Search results for: failure in implementation
485 Perception of Health Care Providers: A Need to Introduce Screening of Maternal Mental Health at Primary Health Care in Nepal
Authors: Manisha Singh, Padam Simkhada
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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.Keywords: maternal mental health, health care providers, screening, Nepal
Procedia PDF Downloads 127484 Approximate Spring Balancing for the Arm of a Humanoid Robot to Reduce Actuator Torque
Authors: Apurva Patil, Ashay Aswale, Akshay Kulkarni, Shubham Bharadiya
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The potential benefit of gravity compensation of linkages in mechanisms using springs to reduce actuator requirements is well recognized, but practical applications have been elusive. Although existing methods provide exact spring balance, they require additional masses or auxiliary links, or all the springs used originate from the ground, which makes the resulting device bulky and space-inefficient. This paper uses a method of static balancing of mechanisms with conservative loads such as gravity and spring loads using non-zero-free-length springs with child–parent connections and no auxiliary links. Application of this method to the developed arm of a humanoid robot is presented here. Spring balancing is particularly important in this case because the serial chain of linkages has to work against gravity.This work involves approximate spring balancing of the open-loop chain of linkages using minimization of potential energy variance. It uses the approach of flattening the potential energy distribution over the workspace and fuses it with numerical optimization. The results show the considerable reduction in actuator torque requirement with practical spring design and arrangement. Reduced actuator torque facilitates the use of lower end actuators which are generally smaller in weight and volume thereby lowering the space requirements and the total weight of the arm. This is particularly important for humanoid robots where the parent actuator has to handle the weight of the subsequent actuators as well. Actuators with lower actuation requirements are more energy efficient, thereby reduce the energy consumption of the mechanism. Lower end actuators are lower in cost and facilitate the development of low-cost devices. Although the method provides only an approximate balancing, it is versatile, flexible in choosing appropriate control variables that are relevant to the design problem and easy to implement. The true potential of this technique lies in the fact that it uses a very simple optimization to find the spring constant, free-length of the spring and the optimal attachment points subject to the optimization constraints. Also, it uses physically realizable non-zero-free-length springs directly, thereby reducing the complexity involved in simulating zero-free-length springs from non-zero-free-length springs. This method allows springs to be attached to the preceding parent link, which makes the implementation of spring balancing practical. Because auxiliary linkages can be avoided, the resultant arm of the humanoid robot is compact. The cost benefits and reduced complexity can be significant advantages in the development of this arm of the humanoid robot.Keywords: actuator torque, child-parent connections, spring balancing, the arm of a humanoid robot
Procedia PDF Downloads 244483 Civic E-Participation in Central and Eastern Europe: A Comparative Analysis
Authors: Izabela Kapsa
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Civic participation is an important aspect of democracy. The contemporary model of democracy is based on citizens' participation in political decision-making (deliberative democracy, participatory democracy). This participation takes many forms of activities like display of slogans and symbols, voting, social consultations, political demonstrations, membership in political parties or organizing civil disobedience. The countries of Central and Eastern Europe after 1989 are characterized by great social, economic and political diversity. Civil society is also part of the process of democratization. Civil society, funded by the rule of law, civil rights, such as freedom of speech and association and private ownership, was to play a central role in the development of liberal democracy. Among the many interpretations of concepts, defining the concept of contemporary democracy, one can assume that the terms civil society and democracy, although different in meaning, nowadays overlap. In the post-communist countries, the process of shaping and maturing societies took place in the context of a struggle with a state governed by undemocratic power. State fraud or repudiation of the institution is a representative state, which in the past was the only way to manifest and defend its identity, but after the breakthrough became one of the main obstacles to the development of civil society. In Central and Eastern Europe, there are many obstacles to the development of civil society, for example, the elimination of economic poverty, the implementation of educational campaigns, consciousness-related obstacles, the formation of social capital and the deficit of social activity. Obviously, civil society does not only entail an electoral turnout but a broader participation in the decision-making process, which is impossible without direct and participative democratic institutions. This article considers such broad forms of civic participation and their characteristics in Central and Eastern Europe. The paper is attempts to analyze the functioning of electronic forms of civic participation in Central and Eastern European states. This is not accompanied by a referendum or a referendum initiative, and other forms of political participation, such as public consultations, participative budgets, or e-Government. However, this paper will broadly present electronic administration tools, the application of which results from both legal regulations and increasingly common practice in state and city management. In the comparative analysis, the experiences of post-communist bloc countries will be summed up to indicate the challenges and possible goals for further development of this form of citizen participation in the political process. The author argues that for to function efficiently and effectively, states need to involve their citizens in the political decision-making process, especially with the use of electronic tools.Keywords: Central and Eastern Europe, e-participation, e-government, post-communism
Procedia PDF Downloads 193482 Evaluation of Cooperative Hand Movement Capacity in Stroke Patients Using the Cooperative Activity Stroke Assessment
Authors: F. A. Thomas, M. Schrafl-Altermatt, R. Treier, S. Kaufmann
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Stroke is the main cause of adult disability. Especially upper limb function is affected in most patients. Recently, cooperative hand movements have been shown to be a promising type of upper limb training in stroke rehabilitation. In these movements, which are frequently found in activities of daily living (e.g. opening a bottle, winding up a blind), the force of one upper limb has to be equally counteracted by the other limb to successfully accomplish a task. The use of standardized and reliable clinical assessments is essential to evaluate the efficacy of therapy and the functional outcome of a patient. Many assessments for upper limb function or impairment are available. However, the evaluation of cooperative hand movement tasks are rarely included in those. Thus, the aim of this study was (i) to develop a novel clinical assessment (CASA - Cooperative Activity Stroke Assessment) for the evaluation of patients’ capacity to perform cooperative hand movements and (ii) to test its inter- and interrater reliability. Furthermore, CASA scores were compared to current gold standard assessments for upper extremity in stroke patients (i.e. Fugl-Meyer Assessment, Box & Blocks Test). The CASA consists of five cooperative activities of daily living including (1) opening a jar, (2) opening a bottle, (3) open and closing of a zip, (4) unscrew a nut and (5) opening a clipbox. Here, the goal is to accomplish the tasks as fast as possible. In addition to the quantitative rating (i.e. time) which is converted to a 7-point scale, also the quality of the movement is rated in a 4-point scale. To test the reliability of CASA, fifteen stroke subjects were tested within a week twice by the same two raters. Intra-and interrater reliability was calculated using the intraclass correlation coefficient (ICC) for total CASA score and single items. Furthermore, Pearson-correlation was used to compare the CASA scores to the scores of Fugl-Meyer upper limb assessment and the box and blocks test, which were assessed in every patient additionally to the CASA. ICC scores of the total CASA score indicated an excellent- and single items established a good to excellent inter- and interrater reliability. Furthermore, the CASA score was significantly correlated to the Fugl-Meyer and Box & Blocks score. The CASA provides a reliable assessment for cooperative hand movements which are crucial for many activities of daily living. Due to its non-costly setup, easy and fast implementation, we suggest it to be well suitable for clinical application. In conclusion, the CASA is a useful tool in assessing the functional status and therapy related recovery in cooperative hand movement capacity in stroke patients.Keywords: activitites of daily living, clinical assessment, cooperative hand movements, reliability, stroke
Procedia PDF Downloads 319481 Effective Service Provision and Multi-Agency Working in Service Providers for Children and Young People with Special Educational Needs and Disabilities: A Mixed Methods Systematic Review
Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove
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It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.Keywords: collaboration, joint commissioning, service delivery, service improvement
Procedia PDF Downloads 108480 Experimental and Computational Fluid Dynamic Modeling of a Progressing Cavity Pump Handling Newtonian Fluids
Authors: Deisy Becerra, Edwar Perez, Nicolas Rios, Miguel Asuaje
