Search results for: primary care clinic
2453 Epstein-Barr Virus-associated Diseases and TCM Syndromes Types: In Search for Correlation
Authors: Xu Yifei, Le Yining, Yang Qingluan, Tu Yanjie
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Objective: This study aims to investigate the distribution features of Traditional Chinese Medicine (TCM) syndromes and syndrome elements in Epstein-Barr virus-associated diseases and then explores the relations between TCM syndromes or syndrome elements and laboratory indicators of Epstein-Barr virus-associated diseases. Methods: A cross-sectional study of 70 patients with EBV infection was described. We assessed the diagnostic information and laboratory indicators of these patients from Huashan Hospital Affiliated to Fudan University between November 2017 and July 2019. The disease diagnosis and syndrome differentiation were based on the diagnostic criteria of EBV-associated diseases and the theory of TCM respectively. Confidence correlation analysis, logistic regression analysis, cluster analysis, and the Sankey diagram were used to analyze the correlation between the data. Results: The differentiation of the 4 primary TCM syndromes in the collected patients was correlated with the indexes of immune function, liver function, inflammation, and anemia, especially the relationship between Qifen syndrome and high lactic acid dehydrogenase level. The common 11 TCM syndrome elements were associated with the increased CD3+ T cell rate, low hemoglobin level, high procalcitonin level, high lactic acid dehydrogenase level, and low albumin level. Conclusion: The changes in immune function indexes, procalcitonin, and liver function-related indexes in patients with EBV-associated diseases were consistent with the evolution law of TCM syndromes. This study provides a reference for judging the pathological stages of these kinds of diseases, predicting their prognosis, and guiding subsequent treatment strategies based on TCM syndrome type.Keywords: EBV-associated diseases, traditional Chinese medicine syndrome, syndrome element, diagnostics
Procedia PDF Downloads 1052452 Optimising Participation in Physical Activity Research for Adults with Intellectual Disabilities
Authors: Yetunde M. Dairo, Johnny Collett, Helen Dawes
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Background and Aim: Engagement with physical activity (PA) research is poor among adults with intellectual disabilities (ID), particularly in those from residential homes. This study explored why, by asking managers of residential homes, adults with ID and their carers. Methods: Participants: A convenient sample of 23 individuals from two UK local authorities, including a group of ID residential home managers, adults with ID and their support staff. Procedures: A) Residential home managers (n=6) were asked questions about their willingness to allow their residents to participate in PA research; B) eleven adults with ID and their support workers (n=6) were asked questions about their willingness to accept 7-day accelerometer monitoring and/or the International Physical Activity Questionnaire-short version (IPAQ-s) as PA measures. The IPAQ-s was administered by the researcher and they were each provided with samples of accelerometers to try on. Results: A) Five out of six managers said that the burden of wearing the accelerometer for seven days would be too high for the people they support, the majority of whom might be unable to express their wishes. They also said they would be unwilling to act as proxy respondents for the same reason. Additionally, they cited time pressure, understaffing, and reluctance to spend time on the research paperwork as further reasons for non-participation. B) All 11 individuals with ID completed the IPAQ-s while only three accepted the accelerometer, one of whom was deemed inappropriate to wear it. Reasons for rejecting accelerometers included statements from participants of: ‘too expensive’, ‘too heavy’, ‘uncomfortable’, and two people said they would not want to wear it for more than one day. All adults with ID (11) and their support workers (6) provided information about their physical activity levels through the IPAQ-s. Conclusions: Care home managers are a barrier to research participation. However, adults with ID would be happy for the IPAQ-s as a PA measure, but less so for the 7-day accelerometer monitoring. In order to improve participation in this population, the choice of PA measure is considered important. Moreover, there is a need for studies exploring how best to engage ID residential home managers in PA research.Keywords: intellectual disability, physical activity measurement, research engagement, research participation
Procedia PDF Downloads 3072451 Beyond Adoption: Econometric Analysis of Impacts of Farmer Innovation Systems and Improved Agricultural Technologies on Rice Yield in Ghana
Authors: Franklin N. Mabe, Samuel A. Donkoh, Seidu Al-Hassan
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In order to increase and bridge the differences in rice yield, many farmers have resorted to adopting Farmer Innovation Systems (FISs) and Improved Agricultural Technologies (IATs). This study econometrically analysed the impacts of adoption of FISs and IATs on rice yield using multinomial endogenous switching regression (MESR). Nine-hundred and seven (907) rice farmers from Guinea Savannah Zone (GSZ), Forest Savannah Transition Zone (FSTZ) and Coastal Savannah Zone (CSZ) were used for the study. The study used both primary and secondary data. FBO advice, rice farming experience and distance from farming communities to input markets increase farmers’ adoption of only FISs. Factors that increase farmers’ probability of adopting only IATs are access to extension advice, credit, improved seeds and contract farming. Farmers located in CSZ have higher probability of adopting only IATs than their counterparts living in other agro-ecological zones. Age and access to input subsidy increase the probability of jointly adopting FISs and IATs. FISs and IATs have heterogeneous impact on rice yield with adoption of only IATs having the highest impact followed by joint adoption of FISs and IATs. It is important for stakeholders in rice subsector to champion the provision of improved rice seeds, the intensification of agricultural extension services and contract farming concept. Researchers should endeavour to researched into FISs.Keywords: farmer innovation systems, improved agricultural technologies, multinomial endogenous switching regression, treatment effect
Procedia PDF Downloads 4262450 A High Content Screening Platform for the Accurate Prediction of Nephrotoxicity
Authors: Sijing Xiong, Ran Su, Lit-Hsin Loo, Daniele Zink
