Search results for: integrated care delivery

Authors: Pushp Lata Sankhwar

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INTRODUCTION: Maternal Hypothyroidism is the most frequent endocrine disorder in pregnancy and varies from 2.5% in the west to 11.0% in India. Maternal Hypothyroidism can have detrimental maternal effects like increased risk of preterm labor, PPROM leading to increased maternal morbidity and also on the neonate in the form of prematurity and its complications, prolonged hospital stay, neurological developmental problems, delayed milestones and mental retardation etc. Henceforth, the study was planned to evaluate the role of Hypothyroidism in preterm labor and its effect on neonates. AIMS AND OBJECTIVES: To Correlate Overt Hypothyroidism, Subclinical Hypothyroidism and Isolated Hypothyroxinemia With Preterm Labor and the neonatal outcome. Material and Methods: A case-control study of singleton pregnancy was performed over a year, in which a total of 500 patients presenting in the emergency with preterm labor were enrolled. The thyroid profile of these patients was sent at the time of admission, on the basis of which they were divided into Cases – Hypothyroidic mothers and Controls – Euthyroid mothers. The cases were further divided into subclinical, overt Hypothyroidism and isolated hypothyroxinemia. The neonatal outcome of these groups was also compared on the basis of the incidence and severity of neonatal morbidity, neonatal respiratory distress, the incidence of neonatal Hypothyroidism and early complications. The feto-maternal data was collected and analysed. RESULTS: In the study, a total of 500 antenatal patients with a history of preterm labor were enrolled, out of which 67 (13.8%) patients were found to be hypothyroid. The majority of the mothers had Subclinical Hypothyroidism (12.2%), followed by Overt Hypothyroidism seen in 1% of the mothers and isolated hypothyroxinemia in 0.6% of cases. The neonates of hypothyroid mothers had higher levels of cord blood TSH, and the mean cord blood TSH levels were highest in the case of neonates of mothers with Overt Hypothyroidism. The need for resuscitation of the neonates at the time of birth was higher in the case of neonates of hypothyroid mothers, especially with Subclinical Hypothyroidism. Also, it was found that the requirement of oxygen therapy in the form of oxygen by nasal prongs, oxygen by a hood, CPAP, CPAP along with surfactant therapy and mechanical ventilation along with surfactant therapy was significantly higher in the case of neonates of hypothyroid mothers. CONCLUSION: The results of our study imply that uncontrolled and untreated maternal Hypothyroidism may also lead to preterm delivery. The neonates of mothers with Hypothyroidism have higher cord blood TSH levels. The study also shows that there is an increased incidence and severity of respiratory distress in the neonates of hypothyroid mothers with untreated subclinical Hypothyroidism. Hence, we propose that routine screening for thyroid dysfunction in pregnant women should be done to prevent thyroid-related feto-maternal complications.

Keywords: high-risk pregnancy, thyroid, dysfunction, hypothyroidism, Preterm labor

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Authors: Min-Tao Hsu

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This study aims to explore the lived experiences of women with breast cancer, including their life world of illness and their adaptation to breast cancer. Breast cancer is not only a potentially lethal disease, but also a disease that may lead to many irreversible changes for female patients. Especially, in a culture where the wholeness is pursuit as an essential value, the sickness and/or broken body bring great challenge of life. Based on holism and symbolic interactionism, this study used interpretive ethnography including in-depth interviews and participant observations to collect the narrative of women with breast cancer concerning their illness experience. In addition, this study used Agar’s hermeneutic cycle to analyze data. The average age of 35 participants was 54.2. A total of 15 patients were within 2 years of onset, 5 patients were within 2-5 years of the treatment observation period, and 15 patients suffered from breast cancer for more than 5 years. The average age of onset was 50.4. Result: The main storyline of the life world of illness is ‘breast cancer is a turning point of life.’ Loss of breast was in terms of ‘no more a woman’ in Taiwanese culture. Two young women, one in her newly wedded and another right before marry, were divorced and cancelled wedding right after being diagnosed. All of them addressed that they have a ‘broken body.’ Single women accounted that they won’t marry for not being humiliated and most of married women said they never show female body in front of her husband or partner even in intimacy encounter. Three common themes were discovered: 1) new self and new identity; 2) new social relationships and new me; 3) new body and new life. The intertwining bodies, illness, selves, suffering, and medical treatments of female patients were observed. More, the recovery, of cause, was happened when new self, relationship, and new body were generated. Their identity to be a woman and a wife is shattered and their life is urged into another facet. For helping them to recovery from such situation, building a new identity and new social fabric on the new body need to be included in nursing care plan.

Keywords: breast cancer, illness narrative, world of illness, self-healing, interpretive ethnography

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Authors: Sungpil Ha, Ju Yong Kang, Sangbaek Park, Seung-Ju Lee, Soo-Won Chae

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The growing number of obese patients in aging societies has led to an increase in the number of patients with knee medial osteoarthritis (OA). Artificial joint insertion is the most common treatment for knee medial OA. Surgery is effective for patients with serious arthritic symptoms, but it is costly and dangerous. It is also inappropriate way to prevent a disease as an early stage. Therefore Non-operative treatments such as toe-in gait are proposed recently. Toe-in gait is one of non-surgical interventions, which restrain the progression of arthritis and relieves pain by reducing knee adduction moment (KAM) to facilitate lateral distribution of load on to knee medial cartilage. Numerous studies have measured KAM in various foot progression angle (FPA), and KAM data could be obtained by motion analysis. However, variations in stress at knee cartilage could not be directly observed or evaluated by these experiments of measuring KAM. Therefore, this study applied motion analysis to major gait points (1st peak, mid –stance, 2nd peak) with regard to FPA, and to evaluate the effects of FPA on the human lower extremity, the finite element (FE) method was employed. Three types of gait analysis (toe-in, toe-out, baseline gait) were performed with markers placed at the lower extremity. Ground reaction forces (GRF) were obtained by the force plates. The forces associated with the major muscles were computed using GRF and marker trajectory data. MRI data provided by the Visible Human Project were used to develop a human lower extremity FE model. FE analyses for three types of gait simulations were performed based on the calculated muscle force and GRF. We observed the maximum stress point during toe-in gait was lower than the other types, by comparing the results of FE analyses at the 1st peak across gait types. This is the same as the trend exhibited by KAM, measured through motion analysis in other papers. This indicates that the progression of knee medial OA could be suppressed by adopting toe-in gait. This study integrated motion analysis with FE analysis. One advantage of this method is that re-modeling is not required even with changes in posture. Therefore another type of gait simulation or various motions of lower extremity can be easily analyzed using this method.

