Search results for: integrated care delivery

Authors: Francisco Fernandez de Castro

Abstract:

The Conditional Cash Transfer (CCT) model gives monetary transfers to beneficiary families on the condition that they take specific education and health actions. According to the economic rationale of CCTs the poor need incentives to invest in their human capital because they are trapped by a lack of information and misleading beliefs. If left to their own decision, the poor will not be able to choose what is in their best interests. The basic assumption of the CCT model is that the poor need incentives to take care of their own education and health-nutrition. Due to the incentives (income cash transfers and conditionalities), beneficiary families are supposed to attend doctor visits and health talks. Children would stay in the school. These incentivized behaviors would produce outcomes such as better health and higher level of education, which in turn will reduce poverty. Based on a grounded theory approach to conduct a two-year period of qualitative data collection in northern Mexico, this study shows that this explanation is incomplete. In addition to the information failure and inadequate beliefs, there are structural barriers in everyday life of households that make health-nutrition and education investments difficult. In-depth interviews and observation work showed that the program takes for granted local conditions in which beneficiary families should fulfill their co-responsibilities. Data challenged the program’s assumptions and unveiled local obstacles not contemplated in the program’s design. These findings have policy and research implications for the CCT agenda. They bring elements for late programming due to the gap between the CCT strategy as envisioned by policy designers, and the program that beneficiary families experience on the ground. As for research consequences, these findings suggest new avenues for scholarly work regarding the causal mechanisms and social processes explaining CCT outcomes.

Keywords: conditional cash transfers, incentives, poverty, structural barriers

Procedia PDF Downloads 103

Authors: Aspasia Koutsokosta, Stefanos Katsavounis

Abstract:

This paper reviews the model-based qualitative and quantitative Operations Management research in the context of Construction Supply Chain Management (CSCM). Construction industry has been traditionally blamed for low productivity, cost and time overruns, waste, high fragmentation and adversarial relationships. The construction industry has been slower than other industries to employ the Supply Chain Management (SCM) concept and develop models that support the decision-making and planning. However the last decade there is a distinct shift from a project-based to a supply-based approach of construction management. CSCM comes up as a new promising management tool of construction operations and improves the performance of construction projects in terms of cost, time and quality. Modeling the Construction Supply Chain (CSC) offers the means to reap the benefits of SCM, make informed decisions and gain competitive advantage. Different modeling approaches and methodologies have been applied in the multi-disciplinary and heterogeneous research field of CSCM. The literature review reveals that a considerable percentage of CSC modeling accommodates conceptual or process models which discuss general management frameworks and do not relate to acknowledged soft OR methods. We particularly focus on the model-based quantitative research and categorize the CSCM models depending on their scope, mathematical formulation, structure, objectives, solution approach, software used and decision level. Although over the last few years there has been clearly an increase of research papers on quantitative CSC models, we identify that the relevant literature is very fragmented with limited applications of simulation, mathematical programming and simulation-based optimization. Most applications are project-specific or study only parts of the supply system. Thus, some complex interdependencies within construction are neglected and the implementation of the integrated supply chain management is hindered. We conclude this paper by giving future research directions and emphasizing the need to develop robust mathematical optimization models for the CSC. We stress that CSC modeling needs a multi-dimensional, system-wide and long-term perspective. Finally, prior applications of SCM to other industries have to be taken into account in order to model CSCs, but not without the consequential reform of generic concepts to match the unique characteristics of the construction industry.

Keywords: construction supply chain management, modeling, operations research, optimization, simulation

Procedia PDF Downloads 499

Authors: Gabriela Rivadeneyra-Romero, Claudia del C. Gutierrez Torres, Sergio A. Martinez-Delgadillo, Victor X. Mendoza-Escamilla, Alejandro Alonzo-Garcia

Abstract:

Ultrasonic degradation is currently being used in sonochemical reactors to degrade pollutant compounds from aqueous media, as emerging contaminants (e.g. pharmaceuticals, drugs and personal care products.) because they can produce possible ecological impacts on the environment. For this reason, it is important to develop appropriate water and wastewater treatments able to reduce pollution and increase reuse. Pollutants such as textile dyes, aromatic and phenolic compounds, cholorobenzene, bisphenol-A and carboxylic acid and other organic pollutants, can be removed from wastewaters by sonochemical oxidation. The effect on the removal of pollutants depends on the type of the ultrasonic frequency used; however, not much studies have been done related to the behavior of the fluid into the sonoreactors operated at different ultrasonic frequencies. Based on the above, it is necessary to study the hydrodynamic behavior of the liquid generated by the ultrasonic irradiation to design efficient sonoreactors to reduce treatment times and costs. In this work, it was studied the hydrodynamic behavior of the fluid in sonochemical reactors at different frequencies (250 kHz, 500 kHz and 1000 kHz). The performances of the sonoreactors at those frequencies were simulated using computational fluid dynamics (CFD). Due to there is great sound speed gradient between piezoelectric and fluid, k-e models were used. Piezoelectric was defined as a vibration surface, to evaluate the different frequencies effect on the fluid into sonochemical reactor. Structured hexahedral cells were used to mesh the computational liquid domain, and fine triangular cells were used to mesh the piezoelectric transducers. Unsteady state conditions were used in the solver. Estimation of the dissipation rate, flow field velocities, Reynolds stress and turbulent quantities were evaluated by CFD and 2D-PIV measurements. Test results show that there is no necessary correlation between an increase of the ultrasonic frequency and the pollutant degradation, moreover, the reactor geometry and power density are important factors that should be considered in the sonochemical reactor design.

