Search results for: inadequate

Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

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Authors: Parisa Göker, Hilal Kahveci, Özlem Candan Hergül

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Humans are generating culture while being in touch with nature. Along with skills, local knowledge based on experience, and many other subjects developed within this process, 'culture' offers humans a chance to survive. For this reason, culture forms the equipment for humans, which facilitates their survival in all ecosystems. Together with technology, quick consumption of natural sources and overuse culture of humans have brought up the eco-village concept. Ecovillages are ecologically, economically, socio-culturally, and spiritually sustainable settlement models. It is known that the eco-village approach is applying a proper methodology on behalf of integrative and versatile solution generation. Today, the eco-village approach, introducing a radical criticism to the understanding of civilization and consumption culture and deeming urban solutions inadequate as a spatial reflection to civilization and consumption culture, while making a difference about integrative solution offering with multidimensional features, along with the goal of creating self-sufficient communities, is creating solutions on the subject of both reducing the ecological footprint of humans and to provide social order and also to solve the injustice seen in terms of income and life standards. In this study, environmental issues, sustainable development, and environmental sustainability topics are examined within the context of eco-tourism and eco-village. Alongside this, the natural and cultural landscape values of Kurşunlu village which are located in Bilecik province’s Gölpazarı county, and a contextual frame is created for the facilitation of sustainability in the event of dynamizing the Kurşunlu village in terms of tourism-oriented activities.

Keywords: eco village, sustainability, rural landscape, cultural landscape

Procedia PDF Downloads 121

Authors: Dhanashree Moghe, Roberta Bullingham, Rizwan Ahmed, Tarun Singhal

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Aim: The NHS Bowel Screening Programme recommends the use of endoscopic tattooing for suspected malignant lesions that later require surgical or endoscopic localisation, using local protocols as guidance. This is in accordance with guidance from the BSG (The British Society of Gastroenterologists). We used a well-recognised local protocol as a standard to audit current tattooing practice in a large district general hospital with no current local guidelines. Method: A retrospective quantitative analysis of 50 patients who underwent segmental colonic resection for cancer over a 6-month period in 2021. We reviewed historic electronic endoscopy reports recording relevant data on tattoo indication and placement. Secondly, we carried out an anonymous survey of 16 independent lower GI endoscopists on self-reported details of their practice. Results: In our study, 28 patients (56%) had a tattoo placed at the time of their colonoscopy. Of these, only 53% (n=15) had the tattoo distal to the lesion, with the measured distance of the tattoo from the lesion only being documented in 8 reports. Only seven patients (25%) had a circumferential (4 quadrant) placement of the tattoo. 13 patients had lesions either in the caecum or rectum, locations deemed unnecessary as per BSG guidelines. Of the survey responses collected, there were four different protocols being used to guide practice. Only 50% of respondents placed tattoos at the correct distance from the lesion, and 83% placed the correct number of tattoos. Conclusion: There is a lack of standardisation of practices in colonic tattooing demonstrated in our study with incomplete compliance to our standard. The inadequate documentation of tattoo location can contribute to confusion and inaccuracy in the intraoperative localisation of lesions. This has the potential to increase operation length and morbidity. There is a need to standardise both technique and documentation in colonoscopic tattooing practice.

Keywords: colorectal cancer, endoscopic tattooing, colonoscopy, NHS BSCP

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Authors: Pooja Kumbhare

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Water is an important resource for the survival of life. The inadequate availability of surface water makes people depend on ground water for fulfilling their needs. However, ground water is generally too hard to satisfy the requirements for domestic as well as industrial applications. Removal of hardness involves various techniques such as lime soda process, ion exchange, reverse osmosis, nano-filtration, distillation, and, evaporation, etc. These techniques have individual problems such as high annual operating cost, sediment formation on membrane, sludge disposal problem, etc. Electrocoagulation (EC) is being explored as modern and cost-effective technology to cope up with the growing demand of high water quality at the consumer end. In general, earlier studies on electrocoagulation for hardness removal are found to deploy batch processes. As batch processes are always inappropriate to deal with large volume of water to be treated, it is essential to develop continuous flow EC process. So, in the present study, an attempt is made to investigate continuous flow EC process for decreasing excessive hardness of bore-well water. The experimental study has been conducted using 12 aluminum electrodes (25cm*10cm, 1cm thick) provided in EC reactor with volume of 8 L. Bore well water sample, collected from a local bore-well (i.e. at – Vishrambag, Sangli; Maharashtra) having average initial hardness of 680 mg/l (Range: 650 – 700 mg/l), was used for the study. Continuous flow electrocoagulation experiments were carried out by varying operating parameters specifically reaction time (Range: 10 – 60 min), voltage (Range: 5 – 20 V), current (Range: 1 – 5A). Based on the experimental study, it is found that hardness removal to the desired extent could be achieved even for continuous flow EC reactor, so the use of it is found promising.