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The kidney is a major target for toxic effects of drugs, industrial and environmental chemicals and other compounds. Typically, nephrotoxicity is detected late during drug development, and regulatory animal models could not solve this problem. Validated or accepted in silico or in vitro methods for the prediction of nephrotoxicity are not available. We have established the first and currently only pre-validated in vitro models for the accurate prediction of nephrotoxicity in humans and the first predictive platforms based on renal cells derived from human pluripotent stem cells. In order to further improve the efficiency of our predictive models, we recently developed a high content screening (HCS) platform. This platform employed automated imaging in combination with automated quantitative phenotypic profiling and machine learning methods. 129 image-based phenotypic features were analyzed with respect to their predictive performance in combination with 44 compounds with different chemical structures that included drugs, environmental and industrial chemicals and herbal and fungal compounds. The nephrotoxicity of these compounds in humans is well characterized. A combination of chromatin and cytoskeletal features resulted in high predictivity with respect to nephrotoxicity in humans. Test balanced accuracies of 82% or 89% were obtained with human primary or immortalized renal proximal tubular cells, respectively. Furthermore, our results revealed that a DNA damage response is commonly induced by different PTC-toxicants with diverse chemical structures and injury mechanisms. Together, the results show that the automated HCS platform allows efficient and accurate nephrotoxicity prediction for compounds with diverse chemical structures.Keywords: high content screening, in vitro models, nephrotoxicity, toxicity prediction
Procedia PDF Downloads 3132449 Supply Side Barriers to Maternal Health Care Utilization in District Gwadar, Balochistan
Authors: Changaiz Khan
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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training
Procedia PDF Downloads 552448 High Pressure Torsion Deformation Behavior of a Low-SFE FCC Ternary Medium Entropy Alloy
Authors: Saumya R. Jha, Krishanu Biswas, Nilesh P. Gurao
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Several recent investigations have revealed medium entropy alloys exhibiting better mechanical properties than their high entropy counterparts. This clearly establishes that although a higher entropy plays a vital role in stabilization of particular phase over complex intermetallic phases, configurational entropy is not the primary factor responsible for the high inherent strengthening in these systems. Above and beyond a high contribution from friction stresses and solid solution strengthening, strain hardening is an important contributor to the strengthening in these systems. In this regard, researchers have developed severe plastic deformation (SPD) techniques like High Pressure Torsion (HPT) to incorporate very high shear strain in the material, thereby leading to ultrafine grained (UFG) microstructures, which cause manifold increase in the strength. The presented work demonstrates a meticulous study of the variation in mechanical properties at different radial displacements from the center of HPT tested equiatomic ternary FeMnNi synthesized by casting route, which is a low stacking fault energy FCC alloy that shows significantly higher toughness than its high entropy counterparts like Cantor alloy. The gradient in grain sizes along the radial direction of these specimens has been modeled using microstructure entropy for predicting the mechanical properties, which has also been validated by indentation tests. The dislocation density is computed by FEM simulations for varying strains and validated by analyzing synchrotron diffraction data. Thus, the proposed model can be utilized to predict the strengthening behavior of similar systems deformed by HPT subjected to varying loading conditions.Keywords: high pressure torsion, severe plastic deformation, configurational entropy, dislocation density, FEM simulation
Procedia PDF Downloads 1532447 Organisational Culture and the Role of the Mental Health Nurse: An Ethnography of the New Graduate Nurse Experience
Authors: Mary-Ellen Hooper, Graeme Browne, Anthony Paul O'Brien
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Background: It has been reported that the experience of the organisational workplace culture for new graduate mental health nurses plays an important role in their attraction and retention to the discipline. Additionally, other research indicates that a negative workplace culture contributes to their dissatisfaction and attrition rate. Method: An ethnographic research design was applied to explore the subcultural experiences of new graduate nurses as they encounter mental health nursing. Data was collected between April and September 2017 across 6 separate Australian, NSW, mental health units. Data comprised of semi-structured interviews (n=24) and 31 episodes of field observation (62 hours). A total number of 26 new graduate and recent graduate nurses participated in the study – 14 new graduate nurses and 12 recently graduated nurses. Results: A key finding from this study was the New Graduate difficulty in articulating the role the of mental health nurse. Participants described a dichotomy between their ideological view of the mental health nurse and the reality of clinical practice. The participants’ ideological view of the mental health nurse involved providing holistic and individualised care within a flexible framework. Participants, however, described feeling powerless to change the recovery practices within the mental health service(s) because of their low status within the hierarchy. Resulting in participants choosing to fit into the existing culture, or considering leaving the field altogether. Conclusion: An incongruence between the values and ideals of an organisational culture and the reality shock of practice are shown to contribute to role ambiguity within its members. New graduate nurses entering the culture of mental health nursing describe role ambiguity resulting in dissatisfaction with practice. The culture and philosophy inherent to a service are posited to be crucial in creating positive experiences for graduate nurses.Keywords: culture, mental health nurse, mental health nursing role, new graduate nurse
Procedia PDF Downloads 1532446 Study of the Influence of Non Genetic Factors Affecting over Nutrition Students in Ayutthaya Province, Thailand
Authors: Thananyada Buapian
