Search results for: outcome and future
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9133

Search results for: outcome and future

3073 Development of Self-Reliant Satellite-Level Propulsion System by Using Hydrogen Peroxide Propellant

Authors: H. J. Liu, Y. A. Chan, C. K. Pai, K. C. Tseng, Y. H. Chen, Y. L. Chan, T. C. Kuo

Abstract:

To satisfy the mission requirement of the FORMOSAT-7 project, NSPO has initialized a self-reliant development on satellite propulsion technology. A trade-off study on different types of on-board propulsion system has been done. A green propellant, high-concentration hydrogen peroxide (H2O2 hereafter), is chosen in this research because it is ITAR-free, nontoxic and easy to produce. As the components designed for either cold gas or hydrazine propulsion system are not suitable for H2O2 propulsion system, the primary objective of the research is to develop the components compatible with H2O2. By cooperating with domestic research institutes and manufacturing vendors, several prototype components, including a diaphragm-type tank, pressure transducer, ball latching valve, and one-Newton thruster with catalyst bed, were manufactured, and the functional tests were performed successfully according to the mission requirements. The requisite environmental tests, including hot firing test, thermal vaccum test, vibration test and compatibility test, are prepared and will be to completed in the near future. To demonstrate the subsystem function, an Air-Bearing Thrust Stand (ABTS) and a real-time Data Acquisition & Control System (DACS) were implemented to assess the performance of the proposed H2O2 propulsion system. By measuring the distance that the thrust stand has traveled in a given time, the thrust force can be derived from the kinematics equation. To validate the feasibility of the approach, it is scheduled to assess the performance of a cold gas (N2) propulsion system prior to the H2O2 propulsion system.

Keywords: FORMOSAT-7, green propellant, Hydrogen peroxide, thruster

Procedia PDF Downloads 427
3072 Blockchain Technology Applications in Patient Tracking Systems Regarding Privacy-Preserving Concerns and COVID-19 Pandemic

Authors: Farbod Behnaminia, Saeed Samet

Abstract:

The COVID-19 pandemic has paralyzed many lives until a vaccine was available, which caused the so-called “new normal.” According to the World Health Organization (WHO), COVID-19 is an infectious disease. It can cause significant illness or death in anyone. Governments and health officials tried to impose rules and regulations to avoid and slow down transmission. Therefore, software engineers worldwide developed applications to trace and track patients’ movements and notify others, mainly using Bluetooth. In this way, everyone could be informed whether they come in close contact with someone who has COVID-19 and takes proper safety precautions. Because most of the applications use technologies that can potentially reveal the user’s identity and location, researchers have debated privacy preservation and how to improve user privacy during such pandemics. Thanks to Distributed Ledger Technology (DLT), there have been some proposed methods to develop privacy-preserving Patient Tracking Systems in the last two years. As an instance of the DLT, Blockchain is like a decentralized peer-to-peer database that maintains a record of transactions. Transactions are immutable, transparent, and anonymous in this system. We conducted a comprehensive evaluation of the literature by looking for papers in the relevant field and dividing them into pre- and post-pandemic systems. Additionally, we discussed the many uses of blockchain technology in pandemic control. We found that two major obstacles facing blockchain implementation across many healthcare systems are scalability and privacy. The Polkadot platform is presented, along with a review of its efficacy in tackling current concerns. A more scalable healthcare system is achievable in the near future using Polkadot as well as a much more privacy-preserving environment.

Keywords: blockchain, electronic record management, EHR, privacy-preserving, patient tracking, COVID-19, trust and confidence, Polkadot

Procedia PDF Downloads 100
3071 The Impact of Artesunate-Amodiaquine on Schistosoma mansoni Infection among Children Infected by Plasmodium in Rural Area of Lemfu, Kongo Central, Democratic Republic of the Congo

Authors: Mbanzulu Kennedy, Zanga Josue, Wumba Roger

Abstract:

Malaria and schistosomiasis remain life-threatening public health problems in sub-Saharan Africa. The infection pattern related to age indicates that preschool and school-age children are at the highest risk of malaria and schistosomiasis. Both parasitic infections, separately or combined, may have negative impacts on the haemoglobin concentration levels. The existing data revealed that artemisinin derivatives commonly used to cure malaria present also in antischistosomal activities. The current study investigated the impact of Artesunate-Amodiaquine (AS-AQ) on schistosomiasis when administered to treat malaria in rural area of Lemfu, DRC. A prospective longitudinal study including 171 coinfected children screened for anaemia, Schistosoma mansoni, and Plasmodium falciparum infections. The egg reduction rate and haemoglobin concentration were assessed four weeks after the treatment with AS-AQ, of all coinfected children of this series. One hundred and twenty-five (74.4%) out of 168 coinfected children treated and present during the assessment were found stool negative for S. mansoni eggs. Out of 43 (25.6%) children who remained positives, 37 (22%) showed a partial reduction of eggs amount, and no reduction was noted in 3.6% of coinfected. The mean of haemoglobin concentration and the prevalence of anaemia were, respectively, 10.74±1.5g/dl , 11.2±1.3g/dl, and 64.8%, 51.8%, respectively, before and after treatment, p<0.001. The AS-AQ commonly used against Plasmodium allowed curing S. mansoni in coinfected children and increasing the Hb level. For the future, the randomized and multicentric clinical trials are needed for a better understanding of the effectiveness of AS-AQ against Schistosoma spp. The trial registration number was 3487183.

Keywords: paludisme, schistosomiase, as-aq, enfants lemfu

Procedia PDF Downloads 101
3070 Development of the Religious Out-Group Aggression Scale

Authors: Rylle Evan Gabriel Zamora, Micah Dennise Malia, Abygail Deniese Villabona

Abstract:

When examining studies on aggression, the studies about individual aggression vastly outnumbers those studies on group aggression. Given the nature of aggression to be violent and cyclical, and the amount violent events that have occurred in the near present, the study of group aggression is relevant now more than ever. This discrepancy is parallel with the number of valid and reliable psychological tests that measure group aggression. Throughout history, one of the biggest causes of group based violence and aggression is religion. This is particularly true within the context of the Philippines as there are a large number of religious groups. Thus, this study aimed to develop a standardized test that measures an individual’s tendency to be aggressive to those who are in conflict with his or her religious beliefs. This study employs a test development design that employs a qualitative phase to ensure the validity of the scale. Thus, the study was divided into three phases. First is a pilot test wherein an instrument was designed from existing literature which was then administered to 173 respondents from the four largest religious groups in the Philippines. After extensive factor analysis and reliability testing, new items were then formed from the qualitative data collected from eight participants, consisting of two individuals per religious group. The final testing integrates all statistically significant items from the first phase, and the newly formed items from the second phase, which was then administered to 200 respondents. The results were then tested further for reliability using Cronbach’s alpha and validity through factor analysis. The items that were proven to be significant were then combined to create a final instrument that may be used by future studies.