Keywords: hardness, continuous flow EC process, aluminum electrode, optimal operating parameters

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Authors: Polycarp Igbojekwe

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The main objective of this study was to determine if emotional labour has become a criterion in performance appraisal, job description, selection, and training schemes in the hotel industry in Nigeria. Our main assumption was that majority of hotel organizations have not built emotional labour into their human resources management schemes. Data were gathered by the use of structured questionnaires designed in Likert format, and interviews. The focus group was managers of the selected hotels. Analyses revealed that majority of the hotels have not built emotional labour into their human resources schemes particularly in the 1, 2, and 3-star hotels. It was observed that service employees of 1, 2, and 3-star hotels have not been adequately trained to perform emotional labour; a critical factor in quality service delivery. Managers of 1, 2, and 3-star hotels have not given serious thought to emotional labour as a critical factor in quality service delivery. The study revealed that suitability of an individual’s characteristics is not being considered as a criterion for selection and performance appraisal for service employees. The implication of this is that, person-job-fit is not seriously considered. It was observed that there has been a disconnect between required emotional competency, its recognition, evaluation, and training. Based on the findings of this study, it is concluded that selection, training, job description and performance appraisal instruments in use in hotels in Nigeria are inadequate. Human resource implications of the findings in this study are presented. It is recommended that hotel organizations should re-design and plan the emotional content and context of their human resources practices to reflect the emotional demands of front line jobs in the hotel industry and the crucial role emotional labour plays during service encounters.

Keywords: emotional labour, employee selection, job description, performance appraisal, person-job-fit, employee compensation

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Authors: Kwanele Shishane

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Numerous countries are faced with challenges such as disease, poverty and other social ills and inadequate government support to meet the needs of the entire population. In developing countries, the concept of child-headed households has become a ubiquitous phenomenon and lived experience. As such, migration of children is common in these countries. This study aims to explore the lived experiences of unaccompanied adolescent migrant, with regards to the utilization of health care in South Africa. The objectives of the study are to examine the lived experiences of health care utilization by unaccompanied adolescent migrants; examine the predisposing, enabling and need factors influencing utilization of health care among unaccompanied adolescent migrants; examine the social and cultural influences on health care utilization among unaccompanied adolescent migrants; and identify the health system barriers to utilization of health care by unaccompanied adolescent migrants. Andersen and Newman’s Model of Health Care Utilization (1995) which explains factors determining the utilization of healthcare will provide the theoretical framework for the empirical investigation of this study. The target population for this study is unaccompanied adolescent migrants, seeking to access services from migrant service organizations in four provinces in South Africa (Limpopo, KwaZulu-Natal, Free State, and Gauteng). Participants will be selected using a purposive sampling procedure. A qualitative research approach utilizing a descriptive phenomenological epistemology will be utilized in this study. Data will be collected through conducting in-depth interviews and focus group discussions with unaccompanied migrant adolescents, to explore their lived experiences related to access and utilization of health care, as an unaccompanied migrant in SA. The qualitative data will be analysed using Tech’s (1990) thematic analytical approach.

Keywords: health care utilisation, unaccompanied migrant youth, South Africa, lived experiences

Procedia PDF Downloads 155

Authors: D. Tappi

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In the past decades, the idea of innovation moved from being considered the result of development to being seen as its means. Innovation and its diffusion are indeed keys to the development and economic catch-up of a country. However, the process of diffusing existing innovation in low income countries has demonstrated dependent on inadequate infrastructures and institutions. The paper examines the role of disruptive innovation in bridging the technology gap between high- and low-income countries, overcoming the lack in infrastructures and institutions. In particular, the focus of this paper goes to the role of disruptive innovation in people transportation in Nigeria. Uber, Taxify, and Smartcab are covering a small and interesting market that was underserved, between the high-end private driver markets, the personal car owners and the low-priced traditional cab and the Keke (tricycle). Indeed the small Nigerian middle class and international community have found in the sharing people transportation market a safe, reasonably priced means of transportation in Nigerian big cities. This study uses mainly qualitative data collection methods in the form of semi-structured interviews with major players and users and quantitative data analysis in the form of a survey among users in order to assess the role of these new transportation modes in shaping the market and even creating a new niche. This paper shows how the new sharing economy in people transportation is creating new solutions to old problems as well as creating new challenges for both the existing market players and institutions. By doing so, the paper shows how disruptive innovations applied to low income countries, not only can overcome the lacking infrastructure problem but could also help bridge the technology gap between those and high income countries. This contribution proves that it is indeed exactly because the market presents these obstacles that disruptive innovations can succeed in countries such as Nigeria.

Keywords: development, disruptive innovation, sharing economy, technology gap

Procedia PDF Downloads 97

Authors: Parmeet Kaur, Nighat Yaseen Sofi, Shakti Kumar Gupta, Veena Pandey, Rajvaedhan Azad

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Nutritional status and prevailing blood glucose level trends amongst hospitalized patients has been linked to clinical outcome. Therefore, the present study was undertaken to assess hospitalized Diabetic Eye Disease (DED) patients' anthropometric and dietary intake trends. DED patients with type 1 or 2 diabetes > 20 years were enrolled. Actual food intake was determined by weighed food record method. Mifflin St Joer predictive equation multiplied by a combined stress and activity factor of 1.3 was applied to estimate caloric needs. A questionnaire was further administered to obtain reasons of inadequate dietary intake. Results indicated validity of joint analyses of body mass index in combination with waist circumference for clinical risk prediction. Dietary data showed a significant difference (p < 0.0005) between average daily caloric and carbohydrate intake and actual daily caloric and carbohydrate needs. Mean fasting and post-prandial plasma glucose levels were 150.71 ± 72.200 mg/dL and 219.76 ± 97.365 mg/dL, respectively. Improvement in food delivery systems and nutrition educations were indicated for reducing plate waste and to enable better understanding of dietary aspects of diabetes management. A team approach of nurses, physicians and other health care providers is required besides the expertise of dietetics professional. To conclude, findings of the present study will be useful in planning nutritional care process (NCP) for optimizing glucose control as a component of quality medical nutrition therapy (MNT) in hospitalized DED patients.

