Search results for: Healthcare Service Delivery

Authors: Charlotte Bose Iro-Idoro, Adebisi Folake Osore, Tajudeen Adisa Jimoh

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All changes in the office environment were and are still driven by advances in technology. The impact of computers on office work has resulted in numerous changes in office activities, procedures and the expectations from office managers and secretaries. This study investigated the level of knowledge and use of computer office application packages by secretaries and office managers in higher educational institutions in Ogun State and the implications of these on their performance enhancement. The study is an ex post facto research and adopted the survey design for the collection of data. Two hypotheses were formulated, and a questionnaire was developed and tested at 0.05 level of significance. All office managers and secretaries in the service of higher educational institutions in Ogun State, Nigeria formed the population of the study. The study was limited to federal institutions and a total of 120 office managers/secretaries were selected to form the sample such that 40 office managers/secretaries were randomly selected from each of the three Federal higher institutions in the State, that is Federal University of Agriculture, Abeokuta, Federal Polytechnic, Ilaro and Federal College of Education, Osiele, Abeokuta, Ogun State. Analysis of data and hypotheses tests were carried out with frequency counts, percentage and T-Test. The result indicated varying levels of awareness on office application tools with limited knowledge and use of computer application packages by office managers/secretaries. The results also showed that good knowledge and high use of office application tools enhance performance of office managers/secretaries. The study recommended that there should be maximum institutional resources and support and personal development on the part of the office managers to ensure update knowledge and maximal use of office application tools by office managers/secretaries.

Keywords: application packages, computer, office managers, performance enhancement

Procedia PDF Downloads 151

Authors: Elena Petersen, Inna Kornienko, Svetlana Guryeva, Sergey Simakov

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In vitro organoid cultivation requires the simultaneous provision of necessary vascularization and nutrients perfusion of cells during organoid development. However, many aspects of this problem are still unsolved. The functionality of vascular network intergrowth is limited during early stages of organoid development since a function of the vascular network initiated on final stages of in vitro organoid cultivation. Therefore, a microchannel network should be created in early stages of organoid cultivation in hydrogel matrix aimed to conduct and maintain minimally required the level of nutrients perfusion for all cells in the expanding organoid. The network configuration should be designed properly in order to exclude hypoxic and necrotic zones in expanding organoid at all stages of its cultivation. In vitro vascularization is currently the main issue within the field of tissue engineering. As perfusion and oxygen transport have direct effects on cell viability and differentiation, researchers are currently limited only to tissues of few millimeters in thickness. These limitations are imposed by mass transfer and are defined by the balance between the metabolic demand of the cellular components in the system and the size of the scaffold. Current approaches include growth factor delivery, channeled scaffolds, perfusion bioreactors, microfluidics, cell co-cultures, cell functionalization, modular assembly, and in vivo systems. These approaches may improve cell viability or generate capillary-like structures within a tissue construct. Thus, there is a fundamental disconnect between defining the metabolic needs of tissue through quantitative measurements of oxygen and nutrient diffusion and the potential ease of integration into host vasculature for future in vivo implantation. A model is proposed for growth prognosis of the organoid perfusion based on joint simulations of general nutrient diffusion, nutrient diffusion to the hydrogel matrix through the contact surfaces and microchannels walls, nutrient consumption by the cells of expanding organoid, including biomatrix contraction during tissue development, which is associated with changed consumption rate of growing organoid cells. The model allows computing effective microchannel network design giving minimally required the level of nutrients concentration in all parts of growing organoid. It can be used for preliminary planning of microchannel network design and simulations of nutrients supply rate depending on the stage of organoid development.

Keywords: 3D model, consumption model, diffusion, spheroid, tissue organoid

Procedia PDF Downloads 297

Authors: Ndou Rembuluwani Moddy, Daniel Ter Goon, Takalani Grace Tshitangano, Lindelani Fhumudzani Mushaphi

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Obesity is a global public health problem. The study aimed to determine the risk factors associated with and the consequences of obesity among residents of Tshikota, Makhado Municipality, Limpopo Province, South Africa. A cross-sectional study involving 318 randomly selected adults aged 18-45 years residing at Tshikota, Makhado Local Municipality, South Africa. Sociodemographic information includes age, gender, educational level, occupation, behavioral lifestyle, environmental, psychological, and family history. Anthropometric, blood pressure, and blood glucose measurements followed standard procedure. The prevalence of obesity and overweight was 35.5% and 28.6%, respectively. About 75.2% of obese do not engage in physical activity. Most participants (63.5%) take meals three times a day, and 19.2% do not skip breakfast. Most participants do not have access to fruits and vegetables. Participants who were pre-hypertensive were 92(28.9%) and 32(10.1%) were in Stage 1 hypertension. Of the participants with Class 1 obesity, 40.9% were pre-hypertensive, and 15.2% were in Stage 1 hypertension. In Class 2 obesity, 37.8% were pre-hypertensive, and 26.7% were in Stage 1 hypertension. There was a significant difference between BMI and blood pressure among participants (p=0.00). About 6.1% of the participants in Class 1 obesity were at high risk, and 3.0% were at very high risk of glucose levels. Regarding cholesterol levels, 65 (20.4%) were at borderline, and 17(5.3%) were at high risk. There was no significant difference in BMI and cholesterol levels among participants (p= 0.20). The prevalence of obesity and overweight was high among residents of this setting. Age, marital and educational status, and employment were significantly associated with obesity. An obesity awareness campaign is crucial, and the availability of supermarkets and full-service grocery stores would provide accessibility to healthy food such as fruits and vegetables.

Keywords: obesity, overweight, risk factors, adults.

Procedia PDF Downloads 65

Authors: Muhammad Mehran Arshad Khan, Chengliang Wang, Zou Minhui, Danyal Badar Soomro

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Security of the smart home in terms of behavior activity pattern recognition is a totally dissimilar and unique issue as compared to the security issues of other scenarios. Sensor devices (low capacity and high capacity) interact and negotiate each other by detecting the daily behavior activity of individuals to execute common tasks. Once a device (e.g., surveillance camera, smart phone and light detection sensor etc.) is compromised, an adversary can then get access to a specific device and can damage daily behavior activity by altering the data and commands. In this scenario, a group of common instruction processes may get involved to generate deadlock. Therefore, an effective suitable security solution is required for smart home architecture. This paper proposes seamless distributed Scheme which fortifies low computational wireless devices for secure communication. Proposed scheme is based on lightweight key-session process to upheld cryptic-link for trajectory by recognizing of individual’s behavior activities pattern. Every device and service provider unit (low capacity sensors (LCS) and high capacity sensors (HCS)) uses an authentication token and originates a secure trajectory connection in network. Analysis of experiments is revealed that proposed scheme strengthens the devices against device seizure attack by recognizing daily behavior activities, minimum utilization memory space of LCS and avoids network from deadlock. Additionally, the results of a comparison with other schemes indicate that scheme manages efficiency in term of computation and communication.