Keywords: religious aggression, group aggression, test development, psychological assessment, social psychology

Procedia PDF Downloads 293
3069 Culturable Microbial Diversity of Agave Artisanal Fermentations from Central Mexico

Authors: Thalía Moreno-García Malo, Santiago Torres-Ríos, María G. González-Cruz, María M. Hernández-Arroyo, Sergio R. Trejo-Estrada

Abstract:

Agave atrovirens is the main source of agave sap, the raw material for the production of pulque, an artisanal fermented beverage, traditional since prehispanic times in the highlands of central Mexico. Agave sap is rich in glucose, sucrose and fructooligosaccharides, and strongly differs from agave syrup from A. tequilana, which is mostly a high molecular weight fructan. Agave sap is converted into pulque by a highly diverse microbial community which includes bacteria, yeast and even filamentous fungi. The bacterial diversity has been recently studied. But the composition of consortia derived from directed enrichments differs sharply from the whole fermentative consortium. Using classical microbiology methods, and selective liquid and solid media formulations, either bacterial or fungal consortia were developed and analyzed. Bacterial consortia able to catabolize specific prebiotic saccharides were selected and preserved for future developments. Different media formulations, selective for bacterial genera such as Bifidobacterium, Lactobacillus, Pediococcus, Lactococcus and Enterococcus were also used. For yeast, specific media, osmotic pressure and unique carbon sources were used as selective agents. Results show that most groups are represented in the enrichment cultures; although very few are recoverable from the whole consortium in artisanal pulque. Diversity and abundance vary among consortia. Potential bacterial probiotics obtained from agave sap and agave juices show tolerance to hydrochloric acid, as well as strong antimicrobial activity.

Keywords: Agave, pulque, microbial consortia, prebiotic activity

Procedia PDF Downloads 394
3068 Non-Adherence to Antidepressant Treatment and Its Predictors among Outpatients with Depressive Disorders

Authors: Selam Mulugeta, Barkot Milkias, Mesfin Araya, Abel Worku, Eyasu Mulugeta

Abstract:

In Ethiopia, there is inadequate information on non-adherence to antidepressant treatment in patients with depressive disorders. Having awareness of the pattern of adherence is important in future prognosis, quality of life, and functionality in these patients. This hospital-based cross-sectional quantitative study was done on a sample of 216 consecutive outpatients with depressive disorders. Data were collected using questionnaires through in-person and phone call interviews. The 8-item Morisky scale was used to assess the pattern of medication adherence. Other specially developed tools were used to obtain sociodemographic and clinical information from electronic medical records and patient interviews. Data were analyzed using the Statistical Package for the Social Sciences Version - 25. Univariate and multivariable analyses were carried out to assess factors associated with non-adherence. 90% of the participants had a primary diagnosis of major depressive disorder. Based on the 8-item Morisky Medication Adherence Scale, the prevalence of non-adherence was found to be 84.7%. Living distance between 11 to 50 km from the hospital (AOR= 11, 95% CI (29,46.6)), post-secondary level of education (AOR= 8.3, 95% CI (1, 64.4)) and taking multiple medications (AOR= 6.1, 95% CI (1, 34.9)) were found to have significantly increased odds of non-adherence. Non-adherence was significantly associated with factors such as increased living distance from the hospital, relatively higher educational level, and polypharmacy. Proper and patient-centered psychoeducation, addressing the communication gap between patients and doctors, adherence to prescribing guidelines, avoiding polypharmacy unless indicated & working on accessibility of treatment is essential to decrease non-adherence.

Keywords: depressive disorders, Ethiopia, medication adherence, Addis Ababa

Procedia PDF Downloads 147
3067 Relationship between Wave Velocities and Geo-Pressures in Shallow Libyan Carbonate Reservoir

Authors: Tarek Sabri Duzan

Abstract:

Knowledge of the magnitude of Geo-pressures (Pore, Fracture & Over-burden pressures) is vital especially during drilling, completions, stimulations, Enhance Oil Recovery. Many times problems, like lost circulation could have been avoided if techniques for calculating Geo-pressures had been employed in the well planning, mud weight plan, and casing design. In this paper, we focused on the relationships between Geo-pressures and wave velocities (P-Wave (Vp) and S-wave (Vs)) in shallow Libyan carbonate reservoir in the western part of the Sirte Basin (Dahra F-Area). The data used in this report was collected from four new wells recently drilled. Those wells were scattered throughout the interested reservoir as shown in figure-1. The data used in this work are bulk density, Formation Mult -Tester (FMT) results and Acoustic wave velocities. Furthermore, Eaton Method is the most common equation used in the world, therefore this equation has been used to calculate Fracture pressure for all wells using dynamic Poisson ratio calculated by using acoustic wave velocities, FMT results for pore pressure, Overburden pressure estimated by using bulk density. Upon data analysis, it has been found that there is a linear relationship between Geo-pressures (Pore, Fracture & Over-Burden pressures) and wave velocities ratio (Vp/Vs). However, the relationship was not clear in the high-pressure area, as shown in figure-10. Therefore, it is recommended to use the output relationship utilizing the new seismic data for shallow carbonate reservoir to predict the Geo-pressures for future oil operations. More data can be collected from the high-pressure zone to investigate more about this area.