Keywords: finite element analysis, gait analysis, human model, motion capture

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Authors: Mikel Niño, Roberto V. Zicari, Todor Ivanov, Kim Hee, Naveed Mushtaq, Marten Rosselli, Concha Sánchez-Ocaña, Karsten Tolle, José Miguel Blanco, Arantza Illarramendi, Jörg Besier, Harry Underwood

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One of the application fields for data analysis techniques and technologies gaining momentum is the area of social good or “common good”, covering cases related to humanitarian crises, global health care, or ecology and environmental issues, among others. The promotion of data-driven projects in this field aims at increasing the efficacy and efficiency of social initiatives, improving the way these actions help humanity in general and people in need in particular. This application field, however, poses its own barriers and challenges when developing data-driven projects, lagging behind in comparison with other scenarios. These challenges derive from aspects such as the scope and scale of the social issue to solve, cultural and political barriers, the skills of main stakeholders and the technological resources available, the motivation to be engaged in such projects, or the ethical and legal issues related to sensitive data. This paper analyzes the application of data projects in the field of social good, reviewing its current state and noteworthy initiatives, and presenting a framework covering the key aspects to analyze in such projects. The goal is to provide guidelines to understand the main challenges and opportunities for this type of data project, as well as identifying the main differential issues compared to “classical” data projects in general. A case study is presented on the initial steps and stakeholder analysis of a data project for the inclusion of refugees in the city of Frankfurt, Germany, in order to empirically confront the framework with a real example.

Keywords: data-driven projects, humanitarian operations, personal and sensitive data, social good, stakeholders analysis

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Authors: Abdel Rahman Khider Hassan

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This paper describes a multi-criteria geospatial model for prediction of landslide hazard zonation (LHZ) for Lake Naivasha catchment (Kenya), based on spatial analysis of integrated datasets of location intrinsic parameters (slope stability factors) and external landslides triggering factors (natural and man-made factors). The intrinsic dataset included: lithology, geometry of slope (slope inclination, aspect, elevation, and curvature) and land use/land cover. The landslides triggering factors included: rainfall as the climatic factor, in addition to the destructive effects reflected by proximity of roads and drainage network to areas that are susceptible to landslides. No published study on landslides has been obtained for this area. Thus, digital datasets of the above spatial parameters were conveniently acquired, stored, manipulated and analyzed in a Geographical Information System (GIS) using a multi-criteria grid overlay technique (in ArcGIS 10.2.2 environment). Deduction of landslide hazard zonation is done by applying weights based on relative contribution of each parameter to the slope instability, and finally, the weighted parameters grids were overlaid together to generate a map of the potential landslide hazard zonation (LHZ) for the lake catchment. From the total surface of 3200 km² of the lake catchment, most of the region (78.7 %; 2518.4 km²) is susceptible to moderate landslide hazards, whilst about 13% (416 km²) is occurring under high hazards. Only 1.0% (32 km²) of the catchment is displaying very high landslide hazards, and the remaining area (7.3 %; 233.6 km²) displays low probability of landslide hazards. This result confirms the importance of steep slope angles, lithology, vegetation land cover and slope orientation (aspect) as the major determining factors of slope failures. The information provided by the produced map of landslide hazard zonation (LHZ) could lay the basis for decision making as well as mitigation and applications in avoiding potential losses caused by landslides in the Lake Naivasha catchment in the Kenya Highlands.

Keywords: decision making, geospatial, landslide, multi-criteria, Naivasha

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Authors: Anamika Sahu

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The Himalayas, like many mountainous regions, is susceptible to multiple hazards. In recent times, the frequency of such disasters is continuously increasing due to extreme weather phenomena. These natural hazards are responsible for irreparable human and economic loss. The Indian Himalayas has repeatedly been ruptured by great earthquakes in the past and has the potential for a future large seismic event as it falls under the seismic gap. Damages caused by earthquakes are different in different localities. It is well known that, during earthquakes, damage to the structure is associated with the subsurface conditions and the quality of construction materials. So, for sustainable mountain development, prior estimation of site characterization will be valuable for designing and constructing the space area and for efficient mitigation of the seismic risk. Both geotechnical and geophysical investigation of the subsurface is required to describe the subsurface complexity. In mountainous regions, geophysical methods are gaining popularity as areas can be studied without disturbing the ground surface, and also these methods are time and cost-effective. The MASW method is used to calculate the Vs30. Vs30 is the average shear wave velocity for the top 30m of soil. Shear wave velocity is considered the best stiffness indicator, and the average of shear wave velocity up to 30 m is used in National Earthquake Hazards Reduction Program (NEHRP) provisions (BSSC,1994) and Uniform Building Code (UBC), 1997 classification. Parameters obtained through geotechnical investigation have been integrated with findings obtained through the subsurface geophysical survey. Joint interpretation has been used to establish inter-relationships among mineral constituents, various textural parameters, and unconfined compressive strength (UCS) with shear wave velocity. It is found that results obtained through the MASW method fitted well with the laboratory test. In both conditions, mineral constituents and textural parameters (grain size, grain shape, grain orientation, and degree of interlocking) control the petrophysical and mechanical properties of rocks and the behavior of shear wave velocity.

Keywords: MASW, mechanical, petrophysical, site characterization

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Authors: Ayesha Akbar

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Pakistan is moving from a security state to a welfare state despite several security challenges both internal and external. Human security signifies a varied approach in different regions depending upon the leadership and policy priorities. The link between human development and economic growth is not automatic. It has to be created consciously by forward-looking policies and strategies by national governments. There are seven components or categories of human security these include: Economic Security, Personal Security, Health Security, Environmental Security, Food Security, Community Security and Political Security. The increasing interest of the international community to clearly understand the dimensions of human security provided the grounds to Pakistani scholars as well to ponder on the issue and delineate lines of human security. A great deal of work has been either done or in process to evaluate human security indicators in Pakistan. Notwithstanding, after having been done a great deal of work the human security in Pakistan is not satisfactory. A range of deteriorating indicators of human development that lies under the domain of human security leaves certain inquiries to be answered. What are the dimensions of human security in Pakistan? And how are they being dealt from the perspective of policy and institution in terms of its operationalization in Pakistan? Is the human security discourse reflects evidence-based policy changes. The methodology is broadly based on qualitative methods that include interviews, content analysis of policy documents. Pakistan is among the most populous countries in the world and faces high vulnerability to climate change. Literacy rate has gone down with the surge of youth bulge to accommodate in the job market. Increasing population is creating food problems as the resources have not been able to compete with the raising demands of food and other social amenities of life. Majority of the people are facing acute poverty. Health outcomes are also not satisfactory with the high infant and maternal mortality rate. Pakistan is on the verge of facing water crisis as the water resources are depleting so fast with the high demand in agriculture and energy sector. Pakistan is striving hard to deal with the declining state of human security but the dilemma is lack of resources that hinders in meeting up with the emerging demands. The government requires to bring about more change with scaling-up economic growth avenues with enhancing the capacity of human resources. A modern performance drive culture with the integration of technology is required to deliver efficient and effective service delivery. On an already fast track process of reforms; e-governance and evidence based policy mechanism is being instilled in the government process for better governance and evidence based decisions.