Keywords: CFD, reactor, ultrasound, wastewater

Procedia PDF Downloads 182

Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

Abstract:

Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

Procedia PDF Downloads 114

Authors: Bulcha Belay Etana, Benny Malengier, Debelo Oljira, Janarthanan Krishnamoorthy, Lieva Vanlangenhove

Abstract:

Electromyography (EMG) is a technique used to measure the electrical activity of muscles. EMG can be used to assess muscle function in a variety of settings, including clinical, research, and sports medicine. The aim of this study was to develop a wearable textile sensor for EMG monitoring. The sensor was designed to be soft, stretchable, and washable, making it suitable for long-term use. The sensor was fabricated using a conductive thread material that was embroidered onto a fabric substrate. The sensor was then connected to a microcontroller unit (MCU) and a Wi-Fi-enabled module. The MCU was programmed to acquire the EMG signal and transmit it wirelessly to the Wi-Fi-enabled module. The Wi-Fi-enabled module then sent the signal to a server, where it could be accessed by a computer or smartphone. The sensor was able to successfully acquire and transmit EMG signals from a variety of muscles. The signal quality was comparable to that of commercial EMG sensors. The development of this sensor has the potential to improve the way EMG is used in a variety of settings. The sensor is soft, stretchable, and washable, making it suitable for long-term use. This makes it ideal for use in clinical settings, where patients may need to wear the sensor for extended periods of time. The sensor is also small and lightweight, making it ideal for use in sports medicine and research settings. The data for this study was collected from a group of healthy volunteers. The volunteers were asked to perform a series of muscle contractions while the EMG signal was recorded. The data was then analyzed to assess the performance of the sensor. The EMG signals were analyzed using a variety of methods, including time-domain analysis and frequency-domain analysis. The time-domain analysis was used to extract features such as the root mean square (RMS) and average rectified value (ARV). The frequency-domain analysis was used to extract features such as the power spectrum. The question addressed by this study was whether a wearable textile sensor could be developed that is soft, stretchable, and washable and that can successfully acquire and transmit EMG signals. The results of this study demonstrate that a wearable textile sensor can be developed that meets the requirements of being soft, stretchable, washable, and capable of acquiring and transmitting EMG signals. This sensor has the potential to improve the way EMG is used in a variety of settings.

Keywords: EMG, electrode position, smart wearable, textile sensor, IoT, IoT-integrated textile sensor

Procedia PDF Downloads 61

Authors: Chaudhary Itisha, Shankar Manu

Abstract:

Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction

Procedia PDF Downloads 314

Authors: Biruk Wolde Eremacho

Abstract:

The Kombolcha to Desse road, linking Addis Ababa with Northern Ethiopia towns traverses through one of the most difficult mountainous ranges in Ethiopia. The presence of loose unconsolidated materials (colluvium materials), highly weathered and fractured basalt rocks high relief, steep natural slopes, nature of geologic formations exposed along the road section, poor drainage conditions, occurrence of high seasonal rains, and seismically active nature of the region created favorable condition for slope instability in the area. Thus, keeping in mind all above points the present study was conceived to study in detail the slope stability condition of the area. It was realized that detailed slope stability studies along this road section are very necessary to identify critical slopes and to provide the best remedial measures to minimize the slope instability problems which frequently disrupt and endanger the traffic movement on this important road. For the present study based on the field manifestation of instability two most critical slope sections were identified for detailed slope stability analysis. The deterministic slope stability analysis approach was followed to perform the detailed slope stability analysis of the selected slope sections. Factor of safety for the selected slope sections was determined for the different anticipated conditions (i.e., static and dynamic with varied water saturations) using Slope/W and Slide software. Both static and seismic slope stability analysis were carried out and factor of safety was deduced for each anticipated conditions. In general, detailed slope stability analysis of the two critical slope sections reveals that for only static dry condition both the slopes sections would be stable. However, for the rest anticipated conditions defined by static and dynamic situations with varied water saturations both critical slope sections would be unstable. Moreover, the causes of slope instability in the study area are governed by different factors; therefore integrated approaches of remedial measures are more appropriate to mitigate the possible slope instability in the study area. Depending on site condition and slope stability analysis result four types of suitable preventive and remedial measures are recommended namely; proper managements of drainages, retaining structures, gabions, and managing steeply cut slopes.

