views regarding this issue to share their experiences and knowledge acquired through managing these children on ART. Results: From a total of 7105 analysable visits, only 44% (3134) were honored as scheduled, with 40% (2828) of children presenting to the clinics after the scheduled appointment date – they missed their appointments, and 11% (768) of treatment collections that took place before the scheduled appointment date. This finding was further confirmed by 90% (97) of the nurses, who reported that they have children who miss scheduled appointments in their public clinics. The primary reasons for children missing appointments were related to caregivers' forgetfulness and conflict between the school schedule and the dates of clinic visits. Conclusion: We confirmed a high prevalence of non-adherence to scheduled monthly ART collections and the existence of health system, social, and caregiver-related factors that threaten treatment adherence and proper clinical outcomes. These findings suggest an urgent need for intervention since non-adherence to ARV therapy can be life-threatening to the child and poses the danger of reduced life expectancy.

Keywords: antiretroviral therapy (art), nimart, virally unsuppressed children, missed appointments

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Authors: Ana M. Lara, Manuela Llano, Felipe Gaitán, Rosa H. Bustos, Ana Maria Perdomo-Arciniegas, Ximena Bonilla

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Umbilical cord blood is used as a source of progenitor and stem cells for the regeneration of the hematopoietic and immune system to treat patients with different hematological or non-hematological diseases. This stem cell source represents an advantage over the use of bone marrow or mobilized peripheral blood because it has a lower incidence rate of graft-versus-host disease, probably due to fewer immunological compatibility restrictions. However, its low cellular dose limits its use in pediatric patients. This work proposes the standardization of a cell expansion technique to compensate for the dose of infused cells through the ex-vivo manipulation of hematopoietic progenitor cells from umbilical cord blood before transplantation. The expansion model is carried out through co-cultures with mesenchymal stem cells (MSC) from bone marrow (BM) and less explored fetal tissues such as Wharton's jelly (WJ) and umbilical cord blood (UCB). Initially, a master cell bank of primary mesenchymal stem cells isolated from different sources was established and characterized following International Society of Cell Therapies (ISCT) indications. Additionally, we assessed the effect of a short 25 Gy cycle of gamma irradiation on cell cycle arrest of mesenchymal cells over the support capacity for the expansion of hematopoietic stem cells from umbilical cord blood was evaluated. The results show that co-cultures with MSC from WJ and UCB allow the cellular dose of HSPC to be maximized between 5 and 16 times having a similar support capacity as BM. In addition, was evaluated the hematopoietic stem progenitor cell's HSPC functionality through the evaluation of migration capacity, their differentiation capacity during culture time by flow cytometry to evaluate the expression of membrane markers associated with lineage-committed progenitors, their clonogenic potential, and the evaluation of secretome profile in the expansion process was evaluated. So far, the treatment with gamma irradiation maintains the hematopoietic support capacity of mesenchymal stem cells from the three sources studied compared to treatments without irradiation, favoring the use of fetal tissues that are generally waste to obtain mesenchymal cell lines for ex-vivo expansion systems. With the results obtained, a standardized protocol that will contribute to the development of ex-vivo expansion with MSC on a larger scale will be achieved, enabling its clinical use and expanding its application in adults.

Keywords: ex-vivo expansion, hematopoietic stem cells, hematopoietic stem cell transplantation, mesenchymal stem cells, umbilical cord blood

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Authors: Weldeabrha Kiros Kidanemaryam