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Progressing Cavity Pump (PCP) is a type of positive displacement pump that is being awarded greater importance as capable artificial lift equipment in the heavy oil field. The most commonly PCP used is driven single lobe pump that consists of a single external helical rotor turning eccentrically inside a double internal helical stator. This type of pump was analyzed by the experimental and Computational Fluid Dynamic (CFD) approach from the DCAB031 model located in a closed-loop arrangement. Experimental measurements were taken to determine the pressure rise and flow rate with a flow control valve installed at the outlet of the pump. The flowrate handled was measured by a FLOMEC-OM025 oval gear flowmeter. For each flowrate considered, the pump’s rotational speed and power input were controlled using an Invertek Optidrive E3 frequency driver. Once a steady-state operation was attained, pressure rise measurements were taken with a Sper Scientific wide range digital pressure meter. In this study, water and three Newtonian oils of different viscosities were tested at different rotational speeds. The CFD model implementation was developed on Star- CCM+ using an Overset Mesh that includes the relative motion between rotor and stator, which is one of the main contributions of the present work. The simulations are capable of providing detailed information about the pressure and velocity fields inside the device in laminar and unsteady regimens. The simulations have a good agreement with the experimental data due to Mean Squared Error (MSE) in under 21%, and the Grid Convergence Index (GCI) was calculated for the validation of the mesh, obtaining a value of 2.5%. In this case, three different rotational speeds were evaluated (200, 300, 400 rpm), and it is possible to show a directly proportional relationship between the rotational speed of the rotor and the flow rate calculated. The maximum production rates for the different speeds for water were 3.8 GPM, 4.3 GPM, and 6.1 GPM; also, for the oil tested were 1.8 GPM, 2.5 GPM, 3.8 GPM, respectively. Likewise, an inversely proportional relationship between the viscosity of the fluid and pump performance was observed, since the viscous oils showed the lowest pressure increase and the lowest volumetric flow pumped, with a degradation around of 30% of the pressure rise, between performance curves. Finally, the Productivity Index (PI) remained approximately constant for the different speeds evaluated; however, between fluids exist a diminution due to the viscosity.Keywords: computational fluid dynamic, CFD, Newtonian fluids, overset mesh, PCP pressure rise
Procedia PDF Downloads 128479 Social Enterprises over Microfinance Institutions: The Challenges of Governance and Management
Authors: Dean Sinković, Tea Golja, Morena Paulišić
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Upon the end of the vicious war in former Yugoslavia in 1995, international development community widely promoted microfinance as the key development framework to eradicate poverty, create jobs, increase income. Widespread claims were made that microfinance institutions would play vital role in creating a bedrock for sustainable ‘bottom-up’ economic development trajectory, thus, helping newly formed states to find proper way from economic post-war depression. This uplifting neoliberal narrative has no empirical support in the Republic of Croatia. Firstly, the type of enterprises created via microfinance sector are small, unskilled, labor intensive, no technology and with huge debt burden. This results in extremely high failure rates of microenterprises and poor individuals plunging into even deeper poverty, acute indebtedness and social marginalization. Secondly, evidence shows that microcredit is exact reflection of dangerous and destructive sub-prime lending model with ‘boom-to-bust’ scenarios in which benefits are solely extracted by the tiny financial and political elite working around the microfinance sector. We argue that microcredit providers are not proper financial structures through which developing countries should look way out of underdevelopment and poverty. In order to achieve sustainable long-term growth goals, public policy needs to focus on creating, supporting and facilitating the small and mid-size enterprises development. These enterprises should be technically sophisticated, capable of creating new capabilities and innovations, with managerial expertise (skills formation) and inter-connected with other organizations (i.e. clusters, networks, supply chains, etc.). Evidence from South-East Europe suggest that such structures are not created via microfinance model but can be fostered through various forms of social enterprises. Various legal entities may operate as social enterprises: limited liability private company, limited liability public company, cooperative, associations, foundations, institutions, Mutual Insurances and Credit union. Our main hypothesis is that cooperatives are potential agents of social and economic transformation and community development in the region. Financial cooperatives are structures that can foster more efficient allocation of financial resources involving deeper democratic arrangements and more socially just outcomes. In Croatia, pioneers of the first social enterprises were civil society organizations whilst forming a separated legal entity. (i.e. cooperatives, associations, commercial companies working on the principles of returning the investment to the founder). Ever since 1995 cooperatives in Croatia have not grown by pursuing their own internal growth but mostly by relying on external financial support. The greater part of today’s registered cooperatives tend to be agricultural (39%), followed by war veterans cooperatives (38%) and others. There are no financial cooperatives in Croatia. Due to the above mentioned we look at the historical developments and the prevailing social enterprises forms and discuss their advantages and disadvantages as potential agents for social and economic transformation and community development in the region. There is an evident lack of understanding of this business model and of its potential for social and economic development followed by an unfavorable institutional environment. Thus, we discuss the role of governance and management in the formation of social enterprises in Croatia, stressing the challenges for the governance of the country’s social enterprise movement.Keywords: financial cooperatives, governance and management models, microfinance institutions, social enterprises
Procedia PDF Downloads 276478 Eggshell Waste Bioprocessing for Sustainable Acid Phosphatase Production and Minimizing Environmental Hazards
Authors: Soad Abubakr Abdelgalil, Gaber Attia Abo-Zaid, Mohamed Mohamed Yousri Kaddah
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Background: The Environmental Protection Agency has listed eggshell waste as the 15th most significant food industry pollution hazard. The utilization of eggshell waste as a source of renewable energy has been a hot topic in recent years. Therefore, finding a sustainable solution for the recycling and valorization of eggshell waste by investigating its potential to produce acid phosphatase (ACP) and organic acids by the newly-discovered B. sonorensis was the target of the current investigation. Results: The most potent ACP-producing B. sonorensis strain ACP2 was identified as a local bacterial strain obtained from the effluent of paper and pulp industries on basis of molecular and morphological characterization. The use of consecutive statistical experimental approaches of Plackett-Burman Design (PBD), and Orthogonal Central Composite Design (OCCD), followed by pH-uncontrolled cultivation conditions in a 7 L bench-top bioreactor, revealed an innovative medium formulation that substantially improved ACP production, reaching 216 U L⁻¹ with ACP yield coefficient Yp/x of 18.2 and a specific growth rate (µ) of 0.1 h⁻¹. The metals Ag+, Sn+, and Cr+ were the most efficiently released from eggshells during the solubilization process by B. sonorensis. The uncontrolled pH culture condition is the most suited and favored setting for improving the ACP and organic acids production simultaneously. Quantitative and qualitative analyses of produced organic acids were carried out using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Lactic acid, citric acid, and hydroxybenzoic acid isomer were the most common organic acids produced throughout the cultivation process. The findings of thermogravimetric analysis (TGA), differential scan calorimeter (DSC), scanning electron microscope (SEM), energy-dispersive spectroscopy (EDS), Fourier-Transform Infrared Spectroscopy (FTIR), and X-Ray Diffraction (XRD) analysis emphasize the significant influence of organic acids and ACP activity on the solubilization of eggshells particles. Conclusions: This study emphasized robust microbial engineering approaches for the large-scale production of a newly discovered acid phosphatase accompanied by organic acids production from B. sonorensis. The biovalorization of the eggshell waste and the production of cost-effective ACP and organic acids were integrated into the current study, and this was done through the implementation of a unique and innovative medium formulation design for eggshell waste management, as well as scaling up ACP production on a bench-top scale.Keywords: chicken eggshells waste, bioremediation, statistical experimental design, batch fermentation
Procedia PDF Downloads 376477 Response Surface Methodology for the Optimization of Radioactive Wastewater Treatment with Chitosan-Argan Nutshell Beads
Authors: Fatima Zahra Falah, Touria El. Ghailassi, Samia Yousfi, Ahmed Moussaif, Hasna Hamdane, Mouna Latifa Bouamrani