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Overnutrition is emerging as a morbid disease in developing and Westernized countries. Because of its comorbidity diseases, it is cost-effective to prevent and manage this disease earlier. In Thailand, this alarming disease has long been studied, but the prevalence is still higher than that in the past. Physicians should recognize it well and have a definite direction to face and combat this dangerous disease. Rapid changes in the tremendous figure of overnutrition students indicate that genetic factors are not the primary determinants since human genes have remained unchanged for a century. This study aims to assess the prevalence of overnutrition students and to investigate the non-genetic factors affecting over nutrition students. A cross-sectional school-based survey was conducted. A two-stage sampling was adopted. Respondents included 1,850 students in grades 4 to 6 in Ayutthaya Province. An anthropometric measurement and questionnaire were developed. Childhood over nutrition was defined as a weight-for-height Z-score above +2SD of NCHS/WHO references. About thirty three percent of the children were over nutrition in Ayutthaya province. Stepwise multiple logistic regression analysis showed that 8 statistically significant non genetic factors explain the variation of childhood over nutrition by 18 percent. Sex is the prime factor to explain the variation of childhood over nutrition, followed by duration of light physical activities, duration of moderate physical activities, having been breastfed, the presence of a healthy role model of the caregiver, number of siblings, birth order, and occupation of the caregiver, respectively. Non genetic factors, especially the subjects’ demographic and physical activities, as well as the caregivers’ background and family environment, should be considered in viable approach to remedy this health imbalance in children.Keywords: non genetic factors, non-genetic, over nutrition, over nutrition students
Procedia PDF Downloads 2722445 Enhancement of Primary User Detection in Cognitive Radio by Scattering Transform
Authors: A. Moawad, K. C. Yao, A. Mansour, R. Gautier
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The detecting of an occupied frequency band is a major issue in cognitive radio systems. The detection process becomes difficult if the signal occupying the band of interest has faded amplitude due to multipath effects. These effects make it hard for an occupying user to be detected. This work mitigates the missed-detection problem in the context of cognitive radio in frequency-selective fading channel by proposing blind channel estimation method that is based on scattering transform. By initially applying conventional energy detection, the missed-detection probability is evaluated, and if it is greater than or equal to 50%, channel estimation is applied on the received signal followed by channel equalization to reduce the channel effects. In the proposed channel estimator, we modify the Morlet wavelet by using its first derivative for better frequency resolution. A mathematical description of the modified function and its frequency resolution is formulated in this work. The improved frequency resolution is required to follow the spectral variation of the channel. The channel estimation error is evaluated in the mean-square sense for different channel settings, and energy detection is applied to the equalized received signal. The simulation results show improvement in reducing the missed-detection probability as compared to the detection based on principal component analysis. This improvement is achieved at the expense of increased estimator complexity, which depends on the number of wavelet filters as related to the channel taps. Also, the detection performance shows an improvement in detection probability for low signal-to-noise scenarios over principal component analysis- based energy detection.Keywords: channel estimation, cognitive radio, scattering transform, spectrum sensing
Procedia PDF Downloads 1962444 Syntheses of Biobased Hybrid Poly(epoxy-hydroxyurethane) Polymers
Authors: Adrien Cornille, Sylvain Caillol, Bernard Boutevon
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The development of polyurethanes began in 1937 at I. G. Farbenindustrie where Bayer with coworkers discovered the addition polymerization reaction between diisocyanates and diols. Since their discovery, the demand in PU has continued to increase and it will attain in 2016 a production of 18 million tons. However, isocyanates compounds are harmful to human and environment. Methylene diphenyl 4,4’-diisocyanate (MDI) and toluene diisocyanate (TDI), the most widely used isocyanates in PU industry, are classified as CMR (Carcinogen, Mutagen, and Reprotoxic). In order to design isocyanate-free materials, an interesting alternative is the use of Polyhydroxyurethanes (PHUs) by reaction between cyclic carbonate and polyfunctional amines. The main problem concerning PHUs synthesis relates to the low reactivity of carbonate/amine reaction. To solve this issue, many studies in the literature have been conducted to design PHU from more reactive cyclic-carbonates, bearing electro-withdrawing substituent or by using six-membered, seven-membered or thio-cyclic carbonate. The main drawback of all these systems remains the low molar masses obtained for the synthesized PHUs, which hinders their use for material applications. Therefore, we developed another strategy to afford new hybrid PHU with high conversion. This very innovative two-step approach consists in the first step in the synthesis of aminotelechelic PHU oligomers with different chain length from bis-cyclic carbonate with different excess of primary amine functions. In the second step, these aminotelechelic PHU oligomers were used in formulation with biobased epoxy monomers (from cashew nut shell liquid and tannins) to synthesize hybrid polyepoxyurethane polymers. These materials were then characterized by thermal and mechanical analyses.Keywords: polyurethane, polyhydroxyurethane, aminotelechelic NIPU oligomers, carbonates, epoxy, amine, epoxyurethane polymers, hybrid polymers
Procedia PDF Downloads 2142443 Effect of Oral Clonidine Premedication on Subarachnoid Block Characteristics of 0.5 % Hyperbaric Bupivacaine for Laparoscopic Gynecological Procedures – A Randomized Control Study
Authors: Buchh Aqsa, Inayat Umar
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Background- Clonidine, α 2 agonist, possesses several properties to make it valuable adjuvant for spinal anesthesia. The study was aimed to evaluate the clinical effects of oral clonidine premedication for laparoscopic gynecological procedures under subarachnoid block. Patients and method- Sixtyfour adult female patients of ASA physical status I and II, aged 25 to 45 years and scheduled for laparoscopic gynecological procedures under the subarachnoid block, were randomized into two comparable equal groups of 32 patients each to received either oral clonidine, 100 µg (Group I) or placebo (Group II), 90 minutes before the procedure. Subarachnoid block was established with of 3.5 ml of 0.5% hyperbaric bupivacaine in all patients. Onset and duration of sensory and motor block, maximum cephalad level, and the regression time to reach S1 sensory level were assessed as primary end points. Sedation, hemodynamic variability, and respiratory depression or any other side effects were evaluated as secondary outcomes. Results- The demographic profile was comparable. The intraoperative hemodynamic parameters showed significant differences between groups. Oral clonidine was accelerated the onset time of sensory and motor blockade and extended the duration of sensory block (216.4 ± 23.3 min versus 165 ± 37.2 min, P <0.05). The duration of motor block showed no significant difference. The sedation score was more than 2 in the clonidine group as compared to the control group. Conclusion- Oral clonidine premedication has extended the duration of sensory analgesia with arousable sedation. It also prevented the post spinal shivering of the subarachnoid block.Keywords: oral clonidine, subarachnoid block, sensory analgesia, laparoscopic gynaecological