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The investigation is to examine intra-organizational supply chain relationships of firms, which will help to look at and give an emphasis on internal processes and operations strength and achievements to make an influence even for external relationship management and outstanding performances of organizations. The purpose of the study is to scrutinize the internal supply chain relationships within manufacturing companies located in Tigray. The qualitative and quantitative data analysis methods were employed during the study by applying the primary data sources (questionnaires & interviews) and secondary data sources (organizational reports and documents) with the purposive sampling method. Thus, a descriptive research design was also applied in the research project in line with the cross-sectional research design which portrays simply the magnitude of the issues and problems by collecting the required and necessary data once from the sample respondents. This is because the study variables don’t have any cause-and-effect relationship in the research project that requires other types of research design than a descriptive research design; it already needs to be assessed and analyzed with a detailed description of the results after quantifying the outcomes and degree of the issues and problems based on the data gathered from respondents. The collected data was also analyzed by using the statistical package for social sciences (SPSS Version 20). The intra-organizational relationships of the companies are moderately accomplished, which requires an improvement for enhancing the performances of each unit or department within the firms so as to upgrade and ensure the progress of the companies’ effectiveness and efficiency. Moreover, the manufacturing companies have low industrial discipline and working culture, weak supervision of manpower, delayed delivery in the process within the companies, unsatisfactory quality of products, underutilization of capacity, and low productivity and profitability, which in turn results in minimizing the performance of intra-organizational supply chain relationships and to reduce the companies’ organizational efficiency, effectiveness and sustainability. Hence, the companies should have to give emphasize building and managing the intra-organizational supply chain relationships effectively because nothing can be done without creating successful and progressive relationships with internal units or functional areas and individuals for the production and provision of the required and qualified products that permits to meet the intended customers’ desires. The study contributes to improving the practical applications and gives an emphasis on the policy measurements and implications of the manufacturing companies with regard to intra-organizational supply chain relationships.

Keywords: supply chain, supply chain relationships, intra-organizational relationships, manufacturing companies

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Authors: Binay Pattanayak

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More than 9 out of every 10 children in Jharkhand struggle to understand the texts and teachers in public schools. The medium of learning in the schools is Hindi, which is very different in structure and vocabulary than those in children’s home languages. Hence around 3 out of 10 children enrolled in early grades drop out in these schools. The state realized the cause of children’s high dropout in 2013-14 when the M-TALL, the language research shared the findings of a state-wide socio-linguistic study. The study findings suggested that there was a great need for initiating a mother-tongue based multilingual education (MTB-MLE) programme for the state in early grades starting from pre-school level. Accordingly, M-TALL in partnership with department of education designed two learning packages: Bhasha Puliya pre-school education programme for 3-6-year-old children for their school readiness with bilingual picture dictionaries in 9 tribal and regional languages. This was followed by a plan for MTB-MLE programme for early primary grades. For this textbooks in five tribal and two regional languages were developed under the guidance of the author. These books were printed and circulated in the 1000 schools of the state for each child. Teachers and community members were trained for facilitating culturally sensitive mother-tongue based learning activities in and around the schools. The mother-tongue based approach of learning has worked very effectively in enabling them to acquire the basic literacy and numeracy skills in own mother-tongues. Using this basic early grade reading skills, these children are able to learn Hindi and English systematically. Community resource groups were constituted in each school for promoting storytelling, singing, painting, dancing, acting, riddles, humor, sanitation, health, nutrition, protection, etc. and were trained. School academic calendar was designed in each school to enable the community resource persons to visit the school as per the learning plan to assist children and teacher in facilitating rich cultural activities in mother-tongue. This enables children to take part in plethora of learning activities and acquire desired knowledge, skills and interest in mother-tongues. Also in this process, it is attempted to promote 21st Century learning skills by enabling children to apply their new knowledge and skills to look at their local issues and address those in a collective manner through team work, innovations and leadership.

Keywords: community resource groups, learning, MTB-MLE, multilingual, socio-linguistic survey

Procedia PDF Downloads 236

Authors: Nikita Rajendra Sharma, Jai Prakash Kushvah, Gerhard Rinkenauer

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Driving a car is a discrete aiming movement in which drivers aim at successful extraction of relevant information and elimination of potentially distracting one. It is the motor preparation which enables one to react to certain stimuli onsite by allowing perceptual process for optimal adjustment. Drivers prepare their responses according to the available resources of advanced and ongoing information to drive efficiently. It requires constant programming and reprogramming of the motor system. The reaction time (RT) is shorter when a response signal is preceded by a warning signal. The reason behind this reduced time in responding to targets is that the warning signal causes the participant to prepare for the upcoming response by updating the motor program before the execution. While performing the primary task of changing lanes while driving, the simultaneous occurrence of additional information during the presentation of cues (congruent or incongruent with respect to target cue) might impact the motor preparation and execution. The presence of additional information (other than warning or response signal) between warning signal and imperative stimulus influences human motor preparation to a reasonable extent. The present study was aimed to assess the impact of congruent and incongruent additional information (with respect to imperative stimulus) on driving performance (reaction time, steering wheel amplitude, and steering wheel duration) during a lane change task. implementing movement pre-cueing paradigm. 22 young valid car-drivers (Mage = 24.1+/- 3.21 years, M = 10, F = 12, age-range 21-33 years) participated in the study. The study revealed that additional information influenced the overall driving performance as potential distractors and relevant information. Findings suggest that the events of additional information relatively influenced the reaction time and steering wheel angle as potential distractor or irrelevant information. Participants took longer to respond, and higher steering wheel angles were reported for targets coupled with additional information in comparison with warning signs preceded by potential distractors and the participants' response time was more for a higher number of lanes (2 Lanes > 1 Lane). The same additional information appearing interchangeably at warning signals and targets worked as relevant information facilitating the motor programming in the trails where they were congruent with the direction of lane change direction.

