Search results for: silver worker
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 724

Search results for: silver worker

184 Sociology of Muslim Endowments (Waqf) in Indian Kashmir: A Thesis Report

Authors: Adfer Rashid Shah

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This study brings an introduction to the concept of waqf and explores the institution of waqf in the valley of Kashmir. Waqfs (pl. Auqaf) are Islamic endowments which can be movable or immovable property by Muslims for the welfare of the poor and the upkeep of the mosques, shrines, imambaras, madrassas, orphanages, etc,. The study was undertaken to venture into the sociology of these endowments and see the dynamics and role of waqf institution in the welfare of masses especially the deserving populace of the state of Jamu and Kashmir. The Jammu and Kashmir Muslim Waqf Board (JKMWB) is a significant religio-social organization for it possesses the largest assets after the State government and has an immense potential and ownership in terms of huge properties besides having rich and perpetual cash and kind donations, gold, silver and other commodities from the believers. It is certainly the perpetual wealth of faith. Therefore this study besides exploring the waqf institution, sociologically probed into the social, religious and philanthropic interventions of the Wakf Board besides studying the waqf of education (both religious and general). Also, a passing reference on personalized Auqaf, local waqf committees particularly shia Auqaf was also made. As far methodology employed, the study was purely a qualitative study using various sociological perspectives like functionalism, grounded theory besides a range other concepts to see the total role of waqf that it has been playing for the people’s welfare in the valley of Kashmir since its establishment in 1940’s. The overall discussion revealed the social dynamics of waqf institution in Kashmir valley is increasing its social interventions and making difference in the lives of many deserving Muslims within its capacities.

Keywords: waqf, wakf board, religious waqf, philanthropy and education waqf, religious waqf, Kashmir

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183 Socio-economic Baselining of Selected Icrmp Sites in Southwestern Cebu, Central Philippines

Authors: Rachel Luz P. Vivas-rica, Gloria G. Delan, Christine M. Corrales, Alfonso S. Piquero, Irene A. Monte

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ABSTRACT -Selected Integrated Coastal Resource Management Program (ICRMP) sites in Southwestern Cebu were studied employing a stratified proportional sampling method using semi-structured questionnaires. Four hundred sixteen (416) respondents from five barangays with Marine Protected Areas (MPAs) and four barangays without marine sanctuaries were considered in the study. Results showed similarity of socio-economic characteristics in terms of average age, majority were middle aged, and married. Households were male dominated, obtained low education for both MPA and Non-MPA areas. In terms of occupation, majority in both areas engaged in fulltime fishing however part time jobs as carpenter, construction worker, driver or farmer as another income source. Most of the households were nuclear families with average family size of five for both MPA and Non-MPA. Fishing experience ranged from less than 1 year to more than 50 years. Fishing grounds were within the 15 kilometer radius of each considered site. Even if the respondents were totally dependent on fishing as a major source of income, still their income is way below the poverty threshold both in the MPA and Non-MPA areas. This is further explained by the marginality of their fishing implements wherein majority uses gill nets, hook & line, spear and paddle boat in fishing. Their volume of catch from an average of 6 hours fishing expedition ranges from half a kilo to a maximum of 4 kilos. Majority are not members of fishing groups or organizations.

Keywords: integrated coastal resource management program, marine protected areas, socio-economic, poverty threshold

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182 Gambling Addiction in Canadian - Vietnamese Community

Authors: Hung Ton

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The Vietnamese community in Toronto, Ontario, Canada, is a minority group with an estimated less than 1% of the population. They have been in Canada since the 1970s, therefore, many funding sources are considering them as a long-time residential group. However, their limitation of resources cannot give them equal opportunities to successfully gain support from many levels of government in Canada, compared to other long-time settled and large groups. In 2020 and 2021, they have zero financial support for addressing problem gambling in the Vietnamese community. In contrast, casinos never forget this community. The gambling industry has been targeting the Vietnamese community as one of their major clientele groups. There are always in-equal battles between low-budget educational workshops by this underserved community group and expensive variety music shows by casinos. In the very same target group, five single lines of free ads by a community project cannot get more attention than a full-page colorful poster by casinos. An outreach worker is running back and forth to talk to a group of 10 or 15 persons in an ESL or Tai Chi class held in a basement of an old community center while fifty thousand dollars variety music shows can attract five thousand audience in their luxury facilities. Five-dollar vouchers for those who attend the problem gambling awareness session are incomparable to two hundred dollar free tickets for people to attend the show in casinos and then exit the gambling area after the show ends. There is only one problem gambling counselor who speaks the Vietnamese language in the Ontario province and in Canada at large. However, there are 70 casinos in Ontario and more than 200 licensed gambling facilities in Canada. He has been lonely in all in-equal "battles" for the last almost 25 years. He exists, fighting over there with or without funding support for the program, he fights still.

