Search results for: Alzheimer’s related quality of life
16188 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures
Authors: Brandon Knopp, Matthew Harris
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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation
Procedia PDF Downloads 14816187 Tranexamic Acid in Prevention of Postpartum Haemorrhage in Elective Cesarean Section
Authors: Ajay Agrawal, Pravin Shah, Shailaja Chhetri, Pappu Rijal
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Background and Objectives: Postpartum hemorrhage (PPH) is a common and occasionally life-threatening complication of labour. Cesarean section (CS) is associated with more blood loss than vaginal delivery. There is a trend for increasing CS rates in both developed and developing countries. This could increase the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of Intravenous Tranexamic Acid (TA) on blood loss during and after elective CS delivery. Materials and Methods: It is a prospective, randomized controlled study. 160 eligible pregnant women of 37 or more POG planned for CS were randomized into two groups either to receive 10ml(1gm) of tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation. Results: The mean estimated blood loss was significantly lower in women treated with TA compared with women in the placebo group (392.13 ml ± 10.06 versus 498.69 ml ± 15.87, respectively; p < 0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the tranexamic acid group than in the control group (0.31 ± 0.18 versus 0.79 ± 0.23, respectively; p < 0.001). Conclusion: Pre-operative use of tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where PPH is a major threat to the life of the mothers, it seems to be a promising option.Keywords: blood loss, cesarean section, postpartum hemorrhage, tranexamic acid
Procedia PDF Downloads 27416186 Socio-Demographic and Clinical Characteristics and Use of Herbal Medicine among Patients Seeking Consultation for Knee Osteoarthritis at Secondary Healthcare Facilities in Oman
Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi
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Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.Keywords: knee joint, osteoarthritis, herbal medicine, Oman
Procedia PDF Downloads 12816185 Geochemical Characteristics and Chemical Toxicity: Appraisal of Groundwater Uranium With Other Geogenic Contaminants in Various Districts of Punjab, India
Authors: Tanu Sharma, Bikramjit Singh Bajwa, Inderpreet Kaur
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Monitoring of groundwater in Tarn-Taran, Bathinda, Faridkot and Mansa districts of Punjab state, India is essential where this freshwater resource is being over-exploited causing quality deterioration, groundwater depletion and posing serious threats to residents. The present integrated study was done to appraise quality and suitability of groundwater for drinking/irrigation purposes, hydro-geochemical characteristics, source identification and associated health risks. In the present study, groundwater of various districts of Punjab state was found to be heavily contaminated with As followed by U, thus posing high cancerous risks to local residents via ingestion, along with minor contamination of Fe, Mn, Pb and F−. Most health concerns in the study region were due to the elevated concentrations of arsenic in groundwater with average values of 130 µg L-1, 176 µg L-1, 272 µg L-1 and 651 µg L-1 in Tarn-Taran, Bathinda, Faridkot and Mansa districts, respectively, which is quite high as compared to the safe limit as recommended by BIS i.e. 10 µg L-1. In Tarn-Taran, Bathinda, Faridkot and Mansa districts, average uranium contents were found to be 37 µg L-1, 88 µg L-1, 61 µg L-1 and 104 µg L-1, with 51 %, 74 %, 61 % and 71 % samples, respectively, being above the WHO limit of 30 µg L-1 in groundwater. Further, the quality indices showed that groundwater of study region is suited for irrigation but not appropriate for drinking purposes. Hydro-geochemical studies revealed that most of the collected groundwater samples belonged to Ca2+ - Mg2+ - HCO3- type showing dominance of MgCO3 type which indicates the presence of temporary hardness in groundwater. Rock-water reactions and reverse ion exchange were the predominant factors for controlling hydro-geochemistry in the study region. Dissolution of silicate minerals caused the dominance of Na+ ions in the aquifers of study region. Multivariate statistics revealed that along with geogenic sources, contribution of anthropogenic activities such as injudicious application of agrochemicals and domestic waste discharge was also very significant. The results obtained abolished the myth that uranium is only root cause for large number of cancer patients in study region as arsenic and mercury were also present in groundwater at levels that were of health concern to groundwater.Keywords: uranium, trace elements, multivariate data analysis, risk assessment
Procedia PDF Downloads 7516184 Development and Performance Evaluation of a Gladiolus Planter in Field for Planting Corms
Authors: T. P. Singh, Vijay Gautam
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Gladiolus is an important cash crop and is grown mainly for its elegant spikes. Traditionally the gladiolus corms are planted manually which is very tedious, time consuming and labor intensive operation. So far, there is no planter available for planting of gladiolus corms. With a view to mechanize the planting operation of this horticultural crop, a prototype of 4-row gladiolus planter was developed and its performance was evaluated in-situ condition. Cup-chain type metering device was used to singulate the gladiolus corms while planting. Three levels of corm spacing viz 15, 20 and 25 cm and four levels of forward speed viz 1.0, 1.5, 2.0 and 2.5 km/h was taken as evaluation parameter for the planter. The performance indicators namely corm spacing in each row, coefficient of uniformity, missing index, multiple index, quality of feed index, number of corms per meter length, mechanical damage to the corms etc. were determined during the field test. The data was statistically analyzed using Completely Randomized Design (CRD) for testing the significance of the parameters. The result indicated that planter was able to drop the corms at required nominal spacing with minor variations. The highest deviation from the mean corm spacing was observed as 3.53 cm with maximum coefficient of variation as 13.88%. The highest missing and quality of feed indexes were observed as 6.33% and 97.45% respectively with no multiples. The performance of the planter was observed better at lower forward speed and wider corm spacing. The field capacity of the planter was found as 0.103 ha/h with an observed field efficiency of 76.57%.Keywords: coefficient of uniformity, corm spacing, gladiolus planter, mechanization
Procedia PDF Downloads 24116183 Optimizing PharmD Education: Quantifying Curriculum Complexity to Address Student Burnout and Cognitive Overload
Authors: Frank Fan