Keywords: authentication, key-session, security, wireless sensors

Procedia PDF Downloads 304

Authors: Arunya Tuicomepee

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During the past two decades, there have been the increasing numbers of studies on online counseling, especially among adolescents who are familiar with the online world. This can be explained by the fact that via this channel enables easier access to the young, who may not be ready for face-to-face service, possibly due to uneasiness to reveal their personal problems with a stranger, the feeling that their problems are to be shamed, or the need to protect their images. Especially, the group of teenagers prone to suicide or despair, who tend to keep things to or isolate from the society to themselves, usually prefer types of services that require no face-to-face encounter and allow their anonymity, such as online services. This study aimed to examine effectiveness of chat-based online counseling for enhancing wellness of undergraduates with emotional crisis tendency. Experimental with pretest-posttest control group design was employed. Participants were 47 undergraduates (10 males and 37 females) with high emotional crisis tendency. They were randomly assigned to experimental group (24 students) and control group (23 students). Participants in the experimental group received a 60-minute, 4-sessions of individual chat-based online counseling led by counselor. Those in control group received no counseling session. Instruments were the Emotional Crisis Scale and Wellness Scales. Two-way mixed-design multivariate analysis of variance was used for data analysis. Finding revealed that the posttest scores on wellness of those in the experimental group were higher than the scores of those in the control group. The posttest scores on emotional crisis tendency of those in the experimental group were lower than the scores of those in the control group. Hence, this study suggests chat-based online counseling services can become a helping source that increasing more adolescents would recognize and turn to in the future and that will receive more attention.

Keywords: chat-based online counseling, emotional crisis, undergraduate student, wellness

Procedia PDF Downloads 218

Authors: Patricia Girrbach

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Currently, our society is facing a new and incremental upheaval technological revolution named digitalization. In order to face the relating challenges organizations have to be prepared. They need appropriate circumstances in order to cope with current issues concerning digital transformation processes. Nowadays digitalization emerged as top issues for companies and business leaders. In this context, it is a pressure on companies to have a positive, productive digital culture. And indeed, Organizations realize that they need to address this important issue. In this context 87 percent of organizations quote culture and engagement as one of their top challenges in terms of any change process, but especially in terms of the digital turn. Executives can give their company a competitive advantage and attract top talent by having a strong workplace culture that supports digitalization. Many current studies attest that fact. Digital-oriented companies can hire more easily, they have the lowest voluntary turnover rates, deliver better customer service, and are more profitable over the long run. Based on this background it is important to provide companies starting points and practical measurements how to reach this goal. The major findings are that firms need to make sense out of digitalization. In this context, they should focus on internal but also on external stakeholders. Furthermore, they should create certain working conditions and they should support the qualification of employees, e.g. by Virtual Reality. These measurements can create positive experiences in terms of digitalization in order to ensure the support of stuff in terms of the digital turn. Based on several current studies and literature research this paper provides concrete measurements for companies in order to enable the digital turn. Therefore, the aim of this paper is providing possible practical starting points which support both the education of employees by digitalization as well as the digital turn itself within the organization.

Keywords: digitalization, industry 4.0, education 4.0, virtual reality

Procedia PDF Downloads 139

Authors: Jamila Fakchich, Mostafa Jamila Lazaar Elachouri, Lakhder Fakchich, Fatna Ouali, Abd Errazzak Belkacem

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Diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients as well as the health care system. By its nature diabetes, is a multisystem disease with wide-ranging complication that span nearly all region of the body. This epidemic problem, however, is not unique to the industrialized society, but has also hardly struck the developing countries. In Morocco, as developing country, there is an epidemic rise in diabetes, with ensuing concern about the management and control of this disease; it began a chronic burdensome disease of largely middle-aged and elderly people, with a long course and serious complications often resulting in high death-rate, the treatment of diabetes spent vast amount of resources including medicines, diets, physical training. Treatment of this disease is considered problematic due to the lack of effective and safe drugs capable of inducing sustained clinical, biochemical, and histological cure. In Moroccan society, the phytoremedies are some times the only affordable sources of healthcare, particularly for the people in remote areas. In this paper, we present a synthesis work obtained from the ethnobotanical data reported in different specialized journals. A Synthesis of four published ethnobotanical studies that have been carried out in different region of Morocco by different team seekers during the period from 1997 to 2015. Medicinal plants inventoried by different seekers in four Moroccan’s areas have been regrouped and codified, then, Factorial Analysis (FA) and Principal Components Analysis (PCA) are used to analyse the aggregated data from the four studies and plants are classified according to their frequency of use by population. Our work deals with an attempt to gather information on some traditional uses of medicinal plants from different regions of Morocco, also, it was designed to give a set of medicinal plants commonly used by Moroccan people in the treatment of diabetes; In this paper, we intended to provide a basic knowledge about plant species used by Moroccan society for treatment of diabetes. One of the most interesting aspects of this type of works is to assess the relative cultural importance of medicinal plants for specific illnesses and exploring its usefulness in the context of diabetes.