Keywords: bulk density, formation mult-tester (FMT) results, acoustic wave, carbonate shalow reservoir, d/jfield velocities

Procedia PDF Downloads 286
3066 Post-Secondary Faculty Treatment of Non-Native English-Speaking Student Writing Errors in Academic Subject Courses

Authors: Laura E. Monroe

Abstract:

As more non-native English-speaking students enroll in English-medium universities, even more faculty will instruct students who are unprepared for the rigors of post-secondary academic writing in English. Many faculty members lack training and knowledge regarding the assessment of non-native English-speaking students’ writing, as well as the ability to provide effective feedback. This quantitative study investigated the possible attitudinal factors, including demographics, which might affect faculty preparedness and grading practices for both native and non-native English-speaking students’ academic writing and plagiarism, as well as the reasons faculty do not deduct points from both populations’ writing errors. Structural equation modeling and SPSS Statistics were employed to analyze the results of a faculty questionnaire disseminated to individuals who had taught non-native English-speaking students in academic subject courses. The findings from this study illustrated that faculty’s native language, years taught, and institution type were significant factors in not deducting points for academic writing errors and plagiarism, and the major reasons for not deducting points for errors were that faculty had too many students to grade, not enough training in assessing student written errors and plagiarism and that the errors and plagiarism would have taken too long to explain. The practical implications gleaned from these results can be applied to most departments in English-medium post-secondary institutions regarding faculty preparedness and training in student academic writing errors and plagiarism, and recommendations for future research are given for similar types of preparation and guidance for post-secondary faculty, regardless of degree path or academic subject.

Keywords: assessment, faculty, non-native English-speaking students, writing

Procedia PDF Downloads 148
3065 Spatial Comparative Analysis on Travels of Mackay in Taiwan

Authors: Shao-Chi Chien, Ying-Ju Chen, Chiao-Yu Tseng, Wan-Ting Lee, Yi-Wen Cheng

Abstract:

Dr. George Leslie Mackay arrived at Takoukang (now Port of Kaohsiung) in Taiwan on December 30, 1871. When Dr. Mackay dedicated at Taiwan for 30 years, he has been an important factor in such areas as preaching, medical and engaged in education. Many researchers have thoroughly studied Dr. Mackay's travels to understand his impact on the state of education, medicine and religion in Taiwan. In the 30-year period of hard work, Dr. Mackay's made outstanding influence on the church in Taiwan. Therefore, the present study will be the mission of the establishment of hospitals, schools, churches which preaching, education, and medicine whether there are related the number of comparisons to explore. According to The Diaries of George Leslie Mackay, our research uses the Geographic Information System (GIS) to map the location of Dr. Mackay's travel in Taiwan and compares it with today's local churches, hospitals, and schools whether there are related the number of comparisons to explore. Therefore, our research focuses on the whole of Taiwan, divided into missionary, medical and education as the main content of the three major parts. Additionally, use of point layer, the surface layer of the property table to establish, in-depth mission of Dr. Mackay's development in Taiwan and Today's comparison. The results will be based on the classification of three different colors pictures that the distance of Mackay's contribution of preaching, medicine, and education. Our research will be compared with the current churches, hospitals, schools and the past churches, hospitals, schools. The results of the present study will provide a reference for future research.

Keywords: George Leslie Mackay, geographic information system, spatial distribution, color categories analysis

Procedia PDF Downloads 395
3064 The Nursing Experience for an Intestinal Perforation Elderly with a Temporary Enterostomy

Authors: Hsiu-Chuan Hsueh, Kuei-Feng Shen Jr., Chia-Ling Chao, Hui-Chuan Pan

Abstract:

This article described a 75 years old woman who has suffered from intestinal perforation and accepted surgery with temporary enterostomy, the operation makes her depressed, refused relatives and friend's care, facing low willingness to participate in various activities due to fear of changing body appearance caused by surgery and leave enterostomy. The author collected information through observation talks, physical evaluation, and medical records during the period of care from November 14 to November 30, 2016, we used the four aspects of physiology, psychology, society and spirituality as a whole sexual assessment to establish the nursing problems of patient, included of acute pain, disturbance of body image,coping ineffective individual. For patient care issues, to encouraged case to express their inner feelings and take part in self-care programs through providing good therapeutic interpersonal relationships with their families. However, it provided clear information about the disease and follow-up treatment plan, give compliments in a timely manner, enhanced self-confidence of individual cases and their motivation to participate in self-care of stoma, further face the disease in a positive manner. At the same time, cross-section team care model and individual care measures were developed to enhance the care skills after returning home and at the same time assist the individual in facing the psychological impact caused by stoma. Hope to provide this experience, as a reference for the future care of the disease.

Keywords: enterostomy, intestinal perforation, nursing experience, ostomy

Procedia PDF Downloads 138
3063 Written Narrative Texts as the Indicators of Communication Competence of Pupils and Students with Hearing Impairment in the Czech Language

Authors: Marie Komorna, Katerina Hadkova

Abstract:

One reason why hearing disabilities as compared to other disabilities are considered to be less serious, is the belief that deaf and hard of hearing persons can read and write without problems and can therefore fairly easily compensate for problems related to their limited ability to hear sound. However in reality this is not the case, especially as regards written Czech, deaf persons are often not able to communicate their message clearly to its recipients. Their inability to communicate fully in written language is one of the most severe problems facing a number of deaf persons, a problem which they face and which makes it difficult for them to function in a sound-based environment. Despite this fact, this issue is one which has been given only a minimum of attention in the Czech Republic. That is why we decided to focus our research on this issue, specifically targeting written communication of deaf pupils in primary and secondary schools. The paper summarizes the background and objectives of this research. The written work of deaf respondents was obtained in response to a narrative based on a series of images which depicted a continuous storyline. Based on an analysis of the obtained written work we tried to describe the specifics of the narrative abilities of the deaf authors of these texts. We also analyzed other aspects and specific traits of text written by deaf authors at a phonetic-phonological, lexical-semantic, morphological and syntactic, respectively pragmatic level. Based on the results of the project it will be possible to increase knowledge of the communication abilities of deaf persons in written Czech. The obtained data may be used during future research and for teaching purposes and/or education concepts for teaching Czech to deaf pupils.

Keywords: communication competence, deaf, narrative, written texts

Procedia PDF Downloads 337
3062 Artificial Intelligence in Bioscience: The Next Frontier

Authors: Parthiban Srinivasan

Abstract:

With recent advances in computational power and access to enough data in biosciences, artificial intelligence methods are increasingly being used in drug discovery research. These methods are essentially a series of advanced statistics based exercises that review the past to indicate the likely future. Our goal is to develop a model that accurately predicts biological activity and toxicity parameters for novel compounds. We have compiled a robust library of over 150,000 chemical compounds with different pharmacological properties from literature and public domain databases. The compounds are stored in simplified molecular-input line-entry system (SMILES), a commonly used text encoding for organic molecules. We utilize an automated process to generate an array of numerical descriptors (features) for each molecule. Redundant and irrelevant descriptors are eliminated iteratively. Our prediction engine is based on a portfolio of machine learning algorithms. We found Random Forest algorithm to be a better choice for this analysis. We captured non-linear relationship in the data and formed a prediction model with reasonable accuracy by averaging across a large number of randomized decision trees. Our next step is to apply deep neural network (DNN) algorithm to predict the biological activity and toxicity properties. We expect the DNN algorithm to give better results and improve the accuracy of the prediction. This presentation will review all these prominent machine learning and deep learning methods, our implementation protocols and discuss these techniques for their usefulness in biomedical and health informatics.