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PharmD (Doctor of Pharmacy) education has confronted an increasing challenge — curricular overload, a phenomenon resulting from the expansion of curricular requirements, as PharmD education strives to produce graduates who are practice-ready. The aftermath of the global pandemic has amplified the need for healthcare professionals, leading to a growing trend of assigning more responsibilities to them to address the global healthcare shortage. For instance, the pharmacist’s role has expanded to include not only compounding and distributing medication but also providing clinical services, including minor ailments management, patient counselling and vaccination. Consequently, PharmD programs have responded by continually expanding their curricula adding more requirements. While these changes aim to enhance the education and training of future professionals, they have also led to unintended consequences, including curricular overload, student burnout, and a potential decrease in program quality. To address the issue and ensure program quality, there is a growing need for evidence-based curriculum reforms. My research seeks to integrate Cognitive Load Theory, emerging machine learning algorithms within artificial intelligence (AI), and statistical approaches to develop a quantitative framework for optimizing curriculum design within the PharmD program at the University of Toronto, the largest PharmD program within Canada, to provide quantification and measurement of issues that currently are only discussed in terms of anecdote rather than data. This research will serve as a guide for curriculum planners, administrators, and educators, aiding in the comprehension of how the pharmacy degree program compares to others within and beyond the field of pharmacy. It will also shed light on opportunities to reduce the curricular load while maintaining its quality and rigor. Given that pharmacists constitute the third-largest healthcare workforce, their education shares similarities and challenges with other health education programs. Therefore, my evidence-based, data-driven curriculum analysis framework holds significant potential for training programs in other healthcare professions, including medicine, nursing, and physiotherapy.Keywords: curriculum, curriculum analysis, health professions education, reflective writing, machine learning
Procedia PDF Downloads 6916182 Sitagliptin-AntiCD4 Mab Conjugated T Cell Targeting Therapy for the Effective Treatment of Type I Diabetes
Authors: T. Mahesh, M. K. Samanta
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Antibody dug conjugate (ADC’s) concept is a less explored and more trustable for the treatment of Type 1 diabetes (T1D). T1D is thought to arise from selective immunologically mediated destruction of the insulin- producing β-cells in the pancreatic islets of Langerhans with consequent insulin deficiency. It is evident that type 1 diabetes can be conquered, by 1) to stop immune destruction of βcells, 2) to replace or regenerate β-cells, and 3) to preserve β-cell function and mass. Many studies found that the regulatory T cells (Tregs) are crucial for the maintenance of immunological tolerance. Immune tolerance is liable for the activation of the Th1 response. The important role of Th1 response in pathology of T1D entails the depletion of CD4+ T cells, which initiated the use of anti-CD4 monoclonal antibodies (mAbs) against CD4+ T cells to interfere with induction of T1D.Insulin is regulated by Glucagon-Like Peptide-1 hormone (GLP-1) which also stimulates β-cells proliferation as the half-life of GLP-1 harmone is less due to rapid degradation by DPP-IV enzyme an alternative DPP-IV-inhibitors can increase the half-life of GLP-1 through which it conquers the replacement and reserve β-cells mass. Thus in the present study Anti-CD4 mAb was conjugated with Sitagliptin which is a DPP-IV inhibitor Drug loaded in Nanoparticles through Sulfo-MBS cross-linkers. The above study can be an effective approach for treatment to overcome the Passive subcutaneous insulin therapy.Keywords: antibody drug conjugates, anti-CD4 Mab, DPP IV inhibitors, GLP-1
Procedia PDF Downloads 39216181 Effects of Certain Natural Food Additives (Pectin, Gelatin and Whey Proteins) on the Qualities of Fermented Milk
Authors: Abderrahim Cheriguene, Fatiha Arioui
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The experimental study focuses on the extraction of pectin, whey protein and gelatin, and the study of their functional properties. Microbiological, physicochemical and sensory approach integrated has been implanted to study the effect of the incorporation of these natural food additives in the matrix of a fermented milk type set yogurt, to study the stability of the product during the periods of fermentation and post-acidification over a period of 21 days at 4°C. Pectin was extracted in hot HCl solution. Thermo-precipitation was carried out to obtain the whey proteins while the gelatin was extracted by hydrolysis of the collagen from bovine ossein. The fermented milk was prepared by varying the concentration of the incorporated additives. The measures and controls carried performed periodically on fermented milk experimental tests were carried out: pH, acidity, viscosity, the enumeration of Streptococcus thermophilus, cohesiveness, adhesiveness, taste, aftertaste, whey exudation, and odor. It appears that the acidity, viscosity, and number of Streptococcus thermophilus increased with increasing concentration of additive added in the experimental tests. Indeed, it seems clear that the quality of fermented milk and storability is more improved than the incorporation rate is high. The products showed a better test and a firmer texture limiting the whey exudation.Keywords: fermented milk, pectin, gelatin, whey proteins, functional properties, quality, conservation, valorization
Procedia PDF Downloads 13716180 Validation of Modern Work Modules and Their Impact on Sustainable Human Resource Management in the Construction Industry
Authors: Robin Becker, Nane Roetmann, Manfred Helmus
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The construction industry faces a significant challenge due to a shortage of skilled work-ers, especially in construction management, despite an increase in graduates. This is main-ly because the job is associated with high stress, long hours, and poor work-life balance. A survey revealed that the profession is unattractive to students, who prioritize personal growth, flexibility, and digitalization in their careers. To address this issue, companies can consider implementing various work modules like "working time documentation," "home office," "job sharing," and "time off." These modules can improve control, work-life bal-ance, and efficiency if tailored to the company's framework. They offer a way to make the field more appealing to future employees while benefiting existing staff, provided that both employers and employees are flexible and considerate of project-specific conditions and teams. The feasibility of these models depends on the company's overall framework, with potential for cost-neutral implementation and positive effects on efficiency and men-tal health. However, their success also relies on the specific context of the company, and more data is needed to assess their full impact.Keywords: modern construction management, construction industry, work modules, shortage of junior staff, sustainable personnel management, making construction management more attractive, working time model
Procedia PDF Downloads 4516179 The Comparison Study of Methanol and Water Extract of Chuanxiong Rhizoma: A Fingerprint Analysis
Authors: Li Chun Zhao, Zhi Chao Hu, Xi Qiang Liu, Man Lai Lee, Chak Shing Yeung, Man Fei Xu, Yuen Yee Kwan, Alan H. M. Ho, Nickie W. K. Chan, Bin Deng, Zhong Zhen Zhao, Min Xu