Procedia PDF Downloads 822442 Exergy Analysis of a Green Dimethyl Ether Production Plant
Authors: Marcello De Falco, Gianluca Natrella, Mauro Capocelli
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CO₂ capture and utilization (CCU) is a promising approach to reduce GHG(greenhouse gas) emissions. Many technologies in this field are recently attracting attention. However, since CO₂ is a very stable compound, its utilization as a reagent is energetic intensive. As a consequence, it is unclear whether CCU processes allow for a net reduction of environmental impacts from a life cycle perspective and whether these solutions are sustainable. Among the tools to apply for the quantification of the real environmental benefits of CCU technologies, exergy analysis is the most rigorous from a scientific point of view. The exergy of a system is the maximum obtainable work during a process that brings the system into equilibrium with its reference environment through a series of reversible processes in which the system can only interact with such an environment. In other words, exergy is an “opportunity for doing work” and, in real processes, it is destroyed by entropy generation. The exergy-based analysis is useful to evaluate the thermodynamic inefficiencies of processes, to understand and locate the main consumption of fuels or primary energy, to provide an instrument for comparison among different process configurations and to detect solutions to reduce the energy penalties of a process. In this work, the exergy analysis of a process for the production of Dimethyl Ether (DME) from green hydrogen generated through an electrolysis unit and pure CO₂ captured from flue gas is performed. The model simulates the behavior of all units composing the plant (electrolyzer, carbon capture section, DME synthesis reactor, purification step), with the scope to quantify the performance indices based on the II Law of Thermodynamics and to identify the entropy generation points. Then, a plant optimization strategy is proposed to maximize the exergy efficiency.Keywords: green DME production, exergy analysis, energy penalties, exergy efficiency
Procedia PDF Downloads 2572441 Impact of Mammographic Screening on Ethnic Inequalities in Breast Cancer Stage at Diagnosis and Survival in New Zealand
Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson
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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.Keywords: breast cancer, screening, ethnicity, inequity
Procedia PDF Downloads 5142440 Groundwater Recharge Pattern in East and West Coast of India: Evidence of Dissimilar Moisture Sources
Authors: Ajit Kumar Behera, Saranya P., Sudhir Kumar, Krishnakumar A
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The stable isotope (δ¹⁸ O and δ²H) composition of groundwater of the coastal areas of Periyar and Mahanadi basins falling along East and West coast of India during North-East (NE) monsoon season have been studied. The east and west coast regions are surrounded by the Bay of Bengal and the Arabian Sea respectively, which are considered to be the primary sources for precipitation over India. The major difference between the Bay of Bengal and the Arabian Sea is that a number of large rivers feed the Bay of Bengal, whereas the Arabian Sea is fed by very few small rivers, resulting in enriched stable isotopic composition of the Arabian Sea than the Bay of Bengal. Previous studies have reported depleted ratios of stable isotopes during Northeast monsoon along East and West coasts due to the influence of the Bay of Bengal moisture source. The isotopic composition of groundwater of the Mahanadi delta in the east coast region varies from -6.87 ‰ to -3.40 ‰ for δ¹⁸ O and -45.42 ‰ to -22.43‰ for δ²H. However, the groundwater of the Periyar basin in the west coast has enriched stable isotope value varying from -4.3‰ to -2.5 ‰ for δ¹⁸ O and for δ²H from -23.7 to -6.4 ‰ which is a characteristic of South-West monsoon season. This suggests the groundwater system of the Mahanadi delta and the Periyar basins are influenced by dissimilar moisture sources. The δ¹⁸ O and δ² H relationship (δ²H= 6.513 δ¹⁸ O - 1.39) and d-excess value (< 10) in the east coast region indicates the influence of NE monsoon implying the quick groundwater recharge after precipitation with significant amount of evaporation. In contrast, the δ¹⁸ O and δ²H regression line (δ²H= 8.408 δ¹⁸ O + 11.71) with high d-excess value (>10) in the west coast region implies delayed recharge due to SW monsoon. The observed isotopic enrichment in west coast suggests that NE winter monsoon rainfall does not replenish groundwater quick enough to produce isotopic depletion during the season.Keywords: Arabian sea, bay of Bengal, groundwater, monsoon, stable isotope
Procedia PDF Downloads 3772439 Health Literacy and Knowledge Related to Tuberculosis among Outpatients at a Referral Hospital in Lima, Peru
Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero
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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge
Procedia PDF Downloads 5052438 Interaction of GCN5L1 with WHAMM and KIF5B Regulates Autolysosome Tubulation
Authors: Allen Seylani
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Lysosome-dependent autophagy is a nutrient-deprivation-induced evolutionarily conserved intracellular recycling program that sequestrates intracellular cargo into autophagosomes (AP), which then fuse with lysosomes to form autolysosomes (ALs) for cargo digestion. To restore free lysosomes, autophagic lysosome reformation (ALR) is initiated by extrusion of tubular structures from autolysosomes at the final stage of autophagy, in a process called lysosomal tubulation (LT). This project aimed to investigate the molecular mechanism of GCN5L1 in LT and the following lysosomal signaling. GCN5L1 belongs to the BORC multiprotein complexes and is involved in controlling lysosomal trafficking; however, the effect of GCN5L1 on lysosome tubulation remains largely unknown. Genetic ablation of GCN5L1 in the mouse primary hepatocytes showed dramatically increased autolysosomes (ALs), decreased lysosome regeneration and absence of lysosomal tubulation. This phenotype suggests the possibility of disruption in lysosome tubulation, which results in the disturbance of the overall lysosome homeostasis. The formation of tubulars from ALs requires kinesin motor protein KIF5B. Immunoprecipitation was employed and confirmed the interaction of GCN5L1 with the ARL8B-KIF5B complex, which recruited KIF5B to ALs. At the same time, GCN5L1 interacted with WHAMM, which promotes the actin nucleation factor, which brings actin cytoskeleton to ALs and initiates LT. Furthermore, impaired LT in GCN5L1 deficient hepatocytes was restored by overexpression of GCN5L1, and this rescue effect was attenuated by knockdown of KIF5B. Additionally, lysosomal mTORC1 activity was upregulated in GCN5L1-/- hepatocytes, while inhibition of mTORC1 abrogated the GCN5L1 mediated rescue of LT in knockout hepatocytes. Altogether these findings revealed a novel mechanism of ALR, in which a simultaneous interaction of GCN5L1 with KIF5B and WHAMM is required for LT and downstream mTORC1 signaling.Keywords: autophagy, autolysosome, GCN5L1, lysosome