Keywords: deep learning, drug discovery, health informatics, machine learning, toxicity prediction

Procedia PDF Downloads 356
3061 Need for E-Learning: An Effective Method in Educating the Persons with Hearing Impairment Using Sign Language

Authors: S. Vijayakumar, S. B. Rathna Kumar, Navnath D Jagadale

Abstract:

Learning and teaching are the challenges ahead in the education of the students with hearing impairment using sign language (SHISL). Either the students or teachers face difficulties in the process of learning/teaching. Communication is one of the main barriers while teaching SHISL. Further, the courses of study or the subjects are limited to SHISL at least in countries like India. Students with hearing impairment mainly opt for sign language as a communication mode. Subjects like physics, chemistry, advanced mathematics etc. are not available in the curriculum for the SHISL since their content and ideas are complex. In India, exemption for language papers is being given for the students with hearing impairment. It may give opportunity to them to secure secondary/ higher secondary qualifications. It is a known fact that students with hearing impairment are facing difficulty in their future carrier. They secure neither a higher study nor a good employment opportunity. Vocational training in various trades will land them in few jobs with few bucks in pocket. However, not all of them are blessed with higher positions in government or private sectors in competitive fields or where the technical knowledge is required. E learning with sign language instructions can be used for teaching languages and science subjects. Computer Based Instruction (CBI), Computer Based Training (CBT), and Computer Assisted Instruction (CAI) are now part-and-parcel of Modern Education. It will also include signed video clip corresponding to the topic. Learning language subjects will improve the understanding of concepts in different subjects. Learning other science subjects like their hearing counterparts will enable the SHISL to go higher in studies and increase their height to pluck a fruit of the tree of employment.

Keywords: students with hearing impairment using sign language, hearing impairment, language subjects, science subjects, e-learning

Procedia PDF Downloads 404
3060 Migrant Labour in Kerala: A Study on Inter-State Migrant Workers

Authors: Arun Perumbilavil Anand

Abstract:

In the recent years, Kerala is witnessing a large inflow of migrants from different parts of the country. Though initially, the migrants were largely from the districts of Tamil Nadu and mostly of seasonal nature, but at a later period, the state started getting migrants from the far-off states like UP, Assam, Bengal, etc. Higher wages for unskilled labour, large opportunities for employment, the reluctance on the part of Kerala workers to do menial and hard physical work, and the shortage of local labour, paradoxically despite the high unemployment rate in the state, led to the massive influx of migrant labourers. This study takes a multi-dimensional overview of migrant labour in Kerala by encompassing factors such as channels of migration, nature of employment contracts entered into and the corresponding wages and benefits obtained by them. The study also analysed the circumstances that led to the large influx of migrants from different states of India. It further makes an attempt to examine the varying dimensions of living and working environment, and also the health conditions of migrants. The study is based on the empirical findings obtained as a result of the primary interviews conducted with migrants in the districts of Palakkad, Malappuram, and Ernakulam. The study concludes by noting that Kerala will inevitably have to depend on migrant labour and is likely to experience heavy in-migration of labour in future, provided that if the existing socioeconomic and demographic situations persist. Since, this is inevitable, the best way before the state is to prepare well in advance to receive and accommodate such migrant labour to lead a comfortable life in a hassle free environment, so that it would definitely play a vital role in further strengthening and sustaining the growth trajectory of not only Kerala’s economy but also the states of origin.

Keywords: Kerala, labour, migration, migrant workers

Procedia PDF Downloads 252
3059 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh

Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

Abstract:

Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

Procedia PDF Downloads 190
3058 Humoral and Cytokine Responses to Major Human Cytomegalovirus Antigens in Mouse Model

Authors: Sahar Essa, Hussain A. Safar, Raj Raghupathy

Abstract:

Human cytomegalovirus (CMV) continues to be a source of severe complications in immunologically immature and immunocompromised hosts. Effective CMV vaccines that help diminish CMV disease in transplant patients and avoid congenital infection are of great importance. Though the exact roles of defense mechanisms are unidentified, viral-specific antibodies and cytokine responses are known to be involved in controlling CMV infections. CMV envelope glycoprotein B (UL55/gB), matrix proteins (UL83/pp65, UL99/pp28, UL32/pp150), and assembly protein UL80a/pp38 are known to be targets of antiviral immune responses. We immunized mice intraperitoneally with these five CMV-related proteins (commercial) for their ability to induce specific antibody responses (in-house immunoassay) and cytokine production (commercial assay) in a mouse model. We observed a significant CMV-antigen-specific antibody response to pp38 and pp65 (E/C ˃2.0, p˂0.001). Mice immunized with pp38 had significantly higher concentrations of GM-CSF, IFN-α, IL-2 IL-4, IL-5, and IL-17A (p˂0.05). Mice immunized with pp65 showed significantly higher concentrations of GM-CSF, IFN-γ, IL-2 IL-4, IL-10, IL-12, IL-17A, and TNF-α. Th1 to Th2 cytokines ratios revealed a Th1 cytokine bias in mice immunized with pp38, pp65, pp150, and gB. We suggest that stimulation with multiple CMV-related proteins, which include pp38, pp65, and gB antigens, will allow both humoral and cellular immune responses to be efficiently activated, thus serving as appropriate CMV antigens for future vaccines.