Keywords: Morocco, medicinal plants, ethnobotanical, diabetes, phytoremedies

Procedia PDF Downloads 308

Authors: Vahid Asadzadeh, Amin Ataee

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Since the advent of social media, there has been a wave of optimism among researchers and civic activists about the influence of virtual networks on the democratization process, which has gradually waned. One of the lesser-known concerns is how to increase the possibility of hearing the voices of different minorities. According to the theory of media logic, the media, using their technological capabilities, act as a structure through which events and ideas are interpreted. Social media, through the use of the learning machine and the use of algorithms, has formed a kind of structure in which the voices of minorities and less popular topics are lost among the commotion of the trends. In fact, the recommended systems and algorithms used in social media are designed to help promote trends and make popular content more popular, and content that belongs to minorities is constantly marginalized. As social networks gradually play a more active role in politics, the possibility of freely participating in the reproduction and reinterpretation of structures in general and political structures in particular (as Laclau‎ and Mouffe had in mind‎) can be considered as criteria to democracy in action. The point is that the media logic of virtual networks is shaped by the rule and even the tyranny of the majority, and this logic does not make it possible to design a self-foundation and self-revolutionary model of democracy. In other words, today's social networks, though seemingly full of variety But they are governed by the logic of homogeneity, and they do not have the possibility of multiplicity as is the case in immanent radical democracies (influenced by Gilles Deleuze). However, with the emergence and increasing popularity of Clubhouse as a new social media, there seems to be a shift in the social media space, and that is the diminishing role of algorithms and systems reconditioners as content delivery interfaces. This has led to the fact that in the Clubhouse, the voices of minorities are better heard, and the diversity of political tendencies manifests itself better. The purpose of this article is to show, first, how social networks serve the elimination of minorities in general, and second, to argue that the media logic of social networks must adapt to new interpretations of democracy that give more space to minorities and human rights. Finally, this article will show how the Clubhouse serves the new interpretations of democracy at least in a minimal way. To achieve the mentioned goals, in this article by a descriptive-analytical method, first, the relation between media logic and postmodern democracy will be inquired. The political economy popularity in social media and its conflict with democracy will be discussed. Finally, it will be explored how the Clubhouse provides a new horizon for the concepts embodied in radical democracy, a horizon that more effectively serves the rights of minorities and human rights in general.

Keywords: algorithmic tyranny, Clubhouse, minority rights, radical democracy, social media

Procedia PDF Downloads 133

Authors: Protus A. Lumiti, Susan O. Wekesa, Mary Omondi

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Performance is a key pillar to the accomplishment of the goals of all organizations, whether private, public or non- profit. Employees are the intellectual assets of the organization and they are an avenue to the achievement of competitive advantage. An employee welfare service in an organization is vital in fostering employee motivation and improving their productivity. In view of this, the main goal of this research was to determine the relationship between employee welfare practices and the performance of non-governmental organizations in Kenya. The study was guided by four objectives, namely: to establish, determine, evaluate and assess the relationship between employee welfare practices and the performance of non-governmental organizations in Kenya. The study utilized a survey design using both qualitative and quantitative approaches. In this study, a purposive, stratified and simple random sampling technique was used to arrive at a sample of 355 respondents who comprised senior managers, middle level managers and operational employees out of the targeted population of 14,283 employees of non-governmental organizations working in Nairobi County. The primary data collection tools were questionnaires supplemented by an interview schedule, while secondary data was obtained from reviewed journals, published books and articles. Data analysis was done using Statistical Packages for Social Sciences Software version 23. The study utilized multiple linear regression and a structural equation model. The findings of the study were that: employee welfare practices had a positive and significant relationship with the performance of Non-governmental organizations in Kenya. In addition, there was also a linear relationship between the independent variables and the dependent variable and the study concluded that there was a relationship between the predictor variable and the dependent variable of the study. The study recommended that management of No-governmental organization boards in Kenya should come up with a comprehensive policy document on employee welfare practices in order to enhance the performance of non-governmental organizations in Kenya.

Keywords: employee, economic, performance, welfare

Procedia PDF Downloads 164

Authors: Luís R. Silva, Fábio Jesus, Catarina Bento, Ana C. Gonçalves

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Over the last few years, the traditional medicine has gained ground at nutritional and pharmacological level. The natural products and their derivatives have great importance in several drugs used in modern therapeutics. Plant-based systems continue to play an essential role in primary healthcare. Additionally, the utilization of their plant parts, such as leaves, stems and flowers as nutraceutical and pharmaceutical products, can add a high value in the natural products market, not just by the nutritional value due to the significant levels of phytochemicals, but also by to the high benefit for the producers and manufacturers business. Stems of Prunus avium L. are a byproduct resulting from the processing of cherry, and have been consumed over the years as infusions and decoctions due to its bioactive properties, being used as sedative, diuretic and draining, to relief of renal stones, edema and hypertension. In this work, we prepared a hydroethanolic and infusion extracts from stems of P. avium collected in Fundão Region (Portugal), and evaluate the phenolic profile by LC/DAD, antioxidant capacity, α-glucosidase inhibitory activity and protection of human erythrocytes against oxidative damage. The LC-DAD analysis allowed to the identification of 19 phenolic compounds, catechin and 3-O-caffolquinic acid were the main ones. In a general way, hydroethanolic extract proved to be more active than infusion. This extract had the best antioxidant activity against DPPH• (IC50=22.37 ± 0.28 µg/mL) and superoxide radical (IC50=13.93 ± 0.30 µg/mL). Furthermore, it was the most active concerning inhibition of hemoglobin oxidation (IC50=13.73 ± 0.67 µg/mL), hemolysis (IC50=1.49 ± 0.18 µg/mL) and lipid peroxidation (IC50=26.20 ± 0.38 µg/mL) on human erythrocytes. On the other hand, infusion revealed to be more efficient towards α-glucosidase inhibitory activity (IC50=3.18 ± 0.23 µg/mL) and against nitric oxide radical (IC50=99.99 ± 1.89 µg/mL). The Sweet cherry sector is very important in Fundão Region (Portugal), and taking profit from the great wastes produced during processing of the cherry to produce added-value products, such as food supplements cannot be ignored. Our results demonstrate that P. avium stems possesses remarkable antioxidant and free radical scavenging properties. It is therefore, suggest, that P. avium stems can be used as a natural antioxidant with high potential to prevent or slow the progress of human diseases mediated by oxidative stress.