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The management and treatment of radioactive wastewater pose significant challenges to environmental safety and public health. This study presents an innovative approach to optimizing radioactive wastewater treatment using a novel biosorbent: chitosan-argan nutshell beads. By employing Response Surface Methodology (RSM), we aimed to determine the optimal conditions for maximum removal efficiency of radioactive contaminants. Chitosan, a biodegradable and non-toxic biopolymer, was combined with argan nutshell powder to create composite beads. The argan nutshell, a waste product from argan oil production, provides additional adsorption sites and mechanical stability to the biosorbent. The beads were characterized using Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM), and X-ray Diffraction (XRD) to confirm their structure and composition. A three-factor, three-level Box-Behnken design was utilized to investigate the effects of pH (3-9), contact time (30-150 minutes), and adsorbent dosage (0.5-2.5 g/L) on the removal efficiency of radioactive isotopes, primarily focusing on cesium-137. Batch adsorption experiments were conducted using synthetic radioactive wastewater with known concentrations of these isotopes. The RSM analysis revealed that all three factors significantly influenced the adsorption process. A quadratic model was developed to describe the relationship between the factors and the removal efficiency. The model's adequacy was confirmed through analysis of variance (ANOVA) and various diagnostic plots. Optimal conditions for maximum removal efficiency were pH 6.8, a contact time of 120 minutes, and an adsorbent dosage of 0.8 g/L. Under these conditions, the experimental removal efficiency for cesium-137 was 94.7%, closely matching the model's predictions. Adsorption isotherms and kinetics were also investigated to elucidate the mechanism of the process. The Langmuir isotherm and pseudo-second-order kinetic model best described the adsorption behavior, indicating a monolayer adsorption process on a homogeneous surface. This study demonstrates the potential of chitosan-argan nutshell beads as an effective and sustainable biosorbent for radioactive wastewater treatment. The use of RSM allowed for the efficient optimization of the process parameters, potentially reducing the time and resources required for large-scale implementation. Future work will focus on testing the biosorbent's performance with real radioactive wastewater samples and investigating its regeneration and reusability for long-term applications.Keywords: adsorption, argan nutshell, beads, chitosan, mechanism, optimization, radioactive wastewater, response surface methodology
Procedia PDF Downloads 36476 Learning Academic Skills through Movement: A Case Study in Evaluation
Authors: Y. Salfati, D. Sharef Bussel, J. Zamir
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In this paper, we present an Evaluation Case Study implementing the eight principles of Collaborative Approaches to Evaluation (CAE) as designed by Brad Cousins in the past decade. The focus of this paper is sharing a rich experience in which we achieved two main goals. The first was the development of a valuable and meaningful new teacher training program, and the second was a successful implementation of the CAE principles. The innovative teacher training program is based on the idea of including physical movement during the process of teaching and learning academic themes. The program is called Learning through Movement. This program is a response to a call from the Ministry of Education, claiming that today children sit in front of screens and do not exercise any physical activity. In order to contribute to children’s health, physical, and cognitive development, the Ministry of Education promotes learning through physical activities. Research supports the idea that sports and physical exercise improve academic achievements. The Learning through Movement program is operated by Kaye Academic College. Students in the Elementary School Training Program, together with students in the Physical Education Training Program, implement the program in collaboration with two mentors from the College. The program combines academic learning with physical activity. The evaluation began at the beginning of the program. During the evaluation process, data was collected by means of qualitative tools, including interviews with mentors, observations during the students’ collaborative planning, class observations at school and focus groups with students, as well as the collection of documentation related to the teamwork and to the program itself. The data was analyzed using content analysis and triangulation. The preliminary results show outcomes relating to the Teacher Training Programs, the student teachers, the pupils in class, the role of Physical Education teachers, and the evaluation. The Teacher Training Programs developed a collaborative approach to lesson planning. The students' teachers demonstrated a change in their basic attitudes towards the idea of integrating physical activities during the lessons. The pupils indicated higher motivation through full participation in classes. These three outcomes are indicators of the success of the program. An additional significant outcome of the program relates to the status and role of the physical education teachers, changing their role from marginal to central in the school. Concerning evaluation, a deep sense of trust and confidence was achieved, between the evaluator and the whole team. The paper includes the perspectives and challenges of the heads and mentors of the two programs as well as the evaluator’s conclusions. The evaluation unveils challenges in conducting a CAE evaluation in such a complex setting.Keywords: collaborative evaluation, training teachers, learning through movement
Procedia PDF Downloads 146475 A Prospective Neurosurgical Registry Evaluating the Clinical Care of Traumatic Brain Injury Patients Presenting to Mulago National Referral Hospital in Uganda
Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund
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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury
Procedia PDF Downloads 236474 Strategic Entrepreneurship: Model Proposal for Post-Troika Sustainable Cultural Organizations
Authors: Maria Inês Pinho
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Recent literature on issues of Cultural Management (also called Strategic Management for cultural organizations) systematically seeks for models that allow such equipment to adapt to the constant change that occurs in contemporary societies. In the last decade, the world, and in particular Europe has experienced a serious financial problem that has triggered defensive mechanisms, both in the direction of promoting the balance of public accounts and in the sense of the anonymous loss of the democratic and cultural values of each nation. If in the first case emerged the Troika that led to strong cuts in funding for Culture, deeply affecting those organizations; in the second case, the commonplace citizen is seen fighting for the non-closure of cultural equipment. Despite this, the cultural manager argues that there is no single formula capable of solving the need to adapt to change. In another way, it is up to this agent to know the existing scientific models and to adapt them in the best way to the reality of the institution he coordinates. These actions, as a rule, are concerned with the best performance vis-à-vis external audiences or with the financial sustainability of cultural organizations. They forget, therefore, that all this mechanics cannot function without its internal public, without its Human Resources. The employees of the cultural organization must then have an entrepreneurial posture - must be intrapreneurial. This paper intends to break this form of action and lead the cultural manager to understand that his role should be in the sense of creating value for society, through a good organizational performance. This is only possible with a posture of strategic entrepreneurship. In other words, with a link between: Cultural Management, Cultural Entrepreneurship and Cultural Intrapreneurship. In order to prove this assumption, the case study methodology was used with the symbol of the European Capital of Culture (Casa da Música) as well as qualitative and quantitative techniques. The qualitative techniques included the procedure of in-depth interviews to managers, founders and patrons and focus groups to public with and without experience in managing cultural facilities. The quantitative techniques involved the application of a questionnaire to middle management and employees of Casa da Música. After the triangulation of the data, it was proved that contemporary management of cultural organizations must implement among its practices, the concept of Strategic Entrepreneurship and its variables. Also, the topics which characterize the Cultural Intrapreneurship notion (job satisfaction, the quality in organizational performance, the leadership and the employee engagement and autonomy) emerged. The findings show then that to be sustainable, a cultural organization should meet the concerns of both external and internal forum. In other words, it should have an attitude of citizenship to the communities, visible on a social responsibility and a participatory management, only possible with the implementation of the concept of Strategic Entrepreneurship and its variable of Cultural Intrapreneurship.Keywords: cultural entrepreneurship, cultural intrapreneurship, cultural organizations, strategic management
Procedia PDF Downloads 182473 Prevalence of Fast-Food Consumption on Overweight or Obesity on Employees (Age Between 25-45 Years) in Private Sector; A Cross-Sectional Study in Colombo, Sri Lanka
Authors: Arosha Rashmi De Silva, Ananda Chandrasekara
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This study seeks to comprehensively examine the influence of fast-food consumption and physical activity levels on the body weight of young employees within the private sector of Sri Lanka. The escalating popularity of fast food has raised concerns about its nutritional content and associated health ramifications. To investigate this phenomenon, a cohort of 100 individuals aged between 25 and 45, employed in Sri Lanka's private sector, participated in this research. These participants provided socio-demographic data through a standardized questionnaire, enabling the characterization of their backgrounds. Additionally, participants disclosed their frequency of fast-food consumption and engagement in physical activities, utilizing validated assessment tools. The collected data was meticulously compiled into an Excel spreadsheet and subjected to rigorous statistical analysis. Descriptive statistics, such as percentages and proportions, were employed to delineate the body weight status of the participants. Employing chi-square tests, our study identified significant associations between fast-food consumption, levels of physical activity, and body weight categories. Furthermore, through binary logistic regression analysis, potential risk factors contributing to overweight and obesity within the young employee cohort were elucidated. Our findings revealed a disconcerting trend, with 6% of participants classified as underweight, 32% within the normal weight range, and a substantial 62% categorized as overweight or obese. These outcomes underscore the alarming prevalence of overweight and obesity among young private-sector employees, particularly within the bustling urban landscape of Colombo, Sri Lanka. The data strongly imply a robust correlation between fast-food consumption, sedentary behaviors, and higher body weight categories, reflective of the evolving lifestyle patterns associated with the nation's economic growth. This study emphasizes the urgent need for effective interventions to counter the detrimental effects of fast-food consumption. The implementation of awareness campaigns elucidating the adverse health consequences of fast food, coupled with comprehensive nutritional education, can empower individuals to make informed dietary choices. Workplace interventions, including the provision of healthier meal alternatives and the facilitation of physical activity opportunities, are essential in fostering a healthier workforce and mitigating the escalating burden of overweight and obesity in Sri LankaKeywords: fast food consumption, obese, overweight, physical activity level