Keywords: factor of safety, remedial measures, slope stability analysis, static and dynamic condition

Procedia PDF Downloads 263

Authors: Anthony Nyamekeh-Armah Adjei, Toshiaki Aoki

Abstract:

The unreliable and poor efficiency of electricity distribution leading to frequent power outages and high losses are the major challenge facing the power distribution sector in Ghana. Distribution system routes electricity from the power generating station at a higher voltage through the transmission grid and steps it down through the low voltage lines to end users. Approximately all electricity problems and disturbances that have increased the call for renewable and sustainable energy in recent years have their roots in the distribution system. Therefore, sustaining electricity distribution efficiency can potentially contribute to the reserve of natural energy resources use in power generation, reducing greenhouse gas emission (GHG), decreasing tariffs for consumers and effective human security. Human Security is a people-centered approach where individual human being is the principal object of concern, focuses on protecting the vital core of all human lives in ways for meeting basic needs that enhance the safety and protection of individuals and communities. The vulnerability is the diminished capacity of an individual or group to anticipate, resist and recover from the effect of natural, human-induced disaster. The research objectives are to explore the causes of frequent power outages to consumers, high losses in the distribution network and the effect of poor electricity distribution efficiency on the vulnerable (poor and ordinary) people that mostly depend on electricity for their daily activities or life to survive. The importance of the study is that in a developing country like Ghana where raising a capital for new infrastructure project is difficult, it would be beneficial to enhance the efficiency that will significantly minimize the high energy losses, reduce power outage, to ensure safe and reliable delivery of electric power to consumers to secure the security of people’s livelihood. The methodology used in this study is both interview and questionnaire survey to analyze the response from the respondents on causes of power outages and high losses facing the electricity company of Ghana (ECG) and its effect on the livelihood on the vulnerable people. Among the outcome of both administered questionnaire and the interview survey from the field were; poor maintenance of existing sub-stations, use of aging equipment, use of poor distribution infrastructure and poor metering and billing system. The main observation of this paper is that the poor network efficiency (high losses and power outages) affects the livelihood of the vulnerable people. Therefore, the paper recommends that policymakers should insist on all regulation guiding electricity distribution to improve system efficiency. In conclusion, there should be decentralization of off-grid solar PV technologies to provide a sustainable and cost-effective, which can increase daily productivity and improve the quality of life of the vulnerable people in the rural communities.

Keywords: electricity efficiency, high losses, human security, power outage

Procedia PDF Downloads 271

Authors: Amr S. Fahil, Eman Ghoneim

Abstract:

Egypt made significant efforts during the past few years to discover significant renewable energy sources. Regions in Egypt that have been identified for geothermal potential investigation include the Gulf of Suez and the Western Desert. One of the most promising sites for the development of Egypt's Northern Western Desert is Siwa Oasis. The geological setting of the oasis, a tectonically generated depression situated in the northernmost region of the Western desert, supports the potential for substantial geothermal resources. Field data obtained from 27 deep oil wells along the Western Desert included bottom-hole temperature (BHT) depth to basement measurements, and geological maps; data were utilized in this study. The major lithological units, elevation, surface gradient, lineaments density, and remote sensing multispectral and topographic were mapped together to generate the related physiographic variables. Eleven thematic layers were integrated in a geographic information system (GIS) to create geothermal maps to aid in the detection of significant potential geothermal spots along the Siwa Oasis and its vicinity. The contribution of total magnetic intensity data with reduction to the pole (RTP) to the first investigation of the geothermal potential in Siwa Oasis is applied in this work. The integration of geospatial data with magnetic field measurements showed a clear correlation between areas of high heat flow and magnetic anomalies. Such anomalies can be interpreted as related to the existence of high geothermal energy and dense rock, which also have high magnetic susceptibility. The outcomes indicated that the study area has a geothermal gradient ranging from 18 to 42 °C/km, a heat flow ranging from 24.7 to 111.3 m.W. k−1, a thermal conductivity of 1.3–2.65 W.m−1.k−1 and a measured amplitude temperature maximum of 100.7 °C. The southeastern part of the Siwa Oasis, and some sporadic locations on the eastern section of the oasis were found to have significant geothermal potential; consequently, this location is suitable for future geothermal investigation. The adopted method might be applied to identify significant prospective geothermal energy locations in other regions of Egypt and East Africa.