Keywords: stems, Prunus avium, phenolic compounds, biological potential

Procedia PDF Downloads 279

Authors: Zhihui Liu, Dongmei Hao, Qian Qiu, Yang An, Lin Yang, Song Zhang, Yimin Yang, Xuwen Li, Dingchang Zheng

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Premature birth, defined as birth before 37 completed weeks of gestation is a leading cause of neonatal morbidity and mortality and has long-term adverse consequences for health. It has recently been reported that the worldwide preterm birth rate is around 10%. The existing measurement techniques for diagnosing preterm delivery include tocodynamometer, ultrasound and fetal fibronectin. However, they are subjective, or suffer from high measurement variability and inaccurate diagnosis and prediction of preterm labor. Electrohysterography (EHG) method based on recording of uterine electrical activity by electrodes attached to maternal abdomen, is a promising method to assess uterine activity and diagnose preterm labor. The purpose of this study is to analyze the difference of EHG signal features between term labor and preterm labor. Free access database was used with 300 signals acquired in two groups of pregnant women who delivered at term (262 cases) and preterm (38 cases). Among them, EHG signals from 38 term labor and 38 preterm labor were preprocessed with band-pass Butterworth filters of 0.08–4Hz. Then, EHG signal features were extracted, which comprised classical time domain description including root mean square and zero-crossing number, spectral parameters including peak frequency, mean frequency and median frequency, wavelet packet coefficients, autoregression (AR) model coefficients, and nonlinear measures including maximal Lyapunov exponent, sample entropy and correlation dimension. Their statistical significance for recognition of two groups of recordings was provided. The results showed that mean frequency of preterm labor was significantly smaller than term labor (p < 0.05). 5 coefficients of AR model showed significant difference between term labor and preterm labor. The maximal Lyapunov exponent of early preterm (time of recording < the 26th week of gestation) was significantly smaller than early term. The sample entropy of late preterm (time of recording > the 26th week of gestation) was significantly smaller than late term. There was no significant difference for other features between the term labor and preterm labor groups. Any future work regarding classification should therefore focus on using multiple techniques, with the mean frequency, AR coefficients, maximal Lyapunov exponent and the sample entropy being among the prime candidates. Even if these methods are not yet useful for clinical practice, they do bring the most promising indicators for the preterm labor.

Keywords: electrohysterogram, feature, preterm labor, term labor

Procedia PDF Downloads 547

Authors: Zeyad Abdelmageid, Xianbin Wang

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Choosing the operational channel for a WLAN access point (AP) in WLAN networks has been a static channel assignment process initiated by the user during the deployment process of the AP, which fails to cope with the dynamic conditions of the assigned channel at the station side afterward. However, the dramatically growing number of Wi-Fi APs and stations operating in the unlicensed band has led to dynamic, distributed, and often severe interference. This highlights the urgent need for the AP to dynamically select the best overall channel of operation for the basic service set (BSS) by considering the distributed and changing channel conditions at all stations. Consequently, dynamic channel selection algorithms which consider feedback from the station side have been developed. Despite the significant performance improvement, existing channel selection algorithms suffer from very high feedback overhead. Feedback latency from the STAs, due to the high overhead, can cause the eventually selected channel to no longer be optimal for operation due to the dynamic sharing nature of the unlicensed band. This has inspired us to develop our own dynamic channel selection algorithm with reduced overhead through the proposed low-overhead, cluster-based station reporting mechanism. The main idea behind the cluster-based station reporting is the observation that STAs which are very close to each other tend to have very similar channel conditions. Instead of requesting each STA to report on every candidate channel while causing high overhead, the AP divides STAs into clusters then assigns each STA in each cluster one channel to report feedback on. With the proper design of the cluster based reporting, the AP does not lose any information about the channel conditions at the station side while reducing feedback overhead. The simulation results show equal performance and, at times, better performance with a fraction of the overhead. We believe that this algorithm has great potential in designing future dynamic channel selection algorithms with low overhead.

Keywords: channel assignment, Wi-Fi networks, clustering, DBSCAN, overhead

Procedia PDF Downloads 95

Authors: Ivy Chumo, Sheillah Simiyu, Hellen Gitau, Isaac Kisiangani, Caroline Kabaria Kanyiva Muindi, Blessing Mberu

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The global sanitation workforce bridges the gap between sanitation infrastructure and the provision of sanitation services through essential public service work. Manual pit emptiers often perform the work at the cost of their dignity, safety, and health as their work requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. This exposes them to occupational and environmental health hazards and risking illness, injury, and death. The study will extend the studies by presenting occupational health risks and suggestions for improvement in informal settlements of Nairobi, Kenya. This is a qualitative study conducted among sanitation stakeholders in Korogocho, Mukuru and Kibera informal settlements in Nairobi. Data were captured using digital voice recorders, transcribed and thematically analysed. The discussion notes were further supported by observational notes made during the interviews. These formed the basis for a robust picture of occupational health of manual pit emptiers; a lack or inappropriate use of protective clothing, and prolonged duration of working hours were described to contribute to the occupational health hazard. To continue working, manual pit emptiers had devised coping strategies which include working in groups, improvised protective clothing, sharing the available protective clothing, working at night and consuming alcohol drinks while at work. Many of these strategies are detrimental to their health. Occupational health hazards among pit emptiers are key for effective working and is as a result of a lack of collaboration amongst stakeholders linked to health, safety and lack of PPE of pit emptiers. Collaborations amongst sanitation stakeholders is paramount for health, safety, and in ensuring the provision and use of personal protective devices.

Keywords: sanitation, occupational health, manual emptiers, informal settlements

Procedia PDF Downloads 176

Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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Background: A mixed method systematic review was undertaken in order to explore issues related to the experiences of health care providers and parents in the care of children with palliative care needs. The aims of this systematic review were to identify existing evidence about the experiences of communication in the care of children with palliative care needs, to appraise the research conducted in this area and to identify gaps in the literature in order to recommend for future related studies. Method: A mixed method systematic review of research on the experience of communication in the care of children with palliative care needs, conducted with parents and health professionals was undertaken. The electronic databases of CINAHL, Cochrane, PubMed, OVID, Social Care Online, Web of Science, Scopus, and ProQuest were searched for the period of 2000-2016. Inclusion was limited to studies of communication experience in the care of children with palliative care needs. Result: Thirty-eight studies were found. The studies were conducted in a variety of countries: Uganda, Jordan, USA, UK, Taiwan, Turkey, Ireland, Poland, Brazil, Australia, Switzerland, Sweden, Netherland, Lebanon, Spain, Greece, and China. The current review shows that parents tend to protect their children when they are discussing their illnesses with them, particularly where they have a life-threatening or life-limiting condition. The approach of parents towards the discussion of sensitive issues concerning death with their children is significantly affected by the cultural background of the families. Conservative cultures encourage collusion behaviours which tend to keep children unaware of the incurable nature of the disease. The major communication challenges reported by health professionals are facing difficulties in judging how much information should be given to parents, responding to difficult questions, conflicts with families and inadequate skills to support grieving families. Conclusion: It is probably significant for the future studies to consider the change of parent-child communication experience over time in order to understand how the parents could change their interaction styles with their children according to the different stages of their children’s disease. Moreover, further studies are required to investigate the experience of communication of parents of children with non-malignant life-threatening and life-limiting illnesses.