Procedia PDF Downloads 51472 An Exploration of Policy-related Documents on District Heating and Cooling in Flanders: A Slow and Bottom-up Process
Authors: Isaura Bonneux
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District heating and cooling (DHC) is increasingly recognized as a viable path towards sustainable heating and cooling. While some countries like Sweden and Denmark have a longstanding tradition of DHC, Belgium is lacking behind. The Northern part of Belgium, Flanders, had only a total of 95 heating networks in July 2023. Nevertheless, it is increasingly exploring its possibilities to enhance the scope of DHC. DHC is a complex energy system, requiring a lot of collaboration between various stakeholders on various levels. Therefore, it is of interest to look closer at policy-related documents at the Flemish (regional) level, as these policies set the scene for DHC development in the Flemish region. This kind of analysis has not been undertaken so far. This paper has the following research question: “Who talks about DHC, and in which way and context is DHC discussed in Flemish policy-related documents?” To answer this question, the Overton policy database was used to search and retrieve relevant policy-related documents. Overton retrieves data from governments, think thanks, NGOs, and IGOs. In total, out of the 244 original results, 117 documents between 2009 and 2023 were analyzed. Every selected document included theme keywords, policymaking department(s), date, and document type. These elements were used for quantitative data description and visualization. Further, qualitative content analysis revealed patterns and main themes regarding DHC in Flanders. Four main conclusions can be drawn: First, it is obvious from the timeframe that DHC is a new topic in Flanders with still limited attention; 2014, 2016 and 2017 were the years with the most documents, yet this number is still only 12 documents. In addition, many documents talked about DHC but not much in depth and painted it as a future scenario with a lot of uncertainty around it. The largest part of the issuing government departments had a link to either energy or climate (e.g. Flemish Environmental Agency) or policy (e.g. Socio-Economic Council of Flanders) Second, DHC is mentioned most within an ‘Environment and Sustainability’ context, followed by ‘General Policy and Regulation’. This is intuitive, as DHC is perceived as a sustainable heating and cooling technique and this analysis compromises policy-related documents. Third, Flanders seems mostly interested in using waste or residual heat as a heating source for DHC. The harbors and waste incineration plants are identified as potential and promising supply sources. This approach tries to conciliate environmental and economic incentives. Last, local councils get assigned a central role and the initiative is mostly taken by them. The policy documents and policy advices demonstrate that Flanders opts for a bottom-up organization. As DHC is very dependent on local conditions, this seems a logic step. Nevertheless, this can impede smaller councils to create DHC networks and slow down systematic and fast implementation of DHC throughout Flanders.Keywords: district heating and cooling, flanders, overton database, policy analysis
Procedia PDF Downloads 44471 Environmental Degradation and Sustainable Measures: A Case Study in Nepal
Authors: Megha Raj Regmi
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Water Supply and Sanitation coverage in Nepal is not satisfactory in South Asia. Far less than expected achievements have been realized in sanitation following the SDG for Nepal. There are so many queues of buckets to fetch water in the heart of the capital city Kathmandu. In Kathmandu Valley, daily water demand is 400 million litres, but the supply is only 200 million litres daily. Over- exploitation of ground water and traditional water sources causing the water levels to drop to alarming levels while most of the traditional waterspouts are also drying up. While about 40% of the World's population is deprived of drinking water, the urban populace uses excessive quantities of fresh water to flush the excreta. Water Supply and Basic Sanitation coverage in Nepal is 86% and 92%, respectively, of the total population. This research work basically deals with more than one thousand dry toilets constructed in peri-urban areas. The work has used appropriate technology and studied their performances in the context of Nepal based on complete laboratory analyses and regular monitoring. It has been found that dry toilets have a clear advantage in NPK recovery over traditional water-borne sanitation technology. This paper also deals with the effect of temperature in the decomposition process in dry toilets and also focuses on the different distinct technologies employed in Kathmandu Valley. This paper suggests the modifications needed in the implementation and study of the effect of human urine in composting and application on agriculture and the experience of more than one thousand Dry toilets in Kathmandu Valley. It also deals with the practices of bio-gas generation and community-led total sanitation to cope with the challenges of sanitation and hygiene in Nepal. The paper also describes in depth the different types of biomass energy production methods from the human and cattle manure units, including bio-gas generation from the kitchen wastes produced by a student hostel mixed with toilet waste. The uses of decomposed feces as a soil conditioner have been described along with the challenges and prospects of the uses of urine in agriculture as eco-friendly fertilizer in the context of Nepal. Finally, the paper exhibits a comparative study of all types of dry toilet developments in developed and developing countries like Australia, South Korea, Malaysia, China, India, Ukraine and Nepal. The community groups in our financial assistance have made many models of public toilets with biogas which are very successful in the height of 600 m up to 2000 meters from the mean sea level. In conclusion it makes a plea for the acceptance of these toilets for planners and decision makers with a set of pragmatic recommendations.Keywords: bio- gas public toilet, dry toilet, low-cost technology, sustainable sanitation, total sanitation
Procedia PDF Downloads 3470 From Stigma to Solutions: Harnessing Innovation and Local Wisdom to Tackle Harms Associated with Menstrual Seclusion (Chhaupadi) in Nepal
Authors: Sara E. Baumann, Megan A. Rabin, Mary Hawk, Bhimsen Devkota, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Annika Agarwal, Jessica G. Burke
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In Nepal, prevailing sociocultural norms associated with menstruation prompt adherence to stringent rules that limit participation in daily activities. Chhaupadi is a specific menstrual tradition in Nepal in which women and girls segregate themselves and follow a series of restrictions during menstruation. Despite having numerous physical and mental health implications, extant interventions have yet to sustainably address the harms associated with chhaupadi. In this study, the authors describe insights garnered from a collaboration with community members in Dailekh district, who formulated their own approaches to mitigate the adverse facets of chhaupadi. Envisaged as an entry point to improve women’s menstrual health experiences, this investigation employed an approach that uses Human-centered Design and a community-engaged approach. The authors conducted a four-day design workshop which unfolded in two phases: The Discovery Phase, to uncover chhaupadi context and key stakeholders, and the Design Phase, to design contextually relevant interventions. Diverse community-members, including those with lived experience practicing chhaupadi, developed five intervention concepts: 1) harnessing Female Community Health Volunteers as role models, for counseling, and raising awareness; 2) focusing on mothers and mother’s groups to instigate behavioral shifts; 3) engaging the broader community in behavior change efforts; 4) empowering fathers to effect change in their homes through counseling and education; and 5) training and emboldening youth to advocate for positive change through advocacy in their schools and homes. This research underscores the importance of employing multi-level approaches tailored to specific stakeholder groups, given Nepal’s rich cultural diversity. The engagement of Female Community Health Volunteers emerged as a promising yet underexplored intervention concept for chhaupadi, warranting broader implementation. Crucially, it is also imperative for interventions to prioritize tackling deleterious aspects of the chhaupadi tradition, emphasizing safety considerations, all while acknowledging chhaupadi’s entrenched cultural history; for some, there are positive aspects of the tradition that women and girls wish to preserve.Keywords: human-centered design, menstrual health, Nepal, community-engagement, intervention development, women's health, rural health
Procedia PDF Downloads 64469 Implementation of the Circular Economy Concept in Greenhouse Production Systems: Microalgae and Biostimulant Production Using Soilless Crops’ Drainage Nutrient Solution
Authors: Nikolaos Katsoulas, Sofia Faliagka, George Kountrias, Eleni Dimitriou, Eleftheria Pechlivani