Keywords: governance, human development index, human security, Pakistan, policy

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Authors: C. Shekhar Parajulee

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Nepal practiced a centralized unitary governing system for a long and has gone through the federal system after the promulgation of the new constitution on 20 September 2015. There is a big paradigm shift in terms of governance after it. Now, there are three levels of governments, one federal government in the center, seven provincial governments and 753 local governments. Federalism refers to a political governing system with multiple tiers of government working together with coordination. It is preferred for self and shared rule. Though it has opened the door for rights of the people, political stability, state restructuring, and sustainable peace and development, there are many prospects and challenges for its proper implementation. This research analyzes the discourses of federalism implementation in Nepal with special reference to one of seven provinces, Gandaki. Federalism is a new phenomenon in Nepali politics and informed debates on it are required for its right evolution. This research will add value in this regard. Moreover, tracking its evolution and the exploration of the attitudes and behaviors of key actors and stakeholders in a new experiment of a new governing system is also important. The administrative and political system of Gandaki province in terms of service delivery and development will critically be examined. Besides demonstrating the performances of the provincial government and assembly, it will analyze the inter-governmental relation of Gandaki with the other two tiers of government. For this research, people from provincial and local governments (elected representatives and government employees), provincial assembly members, academicians, civil society leaders and journalists are being interviewed. The interview findings will be analyzed by supplementing with published documents. Just going into the federal structure is not the solution. As in the case of other provincial governments, Gandaki had also to start from scratch. It gradually took a shape of government and has been functioning sluggishly. The provincial government has many challenges ahead, which has badly hindered its plans and actions. Additionally, fundamental laws, infrastructures and human resources are found to be insufficient at the sub-national level. Lack of clarity in the jurisdiction is another main challenge. The Nepali Constitution assumes cooperation, coexistence and coordination as the fundamental principles of federalism which, unfortunately, appear to be lacking among the three tiers of government despite their efforts. Though the devolution of power to sub-national governments is essential for the successful implementation of federalism, it has apparently been delayed due to the centralized mentality of bureaucracy as well as a political leader. This research will highlight the reasons for the delay in the implementation of federalism. There might be multiple underlying reasons for the slow pace of implementation of federalism and identifying them is very tough. Moreover, the federal spirit is found to be absent in the main players of today's political system, which is a big irony. So, there are some doubts about whether the federal system in Nepal is just a keepsake or a substantive.

Keywords: federalism, inter-governmental relations, Nepal, provincial government

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Authors: Jukka Törrönen

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In the article, we examine the interplay between the practices of heavy drinking and exercise among young people as patterned around the ‘social’ and ‘physical health’ approaches. The comparison helps us to clarify why young people are currently drinking less than earlier and how the neoliberal healthism discourse, as well as the feminine tradition of taking care of one’s body, are modifying young people’s heavy drinking practices. The data is based on interviews (n = 56) in Sweden among 15-16-year-olds and 18˗19-year-olds. By drawing on Pierre Bourdieu’s concepts of habitus, field, and capital, we examine what kinds of resources of wellbeing young people accumulate in the fields of heavy drinking and exercise, how these resources carry symbolic value for distinction, and what kind of health-related habitus they imply. The analysis suggests that as heavy drinking is no longer able to stand as a practice through which one may acquire capital that is more valuable than the capital acquired in other fields, this lessens peer pressure to drink among young people. Our analysis further shows that the healthism discourse modifies young people’s heavy drinking practices both from inside and from outside. The interviewees translate the symbolic value of healthism discourse to social vulnerability and deploy it for the purposes of increasing one’s social status among peers. Moreover, our analysis demonstrates that the social spaces and positions in intoxication and exercise are shaped by gendered dualisms of masculine dominance. However, while the interviewees naturalize the gender binaries in intoxication as based on biological drives, they understand gender binaries in exercise as normative social constructions of neoliberal society. As these binaries emphasize the struggle for recognition of the symbolic value of bodily look, they may shift young men’s attention from risk-taking to issues that traditionally have been female concerns.

Keywords: young people, decline in drinking , health, intoxication, exercise, Bourdieu

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Authors: Rudi Ryacudu, Edi Artono, Gema Wahyudi Purnama

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Oil and gas consumption in Indonesia is currently on the rise due to its nation economic improvement. Unfortunately, Indonesia’s domestic oil production cannot meet it’s own consumption and Indonesia has lost its status as Oil and Gas exporter. Even worse, our conventional oil and gas reserve is declining. Unwilling to give up, the government of Indonesia has taken measures to invite investors to invest in domestic oil and gas exploration to find new potential reserve and ultimately increase production. Yet, it has not bear any fruit. Indonesia has taken steps now to explore new unconventional oil and gas play including Shale Gas, Shale Oil and Tight Sands to increase domestic production. These new plays require definite parameters to differentiate each concept. The purpose of this paper is to provide ways in defining unconventional hydrocarbon reservoir parameters in Shale Gas, Shale Oil and Tight Sands. The parameters would serve as an initial baseline for users to perform analysis of unconventional hydrocarbon plays. Some of the on going concerns or question to be answered in regards to unconventional hydrocarbon plays includes: 1. The TOC number, 2. Has it been well “cooked” and become a hydrocarbon, 3. What are the permeability and the porosity values, 4. Does it need a stimulation, 5. Does it has pores, and 6. Does it have sufficient thickness. In contrast with the common oil and gas conventional play, Shale Play assumes that hydrocarbon is retained and trapped in area with very low permeability. In most places in Indonesia, hydrocarbon migrates from source rock to reservoir. From this case, we could derive a theory that Kitchen and Source Rock are located right below the reservoir. It is the starting point for user or engineer to construct basin definition in relation with the tectonic play and depositional environment. Shale Play concept requires definition of characteristic, description and reservoir identification to discover reservoir that is technically and economically possible to develop. These are the steps users and engineers has to do to perform Shale Play: a. Calculate TOC and perform mineralogy analysis using water saturation and porosity value. b. Reconstruct basin that accumulate hydrocarbon c. Brittlenes Index calculated form petrophysical and distributed based on seismic multi attributes d. Integrated natural fracture analysis e. Best location to place a well.