Procedia PDF Downloads 1552437 Improving Fingerprinting-Based Localization System Using Generative AI
Authors: Getaneh Berie Tarekegn
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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine
Procedia PDF Downloads 602436 The Embodiment of Violence and Liminal Space in Illegality: Rohingya Refugees
Authors: E. Xavier, B. Nandita
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Rohingyas are an ethnic and religious minority that resides in the Rakhine State of Myanmar. Post the military coup in 1962, Rohingyas have not been recognized as one of the ethnic tribes of Burma under the legislation. They have lost citizenship, education, health care rights, and instantly became illegal immigrants. While the historicization of this conflict is crucial, this paper wants to humanize the Rohingya population’s embodiment of violence on three different levels – individual, social, and political. In addition, the study focuses on their liminal existence in refugee camps in Bangladesh and in other parts of the world, such as Malaysia and the United States of America. A multi-medium study, it includes first-hand interviews with the Rohingya community in Wisconsin and Chicago, second-hand interviews from documentaries and past ethnographies from scholars to draw meaningful conclusions about their experience as a community. In the end, it focuses on the group of Rohingyas who have managed to resettle in another country and their transitioning experience. Rohingyas embody violence on their individual, social, and political bodies in different ways. Along with rape, murder, and physical harm, the community also encounters sexually transmitted infections, post-traumatic stress disorder symptoms, and poor mental health. On a social level, they encounter heightened gender discrimination, work industry shifting, and immense, shared emotional pain. As for their political body, the news media and journalism industry uses their bodies for purposes that benefit both parties and flirts with a tone of sensationalism in their reporting. In addition, the Rohingya community fluctuates with the concept of nationality, patriotism, citizenship, and refugee when they think about the future. This study provides a framework that future aid or health programs can use to determine the type of community need and its significance in the Rohingya community.Keywords: embodiment, liminal, refugee, Rohingya
Procedia PDF Downloads 1322435 Building Safer Communities through Institutional Collaboration in Ghana: An Appraisal of Existing Arrangement
Authors: Louis Kusi Frimpong, Martin Oteng-Ababio
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The problem of crime and insecurity in urban environments are often complex, multilayered, multidimensional and sometimes interwoven. It is from this perspective that recent approaches and strategies aimed at responding to crime and insecurity have looked at the problem from a social, economic, spatial and institutional point of view. In Ghana, there is much understanding of how various elements of the social and spatial setting influence crime and safety concerns of residents in urban areas. However, little research attention has been given to the institutional dimension of the problem of crime and insecurity in urban Ghana. In particular, scholars and policymakers in the area of safety and security have scarcely interrogated the forms of collaboration that exist between the various formal and informal institutions and how gaps and lapses in this collaboration influence vulnerability to crime and feelings of insecurity. Using Sekondi-Takoradi as a case study and drawing on both primary and secondary data, this paper assesses the activities of various institutions both formal and informal in crime control and prevention in the Sekondi-Takoradi metropolis, the third largest city in Ghana. More importantly, the paper seeks to address gaps in the institutional arrangement and coordination between and among institutions at the forefront of crime prevention efforts in the metropolis and by extension Ghanaian cities. The study found that whiles there is some form of collaboration between the police and the community, little collaboration existed between planning authorities and the police on the one hand, and the community on the other hand. The paper concludes that in light of the complex nature of a crime, institutional coordination and an inclusive approach involving formal and informal will be critical in promoting safer cities in Ghana.Keywords: crime prevention, coordination, Ghana, institutional arrangement
Procedia PDF Downloads 1262434 The Quest for Institutional Independence to Advance Police Pluralism in Ethiopia
Authors: Demelash Kassaye Debalkie
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The primary objective of this study is to report the tributes that are significantly impeding the Ethiopian police's ability to provide quality services to the people. Policing in Ethiopia started in the medieval period. However, modern policing was introduced instead of vigilantism in the early 1940s. The progress counted since the date police became modernized is, however, under contention when viewed from the standpoint of officers’ development and technologies in the 21st century. The police in Ethiopia are suffering a lot to be set free from any form of political interference by the government and to be loyal to impartiality, equity, and justice in enforcing the law. Moreover, the institutional competence of the police in Ethiopia is currently losing its power derived from the constitution as a legitimate enforcement agency due to the country’s political landscape encouraging ethnic-based politics. According to studies, the impact of ethnic politics has been a significant challenge for police in controlling conflicts between two ethnic groups. The study used qualitative techniques and data was gathered from key informants selected purposely. The findings indicate that governments in the past decades were skeptical about establishing a constitutional police force in the country. This has certainly been one of the challenges of pluralizing the police: building police-community relations based on trust. The study conducted to uncover the obstructions has finally reported that the government’s commitment to form a non-partisan, functionally decentralized, and operationally demilitarized police force is too minimal and appalling. They mainly intend to formulate the missions of the police in accordance with their interests and political will to remain in power. It, therefore, reminds the policymakers, law enforcement officials, and the government in power to revise its policies and working procedures already operational to strengthen the police in Ethiopia based on public participation and engagement.Keywords: community, constitution, Ethiopia, law enforcement