Keywords: Canadian Vietnamese, gambling addiction, gambling treatment, community awareness

Procedia PDF Downloads 38
181 Assessment of the Work-Related Stress and Associated Factors among Sanitation Workers in Public Hospitals during COVID-19, Addis Ababa, Ethiopia

Authors: Zerubabel Mihret

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Background: Work-related stress is a pattern of reactions to work demands unmatched by worker’s knowledge, skills, or abilities. Healthcare institutions are considered high-risk and intensive work areas for work-related stress. However, there is the nonexistence of clear and strong data about the magnitude of work-related stress on sanitation workers in hospitals in Ethiopia. The aim of this study was to determine the magnitude of work-related stress among sanitation workers in public hospitals during COVID-19 in Addis Ababa, Ethiopia. Methods: Institution-based cross-sectional study was conducted from October 2021 to February 2022 among 494 sanitation workers who were selected from 4 hospitals. HSE (Health and Safety Executive of UK) standard data collection tool was used, and an interviewer-administered questionnaire was used to collect the data using KOBO collect application. The collected data were cleaned and analyzed using SPSS version 20.0. Both binary and multivariable logistic regression analyses were done to identify important factors having an association with work-related stress. Variables with p-value ≤ 0.25 in the bivariate analysis were entered into the multivariable logistic regression model. A statistically significant level was declared at a p-value ≤ 0.05. Results: This study revealed that the magnitude of work-related stress among sanitation workers was 49.2% (95% CI 45-54). Significant proportions (72.7%) of sanitation workers were dissatisfied with their current job. Sex, age, experience, and chewing khat were significantly associated with work-related stress. Conclusion: Work-related stress is significantly high among sanitation workers. Sex, age, experience, and chewing khat were identified as factors associated with work-related stress. Intervention program focusing on the prevention and control of stress is desired by hospitals.

Keywords: work-related stress, sanitation workers, Likert scale, public hospitals, Ethiopia

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180 Enhancement of Critical Temperature and Improvement of Mechanical Properties of Yttrium Barium Copper Oxide Superconductor

Authors: Hamed Rahmati

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Nowadays, increasing demand for electric energy makes applying high-temperature superconductors inevitable. However, the most important problem of the superconductors is their critical temperature, which necessitates using a cryogenic system for keeping these substances’ temperatures lower than the critical level. Cryogenic systems used for this reason are not efficient enough, and keeping these large systems maintained is costly. Moreover, the low critical temperature of superconductors has delayed using them in electrical equipment. In this article, at first, characteristics of three superconductors, magnesium diboride (MgB2), yttrium barium copper oxide (YBCO), and iron-based superconductors (FeSC), have been analyzed and a new structure of YBCO superconductors is presented. Generally, YBCO (YBa2Cu7O2) has a weak mechanical structure. By introducing some changes in its configuration and adding one silver atom (Ag) to it, its mechanical characteristics improved significantly. Moreover, for each added atom, a star-form structure was introduced in which changing the location of Ag atom led to considerable changes in temperature. In this study, Ag has been added by applying two accurate methods named random and substitute ones. The results of both methods have been examined. It has been shown that adding Ag by applying the substitute method can improve the mechanical properties of the superconductor in addition to increasing its critical temperature. In the mentioned strategy (using the substitute method), the critical temperature of the superconductor was measured up to 99 Kelvin. This new structure is usable in designing superconductors’ rings to be applied in superconducting magnetic energy storage (SMES). It can also lead to a reduction in the cryogenic system size, a decline in conductor wastes, and a decrease in costs of the whole system.

Keywords: critical temperature, cryogenic system, high-temperature superconductors, YBCO

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179 Fly Ash Derived Zeolites as Potential Sorbents for Elemental Mercury Removal from Simulated Gas Stream

Authors: Piotr Kunecki, Magdalena Wdowin

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The fly ash produced as waste in the process of conventional coal combustion was utilized in the hybrid synthesis of zeolites X and A from Faujasite (FAU) and Linde Type A (LTA) frameworks, respectively. The applied synthesis method included modification together with the crystallization stage. The sorbent modification was performed by introducing metals into the zeolite structure in order to create an ability to form stable bonds with elemental mercury (Hg0). The use of waste in the form of fly ash as a source of silicon and aluminum, as well as the proposed method of zeolite synthesis, fits the circular economy idea. The effect of zeolite modification on Hg0 removal from a simulated gas stream was studied empirically using prototype installation designed to test the effectiveness of sorption by solid-state sorbents. Both derived zeolites X and A modified with silver nitrate revealed significant mercury uptake during a 150-minute sorption experiment. The amount of elemental mercury removed in the experiment ranged from 5.69 to 6.01 µg Hg0/1g of sorbent for zeolites X and from 4.47 to 4.86 µg Hg0/1g of sorbent for zeolites A. In order to confirm the effectiveness of the sorbents towards mercury bonding, the possible re-emission effect was tested as well. Derived zeolites X and A did not show mercury re-emission after the sorption process, which confirms the stable bonding of Hg0 in the structure of synthesized zeolites. The proposed hybrid synthesis method possesses the potential to be implemented for both fly ash utilization as well as the time and energy-saving production of aluminosilicate, porous materials with high Hg0 removal efficiency. This research was supported by National Science Centre, Poland, grant no 2021/41/N/ST5/03214.

Keywords: fly ash, synthetic zeolites, elemental mercury removal, sorption, simulated gas stream

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178 Oxalate Content of Raw and Cooked Amaranth and Strawberry Spinach Grown in an Elevated CO₂ Atmosphere

Authors: Madhuri Kanala, Geoffrey Savage

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Worldwide CO₂ levels are slowly rising, and this may have effects on the growth and nutritional composition of many food plants. The production of secondary metabolites such as oxalates has not been investigated in depth. The oxalate content of many food plants are known to have adverse nutritional effects on humans and reduction in the oxalate contents of food plants is a very positive move. Recent studies had shown that the oxalate content of the leaves of spinach and silver beet reduced when the plants were grown in an environment where CO₂ was increased. The response of amaranth and strawberry spinach leaves to changes in the high CO₂ environment have not been understood though it is known that the plants do contain appreciable oxalate contents. A study was conducted where amaranth and strawberry spinach plants were grown in identical plant growth chambers with the same environmental conditions except that one chamber was supplied with ambient air (CO₂ 405 ppm) while the other chamber had the CO₂ level increased to 650 ppm. The total and soluble oxalate content of the leaves of raw and cooked amaranth and strawberry spinach were determined by HPLC and calcium levels were determined using ICP following 6 weeks of growth. The total oxalate content of the fresh leaves of amaranth and strawberry spinach were reduced by 29.5 % and 24.6% respectively in the leaves of the plants grown in increased CO₂ conditions compared to ambient levels. The soluble oxalate content of amaranth leaves grown under ambient and increased CO₂ conditions were future reduced by 42% and 26.8% respectively following cooking as the soluble oxalate was leached into the cooking water and discarded. The reduction of the oxalate and calcium levels of raw and cooked amaranth and strawberry spinach leaves following an increase in CO₂ content in the air is an interesting positive response to an otherwise significant environmental problem.