Keywords: magnetic data, SRTM, depth to basement, remote sensing, GIS, geothermal gradient, heat flow, thermal conductivity

Procedia PDF Downloads 96

Authors: L. R. Valencia Pérez, A. Morita Alexander, Peña A. Juan Manuel, A. Lamadrid Álvarez

Abstract:

This research shows the reflection and identification of explanatory variables and their relationships between different variables that are involved with educational technology, all of them encompassed in macro-concepts which are: cognitive inequality, economy, food and language; These will give the guideline to have a more detailed knowledge of educational systems, the communication and equipment, the physical space and the teachers; All of them interacting with each other give rise to what is called educational technology management. These elements contribute to have a very specific knowledge of the equipment of communications, networks and computer equipment, systems and content repositories. This is intended to establish the importance of knowing a global environment in the transfer of knowledge in poor countries, so that it does not diminish the capacity to be authentic and preserve their cultures, their languages or dialects, their hierarchies and real needs; In short, to respect the customs of different towns, villages or cities that are intended to be reached through the use of internationally agreed professional educational technologies. The methodology used in this research is the analytical - descriptive, which allows to explain each of the variables, which in our opinion must be taken into account, in order to achieve an optimal incorporation of the educational technology in a model that gives results in a medium term. The idea is that in an encompassing way the concepts will be integrated to others with greater coverage until reaching macro concepts that are of national coverage in the countries and that are elements of conciliation in the different federal and international reforms. At the center of the model is the educational technology which is directly related to the concepts that are contained in factors such as the educational system, communication and equipment, spaces and teachers, which are globally immersed in macro concepts Cognitive inequality, economics, food and language. One of the major contributions of this article is to leave this idea under an algorithm that allows to be as unbiased as possible when evaluating this indicator, since other indicators that are to be taken from international preference entities like the OECD in the area of education systems studied, so that they are not influenced by particular political or interest pressures. This work opens the way for a relationship between involved entities, both conceptual, procedural and human activity, to clearly identify the convergence of their impact on the problem of education and how the relationship can contribute to an improvement, but also shows possibilities of being able to reach a comprehensive education reform for all.

Keywords: relationships macro-concepts, cognitive inequality, economics, alimentation and language

Procedia PDF Downloads 190

Authors: Paola Millare, Nelinda Catherine Pangilinan

Abstract:

Background and Aim: Cervical cancer is the most commonly diagnosed gynecological malignancy during pregnancy. Owing to the rarity of the disease, and the complexity of all factors that have to be taken into consideration, standardization of treatment is very difficult. Cervical cancer is the second most common malignancy among women. The treatment of cancer during pregnancy is most challenging in the case of cervical cancer, since the pregnant uterus itself is affected. This report aims to present a case of cervical cancer in a pregnant woman and how to manage this case and several issues accompanied with it. Methods: This is a case of a 28 year-old, Gravida 4 Para 2 (1111), who presented with watery to mucoid, whitish, non-foul smelling and increasing in amount. Internal examination revealed normal external genitalia, parous outlet, cervix was transformed into a fungating mass measuring 5x4 cm, with left parametrial involvement, body of uterus was enlarged to 24 weeks size, no adnexal mass or tenderness. She had cervical punch biopsy, which revealed, adenocarcinoma, well-differentiated cervical tissue. Standard management for cases with stage 2B cervical carcinoma was to start radiation or radical hysterectomy. In the case of patients diagnosed with cervical cancer and currently pregnant, these kind of management will result to fetal loss. The patient still declined the said management and opted to delay the treatment and wait for her baby to reach at least term and proceed to cesarean section as route of delivery. Results: The patient underwent an elective cesarean section at 37th weeks age of gestation, with an outcome of a term, live baby boy APGAR score 7,9 birthweight 2600 grams. One month postpartum, the patient followed up and completed radiotherapy, chemotherapy and brachytherapy. She was advised to go back after 6 months for monitoring. On her last check up, an internal examination was done which revealed normal external genitalia, vagina admits 2 fingers with ease, there is a palpable fungating mass at the cervix measuring 2x2 cm. A repeat gynecologic oncologic ultrasound was done revealing cervical mass, endophytic, grade 1 color score with stromal invasion 35% post radiation reactive lymph nodes with intact paracolpium, pericervical, and parametrial involvement. The patient was then advised to undergo pelvic boost and for close monitoring of the cervical mass. Conclusion: Cervical cancer in pregnancy is rare but is a dilemma for women and their physicians. Treatment should be multidisciplinary and individualized following careful counseling. In this case, the treatment was clearly on the side of preventing the progression of cervical cancer while she is pregnant, however due to ethical reasons, the management deviates on the right of the patient to decide for her own health and her unborn child. The collaborative collection of data relating to treatment and outcome is strongly encouraged.