Keywords: nutritional status, diabetic eye disease, nutrition care process, medical nutrition therapy

Procedia PDF Downloads 337

Authors: Amna J. Ghith, Khaled Abu Zid, Khairia Youssef, Nasser Saad

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Backgrounds: The multikinase and vascular endothelial growth factor (VEGF) receptor inhibitors interrupt the pathway by which angiogenesis becomes established and promulgated, resulting in the inadequate nourishment of metastatic disease. VEGFR-2 has been the principal target of anti-angiogenic therapies. We disclose the new thieno pyrimidines as inhibitors of VEGFR-2 designed by a molecular modeling approach with increased synergistic activity and decreased side effects. Purpose: 2-substituted thieno pyrimidines are designed and synthesized with anticipated anticancer activity based on its in silico molecular docking study that supports the initial pharmacophoric hypothesis with a same binding mode of interaction at the ATP-binding site of VEGFR-2 (PDB 2QU5) with high docking score. Methods: A series of compounds were designed using discovery studio 4.1/CDOCKER with a rational that mimic the pharmacophoric features present in the reported active compounds that targeted VEGFR-2. An in silico ADMET study was also performed to validate the bioavailability of the newly designed compounds. Results: The Compounds to be synthesized showed interaction energy comparable to or within the range of the benzimidazole inhibitor ligand when docked with VEGFR-2. ADMET study showed comparable results most of the compounds showed absorption within (95-99) zone varying according to different substitutions attached to thieno pyrimidine ring system. Conclusions: A series of 2-subsituted thienopyrimidines are to be synthesized with anticipated anticancer activity and according to docking study structure requirement for the design of VEGFR-2 inhibitors which can act as powerful anticancer agents.

Keywords: docking, discovery studio 4.1/CDOCKER, heterocycles based anticancer agents, 2-subsituted thienopyrimidines

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Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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The construction industry, particularly tunnel construction, exposes workers to respirable crystalline silica (RCS), which can cause incurable illnesses such as silicosis and lung cancer. Despite various control measures, exposures remain inadequately controlled. This research aimed to identify the barriers and challenges hindering the implementation of effective controls and the adoption of safe work practices to protect workers from RCS exposure in tunnelling. A mixed-method approach was employed for this research. Tunnel construction workers were observed, surveyed and interviewed to gauge their knowledge and attitudes and understand their challenges in reducing RCS exposure. The preliminary analysis of the data reveals a diverse array of sociotechnical factors interacting to influence RCS exposure. It is noteworthy that participants consistently emphasised the project as the most exemplary one they have been involved in, although there is room for improvement. While there is a commendable level of knowledge about RCS exposure and control in tunnelling, there is a striking lack of perceived satisfaction regarding dust control. Several factors were identified as interacting to prevent the effective management of dust. These include perceived time pressure, absence of on-tool dust controls, low risk perceptions among workers, and inadequate enforcement of controls. Moreover, participants highlighted communication and heat-related challenges as hindrances to the continuous wear of respirators. This research highlights the need for a paradigm shift in tunnel construction to address the barriers associated with RCS exposure reduction. It emphasises the importance of collaboration among various stakeholders, advocating for more effective controls and enforcement strategies and enhanced worker education through knowledge sharing.

Keywords: respirable crystalline silica, dust control, worker practices, exposure prevention, silicosis

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Authors: Mario M. J. Musonda

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Access to health care is a human right, which includes having timely access to affordable and quality essential medicines at the right place and in sufficient quantity. However, inefficient public sector supply chain management contributes to constant shortages of essential medicines at health facilities. Literature review involved a desktop study of published research studies and reports on risk management, supply chain management of essential medicines and their integration to increase the efficiency of the latter. The research was conducted on a sample population of offices under Ministry of Health Headquarters, Lusaka Provincial and District Offices, selected health facilities in Lusaka, Medical Stores Limited, Zambia Medicines Regulatory Authority and Cooperating Partners. Individuals involved in study were selected judgmentally by their functions under selection and quantification, regulation, procurement, storage, distribution, quality assurance, and dispensing of essential medicines. Structured interviews and discussions were held with selected experts and self-administered questionnaires were distributed. Collected and analysed data of 35 returned and usable questionnaires from the 50 distributed. The highest prioritised risks were; inadequate and inconsistent fund disbursements, weak information management systems, weak quality management systems and insufficient resources (HR and infrastructure) among others. The results for this research can be used to increase the efficiency of the public sector supply chain of essential medicines and other pharmaceuticals. The results of the study showed that there is need to implement effective risk management systems by participating institutions and organisations to increase the efficiency of the entire supply chain in order to avoid and/or reduce shortages of essential medicines at health facilities.

Keywords: essential medicine, risk assessment, risk management, supply chain, supply chain risk management

Procedia PDF Downloads 423

Authors: R. M. Rajapaksa

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Construction industry is one of the key players in driving the economy of a country to achieve its prosperity. However, a dispute is one of the crucial factors which prevent the completion of construction contracts within the budgeted cost, scheduled time, and accepted quality. Disputes are inevitable in the construction contract. Accordingly, a study has been undertaken to identify the factors affecting contractual disputes in construction projects in Sri Lanka. The study was a mixed approach with major qualitative and minor quantitative. Qualitative study was set in the form of in-depth interviews with eighteen participants, and quantitative study was conducted using a questionnaire with twenty-four respondents from previously implemented projects by the National Water Supply & Drainage Board representing the employer, engineer and the Contractor to identify the factors affecting contractual disputes and to verify most critical factors respectively. Data analysis for qualitative and quantitative studies was carried out by means of transcribing, code & categorizeand average score methods, respectively. The study reveals that there are forty factors affecting the contractual disputes in construction contracts in Sri Lanka. The finding further illustrates that conflicting decisions by inexperience personnel in the higher position of the Employer, ambiguities resulting inadequate descriptions of the preliminary/general items in price schedule, unfair valuation and late confirmation of variations, unfair determination due to lack of experience of the Engineer/Consultant, under certification of progress payments, unfair grant of EOT & application of delay damages, unreasonable claims for variation of works, errors/discrepancies/ambiguities in the contract conditions and discrepancies & errors in designs & specifications are the most critical factors affecting contractual disputes. Finally, the study proposed remedial measures to most critical factors affecting contractual disputes.