Keywords: amaranth, calcium oxalate, enriched CO₂, oxalates, strawberry spinach

Procedia PDF Downloads 175
177 Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda

Authors: Humphrey Atwijukiire, Gladys Nakidde, Anne Tweheyo Otwine, Jane Kabami

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Experiences of HIV Positive Serostatus Disclosure to Sexual Partner Among Individuals in Discordant Couples in Mbarara City, Southwestern Uganda Introduction: Disclosure of HIV status is key in HIV management. Despite many studies on serostatus disclosure, there is a gap in experiences regarding HIV status disclosure among discordant couples. This study explored the lived experiences of serostatus disclosure among discordant couples in Mbarara City, South Western Uganda. Methods: We conducted 12 in-depth interviews using translated interview guide, and audio recorders. Participants were purposively enrolled in the study. The study was conducted at three public health facilities in Mbarara City. Data was analyzed using thematic content analysis. Approval for this research was obtained from Mbarara University Research Ethics Committee and administrative clearance from city clerk of Mbarara City. Results: The mean age of participants was 38 years. An equal number of males (six) and females participated. Most of them had at least secondary level education, only three had primary education. Experienced benefits of HIV serostatus disclosure included: social support and care; decisions regarding health, fertility, and child bearing; sharing information on HIV prevention and protection; positive living; and, ease of HIV disclosure. The challenges included: misunderstandings in the families. Conclusion: Socially, psychologically and financially PLWHIV have benefited from their negative partners. Health wise, they have been supported, and cared for, but some have faced challenges, such as family misunderstandings. Couple HIV counseling and testing by a trained health worker is beneficial in HIV care and could mitigate the challenges related HIV serostatus disclosure.

Keywords: discordant couples, disclosure, experiences, HIV

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176 Investigation and Analysis of Residential Building Energy End-Use Profile in Hot and Humid Area with Reference to Zhuhai City in China

Authors: Qingqing Feng, S. Thomas Ng, Frank Xu

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Energy consumption in domestic sector has been increasing rapidly in China all along these years. Confronted with environmental challenges, the international society has made a concerted effort by setting the Paris Agreement, the Sustainable Development Goals, and the New Urban Agenda. Thus it’s very important for China to put forward reasonable countermeasures to boost building energy conservation which necessitates looking into the actuality of residential energy end-use profile and its influence factors. In this study, questionnaire surveys have been conducted in Zhuhai city in China, a typical city in hot summer warm winter climate zone. The data solicited mainly include the occupancy schedule, building’s information, residents’ information, household energy uses, the type, quantity and use patterns of appliances and occupants’ satisfaction. Over 200 valid samples have been collected through face-to-face interviews. Descriptive analysis, clustering analysis, correlation analysis and sensitivity analysis were then conducted on the dataset to understand the energy end-use profile. The findings identify: 1) several typical clusters of occupancy patterns and appliances utilization patterns; 2) the top three sensitive factors influencing energy consumption; 3) the correlations between satisfaction and energy consumption. For China with many different climates zones, it’s difficult to find a silver bullet on energy conservation. The aim of this paper is to provide a theoretical basis for multi-stakeholders including policy makers, residents, and academic communities to formulate reasonable energy saving blueprints for hot and humid urban residential buildings in China.

Keywords: residential building, energy end-use profile, questionnaire survey, sustainability

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175 Comparing the Effects of Systemic Family Intervention on End Stage Renal Disease: Families of Different Modalities

Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

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174 Attraction and Retention of Newly Graduated Medical Doctors to Deprived Regions in Ghana: A Qualitative Case Study

Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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173 Facile Fabrication of TiO₂NT/Fe₂O₃@Ag₂CO₃ Nanocomposite and Its Highly Efficient Visible Light Photocatalytic and Antibacterial Activity

Authors: Amal A. Al-Kahlawy, Heba H. El-Maghrabi

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Due to the increasing need to environment protection in real time need to energize new materials are under extensive investigations. Between others, TiO2 nanotubes (TNTs) nanocomposite with iron oxide and silver carbonate, are promising alternatives as high-efficiency visible light photocatalyst due to their unique properties and their superior charge transport properties. Our efforts in this domain aim the construction of novel nanocomposite of TiO2NT/Fe2O3@Ag2CO3. The structure, surface morphology, chemical composition and optical properties were characterized by X-ray diffraction (XRD), Raman, Fourier-transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy dispersive X-ray spectrometer (EDS), transmission electron microscopy (TEM), selected area electron diffraction (SAED) and UV–vis diffuse reflectance spectroscopy (DRS). XRD results confirm the interaction of TiO2-NT with iron oxide. This novel nanocomposite shows remarkably enhanced performance for phenol compounds photodegradation. The experimental data shows a promising photocatalytic activity. In particular, a maximum value of 450 mg/g was removed within 60 min at solar light irradiation with degradation efficiency of 99.5%. The high photocatalytic activity of the nanocomposite is found to be related to the increased adsorption toward chemical species, enhanced light absorption and efficient charge separation and transfer. Finally, the designed TiO2NT/Fe2O3@Ag2CO3 nanocomposite has a great degree of sustainability and could has a potential application for the industrial treatment of wastewater containing toxic organic materials.