Keywords: unconventional hydrocarbon, shale gas, shale oil tight sand reservoir parameters, shale play

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Authors: Mohd Shazad, Kamal Kumar Gupta

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Aedes aegypti (Diptera: Culicidae), commonly known as tiger mosquito is the vector of dengue fever, yellow fever, chikungunya and zika virus. In the absence of any effective vaccine against these diseases, control the mosquito population is the only promising mean to prevent the diseases. Currently used chemical insecticides cause environmental contamination, high mammalian toxicity and hazards to non-target organisms, insecticide resistance and vector resurgence. Present research work aimed to explore the potentials of phytochemicals present in the Ocimum sanctum in management of mosquito population. The leaves of Ocimum were extracted with ethanol by ‘cold extraction method’. 0-24h old fourth instar larvae of Aedes aegypti were treated with the extract of concentrations 50ppm, 100ppm, 200ppm and 400ppm for 24h. Survival, growth and development of the treated larvae were evaluated. The adults emerged from the treated larvae were used for the reproductive fitness studies. Our results indicate 77.2% mortality in the larvae exposed to 400 ppm. At lower doses, although there was no significant reduction in the survival after 24h however, it decreased during subsequent days of observations. In control experiments, no mortality was observed. It was also observed that the larvae survived after treatment showed severe growth and developmental abnormalities. There was significant increase in larval duration. In control, fourth instar moulted into pupa after 3 days while larvae treated with 400 ppm extract were moulted after 4.6 days. Larva-pupa intermediates and the pupa-adult intermediates were observed in many cases. The adults emerged from the treated larvae showed impaired mating and oviposition behaviour. The females exhibited longer preoviposition period, reduced oviposition rate and decreased egg output. GCMS analysis of the ethanol extract revealed presence of JH mimics and intermediates of JH biosynthetic pathway. Potentials of Ocimum sanctum in integrated vector management programme of Aedes aegypti were discussed.

Keywords: Aedes aegypti, Ocimum sanctum, oviposition, survival

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Authors: Susan Lubbers

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This study applies critical discourse analysis to the language used by educators to frame international students of Asian backgrounds in Anglo-Western universities as quiet, shy, passive and unable to think critically. Emphasis is on the self-promoted ‘internationalised’ Australian tertiary context, where negative stereotypes are commonly voiced not only in the academy but also in the media. Parallels are drawn as well with other Anglo-Western educational contexts. The study critically compares the discourse of these persistent negative stereotypes, with in-class and interview discourses of international students of Asian and Western language, cultural and educational backgrounds enrolled in a Media and Popular Culture unit in an Australian university. The focus of analysis of the student discourse is on their engagement in critical dialogic interactions on the topics of culture and interculturality. The evidence is also drawn from student interviews and focus groups and from observation of whole-class discussion participation rates. The findings of the research project provide evidence that counters the myth of student as problem. They point rather to the widespread lack of intercultural awareness of Western educators and students as being at the heart of the negative perceptions of students of Asian backgrounds. The study suggests the efficacy of an approach to developing intercultural competence that is embedded, or integrated, into tertiary programs. The presentation includes an overview of the main strategies that have been developed by the tertiary educator (author) to support the development of intercultural competence of and among the student cohort. The evidence points to the importance of developing intercultural competence among tertiary educators and students. The failure by educators to ensure that the diverse voices, ideas and perspectives of students from all cultural, educational and language backgrounds are heard in our classrooms means that our universities can hardly be regarded or promoted as genuinely internationalised. They will continue as undemocratic institutions that perpetrate persistent Western educational hegemony.

Keywords: critical discourse analysis, critical thinking, embedding, intercultural competence, interculturality, international student, internationalised education

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Authors: Hardisiswo Soedjana, Inne Caroline

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Deep dermal or full thickness burns are inevitably lead to post-burn contractures. These contractures remain to be one of the most concerning late complications of burn injuries. Surgical management includes releasing the contracture followed by resurfacing the defect accompanied by post-operative rehabilitation. Optimal treatment of post-burn contractures depends on the characteristics of the contractures. This study is aimed to describe clinical characteristics, problems, and management of post-burn contractures in adults and children. A retrospective analysis was conducted from medical records of patients suffered from contractures after burn injuries admitted to Hasan Sadikin general hospital between January 2016 and January 2018. A total of 50 patients with post burn contractures were included in the study. There were 17 adults and 33 children. Most patients were male, whose age range within 15-59 years old and 5-9 years old. Educational background was mostly senior high school among adults, while there was only one third of children who have entered school. Etiology of burns was predominantly flame in adults (82.3%); whereas flame and scald were the leading cause of burn injury in children (11%). Based on anatomical regions, hands were the most common affected both in adults (35.2%) and children (48.5%). Contractures were identified in 6-12 months since the initial burns. Most post-burn hand contractures were resurfaced with full-thickness skin graft (FTSG) both in adults and children. There were 11 patients who presented with recurrent contracture after previous history of contracture release. Post-operative rehabilitation was conducted for all patients; however, it is important to highlight that it is still challenging to control splinting and exercise when patients are discharged and especially the compliance in children. In order to improve quality of life in patients with history of deep burn injuries, prevention of contractures should begin right after acute care has been established. Education for the importance of splinting and exercise should be administered as comprehensible as possible for adult patients and parents of pediatric patients.

Keywords: burn, contracture, education, exercise, splinting

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Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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Authors: Yutong Wan, John N. Wood

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Introduction: SCN9A encoded Nav1.7 is an ideal therapeutic target with minimal side effects for the pharmaceutical industry because SCN9A variants can cause both human gains of function pain-related mutations and loss of function pain-free mutations. This study reviews the clinical effectiveness of existing Nav1.7 inhibitors, which theoretically should be powerful analgesics. Methods: A systematic review is conducted on the effectiveness of current Nav1.7 blockers undergoing clinical trials. Studies were mainly extracted from PubMed, U.S. National Library of Medicine Clinical Trials, World Health Organization International Clinical Trials Registry, ISRCTN registry platform, and Integrated Research Approval System by NHS. Only studies with full text available and those conducted using double-blinded, placebo controlled, and randomised designs and reporting at least one analgesic measurement were included. Results: Overall, 61 trials were screened, and eight studies covering PF 05089771 (Pfizer), TV 45070 (Teva & Xenon), and BIIB074 (Biogen) met the inclusion criteria. Most studies were excluded because results were not published. All three compounds demonstrated insignificant analgesic effects, and the comparison between PF 05089771 and pregabalin/ibuprofen showed that PF 05089771 was a much weaker analgesic. All three drug candidates only have mild side effects, indicating the potentials for further investigation of Nav1.7 antagonists. Discussion: The failure of current Nav1.7 small molecule inhibitors might attribute to ignorance of the key role of endogenous systems in Nav1.7 null mutants, the lack of selectivity and blocking potency, and central impermeability. The synergistic combination of analgesic drugs, a recent UCL patent, combining a small dose of Nav1.7 blockers and opioids or enkephalinase inhibitors dramatically enhanced the analgesic effects. Conclusion: The current clinical testing Nav1.7 blockers are generally disappointing. However, the newer generation of Nav1.7 targeting analgesics has overcome the major constraints of its predecessors.