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The challenges to feed the world in 2050 are becoming more and more apparent. This calls for producing more with fewer inputs (most of them under scarcity), higher resource efficiency, minimum or zero effect on the environment, and higher sustainability. Therefore, increasing the circularity of production systems is highly significant for their sustainability. Protected horticulture offers opportunities for maximum resource efficiency across various levels within and between farms and at the regional level), high-quality production, and contributes significantly to the nutrition security as part of the world food production. In greenhouses, closed soilless cultivation systems give the opportunity to increase the water and nutrient use efficiency and reduce the environmental impact of the cultivation system by the reuse of the drained water and nutrients. However, due to the low quality of the water used in the Mediterranean countries, a completely closed system is not feasible. Partial discharge of the drainage nutrient solution when the levels of electrical conductivity (EC) or of the toxic ions in the system are reached is still a necessity. Thus, in the frame of the circular economy concept, this work presents the utilisation of the drainage solution of soilless cultivation systems for microalgae and biofertilisers production. The system includes a greenhouse equipped with a soilless cultivation system, a drainage solution collection tank, a closed bioreactor for microalgae production, and a biocatalysis tank. The bioreactor tested in the frame of this work includes two closed tube loops of a capacity of 1000 L each where, after the initial inoculation, the microalgae is developed using as a growth medium the drainage solution collected from the greenhouse crops. The bioreactor includes light and temperature control while pH is still manually regulated. As soon as the microalgae culture reaches a certain density level, 20% of the culture is harvested, and the culture system is refiled by a drainage nutrient solution. The microalgae produced goes through a biocatalysis process, which leads to the production of a rich aminoacids (and nitrogen) biofertiliser. The produced biofertiliser is then used for the fertilisation of greenhouse crops. The complete production cycle along with the effects of the biofertiliser produced on crop growth and yield are presented and discussed in this manuscript. Acknowledgment: This work was carried out under the PestNu project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Green Deal grant agreement No. 101037128 — PestNu.Keywords: soilless, water use efficiency, nutrients use efficiency, biostimulant
Procedia PDF Downloads 89468 Benefits of Shaping a Balance on Environmental and Economic Sustainability for Population Health
Authors: Edna Negron-Martinez
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Our time's global challenges and trends —like those associated with climate change, demographics displacements, growing health inequalities, and increasing burden of diseases— have complex connections to the determinants of health. Information on the burden of disease causes and prevention is fundamental for public health actions, like preparedness and responses for disasters, and recovery resources after the event. For instance, there is an increasing consensus about key findings of the effects and connections of the global burden of disease, as it generates substantial healthcare costs, consumes essential resources and prevents the attainment of optimal health and well-being. The goal of this research endeavor is to promote a comprehensive understanding of the connections between social, environmental, and economic influences on health. These connections are illustrated by pulling from clearly the core curriculum of multidisciplinary areas —as urban design, energy, housing, and economy— as well as in the health system itself. A systematic review of primary and secondary data included a variety of issues as global health, natural disasters, and critical pollution impacts on people's health and the ecosystems. Environmental health is challenged by the unsustainable consumption patterns and the resulting contaminants that abound in many cities and urban settings around the world. Poverty, inadequate housing, and poor health are usually linked. The house is a primary environmental health context for any individual and especially for more vulnerable groups; such as children, older adults and those who are sick. Nevertheless, very few countries show strong decoupling of environmental degradation from economic growth, as indicated by a recent 2017 Report of the World Bank. Worth noting, the environmental fraction of the global burden of disease in a 2016 World Health Organization (WHO) report estimated that 12.6 million global deaths, accounting for 23% (95% CI: 13-34%) of all deaths were attributable to the environment. Among the environmental contaminants include heavy metals, noise pollution, light pollution, and urban sprawl. Those key findings make a call to the significance to urgently adopt in a global scale the United Nations post-2015 Sustainable Development Goals (SDGs). The SDGs address the social, environmental, and economic factors that influence health and health inequalities, advising how these sectors, in turn, benefit from a healthy population. Consequently, more actions are necessary from an inter-sectoral and systemic paradigm to enforce an integrated sustainability policy implementation aimed at the environmental, social, and economic determinants of health.Keywords: building capacity for workforce development, ecological and environmental health effects of pollution, public health education, sustainability
Procedia PDF Downloads 107467 Life Cycle Assessment of Todays and Future Electricity Grid Mixes of EU27
Authors: Johannes Gantner, Michael Held, Rafael Horn, Matthias Fischer
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At the United Nations Climate Change Conference 2015 a global agreement on the reduction of climate change was achieved stating CO₂ reduction targets for all countries. For instance, the EU targets a reduction of 40 percent in emissions by 2030 compared to 1990. In order to achieve this ambitious goal, the environmental performance of the different European electricity grid mixes is crucial. First, the electricity directly needed for everyone’s daily life (e.g. heating, plug load, mobility) and therefore a reduction of the environmental impacts of the electricity grid mix reduces the overall environmental impacts of a country. Secondly, the manufacturing of every product depends on electricity. Thereby a reduction of the environmental impacts of the electricity mix results in a further decrease of environmental impacts of every product. As a result, the implementation of the two-degree goal highly depends on the decarbonization of the European electricity mixes. Currently the production of electricity in the EU27 is based on fossil fuels and therefore bears a high GWP impact per kWh. Due to the importance of the environmental impacts of the electricity mix, not only today but also in future, within the European research projects, CommONEnergy and Senskin, time-dynamic Life Cycle Assessment models for all EU27 countries were set up. As a methodology, a combination of scenario modeling and life cycle assessment according to ISO14040 and ISO14044 was conducted. Based on EU27 trends regarding energy, transport, and buildings, the different national electricity mixes were investigated taking into account future changes such as amount of electricity generated in the country, change in electricity carriers, COP of the power plants and distribution losses, imports and exports. As results, time-dynamic environmental profiles for the electricity mixes of each country and for Europe overall were set up. Thereby for each European country, the decarbonization strategies of the electricity mix are critically investigated in order to identify decisions, that can lead to negative environmental effects, for instance on the reduction of the global warming of the electricity mix. For example, the withdrawal of the nuclear energy program in Germany and at the same time compensation of the missing energy by non-renewable energy carriers like lignite and natural gas is resulting in an increase in global warming potential of electricity grid mix. Just after two years this increase countervailed by the higher share of renewable energy carriers such as wind power and photovoltaic. Finally, as an outlook a first qualitative picture is provided, illustrating from environmental perspective, which country has the highest potential for low-carbon electricity production and therefore how investments in a connected European electricity grid could decrease the environmental impacts of the electricity mix in Europe.Keywords: electricity grid mixes, EU27 countries, environmental impacts, future trends, life cycle assessment, scenario analysis
Procedia PDF Downloads 186466 Act Local, Think Global: Superior Institute of Engineering of Porto Campaign for a Sustainable Campus
Authors: R. F. Mesquita Brandão
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Act Local, Think Global is the name of a campaign implemented at Superior Institute of Engineering of Porto (ISEP), one of schools of Polytechnic of Porto, with the main objective of increase the sustainability of the campus. ISEP has a campus with 52.000 m2 and more than 7.000 students. The campaign started in 2019 and the results are very clear. In 2019 only 16% of the waste created in the campus was correctly separate for recycling and now almost 50% of waste goes to the correct waste container. Actions to reduce the energy consumption were implemented with significantly results. One of the major problems in the campus are the water leaks. To solve this problem was implemented a methodology for water monitoring during the night, a period of time where consumptions are normally low. If water consumption in the period is higher than a determinate value it may mean a water leak and an alarm is created to the maintenance teams. In terms of energy savings, some measurements were implemented to create savings in energy consumption and in equivalent CO₂ produced. In order to reduce the use of plastics in the campus, was implemented the prohibition of selling 33 cl plastic water bottles and in collaboration with the students association all meals served in the restaurants changed the water plastic bottle for a glass that can be refilled with water in the water dispensers. This measures created a reduction of use of more than 75.000 plastic bottles per year. In parallel was implemented the ISEP water glass bottle to be used in all scientific meetings and events. Has a way of involving all community in sustainability issues was developed and implemented a vertical garden in aquaponic system. In 2019, the first vertical garden without soil was installed inside a large campus building. The system occupies the entire exterior façade (3 floors) of the entrance to ISEP's G building. On each of these floors there is a planter with 42 positions available for plants. Lettuces, strawberries, peppers are examples of some vegetable produced that can be collected by the entire community. Associated to the vertical garden was developed a monitoring system were some parameters of the system are monitored. This project is under development because it will work in a stand-alone energy feeding, with the use of photovoltaic panels for production of energy necessities. All the system was, and still is, developed by students and teachers and is used in class projects of some ISEP courses. These and others measures implemented in the campus, will be more developed in the full paper, as well as all the results obtained, allowed ISEP to be the first Portuguese high school to obtain the certification “Coração Verde” (Green Heart), awarded by LIPOR, a Portuguese company with the mission of transform waste into new resources through the implementation of innovative and circular practices, generating and sharing value.Keywords: aquaponics, energy efficiency, recycling, sustainability, waste separation