Keywords: nanocomposite, photocatalyst, solar energy, titanium dioxide nanotubes

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172 Lipase-Catalyzed Synthesis of Novel Nutraceutical Structured Lipids in Non-Conventional Media

Authors: Selim Kermasha

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A process for the synthesis of structured lipids (SLs) by the lipase-catalyzed interesterification of selected endogenous edible oils such as flaxseed oil (FO) and medium-chain triacylglyceols such as tricaprylin (TC) in non-conventional media (NCM), including organic solvent media (OSM) and solvent-free medium (SFM), was developed. The bioconversion yield of the medium-long-medium-type SLs (MLM-SLs were monitored as the responses with use of selected commercial lipases. In order to optimize the interesterification reaction and to establish a model system, a wide range of reaction parameters, including TC to FO molar ratio, reaction temperature, enzyme concentration, reaction time, agitation speed and initial water activity, were investigated to establish the a model system. The model system was monitored with the use of multiple response surface methodology (RSM) was used to obtain significant models for the responses and to optimize the interesterification reaction, on the basis of selected levels and variable fractional factorial design (FFD) with centre points. Based on the objective of each response, the appropriate level combination of the process parameters and the solutions that met the defined criteria were also provided by means of desirability function. The synthesized novel molecules were structurally characterized, using silver-ion reversed-phase high-performance liquid chromatography (RP-HPLC) atmospheric pressure chemical ionization-mass spectrophotometry (APCI-MS) analyses. The overall experimental findings confirmed the formation of dicaprylyl-linolenyl glycerol, dicaprylyl-oleyl glycerol and dicaprylyl-linoleyl glycerol resulted from the lipase-catalyzed interesterification of FO and TC.

Keywords: enzymatic interesterification, non-conventinal media, nutraceuticals, structured lipids

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171 When Your Change The Business Model ~ You Change The World

Authors: H. E. Amb. Terry Earthwind Nichols

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Over the years Ambassador Nichols observed that successful companies all have one thing in common - belief in people. His observations of people in many companies, industries, and countries have also concluded one thing - groups of achievers far exceed the expectations and timelines of their superiors. His experience with achieving this has brought forth a model for the 21st century that will not only exceed expectations of companies, but it will also set visions for the future of business globally. It is time for real discussion around the future of work and the business model that will set the example for the world. Methodologies: In-person observations over 40 years – Ambassador Nichols present during the observations. Audio-visual observations – TV, Cinema, social media (YouTube, etc.), various news outlet Reading the autobiography of some of successful leaders over the last 75 years that lead their companies from a distinct perspective your people are your commodity. Major findings: People who believe in the leader’s vision for the company so much so that they remain excited about the future of the company and want to do anything in their power to ethically achieve that vision. People who are achieving regularly in groups, division, companies, etcetera: Live more healthfully lowering both sick time off and on-the-job accidents. Cannot wait to physically get to work as much as they can to feed off the high energy present in these companies. They are fully respected and supported resulting in near zero attrition. Simply put – they do not “Burn Out”. Conclusion: To the author’s best knowledge, 20th century practices in business are no longer valid and people are not going to work in those environments any longer. The average worker in the post-covid world is better educated than 50 years ago and most importantly, they have real-time information about any subject and can stream injustices as they happen. The Consortium Model is just the model for the evolution of both humankind and business in the 21st century.

Keywords: business model, future of work, people, paradigm shift, business management

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170 Hearing Conservation Program for Vector Control Workers: Short-Term Outcomes from a Cluster-Randomized Controlled Trial

Authors: Rama Krishna Supramanian, Marzuki Isahak, Noran Naqiah Hairi

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Noise-induced hearing loss (NIHL) is one of the highest recorded occupational diseases, despite being preventable. Hearing Conservation Program (HCP) is designed to protect workers hearing and prevent them from developing hearing impairment due to occupational noise exposures. However, there is still a lack of evidence regarding the effectiveness of this program. The purpose of this study was to determine the effectiveness of a Hearing Conservation Program (HCP) in preventing or reducing audiometric threshold changes among vector control workers. This study adopts a cluster randomized controlled trial study design, with district health offices as the unit of randomization. Nine district health offices were randomly selected and 183 vector control workers were randomized to intervention or control group. The intervention included a safety and health policy, noise exposure assessment, noise control, distribution of appropriate hearing protection devices, training and education program and audiometric testing. The control group only underwent audiometric testing. Audiometric threshold changes observed in the intervention group showed improvement in the hearing threshold level for all frequencies except 500 Hz and 8000 Hz for the left ear. The hearing threshold changes range from 1.4 dB to 5.2 dB with largest improvement at higher frequencies mainly 4000 Hz and 6000 Hz. Meanwhile for the right ear, the mean hearing threshold level remained similar at 4000 Hz and 6000 Hz after 3 months of intervention. The Hearing Conservation Program (HCP) is effective in preserving the hearing of vector control workers involved in fogging activity as well as increasing their knowledge, attitude and practice towards noise-induced hearing loss (NIHL).