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Background: Chuangxiong Rhizoma (Chuangxion, CX) is one of the most frequently used herbs in Chinese medicine because of its wide therapeutic effects such as vasorelaxation and anti-inflammation. Aim: The purposes of this study are (1) to perform non-targeted / targeted analyses of CX methanol extract and water extract, and compare the present data with previously LC-MS or GC-MS fingerprints; (2) to examine the difference between CX methanol extract and water extract for preliminarily evaluating whether current compound markers of methanol extract from crude CX materials could be suitable for quality control of CX water extract. Method: CX methanol extract was prepared according to the Hong Kong Chinese Materia Medica Standards. DG water extract was prepared by boiling with pure water for three times (one hour each). UHPLC-Q-TOF-MS/MS fingerprint analysis was performed by C18 column (1.7 µm, 2.1 × 100 mm) with Agilent 1290 Infinity system. Experimental data were analyzed by Agilent MassHunter Software. A database was established based on 13 published LC-MS and GC-MS CX fingerprint analyses. Total 18 targeted compounds in database were selected as markers to compare present data with previous data, and these markers also used to compare CX methanol extract and water extract. Result: (1) Non-targeted analysis indicated that there were 133 compounds identified in CX methanol extract, while 325 compounds in CX water extract that was more than double of CX methanol extract. (2) Targeted analysis further indicated that 9 in 18 targeted compounds were identified in CX methanol extract, while 12 in 18 targeted compounds in CX water extract that showed a lower lose-rate of water extract when compared with methanol extract. (3) By comparing CX methanol extract and water extract, Senkyunolide A (+1578%), Ferulic acid (+529%) and Senkyunolide H (+169%) were significantly higher in water extract when compared with methanol extract. (4) Other bioactive compounds such as Tetramethylpyrazine were only found in CX water extract. Conclusion: Many new compounds in both CX methanol and water extracts were found by using UHPLC Q-TOF MS/MS analysis when compared with previous published reports. A new standard reference including non-targeted compound profiling and targeted markers functioned especially for quality control of CX water extract (herbal decoction) should be established in future. (This project was supported by Hong Kong Baptist University (FRG2/14-15/109) & Natural Science Foundation of Guangdong Province (2014A030313414)).Keywords: Chuanxiong rhizoma, fingerprint analysis, targeted analysis, quality control
Procedia PDF Downloads 50116178 Prediction of Marijuana Use among Iranian Early Youth: an Application of Integrative Model of Behavioral Prediction
Authors: Mehdi Mirzaei Alavijeh, Farzad Jalilian
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Background: Marijuana is the most widely used illicit drug worldwide, especially among adolescents and young adults, which can cause numerous complications. The aim of this study was to determine the pattern, motivation use, and factors related to marijuana use among Iranian youths based on the integrative model of behavioral prediction Methods: A cross-sectional study was conducted among 174 youths marijuana user in Kermanshah County and Isfahan County, during summer 2014 which was selected with the convenience sampling for participation in this study. A self-reporting questionnaire was applied for collecting data. Data were analyzed by SPSS version 21 using bivariate correlations and linear regression statistical tests. Results: The mean marijuana use of respondents was 4.60 times at during week [95% CI: 4.06, 5.15]. Linear regression statistical showed, the structures of integrative model of behavioral prediction accounted for 36% of the variation in the outcome measure of the marijuana use at during week (R2 = 36% & P < 0.001); and among them attitude, marijuana refuse, and subjective norms were a stronger predictors. Conclusion: Comprehensive health education and prevention programs need to emphasize on cognitive factors that predict youth’s health-related behaviors. Based on our findings it seems, designing educational and behavioral intervention for reducing positive belief about marijuana, marijuana self-efficacy refuse promotion and reduce subjective norms encourage marijuana use has an effective potential to protect youths marijuana use.Keywords: marijuana, youth, integrative model of behavioral prediction, Iran
Procedia PDF Downloads 55716177 Intelligent Chemistry Approach to Improvement of Oxygenates Analytical Method in Light Hydrocarbon by Multidimensional Gas Chromatography - FID and MS
Authors: Ahmed Aboforn
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Butene-1 product is consider effectively raw material in Polyethylene production, however Oxygenates impurities existing will be effected ethylene/butene-1 copolymers synthesized through titanium-magnesium-supported Ziegler-Natta catalysts. Laterally, Petrochemical industries are challenge against poor quality of Butene-1 and other C4 mix – feedstock that reflected on business impact and production losing. In addition, propylene product suffering from contamination by oxygenates components and causing for lose production and plant upset of Polypropylene process plants. However, Multidimensional gas chromatography (MDGC) innovative analytical methodology is a chromatography technique used to separate complex samples, as mixing different functional group as Hydrocarbon and oxygenates compounds and have similar retention factors, by running the eluent through two or more columns instead of the customary single column. This analytical study striving to enhance the quality of Oxygenates analytical method, as monitoring the concentration of oxygenates with accurate and precise analytical method by utilizing multidimensional GC supported by Backflush technique and Flame Ionization Detector, which have high performance separation of hydrocarbon and Oxygenates; also improving the minimum detection limits (MDL) to detect the concentration <1.0 ppm. However different types of oxygenates as (Alcohols, Aldehyde, Ketones, Ester and Ether) may be determined in other Hydrocarbon streams asC3, C4-mix, until C12 mixture, supported by liquid injection auto-sampler.Keywords: analytical chemistry, gas chromatography, petrochemicals, oxygenates
Procedia PDF Downloads 8616176 Using Technology to Deliver and Scale Early Childhood Development Services in Resource Constrained Environments: Case Studies from South Africa
Authors: Sonja Giese, Tess N. Peacock
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South African based Innovation Edge is experimenting with technology to drive positive behavior change, enable data-driven decision making, and scale quality early years services. This paper uses five case studies to illustrate how technology can be used in resource-constrained environments to first, encourage parenting practices that build early language development (using a stage-based mobile messaging pilot, ChildConnect), secondly, to improve the quality of ECD programs (using a mobile application, CareUp), thirdly, how to affordably scale services for the early detection of visual and hearing impairments (using a mobile tool, HearX), fourthly, how to build a transparent and accountable system for the registration and funding of ECD (using a blockchain enabled platform, Amply), and finally enable rapid data collection and feedback to facilitate quality enhancement of programs at scale (the Early Learning Outcomes Measure). ChildConnect and CareUp were both developed using a design based iterative research approach. The usage and uptake of ChildConnect and CareUp was evaluated with qualitative and quantitative methods. Actual child outcomes were not measured in the initial pilots. Although parents who used and engaged on either platform felt more supported and informed, parent engagement and usage remains a challenge. This is contrast to ECD practitioners whose usage and knowledge with CareUp showed both sustained engagement and knowledge improvement. HearX is an easy-to-use tool to identify hearing loss and visual impairment. The tool was tested with 10000 children in an informal settlement. The feasibility of cost-effectively decentralising screening services was demonstrated. Practical and financial barriers remain with respect to parental consent and for successful referrals. Amply uses mobile and blockchain technology to increase impact and accountability of public services. In the pilot project, Amply is being used to replace an existing paper-based system to register children for a government-funded pre-school subsidy in South Africa. Early Learning Outcomes Measure defines what it means for a child to be developmentally ‘on track’ at aged 50-69 months. ELOM administration is enabled via a tablet which allows for easy and accurate data collection, transfer, analysis, and feedback. ELOM is being used extensively to drive quality enhancement of ECD programs across multiple modalities. The nature of ECD services in South Africa is that they are in large part provided by disconnected private individuals or Non-Governmental Organizations (in contrast to basic education which is publicly provided by the government). It is a disparate sector which means that scaling successful interventions is that much harder. All five interventions show the potential of technology to support and enhance a range of ECD services, but pathways to scale are still being tested.Keywords: assessment, behavior change, communication, data, disabilities, mobile, scale, technology, quality