Keywords: children with life-threatening or life- limiting illnesses, end of life, experience of communication, healthcare care providers, paediatric palliative care

Procedia PDF Downloads 280

Authors: Hasan Izhar Khan, Naiqiang Zhang, Hong Xu, Zhongliang Zhu, Dongfang Jiang

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Inconel 625 is a nickel-based alloy having outstanding corrosion resistance and developed for use at service temperatures ranging from cryogenic to 980°C. It got a wide range of applications in nuclear, petrochemical, chemical, marine, aeronautical, and aerospace industries. Currently, it is one of the candidate materials to be used as a structural material in ultra-supercritical (USC) power plants. In the high-temperature corrosive medium environment, metallic materials are susceptible to corrosion fatigue (CF). CF is an interaction between cyclic stress and corrosive medium environment that acts on a susceptible material and results in initiation and propagation of cracks. For the application of Inconel 625 as a structural material in USC power plants, CF behavior must be evaluated in steam and supercritical water (SCW) environment. Fatigue crack growth rate (FCGR) curves obtained from CF experiments are required to predict residual life of metallic materials used in power plants. In this study, FCGR tests of Inconel 625 were obtained by using compact tension specimen at 550-650 °C in steam (8 MPa) and SCW (25 MPa). The dissolved oxygen level was kept constant at 8000 ppb for the test conducted in steam and SCW. The tests were performed under sine wave loading waveform, 1 Hz loading frequency, stress ratio of 0.6 and maximum stress intensity factor of 32 MPa√m. Crack growth rate (CGR) was detected by using direct current potential drop technique. Results showed that CGR increased with an increase in temperature in the tested environmental conditions. The mechanism concerning the influence of temperature on FCGR are further discussed.

Keywords: corrosion fatigue, crack growth rate, nickel-based alloy, temperature

Procedia PDF Downloads 117

Authors: Karthik K. R, Viswanath V, Asraff A. K

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The first stage of a new-generation launch vehicle of ISRO makes use of large pressure vessels made of Aluminium alloy AA2219 to store fuel and oxidizer. These vessels have many weld joints that may contain cracks or crack-like defects during their fabrication. These defects may propagate across the vessel during pressure testing or while in service under the influence of tensile stresses leading to catastrophe. Though ductile materials exhibit significant stable crack growth prior to failure, it is not generally acceptable for an aerospace component. There is a need to predict the initiation of stable crack growth. The structural integrity of the vessel from fracture considerations can be studied by constructing the Failure Assessment Diagram (FAD) that accounts for both brittle fracture and plastic collapse. Critical crack sizes of the pressure vessel may be highly conservative if it is predicted from FAD alone. If the J-R curve for material under consideration is available apriori, the critical crack sizes can be predicted to a certain degree of accuracy. In this paper, a novel approach is proposed to predict the integrity of a weld in a pressure vessel made of AA2219 material. Fracture parameter ‘J-integral’ at the crack front, evaluated through finite element analyses, is used in the new procedure. Based on the simulation of tension tests carried out on SCT specimens by NASA, a cut-off value of J-integral value (J?ᵤₜ_ₒ??) is finalised. For the pressure vessel, J-integral at the crack front is evaluated through FE simulations incorporating different surface cracks at long seam weld in a cylinder and in dome petal welds. The obtained J-integral, at vessel level, is compared with a value of J?ᵤₜ_ₒ??, and the integrity of vessel weld in the presence of the surface crack is firmed up. The advantage of this methodology is that if SCT test data of any metal is available, the critical crack size in hardware fabricated using that material can be predicted to a better level of accuracy.

Keywords: FAD, j-integral, fracture, surface crack

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Authors: Bruno Valverde Chahaira, Matheus Jeronimo Low Lopes, Marta Beatriz Tanaka Ferdinandi

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This paper proposes to dissect the meanings and / or directions of the State, in order, to present the State models to elaborate a conceptual framework about its function in the legal scope. To do so, it points out the possible contracts established between the State and the Society, since the general principles immanent in them can guide the models of society in force. From this orientation arise the contracts, whose purpose is by the effect to modify the status (the being and / or the opinion) of each of the subjects in presence - State and Society. In this logic, this paper announces the fiduciary contracts and “veredicção”(portuguese word) contracts, from the perspective of semiotics discourse (or greimasian). Therefore, studies focus on the issue of manifest language in unilateral and bilateral or reciprocal relations between the State and Society. Thus, under the biases of the model of the communicative situation and discourse, the guidelines of these contractual relations will be analyzed in order to see if there is a pragmatic sanction: positive when the contract is signed between the subjects (reward), or negative when the contract between they are broken (punishment). In this way, a third path emerges which, in this specific case, passes through the subject-third sector. In other words, the proposal, which is systemic in nature, is to analyze whether, since the contract of the welfare state is not carried out in the constitutional program on fundamental rights: education, health, housing, an others. Therefore, in the structure of the exchange demanded by the society according to its contractual obligations (others), the third way (Third Sector) advances in the empty space left by the State. In this line, it presents the modalities of action of the third sector in the social scope. Finally, the normative communication organization of these three subjects is sought in the pragmatic model of discourse, namely: State, Society and Third Sector, in an attempt to understand the constant dynamics in the Law and in the language of the relations established between them.