Keywords: chronic pain, Nav1.7 blockers, SCN9A, systematic review

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Authors: Lin Fu-Gong

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Background: As WHO announced, people with intellectual disability (ID) were vulnerable to mental health problems. And there were few custom-made mental health scales for those people to monitor their mental health. Those people with mental problems often accompanied worse prognosis and usually became to be a heavier burden on the caregivers. Purpose: In this study, we intend to develop a psychopathy scale as a practical tool for monitoring the mental health for people with ID living in institute. Methods: In this study, we adopt the Psychopathology Inventory for Mentally Retarded Adults developed by professor Matson with certified reliability and validity in Western countries with Dr. Matson’s agreement in advance. We first translated the inventory into Chinese validated version considering the domestic culture background in the past year. And the validity and reliability evaluation of mental health status using this inventory among the people with intellectual living in the institute were done. Results: The inventory includes eight psychiatric disorder scales as schizophrenic, affective, psychosexual, adjustment, anxiety, somatoform, personality disorders and inappropriate mental adjustment. Around 83% of 40 invested people, who randomly selected from the institute, were found to have at least one disorder who were recommended with medical help by two evaluators. Among the residents examined, somatoform disorder and inappropriate mental adjustment were most popular with 60% and 78% people respectively. Conclusion: The result showed the prevalence psychiatric disorders were relatively high among people with ID in institute and the mental problems need to be further cared and followed for their mental health. The results showed that the psychopathology inventory was a useful tool for institute caregiver, manager and for long-term care policy to the government. In the coming stage, we plan to extend the use of the valid Chinese version inventory among more different type institutes for people with ID to establish their dynamic mental health status including medical need, relapse and rehabilitation to promote their mental health.

Keywords: intellectual disability, psychiatric disorder, psychopathology inventory, mental health, the institute

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Authors: Jennifer Nutton, Gayle Ployer, Ky Scott, Jenny Morgan

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Working in a circle within higher education creates a decolonial space of mutual respect, responsibility, and reciprocity that facilitates collaborative learning and deep connections among learners and instructors. This approach is beyond simply facilitating a group in a circle but opens the door to creating a sacred space connecting each member to the land, to the Indigenous peoples who have taken care of the lands since time immemorial, to one another, and to one’s own positionality. These deep connections not only center human knowledges and relationships but also acknowledges responsibilities to land. Working in a circle as a relational pedagogical praxis also disrupts institutional power dynamics by creating a space of collaborative learning and deep connections in the classroom. Inherent within circle work is to facilitate connections not just academically but emotionally, physically, culturally, and spiritually. Recent literature supports the use of online talking circles, finding that it can offer a more relational and experiential learning environment, which is often absent in the virtual world and has been made more evident and necessary since the pandemic. These deeper experiences of learning and connection, rooted in both knowledge and the land, can then be shared with openness and vulnerability with one another, facilitating growth and change. This process of beginning with the land is critical to ensure we have the grounding to obstruct the ongoing realities of colonialism. The authors, who identify as both Indigenous and non-Indigenous, as both educators and learners, reflect on their teaching and learning experiences in circle. They share a relational pedagogical praxis framework that has been successful in educating future social workers, environmental activists, and leaders in social and human services, health, legal and political fields.

Keywords: circle work, relational pedagogies, decolonization, distance education

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Authors: Mohd Aslam Aslam

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Chronic renal failure is a debilitating condition responsible for high morbidity and mortality. Because of its costs and the complexity of its treatment, proper care is available to very few patients in India. According to researchers, the number of adults aged 30 or older who have chronic kidney disease is projected to increase from 13.2 percent currently, to 14.4 percent in 2020 and 16.7 percent in 2030. The aerial part of Aerva lanata (Busehri booti) have been used in kidney disorders by the Unani physicians. In the present study, the effect of extract of Aerva lanata was investigated on cisplatin-induced nephrotoxicity in rats. The renal effects of this drug was evaluated by monitoring levels of blood urea nitrogen (BUN), serum creatinine, serum uric acid in blood and histopathological examination of kidney. Aerva lanata was evaluated at two different doses (1400 mg/kg and 2800 mg/kg). The effect of higher dose was more pronounced in terms of inhibition in the rise of BUN, serum creatinine and uric acid. Higher dose show greater prevention in the rise of BUN, serum creatinine, and uric acid. The histopathological examination of the kidney tissue of the rats treated with aqueous methanolic extract of Aerva lanata (Higher dose-2800 mg/kg) showed marked inhibition of glomerular congestion, tubular casts, peritubular congestion, epithelial desquamation, blood vessel congestion, interstitial edema and inflammatory cells produced by the cisplatin-induced nephrotoxicity. This finding clearly indicates the protective role of Aerva lanata at higher dose. Present investigation validates the use of Aerva lanata in kidney disorders by Unani physicians.

Keywords: Aerva lanata, Busehri booti, nephroprotective, unani medicine

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Authors: Ghazal Faraj, Andras Micsik

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The CIDOC Conceptual Reference Model (CRM) is an extensible ontology that provides integrated access to heterogeneous and digital datasets. The CIDOC-CRM offers a “semantic glue” intended to promote accessibility to several diverse and dispersed sources of cultural heritage data. That is achieved by providing a formal structure for the implicit and explicit concepts and their relationships in the cultural heritage field. The COURAGE (“Cultural Opposition – Understanding the CultuRal HeritAGE of Dissent in the Former Socialist Countries”) project aimed to explore methods about socialist-era cultural resistance during 1950-1990 and planned to serve as a basis for further narratives and digital humanities (DH) research. This project highlights the diversity of flourished alternative cultural scenes in Eastern Europe before 1989. Moreover, the dataset of COURAGE is an online RDF-based registry that consists of historical people, organizations, collections, and featured items. For increasing the inter-links between different datasets and retrieving more relevant data from various data silos, a shared federated ontology for reconciled data is needed. As a first step towards these goals, a full understanding of the CIDOC CRM ontology (target ontology), as well as the COURAGE dataset, was required to start the work. Subsequently, the queries toward the ontology were determined, and a table of equivalent properties from COURAGE and CIDOC CRM was created. The structural diagrams that clarify the mapping process and construct queries are on progress to map person, organization, and collection entities to the ontology. Through mapping the COURAGE dataset to CIDOC-CRM ontology, the dataset will have a common ontological foundation with several other datasets. Therefore, the expected results are: 1) retrieving more detailed data about existing entities, 2) retrieving new entities’ data, 3) aligning COURAGE dataset to a standard vocabulary, 4) running distributed SPARQL queries over several CIDOC-CRM datasets and testing the potentials of distributed query answering using SPARQL. The next plan is to map CIDOC-CRM to other upper-level ontologies or large datasets (e.g., DBpedia, Wikidata), and address similar questions on a wide variety of knowledge bases.