Keywords: cancer, cervical, ethical, pregnancy

Procedia PDF Downloads 231

Authors: Seemabahen Dave, Maria Varua, Basant Maheshwari, Roger Packham

Abstract:

The declining groundwater levels and quality are acknowledged to be affecting the well-being of farmers especially those located in the semi-arid regions where groundwater is the only source of water for domestic and agricultural use. Further, previous studies have identified the need to examine the quality of life of farmers beyond economic parameters and for a shift in setting rural development policy goals to the perspective of beneficiaries. To address these gaps, this paper attempts to ascertain the subjective wellbeing of farmers from two semi-arid regions of India. The study employs the integrated conceptual framework for the assessment of individual and regional subjective wellbeing developed by Larson in 2009 at Australia. The method integrates three domains i.e. society, natural environment and economic services consisting of 37 wellbeing factors. The original set of 27 revised wellbeing factors identified by John Ward is further revised in current study to make it more region specific. Generally, researchers in past studies select factors of wellbeing based on literature and assign the weights arbitrary. In contrast, the present methodology employs a unique approach by asking respondents to identify the factors most important to their wellbeing and assign weights of importance based on their responses. This method minimises the selection bias and assesses the wellbeing from farmers’ perspectives. The primary objectives of this study are to identify key wellbeing attributes and to assess the influence of groundwater on subjective wellbeing of farmers. Findings from 507 farmers from 11 villages of two watershed areas of Rajasthan and Gujarat, India chosen randomly and were surveyed using a structured face-to-face questionnaire are presented in this paper. The results indicate that significant differences exist in the ranking of wellbeing factors at individual, village and regional levels. The top five most important factors in the study areas include electricity, irrigation infrastructure, housing, land ownership, and income. However, respondents are also most dissatisfied with these factors and correspondingly perceive a high influence of groundwater on them. The results thus indicate that intervention related to improvement of groundwater availability and quality will greatly improve the satisfaction level of well-being factors identified by the farmers.

Keywords: groundwater, farmers, semi-arid regions, subjective wellbeing

Procedia PDF Downloads 249

Authors: Balasooriya B. M. C. M., Sujeeva N., Thowfeek Z., Siddiqa Omo, Liyanagunawardana J. E., Jayawardana Saiu, Manathunga S. S., Katulanda G. W.

Abstract:

Introduction and objectives: Adrenal venous sampling (AVS) is the gold standard to discriminate unilateral primary aldosteronism (UPA) from bilateral disease (BPA). AVS is technically demanding and only performed in a limited number of centers worldwide. To the best of our knowledge, Except for one study conducted in India, no other research studies on this area have been conducted in South Asia. This study aimed to evaluate the effectiveness of AVS in the management of primary aldosteronism. Methods: A total of 32 patients who underwent AVS at the National Hospital of Sri Lanka from April 2021 to April 2023 were enrolled. Demographic, clinical and laboratory data were obtained retrospectively. A procedure was considered successful when adequate cannulation of both adrenal veins was demonstrated. Cortisol gradient across the adrenal vein (AV) and the peripheral vein was used to establish the success of venous cannulation. Lateralization was determined by the aldosterone gradient between the two sides. Continuous and categorical variables were summarized with mean, SD, and proportions, respectively. The mean and standard deviation of the contralateral suppression index (CSI) were estimated with an intercept-only Bayesian inference model. Results: Of the 32 patients, the average age was 52.47 +26.14 and 19 (59.4%) were males. Both AVs were successfully cannulated in 12 (37.5%). Among them, lateralization was demonstrated in 11(91.7%), and one was diagnosed as a bilateral disease. There were no total failures. Right AV cannulation was unsuccessful in 18 (56.25%), of which lateralization was demonstrated in 9 (50%), and others were inconclusive. Left AV cannulation was unsuccessful only in 2 (6.25%); one was lateralized, and the other remained inconclusive. The estimated mean of the CSI was 0.33 (89% credible interval 0.11-0.86). Seven patients underwent unilateral adrenalectomy and demonstrated significant improvement in blood pressure during follow-up. Two patients await surgery. Others were treated medically. Conclusions: Despite failure due to procedural difficulties, AVS remained useful in the management of patients with PA. Moreover, the success of the procedure needs experienced hands and advanced equipment to achieve optimal outcomes in PA.

Keywords: adrenal venous sampling, lateralization, contralateral suppression index, primary aldosteronism

Procedia PDF Downloads 53

Authors: Evangelos Kaisar, Anika Tabassum, Taraneh Ardalan, Majed Al-Ghandour

Abstract:

The economy of any country is dependent on its ability to accommodate the movement and delivery of goods. The demand for goods movement and services increases truck traffic on highways and inside the cities. The livability of most cities is directly affected by the congestion and environmental impacts of trucks, which are the backbone of the urban freight system. Better operation of heavy vehicles on highways and arterials could lead to the network’s efficiency and reliability. In many cases, roundabouts can respond better than at-level intersections to enable traffic operations with increased safety for both cars and heavy vehicles. Recently emerged, the concept of turbo-roundabout is a viable alternative to the two-lane roundabout aiming to improve traffic efficiency. The primary objective of this study is to evaluate the operation and performance level of an at-grade intersection, a conventional two-lane roundabout, and a basic turbo roundabout for freight movements. To analyze and evaluate the performances of the signalized intersections and the roundabouts, micro simulation models were developed PTV VISSIM. The networks chosen for this analysis in this study are to experiment and evaluate changes in the performance of the movement of vehicles with different geometric and flow scenarios. There are several scenarios that were examined when attempting to assess the impacts of various geometric designs on vehicle movements. The overall traffic efficiency depends on the geometric layout of the intersections, which consists of traffic congestion rate, hourly volume, frequency of heavy vehicles, type of road, and the ratio of major-street versus side-street traffic. The traffic performance was determined by evaluating the delay time, number of stops, and queue length of each intersection for varying truck percentages. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. More specifically, it is clear that two-lane roundabouts are seen to have shorter queue lengths compared to signalized intersections and turbo-roundabouts. For instance, considering the scenario where the volume is highest, and the truck movement and left turn movement are maximum, the signalized intersection has 3 times, and the turbo-roundabout has 5 times longer queue length than a two-lane roundabout in major roads. Similarly, on minor roads, signalized intersections and turbo-roundabouts have 11 times longer queue lengths than two-lane roundabouts for the same scenario. As explained from all the developed scenarios, while the traffic demand lowers, the queue lengths of turbo-roundabouts shorten. This proves that turbo roundabouts perform well for low and medium traffic demand. The results indicate that turbo-roundabouts can replace signalized intersections and two-lane roundabouts only when the traffic demand is low, even with high truck volume. Finally, this study provides recommendations on the conditions under which different intersections perform better than each other.

Keywords: At-grade intersection, simulation, turbo-roundabout, two-lane roundabout

Procedia PDF Downloads 134

Authors: Merertu Wakuma Rundassa

Abstract:

Global competition and rapidly changing customer requirements are forcing major changes in the production styles and configuration of manufacturing organizations. Increasingly, traditional centralized and sequential manufacturing planning, scheduling, and control mechanisms are being found insufficiently flexible to respond to changing production styles and highly dynamic variations in product requirements. The traditional approaches limit the expandability and reconfiguration capabilities of the manufacturing systems. Thus many business houses face increasing pressure to lower production cost, improve production quality and increase responsiveness to customers. In a textile and apparel manufacturing, globalization has led to increase in competition and quality awareness and these industries have changed tremendously in the last few years. So, to sustain competitive advantage, companies must re-examine and fine-tune their business processes to deliver high quality goods at very low costs and it has become very important for the textile and apparel industries to integrate themselves with information technology to survive. IT can create competitive advantages for companies to improve coordination and communication among trading partners, increase the availability of information for intermediaries and customers and provide added value at various stages along the entire chain. Ethiopia is in the process of realizing its potential as the future sourcing location for the global textile and garments industry. With a population of over 90 million people and the fastest growing non-oil economy in Africa, Ethiopia today represents limitless opportunities for international investors. For the textile and garments industry Ethiopia promises a low cost production location with natural resources such as cotton to enable the setup of vertically integrated textile and garment operation. However; due to lack of integration of their business activities textile and apparel industry of Ethiopia faced a problem in that it can‘t be competent in the global market. On the other hand the textile and apparel industries of other countries have changed tremendously in the last few years and globalization has led to increase in competition and quality awareness. So the aim of this paper is to study the trend of Ethiopian Textile and Apparel Industry on the application of different IT system to integrate them in the global market.

Keywords: information technology, business integrity, textile and apparel industries, Ethiopia

Procedia PDF Downloads 346

Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz

Abstract:

In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.

Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes

Procedia PDF Downloads 206

Authors: Fatemeh Abdollahi, Munn-Sann Lye, Jamshid Yazdani Charati, Mehran Zarghami

Abstract:

Fathers are at risk of depression during the postpartum period. Some studies have been reported maternal depression is the key predictor of paternal postpartum depression (PPD). This study aimed to estimate the prevalence and predictors of parental PPD and its association with maternal PPD. In a cross-sectional study, via a stratified random and convenience sampling method, participants referring to health centers during 2-8 weeks postpartum were recruited from March to October 2017. Paternal PPD and its relation to maternal PPD and other related factors were assessed using multiple logistic regression. Participants were 591 literate couples who referred to Mazandaran province primary health centers during to study period. Couples were screened for depression using Edinburgh Postnatal Depression Scale (EPDS). Fathers provided information on socio-demographic characteristics, life events, neonatal stressor, perceived stress (Perceived Stress Scale), social support (Multidimensional Scale of Perceived Social Support), and general health status using General Health Questionnaire (GHQ) as well. Data on mothers ‘demographic characteristics and obstetrics factors was also gathered. Overall, 93 fathers (15.7%) and 188 mothers (31.8%) reported depressive symptoms above the cut-off EPDS score of 12. In the multiple logistic regression model, older age [OR=1.20, (95%CI: 1.05- 1.36)], maternal depressive symptoms [OR=1.15, (95%CI: 1.04-1.27)], higher GHQ scores [OR=1.21, (95%CI: 1.11-1.33)] and increased recent life events [OR=1.42, (95%CI: 1.01-1.2.00)] were related to paternal PPD. A significant inverse association was found between number of children and paternal PPD [OR=0.20, (95%CI: 0.07-0.53)]. Depressive symptoms, especially in first-time fathers following the birth of a child, are not uncommon. Maternal depressive symptoms and paternal well-being were strong predictors of parental PPD. Creating opportunities for men to access special health care services, parental education to help adapting to parenthood, screening programs, and psychiatric/psychosocial interventions to decrease the suffering of depression for both depressed parents are recommended.