Keywords: access to justice, state, social rights, third sector

Procedia PDF Downloads 125

Authors: Auezhan Amanov, Inho Cho, Young-Sik Pyun

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Control element drive mechanism (CEDM) nozzle is manufactured as welded on the reactor vessel and currently uses Alloy 690 material. The top of the reactor is equipped with about 100 CEDM nozzles with an internal diameter of about 70 mm. Relatively large Inlet/Outlet nozzles are equipped with two outlet nozzles and four inlet nozzles on the reactor wall. The inner diameter of the nozzle is vulnerable to stress corrosion cracking (SCC), and in order to solve this problem, an ultrasonic nanocrystal surface modification (UNSM) treatment is performed on the inner diameter of the nozzle and the weld surface. The ultimate goal is to improve the service life of parts by applying compressive residual stress and suppressing primary water stress corrosion cracking (PWSCC). The main purpose is to design and fabricate a UNSM treatment device for the internal diameter processing of CEDM nozzles and inlet/outlet nozzles. In order to develop the system, the basic technology such as the development of UNSM tooling is developed and the mechanical properties and fatigue performance of before and after UNSM treatment of reactor nozzle material made of Ni-based alloys using the specimen are compared and evaluated. The inner diameter of the nozzle was treated by a newly developed UNSM treatment under the optimized treatment parameters. It was found that the mechanical properties and fatigue performance of nozzle were improved in comparison with the untreated nozzle, which may be attributed to the increase in hardness, induced compressive residual stress.

Keywords: control element drive mechanism nozzle, fatigue, Ni-based alloy, ultrasonic nanocrystal surface modification, UNSM

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Authors: Javed Mohammed

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Right now, bio-medical infrastructure lags well behind the curve. Our healthcare system is dispersed and disjointed; medical records are a bit of a mess; and we do not yet have the capacity to store and process the crazy amounts of data coming our way from widespread whole-genome sequencing. And then there are privacy issues. Despite these infrastructure challenges, some researchers are plunging into bio medical Big Data now, in hopes of extracting new and actionable knowledge. They are doing delving into molecular-level data to discover bio markers that help classify patients based on their response to existing treatments; and pushing their results out to physicians in novel and creative ways. Computer scientists and bio medical researchers are able to transform data into models and simulations that will enable scientists for the first time to gain a profound under-standing of the deepest biological functions. Solving biological problems may require High-Performance Computing HPC due either to the massive parallel computation required to solve a particular problem or to algorithmic complexity that may range from difficult to intractable. Many problems involve seemingly well-behaved polynomial time algorithms (such as all-to-all comparisons) but have massive computational requirements due to the large data sets that must be analyzed. High-throughput techniques for DNA sequencing and analysis of gene expression have led to exponential growth in the amount of publicly available genomic data. With the increased availability of genomic data traditional database approaches are no longer sufficient for rapidly performing life science queries involving the fusion of data types. Computing systems are now so powerful it is possible for researchers to consider modeling the folding of a protein or even the simulation of an entire human body. This research paper emphasizes the computational biology's growing need for high-performance computing and Big Data. It illustrates this article’s indispensability in meeting the scientific and engineering challenges of the twenty-first century, and how Protein Folding (the structure and function of proteins) and Phylogeny Reconstruction (evolutionary history of a group of genes) can use HPC that provides sufficient capability for evaluating or solving more limited but meaningful instances. This article also indicates solutions to optimization problems, and benefits Big Data and Computational Biology. The article illustrates the Current State-of-the-Art and Future-Generation Biology of HPC Computing with Big Data.

Keywords: high performance, big data, parallel computation, molecular data, computational biology

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Authors: Arbolino Roberta, Boffardi Raffaele

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Achieving the highest effectiveness for the National Plans for Recovery and Resilience (NPRR) while strengthening the objectives of cohesion and reduction of intra-EU unbalances is only possible by means of strategic, coordinated, and coherent policy planning. Therefore, the present research aims at assessing and quantifying the potential impact of NPRRs across the twenty-seven European Member States in terms of economic convergence, considering disaggregated data on industrial, construction, and service sectors. The first step of the research involves a performance analysis of the main macroeconomic indicators describing the trends of twenty-seven EU economies before the pandemic outbreak. Subsequently, in order to define the potential effect of the resources allocated, we perform an impact analysis of previous similar EU investment policies, estimating national-level sectoral elasticity associated with the expenditure of the 2007-2013 and 2014-2020 Cohesion programmes funds. These coefficients are then exploited to construct adjustment scenarios. Finally, convergence analysis is performed on the data used for constructing scenarios in order to understand whether the expenditure of funds might be useful to foster economic convergence besides driving recovery. The results of our analysis show that the allocation of resources largely mirrors the aims of the policy framework underlying the NPRR, thus reporting the largest investments in both those sectors most affected by the economic shock (services) and those considered fundamental for the digital and green transition. Notwithstanding an overall positive effect, large differences exist among European countries, while no convergence process seems to be activated or fostered by these interventions.

Keywords: NPRR, policy evaluation, cohesion policy, scenario Nalsysi

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Authors: Iman Shabanzadeh

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Over the last three decades, the main demands of the Iranian workforce have been focused on three areas: "The right to a decent wage", "The right to organize" and "The right to job security". In order to investigate and analyze this situation, the present study focuses on the component of job security. The purpose of the study is to figure out what mechanisms in Iran's Labor Law have led to the destabilization and undermining of workers' job security. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws related to labor rights in Iran and, semi-structured interviews with experts have been used. In the data analysis stage, the qualitative content analysis method was also used. The trend analysis of the statistics related to the labor force situation in Iran in the last three decades shows that the employment structure has been facing an increase in the active population, but in the last decade, a large part of this population has been mainly active in the service sector, and contract-free enterprises, so a smaller share of this employment has insurance coverage and a larger share has underemployment. In this regard, the results of this study show that four contexts have been proposed as the main legal and executive mechanisms of labor instability in Iran, which are: 1) temporaryization of the labor force by providing different interpretations of labor law, 2) adjustment labor in the public sector and the emergence of manpower contracting companies, 3) the cessation of labor law protection of workers in small workshops and 4) the existence of numerous restrictions on the effective organization of workers. The theoretical conclusion of this article is that the main root of the challenges of the labor society and the destabilized workforce in Iran is the existence of structural inequalities in the field of labor security, whose traces can be seen in the legal provisions and executive regulations of this field.