Procedia PDF Downloads 94465 Harnessing Clinical Trial Capacity to Mitigate Zoonotic Diseases: The Role of Expert Scientists in Ethiopia
Authors: Senait Belay Adugna, Mirutse Giday, Tsegahun Manyazewal
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Background: The emergence and resurgence of zoonotic diseases have continued to be a major threat to global health and the economy. Developing countries are particularly vulnerable due to agricultural expansions and the domestication of animals by humans. Scientifically sound clinical trials are important to find better ways to prevent, diagnose, and treat zoonotic diseases, while there is a lack of evidence to inform the clinical trials’ capacity and practice in countries highly affected by the diseases. This study aimed to investigate researchers’ perceptions and experiences in conducting clinical trials on zoonotic diseases in Ethiopia. Methods: This study employed a descriptive, qualitative study design. It included major academic and research institutions in Ethiopia that had active engagements in veterinary and public health research. It included the National Veterinary Institute, the National Animal Health Diagnostic and Investigation Center, the College of Veterinary Medicine at Addis Ababa University, the Ethiopian Public Health Institute, the Armauer Hansen Research Institute, and the College of Health Sciences at Addis Ababa University. In-depth interviews were conducted with 14 senior researcher investigators in the institutions who hold a proven exhibit primarily leading research activities or research units. Data were collected from October 2019 to April 2020. Data analysis was undertaken using open code 4.03 for qualitative data analysis. Results: Five major themes, with 18 sub-themes, emerged from the in-depth interview in connection. These were: challenges in the prevention, control, and treatment of zoonotic diseases; One Health approach to mitigate zoonotic diseases; personal and institutional experiences in conducting clinical trials on zoonotic diseases; barriers in conducting clinical trials towards zoonotic diseases; and strategies that promote conducting clinical trials on zoonotic diseases. Conducting clinical trials on zoonotic diseases in Ethiopia is hampered by a lack of clearly articulated ethics and regulatory frameworks, trial experts, financial resources, and good governance. Conclusions: In Ethiopia, conducting clinical trials on zoonotic diseases deserves due attention. Strengthening institutional and human resources capacity is a precondition to harnessing effective implementation of clinical trials on zoonotic diseases in the country. In Ethiopia, where skilled human resource is scarce, the One Health approach has the potential to form multidisciplinary teams to systematically improve clinical trials capacity and outcomes in the country.Keywords: Ethiopia, clinical triak, zoonoses, disease
Procedia PDF Downloads 93464 Water Management of Polish Agriculture and Adaptation to Climate Change
Authors: Dorota M. Michalak
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The agricultural sector, due to the growing demand for food and over-exploitation of the natural environment, contributes to the deepening of climate change, on the one hand, and on the other hand, shrinking freshwater resources, as a negative effect of climate change, threaten the food security of each country. Therefore, adaptation measures to climate change should take into account effective water management and seek solutions ensuring food production at an unchanged or higher level, while not burdening the environment and not contributing to the worsening of the negative consequences of climate change. The problems of Poland's water management result not only from relatively small, natural water resources but to a large extent on the low efficiency of their use. Appropriate agricultural practices and state solutions in this field can contribute to achieving significant benefits in terms of economical water management in agriculture, providing a greater amount of water that could also be used for other purposes, including for purposes related to environmental protection. The aim of the article is to determine the level of use of water resources in Polish agriculture and the advancement of measures aimed at adapting Polish agriculture in the field of water management to climate change. The study provides knowledge about Polish legal regulations and water management tools, the shaping of water policy of Polish agriculture against the background of EU countries and other sources of energy, and measures supporting Polish agricultural holdings in the effective management of water resources run by state budget institutions. In order to achieve the above-mentioned goals, the author used research tools such as the analysis of existing sources and a survey conducted among five groups of entities, i.e. agricultural advisory centers and departments, agricultural, rural and environmental protection departments, regional water management boards, provincial agricultural chambers and restructuring and modernization of agriculture. The main conclusion of the analyses carried out is the low use of water in Polish agriculture in relation to other EU countries, other sources of intake in Poland, as well as irrigation. The analysis allows us to observe another problem, which is the lack of reporting and data collection, which is extremely important from the point of view of the effectiveness of adaptation measures to climate change. The results obtained from the survey indicate a very low level of support for government institutions in the implementation of adaptation measures to climate change and the water management of Polish farms. Some of the basic problems of the adaptation policy to change climate with regard to water management in Polish agriculture include a lack of knowledge regarding climate change, the possibilities of adapting, the available tools or ways to rationalize the use of water resources. It also refers to the lack of ordering procedures and the separation of responsibility with a proper territorial unit, non-functioning channels of information flow and practically low effects.Keywords: water management, adaptation policy, agriculture, climate change
Procedia PDF Downloads 142463 Chemical Technology Approach for Obtaining Carbon Structures Containing Reinforced Ceramic Materials Based on Alumina
Authors: T. Kuchukhidze, N. Jalagonia, T. Archuadze, G. Bokuchava
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The growing scientific-technological progress in modern civilization causes actuality of producing construction materials which can successfully work in conditions of high temperature, radiation, pressure, speed, and chemically aggressive environment. Such extreme conditions can withstand very few types of materials and among them, ceramic materials are in the first place. Corundum ceramics is the most useful material for creation of constructive nodes and products of various purposes for its low cost, easy accessibility to raw materials and good combination of physical-chemical properties. However, ceramic composite materials have one disadvantage; they are less plastics and have lower toughness. In order to increase the plasticity, the ceramics are reinforced by various dopants, that reduces the growth of the cracks. It is shown, that adding of even small amount of carbon fibers and carbon nanotubes (CNT) as reinforcing material significantly improves mechanical properties of the products, keeping at the same time advantages of alundum ceramics. Graphene in composite material acts in the same way as inorganic dopants (MgO, ZrO2, SiC and others) and performs the role of aluminum oxide inhibitor, as it creates shell, that gives possibility to reduce sintering temperature and at the same time it acts as damper, because scattering of a shock wave takes place on carbon structures. Application of different structural modification of carbon (graphene, nanotube and others) as reinforced material, gives possibility to create multi-purpose highly requested composite materials based on alundum ceramics. In the present work offers simplified technology for obtaining of aluminum oxide ceramics, reinforced with carbon nanostructures, during which chemical modification with doping carbon nanostructures will be implemented in the process of synthesis of final powdery composite – Alumina. In charge doping carbon nanostructures connected to matrix substance with C-O-Al bonds, that provide their homogeneous spatial distribution. In ceramic obtained as a result of consolidation of such powders carbon fragments equally distributed in the entire matrix of aluminum oxide, that cause increase of bending strength and crack-resistance. The proposed way to prepare the charge simplifies the technological process, decreases energy consumption, synthesis duration and therefore requires less financial expenses. In the implementation of this work, modern instrumental methods were used: electronic and optical microscopy, X-ray structural and granulometric analysis, UV, IR, and Raman spectroscopy.Keywords: ceramic materials, α-Al₂O₃, carbon nanostructures, composites, characterization, hot-pressing