Keywords: adult, hearing conservation program, noise-induced hearing loss, vector control worker

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169 Preventive Interventions for Central Venous Catheter Infections in Intensive Care Units: A Systematic Literature Review

Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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168 In Vitro Propagation in Barleria prionitis L. Via Callus Organogenesis

Authors: Rashmi Ranade, Neelu Joshi

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Barleria prionitis L. is a well explored Indian medicinal plant valued for its stem and leaf which forms an important ingredient of many Ayurvedic formulations. It is used for the treatment of various disorders like toothache, bleeding gums, strengthening gums, whooping cough, inflammation, arthritis, enlargement of scrotum and sciatica etc. The plant is propagated vegetatively through stem cuttings. Frequent harvesting of this plant has led to the shortage of planting material, and it has acquired the status of vulnerable plant species. Plant tissue culture technology offers a very good alternative for propagation and conservation of such plant species. The present investigation was undertaken to develop in vitro regeneration protocol for B. prionitis L. via callus organogenesis pathway. Stem and leaf explants were used for this purpose. Different media and plant growth regulators were optimized to develop the protocol. The problem of phenol secretion and browning and in vitro cultures at the establishment phase was successfully curbed with the usage of antibrowning agents such as ascorbic acid and activated charcoal. Optimum shoot multiplication was achieved by the use of liquid media and incorporation of silver nitrate and TIBA (triiodobenzoic acid) into the media. High percent rooting (76%) was observed on WPM media supplemented with IBA (2.0 mg/l), IAA (0.5 mg/l), GA3(0.5) and activated charcoal(500 mg/l). The rooted plantlets were subjected to in vitro hardening on sterile potting mix (soil:farmyard manure:compost; 1:2:1) and acclimatized under greenhouse conditions. Around 85% survival of plantlets was recorded upon acclimatization. This lab scale protocol would be tested for in vitro scaling up production of B. prionitis L.

Keywords: explant browning, liquid culture, micropropagation, shoot multiplication, phenolic secretion

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167 Protection of the Rights of Outsourced Employees and the Effect on Job Performance in Nigerian Banking Sector

Authors: Abiodun O. Ibude

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Several organizations have devised the strategy of engaging the services of staff not directly employed by them in their production and service delivery. Some organizations also engage on contracting another organization to carry out a part of service or production process on their behalf. Outsourcing is becoming an important alternative employment option for most organizations. This paper attempts an exposition on the rights of workers within the more specific context of outsourcing as a human resource management phenomenon. Outsourced employees and their rights are treated conceptually and analytically in a generic sense as a mere subset of the larger whole, that is, labor. Outsourced employees derive their rights, like all workers, from their job context as well as the legal environment (municipal and global) in which they operate. The dynamics of globalization and the implications of this development for labor practices receive considerable attention in this exposition. In this regard, a guarded proposition is made, to examine the practice and effect of engaging outsourcing as an economic decision designed primarily to cut down on operational costs rather than a Human Resources Management decision to improve worker welfare. The population of the study was selected from purposive and simple random sampling techniques. Data obtained were analyzed through a simple percentage, Pearson product-moment correlation, and cross-tabulation. From the research conducted, it was discovered that, although outsourcing possesses opportunities for organizations, there are drawbacks arising from its implementation of job securities. It was also discovered that some employees are being exploited through this strategy. This gives rise to lower motivation and thereby decline in performance. In conclusion, there is need for examination of Human Resource Managers’ strategies that can serve as management policy tools for the protection of the rights of outsourced employees.

Keywords: legal environment, operational cost, outsourcing, protection

Procedia PDF Downloads 118
166 Recovery of Au and Other Metals from Old Electronic Components by Leaching and Liquid Extraction Process

Authors: Tomasz Smolinski, Irena Herdzik-Koniecko, Marta Pyszynska, M. Rogowski

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Old electronic components can be easily found nowadays. Significant quantities of valuable metals such as gold, silver or copper are used for the production of advanced electronic devices. Old useless electronic device slowly became a new source of precious metals, very often more efficient than natural. For example, it is possible to recover more gold from 1-ton personal computers than seventeen tons of gold ore. It makes urban mining industry very profitable and necessary for sustainable development. For the recovery of metals from waste of electronic equipment, various treatment options based on conventional physical, hydrometallurgical and pyrometallurgical processes are available. In this group hydrometallurgy processes with their relatively low capital cost, low environmental impact, potential for high metal recoveries and suitability for small scale applications, are very promising options. Institute of Nuclear Chemistry and Technology has great experience in hydrometallurgy processes especially focused on recovery metals from industrial and agricultural wastes. At the moment, urban mining project is carried out. The method of effective recovery of valuable metals from central processing units (CPU) components has been developed. The principal processes such as acidic leaching and solvent extraction were used for precious metals recovery from old processors and graphic cards. Electronic components were treated by acidic solution at various conditions. Optimal acid concentration, time of the process and temperature were selected. Precious metals have been extracted to the aqueous phase. At the next step, metals were selectively extracted by organic solvents such as oximes or tributyl phosphate (TBP) etc. Multistage mixer-settler equipment was used. The process was optimized.