Keywords: cytomegalovirus, UL99/pp28, UL80a/pp38, UL83/pp65, UL32/pp150, UL55/gB, CMV-antigen-specific antibody, CMV antigen-specific cytokine responses

Procedia PDF Downloads 78
3057 The Determinants of Customer’s Purchase Intention of Islamic Credit Card: Evidence from Pakistan

Authors: Nasir Mehmood, Muhammad Yar Khan, Anam Javeed

Abstract:

This study aims to scrutinize the dynamics which tend to impact customer’s purchasing intention of Islamic credit card and nexus of product’s knowledge and religiosity with the attitude of potential Islamic credit card’s customer. The theory of reasoned action strengthened the idea that intentions due to its proven predictive power are most likely to instigate intended consumer behavior. Particularly, the study examines the relationships of perceived financial cost (PFC), subjective norms (SN), and attitude (ATT) with the intention to purchase Islamic credit cards. Using a convenience sampling approach, data have been collected from 450 customers of banks located in Rawalpindi and Islamabad. A five-point Likert scale self-administered questionnaire was used to collect the data. The data were analyzed using the Statistical Package of Social Sciences (SPSS) through the procedures of principal component and multiple regression analysis. The results suggested that customer’s religiosity and product knowledge are strong indicators of attitude towards buying Islamic credit cards. Likewise, subjective norms, attitude, and perceived financial cost have a significant positive impact on customers’ purchase intent of Islamic bank’s credit cards. This study models a useful path for future researchers to further investigate the underlined phenomenon along with a variety of psychodynamic factors which are still in its infancy, at least in the Pakistani banking sector. The study also provides an insight to the practitioners and Islamic bank managers for directing their efforts toward educating customers regarding the use of Islamic credit cards and other financial products.

Keywords: attitude, Islamic credit card, religiosity, subjective norms

Procedia PDF Downloads 143
3056 Impact of International Student Mobility on European and Global Identity: A Case Study of Switzerland

Authors: Karina Oborune

Abstract:

International student mobility involves a unique spatio-temporal context and exploring the various aspects of mobile students’ experience can lead to new findings within identity studies. The previous studies have mainly focused on student mobility within Europe and its impact on European identity arguing that students who participate in intra-European mobility already feel European before exchange. Contrary to previous studies, in this paper student mobility is analyzed from different point of view. In order to see whether a true Europeanization of identities is taking place, it is necessary to contrast European identity with alternative supranational identity which could similarly result from student mobility and in particular a global identity. Besides, in the paper there is explored whether geographical constellation (host country continental location during mobility- Europe vs. outside of Europe) plays a role. Based on newly developed model of multicultural, social and socio-demographic variables there is argued that after intra-European mobility only global identity of students could be increased (H1), but the mobility to countries outside of Europe causes changes in European identity (H2). The quantitative study (survey, n=1440, 22 higher education institutions, experimental group of former and future/potential mobile students and control group of non-mobile students) was held in Switzerland where is equally high number of students who participate in intra-European and outside of Europe mobility. The results of multivariate linear regression showed that students who participate in exchange in Europe increase their European identity due to having close friends from Europe, as well as due to length of the mobility experience had impact, but students who participate in exchange outside of Europe increase their global identity due to having close friends from outside of Europe and proficiency in foreign languages.

Keywords: student mobility, European identity, global identity, global identity

Procedia PDF Downloads 728
3055 Guard@Lis: Birdwatching Augmented Reality Mobile Application

Authors: Jose A. C. Venancio, Alexandrino J. M. Goncalves, Anabela Marto, Nuno C. S. Rodrigues, Rita M. T. Ascenso

Abstract:

Nowadays, it is common to find people who are concerned about getting away from the everyday life routine, looking forward to outcome well-being and pleasant emotions. Trying to disconnect themselves from the usual places of work and residence, they pursue different places, such as tourist destinations, aiming to have unexpected experiences. In order to make this exploration process easier, cities and tourism agencies seek new opportunities and solutions, creating routes with diverse cultural landmarks, including natural landscapes and historic buildings. These offers frequently aspire to the preservation of the local patrimony. In nature and wildlife, birdwatching is an activity that has been increasing, both in cities and in the countryside. This activity seeks to find, observe and identify the diversity of birds that live permanently or temporarily in these places, and it is usually supported by birdwatching guides. Leiria (Portugal) is a well-known city, presenting several historical and natural landmarks, like the Lis river and the castle where King D. Dinis lived in the 13th century. Along the Lis River, a conservation process was carried out and a pedestrian route was created (Polis project). This is considered an excellent spot for birdwatching, especially for the gray heron (Ardea cinerea) and for the kingfisher (Alcedo atthis). There is also a route through the city, from the riverside to the castle, which encloses a characterized variety of species, such as the barn swallow (Hirundo rustica), known for passing through different seasons of the year. Birdwatching is sometimes a difficult task since it is not always possible to see all bird species that inhabit a given place. For this reason, a need to create a technological solution was found to ease this activity. This project aims to encourage people to learn about the various species of birds that live along the Lis River and to promote the preservation of nature in a conscious way. This work is being conducted in collaboration with Leiria Municipal Council and with the Environmental Interpretation Centre. It intends to show the majesty of the Lis River, a place visited daily by several people, such as children and families, who use it for didactic and recreational activities. We are developing a mobile multi-platform application (Guard@Lis) that allows bird species to be observed along a given route, using representative digital 3D models through the integration of augmented reality technologies. Guard@Lis displays a route with points of interest for birdwatching and a list of species for each point of interest, along with scientific information, images and sounds for every species. For some birds, to ensure their observation, the user can watch them in loco, in their real and natural environment, with their mobile device by means of augmented reality, giving the sensation of presence of these birds, even if they cannot be seen in that place at that moment. The augmented reality feature is being developed with Vuforia SDK, using a hybrid approach to recognition and tracking processes, combining marks and geolocation techniques. This application proposes routes and notifies users with alerts for the possibility of viewing models of augmented reality birds. The final Guard@Lis prototype will be tested by volunteers in-situ.

Keywords: augmented reality, birdwatching route, mobile application, nature tourism, watch birds using augmented reality

Procedia PDF Downloads 172
3054 The Impact of Quality Cost on Revenue Sharing in Supply Chain Management

Authors: Fayza M. Obied-Allah

Abstract:

Customer’ needs, quality, and value creation while reducing costs through supply chain management provides challenges and opportunities for companies and researchers. In the light of these challenges, modern ideas must contribute to counter these challenges and exploit opportunities. Perhaps this paper will be one of these contributions. This paper discusses the impact of the quality cost on revenue sharing as a most important incentive to configure business networks. No doubt that the costs directly affect the size of income generated by a business network, so this paper investigates the impact of quality costs on business networks revenue, and their impact on the decision to participate the revenue among the companies in the supply chain. This paper develops the quality cost approach to align with the modern era, the developed model includes five categories besides the well-known four categories (namely prevention costs, appraisal costs, internal failure costs, and external failure costs), a new category has been developed in this research as a new vision of the relationship between quality costs and innovations of industry. This new category is Recycle Cost. This paper is organized into six sections, Section I shows quality costs overview in the supply chain. Section II discusses revenue sharing between the parties in supply chain. Section III investigates the impact of quality costs in revenue sharing decision between partners in supply chain. The fourth section includes survey study and presents statistical results. Section V discusses the results and shows future opportunities for research. Finally, Section VI summarizes the theoretical and practical results of this paper.