Keywords: depression, men, postpartum, risk factors, women

Procedia PDF Downloads 73

Authors: Agnieszka A. Malinowska, R. Hejmanowski

Abstract:

A number of European cities are strongly affected by ground movements caused by anthropogenic activities or post-anthropogenic metamorphosis. Those are mainly water pumping, current mining operation, the collapse of post-mining underground voids or mining-induced earthquakes. These activities lead to large and small-scale ground displacements and a ground ruptures. The ground movements occurring in urban areas could considerably affect stability and safety of structures and infrastructures. The complexity of the ground deformation phenomenon in relation to the structures and infrastructures vulnerability leads to considerable constraints in assessing the threat of those objects. However, the increase of access to the free software and satellite data could pave the way for developing new methods and strategies for environmental risk mitigation and management. Open source geographical information systems (OS GIS), may support data integration, management, and risk analysis. Lately, developed methods based on fuzzy logic and experts methods for buildings and infrastructure damage risk assessment could be integrated into OS GIS. Those methods were verified base on back analysis proving their accuracy. Moreover, those methods could be supported by ground displacement observation. Based on freely available data from European Space Agency and free software, ground deformation could be estimated. The main innovation presented in the paper is the application of open source software (OS GIS) for integration developed models and assessment of the threat of urban areas. Those approaches will be reinforced by analysis of ground movement based on free satellite data. Those data would support the verification of ground movement prediction models. Moreover, satellite data will enable our mapping of ground deformation in urbanized areas. Developed models and methods have been implemented in one of the urban areas hazarded by underground mining activity. Vulnerability maps supported by satellite ground movement observation would mitigate the hazards of land displacements in urban areas close to mines.

Keywords: fuzzy logic, open source geographic information science (OS GIS), risk assessment on urbanized areas, satellite interferometry (InSAR)

Procedia PDF Downloads 153

Authors: Andy S.K. Cheng, Samuel Leung, Cindy Kwok, Hector Tsang

Abstract:

Background: Telephone counselling is one of the essential interventions that can be found in most of the Employee Assistance Programs (EAP). The purposes of this study were to (1) explore the trend of the telephone counselling from 2003-2016 in Hong Kong; (2) explore which EAP issue requires more follow-up; and 3) examine the relationship between the EAP issues and demographic data such as gender and job ranking. Method: Date of EAP services usage was collected from EAP providers in Hong Kong during 2003-2016. EAP issues were categorized into two domains, namely workplace issues and personal issues. Each domain has 12 sub-categories. Two hypotheses were formulated in this study (1) there was a gender difference in EAP issues and the follow-up hours; and (2) there was a significant difference between job ranking, EAP issues and follow-up hours. Results: A total of eight hundred and ninety-three valid cases were identified for analysis. Of them, three hundred and forty-three cases sought for follow-up. The duration of follow-up by hours was calculated for each of the follow-up cases. The results of the study shows that the top three workplace issues that required the longest duration of follow-up were (1) workload, (2) supervisor-subordinate relationship; and (3) team member’s relationship. On the other hand, the top three personal issues that required the longest duration of follow-up were (1) parenting/parent-child relationship, (2) family care, and (3) marital relationship. Two-way ANOVA was performed to compare the total follow-up hours (excluding first intake) between gender and EAP issues. There was no statistical significance for gender (p =.891), but a statistically significant main effect for EAP issues (p <.001) was found. Post-hoc analysis (Tukey’s test) showed that total follow-up hour in personal issues was statistically significant higher than that in handling workplace issues (p <.001). However, there was no statistically significant interaction effect between gender and EAP issues (p=.879) and between job ranking and EAP issues (p=.843). Conclusion: Telephone counselling is a very common intervention in addressing EAP issues arising from workplace and personal level in Hong Kong. It was frequently used to handle interpersonal relationships and the service usage was independent of gender and job ranking.

Keywords: employee assistance program, follow-up time, interpersonal relationships, telephone counselling

Procedia PDF Downloads 207

Authors: Semaw A., Awet H., Yohannes M.