Keywords: electronic waste, leaching, hydrometallurgy, metal recovery, solvent extraction

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165 A Multi-Site Knowledge Attitude and Practice Survey of Ebola Virus Disease (EVD) in Nigeria

Authors: Ilyasu G., Ogoina D., Otu AA, Muhammed FD, Ebenso B., Otokpa D., Rotifa S., Tuduo-Wisdom O., Habib AG

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Background: The 2014 Ebola Virus Disease (EVD) outbreak was characterized by fear, misconceptions and irrational behaviors. We conducted a knowledge attitude and practice survey of EVD in Nigeria to inform the institution of effective control measures. Methods: Between July 30th and September 30th 2014, a cross-sectional study on knowledge, attitude and practice (KAP) of Ebola Virus Disease (EVD) was undertaken among adults of the general population and healthcare workers (HCW) in three states of Nigeria, including Kano, Cross River and Bayelsa states. Demographic information and data on KAP were obtained using a self-administered standardized questionnaire. The percentage KAP scores were categorized as good and poor. Independent predictors of good knowledge of EVD were ascertained using a binary logistic regression model. Results: Out of 1035 study participants with a median age of 32 years, 648 (62.6%) were males, 846 (81.7%) had tertiary education and 441 (42.6%) were HCW. There were 218, 239 and 578 respondents from Bayelsa, Cross Rivers, and Kano states, respectively. The overall median percentage KAP scores and interquartile ranges (IQR) were 79.46% (15.07%), 95.0% (33.33%), and 49.95% (37.50%), respectively. Out of the 1035 respondents, 470 (45.4%), 544(52.56%), and 252 (24.35%) had good KAP of EVD defined using 80%, 90%, and 70% score cut-offs, respectively. Independent predictors of good knowledge of EVD were a HCW (Odds Ratio-OR-2.89, 95% Confidence interval-CI of 1.41-5.90), reporting ‘moderate to high fear of EVD’ (OR-2.15, 95% CI-1.47-3.13) and ‘willingness to modify habit’ (OR-1.68, 95% CI-1.23-2.30). Conclusion: Our results reveal suboptimal EVD-related knowledge, attitude and practice among adults in Nigeria. To effectively control future outbreaks of EVD in Nigeria, there is a need to institute public sensitization programs that improve understanding of EVD and address EVD-related myths and misconceptions, especially among the general population.

Keywords: Ebola, health care worker, knowledge, attitude

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164 The Sustainability of Health and Safety on Construction Sites in Zamfara State

Authors: Ismaila Oladunni Muhammed, Adegbenga Raphael Ashiru

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Construction industry has been attributed to be the engine growth of Nigerian economic and infrastructural development. It promotes infrastructural development and grows an average output of Nigerian Gross Domestic Profit. However, from this great prospect, yearly reports show that consistent accidents on construction sites in Zamfara State has affected a substantial number of workers as they become temporarily or permanently disabled, thereby making many construction sites a death trap. This posed a great threat to the industry’s sustainability, de- motivate workers from working in the industry, and further have negative impact on the economy as well. It is as a result of high construction site accident currently experiencing in Zamfara state that this research was carried out to appraise the sustainability of health and safety of construction workers on sites. The proper practice and compliance to Construction Health and safety laws are very vital to the output and growth of Zamfara State construction sector. However, a quantitative approach was adopted to justify the aforesaid statement which will provide a broader understanding of the study. Descriptive statistical analysis was obtained through Statistical Package for the Social Sciences (SPSS Version 20). Furthermore, the findings from the research highlighted that the performance and output of construction workers on construction sites depends on the proper practice of health and safety. The research findings also recommended ways to enhance employers and employee’s compliance with existing laws guiding health and safety on Zamfara State construction sites. Nevertheless, the purpose of the paper is to appraise the sustainability of Health and Safety on Zamfara State construction sites. This study further provided thorough information for resolving challenges of construction sites accidents to improve construction firm productivity and also ensured construction worker’s safety on site.

Keywords: construction industry, health and safety regulations, causes of accident, construction safety practices

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163 An Anode Based on Modified Silicon Nanostructured for Lithium – Ion Battery Application

Authors: C. Yaddaden, M. Berouaken, L. Talbi, K. Ayouz, M. Ayat, A. Cheriet, F. Boudeffar, A. Manseri, N. Gabouze

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Lithium-ion batteries (LIBs) are widely used in various electronic devices due to their high energy density. However, the performance of the anode material in LIBs is crucial for enhancing the battery's overall efficiency. This research focuses on developing a new anode material by modifying silicon nanostructures, specifically porous silicon nanowires (PSiNWs) and porous silicon nanoparticles (NPSiP), with silver nanoparticles (Ag) to improve the performance of LIBs. The aim of this research is to investigate the potential application of PSiNWs/Ag and NPSiP/Ag as anodes in LIBs and evaluate their performance in terms of specific capacity and Coulombic efficiency. The research methodology involves the preparation of PSiNWs and NPSiP using metal-assisted chemical etching and electrochemical etching techniques, respectively. The Ag nanoparticles are introduced onto the nanostructures through electrodissolution of the porous film and ultrasonic treatment. Galvanostatic charge/discharge measurements are conducted between 1 and 0.01 V to evaluate the specific capacity and Coulombic efficiency of both PSiNWs/Ag and NPSiP/Ag electrodes. The specific capacity of the PSiNWs/Ag electrode is approximately 1800 mA h g-1, with a Coulombic efficiency of 98.8% at the first charge/discharge cycle. On the other hand, the NPSiP/Ag electrode exhibits a specific capacity of 2600 mAh g-1. Both electrodes show a slight increase in capacity retention after 80 cycles, attributed to the high porosity and surface area of the nanostructures and the stabilization of the solid electrolyte interphase (SEI). This research highlights the potential of using modified silicon nanostructures as anodes for LIBs, which can pave the way for the development of more efficient lithium-ion batteries.