Procedia PDF Downloads 13716175 The Effect of Using the Active Learning on Achievement and Attitudes toward Studying the Human Rights Course for the Bahrain Teachers College Students
Authors: Abdelbaky Abouzeid
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The study aimed at determining the effect of using the active learning on achievement and attitudes toward studying the human rights course for the Bahrain Teachers College students and the extent to which any differences of statistical significance according to gender and section can exist. To achieve the objectives of the study, the researcher developed and implemented research tools such as academic achievement test and the scale of attitudes towards the study of the Human Rights Course. The scale of attitudes towards Human Rights was constructed of 40 items investigating four dimensions; the cognitive dimension, the behavioral dimension, the affective dimension, and course quality dimension. The researcher then applied some of the active learning strategies in teaching this course to all students of the first year of the Bahrain Teachers College (102 male and female students) after excluding two students who did not complete the course requirements. Students were divided into five groups. These strategies included interactive lecturing, presentations, role playing, group projects, simulation, brainstorming, concept maps and mind maps, reflection and think-pair-share. The course was introduced to students during the second semester of the academic year 2016-2017. The study findings revealed that the use of active learning strategies affected the achievement of students of Bahrain Teachers College in the Human Rights course. The results of the T-test showed statistically significant differences on the pre-test and post-test in favor of the post-test. No statistically significant differences in the achievement of students according to the section and gender were found. The results also indicated that the use of active learning strategies had a positive effect on students' attitudes towards the study of the Human Rights Course on all the scale’s items. The general average reached (4.26) and the percentage reached (85.19%). Regarding the effect of using active learning strategies on students’ attitudes towards all the four dimensions of the scale, the study concluded that the behavioral dimension came first; the quality of the course came second, the cognitive dimension came third and in the fourth place came the affective dimension. No statistically significant differences in the attitude towards studying the Human Rights Course for the students according to their sections or gender were found. Based on the findings of the study, the researchers suggested some recommendations that can contribute to the development of teaching Human Rights Course at the University of Bahrain.Keywords: attitudes, academic achievement, human rights, behavioral dimension, cognitive dimension, affective dimension, quality of the course
Procedia PDF Downloads 20116174 Health Outcomes and Economic Growth Nexus: Testing for Long-run Relationships and Causal Links in Nigeria
Authors: Haruna Modibbo Usman, Mustapha Muktar, Nasiru Inuwa
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This paper examined the long run relationship between health outcomes and economic growth in Nigeria from 1961 to 2012. Using annual time series data, Augmented Dickey-Fuller (ADF) test is conducted to check the stochastic properties of the variables. Also, the long run relationship among the variables is confirmed based on Johansen Multivariate Cointegration approach whereas the long run and short run dynamics are observed using Vector Error Correction Mechanism (VECM). In addition, VEC Granger causality test is employed to examine the direction of causality among the variables. On the whole, the results obtained revealed the existence of a long run relationship between health outcomes and economic growth in Nigeria and that both life expectancy and crude death rate as measures of health are found to have a long run negative and statistically significant impact on the economic growth over the study period. This is further buttressed by the results of Granger causality test which indicated the existence of unidirectional causality running from life expectancy and crude death rate to economic growth. The study therefore, calls for governments at various levels to create preconditions for health improvements in Nigeria in order to boost the level of health outcomes.Keywords: cointegration, economic growth, Granger causality, health outcomes, VECM
Procedia PDF Downloads 49516173 Flow Boiling Heat Transfer at Low Mass and Heat Fluxes: Heat Transfer Coefficient, Flow Pattern Analysis and Correlation Assessment
Authors: Ernest Gyan Bediako, Petra Dancova, Tomas Vit
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Flow boiling heat transfer remains an important area of research due to its relevance in thermal management systems and other applications. Despite the enormous work done in the field of flow boiling heat transfer over the years to understand how flow parameters such as mass flux, heat flux, saturation conditions and tube geometries influence the characteristics of flow boiling heat transfer, there are still many contradictions and lack of agreement on the actual mechanisms controlling heat transfer and how flow parameters impact the heat transfer. This work thus seeks to experimentally investigate the heat transfer characteristics and flow patterns at low mass fluxes, low heat fluxes and low saturation pressure conditions which are of less attention in literature but prevalent in refrigeration, air-conditioning and heat pump applications. In this study, flow boiling experiment was conducted for R134a working fluid in a 5 mm internal diameter stainless steel horizontal smooth tube with mass flux ranging from 80- 100 kg/m2 s, heat fluxes ranging from 3.55kW/m2 - 25.23 kW/m2 and saturation pressure of 460 kPa. Vapor quality ranged from 0 to 1. A well-known flow pattern map created by Wojtan et al. was used to predict the flow patterns noticed during the study. The experimental results were correlated with well-known flow boiling heat transfer correlations in literature. The findings show that, heat transfer coefficient was influenced by both mass flux and heat fluxes. However, for an increasing heat flux, nucleate boiling was observed to be the dominant mechanism controlling the heat transfer especially at low vapor quality region. For an increasing mass flux, convective boiling was the dominant mechanism controlling the heat transfer especially in the high vapor quality region. Also, the study observed an unusual high heat transfer coefficient at low vapor qualities which could be due to periodic wetting of the walls of the tube due to slug flow pattern and stratified wavy flow patterns. The flow patterns predicted by Wojtan et al. flow pattern map were mixture of slug and stratified wavy, purely stratified wavy and dry out. Statistical assessment of the experimental data with various well-known correlations from literature showed that, none of the correlations reported in literature could predicted the experimental data with enough accuracy.Keywords: flow boiling, heat transfer coefficient, mass flux, heat flux.