Keywords: dispute, contractual, factors, employer, engineer, contractor, construction projects

Procedia PDF Downloads 194

Authors: H. Z. M. Chong, M. E. Y. Leong, G. L. Khor, S. C. Loke

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Vitamin D insufficiency is reported to be prevalent among women living in different altitudes including the equator where sunshine is available throughout the year. Multiple factors for vitamin D insufficiency include poor intake of vitamin D rich food and inadequate sun exposure, especially among women working indoor with a sedentary lifestyle. Furthermore, Muslim women in Malaysia whose attire covers the entire body are likely to receive poor sun exposure. This research determined serum vitamin D status, vitamin D intake and sun exposure of women aged 20-45 years of different ethnicity in Kuala Lumpur, Malaysia. Blood samples were collected from 106 women for determination of serum 25(OH)D levels. Information about vitamin D intake and sun exposure were obtained by interviewing the subjects using pre-tested questionnaires. The overall mean serum 25(OH)D was found to be 29.9 ± 14 nmol/L. Vitamin D deficiency and insufficiency was prevalent and highest among the Malay women. Less than ten percent of the subjects in this study met the sufficient vitamin D level recommendation of ≥50 nmol/L. Intake of vitamin D rich food such as oily fishes was poor across the different ethnicity. Other dietary sources of vitamin D in the diet were fortified bread and skim milk. On the other hand, the median sunlight exposure of the subjects was 3.9 hours per week. The Malay women reported to have the highest duration being exposed to the sun. Nevertheless, due to cultural clothing practices, these women had the least body surface area exposed to sunlight, resulting in the lowest calculated sun index score compared to the Chinese and the Indians. Low intake of vitamin D rich foods and sun exposure were negatively correlated with serum 25(OH)D level. In conclusion, intake of food sources rich in vitamin D and adequate body surface area exposed to the sun are essential to ensure healthy vitamin D level. Supplementation of vitamin D may be recommended to women whom unable to meet these recommendations.

Keywords: serum 25-OH, sun exposure, vitamin D food frequency, vitamin D deficiency

Procedia PDF Downloads 249

Authors: Abraham Kidane

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The study aims at assessing the prospects and challenges of community-based ecotourism development in and around the Guassa Community Conservation Area (GCCA) for the establishment of alternative sources of livelihood for local people and the conservation of natural resources. The Guassa area and its surrounding area are endowed with natural, cultural, and religious tourism resources. The study is descriptive in its design and uses both qualitative and quantitative research methods. Interviews and questionnaires were used as an instrument for data gathering. The interview was undertaken with government officials, NGO officials, and experts, with three local community representatives. The three Kebeles of Guassa were chosen using purposive sampling because of the fact that they are immediate neighbors to GCCA, and hence, 150 questionnaires were administered proportionally to the household numbers in each kebeles. The perspectives of the MoCT, EWCA, and some Tour Operation agencies were uncovered through questionnaires; for each of them, five questionnaires were administered, and all the returns were used in the analysis. Frequency, percentage, average mean, One Way-ANOVA, and independent t-test are used to analyze quantitative data. The findings revealed that food insecurity is commonplace in the study area. The local people's reliance on the conservation area’s resources has been increasing, and the area size is also dwindling from time to time. On the other hand, the local people's levels of awareness about Community-Based Ecotourism (CBET) are low. In addition, the local capacity in relation to conservation and CBET development is also low, even though there is inadequate training offered by the government and NGOs. In general, tourism is not yet considered an alternative source of income and a means of conserving natural resources. In addition, the challenges for CBET development apart from low awareness level about CBET and low capacity, poor infrastructure, and poor tourism facilities were also identified as challenges in the study area.

Keywords: ecotourism, CBET, alternative livelihood, conservation

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Authors: S. Ibrahim, Bashir Umar

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Agricultural credit is very important for sustainable agricultural development to be achieved in any country of the world. Rural credit has proven to be a powerful instrument against poverty reduction and development in rural area. Agricultural credit enhances productivity and promotes standard of living by breaking vicious cycle of poverty of small scale farmers. This study examined access to credit among rural farmers in Giwa local government area of Kaduna state. Two stages sampling procedure was employed to select forty-two (42) respondents for the study. Primary data were collected using structured questionnaire with the help of well-trained enumerators. Data were analyzed using simple descriptive statistics. The results revealed that farmers were predominantly male (57.1%) and most (54.7%), were married with one level of education or another (66.5.%). Majority of the households’ head were between the ages of 31 to 50. majority of the farmers (68.2%) had more than 2ha of farmlands with at least 5 years of farming experience and an annual farm income of N 61,000 to 100,000 (61.9%). The Various sources of credit by the farmers in the study area were commercial banks (38.1%), Co-operative banks (47.6%), Development banks (14.2%) (formal) and Relatives (26.1%), Personal Savings (Adashi scheme) (52.3%), Moneylenders (21.4%) (informal). As regard to the amount of credit obtained by the farmers 38.1% received N 50,000-100,000, 50 % obtained N 100,001-500,000 while 11.9% obtained N 500,001-1,000,000. High interest Inadequate collateral, Complicated Procedures, lack of guarantor were the major constrains encountered by the farmers in accessing loans. The study therefore recommends that Rural farmers should be encouraged to form credit and thrift cooperative societies from which they can access much cheaper credits, Moreover, to ensure that any credit obtained may be manageable for the farmers, financial institutions should provide loans with low interest rates and government and non-governmental organizations should simplify procedures associated with accessing loans.