Keywords: quality cost, recycle cost, revenue sharing, supply chain management

Procedia PDF Downloads 442
3053 Revisiting the Link between Corporate Social Performance and Corporate Financial Performance Post 2008 Global Economic Crisis

Authors: Anand Choudhary

Abstract:

Following the global economic crisis in 2008, businesses and more especially the big multinational conglomerates were increasingly viewed by the people world over as one of the major causes of the economic problems faced by millions globally, in terms of job loss and lifetime savings being wiped out as banks and pension funds went bankrupt and people stared at an insecure financial future. This caused a lot of resentment in the public against big businesses and fueled several protest movements by the people such as “Occupy Wall Street” in different parts of the world. This forced the big businesses to respond to the challenge by adopting more people-centric policies and initiatives for local communities in societies where they operate as part of their corporate social responsibility (CSR), in order to regain their social acceptance among the people whilst earning their ‘social license to operate’. The current paper studies many of such large MNCs across the United States of America, India and South Africa, which changed the way they did business earlier, following the global economic crisis in 2008, by incorporating capacity building initiatives for local communities as part of their CSR strategy and explores whether it has contributed to improving their financial performance. It is a conceptual research paper using secondary source data. The findings reveal that there is a positive correlation between the companies’ corporate social performance and corporate financial performance. In addition, the findings also bring to light that the MNCs examined as part of the current paper have improved their image in the eyes of their stakeholders following the change in their CSR strategy and initiatives.

Keywords: corporate social responsibility (CSR), Corporate Social Performance (CSP), Corporate Financial Performance (CFP), local communities

Procedia PDF Downloads 335
3052 Cultural Disposition and Implicit Dehumanization of Sexualized Females by Women

Authors: Hong Im Shin

Abstract:

Previous research demonstrated that self-objectification (women view themselves as objects for use) is related to system-justification. Three studies investigated whether cultural disposition as its system-justifying function could have an impact on self-objectification and dehumanization of sexualized women and men. Study 1 (N = 91) employed a survey methodology to examine the relationship between cultural disposition (collectivism vs. individualism), trait of system-justification, and self-objectification. The results showed that the higher tendency of collectivism was related to stronger system-justification and self-objectification. Study 2 (N = 60 females) introduced a single category implicit association task (SC-IAT) to assess the extent to which sexually objectified women were associated with uniquely human attributes (i.e., culture) compared to animal-related attributes (i.e., nature). According to results, female participants associated sexually objectified female targets less with human attributes compared to animal-related attributes. Study 3 (N = 46) investigated whether priming to individualism or collectivism was associated to system justification and sexual objectification of men and women with the use of a recognition task involving upright and inverted pictures of sexualized women and men. The results indicated that the female participants primed to individualism showed an inversion effect for sexualized women and men (person-like recognition), whereas there was no inversion effect for sexualized women in the priming condition of collectivism (object-like recognition). This implies that cultural disposition plays a mediating role for rationalizing the gender status, implicit dehumanization of sexualized females and self-objectification. Future research directions are discussed.

Keywords: cultural disposition, dehumanization, implicit test, self-objectification

Procedia PDF Downloads 237
3051 Impact of Adolescent Smoking on the Behaviour, Academic and Health Aspects in Qatar

Authors: Abdelsalam Gomaa, Mahjabeen Ramzan, Tooba Ali Akbar, Huma Nadeem

Abstract:

The use of tobacco and the health risks linked to it are well known in this day and age due to the presence of easily available information through the internet. The media is a powerful platform that is used by many anti-smoking awareness campaigns to reach their target audience; yet, it has been found that adolescents are taking up smoking every passing day. Half of this smoking population of youngsters resides in Asia alone, which includes Qatar, the focus country of this study. As smoking happens to be one of the largest avoidable causes of serious diseases like cancers and heart problems, children are taking up smoking at an alarming rate everywhere including Qatar. Importance of the health of the citizens of Qatar is one of the pillars of the Qatar vision 2030, which is to ensure a healthy population, both physically and mentally. Since the youth makes up a significant percentage of the population and in order to achieve the health objectives of the Qatar vision 2030, it is essential to ensure the health and well-being of this part of the population of the country as they are the future of Qatar. Children, especially boys who tend to be more aggressive by nature, are highly likely to develop behavioral and health issues due to smoking at an early age. Research conducted around the world has also emphasized on this association between the smokers developing a bad behaviour as well as poor social communication skills. However, due to lack of research into this association, very little is known about the extent to which smoking impacts the children’s academics, health and behaviour. Moreover, a study of this nature has not yet been conducted in Qatar previously as most of the studies focus on adult smokers and ways to minimize the number of smoking habits in universities and workplaces. This study solely focuses on identifying a relationship between smoking and its impacts on the adolescents by conducting a research on different schools across Qatar.

Keywords: adolescents, modelling techniques, Qatar, smoking

Procedia PDF Downloads 244
3050 Subsea Processing: Deepwater Operation and Production

Authors: Md Imtiaz, Sanchita Dei, Shubham Damke

Abstract:

In recent years, there has been a rapidly accelerating shift from traditional surface processing operations to subsea processing operation. This shift has been driven by a number of factors including the depletion of shallow fields around the world, technological advances in subsea processing equipment, the need for production from marginal fields, and lower initial upfront investment costs compared to traditional production facilities. Moving production facilities to the seafloor offers a number of advantage, including a reduction in field development costs, increased production rates from subsea wells, reduction in the need for chemical injection, minimization of risks to worker ,reduction in spills due to hurricane damage, and increased in oil production by enabling production from marginal fields. Subsea processing consists of a range of technologies for separation, pumping, compression that enables production from offshore well without the need for surface facilities. At present, there are two primary technologies being used for subsea processing: subsea multiphase pumping and subsea separation. Multiphase pumping is the most basic subsea processing technology. Multiphase pumping involves the use of boosting system to transport the multiphase mixture through pipelines to floating production vessels. The separation system is combined with single phase pumps or water would be removed and either pumped to the surface, re-injected, or discharged to the sea. Subsea processing can allow for an entire topside facility to be decommissioned and the processed fluids to be tied back to a new, more distant, host. This type of application reduces costs and increased both overall facility and integrity and recoverable reserve. In future, full subsea processing could be possible, thereby eliminating the need for surface facilities.