Procedia PDF Downloads 12116172 Urban Livelihoods and Climate Change: Adaptation Strategies for Urban Poor in Douala, Cameroon
Authors: Agbortoko Manyigbe Ayuk Nkem, Eno Cynthia Osuh
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This paper sets to examine the relationship between climate change and urban livelihood through a vulnerability assessment of the urban poor in Douala. Urban development in Douala places priority towards industrial and city-centre development with little focus on the urban poor in terms of housing units and areas of sustenance. With the high rate of urbanisation and increased land prices, the urban poor are forced to occupy marginal lands which are mainly wetlands, wastelands and along abandoned neighbourhoods prone to natural hazards. Due to climate change and its effects, these wetlands are constantly flooded thereby destroying homes, properties, and crops. Also, most of these urban dwellers have found solace in urban agriculture as a means for survival. However, since agriculture in tropical regions like Cameroon depends largely on seasonal rainfall, the changes in rainfall pattern has led to misplaced periods for crop planting and a huge wastage of resources as rainfall becomes very unreliable with increased temperature levels. Data for the study was obtained from both primary and secondary sources. Secondary sources included published materials related to climate change and vulnerability. Primary data was obtained through focus-group discussions with some urban farmers while a stratified sampling of residents within marginal lands was done. Each stratum was randomly sampled to obtain information on different stressors related to climate change and their effect on livelihood. Findings proved that the high rate of rural-urban migration into Douala has led to increased prevalence of the urban poor and their vulnerability to climate change as evident in their constant fight against flood from unexpected sea level rise and irregular rainfall pattern for urban agriculture. The study also proved that women were most vulnerable as they depended solely on urban agriculture and its related activities like retailing agricultural products in different urban markets which to them serves as a main source of income in the attainment of basic needs for the family. Adaptation measures include the constant use of sand bags, raised makeshifts as well as cultivation along streams, planting after evidence of constant rainfall has become paramount for sustainability.Keywords: adaptation, Douala, Cameroon, climate change, development, livelihood, vulnerability
Procedia PDF Downloads 29816171 A Study on the Impact of Employment Status of the Elderly on Their Mental Well-Being in India
Authors: Santosh B. Phad, Priyanka V. Janbandhu, Dhananjay W. Bansod
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Population Ageing is a growing concern for the social scientists. There is a higher level of aged male participation compared to elderly females. Now, the critical question is whether participation in work improves the quality of life among the elderly and the impact of working status on the mental well-being of the elderly. While examining these research questions, the present paper focuses on the workforce participation of the elderly and the reasons behind it, additionally, determines the association between employment status and the mental well-being of the elderly. The present study has a base of two data sources. First one is Census of India data, 2001 and 2011, and another one is – the Study on Global Ageing and Adult Health (SAGE), a survey conducted in 2007. To capture the trend of workforce participation elderly Census data is significant and to obtain other information associated with this issue the SAGE data is studied. The research piece consists of univariate and bivariate analysis along with some statistical methods like principal component analysis (PCA) and regression modeling – to investigate the association between workforce participation of elderly and subjective well-being (SWB). The results show that the percentage of elderly participating in the labor market is gradually reducing, but the share of working elderly has increased within the group of overall workers. i.e., the ratio of aged workers to non-aged workers is rising. The findings from survey data specify that there is a considerable share of the elderly in the labor market; three-fourths of the employed elderly enrolled the workforce unwillingly. They are in need of some earnings mainly to afford the medical expenses on their health or the health of their spouse, also to support their family members who are economically inactive. Apart from need, duration of working is another vital aspect for the elderly, whereas more than 80 percent of the elderly are working for six hours or more, and most of them engaged in self-employment. However, more than one-third of the working elderly falls into a negative cluster of the subjective well-being (SWB) index, and it is consistent with the result of the discriminant analysis. Here, the SWB index calculated from the 12 items and the reliability score of these items is 0.89.Keywords: ageing, workforce, census of India, SAGE
Procedia PDF Downloads 15516170 Nano-Plasmonic Diagnostic Sensor Using Ultraflat Single-Crystalline Au Nanoplate and Cysteine-Tagged Protein G
Authors: Hwang Ahreum, Kang Taejoon, Kim Bongsoo
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Nanosensors for high sensitive detection of diseases have been widely studied to improve the quality of life. Here, we suggest robust nano-plasmonic diagnostic sensor using cysteine tagged protein G (Cys3-protein G) and ultraflat, ultraclean and single-crystalline Au nanoplates. Protein G formed on an ultraflat Au surface provides ideal background for dense and uniform immobilization of antibodies. The Au is highly stable in diverse biochemical environment and can immobilize antibodies easily through Au-S bonding, having been widely used for various biosensing applications. Especially, atomically smooth single-crystalline Au nanomaterials synthesized using chemical vapor transport (CVT) method are very suitable to fabricate reproducible sensitive sensors. As the C-reactive protein (CRP) is a nonspecific biomarker of inflammation and infection, it can be used as a predictive or prognostic marker for various cardiovascular diseases. Cys3-protein G immobilized uniformly on the Au nanoplate enable CRP antibody (anti-CRP) to be ordered in a correct orientation, making their binding capacity be maximized for CRP detection. Immobilization condition for the Cys3-protein G and anti-CRP on the Au nanoplate is optimized visually by AFM analysis. Au nanoparticle - Au nanoplate (NPs-on-Au nanoplate) assembly fabricated from sandwich immunoassay for CRP can reduce zero-signal extremely caused by nonspecific bindings, providing a distinct surface-enhanced Raman scattering (SERS) enhancement still in 10-18 M of CRP concentration. Moreover, the NP-on-Au nanoplate sensor shows an excellent selectivity against non-target proteins with high concentration. In addition, comparing with control experiments employing a Au film fabricated by e-beam assisted deposition and linker molecule, we validate clearly contribution of the Au nanoplate for the attomolar sensitive detection of CRP. We expect that the devised platform employing the complex of single-crystalline Au nanoplates and Cys3-protein G can be applied for detection of many other cancer biomarkers.Keywords: Au nanoplate, biomarker, diagnostic sensor, protein G, SERS
Procedia PDF Downloads 25916169 Study of the Facilities in the Cultural and Ecotourism Route in the Area of Om Nont Canal, Nonthaburi Provice, Thailand
Authors: Supattra Suanlim