Keywords: CIDOC CRM, cultural heritage data, COURAGE dataset, ontology alignment

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Authors: Dawit Thomas

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Feeding and weaning practices vary from culture to culture and depend on different child-rearing values. The socio-cultural dimensions that influence the acceptable infant feeding practices are varied and complex. Understanding cultural differences in beliefs and practices relating to infant feeding is important to enhance designing programs for delivering successful psychological, social, physiological and economic well-being of mothers and infants. The main purpose of this study was exploring mothers infant feeding practices in the context of Hadiyya culture. After purposively selecting Harche Huyaya Uyaya Kebele eight infant feeding mothers were selected using snowball sampling technique. The study employed interviews and focus group discussion. The study found out early initiation and prolonged breastfeeding and early complementary feeding in some instances immediately after birth. In addition, infants were not forced to wean unless the mothers encounter pressing issues like pregnancy and health related problems. Furthermore, the main weaning techniques were putting unpleasant materials on the tip of nipples and sending infants to grandparents home. The study also found out gender difference in weaning, i.e., early initiation of weaning for girls. This can be indicative of gender-based bias on weaning practice. Finally, health extension workers, office of women and children affairs and Hadiyya Zone Tourism office should organize awareness raising programs to preserve vital infant feeding practices like prolonged breastfeeding and length of weaning. In addition, the offices should raise awareness among communities on negative side effects of sending infant to grandparents home that may weaken infant-mothers attachment and create favorable ground for the development of phobia.

Keywords: feeding, infant, practices, weaning

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Authors: Atabak Rashidian

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In duplex backhaul wireless communication systems, two separate transmit and receive high-gain antennas are required if an antenna switch is not implemented. Although the switch loss, which is considerable and in the order of 1.5 dB at 60 GHz, is avoided, the large separate antenna systems make the design bulky and not cost-effective. To avoid two large reflectors for such a system, transmit and receive antenna feeds with a common phase center are required. The phase center should coincide with the focal point of the reflector to maximize the efficiency and gain. In this work, we present an ultra-compact design in which stacked patch antennas are used as the feeds for a 12-inch reflector. The transmit antenna is a 1 × 2 array and the receive antenna is a single element located in the middle of the transmit antenna elements. Antenna elements are designed as stacked patches to provide the required impedance bandwidth for four standard channels of WiGigTM applications. The design includes three metallic layers and three dielectric layers, in which the top dielectric layer is a 100 µm-thick protective layer. The top two metallic layers are specified to the main and parasitic patches. The bottom layer is basically ground plane with two circular openings (0.7 mm in diameter) having a center through via which connects the antennas to a single input/output Si-Ge Bi-CMOS transceiver chip. The reflection coefficient of the stacked patch antenna is fully investigated. The -10 dB impedance bandwidth is about 11%. Although the gap between transmit and receive antenna is very small (g = 0.525 mm), the mutual coupling is less than -12 dB over the desired frequency band. The three dimensional radiation patterns of the transmit and receive reflector antennas at 60 GHz is investigated over the impedance bandwidth. About 39 dBi realized gain is achieved. Considering over 15 dBm of output power of the silicon chip in the transmit side, the EIRP should be over 54 dBm, which is good enough for over one kilometer multi Gbps data communications. The performance of the reflector antenna over the bandwidth shows the peak gain is 39 dBi and 40 dBi for the reflector antenna with 2-element and single element feed, respectively. This type of the system design is cost-effective and efficient.

Keywords: Antenna, integrated circuit, millimeter-wave, phase center

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Authors: Carmela Nardelli, Laura Iaffaldano, Valentina Capobianco, Antonietta Tafuto, Maddalena Ferrigno, Angela Capone, Giuseppe Maria Maruotti, Maddalena Raia, Rosa Di Noto, Luigi Del Vecchio, Pasquale Martinelli, Lucio Pastore, Lucia Sacchetti

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Maternal obesity and nutrient excess in utero increase the risk of future metabolic diseases in the adult life. The mechanisms underlying this process are probably based on genetic, epigenetic alterations and changes in foetal nutrient supply. In mammals, the placenta is the main interface between foetus and mother, it regulates intrauterine development, modulates adaptive responses to sub optimal in uterus conditions and it is also an important source of human amniotic mesenchymal stem cells (hA-MSCs). We previously highlighted a specific microRNA (miRNA) profiling in amnion from obese (Ob) pregnant women, here we compared the miRNA expression profile of hA-MSCs isolated from (Ob) and control (Co) women, aimed to search for any alterations in metabolic pathways that could predispose the new-born to the obese phenotype. Methods: We isolated, at delivery, hA-MSCs from amnion of 16 Ob- and 7 Co-women with pre-pregnancy body mass index (mean/SEM) 40.3/1.8 and 22.4/1.0 kg/m2, respectively. hA-MSCs were phenotyped by flow cytometry. Globally, 384 miRNAs were evaluated by the TaqMan Array Human MicroRNA Panel v 1.0 (Applied Biosystems). By the TargetScan program we selected the target genes of the miRNAs differently expressed in Ob- vs Co-hA-MSCs; further, by KEGG database, we selected the statistical significant biological pathways. Results: The immunophenotype characterization confirmed the mesenchymal origin of the isolated hA-MSCs. A large percentage of the tested miRNAs, about 61.4% (232/378), was expressed in hA-MSCs, whereas 38.6% (146/378) was not. Most of the expressed miRNAs (89.2%, 207/232) did not differ between Ob- and Co-hA-MSCs and were not further investigated. Conversely, 4.8% of miRNAs (11/232) was higher and 6.0% (14/232) was lower in Ob- vs Co-hA-MSCs. Interestingly, 7/232 miRNAs were obesity-specific, being expressed only in hA-MSCs isolated from obese women. Bioinformatics showed that these miRNAs significantly regulated (P<0.001) genes belonging to several metabolic pathways, i.e. MAPK signalling, actin cytoskeleton, focal adhesion, axon guidance, insulin signaling, etc. Conclusions: Our preliminary data highlight an altered miRNA profile in Ob- vs Co-hA-MSCs and suggest that an epigenetic miRNA-based mechanism of gene regulation could affect pathways involved in placental growth and function, thereby potentially increasing the newborn’s risk of metabolic diseases in the adult life.