Keywords: additional information, lane change task, motor preparation, movement pre-cueing, reaction time, steering wheel amplitude

Procedia PDF Downloads 191

Authors: I. Gupta, N. Setia

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Introduction. Buyer conduct is a progression of practices or examples that buyers pursue before making a buy. It begins when the shopper ends up mindful of a need or wish for an item, at that point finishes up with the buying exchange. Business visionaries can't generally simply shake hands with their intended interest group people and become more acquainted with them. Research is often necessary, so every organization primarily involves doing continuous research to understand and satisfy consumer needs pattern. Aims and Objectives: The aim of the present study is to examine the different behaviors of the consumer, including pre-purchase, purchase, and post-purchase behavior. Materials and Methods: In order to get results, face to face interview held with 80 people which comprise a larger part of female individuals having upper as well as middle-class status. The prime source of data collection was primary. However, the study has also used the theoretical contribution of many researchers in their respective field. Results: Majority of the respondents were females (70%) from the age group of 20-50. The collected data was analyzed through hypothesis testing statistical techniques such as correlation analysis, single regression analysis, and ANOVA which has rejected the null hypothesis that there is no relation between researching the consumer behavior at different stages and organizational performance. The real finding of this study is that simply focusing on the buying part isn't enough to gain profits and fame, however, understanding the pre, buy and post-buy behavior of consumer performs a huge role in organization success. The outcomes demonstrated that the organization, which deals with the three phases of research of purchasing conduct is able to establish a great brand image as compare to their competitors. Alongside, enterprises can observe customer conduct in a considerably more proficient manner. Conclusion: The analyses of consumer behavior presented in this study is an attempt to understand the factors affecting consumer purchasing behavior. This study has revealed that those corporations are more successful, which work on understanding buying behavior instead to just focus on the selling products. As a result, organizations perform good and grow rapidly because consumers are the one who can make or break the company. The interviews that were conducted face to face, clearly revealed that those organizations become at top-notch whom consumers are satisfied, not just with product but also with services of the company. The study is not targeting the particular class of audience; however, it brings out benefits to the masses, in particular to business organizations.

Keywords: consumer behavior, pre purchase, post purchase, consumer satisfaction

Procedia PDF Downloads 112

Authors: Ahmed Tamer AlMotasem, Jens Bergström, Anders Gåård, Pavel Krakhmalev, Thijs Jan Holleboom

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In sheet metal forming processes, accumulation and transfer of sheet material to tool surfaces, often referred to as galling, is the major cause of tool failure. Initiation of galling is assumed to occur due to local adhesive wear between two surfaces. Therefore, reducing adhesion between the tool and the work sheet has a great potential to improve the tool materials galling resistance. Experimental observations and theoretical studies show that the presence of primary micro-sized carbides and/or nitrides in alloyed steels may significantly improve galling resistance. Generally, decreased adhesion between the ceramic precipitates and the sheet material counter-surface are attributed as main reason to the latter observations. On the other hand, adhesion processes occur at an atomic scale and, hence, fundamental understanding of galling can be obtained via atomic scale simulations. In the present study, molecular dynamics simulations are used, with utilizing second nearest neighbor embedded atom method potential to investigate the influence of nano-sized cementite precipitates embedded in tool atoms. The main aim of the simulations is to gain new fundamental knowledge on galling initiation mechanisms. Two tool/work piece configurations, iron/iron and iron-cementite/iron, are studied under dry sliding conditions. We find that the average frictional force decreases whereas the normal force increases for the iron-cementite/iron system, in comparison to the iron/iron configuration. Moreover, the average friction coefficient between the tool/work-piece decreases by about 10 % for the iron-cementite/iron case. The increase of the normal force in the case of iron-cementite/iron system may be attributed to the high stiffness of cementite compared to bcc iron. In order to qualitatively explain the effect of cementite on adhesion, the adhesion force between self-mated iron/iron and cementite/iron surfaces has been determined and we found that iron/cementite surface exhibits lower adhesive force than that of iron-iron surface. The variation of adhesion force with temperature was investigated up to 600 K and we found that the adhesive force, generally, decreases with increasing temperature. Structural analyses show that plastic deformation is the main deformation mechanism of the work-piece, accompanied with dislocations generation.