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Nonthaburi province is one of the provinces in the central region of Thailand. There is the Chao Phraya River, which is a large and important river of Thailand passing through the province. With the way of life and social changes since the past. There is a digging canal called Lat canal or Om canal, communities along the canal have dense settlements. Important in life and culture. This research has 3 objectives as follows. 1.To explore cultural and ecotourism attractions in the Om Nont canal area. 2.To explore the facilities in the Om Nont canal tourist attraction. To suggest facilities for tourist attractions in the Om Nont canal, Nonthaburi, Thailand. This research is a qualitative research, using research methods by collecting data and surveying tourist attractions by water traffic. The results of the research can be concluded that There are 21 tourist attractions that have the potential to welcome tourists who want to travel cultural. 16 temples or places of worship, 2 government offices, 1 market, 2 landmarks. Each should be improved to increase the potential of the paths. There should be improvements in the road landscape that is a connection to water traffic. Districts should have signage and signage installation within tourist sites and have guidelines for architectural improvements. And the Nodes should improve the public space of the community. Such as the Nonthaburi pier area to have the idea of designing a tourist center Provide information in both Thai and English.Keywords: Community, Cultural, Ecotourism, Facility
Procedia PDF Downloads 13716168 Effect of Pretreatment on Quality Parameters of Natural Convection Mixed-Mode Solar Dried Potato
Authors: Kshanaprava Dhalsamant, Punyadarshini P. Tripathy, Shanker L. Shrivastava
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With present high global population, the need for rising food usage by minimizing food wastage and investment is highly necessary to achieve food security. The purpose of this study is to enlighten the effect of pre-drying treatment on rehydration, color, texture, nanohardness, microstructure and surface morphology of solar dried potato samples dried in the mixed-mode solar dryer. Locally bought potatoes were cleaned and cut into cylindrical pieces and pretreated with sodium metabisulfite (0.5%) for 10 min before placing them in natural convection solar dryer designed and developed in Indian Institute of Technology Kharagpur, India. Advanced quality characteristics were studied using Atomic Force Microscope (AFM), Scanning Electron Microscopy (SEM) and nanoindentation method, along with color, texture and water activity. The rehydration indices of solar dried potatoes were significantly biased by pretreatment followed by rehydration temperature. A lower redness index (a*) with a higher value of yellowness index (b*), chroma (C*) and hue angle (h*) were obtained for pretreated samples. Also, the average nanohardness (H) of untreated samples exhibited substantial lower value (18.46%) compared to pretreated samples. Additionally, a creep displacement of 43.27 nm during 20 s dwell time under constant load of 200Keywords: pretreatment, nanohardness, microstructure, surface morphology
Procedia PDF Downloads 17116167 Sustainable Integrated Waste Management System
Authors: Lidia Lombardi
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Waste management in Europe and North America is evolving towards sustainable materials management, intended as a systemic approach to using and reusing materials more productively over their entire life cycles. Various waste management strategies are prioritized and ranked from the most to the least environmentally preferred, placing emphasis on reducing, reusing, and recycling as key to sustainable materials management. However, non-recyclable materials must also be appropriately addressed, and waste-to-energy (WtE) offers a solution to manage them, especially when a WtE plant is integrated within a complex system of waste and wastewater treatment plants and potential users of the output flows. To evaluate the environmental effects of such system integration, Life Cycle Assessment (LCA) is a helpful and powerful tool. LCA has been largely applied to the waste management sector, dating back to the late 1990s, producing a large number of theoretical studies and applications to the real world as support to waste management planning. However, LCA still has a fundamental role in helping the development of waste management systems supporting decisions. Thus, LCA was applied to evaluate the environmental performances of a Municipal Solid Waste (MSW) management system, with improved separate material collection and recycling and an integrated network of treatment plants including WtE, anaerobic digestion (AD) and also wastewater treatment plant (WWTP), for a reference study case area. The proposed system was compared to the actual situation, characterized by poor recycling, large landfilling and absence of WtE. The LCA results showed that the increased recycling significantly increases the environmental performances, but there is still room for improvement through the introduction of energy recovery (especially by WtE) and through its use within the system, for instance, by feeding the heat to the AD, to sludge recovery processes and supporting the water reuse practice. WtE offers a solution to manage non-recyclable MSW and allows saving important resources (such as landfill volumes and non-renewable energy), reducing the contribution to global warming, and providing an essential contribution to fulfill the goals of really sustainable waste management.Keywords: anaerobic digestion, life cycle assessment, waste-to-energy, municipal solid waste
Procedia PDF Downloads 6416166 Histopathological, Proliferative, Apoptotic, and Hormonal Characteristics of Various Types of Leiomyomas
Authors: Kiknadze T, Tevdorashvili G, Muzashvili T, Gachechiladze M, Burkadze G
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Uterine leiomyomas decrease the quality of life by causing significant morbidity among women of reproductive age. Histologically various types of leiomyoma's can be differentiated. We have analysed th histopathological, proliferation, apoptotic, and hormonal profile in different types of leiomyomas. Study included altogether140 cases distributed into the following groups: group I-normal myometrium (20cases), group II-classic leiomyoma (69 cases), group III-cellular leiomyoma (15 cases), group IV-bizarre cell/atypical leiomyoma (22cases), group V-smooth muscle tumors of uncertain malignancy potential (STUMP) (8 cases) and group VI-leiomyosarcoma (6 cases). Together with classic histopathological features such as nuclear atypia, cellularity, presence of mitoses, vasculature and necrosis, immunohistochemical phenotype using antibodies against Ki67,Cas3, ER, and PR were analysed. The results of our study showed that leiomyomas are charterised with variable histopathological and immunohistocthemical phenotype. Histopathological parameters mainly correlate with the degree of malignancy except for two bizarre/atypical leiomyoma and STUMP, where two distinct subgroups could be identified. In bizarre/ atipycal leiomyoma, 31% of cases are characterized with the features of classic leiomyoma, whilst the rest of the cases reveal more atipycal phenotype. In STUMP 37.5 % of cases are characterized with the features of atipycal leiomyomas. The result of the immunohistochemical study also reveald that half of bizarre/atipycal leiomyomas are characterized with the low proliferation index, high apoptotic index, and high ER and PR index, whilst another half is characterized with high proliferation index, low apoptotic index, and low ER and PR index. Similarly, part of the STUMP cases are characterized with low proliferation index, high Er, and PR index and whilst part of the cases are characterized whith high proliferation index, low apoptotic index and low ER and PR index. The results of the histopathological and immunohistochemical study indicate that these two entities represent the heterogenous group of diseases, which might be the explanation of their different prognosis. Presented histopathological and immunohistochemical features should be considered in the diagnosis of myometrial smooth muscle tumors.Keywords: proliferation, apoptosis, bizarre cell, leiomyosarcoma., leiomyoma