Procedia PDF Downloads 862433 “Who Will Marry Me?”: The Marital Status of Disabled Women in India
Authors: Sankalpa Satapathy
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The stigma attached to disability is very high in India and given its patriarchal society women and their interests have always been pushed to the background. The identity of disabled women is compromised under the social construction of disability which lowers their self-esteem and hampers their development. Disability policies in India have focused on provision of educational and employment opportunities to make them economically productive members of the society. This preoccupation with the materialistic spheres of lives of the disabled has led to a neglect of the private sphere concerning intimate social relationships and motherhood. This paper seeks to bring to forefront the private lives of disabled women. Semi-structured in-depth interviews were conducted with twenty seven women with physical disability (congenital/acquired) from Odisha, a state in India. Sampling was done in a manner to include women from various strata of the society to allow meaningful analysis. In a society where paramount importance is attached to wifehood and motherhood, the chances of marriage for disabled women were very low compared to disabled men. Majority believed that marriage and having a family was meant for non disabled women and had decided against getting married. Socialization process was found to be a major factor in determining the ideas and aspirations of disabled women. They were clearly sidelined by their families on the issue of marriage. Education and employment levels did not seem to increase the appeal of disabled women to prospective suitors. But not all the women interviewed were closed to the idea of intimate relationships and marriage. Disabled women who were married or hoped to get married in future were found to have a better body image and greater self motivation. It is interesting to understand the means by which these women, who have been brought up to internalize ideas of their unattractiveness, undesirability, asexuality and inability to care, established identities which have so long been denied to them. With these stories of personal triumphs an attempt is made for reclamation of private spheres which have been abandoned by disability policies and make them gender sensitive.Keywords: disability, gender, marriage, relationships
Procedia PDF Downloads 3572432 Impact of Maternal Nutrition on Newborn Anthropometry and Hemoglobin
Authors: Vinay Mishra, Meena Malkani
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Objectives: To study the effect of physical maternal nutritional markers (viz. weight, height, gestational weight gain, BMI) and third-trimester haemoglobin concentration on anthropometry and cord blood haemoglobin of their newborn. Methods: Study area: Post-natal ward of a tertiary care hospital in an urban area. Study population: All post-partum women and their newborns. Sample size: 100. Maternal and neonatal data and anthropometric measurements were recorded in semi-structured case proforma. Data analysis: The data obtained was analysed using SPSS 20 software.The comparison between the groups was done using One-Way Analysis of Variance for two groups. For more than two groups comparisons further posthoc analysis was done using Tukey test. Pearson correlation coefficient was used for correlating the variables. A P value less than 0.05 was considered significant. Results: 1. Out of the 100 studied mothers, 52% were anaemic. 2. Cord blood haemoglobin values decreased significantly with the order of birth. 3. Cord blood haemoglobin of normal-weight newborns is significantly higher as compared to that of LBW newborns. 4. Cord blood haemoglobin has strong statistical significance with maternal anaemia. 5. Pre-pregnancy weight and gestational weight gain significantly influence the neonates anthropometry. Conclusions: 1. Birth order has a prominent inverse effect on the cord blood haemoglobin. 2. Majority of the expectant mothers are anaemic and give birth to LBW babies with reduced anthropometric markers. 3. Pre-pregnancy weight, height and gestational weight gain has a very significant impact on the neonatal anthropometry. 4. Thus, maternal nutrition during gestation and during the crucial periods of growth in the pre-child bearing age group has a very significant impact on foetal development.Keywords: maternal nutrition, anthropometry, cord blood hemoglobin, newborn
Procedia PDF Downloads 3922431 Achievements of Healthcare Services Vis-À-Vis the Millennium Development Goals Targets: Evidence from Pakistan
Authors: Saeeda Batool, Ather Maqsood Ahmed
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This study investigates the impact of public healthcare facilities and socio-economic circumstances on the status of child health in Pakistan. The complete analysis is carried out in correspondence with fourth and sixth millennium development goals. Further, the health variables chosen are also inherited from targeted indicators of the mentioned goals (MDGs). Trends in the Human Opportunity Index (HOI) for both health inequalities and coverage are analyzed using the Pakistan Social and Living Standards Measurement (PLSM) data set for 2001-02 to 2012-13 at the national and provincial level. To reveal the relative importance of each circumstance in achieving the targeted values for child health, Shorrocks decomposition is applied on HOI. The annual point average growth rate of HOI is used to simulate the time period for the achievement of target set by MDGs and universal access also. The results indicate an improvement in HOI for a reduction in child mortality rates from 52.1% in 2001-02 to 67.3% in 2012-13, which confirms the availability of healthcare opportunities to a larger segment of society. Similarly, immunization against measles and other diseases such as Diphtheria, Polio, Bacillus Calmette-Guerin (BCG), and Hepatitis has also registered an improvement from 51.6% to 69.9% during the period of study at the national level. On a positive note, no gender disparity has been found for child health indicators and that health outcome is mostly affected by the parental and geographical features and availability of health infrastructure. However, the study finds that this achievement has been uneven across provinces. Pakistan is not only lagging behind in achieving its health goals, disappointingly with the current rate of health care provision, but it will take many additional years to achieve its targets.Keywords: socio-economic circumstances, unmet MDGs, public healthcare services, child and infant mortality