Keywords: FPSO, marginal field, Subsea processing, SWAG

Procedia PDF Downloads 412
3049 Classification of Regional Innovation Types and Region-Based Innovation Policies

Authors: Seongho Han, Dongkwan Kim

Abstract:

The focus of regional innovation policies is shifting from a central government to local governments. The central government demands that regions enforce autonomous and responsible regional innovation policies and that regional governments seek for innovation policies fit for regional characteristics. However, the central government and local governments have not arrived yet at a conclusion on what innovation policies are appropriate for regional circumstances. In particular, even if each local government is trying to find regional innovation strategies that are based on the needs of a region, its innovation strategies turn out to be similar with those of other regions. This leads to a consequence that is inefficient not only at a national level, but also at a regional level. Existing researches on regional innovation types point out that there are remarkable differences in the types or characteristics of innovation among the regions of a nation. In addition they imply that there would be no expected innovation output in cases in which policies are enforced with ignoring such differences. This means that it is undesirable to enforce regional innovation policies under a single standard. This research, given this problem, aims to find out the characteristics and differences in innovation types among the regions in Korea and suggests appropriate policy implications by classifying such characteristics and differences. This research, given these objectives, classified regions in consideration of the various indicators that comprise the innovation suggested by existing related researches and illustrated policies based on such characteristics and differences. This research used recent data, mainly from 2012, and as a methodology, clustering analysis based on multiple factor analysis was applied. Supplementary researches on dynamically analyzing stability in regional innovation types, establishing systematic indicators based on the regional innovation theory, and developing additional indicators are necessary in the future.

Keywords: regional innovation policy, regional innovation type, region-based innovation, multiple factor analysis, clustering analysis

Procedia PDF Downloads 475
3048 Challenges Faced by the Visually Impaired Children and their Parents in Doing Homework Assignments Using Braille

Authors: Shazia Farooq Mirza

Abstract:

The purpose of this study was to explore the challenges faced by visually impaired children and their parents in doing homework assignments using Braille. This study had a quantitative approach and it was descriptive in nature. It took place in 6 public and special private schools of Lahore.177 visually impaired children of grades 4-10 and 153 parents of the visually impaired children were the volunteer participants of this study which were selected through a convenient sampling method. A survey method was adopted for the data collection. And for this purpose 2 self-developed validated questionnaires were used as instruments. The instruments were constructed by exploring the factors and sub-factors from the literature review. Thirty students with visual impairment and 30 parents of the students with visual impairment filled the questionnaires as a pilot study, and it ensured the reliability of the instruments. Data were analyzed using a statistical package of social sciences and it was completely interpreted. Findings revealed that the common challenges faced by the students with visual impairment were Physical Stress, Readiness, Braille Knowledge, Braille Skill and Communications. And the major challenges faced by the parents of the students with visual impairment were the Availability of the helping material, the Availability of the reading material, Braille Knowledge, Braille skills, School and family interactions, Behavior management and the Environment and equipment. Conclusions were drawn on the basis of the major findings. Future suggestions are given in light of the conclusions. This study will be beneficial for the children with visual impairment, the parents of the children with visual impairment, the special education teachers and for the policymakers of the special schools.

Keywords: challenges, visually impaired children, homework, parents, braille

Procedia PDF Downloads 121
3047 Integration of Building Information Modeling Framework for 4D Constructability Review and Clash Detection Management of a Sewage Treatment Plant

Authors: Malla Vijayeta, Y. Vijaya Kumar, N. Ramakrishna Raju, K. Satyanarayana

Abstract:

Global AEC (architecture, engineering, and construction) industry has been coined as one of the most resistive domains in embracing technology. Although this digital era has been inundated with software tools like CAD, STADD, CANDY, Microsoft Project, Primavera etc. the key stakeholders have been working in siloes and processes remain fragmented. Unlike the yesteryears’ simpler project delivery methods, the current projects are of fast-track, complex, risky, multidisciplinary, stakeholder’s influential, statutorily regulative etc. pose extensive bottlenecks in preventing timely completion of projects. At this juncture, a paradigm shift surfaced in construction industry, and Building Information Modeling, aka BIM, has been a panacea to bolster the multidisciplinary teams’ cooperative and collaborative work leading to productive, sustainable and leaner project outcome. Building information modeling has been integrative, stakeholder engaging and centralized approach in providing a common platform of communication. A common misconception that BIM can be used for building/high rise projects in Indian Construction Industry, while this paper discusses of the implementation of BIM processes/methodologies in water and waste water industry. It elucidates about BIM 4D planning and constructability reviews of a Sewage Treatment Plant in India. Conventional construction planning and logistics management involves a blend of experience coupled with imagination. Even though the excerpts or judgments or lessons learnt gained from veterans might be predictive and helpful, but the uncertainty factor persists. This paper shall delve about the case study of real time implementation of BIM 4D planning protocols for one of the Sewage Treatment Plant of Dravyavati River Rejuvenation Project in India and develops a Time Liner to identify logistics planning and clash detection. With this BIM processes, we shall find that there will be significant reduction of duplication of tasks and reworks. Also another benefit achieved will be better visualization and workarounds during conception stage and enables for early involvement of the stakeholders in the Project Life cycle of Sewage Treatment Plant construction. Moreover, we have also taken an opinion poll of the benefits accrued utilizing BIM processes versus traditional paper based communication like 2D and 3D CAD tools. Thus this paper concludes with BIM framework for Sewage Treatment Plant construction which will achieve optimal construction co-ordination advantages like 4D construction sequencing, interference checking, clash detection checking and resolutions by primary engagement of all key stakeholders thereby identifying potential risks and subsequent creation of risk response strategies. However, certain hiccups like hesitancy in adoption of BIM technology by naïve users and availability of proficient BIM trainers in India poses a phenomenal impediment. Hence the nurture of BIM processes from conception, construction and till commissioning, operation and maintenance along with deconstruction of a project’s life cycle is highly essential for Indian Construction Industry in this digital era.