Keywords: adhesion, cementite, galling, molecular dynamics

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Authors: Sharifullah Ahmed, Sarwar Jahan Md. Yasin

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Shallow foundations on unimproved soft natural soils can undergo a high consolidation and secondary settlement. For low and medium rise building projects on such soil condition, pile foundation may not be cost effective. In such cases an alternative to pile foundations may be shallow strip footings placed on a double layered improved soil system soil. The upper layer of this system is untreated or cement treated compacted sand and underlying layer is natural soft clay. This system will reduce the settlement to an allowable limit. The current research has been conducted with the settlement of a rigid plane-strain strip footing of 2.5 m width placed on the surface of a soil consisting of an untreated or cement treated sand layer overlying a bed of homogeneous soft clay. The settlement of the mentioned shallow foundation has been studied considering both cases with the thicknesses of the sand layer are 0.3 to 0.9 times the width of footing. The response of the clay layer is assumed as undrained for plastic loading stages and drained during consolidation stages. The response of the sand layer is drained during all loading stages. FEM analysis was done using PLAXIS 2D Version 8.0. A natural clay deposit of 15 m thickness and 18 m width has been modeled using Hardening Soil Model, Soft Soil Model, Soft Soil Creep Model, and upper improvement layer has been modeled using only Hardening Soil Model. The groundwater level is at the top level of the clay deposit that made the system fully saturated. Parametric study has been conducted to determine the effect of thickness, density, cementation of the sand mat and density, shear strength of the soft clay layer on the settlement of strip foundation under the uniformly distributed vertical load of varying value. A set of the chart has been established for designing shallow strip footing on the sand mat over thick, soft clay deposit through obtaining the particular thickness of sand mat for particular subsoil parameter to ensure no punching shear failure and no settlement beyond allowable level. Design guideline in the form of non-dimensional charts has been developed for footing pressure equivalent to medium-rise residential or commercial building foundation with strip footing on soft inorganic Normally Consolidated (NC) soil of Bangladesh having void ratio from 1.0 to 1.45.

Keywords: design charts, ground improvement, PLAXIS 2D, primary and secondary settlement, sand mat, soft clay

Procedia PDF Downloads 123

Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

Procedia PDF Downloads 337

Authors: Taba Tath

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Arunachal Pradesh, located in the easternmost part of India, is known for its natural beauty and diverse tribal lifestyles. The state has the highest species richness and biological diversity among Northeast states in terms of flora, fauna, and tribal traditions and culture. The protection of nature and culture is a practice that is widely used by governments or nongovernmental organizations seeking to preserve the scenic beauty of landscapes and their natural resources in spaces that stand out for their natural and cultural value and have not been heavily impacted by human activity. The whole of Arunachal Pradesh comes under the purview of special permits such as the Inner Line Permit (ILP) and Protected Area Permit (PAP) for domestic and foreign travellers, respectively. Due to politically vibrant areas and naturally fragile in nature, the state needs to be protected, but at the same time, the demand for tourism activities is increasing gradually due to its unique blend of nature and socio-cultural richness. There are 13 protected areas in the state which is unexplored, and there are no tourism activities in these protected areas except for Namdapha National Park. Out of 13 protected areas, the Pakke Wildlife Sanctuary is one of the well-managed protected areas located near the Assam-Arunachal border, approximately 40km away from Tezpur town, Assam. The state has great potential for wildlife and nature-based tourism development, which can also indirectly support wildlife and nature-based livelihood options for the local inhabitants living in the peripheral of the sanctuary area due to its high richness in terms of flora and fauna. To promote the richness of the state, boost tourism, and the economic, social and environmental development of the area and local communities, a proper tourism management practice and framework are very much required. The research paper has made an attempt to study the role of stakeholders in preserving and promoting the Protected Areas for tourism development in a sustainable way. This is both a primary and secondary study conducted with field visits, interaction, questionnaire and observation with the various stakeholders and also conducted with the Government reports, magazines and other published sources available. Furthermore, this study will be relevant to all stakeholders for having knowledge and processes for promoting tourism in Protected Areas in a sustainable way. The results will provide relevant information and process for the management and promotion of the protected Areas and to strengthen the sustainable tourism activities in these areas.