Keywords: analysis, access, credit, farmers

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Authors: Mary Kiviiri Nakawuka, Mary Namugalu, Andrew Otiti

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BACKGROUND Cervical cancer is the fourth most common cancer in women and seventh overall among all cancers worldwide. It accounts for about 7.5% of all female-cancer deaths with 85% occurring in low and middle-income countries and the first most common female cancer in women aged 15 to 44 years in Uganda with an annual number of new cases at 3,915 and 2,275 annual number of cervical cancer deaths in 2012 (ICO INFORMATION CENTRE ON HPV AND CANCER, 2017).Despite the available free cervical cancer screening services whose uptake has been documented to improve the chances of successful treatment of pre-cancers and cancers among women of reproductive age, there is a low uptake of these services thus we sought to examine the uptake of cervical cancer services and associated factors among women of reproductive age (25-49) attending the ART clinic of KISWA HCII in Kampala, Uganda METHODS The research was carried out in the ART clinic of KISWA HCII among 385 participants. An analytical, cross-sectional study with quantitative methods of data collection was used. The study adopted a non-probability convenience sampling method to select participants. Quantitative data was collected through structured questionnaires. RESULTS 72.2% of the participants were found to have been screened for cervical cancer. 36 % of the screened women had a positive HPV or VIA result ,59.2% of the screened women had a negative HPV or VIA result and 4.8% had an invalid HPV test result. Only 39.5% of the participants had adequate overall knowledge about cervical cancer, more than a third of the participants (50%) had moderate or low knowledge and minority of them (10.5%) had no knowledge. There was no significant association between the uptake of cervical cancer screening services among participants and their socio-demographic characteristics. CONCLUSIONS Although majority of the women surveyed had been screened for cervical cancer, a comparatively large number of participants had inadequate knowledge about cervical cancer and therefore there is still need to continue teaching about cervical cancer and this may include education campaigns, improvements to the accessibility and convenience of the screening services.

Keywords: cervical cancer uptake, cervical cancer screening, women of reproductive age., cervical cancer knowledge

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Authors: Pornpote Nusen, Manop Kaewmoracharoen

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In recent years, there was an observable shift in fully developed countries from constructing new buildings to modifying existing buildings. The issue was that although an effective instrument like BIM (Building Information Modeling) was well developed for constructing new buildings, it was not widely used to renovate old buildings. BIM was accepted as an effective means to overcome common managerial problems such as project delay, cost overrun, and poor quality of the project life cycle. It was recently introduced in Thailand and rarely used in a renovation project. Today, in Thailand, BIM is mostly used for creating aesthetic 3D models and quantity takeoff purposes, though it can be an effective tool to use as a project management tool in planning and scheduling. Now the governmental sector in Thailand begins to recognize the uses of using BIM to manage a construction project, but the knowledge about the BIM implementation to governmental construction projects is underdeveloped. Further studies need to be conducted to maximize its advantages for the governmental sector. An educational extra large governmental building of 17,000 square-meters was used in this research. It is currently under construction for a two-year renovation project. BIM models of the building for the exterior and interior areas were created for the whole five floors. Then 4D BIM with combination of 3D BIM plus time was created for planning and scheduling. Three focus groups had been done with executive committee, contractors, and officers of the building to discuss the possibility of usage and usefulness of BIM approach over the traditional process. Several aspects were discussed in the positive sides, especially several foreseen problems, such as the inadequate accessibility of ways, the altered ceiling levels, the impractical construction plan created through a traditional approach, and the lack of constructability information. However, for some parties, the cost of BIM implementation was a concern, though, this study believes, its uses outweigh the cost.

Keywords: building information modeling, extra large building, governmental building renovation, project management, renovation, 4D BIM

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Sindhu Govardhan, Kenneth G. Crowther

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Modernisation of the water sector is leading to increased connectivity and integration of emerging technologies with traditional ones, leading to new security risks. The convergence of Information Technology (IT) with Operation Technology (OT) results in solutions that are spread across larger geographic areas, increasingly consist of interconnected Industrial Internet of Things (IIOT) devices and software, rely on the integration of legacy with modern technologies, use of complex supply chain components leading to complex architectures and communication paths. The result is that multiple parties collectively own and operate these emergent technologies, threat actors find new paths to exploit, and traditional cybersecurity controls are inadequate. Our approach is to explicitly identify and draw data flows that cross trust boundaries between owners and operators of various aspects of these emerging and interconnected technologies. On these data flows, we layer potential attack vectors to create a frame of reference for evaluating possible risks against connected technologies. Finally, we identify where existing controls, mitigations, and other remediations exist across industry partners (e.g., suppliers, product vendors, integrators, water utilities, and regulators). From these, we are able to understand potential gaps in security, the roles in the supply chain that are most likely to effectively remediate those security gaps, and test cases to evaluate and strengthen security across these partners. This informs a “shared responsibility” solution that recognises that security is multi-layered and requires collaboration to be successful. This shared responsibility security framework improves visibility, understanding, and control across the entire supply chain, and particularly for those water utilities that are accountable for safe and continuous operations.