Procedia PDF Downloads 2292430 Factors Affecting Context of Innovation: A Case Study of a Farming-as-a-Service Company
Authors: Kunal Mankodi, Sudhir Pandey
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This study aims to assess the factors that play a role in setting up and running a social enterprise driven towards sustainability at the intersection of energy, environment, and poverty alleviation. According to the theory of sustainability-oriented innovation (SOI), conventional organisations adapt their processes to focus on sustainability-oriented innovations. On the other hand, social enterprises that are purpose-driven are also influenced by the context of innovation, which need due attention. This paper presents an account of innovation at Oorja - an Indian social enterprise operating with a farming-as-a-service business model. It aims to illustrate the contexts in which the innovative solutions were developed to work at an intersection between agriculture and clean energy, thereby allowing small farmers access to efficient solutions in the agriculture cycle. Primary data was collected through in-depth interviews, and secondary data was collected from company sources. The study finds that in the case of a social enterprise, the definition of innovation assumes a wider scope by going beyond the introduction of a new product/service. The context of innovation for social enterprise is affected by organisational factors such as organisation’s philosophical mindset, behaviour towards innovation, organisation’s capabilities, regulatory environment, and customer receptiveness. Additionally, the study also finds that the context of innovation for a social enterprise is affected by its organizational structure. A majority of these organizational factors are, in turn, affected by individual (Founder’s) factors such as the founder’s formative years, education, direct exposure to relevant issues, complementary skills of co-founders, and a common calling.Keywords: context of innovation, social enterprise, sustainability oriented innovations, emerging markets, agriculture
Procedia PDF Downloads 1432429 Life Stories: High Quality of Life until the End with the Narrative Medicine and the Storytelling
Authors: Danila Zuffetti, Lorenzo Chiesa
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Background: A hospice narrative interview aims at putting the sick at the core of disease and treatment allowing them to explore their most intimate facets. The aim of this work is to favor authentic narration by leading towards awareness and acceptance of terminality and to face death with serenity. Narration in palliative care aims at helping to reduce the chaos generated by the disease and to elaborate interpretations on the course of reality, besides, the narration delivered to the doctor is fundamental and communicates the meaning given to symptoms. Methods: The narrative interview has become a regular activity in the Castellini Foundation since 2017. Patients take part every week, and for more days, in one hour sessions, in a welcoming and empathic setting and the interaction with the operator leads to a gradual awareness of their terminality. Patients are submitted with free answer questions with the purpose of facilitating and stimulating self-narration. Narration has not always been linear, but patients are left free to shift in time to revisit their disease process by making use of different tools, such as digital storytelling. Results: The answers provided by the patients show to which extent the narrative interview is an instrument allowing the analysis of the stories and gives the possibility to better understand and deepen the different implications of patient and caregiver’s background. Conclusion: The narration work in the hospice demonstrates that narrative medicine is an added value. This instrument has proven useful not only in the support of patients but also for the palliative doctor to identify wishes for accompanying them to the end with dignity and serenity. The narrative interview favors the construction of an authentic therapeutic relationship. The sick are taken wholly in charge, and they are guaranteed a high quality of life until their very last instant.Keywords: construction of an authentic therapy relationship, gradual awareness of their terminality, narrative interview, reduce the chaos generated by the desease
Procedia PDF Downloads 1762428 Global Culture Museums: Bridging Societies, Fostering Understanding, and Preserving Heritage
Authors: Hossam Hegazi
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Global culture museums play a pivotal role in fostering cross-cultural connections, enhancing mutual understanding, and safeguarding the rich tapestry of cultural heritage. These institutions serve as dynamic bridges, facilitating the exchange of ideas and values among diverse societies. One of the primary functions of global culture museums is to connect people from different backgrounds. By showcasing the artistic expressions, traditions, and historical artifacts of various civilizations, these museums create a shared space for dialogue. Visitors are afforded the opportunity to explore and appreciate the nuances of cultures different from their own, promoting a sense of global interconnectedness. Moreover, these museums contribute significantly to mutual understanding. Through interactive exhibits, innovative technologies, and educational programs, they offer immersive experiences that transcend linguistic and geographical barriers. Visitors gain insights into the customs, beliefs, and lifestyles of others, fostering empathy and appreciation for cultural diversity. Preserving cultural heritage stands as another key objective of global culture museums. By housing and curating artifacts, artworks, and historical items, these institutions play a crucial role in safeguarding the collective memory of humanity. This preservation effort ensures that future generations have access to the cultural legacies that have shaped societies across the globe. In conclusion, global culture museums serve as dynamic hubs that bring people together, promote understanding, and safeguard the wealth of human cultural heritage. Their impact extends beyond the walls of exhibition halls, contributing to a more interconnected and culturally enriched world.Keywords: global culture museums, cross-cultural connections, mutual understanding, societal dialogue
Procedia PDF Downloads 292427 Culture and Mental Health in Nigeria: A Qualitative Study of Berom, Hausa, Yoruba and Igbo Cultural Beliefs
Authors: Dung Jidong, Rachel Tribe, Poul Rohlerder, Aneta Tunariu