Procedia PDF Downloads 119462 Evidence-Based Health System Strengthening in Urban India: Drawing Insights from Rapid Assessment Study
Authors: Anisur Rahman, Sabyasachi Behera, Pawan Pathak, Benazir Patil, Rajesh Khanna
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Background: Nearly half of India’s population is expected to reside in urban areas by 2030. The extent to which India's health system can provide for this large and growing city-based population will determine the country's success in achieving universal health coverage and improved national health indices. National Urban Health Mission (NUHM) strive for improving access to primary health care in urban areas. Implementation of NUHM solicits sensitive, effective and sustainable strategies to strengthen the service delivery mechanisms. The Challenge Initiative for Healthy Cities (TCIHC) is working with the Government of India and three provincial states to develop effective service delivery mechanisms for reproductive, maternal, newborn and child health (RMNCH) through a health systems approach for the urban poor. Method: A rapid assessment study was conceptualized and executed to generate evidence in order to address the challenges impeding in functioning of urban health facilities to deliver effective, efficient and equitable health care services in 7 cities spread across two project States viz. Madhya Pradesh and Odisha. Results: The findings of the assessment reflect: 1. The overall ecosystem pertaining to planning and management of public health interventions is not conducive. 2. The challenges regarding population dynamics like migration keeps on influencing the demand-supply-enabling environment triangle for both public and private service providers. 3. Lack of norms for planning and benchmark for service delivery further impedes urban health system as a whole. 4. Operationalization of primary level services have enough potential to meet the demand of slum dwellers at large. 5. Lack of policy driven strategies on how to integrate the NUHM with other thematic areas of Maternal, Newborn & Child Health (MNCH) and Family Planning (FP). 5. The inappropriate capacity building and acute shortage of Human Resources has huge implication on service provisioning and adherence to the service delivery protocols. Conclusion: The findings from rapid assessment are aimed to inform pertinent stakeholders to develop a multiyear city health action plan to strengthen the health systems in order to improve the efficacy of service delivery mechanism in urban settings.Keywords: city health plan, health system, rapid assessment, urban mission
Procedia PDF Downloads 169461 Optimising Apparel Digital Production in Industrial Clusters
Authors: Minji Seo
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Fashion stakeholders are becoming increasingly aware of technological innovation in manufacturing. In 2020, the COVID-19 pandemic caused transformations in working patterns, such as working remotely rather thancommuting. To enable smooth remote working, 3D fashion design software is being adoptedas the latest trend in design and production. The majority of fashion designers, however, are still resistantto this change. Previous studies on 3D fashion design software solely highlighted the beneficial and detrimental factors of adopting design innovations. They lacked research on the relationship between resistance factors and the adoption of innovation. These studies also fell short of exploringthe perspectives of users of these innovations. This paper aims to investigate the key drivers and barriers of employing 3D fashion design software as wellas to explore the challenges faced by designers.It also toucheson the governmental support for digital manufacturing in Seoul, South Korea, and London, the United Kingdom. By conceptualising local support, this study aims to provide a new path for industrial clusters to optimise digital apparel manufacturing. The study uses a mixture of quantitative and qualitative approaches. Initially, it reflects a survey of 350 samples, fashion designers, on innovation resistance factors of 3D fashion design software and the effectiveness of local support. In-depth interviews with 30 participants provide a better understanding of designers’ aspects of the benefits and obstacles of employing 3D fashion design software. The key findings of this research are the main barriers to employing 3D fashion design software in fashion production. The cultural characteristics and interviews resultsare used to interpret the survey results. The findings of quantitative data examine the main resistance factors to adopting design innovations. The dominant obstacles are: the cost of software and its complexity; lack of customers’ interest in innovation; lack of qualified personnel, and lack of knowledge. The main difference between Seoul and London is the attitudes towards government support. Compared to the UK’s fashion designers, South Korean designers emphasise that government support is highly relevant to employing 3D fashion design software. The top-down and bottom-up policy implementation approach distinguishes the perception of government support. Compared to top-down policy approaches in South Korea, British fashion designers based on employing bottom-up approaches are reluctant to receive government support. The findings of this research will contribute to generating solutions for local government and the optimisation of use of 3D fashion design software in fashion industrial clusters.Keywords: digital apparel production, industrial clusters, innovation resistance, 3D fashion design software, manufacturing, innovation, technology, digital manufacturing, innovative fashion design process
Procedia PDF Downloads 102460 Knowledge Management in the Tourism Industry in Project Management Paradigm
Authors: Olga A. Burukina
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Tourism is a complex socio-economic phenomenon, partly regulated by national tourism industries. The sustainable development of tourism in a region, country or in tourist destination depends on a number of factors (political, economic, social, cultural, legal and technological), the understanding and correct interpretation of which is invariably anthropocentric. It is logical that for the successful functioning of a tour operating company, it is necessary to ensure its sustainable development. Sustainable tourism is defined as tourism that fully considers its current and future economic, social and environmental impacts, taking into account the needs of the industry, the environment and the host communities. For the business enterprise, sustainable development is defined as adopting business strategies and activities that meet the needs of the enterprise and its stakeholders today while protecting, sustaining and enhancing the human and natural resources that will be needed in the future. In addition to a systemic approach to the analysis of tourist destinations, each tourism project can and should be considered as a system characterized by a very high degree of variability, since each particular case of its implementation differs from the previous and subsequent ones, sometimes in a cardinal way. At the same time, it is important to understand that this variability is predominantly of anthropogenic nature (except for force majeure situations that are considered separately and afterwards). Knowledge management is the process of creating, sharing, using and managing the knowledge and information of an organization. It refers to a multidisciplinary approach to achieve organisational objectives by making the best use of knowledge. Knowledge management is seen as a key systems component that allows obtaining, storing, transferring, and maintaining information and knowledge in particular, in a long-term perspective. The study aims, firstly, to identify (1) the dynamic changes in the Italian travel industry in the last 5 years before the COVID19 pandemic, which can be considered the scope of force majeure circumstances, (2) the impact of the pandemic on the industry and (3) efforts required to restore it, and secondly, how project management tools can help to improve knowledge management in tour operating companies to maintain their sustainability, diminish potential risks and restore their pre-pandemic performance level as soon as possible. The pilot research is based upon a systems approach and has employed a pilot survey, semi-structured interviews, prior research analysis (aka literature review), comparative analysis, cross-case analysis, and modelling. The results obtained are very encouraging: PM tools can improve knowledge management in tour operating companies and secure the more sustainable development of the Italian tourism industry based on proper knowledge management and risk management.Keywords: knowledge management, project management, sustainable development, tourism industr
Procedia PDF Downloads 156459 A Case Study of Remote Location Viewing, and Its Significance in Mobile Learning
Authors: James Gallagher, Phillip Benachour