Keywords: porous silicon nanowires, silicon nanoparticles, lithium-ion batteries, galvanostatic charge/discharge

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162 Optimisation Model for Maximising Social Sustainability in Construction Scheduling

Authors: Laura Florez

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The construction industry is labour intensive, and the behaviour and management of workers have a direct impact on the performance of construction projects. One of the issues it currently faces is how to recruit and maintain its workers. Construction is known as an industry where workers face the problem of short employment durations, frequent layoffs, and periods of unemployment between jobs. These challenges not only creates pressures on the workers but also project managers have to constantly train new workers, face skills shortage, and uncertainty on the quality of the workers it will attract. To consider worker’s needs and project managers expectations, one practice that can be implemented is to schedule construction projects to maintain a stable workforce. This paper proposes a mixed integer programming (MIP) model to schedule projects with the objective of maximising social sustainability of construction projects, that is, maximise labour stability. Aside from the social objective, the model accounts for equipment and financial resources required by the projects during the construction phase. To illustrate how the solution strategy works, a construction programme comprised of ten projects is considered. The projects are scheduled to maximise labour stability while simultaneously minimising time and minimising cost. The tradeoff between the values in terms of time, cost, and labour stability allows project managers to consider their preferences and identify which solution best suits their needs. Additionally, the model determines the optimal starting times for each of the projects, working patterns for the workers, and labour costs. This model shows that construction projects can be scheduled to not only benefit the project manager, but also benefit current workers and help attract new workers to the industry. Due to its practicality, it can be a valuable tool to support decision making and assist construction stakeholders when developing schedules that include social sustainability factors.

Keywords: labour stability, mixed-integer programming (MIP), scheduling, workforce management

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161 Improvement of Resistance Features of Anti- Mic Polyaspartic Coating (DTM) Using Nano Silver Particles by Preventing Biofilm Formation

Authors: Arezoo Assarian, Reza Javaherdashti

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Microbiologically influenced corrosion (MIC) is an electrochemical process that can affect both metals and non-metals. The cost of MIC can amount to 40% of the cost of corrosion. MIC is enhanced via factors such as but not limited to the presence of certain bacteria and archaea as well as mechanisms such as external electron transfer. There are five methods by which electrochemical corrosion, including MIC, can be prevented, of which coatings are an effective method due to blinding anode, cathode and, electrolyte from each other. Conventional ordinary coatings may themselves become nutrient sources for the bacteria and therefore show low efficiency in dealing with MIC. Recently our works on polyaspartic coating (DTM) have shown promising results, therefore nominating DTM as the most appropriate coating material to manage both MIC and general electrochemical corrosion very efficiently. Nanosilver particles are known for their antimicrobial properties that make them of desirable distractive impacts on any germs. This coating will be formulated based on Nanosilver phosphate and copper II oxide in the resin network and co-reactant. The nanoparticles are light and heat-sensitive agents. The method which is used to keep nanoparticles in the film coating is the encapsulation of active ingredients. By this method, it will prevent incompatibility between different particles. For producing microcapsules, the interfacial cross-linking method will be used. This is achieved by adding an active ingredient to an aqueous solution of the cross-linkable polymer. In this paper, we will first explain the role of coating materials in controlling and preventing electrochemical corrosion. We will explain MIC and some of its fundamental principles, such as bacteria establishment (biofilm) and the role they play in enhancing corrosion via mechanisms such as the establishment of differential aeration cells. Later we will explain features of DTM coatings that highly contribute to preventing biofilm formation and thus microbial corrosion.

Keywords: biofilm, corrosion, microbiologically influenced corrosion(MIC), nanosilver particles, polyaspartic coating (DTM)

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160 Electrospun Membrane doped with Gold Nanorods for Surface-Enhanced Raman Sepctroscopy

Authors: Ziwei Wang, Andrea Lucotti, Luigi Brambilla, Matteo Tommasini, Chiara Bertarelli

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Surface-enhanced Raman Spectroscopy (SERS) is a highly sensitive detection that provides abundant information on low concentration analytes from various researching areas. Based on localized surface plasmon resonance, metal nanostructures including gold, silver and copper have been investigated as SERS substrate during recent decades. There has been increasing more attention of exploring good performance, homogenous, repeatable SERS substrates. Here, we show that electrospinning, which is an inexpensive technique to fabricate large-scale, self-standing and repeatable membranes, can be effectively used for producing SERS substrates. Nanoparticles and nanorods are added to the feed electrospinning solution to collect functionalized polymer fibrous mats. We report stable electrospun membranes as SERS substrate using gold nanorods (AuNRs) and poly(vinyl alcohol). Particularly, a post-processing crosslinking step using glutaraldehyde under acetone environment was carried out to the electrospun membrane. It allows for using the membrane in any liquid environment, including water, which is of interest both for sensing of contaminant in wastewater, as well as for biosensing. This crosslinked AuNRs/PVA membrane has demonstrated excellent performance as SERS substrate for low concentration 10-6 M Rhodamine 6G (Rh6G) aqueous solution. This post-processing for fabricating SERS substrate is the first time reported and proved through Raman imaging of excellent stability and outstanding performance. Finally, SERS tests have been applied to several analytes, and the application of AuNRs/PVA membrane is broadened by removing the detected analyte by rinsing. Therefore, this crosslinked AuNRs/PVA membrane is re-usable.