Keywords: protected area, inner line permit, protected area permit, management, government, nongovernmental organization, stakeholders, sustainable, natural resources

Procedia PDF Downloads 43

Authors: Shankha Pratim Bhattacharya

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In general building repair and renovation projects are minor in nature. It requires less attention as the primary cost involvement is relatively small. Although the building repair and maintenance projects look simple, it involves much complexity during execution. Many of the present research indicate that few uncertain situations are usually linked with maintenance projects. Those may not be read properly in the planning stage of the projects, and finally, lead to time overrun. Building repair and maintenance become essential and periodical after commissioning of the building. In Institutional buildings, the regular maintenance projects also include addition –alteration, modification activities. Increase in the student admission, new departments, and sections, new laboratories and workshops, up gradation of existing laboratories are very common in the institutional buildings in the developing nations like India. The project becomes very critical because it undergoes space problem, architectural design issues, structural modification, etc. One of the prime factors in the institutional building maintenance and modification project is the time constraint. Mostly it required being executed a specific non-work time period. The present research considered only the institutional buildings of the Eastern part of India to analyse the repair and maintenance project delay. A general survey was conducted among the technical institutes to find the causes and corresponding nature of construction delay factors. Five technical institutes are considered in the present study with repair, renovation, modification and extension type of projects. Construction delay factors are categorically subdivided into four groups namely, material, manpower (works), Contract and Site. The survey data are collected for the nature of delay responsible for a specific project and the absolute amount of delay through proposed and actual duration of work. In the first stage of the paper, a relative importance index (RII) is proposed for the delay factors. The occurrence of the delay factors is also judged by its frequency-severity nature. Finally, the delay factors are then rated and linked with the type of work. In the second stage, a regression analysis is executed to establish an empirical relationship between the actual time of a project and the percentage of delay. It also indicates the impact of the factors for delay responsibility. Ultimately, the present paper makes an effort to identify the critical delay factors for the repair and renovation type project in the Eastern Indian Institutional building.

Keywords: delay factor, institutional building, maintenance, relative importance index, regression analysis, repair

Procedia PDF Downloads 250

Authors: Sarah Atalla, Shubham Gupta, Kim Alipio, Tanya Maric

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Background: Chelsea and Westminster Hospital have introduced the Birmingham Symptom Specific Obstetric Triage System (BSOTS) for patients who present acutely to the Maternity Assessment Suite (MAS) to prioritise care by urgency. The primary objective was to evaluate whether BSOTS was used appropriately to assess patients (defined as a 90% threshold). The secondary objective was to assess whether patients were seen within their designated triaged timeframe (defined as a 90% threshold). Methodology: MAS records were retrospectively reviewed for a randomly selected one-week period of data from 2020 (21/09/2020 - 27/09/2020). 189 patients presented to MAS during this time. Data were collected on the presenting complaint, time of attendance (divided into four time categories), and triage colour code for the urgency of a review by a doctor (red: immediately, orange: within 15 minutes, yellow: within 1 hour, green: within 4 hours). The number of triage waiting times that were breached and the outcome of the attendance was noted. Results: 49% of patients presenting to MAS during this time period were triaged, which therefore did not meet the 90% target. 67% of patients who were triaged were seen within their allocated timeframe as designated by their triage colour code, which therefore did not meet the 90% target. The most frequent reason for patient attendance was reduced fetal movements (30.5% of attendances). The busiest time of day (when most patients presented) was between 06:01-12:00, and this was also when the highest number of patients were not triaged (26 patients or 54% of patients presenting in this time category). The most used triage category (59%) was the green colour code (to be seen by a doctor within 4 hours), followed by orange (24%), yellow (14%), and red (3%). 45% of triaged patients were admitted, whilst 55% were discharged. 62% of patients allocated to the green triage category were discharged, as compared to 56% of yellow category patients, 27% of orange category patients, and 50% of red category patients. The time of patient presentation to the hospital was also associated with the level of urgency and outcome. Patients presenting from 12:01 to 18:00 were more likely to be discharged (72% discharged) compared to 00:01-06:00 where only 12.5% of patients were discharged. Conclusion: The triage system for assessing the urgency of acutely presenting obstetric patients is only being effectively utilised for 49% of patients. There is potential for enhancing the employment of the triage system to enable further efficiency and boost the promotion of patient safety. It is noted that MAS was busiest at 06:01 - 12:00 when there was also the highest number of non-triaged patients – this highlights some areas where we can improve, including higher levels of staffing, better use of BSOTS to triage patients, and patient education.