Procedia PDF Downloads 11316165 Biomass and Biogas Yield of Maize as Affected by Nitrogen Rates with Varying Harvesting under Semi-Arid Condition of Pakistan
Authors: Athar Mahmood, Asad Ali
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Management considerations including harvesting time and nitrogen application considerably influence the biomass yield, quality and biogas production. Therefore, a field study was conducted to determine the effect of various harvesting times and nitrogen rates on the biomass yield, quality and biogas yield of maize crop. This experiment was consisted of various harvesting times i.e., harvesting after 45, 55 and 65 days of sowing (DAS) and nitrogen rates i.e., 0, 100, 150 and 200 kg ha-1 respectively. The data indicated that maximum plant height, leaf area, dry matter (DM) yield, protein, acid detergent fiber, neutral detergent fiber, crude fiber contents and biogas yield were recorded 65 days after sowing while lowest was recorded 45 days after sowing. In contrary to that significantly higher chlorophyll contents were observed at 45 DAS. In case of nitrogen rates maximum plant height, leaf area, and DM yield, protein contents, ash contents, acid detergent fiber, neutral detergent fiber, crude fiber contents and chlorophyll contents were determined with nitrogen at the rate of 200 kg ha-1, while minimum was observed when no N was applied. Therefore, harvesting 65 DAS and N application @ 200 kg ha-1 can be suitable for getting the higher biomass and biogas production.Keywords: chemical composition, fiber contents, biogas, nitrogen, harvesting time
Procedia PDF Downloads 16516164 Engineers’ Ability to Lead Effectively the Transformation to Sustainable Manufacturing: A Case Study of Saudi Arabia
Authors: Mohammed Alharbi, Clare Wood, Vasileios Samaras
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Sustainability leadership is a controversial topic, particularly in the engineering context. The theoretical and practical technical focus of the engineering profession impacts our lives. Technologically, engineers significantly contribute to our modern civilization. Industrial revolutions are among the top engineering accomplishments that have contributed to the flourishing of our life. However, engineers have not always received the credit they deserve; instead, they have been blamed for the advent of various global issues, among them the global warming phenomena that are believed to be a result of the industrial revolutions. Global challenges demand engineers demonstrate more than their technical skills for effective contribution to a sustainable future. As a result, engineering leadership has emerged as a new research field. Sustainable manufacturing is a cornerstone for sustainable development. Investigating the change to more sustainable manufacturing practices is a significant issue for all, and even more in the field of engineering leadership. Engineers dominate the manufacturing industry; however, one of the main criticism of engineers is the lack of leadership skills. The literature on engineering leadership has not highlighted enough the engineers' leadership ability in leading sustainable manufacturing. Since we are at the cusp of a new industrial revolution -Industry 4.0, it is vital to investigate the ability of engineers to lead the industry towards a sustainable future. The primary purpose of this paper is to evaluate engineers' sustainability leadership competencies utilizing The Cambridge University Behavioral Competency Model. However, the practical application of the Cambridge model is limited due to the absence of a reliable measurement tool. Therefore, this study developed a valid and reliable survey instrument tool compatible with the Cambridge model as a secondary objective. More than 300 Saudi engineers from the manufacturing industry responded to an online questionnaire collected through the Qualtrics platform and analyzed using SPSS software. The findings provide a contemporary understanding of engineers' mindset related to sustainability leadership. The output of this research study could be valuable in designing effective engineering leadership programs in academia or industry, particularly for enhancing a sustainable manufacturing environment.Keywords: engineer, leadership, manufacturing, sustainability
Procedia PDF Downloads 16116163 Using Audit Tools to Maintain Data Quality for ACC/NCDR PCI Registry Abstraction
Authors: Vikrum Malhotra, Manpreet Kaur, Ayesha Ghotto
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Background: Cardiac registries such as ACC Percutaneous Coronary Intervention Registry require high quality data to be abstracted, including data elements such as nuclear cardiology, diagnostic coronary angiography, and PCI. Introduction: The audit tool created is used by data abstractors to provide data audits and assess the accuracy and inter-rater reliability of abstraction performed by the abstractors for a health system. This audit tool solution has been developed across 13 registries, including ACC/NCDR registries, PCI, STS, Get with the Guidelines. Methodology: The data audit tool was used to audit internal registry abstraction for all data elements, including stress test performed, type of stress test, data of stress test, results of stress test, risk/extent of ischemia, diagnostic catheterization detail, and PCI data elements for ACC/NCDR PCI registries. This is being used across 20 hospital systems internally and providing abstraction and audit services for them. Results: The data audit tool had inter-rater reliability and accuracy greater than 95% data accuracy and IRR score for the PCI registry in 50 PCI registry cases in 2021. Conclusion: The tool is being used internally for surgical societies and across hospital systems. The audit tool enables the abstractor to be assessed by an external abstractor and includes all of the data dictionary fields for each registry.Keywords: abstraction, cardiac registry, cardiovascular registry, registry, data
Procedia PDF Downloads 10916162 Advancements in Electronic Sensor Technologies for Tea Quality Evaluation
Authors: Raana Babadi Fathipour