Keywords: hA-MSCs, obesity, miRNA, biosystem

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Authors: Kasipandi Muniyandi, Parimelazhagan Thangaraj

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Plants are important prospective wealth of a country, combination of local health care information about a specific plant together with data published by several groups of scientists, can help in deciding whether it should be considered acceptable for medicinal use. In the developed countries, too, plant-derived drugs may be of importance. The wide variety of ailments that are being treated with Plectranthus is an indication of the medicinal value of the genus. A number of species are not toxic and so may be taken orally, whilst others are used topically on the skin or as enemas. This study was designed to evaluate the different properties of Plectranthus stocksii and the aerial parts were collected and extracted with petroleum ether, chloroform, ethyl acetate, acetone and methanol by Soxhlet apparatus and finally macerated with hot water. The quantification assays revealed that, leaf methanol extract showed higher total phenolic (415.41 mg GAE/ g extract) and tannin (177.53 mg GAE/ g extract) contents whereas leaf ethyl acetate exhibited higher flavonoids (777.11 mg RE/ g extract) content. The antioxidant efficiency of the extracts was analyzed by various radical scavenging assays. Among the different antioxidant assays, leaf ethyl acetate extract showed higher free radical scavenging activities against DPPH (IC50 = 3.46 µg/mL), ABTS (27417.65 µM TE/ g extract), FRAP (152.17 mM Fe(II)E/ mg extract) NO• radical (21.46%) and Superoxide radical (IC50 = 24.16 µg/mL) assays. All the parts P. stocksii extracts showed significant protection against OH• induced DNA damage at 50 µg concentration. The HPLC analysis of leaf ethyl acetate extract revealed the presence of Quercetin (30.29 µg/mg of extract) was the major compound. Anticancer activity of leaf ethyl acetate extract showed better IC50 values were 48.87 and 36.08 µg/ mL against MCF-7 and Caco-2 respectively. From this study, P. stocksii can act as a potent antioxidant and cytotoxic antimicrobial agent. The scope for drug development from this plant is endless and there is undoubtedly a call for further research in pharmaceutical industries.

Keywords: antioxidant, cytotoxicity, phenolics, plectranthus stocksii

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Authors: A. Raj Kumar, A. Okunseinde, P. Raghavan, V. Kapila

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Stroke is the leading cause of adult disability worldwide. With recent advances in immediate post-stroke care, there is an increasing number of young stroke survivors, under the age of 65 years. While most stroke survivors will regain the ability to walk, they often experience long-term arm and hand motor impairments. Long term upper limb rehabilitation is needed to restore movement and function, and prevent deterioration from complications such as learned non-use and learned bad-use. We have developed a novel virtual coach, a wearable instrumented rehabilitation jacket, to motivate individuals to participate in long-term skill re-learning, that can be personalized to their impairment profile. The jacket can estimate the movements of an individual’s arms using embedded off-the-shelf sensors (e.g., 9-DOF IMU for inertial measurements, flex-sensors for measuring angular orientation of fingers) and a Bluetooth Low Energy (BLE) powered microcontroller (e.g., RFduino) to non-intrusively extract data. The 9-DOF IMU sensors contain 3-axis accelerometer, 3-axis gyroscope, and 3-axis magnetometer to compute the quaternions, which are transmitted to a computer to compute the Euler angles and estimate the angular orientation of the arms. The data are used in a gaming environment to provide visual, and/or haptic feedback for goal-based, augmented-reality training to facilitate re-learning in a cost-effective, evidence-based manner. The full paper will elaborate the technical aspects of communication, interactive gaming environment, and physical aspects of electronics necessary to achieve our stated goal. Moreover, the paper will suggest methods to utilize the proposed system as a cheaper, portable, and versatile system vis-à-vis existing instrumentation to facilitate post-stroke personalized arm rehabilitation.

Keywords: feedback, gaming, Euler angles, rehabilitation, augmented reality

Procedia PDF Downloads 271

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

Procedia PDF Downloads 623

Authors: Samuel John, S. Sharanya

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Automation has become an important part of our life. It has been used to control home entertainment systems, changing the ambience of rooms for different events etc. One of the main parameters to control in a smart home is the atmospheric comfort. Atmospheric comfort mainly includes temperature and relative humidity. In homes, the desired temperature of different rooms varies from 20 °C to 25 °C and relative humidity is around 50%. However, it varies widely. Hence, automated measurement of these parameters to ensure comfort assumes significance. To achieve this, a fuzzy logic controller using Arduino was developed using MATLAB. Arduino is an open source hardware consisting of a 24 pin ATMEGA chip (atmega328), 14 digital input /output pins and an inbuilt ADC. It runs on 5v and 3.3v power supported by a board voltage regulator. Some of the digital pins in Aruduino provide PWM (pulse width modulation) signals, which can be used in different applications. The Arduino platform provides an integrated development environment, which includes support for c, c++ and java programming languages. In the present work, soft sensor was introduced in this system that can indirectly measure temperature and humidity and can be used for processing several measurements these to ensure comfort. The Sugeno method (output variables are functions or singleton/constant, more suitable for implementing on microcontrollers) was used in the soft sensor in MATLAB and then interfaced to the Arduino, which is again interfaced to the temperature and humidity sensor DHT11. The temperature-humidity sensor DHT11 acts as the sensing element in this system. Further, a capacitive humidity sensor and a thermistor were also used to support the measurement of temperature and relative humidity of the surrounding to provide a digital signal on the data pin. The comfort sensor developed was able to measure temperature and relative humidity correctly. The comfort percentage was calculated and accordingly the temperature in the room was controlled. This system was placed in different rooms of the house to ensure that it modifies the comfort values depending on temperature and relative humidity of the environment. Compared to the existing comfort control sensors, this system was found to provide an accurate comfort percentage. Depending on the comfort percentage, the air conditioners and the coolers in the room were controlled. The main highlight of the project is its cost efficiency.