Keywords: birmingham, BSOTS, maternal, obstetric, pregnancy, specific, symptom, triage

Procedia PDF Downloads 105

Authors: Maximiliano Guerra, Lexi Frankel, Amalia D. Ardeljan, Sarah Ghali, Diya Kohli, Omar M. Rashid.

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Introduction/Background: Haemophilus influenzae is present as a commensal organism in the nasopharynx of most healthy adults from where it can spread to cause both systemic and respiratory tract infection. Pathogenic properties of this bacterium as well as defects in host defense may result in the spread of these bacteria throughout the body. This can result in a proinflammatory state and colonization particularly in the lungs. Recent studies have failed to determine a link between H. Influenzae colonization and prostate cancer, despite previous research demonstrating the presence of proinflammatory states in preneoplastic and neoplastic prostate lesions. Given these contradictory findings, the primary goal of this study was to evaluate the correlation between H. Influenzae infection and the incidence of prostate cancer. Methods: To evaluate the incidence of Haemophilus influenzae infection and the development of prostate cancer in the future we used data provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database. We were afforded access to this database by Holy Cross Health, Fort Lauderdale for the express purpose of academic research. Standard statistical methods were employed in this study including Pearson’s chi-square tests. Results: Between January 2010 and December 2019, the query was analyzed and resulted in 13, 691 patients in both the control and C. difficile infected groups, respectively. The two groups were matched by age range and CCI score. In the Haemophilus influenzae infected group, the incidence of prostate cancer was 1.46%, while the incidence of the prostate cancer control group was 4.56%. The observed difference in cancer incidence was determined to be a statistically significant p-value (< 2.2x10^-16). This suggests that patients with a history of C. difficile have less risk of developing prostate cancer (OR 0.425, 95% CI: 0.382 - 0.472). Treatment bias was considered, the data was analyzed and resulted in two groups matched groups of 3,208 patients in both the infected with H. Influenzae treated group and the control who used the same medications for a different cause. Patients infected with H. Influenzae and treated had an incidence of prostate cancer of 2.49% whereas the control group incidence of prostate cancer was 4.92% with a p-value (< 2.2x10^-16) OR 0.455 CI 95% (0.526 -0.754), proving that the initial results were not due to the use of medications. Conclusion: The findings of our study reveal a statistically significant correlation between H. Influenzae infection and a decreased incidence of prostate cancer. Our findings suggest that prior infection with H. Influenzae may confer some degree of protection to patients and reduce their risk for developing prostate cancer. Future research is recommended to further characterize the potential role of Haemophilus influenzae in the pathogenesis of prostate cancer.

Keywords: Haemophilus Influenzae, incidence, prostate cancer, risk.

Procedia PDF Downloads 198

Authors: Mayank Mishra

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Market Economy can be broadly defined as economic system where supply and demand regulate the economy and in which decisions pertaining to production, consumption, allocation of resources, price and competition are made by collective actions of individuals or organisations with limited government intervention. On the other hand Market Society is one where instead of the economy being embedded in social relations, social relations are embedded in the economy. A market economy becomes a market society when all of land, labour and capital are commodified. This transition also has effect on people’s attitude and values. Such a transition commence impacting the non-material aspect of life such as public education, public health and the like. The inception of neoliberal policies in non-market norms altered the nature of social goods like public health that raised the following questions. What impact would the transition to a market society make on people in terms of accessibility to public health? Is healthcare a commodity that can be subjected to a competitive market place? What kind of private investments are being made in public health and how do private investments alter the nature of a public good like healthcare? This research problem will employ empirical-analytical approach that includes deductive reasoning which will be using the existing concept of market economy and market society as a foundation for the analytical framework and the hypotheses to be examined. The research also intends to inculcate the naturalistic elements of qualitative methodology which refers to studying of real world situations as they unfold. The research will analyse the existing literature available on the subject. Concomitantly the research intends to access the primary literature which includes reports from the World Bank, World Health Organisation (WHO) and the different departments of respective ministries of the countries for the analysis. This paper endeavours to highlight how the issue of commodification of public health would lead to perpetual increase in its inaccessibility leading to stratification of healthcare services where one can avail the better services depending on the extent of one’s ability to pay. Since the fundamental maxim of private investments is to churn out profits, these kinds of trends would pose a detrimental effect on the society at large perpetuating the lacuna between the have and the have-nots.The increasing private investments, both, domestic and foreign, in public health sector are leading to increasing inaccessibility of public health services. Despite the increase in various public health schemes the quality and impact of government public health services are on a continuous decline.