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Tea, second only to water in global consumption rates, holds a significant place as the beverage of choice for many around the world. The process of fermenting tea leaves plays a crucial role in determining its ultimate quality, traditionally assessed through meticulous observation by tea tasters and laboratory analysis. However, advancements in technology have paved the way for innovative electronic sensing platforms like the electronic nose (e-nose), electronic tongue (e-tongue), and electronic eye (e-eye). These cutting-edge tools, coupled with sophisticated data processing algorithms, not only expedite the assessment of tea's sensory qualities based on consumer preferences but also establish new benchmarks for this esteemed bioactive product to meet burgeoning market demands worldwide. By harnessing intricate data sets derived from electronic signals and deploying multivariate statistical techniques, these technological marvels can enhance accuracy in predicting and distinguishing tea quality with unparalleled precision. In this contemporary exploration, a comprehensive overview is provided of the most recent breakthroughs and viable solutions aimed at addressing forthcoming challenges in the realm of tea analysis. Utilizing bio-mimicking Electronic Sensory Perception systems (ESPs), researchers have developed innovative technologies that enable precise and instantaneous evaluation of the sensory-chemical attributes inherent in tea and its derivatives. These sophisticated sensing mechanisms are adept at deciphering key elements such as aroma, taste, and color profiles, transitioning valuable data into intricate mathematical algorithms for classification purposes. Through their adept capabilities, these cutting-edge devices exhibit remarkable proficiency in discerning various teas with respect to their distinct pricing structures, geographic origins, harvest epochs, fermentation processes, storage durations, quality classifications, and potential adulteration levels. While voltammetric and fluorescent sensor arrays have emerged as promising tools for constructing electronic tongue systems proficient in scrutinizing tea compositions, potentiometric electrodes continue to serve as reliable instruments for meticulously monitoring taste dynamics within different tea varieties. By implementing a feature-level fusion strategy within predictive models, marked enhancements can be achieved regarding efficiency and accuracy levels. Moreover, by establishing intrinsic linkages through pattern recognition methodologies between sensory traits and biochemical makeup found within tea samples, further strides are made toward enhancing our understanding of this venerable beverage's complex nature.Keywords: classifier system, tea, polyphenol, sensor, taste sensor
Procedia PDF Downloads 1016161 An Analytic Cross-Sectional Study on the Association between Social Determinants of Health, Maternal and Child Health-Related Knowledge and Attitudes, and Utilization of Maternal, Newborn, Child Health and Nutrition Strategy-Prescribed Services for M
Authors: Rafael Carlos C. Aniceto, Bryce Abraham M. Anos, Don Christian A. Cornel, Marjerie Brianna S. Go, Samantha Nicole U. Roque, Earl Christian C. Te
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Indigenous peoples (IPs) in the Philippines are a vulnerable, marginalized group in terms of health and overall well-being due to social inequities and cultural differences. National standards regarding maternal healthcare are geared towards facility-based delivery with modern medicine, health services, and skilled birth attendants. Standards and procedures of care for pregnant mothers do not take into account cultural differences between indigenous people and the majority of the population. There do exist, however, numerous other factors that cause relatively poorer health outcomes among indigenous peoples (IPs). This analytic cross-sectional study sought to determine the association between social determinants of health (SDH), focusing on status as indigenous peoples, and maternal health-related knowledge and attitudes (KA), and health behavior of the Dumagat-Agta indigenous people of Barangay Catablingan and Barangay San Marcelino, General Nakar, Quezon Province, and their utilization of health facilities for antenatal care, facility-based delivery and postpartum care, which would affect their health outcomes (that were not within the scope of this study). To quantitatively measure the primary/secondary exposures and outcomes, a total of 90 face-to-face interviews with IP and non-IP mothers were done. For qualitative information, participant observation among 6 communities (5 IP and 1 non-IP), 11 key informant interviews (traditional and modern health providers) and 4 focused group discussions among IP mothers were conducted. Primary quantitative analyses included chi-squared, T-test and binary logistic regression, while secondary qualitative analyses involved thematic analysis and triangulation. The researchers spent a total of 15 days in the community to learn the culture and participate in the practices of the Dumagat-Agta more intensively and deeply. Overall, utilization of all MNCHN services measured in the study was lower for IP mothers compared to their non-IP counterparts. After controlling for confounders measured in the study, IP status (primary exposure) was found to be significantly correlated with utilization of and adherence to two MNCHN-prescribed services: number of antenatal care check-ups and place of delivery (secondary outcomes). Findings show that being an indigenous mother leads to unfavorable social determinants of health, and if compounded by a difference in knowledge and attitudes, would then lead to poor levels of utilization of MNCHN-prescribed services. Key themes from qualitative analyses show that factors that affected utilization were: culture, land alienation, social discrimination, socioeconomic status, and relations between IPs and non-IPs, specifically with non-IP healthcare providers. The findings of this study aim to be used to help and guide in policy-making, to provide healthcare that is not only adequate and of quality, but more importantly, that addresses inequities stemming from various social determinants, and which is socio-culturally acceptable to indigenous communities. To address the root causes of health problems of IPs, there must be full recognition and exercise of their collective rights to communal assets, specifically land, and self-determination. This would improve maternal and child health outcomes to one of the most vulnerable and neglected sectors in society today.Keywords: child health, indigenous people, knowledge-attitudes-practices, maternal health, social determinants of health
Procedia PDF Downloads 19916160 Improving Numeracy Standards for UK Pharmacy Students
Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman
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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.Keywords: attainment, ethnicity, numeracy, pharmacy, support
Procedia PDF Downloads 23716159 Peruvian Diagnostic Reference Levels for Patients Undergoing Different X-Rays Procedures
Authors: Andres Portocarrero Bonifaz, Caterina Sandra Camarena Rodriguez, Ricardo Palma Esparza, Nicolas Antonio Romero Carlos
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Reference levels for common X-rays procedures have been set in many protocols. In Peru, during quality control tests, the dose tolerance is set by these international recommendations. Nevertheless, further studies can be made to assess the national reality and relate dose levels with different parameters such as kV, mA/mAs, exposure time, type of processing (digital, digitalized or conventional), etc. In this paper three radiologic procedures were taken into account for study, general X-rays (fixed and mobile), intraoral X-rays (fixed, mobile and portable) and mammography. For this purpose, an Unfors Xi detector was used; the dose was measured at a focus - detector distance which varied depending on the procedure, and was corrected afterward to find the surface entry dose. The data used in this paper was gathered over a period of over 3 years (2015-2018). In addition, each X-ray machine was taken into consideration only once. The results hope to achieve a new standard which reflects the local practice, and address the issues of the ‘Bonn Call for Action’ in Peru. For this purpose, the 75% percentile of the dose of each radiologic procedure was calculated. In future quality control services, those machines with dose values higher than the selected threshold should be informed that they surpass the reference dose levels established in comparison other radiological centers in the country.Keywords: general X-rays, intraoral X-rays, mammography, reference dose levels
Procedia PDF Downloads 161