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Cultural understandings of mental health problems are frequently overshadowed by the western conceptualizations. Research on culture and mental health in the Nigerian context seems to be lacking. This study examined the linguistic understandings and cultural beliefs that have implications for mental health among the Berom, Hausa, Yoruba and Igbo people of Nigeria. A purposive sample of 53 participants underwent semi-structured interviews that lasted approximately 55 minutes each. Of the N=53 participants, n=26 were psychology-aligned practitioners and n=27 ‘laypersons’. Participants were recruited from four states in Nigeria, Plateau, Kaduna, Ekiti, and Enugu. All participants were self-identified as members of their ethnic groups who speak and understand their native-languages, cultural beliefs, and also are domiciled within their ethnic communities. Thematic analysis using socio-constructionism from a critical-realist position was employed to explore the participants’ beliefs about mental health, and the clash between western trained practitioners’ views and the cultural beliefs of the ‘laypersons’. Data analysis found three main themes that re-emerged across the four ethnic samples: (i) beliefs about mental health problems as a spiritual curse (ii) traditional and religious healing are used more often than western mental health care (iii) low levels of mental health awareness. In addition, the Nigerian traditional and religious healing are also revealed to be helpful as the practice gives prominence to the native-languages, religious and cultural values. However, participants described the role of ‘false’ traditional or religious healers in communities as being potentially harmful. Finally, due to the current lack of knowledge about mental health problems, awareness creation and re-orientation may be beneficial for both rural and urban Nigerian communities.Keywords: beliefs cultures, health mental, languages religions, values
Procedia PDF Downloads 2842426 A Prospective Randomised Observational Study of Obstructed Total Anamalous Pulmonary Venous Connection (TAPVC) Repair Patients
Authors: Sanjeev Singh
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Background: Obstructed total anomalous pulmonary venous connection (OTAPVC) typically presents with severe cardiovascular decompensation and requires urgent surgical management. Pulmonary arterial hypertension (PAH) is a major risk factor affecting mortality. Perioperative management focuses on providing inotropic support and managing potential pulmonary hypertensive episodes. The aim of this study was to determine the outcome of patients with high pulmonary arterial pressure (PAP) with milrinone alone and a combination of milrinone and inhaled nitric oxide (INO). Material and Methods: After the approval of the ethical committee, this single-center prospective randomized and observational study was conducted over a period of two years among eighty-six patients with obstructed TAPVC repair with severe PAH. Group-I patients received milrinone, and Group-II patients received both milrinone (after aortic cross-clamp removal) and INO during the post-operative period at the cardiac care unit (CCU). Clinical outcomes such as ventilation time, length of stay (LOS) in the CCU, LOS in the hospital, complications, and hospital mortality were compared between the two groups. Result: The average ventilation time, LOS in CCU, and LOS in hospital for group I were 96.82 ± 19.46 hours, 10.91 ± 7.53 days, and 14.46 ± 7.58 days, respectively, and for group II, it was 85.14 ± 15.79 hours, 7.28 ± 3.68 days, and 10.21 ± 3.14 days, respectively, which was statistically significantly lower for group II. Reintubation, RV dysfunction, and hospital mortality were 16.3%, 37.2%, and 6.9% in group I, and 4.8%, 14.6%, and 2.4% in group II, respectively. The P value for each variable was significant < 0.05 (except mortality). Conclusion: Preoperative obstruction is a risk factor for postoperative obstruction, as 235 patients with obstructed TAPVC had severe PAH (39.98%) in this study. Management of severe PAH with a combination of milrinone and INO had a better outcome than milrinone alone.Keywords: inhaled nitric oxide, milrinone, pulmonary artery hypertension, total anomalous pulmonary venous connection
Procedia PDF Downloads 222425 A Conceptual Framework of Impact of Lean on the Performance of Construction Industry
Authors: Jaber Shurrab, Matloub Hussain
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The rapid pace of changes in the construction industry, technological advancements, and rising costs present tremendous challenges for project managers. Project managers are under severe pressure to minimize the waste, improve the efficiency of the entire operations and the philosophy of ‘lean thinking’ so that ‘more could be achieved with less’ is becoming very popular. Though, lean management has strong roots in manufacturing industry and over the last decade lean philosophy has started gaining attention in the service industry as well. However, little has been known in the context of waste minimization and lean implementation in the construction industry and this paper deals with this important issue. The primary objective of this paper is to propose a conceptual framework for the exploration of appropriate lean techniques applicable to medium and large construction companies and measure their impact on the competitiveness and economic performance of construction companies of United Arab Emirates (UAE). To this end, a comprehensive literature review and interviews with eight project managers of medium and large construction companies of UAE have been conducted. It has been found that competitive, reduce waste and costs are critical to the construction industry. This is an ongoing research in lean management, giving project managers a practical framework for improving the efficiency of their project through various lean techniques. Originality/value: Research significance emphasizes increasing the effectiveness of the construction industry, influences the development of lean construction framework which improves lean construction practices using the lean techniques. This contributes to the effort of applying lean techniques in the construction industry. Limited publications were done in the construction industry mainly in United Arab Emirates (UAE) compared to the lean manufacturing. This research will recommend a systematic approach for the implementing of the anticipated framework within a cyclical look-ahead period and emphasizes the practical implications of the proposed approach.Keywords: construction, lean, lean manufacturing, waste
Procedia PDF Downloads 2862424 Findings from an Access Improvement Project for Antiretroviral Therapy Uptake through Traditional Birth Attendants at Mother Theresa Hospital, Lagos, Nigeria
Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko
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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake
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