Keywords: commodity, India and Pakistan, market society, public health

Procedia PDF Downloads 312

Authors: Ana Caroline Ibrahim Lino, Denise Bomtempo Birche de Carvalho

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The background of this research is the international process of control and monitoring of illicit psychoactive substances that has commenced in the early 20th century. This process was intensified with the UN Single Convention on Narcotic Drugs of 1961 and had its culmination in the 1970s with the "War on drugs", a doctrine undertaken by the United States of America. Since then, the phenomenon of drug prohibition has been pushing debates around alternatives of public policies to confront their consequences at a global level and in the specific context of Latin America. Previous research has answered the following key questions: a) With what characteristics and models has the international illicit drug control system consolidated in Latin America with the creation of the Organization of American States (OAS) and the Inter-American Drug Abuse Control Commission (CICAD)? b) What drug policies and programs were determined as guidelines for the member states by the OAS and CICAD? The present paper mainly addresses the analysis of the drug strategies developed by the OAS/CICAD for the Americas from 2004 to 2016. The primary sources have been extracted from the OAS/CICAD documents and reports, listed on the Internet sites of these organizations. Secondary sources refer to bibliographic research on the subject with the following descriptors: illicit drugs, public policies, international organizations, OAS, CICAD, and reducing the demand and supply of illicit drugs. The "content analysis" technique was used to organize the collected material and to choose the axes of analysis. The results show that the policies, strategies, and action plans for Latin America had been focused on anti-drug actions since the creation of the Commission until 2010. The discourses and policies to reduce drug demand and supply were of great importance for solving the problem. However, the real focus was on eliminating the substances by controlling the production, marketing, and distribution of illicit drugs. Little attention was given to the users and their families. The research is of great relevance to the Social Work. The guidelines and parameters of the Social Worker's profession are in line with the need for social, ethical, and political strengthening of any dimension that guarantees the rights of users of psychoactive substances. In addition, it contributed to the understanding of the political, economic, social, and cultural factors that structure the prohibitionism, whose matrix anchors the deprivation of rights and violence.

Keywords: illicit drug policies, international organizations, latin America, prohibitionism, reduce the demand and supply of illicit drugs

Procedia PDF Downloads 161

Authors: Gedefaye Nibret Mihretie

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Background: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. Many primary studies in Sub-Saharan Africa have been conducted to assess the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. Method: Cross-sectional studies were systematically searched from March 6, 2022, to April 24, 2022, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of transactional sex and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years, source of data, sample sizes and geographical location. Results: Four thousand one hundred thirty articles were extracted from various databases. The final thirty-two studies were included in this systematic review, including 108,075 participants. The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55%, with a confidence interval of 9.59% to 15.52%. Educational status (OR = .48, 95%CI, 0.27, 0.69) was the protective factors of transactional sex whereas, alcohol use (OR = 1.85, 95% CI: 1.19, 2.52), early sex debut (OR = 2.57, 95%CI, 1.17, 3.98), substance abuse (OR = 4.21, 95% CI: 2.05, 6.37), having history of sexual experience abuse (OR = 4.08, 95% CI: 1.38, 6.78), physical violence abuse (OR = 6.59, 95% CI: 1.17, 12.02), and sexual violence abuse (OR = 3.56, 95% CI: 1.15, 8.27) were the risk factors of transactional sex. Conclusion: The prevalence of transactional sex among women in Sub-Saharan Africa was high. Educational status, alcohol use, substance abuse, early sex debut, having a history of sexual experiences, physical violence, and sexual violence were predictors of transaction sex. Governmental and other stakeholders are designed to reduce alcohol utilization, provide health information about the negative consequences of early sex debut, substance abuse, and reduce sexual violence, ensuring gender equality through mass media, which should be included in state policy.