Keywords: SERS spectroscopy, electrospinning, crosslinking, composite materials

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159 A Comparative Legal Enquiry on the Concept of Invention

Authors: Giovanna Carugno

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The concept of invention is rarely scrutinized by legal scholars since it is a slippery one, full of nuances and difficult to be defined. When does an idea become relevant for the patent law? When is it simply possible to talk of what an invention is? It is the first question to be answered to obtain a patent, but it is sometimes neglected by treaties or reduced to very simple and automatically re-cited definitions. Maybe, also because it is more a transnational and cultural concept than a mere institution of law. Tautology is used to avoid the challenge (in the United States patent regulation, the inventor is the one who contributed to have a patentable invention); in other case, a clear definition is surprisingly not even provided (see, e.g., the European Patent Convention). In Europe, the issue is still more complicated because there are several different solutions elaborate inorganically be national systems of courts varying one to the other only with the aim of solving different IP cases. Also a neighbor domain, like copyright law, is not assisting us in the research, since an author in this field is entitles to be the 'inventor' or the 'author' and to protect as far as he produces something new. Novelty is not enough in patent law. A simple distinction between mere improvement that can be achieved by a man skilled in the art (a sort of reasonable man, in other sectors) or a change that is not obvious rising to the dignity of protection seems not going too far. It is not still defining this concept; it is rigid and not fruitful. So, setting aside for the moment the issue related to the definition of the invention/inventor, our proposal is to scrutinize the possible self-sufficiency of a system in which the inventor or the improver should be awarded of royalties or similar compensation according to the economic improvement he was able to bring. The law, in this case, is in the penumbras of misleading concepts, divided between facts that are obscure and technical, and not involving necessarily legal issues. The aim of this paper is to find out a single definition (or, at least, the minimum elements common in the different legal systems) of what is (legally) an invention and what can be the hints to practically identify an authentic invention. In conclusion, it will propose an alternative system in which the invention is not considered anymore and the only thing that matters are the revenues generated by technological improvement, caused by the worker's activity.

Keywords: comparative law, intellectual property, invention, patents

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158 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

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157 A Study on Al-Riba Al-Hukmi and Its Instances from View of Islam

Authors: Abolfazl Alishahi Ghalehjoughi, Bi Bi Zeinab Hoseni

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Islam is a comprehensive religion, and has rules for any thing. Islam attaches respect and importance to properties as well, and outlaws some types of transaction. A type of transaction that is strictly forbidden by the Islam is riba (usury), for which special punishments is considered in the Qur’an and hadiths. Usury is divided into (riba qarzi) loan usury and riba muamili (transaction usury); sometimes, in transaction and interest free loan contracts, ziyadah aini (interest in kind and of the same kind as that of the object of transaction) is not stipulated, but performance of work, provision of an advantage or a service, or a respite is stipulated, in which case although no ziyadah aini is in place, the transaction still constitutes usury and is outlaw. For instance, if a bank stipulates in an interest free loan contract that it pays a person the interest free loan only if he/she deposits a sum in the bank, this is an instance of riba hukmi. Or, for muamilah sarfi (transaction is which object of transaction and consideration is gold or silver) to be legitimate, it necessary that both the object of transaction and the consideration be handed over between the parties, because if a party takes delivery of the considered or object of transaction while the other party does not, the party who has taken delivery will accrue a benefit, as he/she wins time until he/she makes delivery to the other party, and this tantamount to usury in muamilah sarfi. Or, if a person lends a sum to another person, while the lender is indebted to the borrower, if the lender stipulates that he/she lends such amount only if the borrower postpones the maturity date of the lender’s debt to borrower, which is in one month, for a particular period of time, such loan will constitute usury. This research first provides views on riba hukmi, and then proceeds to analysis of views, trying to study fundamentals and proof regarding prohibition of riba hukmi, and to analyze instances of riba hukmi according to religious and hadith books.

Keywords: Islam, riba, prohibition, riba hukmi

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156 Effect of Zidovudine on Hematological and Virologic Parameters among Female Sex Workers Receiving Antiretroviral Therapy (ART) in North-Western Nigeria

Authors: N. M. Sani, E. D. Jatau, O. S. Olonitola, M. Y. Gwarzo, P. Moodley, N. S. Mujahid

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Haemoglobin (HB) indicates anaemia level and by extension may reflect the nutritional level and perhaps the immunity of an individual. Some antiretroviral drugs like zidovudine are known to cause anaemia in People living with HIV/AIDS (PLWHA). A cross-sectional study using demographic data and blood specimen from 218 female commercial sex workers attending antiretroviral therapy (ART) clinics was conducted between December 2009 and July 2011 to assess the effect of zidovudine on haematologic and RNA viral load of female sex workers receiving antiretroviral treatment in north-western Nigeria. Anaemia is a common and serious complication of both HIV infection and its treatment. In the setting of HIV infection, anaemia has been associated with decreased quality of life, functional status, and survival. Antiretroviral therapy, particularly the highly active antiretroviral therapy (HAART), has been associated with a decrease in the incidence and severity of anaemia in HIV-infected patients who have received a HAART regimen for at least 1 year. In this study, result has shown that out of 218 patients, 26 with haemoglobin count between 5.1–10 g/dl were observed to have the highest viral load count of 300,000–350,000 copies/ml. It was also observed that most patients (190) with HB of 10.1–15.0 g/dl had viral load count of 200,000–250,000 copies/ml. An inverse relationship therefore exists, i.e. the lower the haemoglobin level, the higher the viral load count, even though the test statistics did not show any significance between the two (P=0.206). This shows that multivariate logistic regression analysis demonstrated that anaemia was associated with a CD4+ cell count below 50/µL in female sex workers with a viral load above 100,000 copies/mL who use zidovudine. Severe anaemia was less prevalent in this study population than in historical comparators; however, mild to moderate anaemia rates remain high. The study, therefore, recommends that hematological and virologic parameters be monitored closely in patients receiving first line ART regimen.

Keywords: anaemia, female sex worker, haemoglobin, Zidovudine

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155 Health and the Politics of Trust: Multi-Drug-Resistant Tuberculosis in Kathmandu

Authors: Mattia Testuzza

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Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.

Keywords: trust, tuberculosis, drug-resistance, politics of health

Procedia PDF Downloads 234