Keywords: inequality, precariat, temporaryization, labor force, labor law

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Authors: Siti Anis Nadia Abu Bakar, Vani Tanggamani

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Over recent years, the quality and environmental management practices are the necessary tasks in hospitality industry in order to provide high quality services, a comfortable and safe environment for occupants as well as innovative nature and shareholders' satisfaction, its environmental and social added value sustainable. Numerous studies have observed and measured quality management program (QMProg) and environmental management practices (EMPrac) independently. This paper analyzed the level of QMProg, and EMPrac in hospitality industry, particularly on hotel performance, specifically in the context of Malaysia as hotel industry in Malaysia has contributed tremendously to the development in the Malaysia tourism industry.The research objectives are; (1) to analyze how the level of QMProg influences on firm performance; (2) to investigate the level of EMPrac and its influence on firm performance. This paper contributes to the literature by providing added-value to the service industry strategic decision-making processes by helping to predict the varying impacts of positive and negative corporate social responsibility (CSR) activities on financial performance in their respective industries. Further, this paper also contributes to develop more applicable CSR strategies. As a matter of fact, the findings of this paper has contributed towards an integrated management system that will assist a firm in implementation of their environmental strategy by creating a higher level of accountability for environmental performance. The best results in environmental systems have instigated managers to explore more options when dealing with problems, especially problems involving the reputation of their hotel. In conclusion, the results of the study infer that the best CSR strategies of the quality and environmental management practices influences hotel performance.

Keywords: corporate social responsibility (CSR), environmental management practices (EMPrac), performance (PERF), quality management program (QMProg)

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Authors: Mahadehe Hassan

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In most countries manufacturing, trading and distribution of gasoline and diesel fuels belongs to the most important sectors of national economy. For Bangladesh, a robust, well-functioning, secure and smartly managed national fuel distribution chain is an essential precondition for achieving Government top priorities in development and modernization of transportation infrastructure, protection of national environment and population health as well as, very importantly, securing due tax revenue for the State Budget. Bangladesh is a developing country with complex fuel supply network, high fuel taxes incidence and – till now - limited possibilities in application of modern, automated technologies for Government national fuel market control. Such environment allows dishonest physical and legal persons and organized criminals to build and profit from illegal fuel distribution schemes and fuel illicit trade. As a result, the market transparency and the country attractiveness for foreign investments, law-abiding economic operators, national consumers, State Budget and the Government ability to finance development projects, and the country at large suffer significantly. Research shows that over 50% of retail petrol stations in major agglomerations of Bangladesh sell adulterated fuels and/or cheat customers on the real volume of the fuel pumped into their vehicles. Other forms of detected fuel illicit trade practices include misdeclaration of fuel quantitative and qualitative parameters during internal transit and selling of non-declared and smuggled fuels. The aim of the study is to recommend the implementation of a National Fuel Distribution Integrity Program (FDIP) in Bangladesh to address and resolve fuel adulteration and illicit trade problems. The program should be customized according to the specific needs of the country and implemented in partnership with providers of advanced technologies. FDIP should enable and further enhance capacity of respective Bangladesh Government authorities in identification and elimination of all forms of fuel illicit trade swiftly and resolutely. FDIP high-technology, IT and automation systems and secure infrastructures should be aimed at the following areas (1) fuel adulteration, misdeclaration and non-declaration; (2) fuel quality and; (3) fuel volume manipulation at retail level. Furthermore, overall concept of FDIP delivery and its interaction with the reporting and management systems used by the Government shall be aligned with and support objectives of the Vision 2041 and Smart Bangladesh Government programs.

Keywords: fuel adulteration, octane, kerosene, diesel, petrol, pollution, carbon emissions

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Authors: Fanyuan Shao, Wei Liu, Deli Gao

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Polycrystalline diamond composite (PDC) cutter is made of diamond powder as raw material, cobalt metal or non-metallic elements as a binder, mixed with WC cemented carbide matrix assembly, through high temperature and high-pressure sintering. PDC bits with PDC cutters are widely used in oil and gas drilling because of their high hardness, good wear resistance and excellent impact toughness. And PDC cutter is the main cutting tool of bit, which seriously affects the service of the PDC bit. The wear resistance of the PDC cutter is measured by cutting granite with a vertical turret lathe (VTL). This experiment can achieve long-distance cutting to obtain the relationship between the wear resistance of the PDC cutter and cutting distance, which is more closely to the real drilling situation. Load cell and 3D optical profiler were used to obtain the value of cutting forces and wear area, respectively, which can also characterize the damage and wear of the PDC cutter. PDC cutters were cut via electrical discharge machining (EDM) and then flattened and polished. A scanning electron microscope (SEM) was used to observe the distribution of binder cobalt and the size of diamond particles in a diamond PDC cutter. The cutting experimental results show that the wear area of the PDC cutter has a good linear relationship with the cutting distance. Simultaneously, the larger the wear area is and the greater the cutting forces are required to maintain the same cutting state. The size and distribution of diamond particles in the polycrystalline diamond layer have a great influence on the wear resistance of the diamond layer. And PDC cutter with fine diamond grains shows more wear resistance than that with coarse grains. The deep leaching process is helpful to reduce the effect of binder cobalt on the wear resistance of the polycrystalline diamond layer. The experimental study can provide an important basis for the application of PDC cutters in oil and gas drilling.

Keywords: polycrystalline diamond compact, scanning electron microscope, wear resistance, cutting distance

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Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung

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Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Vanja Skoric

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The paper examines whether the impacts of artificial intelligence (AI) can be meaningfully addressed through the rights-based approach to AI design, investigating in particular how the inclusive, participatory process of assessing the AI impact would make this viable. There is a significant gap between envisioning rights-based AI systems and their practical application. Plausibly, internalizing human rights approach within AI design process might be achieved through identifying and assessing implications of AI features human rights, especially considering the case of vulnerable individuals and communities. However, there is no clarity or consensus on how such an instrument should be operationalised to usefully identify the impact, mitigate harms and meaningfully ensure relevant stakeholders’ participation. In practice, ensuring the meaningful inclusion of those individuals, groups, or entire communities who are affected by the use of the AI system is a prerequisite for a process seeking to assess human rights impacts and risks. Engagement in the entire process of the impact assessment should enable those affected and interested to access information and better understand the technology, product, or service and resulting impacts, but also to learn about their rights and the respective obligations and responsibilities of developers and deployers to protect and/or respect these rights. This paper will provide an overview of the study and practice of the participatory design process for AI, including inclusive impact assessment, its main elements, propose a framework, and discuss the lessons learned from the existing theory. In addition, it will explore pathways for enhancing and promoting individual and group rights through such engagement by discussing when, how, and whom to include, at which stage of the process, and what are the pre-requisites for meaningful and engaging. The overall aim is to ensure using the technology that works for the benefit of society, individuals, and particular (historically marginalised) groups.