Keywords: women’s health, child health, reproductive health, midwifery

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Authors: Vinayak Malhotra, Samanyu Raina, Ajinkya Vajurkar

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Enhancing the rocket efficiency by controlling the external factors in solid rockets motors has been an active area of research for most of the terrestrial and extra-terrestrial system operations. Appreciable work has been done, but the complexity of the problem has prevented thorough understanding due to heterogenous heat and mass transfer. On record, severe issues have surfaced amounting to irreplaceable loss of mankind, instruments, facilities, and huge amount of money being invested every year. The coupled effect of an external heat source and external heat sink is an aspect yet to be articulated in combustion. Better understanding of this coupled phenomenon will induce higher safety standards, efficient missions, reduced hazard risks, with better designing, validation, and testing. The experiment will help in understanding the coupled effect of an external heat sink and heat source on the burning process, contributing in better combustion and fire safety, which are very important for efficient and safer rocket flights and space missions. Safety is the most prevalent issue in rockets, which assisted by poor combustion efficiency, emphasizes research efforts to evolve superior rockets. This signifies real, engineering, scientific, practical, systems and applications. One potential application is Solid Rocket Motors (S.R.M). The study may help in: (i) Understanding the effect on efficiency of core engines due to the primary boosters if considered as source, (ii) Choosing suitable heat sink materials for space missions so as to vary the efficiency of the solid rocket depending on the mission, (iii) Giving an idea about how the preheating of the successive stage due to previous stage acting as a source may affect the mission. The present work governs the temperature (resultant) and thus the heat transfer which is expected to be non-linear because of heterogeneous heat and mass transfer. The study will deepen the understanding of controlled inter-energy conversions and the coupled effect of external source/sink(s) surrounding the burning fuel eventually leading to better combustion thus, better propulsion. The work is motivated by the need to have enhanced fire safety and better rocket efficiency. The specific objective of the work is to understand the coupled effect of external heat source and sink on propellant burning and to investigate the role of key controlling parameters. Results as of now indicate that there exists a singularity in the coupled effect. The dominance of the external heat sink and heat source decides the relative rocket flight in Solid Rocket Motors (S.R.M).

Keywords: coupled effect, heat transfer, sink, solid rocket motors, source

Procedia PDF Downloads 223

Authors: Shivani, Seema Sharma, Shveta Singh, Akriti Chandra

Abstract:

Business activities contribute to various environmental issues such as deforestation, waste generation, and pollution. Therefore, integration of environmental concerns within manufacturing operations is vital for the long-term survival of businesses. In this context, green entrepreneurial orientation (GEO) is recognized as a firm-level internal strategy to mitigate ecological damage through initiating green business practices. However, despite the surge in research on GEO in recent years, ambiguity remains on the genesis of GEO and the mechanism through which GEO impacts various organizational outcomes. This prompts an examination of the ongoing scholarly discourse about GEO and its domain knowledge structure within the entrepreneurship literature using bibliometric analysis and the Theories, Contexts, Characteristics, and Methodologies (TCCM) framework. The authors analyzed a dataset comprising 73 scientific documents sourced from the Scopus and Web of Science database from 2005 to 2024 to provide insights into the publication trends, prominent journals, authors, articles, countries' collaboration, and keyword analysis in GEO research. The findings indicate that the number of relevant papers and citations has increased consistently, with authors from China being the main contributors. The articles are mainly published in Business Strategy and the Environment and Sustainability. Dynamic capability view is the dominant framework applied in the GEO domain, with large manufacturing firms and SMEs constituting the majority of the sample. Further, various antecedents of GEO have been identified at an organizational level to which managers can focus their attention. The studies have used various contextual factors to explain when GEO translates into superior organizational outcomes. The Method analysis reveals that PLS-SEM is the commonly used approach for analyzing the primary data collected through surveys. Moreover, the content analysis indicates four emerging research frontiers identified as unidimensional vs. multidimensional perspectives of GEO, typologies of green innovation, environmental management in the hospitality industry, and tech-savvy sustainability in the agriculture sector. This study is one of the earliest to apply quantitative methods to synthesize the extant literature on GEO. This research holds relevance for management practice due to the escalating levels of carbon emissions, energy consumption, and waste discharges observed in recent years, resulting in increased apprehension about climate change.

Keywords: green entrepreneurship, sustainability, SLR, TCCM

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