Keywords: cyber security, shared responsibility, IIOT, threat modelling

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Authors: Mahboubeh Kabiri, Saba Aslani

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Among various approaches used for the treatment of cardiovascular diseases, the occlusion of the small-diameter vascular graft (SDVG) is still an unresolved problem which seeks further research to address them. Though autografts are now the gold standards to be replaced for blocked coronary arteries, they suffer from inadequate quality and quantity. On the other hand, the major problems of the tissue engineered grafts are thrombosis and intimal hyperplasia. Provision of a suitable spatiotemporal release pattern of anticoagulant agents such as heparin and aspirin can be a step forward to overcome such issues . Herein, we fabricated electrospun scaffolds from FDA (Food and Drug Administration) approved poly-L-lactic acid (PLLA) with aspirin loaded into the nanofibers. Also, we surface coated the scaffolds with Amniotic Membrane lysate as a source for natural elastic polymers and a mimic of endothelial basement membrane. The scaffolds were characterized thoroughly structurally and mechanically for their morphology, fiber orientation, tensile strength, hydrophilicity, cytotoxicity, aspirin release and cell attachment support. According to the scanning electron microscopy (SEM) images, the size of fibers ranged from 250 to 500 nm. The scaffolds showed appropriate tensile strength expected for vascular grafts. Cellular attachment, growth, and infiltration were proved using SEM and MTT (3-(4,5-Dimethylthiazol-2-Yl)-2,5-Diphenyltetrazolium Bromide) assay. Drug-loaded scaffolds showed a sustained release profile of aspirin in 7 days. An enhanced cytocompatibility was observed in AM-coated electrospun PLLA fibers compared to uncoated scaffolds. Our results together indicated that AM lysate coated ASA releasing scaffolds have promising potentials for development of a biocompatible SDVG.

Keywords: vascular tissue engineering, vascular grafts, anticoagulant agent, aspirin, amniotic membrane

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Authors: Usma Iftikhar, Khorshed Alam

Abstract:

Background: Digital health platforms and digital health interventions are gaining increasing importance with the shift to online health-seeking behaviour, especially post-Covid. Subsequently, the importance of digital health literacy is increasingly being recognized. With the surge in culturally and linguistically diverse populations in First World countries, especially females, the predictors of digital health access in this population remain elusive. Keeping in view the inadequate digital infrastructure in rural and remote Australia, with lack of specialist services, the determinants of digital access gain even more importance. Objectives: The objective of this research are to measure the digital health literacy levels in this population, including the predictors of digital health literacy like sociodemographics and the correlation between the predictors and digital health literacy levels. Methods: A population-based quantitative survey was carried out in Regional Queensland from Jan 2022- Dec 2023 on culturally and linguistically diverse adult females. Sociodemographics like age, literacy levels, socioeconomic status, access to digital devices were recorded after informed consent. Digital health literacy levels were measured by specially designed questionnaires. The relationship between sociodemographics and digital health literacy levels was estimated by Pearson correlation. Results: Mean DHL was 2.66 + 0.35. There was a negative significant relationship (p<0.005) between demographics like age and access to a digital device with digital health literacy levels. Also observed was a positive significant relationship between literacy levels and proficiency in English. Conclusion: Age, literacy levels and English proficiency are some of the highest predictors of digital health access. This is important because remote areas rely on digital health access due to less developed health infrastructure, including specialist services. Guide for Policy makers to focus on the populations most in need.

Keywords: digital health literacy, eHealth literacy, culturally and linguistically diverse, ethnic minorities, regional areas, rural and remote areas

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Authors: Tahani Amutairi, Paul May, Neil Allan

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Many properties of semiconductor materials (mechanical, electronic, magnetic, and optical) can be significantly modified by introducing a point defect. Diamond offers extraordinary properties as a semiconductor, and doping seems to be a viable method of solving the problem associated with the fabrication of diamond-based electronic devices in order to exploit those properties. The dopants are believed to play a significant role in reducing the energy barrier to conduction and controlling the mobility of the carriers and the resistivity of the film. Although it has been proven that the n-type diamond semiconductor can be obtained with phosphorus doping, the resulting ionisation energy and mobility are still inadequate for practical application. Theoretical studies have revealed that this is partly because the effects of the many phosphorus atoms incorporated in the diamond lattice are compensated by acceptor states. Using spin-polarised hybrid density functional theory and a supercell approach, we explored the effects of bonding one N atom to a P in adjacent substitutional sites in diamond. A range of hybrid functional, including HSE06, B3LYP, PBE0, PBEsol0, and PBE0-13, were used to calculate the formation, binding, and ionisation energies, in order to explore the solubility and stability of the point defect. The equilibrium geometry and the magnetic and electronic structures were analysed and presented in detail. The defect introduces a unique reconstruction in a diamond where one of the C atoms coordinated with the N atom involved in the elongated C-N bond and creates a new bond with the P atom. The simulated infrared spectra of phosphorus-nitrogen defects were investigated with different supercell sizes and found to contain two sharp peaks at the edges of the spectrum, one at a high frequency 1,379 cm⁻¹ and the second appearing at the end range, 234 cm⁻¹, as obtained with the largest supercell (216).