Keywords: rights-based design, AI impact assessment, inclusion, harm mitigation

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Authors: Mimoza Canga, Irene Malagnino, Vergjini Mulo, Alketa Qafmolla, Vito Antonio Malagnino

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Background: Dental caries is the most common dental disease and pregnancy represents a special process of physical, hormonal and metabolic changes in pregnant women, which is accompanied by an imbalance in the oral cavity. Objective: The objective of this study is to evaluate caries reduction after dental visits, the scaling of teeth, fluoridated water, brushing of the teeth and using fluoride toothpaste before and during pregnancy. Materials and methods: This study was conducted in the time period March 2018- September 2021, the age range of the participants was: 18-41 years old. The sample taken under observation was composed of 84 pregnant women. The questionnaire included the demographic characteristics of the sample, such as age, women's education level was primary, secondary, and higher education. Based on women's education level, our analysis found that 25.9% of pregnant women had completed primary education, 35.2% of them had secondary education and 38.9% of pregnant women had higher education. The descriptive and analytical research analysis is formulated as a longitudinal study. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: In the present study, it was observed that there is a strong relationship between dental visits and the scaling of the teeth with the value of P˂ .0001. While the number of teeth with caries before pregnancy and fluoridated water have a P-value=0.002. If we compare the same factor with the number of teeth with dental caries during pregnancy, the correlation is P-value = 0.0001. The number of teeth with caries before pregnancy and carbohydrates consumption has a strong relation with P-value=0.05. According to the present research, the number of teeth with dental caries before pregnancy in relation to brushing the teeth has a P-value ˂ 0.05. Furthermore, in the actual research, it was established that using fluoride toothpaste doesn’t affect the number of teeth with caries before pregnancy with a P-value= .314. Conclusion: According to the results of the present study performed in Albania, it was found out that the periodical dental visits, scaling of the teeth, fluoridated water, brushing of the teeth influenced caries reduction before and during pregnancy. In comparison, the usage of fluoride toothpaste did not have any effect on dental caries reduction in the same time period. The recommendations are as follows: maintaining oral hygiene, using fluoridated water and brushing the teeth regularly. Healthcare providers should inform pregnant women about the importance of oral health and the implementation of measures to manage dental caries.

Keywords: brushing of the teeth, dental visits, dental scaling, fluoridated water, pregnancy

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Authors: Sarinra Thongmee, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk, Krittaphon Prakobsaeng

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The purposes of this research and development was to develop and evaluation of clinical nursing practice guideline (CNPG) for the prevention of infection during intubation in patient withsuspected or confirmedCOVID-19 patient. This study was developed by using the evidence based practice model of Soukup (2000) as a conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patients with confirmed COVID-19, 2) development the CNPG, 3) apply the NPG to trial, and 4) evaluation of the NPG. Thesample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) CNPG, 2) the nurses anesthetist opinion questionnaire to the guideline, 3) the evaluation practice form, and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results found that this developed NPG consists of 4 sections: 1) NPG for Preventing Airborne Infection Prevention2) preparation of anesthetic and intubation equipments 3) roles and duties of the intubation team 4) guidelines for intubation in suspected or confirmed COVID-19patients. The result found that 1) provider: using NPG in providers revealed that nurse anesthetist had higher mean of knowledge scores than before using NPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% in all activities. The anesthetic team was not infected with COVID-19from intubation outside operating room.2) Client: the patient was safe, no complications from intubation. Summary CNPG to prevent infection in intubation of suspected or confirmedCOVID-19 patient was appropriate and applicable to practice.

Keywords: nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: Asrat Agalu Abejew

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Background: Antimicrobial resistance (AMR) is a silent tsunami and one of the top global threats to health care and public health. It is one of the common agendas globally and in Ethiopia. Emerging AMR will be a double burden to Ethiopia, which is facing a series of problems from infectious disease morbidity and mortality. In Ethiopia, although there are attempts to document AMR in healthcare institutions, comprehensive and all-inclusive analysis is still lacking. Thus, this study is aimed to determine trends in AMR from 2016-2021. Methods: A retrospective analysis of secondary data recorded in the Amhara Public Health Institute (APHI) from 2016 to 2021 G.C was conducted. Blood, Urine, Stool, Swabs, Discharge, body effusions, and other Microbiological specimens were collected from each study participants, and Bacteria identification and Resistance tests were done using the standard microbiologic procedure. Data was extracted from excel in August 2022, Trends in AMR were analyzed, and the results were described. In addition, the chi-square (X2) test and binary logistic regression were used, and a P. value < 0.05 was used to determine a significant association. Results: During 6 years period, there were 25143 culture and susceptibility tests. Overall, 265 (46.2%) bacteria were resistant to 2-4 antibiotics, 253 (44.2%) to 5-7 antibiotics, and 56 (9.7%) to >=8 antibiotics. The gram-negative bacteria were 166 (43.9%), 155 (41.5%), and 55 (14.6%) resistant to 2-4, 5-7, and ≥8 antibiotics, respectively, whereas 99(50.8%), 96(49.2% and 1 (0.5%) of gram-positive bacteria were resistant to 2-4, 5-7 and ≥8 antibiotics respectively. K. pneumonia 3783 (15.67%) and E. coli 3199 (13.25%) were the most commonly isolated bacteria, and the overall prevalence of AMR was 2605 (59.9%), where K. pneumonia 743 (80.24%), E. cloacae 196 (74.81%), A. baumannii 213 (66.56%) being the most common resistant bacteria for antibiotics tested. Except for a slight decline during 2020 (6469 (25.4%)), the overall trend of AMR is rising from year to year, with a peak in 2019 (8480 (33.7%)) and in 2021 (7508 (29.9%). If left un-intervened, the trend in AMR will increase by 78% of variation from the study period, as explained by the differences in years (R2=0.7799). Ampicillin, Augmentin, ciprofloxacin, cotrimoxazole, tetracycline, and Tobramycin were almost resistant to common bacteria they were tested. Conclusion: AMR is linearly increasing during the last 6 years. If left as it is without appropriate intervention after 15 years (2030 E.C), AMR will increase by 338.7%. A growing number of multi-drug resistant bacteria is an alarm to awake policymakers and those who do have the concern to intervene before it is too late. This calls for a periodic, integrated, and continuous system to determine the prevalence of AMR in commonly used antibiotics.

Keywords: AMR, trend, pattern, MDR

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