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As location aware mobile technologies become ever more omnipresent, the prospect of exploiting their context awareness to enforce learning approaches thrives. Utilizing the growing acceptance of ubiquitous computing, and the steady progress both in accuracy and battery usage of pervasive devices, we present a case study of remote location viewing, how the application can be utilized to support mobile learning in situ using an existing scenario. Through the case study we introduce a new innovative application: Mobipeek based around a request/response protocol for the viewing of a remote location and explore how this can apply both as part of a teacher lead activity and informal learning situations. The system developed allows a user to select a point on a map, and send a request. Users can attach messages alongside time and distance constraints. Users within the bounds of the request can respond with an image, and accompanying message, providing context to the response. This application can be used alongside a structured learning activity such as the use of mobile phone cameras outdoors as part of an interactive lesson. An example of a learning activity would be to collect photos in the wild about plants, vegetation, and foliage as part of a geography or environmental science lesson. Another example could be to take photos of architectural buildings and monuments as part of an architecture course. These images can be uploaded then displayed back in the classroom for students to share their experiences and compare their findings with their peers. This can help to fosters students’ active participation while helping students to understand lessons in a more interesting and effective way. Mobipeek could augment the student learning experience by providing further interaction with other peers in a remote location. The activity can be part of a wider study between schools in different areas of the country enabling the sharing and interaction between more participants. Remote location viewing can be used to access images in a specific location. The choice of location will depend on the activity and lesson. For example architectural buildings of a specific period can be shared between two or more cities. The augmentation of the learning experience can be manifested in the different contextual and cultural influences as well as the sharing of images from different locations. In addition to the implementation of Mobipeek, we strive to analyse this application, and a subset of other possible and further solutions targeted towards making learning more engaging. Consideration is given to the benefits of such a system, privacy concerns, and feasibility of widespread usage. We also propose elements of “gamification”, in an attempt to further the engagement derived from such a tool and encourage usage. We conclude by identifying limitations, both from a technical, and a mobile learning perspective.Keywords: context aware, location aware, mobile learning, remote viewing
Procedia PDF Downloads 291458 Breast Cancer Metastasis Detection and Localization through Transfer-Learning Convolutional Neural Network Classification Based on Convolutional Denoising Autoencoder Stack
Authors: Varun Agarwal
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Introduction: With the advent of personalized medicine, histopathological review of whole slide images (WSIs) for cancer diagnosis presents an exceedingly time-consuming, complex task. Specifically, detecting metastatic regions in WSIs of sentinel lymph node biopsies necessitates a full-scanned, holistic evaluation of the image. Thus, digital pathology, low-level image manipulation algorithms, and machine learning provide significant advancements in improving the efficiency and accuracy of WSI analysis. Using Camelyon16 data, this paper proposes a deep learning pipeline to automate and ameliorate breast cancer metastasis localization and WSI classification. Methodology: The model broadly follows five stages -region of interest detection, WSI partitioning into image tiles, convolutional neural network (CNN) image-segment classifications, probabilistic mapping of tumor localizations, and further processing for whole WSI classification. Transfer learning is applied to the task, with the implementation of Inception-ResNetV2 - an effective CNN classifier that uses residual connections to enhance feature representation, adding convolved outputs in the inception unit to the proceeding input data. Moreover, in order to augment the performance of the transfer learning CNN, a stack of convolutional denoising autoencoders (CDAE) is applied to produce embeddings that enrich image representation. Through a saliency-detection algorithm, visual training segments are generated, which are then processed through a denoising autoencoder -primarily consisting of convolutional, leaky rectified linear unit, and batch normalization layers- and subsequently a contrast-normalization function. A spatial pyramid pooling algorithm extracts the key features from the processed image, creating a viable feature map for the CNN that minimizes spatial resolution and noise. Results and Conclusion: The simplified and effective architecture of the fine-tuned transfer learning Inception-ResNetV2 network enhanced with the CDAE stack yields state of the art performance in WSI classification and tumor localization, achieving AUC scores of 0.947 and 0.753, respectively. The convolutional feature retention and compilation with the residual connections to inception units synergized with the input denoising algorithm enable the pipeline to serve as an effective, efficient tool in the histopathological review of WSIs.Keywords: breast cancer, convolutional neural networks, metastasis mapping, whole slide images
Procedia PDF Downloads 130457 Energy Atlas: Geographic Information Systems-Based Energy Analysis and Planning Tool
Authors: Katarina Pogacnik, Ursa Zakrajsek, Nejc Sirk, Ziga Lampret
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Due to an increase in living standards along with global population growth and a trend of urbanization, municipalities and regions are faced with an ever rising energy demand. A challenge has arisen for cities around the world to modify the energy supply chain in order to reduce its consumption and CO₂ emissions. The aim of our work is the development of a computational-analytical platform for dynamic support in decision-making and the determination of economic and technical indicators of energy efficiency in a smart city, named Energy Atlas. Similar products in this field focuse on a narrower approach, whereas in order to achieve its aim, this platform encompasses a wider spectrum of beneficial and important information for energy planning on a local or regional scale. GIS based interactive maps provide an extensive database on the potential, use and supply of energy and renewable energy sources along with climate, transport and spatial data of the selected municipality. Beneficiaries of Energy atlas are local communities, companies, investors, contractors as well as residents. The Energy Atlas platform consists of three modules named E-Planning, E-Indicators and E-Cooperation. The E-Planning module is a comprehensive data service, which represents a support towards optimal decision-making and offers a sum of solutions and feasibility of measures and their effects in the area of efficient use of energy and renewable energy sources. The E-Indicators module identifies, collects and develops optimal data and key performance indicators and develops an analytical application service for dynamic support in managing a smart city in regards to energy use and sustainable environment. In order to support cooperation and direct involvement of citizens of the smart city, the E-cooperation is developed with the purpose of integrating the interdisciplinary and sociological aspects of energy end-users. Interaction of all the above-described modules contributes to regional development because it enables for a precise assessment of the current situation, strategic planning, detection of potential future difficulties and also the possibility of public involvement in decision-making. From the implementation of the technology in Slovenian municipalities of Ljubljana, Piran, and Novo mesto, there is evidence to suggest that the set goals are to be achieved to a great extent. Such thorough urban energy planning tool is viewed as an important piece of the puzzle towards achieving a low-carbon society, circular economy and therefore, sustainable society.Keywords: circular economy, energy atlas, energy management, energy planning, low-carbon society
Procedia PDF Downloads 305456 Computational Homogenization of Thin Walled Structures: On the Influence of the Global vs Local Applied Plane Stress Condition
Authors: M. Beusink, E. W. C. Coenen
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The increased application of novel structural materials, such as high grade asphalt, concrete and laminated composites, has sparked the need for a better understanding of the often complex, non-linear mechanical behavior of such materials. The effective macroscopic mechanical response is generally dependent on the applied load path. Moreover, it is also significantly influenced by the microstructure of the material, e.g. embedded fibers, voids and/or grain morphology. At present, multiscale techniques are widely adopted to assess micro-macro interactions in a numerically efficient way. Computational homogenization techniques have been successfully applied over a wide range of engineering cases, e.g. cases involving first order and second order continua, thin shells and cohesive zone models. Most of these homogenization methods rely on Representative Volume Elements (RVE), which model the relevant microstructural details in a confined volume. Imposed through kinematical constraints or boundary conditions, a RVE can be subjected to a microscopic load sequence. This provides the RVE's effective stress-strain response, which can serve as constitutive input for macroscale analyses. Simultaneously, such a study of a RVE gives insight into fine scale phenomena such as microstructural damage and its evolution. It has been reported by several authors that the type of boundary conditions applied to the RVE affect the resulting homogenized stress-strain response. As a consequence, dedicated boundary conditions have been proposed to appropriately deal with this concern. For the specific case of a planar assumption for the analyzed structure, e.g. plane strain, axisymmetric or plane stress, this assumption needs to be addressed consistently in all considered scales. Although in many multiscale studies a planar condition has been employed, the related impact on the multiscale solution has not been explicitly investigated. This work therefore focuses on the influence of the planar assumption for multiscale modeling. In particular the plane stress case is highlighted, by proposing three different implementation strategies which are compatible with a first-order computational homogenization framework. The first method consists of applying classical plane stress theory at the microscale, whereas with the second method a generalized plane stress condition is assumed at the RVE level. For the third method, the plane stress condition is applied at the macroscale by requiring that the resulting macroscopic out-of-plane forces are equal to zero. These strategies are assessed through a numerical study of a thin walled structure and the resulting effective macroscale stress-strain response is compared. It is shown that there is a clear influence of the length scale at which the planar condition is applied.Keywords: first-order computational homogenization, planar analysis, multiscale, microstrucutures
Procedia PDF Downloads 233