Keywords: integrated BIM workflow, 4D planning with BIM, building information modeling, clash detection and visualization, constructability reviews, project life cycle

Procedia PDF Downloads 121
3046 Genome Editing in Sorghum: Advancements and Future Possibilities: A Review

Authors: Micheale Yifter Weldemichael, Hailay Mehari Gebremedhn, Teklehaimanot Hailesslasie

Abstract:

The advancement of target-specific genome editing tools, including clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein9 (Cas9), mega-nucleases, base editing (BE), prime editing (PE), transcription activator-like endonucleases (TALENs), and zinc-finger nucleases (ZFNs), have paved the way for a modern era of gene editing. CRISPR/Cas9, as a versatile, simple, cost-effective and robust system for genome editing, has dominated the genome manipulation field over the last few years. The application of CRISPR/Cas9 in sorghum improvement is particularly vital in the context of ecological, environmental and agricultural challenges, as well as global climate change. In this context, gene editing using CRISPR/Cas9 can improve nutritional value, yield, resistance to pests and disease and tolerance to different abiotic stress. Moreover, CRISPR/Cas9 can potentially perform complex editing to reshape already available elite varieties and new genetic variations. However, existing research is targeted at improving even further the effectiveness of the CRISPR/Cas9 genome editing techniques to fruitfully edit endogenous sorghum genes. These findings suggest that genome editing is a feasible and successful venture in sorghum. Newer improvements and developments of CRISPR/Cas9 techniques have further qualified researchers to modify extra genes in sorghum with improved efficiency. The fruitful application and development of CRISPR techniques for genome editing in sorghum will not only help in gene discovery, creating new, improved traits in sorghum regulating gene expression sorghum functional genomics, but also in making site-specific integration events.

Keywords: CRISPR/Cas9, genome editing, quality, sorghum, stress, yield

Procedia PDF Downloads 57
3045 Analysis of Earthquake Potential and Shock Level Scenarios in South Sulawesi

Authors: Takhul Bakhtiar

Abstract:

In South Sulawesi Province, there is an active Walanae Fault causing this area to frequently experience earthquakes. This study aims to determine the level of seismicity of the earthquake in order to obtain the potential for earthquakes in the future. The estimation of the potential for earthquakes is then made a scenario model determine the estimated level of shocks as an effort to mitigate earthquake disasters in the region. The method used in this study is the Gutenberg Richter Method through the statistical likelihood approach. This study used earthquake data in the South Sulawesi region in 1972 - 2022. The research location is located at the coordinates of 3.5° – 5.5° South Latitude and 119.5° – 120.5° East Longitude and divided into two segments, namely the northern segment at the coordinates of 3.5° – 4.5° South Latitude and 119,5° – 120,5° East Longitude then the southern segment with coordinates of 4.5° – 5.5° South Latitude and 119,5° – 120.5° East Longitude. This study uses earthquake parameters with a magnitude > 1 and a depth < 50 km. The results of the analysis show that the potential for earthquakes in the next ten years with a magnitude of M = 7 in the northern segment is estimated at 98.81% with an estimated shock level of VI-VII MMI around the cities of Pare-Pare, Barru, Pinrang and Soppeng then IV - V MMI in the cities of Bulukumba, Selayar, Makassar and Gowa. In the southern segment, the potential for earthquakes in the next ten years with a magnitude of M = 7 is estimated at 32.89% with an estimated VI-VII MMI shock level in the cities of Bulukumba, Selayar, Makassar and Gowa, then III-IV MMI around the cities of Pare-Pare, Barru, Pinrang and Soppeng.

Keywords: Gutenberg Richter, likelihood method, seismicity, shakemap and MMI scale

Procedia PDF Downloads 119
3044 Prevalence, Median Time, and Associated Factors with the Likelihood of Initial Antidepressant Change: A Cross-Sectional Study

Authors: Nervana Elbakary, Sami Ouanes, Sadaf Riaz, Oraib Abdallah, Islam Mahran, Noriya Al-Khuzaei, Yassin Eltorki

Abstract:

Major Depressive Disorder (MDD) requires therapeutic interventions during the initial month after being diagnosed for better disease outcomes. International guidelines recommend a duration of 4–12 weeks for an initial antidepressant (IAD) trial at an optimized dose to get a response. If depressive symptoms persist after this duration, guidelines recommend switching, augmenting, or combining strategies as the next step. Most patients with MDD in the mental health setting have been labeled incorrectly as treatment-resistant where in fact they have not been subjected to an adequate trial of guideline-recommended therapy. Premature discontinuation of IAD due to ineffectiveness can cause unfavorable consequences. Avoiding irrational practices such as subtherapeutic doses of IAD, premature switching between the ADs, and refraining from unjustified polypharmacy can help the disease to go into a remission phase We aimed to determine the prevalence and the patterns of strategies applied after an IAD was changed because of a suboptimal response as a primary outcome. Secondary outcomes included the median survival time on IAD before any change; and the predictors that were associated with IAD change. This was a retrospective cross- sectional study conducted in Mental Health Services in Qatar. A dataset between January 1, 2018, and December 31, 2019, was extracted from the electronic health records. Inclusion and exclusion criteria were defined and applied. The sample size was calculated to be at least 379 patients. Descriptive statistics were reported as frequencies and percentages, in addition, to mean and standard deviation. The median time of IAD to any change strategy was calculated using survival analysis. Associated predictors were examined using two unadjusted and adjusted cox regression models. A total of 487 patients met the inclusion criteria of the study. The average age for participants was 39.1 ± 12.3 years. Patients with first experience MDD episode 255 (52%) constituted a major part of our sample comparing to the relapse group 206(42%). About 431 (88%) of the patients had an occurrence of IAD change to any strategy before end of the study. Almost half of the sample (212 (49%); 95% CI [44–53%]) had their IAD changed less than or equal to 30 days. Switching was consistently more common than combination or augmentation at any timepoint. The median time to IAD change was 43 days with 95% CI [33.2–52.7]. Five independent variables (age, bothersome side effects, un-optimization of the dose before any change, comorbid anxiety, first onset episode) were significantly associated with the likelihood of IAD change in the unadjusted analysis. The factors statistically associated with higher hazard of IAD change in the adjusted analysis were: younger age, un-optimization of the IAD dose before any change, and comorbid anxiety. Because almost half of the patients in this study changed their IAD as early as within the first month, efforts to avoid treatment failure are needed to ensure patient-treatment targets are met. The findings of this study can have direct clinical guidance for health care professionals since an optimized, evidence-based use of AD medication can improve the clinical outcomes of patients with MDD; and also, to identify high-risk factors that could worsen the survival time on IAD such as young age and comorbid anxiety

Keywords: initial antidepressant, dose optimization, major depressive disorder, comorbid anxiety, combination, augmentation, switching, premature discontinuation

Procedia PDF Downloads 150