Keywords: DFT, HSE06, B3LYP, PBE0, PBEsol0, PBE0-13

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Authors: Funmilayo Juliana Afolabi, Joke Haafkens, Paul De Beer

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Globally, there is a growing concern on reducing workplace accidents in the informal sector. However, there is a dearth of study on the perception of the informal workers on occupational risks they are exposed to. The way a worker perceives the workplace risk will influence his/her risk tolerance and risk behavior. The aim of this paper, therefore, is to have an in-depth understanding of the way the artisans perceive the risks at their workplace and how it influences their risk tolerance and risk behavior. This will help in designing meaningful intervention for the artisans and it will assist the policy makers in formulating a policy that will help them. Methods: Forty-three artisans were purposely selected for the study; data were generated through observation of the workplace and work practices of the artisans and in-depth interview from automobile artisans (Panel beater, Mechanic, Vulcanizer, and Painters) in Osun State, Nigeria. The transcriptions were coded and analyzed using MAXQDA software. Results: The perceived occupational risks among the study groups are a danger of being run over by oncoming vehicles while working by the roadside, a risk of vehicle falling on workers while working under the vehicle, cuts, and burns, fire explosion, falls from height and injuries from bursting of tires. The identified risk factors are carelessness of the workers, pressure from customers, inadequate tools, preternatural forces, God’s will and lack of apprentices that will assist them in the workplace. Furthermore, the study revealed that artisans engage in risky behavior like siphoning fuel with mouth because of perception that fuel is good for expelling worms and will make them free from any stomach upset. Conclusions: The study concluded that risky behaviors are influenced by culture, beliefs, and perception of the artisans. The study, therefore, suggested proper health and safety education for the artisans.

Keywords: automobile artisans, informal, occupational risks, Nigeria, sociological enquiry

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Authors: Mergim Gasia, Bojan Milovanovica, Sanjin Gumbarevic

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Better energy performance of the building envelope is one of the most important aspects of energy savings if the goals set by the European Union are to be achieved in the future. Dynamic heat transfer simulations are being used for the calculation of building energy consumption because they give more realistic energy demands compared to the stationary calculations that do not take the building’s thermal mass into account. Software used for these dynamic simulation use methods that are based on the analytical models since numerical models are insufficient for longer periods. The analytical models used in this research fall in the category of the conduction transfer functions (CTFs). Two methods for calculating the CTFs covered by this research are the Laplace method and the State-Space method. The literature review showed that the main disadvantage of these methods is that they are inadequate for heavyweight façade elements and shorter time periods used for the calculation. The algorithms for both the Laplace and State-Space methods are implemented in Mathematica, and the results are compared to the results from EnergyPlus and TRNSYS since these software use similar algorithms for the calculation of the building’s energy demand. This research aims to check the efficiency of the Laplace and the State-Space method for calculating the building’s energy demand for heavyweight building elements and shorter sampling time, and it also gives the means for the improvement of the algorithms used by these methods. As the reference point for the boundary heat flux density, the finite difference method (FDM) is used. Even though the dynamic heat transfer simulations are superior to the calculation based on the stationary boundary conditions, they have their limitations and will give unsatisfactory results if not properly used.

Keywords: Laplace method, state-space method, conduction transfer functions, finite difference method

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Authors: Antonio Pizzarello, Oris Friesen

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Networks, such as the electric power grid, must demonstrate exemplary performance and integrity. Integrity depends on the quality of both the system design model and the deployed software. Integrity of the deployed software is key, for both the original versions and the many that occur throughout numerous maintenance activity. Current software engineering technology and practice do not produce adequate integrity. Distributed systems utilize networks where each node is an independent computer system. The connections between them is realized via a network that is normally redundantly connected to guarantee the presence of a path between two nodes in the case of failure of some branch. Furthermore, at each node, there is software which may fail. Self-stabilizing protocols are usually present that recognize failure in the network and perform a repair action that will bring the node back to a correct state. These protocols first introduced by E. W. Dijkstra are currently present in almost all Ethernets. Super stabilization protocols capable of reacting to a change in the network topology due to the removal or addition of a branch in the network are less common but are theoretically defined and available. This paper describes how to use the Software Integrity Assessment (SIA) methodology to analyze self-stabilizing software. SIA is based on the UNITY formalism for parallel and distributed programming, which allows the analysis of code for verifying the progress property p leads-to q that describes the progress of all computations starting in a state satisfying p to a state satisfying q via the execution of one or more system modules. As opposed to demonstrably inadequate test and evaluation methods SIA allows the analysis and verification of any network self-stabilizing software as well as any other software that is designed to recover from failure without external intervention of maintenance personnel. The model to be analyzed is obtained by automatic translation of the system code to a transition system that is based on the use of the weakest precondition.

Keywords: network, power grid, self-stabilization, software integrity assessment, UNITY, weakest precondition

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Authors: Shulamit Sternin

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Athletes experience injuries that can have both a physical and psychological impact on the individual. In such instances, athletes are able to rely on the established field of sports psychology to facilitate holistic rehabilitation. Musicians, like athletes rely on their bodies to perform in much the same way athletes do and are also susceptible to injury. Due to the similar performative nature of succeeding as an athletes or a musician, these careers share many of the same primary psychological concerns and therefore it is reasonable that athletes and musicians may require similar rehabilitation post-injury. However, musicians face their own unique psychological challenges and understanding the needs of an injured athlete can serve as a foundation for understanding the injured musician but is not enough to fully rehabilitate an injured musician. The current research surrounding musicians and their injuries is primarily focused on physiological aspects of injury and rehabilitation; the psychological aspects have not yet received adequate attention resulting in poor musician rehabilitation post- injury. This review paper uses current models of psychological response to injury in athletes to draw parallels with the psychological response to injury in musicians. Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as psychological response, injury, athlete, and musician. Studies that focused on post-injury psychology of either the musician or the athlete were included. Within the literature there is evidence to support psychological responses, unique to the musician, that are not accounted for by current models of response in athletes. The models of psychological response to injury in athletes are inadequate tools for application to the musician. Future directions for performance arts research that can fill the gaps in our understanding and modeling of musicians’ response to injury are discussed. A better understanding of the psychological impact of injuries on musicians holds significant implications for health care practitioners working with injured musicians. Understanding the unique barriers musicians face post-injury, and how support for this population must be tailored to properly suit musicians’ needs will aid in more holistic rehabilitation and a higher likelihood of musician’s returning to pre-injury performance levels.