Keywords: arduino, DHT11, soft sensor, sugeno

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Authors: K. Yang, Y. Wei, M. Zhang, S. Yong, R. Torah, J. Tudor, S. Beeby

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E-textiles are traditional textiles with integrated electronic functionality. It is an emerging innovation with numerous applications in fashion, wearable computing, health and safety monitoring, and the military and medical sectors. The piezoelectric effect is a widespread and versatile transduction mechanism used in sensor and actuator applications. Piezoelectric materials produce electric charge when stressed. Conversely, mechanical deformation occurs when an electric field is applied across the material. Lead Zirconate Titanate (PZT) is a widely used piezoceramic material which has been used to fabricate e-textiles through screen printing, electro spinning and hydrothermal synthesis. This paper explores an alternative fabrication process: Spray coating. Spray coating is a straightforward and cost effective fabrication method applicable on both flat and curved surfaces. It can also be applied selectively by spraying through a stencil which enables the required design to be realised on the substrate. This work developed a sprayable PZT based piezoelectric ink consisting of a binder (Fabink-Binder-01), PZT powder (80 % 2 µm and 20 % 0.8 µm) and acetone as a thinner. The optimised weight ratio of PZT/binder is 10:1. The components were mixed using a SpeedMixer DAC 150. The fabrication processes is as follows: 1) Screen print a UV-curable polyurethane interface layer on the textile to create a smooth textile surface. 2) Spray one layer of a conductive silver polymer ink through a pre-designed stencil and dry at 90 °C for 10 minutes to form the bottom electrode. 3) Spray three layers of the PZT ink through a pre-designed stencil and dry at 90 °C for 10 minutes for each layer to form a total thickness of ~250µm PZT layer. 4) Spray one layer of the silver ink through a pre-designed stencil on top of the PZT layer and dry at 90 °C for 10 minutes to form the top electrode. The domains of the PZT elements were aligned by polarising the material at an elevated temperature under a strong electric field. A d33 of 37 pC/N has been achieved after polarising at 90 °C for 6 minutes with an electric field of 3 MV/m. The application of the piezoelectric textile was demonstrated by fabricating a pressure sensor to switch an LED on/off. Other potential applications on e-textiles include motion sensing, energy harvesting, force sensing and a buzzer.

Keywords: piezoelectric, PZT, spray coating, pressure sensor, e-textile

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Authors: Jacinta Musyoka, Wesley Too

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Cervical cancer is the second leading cause of cancer-related deaths in Kenya and the second most common cancer among women, yet preventable following prevention strategies put in place, which includes vaccination with Human Papilloma Virus Vaccine (HPPV) among the young adolescent girls. Kenya has the highest burden of cervical cancer and the leading cause of death among women of reproductive age and is a known frequent type of cancer amongst women. This is expected to double by 2025 if the necessary steps are not taken, which include vaccinating girls between the ages of 9 and 14 and screening women. Parental decision is critical in ensuring that their daughters receive this vaccine. Hence this study sought to establish parental willingness and factors associate with the acceptability to vaccine adolescent daughters against the human papilloma virus for cervical cancer prevention in Machakos County, Eastern Region of Kenya. Method: Cross-sectional study design utilizing a mixed methods approach was used to collect data from Nguluni Health Centre in Machakos County; Matungulu sub-county, Kenya. This study targeted all parents of adolescent girls seeking health care services in the Matungulu sub-county area who were aged 18 years and above. A total of 220 parents with adolescent girls aged 10-14 years were enrolled into the study after informed consent were sought. All ethical considerations were observed. Quantitative data were analyzed using Multivariate regression analysis, and thematic analysis was used for qualitative data related to perceptions of parents on HPVV. Results, conclusions, and recommendations- ongoing. We expect to report findings and articulate contributions based on the study findings in due course before October 2022

Keywords: adolescents, human papilloma virus, kenya, parents

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Authors: Leon Mortari

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The Metropolitan East region of Rio de Janeiro state, Brazil, faces a historic water scarcity. Among the alternatives studied to solve this situation, the possibility of adduction of the available water in the reservoir Lagoa de Juturnaíba to supply the region's municipalities stands out. The allocation of a linear engineering project must occur through an evaluation of different aspects, such as altitude, slope, proximity to roads, distance from watercourses, land use and occupation, and physical and chemical features of the soil. This work aims to apply a multi-criteria model that combines geoprocessing techniques, decision-making, and geometric search algorithm to optimize a hypothetical adductor system in the scenario of expanding the water supply system that serves this region, known as Imunana-Laranjal, using the Lagoa de Juturnaíba as the source. It is proposed in this study, the construction of a spatial database related to the presented evaluation criteria, treatment and rasterization of these data, and standardization and reclassification of this information in a Geographic Information System (GIS) platform. The methodology involves the integrated analysis of these criteria, using their relative importance defined by weighting them based on expert consultations and the Analytic Hierarchy Process (AHP) method. Three approaches are defined for weighting the criteria by AHP: the first treats all criteria as equally important, the second considers weighting based on a pairwise comparison matrix, and the third establishes a hierarchy based on the priority of the criteria. For each approach, a distinct group of weightings is defined. In the next step, map algebra tools are used to overlay the layers and generate cost surfaces, that indicates the resistance to the passage of the adductor route, using the three groups of weightings. The Dijkstra algorithm, a geometric search algorithm, is then applied to these cost surfaces to find an optimized path within the geographical space, aiming to minimize resources, time, investment, maintenance, and environmental and social impacts.

Keywords: geometric search algorithm, GIS, pipeline, route optimization, spatial multi-criteria analysis model

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Authors: Eleanor Nel

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Research output is an indicator of institutional performance (and quality), resulting in increased pressure on academic institutions to perform in the research arena. Research output is further utilised to obtain research funding. Resultantly, academic institutions face significant pressure from governing bodies to provide evidence on the return for research investments. Research output has thus become a substantial discourse within institutions, mainly due to the processes linked to evaluating research output and the associated allocation of research funding. This focus on research outputs often surpasses the development of robust, widely accepted tools to additionally measure research impact at institutions. A publication writing programme, for enhancing research output, was launched at a South African university in 2011. Significant amounts of time, money, and energy have since been invested in the programme. Although participants provided feedback after each session, no formal review was conducted to evaluate the research output directly associated with the programme. Concerns in higher education about training costs, learning results, and the effect on society have increased the focus on value for money and the need to improve training, research performance, and productivity. Furthermore, universities rely on efficient and reliable monitoring and evaluation systems, in addition to the need to demonstrate accountability. While publishing does not occur immediately, achieving a return on investment from the intervention is critical. A multi-method study, guided by the New World Kirkpatrick Model (NWKM), was conducted to determine the impact of the publication writing programme for the period of 2011 to 2018. Quantitative results indicated a total of 314 academics participating in 72 workshops over the study period. To better understand the quantitative results, an open-ended questionnaire and semi-structured interviews were conducted with nine participants from a particular faculty as a convenience sample. The purpose of the research was to collect information to develop a comprehensive framework for impact evaluation that could be used to enhance the current design and delivery of the programme. The qualitative findings highlighted the critical role of a multi-stakeholder strategy in strengthening support before, during, and after a publication writing programme to improve the impact and research outputs. Furthermore, monitoring on-the-job learning is critical to ingrain the new skills academics have learned during the writing workshops and to encourage them to be accountable and empowered. The NWKM additionally provided essential pointers on how to link the results more effectively from publication writing programmes to institutional strategic objectives to improve research performance and quality, as well as what should be included in a comprehensive evaluation framework.

Keywords: evaluation, framework, impact, research output

Procedia PDF Downloads 68