Keywords: athlete, injury, musician, psychological response

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Authors: Victoria Masi Haruna Karatu, Nik Kamariah Nikmat

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In recent times awareness about the environment and green purchase has been on the increase across nations due to global warming. Previous researchers have attempted to determine what actually influences the purchase intention of consumers in this environmentally conscious epoch. The consumers too have become conscious of what to buy and who to buy from in their purchasing decisions as this action will reflect their concern about the environment and their personal well-being. This trend is a widespread phenomenon in most developed countries of the world. On the contrary evidence revealed that only 5% of the populations of Nigeria involve in green purchase activities thus making the country lag behind its counterparts in green practices. This is not a surprise as Nigeria is facing problems of inadequate green knowledge, non-enforcement of environmental regulations, sensitivity to the price of green products when compared with the conventional ones and distrust towards green products which has been deduced from prior studies of other regions. The main objectives of this study is to examine the direct antecedents of green purchase intention (green availability, government regulations, perceived green knowledge, perceived value and green price sensitivity) in Nigeria and secondly to establish the mediating role of perceived behavioral control on the relationship between these antecedents and green purchase intention. The study adopts quantitative method whereby 700 questionnaires were administered to lecturers in three Nigerian universities. 502 datasets were collected which represents 72 percent response rate. After screening the data only 440 were usable and analyzed using structural equation modeling (SEM) and bootstrapping. From the findings, three antecedents have significant direct relationships with green purchase intention (perceived green knowledge, perceived behavioral control, and green availability) while two antecedents have positive and significant direct relationship with perceived behavioral control (perceived value and green price sensitivity). On the other hand, PBC does not mediate any of the paths from the predictors to criterion variable. This result is discussed in the Nigerian context.

Keywords: Green Availability, Green Price Sensitivity, Green Purchase Intention, Perceived Green Knowledge, Perceived Value

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Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

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Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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Authors: Mehmet Akköse

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Concern about seismic safety of concrete dams have been growing around the world, partly because the population at risk in locations downstream of major dams continues to expand and also because it is increasingly evident that the seismic design concepts in use at the time most existing dams were built were inadequate. Most of the investigations in the past have been conducted on large dams, typically above 100m high. A large number of concrete dams in our country and in other parts of the world are less than 50m high. Most of these dams were usually designed using pseudo-static methods, ignoring the dynamic characteristics of the structure as well as the characteristics of the ground motion. Therefore, it is important to carry out investigations on seismic behavior this category of dam in order to assess and evaluate the safety of existing dams and improve the knowledge for different high dams to be constructed in the future. In this study, size effects on structural performance of concrete gravity dams subjected to near and far-fault ground motions are investigated including dam-water-foundation interaction. For this purpose, a benchmark problem proposed by ICOLD (International Committee on Large Dams) is chosen as a numerical application. Structural performance of the dam having five different heights is evaluated according to damage criterions in USACE (U.S. Army Corps of Engineers). It is decided according to their structural performance if non-linear analysis of the dams requires or not. The linear elastic dynamic analyses of the dams to near and far-fault ground motions are performed using the step-by-step integration technique. The integration time step is 0.0025 sec. The Rayleigh damping constants are calculated assuming 5% damping ratio. The program NONSAP modified for fluid-structure systems with the Lagrangian fluid finite element is employed in the response calculations.

Keywords: concrete gravity dams, Lagrangian approach, near and far-fault ground motion, USACE damage criterions

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Authors: Susan Marie R. De La Cruz, Bernadette F. De La Cruz, Georgia D. Demavibas

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This study determined the top 10 perceived students’ academic needs, personal needs, personal obstacles in achieving their academic goals, are as they need assistance, and their perceived feelings in math, reading and writing. The North Carolina State College, Student Support Services needs assessment survey was used. The respondents were the randomly chosen122Graduate school students. The top 10 academic needs are as follows: need to improve memory, communication skills, study habits, time management skills, career decisions, vocabulary, math skills, test taking skills, reading comprehension, and the need to reduce math anxiety. Top 10 personal needs are as follows: difficulty meeting deadline, difficulty managing money, inadequate computer skills, afraid of failing graduate school, difficulty participating in class/group discussions, absence from school, anxiety during exams, little or no experience with internet, personal counseling needs, and unsure of university academic procedures. Students’ top 10 perceived personal obstacles were as follows: issues surrounding sickness in family, lack of time management, lack of money, feeling tired, fears to speak in class, poor study habits, problems at home, late in class, too shy, and always feeling sick and easily distracted. Students felt need assistance in areas surrounding personal budget, stress management, motivation, anxiety, depressions, leadership development and goals/decision making. It is recommended that enrichment activities be provided to respond to students’ academic and personal needs. Also, Graduate School Guidance Counselor collaborates with other licensed Guidance Counselors in other colleges to have a well-coordinated and effective delivery of services responsive to students’ needs.

Keywords: academic needs, guidance counsellors, guidance service, needs assessment survey, personal needs, student services

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