Abstract:

Background: Hepatitis B Virus (HBV) is a major global public health problem. Individuals living in Sub-Sahara Africa have 60% lifetime risk of acquiring HBV infection. Evidences showed that 80-90% of those born from infected mothers developed chronic HBV. Perinatal HBV transmission is a major determinant of HBV carrier status, its chronic squeal and maintains HBV transmission across generations. Method: Institution based cross-sectional study was conducted among 406 pregnant mothers attending Antenatal clinics at Mekelle and Ayder referral hospital from January 30 to April 1/2014. Epidata version 3.1 was used for data entry and SPSS version 21 statistical software was used for data cleaning, management and finally determine associated factors of hepatitis B surface antigen adjusting important confounders using multivariable logistic regression analysis at 5% level of significance. Result: The overall prevalence of hepatitis B surface antigen among pregnant women was 33 (8.1%). The socio-demographic characteristic of the study population showed that there is high positivity among secondary school 189 (46.6%). In the multivariable logistic regression analysis, history of a contact with individuals who had history of hepatitis B infection or jaundice and lifetime number of multiple sexual partners were found to be significantly associated with HBsAg positivity at AOR = 3.73 95%C.I (1.373-10.182) and AOR = 2.57 95%C.I (1.173-5.654), respectively. Moreover, Human Immunodeficiency Virus (HIV) and HBV confection rate was found 3.6%. Conclusion: This study has shown that HBV prevalence in pregnant women is highly prevalent (8.1%) in the study area. Contact with individuals who had a history of hepatitis or have jaundice and report of multiple lifetime sexual partnership were associated with hepatitis B infection. Education about HBV transmission and prevention as well as screening all pregnant mothers shall be sought to reduce the serious public health crisis of HBV.

Keywords: HBsAg, hepatitis B, pregnant women, prevalence

Procedia PDF Downloads 328

Authors: A. Rezazadeh, B Damari, S. Riazi-Esfahani, M. Hajian

Abstract:

The consumption of junk food in Iran is alarmingly increasing. This study aimed to investigate the influencing factors of junk food consumption and amendable interventions that are criticized and approved by stakeholders, in order to presented to health policy makers. The articles and documents related to the content of study were collected by using the appropriate key words such as junk food, carbonated beverage, chocolate, candy, sweets, industrial fruit juices, potato chips, French fries, puffed corn, cakes, biscuits, sandwiches, prepared foods and popsicles, ice cream, bar, chewing gum, pastilles and snack, in scholar.google.com, pubmed.com, eric.ed.gov, cochrane.org, magiran.com, medlib.ir, irandoc.ac.ir, who.int, iranmedex.com, sid.ir, pubmed.org and sciencedirect.com databases. The main key points were extracted and included in a checklist and qualitatively analyzed. Then a summarized abstract was prepared in a format of a questionnaire to be presented to stakeholders. The design of this was qualitative (Delphi). According to this method, a questionnaire was prepared based on reviewing the articles and documents and it was emailed to stakeholders, who were asked to prioritize and choose the main problems and effective interventions. After three rounds, consensus was obtained.            Studies revealed high consumption of junk foods in the Iranian population, especially in children and adolescents. The most important affecting factors include availability, low price, media advertisements, preference of fast foods taste, the variety of the packages and their attractiveness, low awareness and changing in lifestyle. Main interventions recommended by stakeholders include developing a protective environment, educational interventions, increasing healthy food access and controlling media advertisements and putting pressure from the Industry and Mining Ministry on producers to produce healthy snacks. According to the findings, the results of this study may be proposed to public health policymakers as an advocacy paper and to be integrated in the interventional programs of Health and Education ministries and the media. Also, implementation of supportive meetings with the producers of alternative healthy products is suggested.

Keywords: junk foods, situation, qualitative study, Iran

Procedia PDF Downloads 241

Authors: Nyimas Annissa Mutiara Andini

Abstract:

There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

Procedia PDF Downloads 268

Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

Abstract:

Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

Procedia PDF Downloads 151

Authors: Yuliya Kovalenko

Abstract:

Given the social nature of people, it is interesting to explore strategies of responding to psycho-traumatic situations in individuals of different ethnic and religious identity. This would allow to substantially expand the idea of human behavior in general, and coping behavior, in particular. This paper investigated the weighted impact of ethnic and religious identities on the patterns of coping behavior. This cross-cultural research empirically revealed intergroup differences in coping strategies and behavior in the samples of young students and teachers of different ethnic identities (Egyptians N=216 and Ukrainians N=109) and different religious identities (Egyptian Muslims N=147 and Christians, including Egyptian Christians N=68 and Ukrainian Christians N = 109). The empirical data were obtained using the questionnaires SACS and COPE. Statistical analysis and interpretation of the results were performed with IBM SPSS-23.0. It was found that, compared to the religious identity, the ethnic identity of the subjects appeared more predictive of coping behavior. It was shown that the constant exchange of information and the unity of biological and social contributed to a more homogeneous picture in the society where Christians and Muslims were integrated into a single cultural space. It was concluded that depending on their ethnic identity, individuals would form a specific hierarchy of coping strategies resulting in a specific pattern of coping with certain stressors. The Egyptian subjects revealed the following pattern of coping with various kinds of academic stress: 'seeking social support', 'problem solving', 'adapting', 'seeking information'. The coping pattern demonstrated by the Ukrainian subjects could be presented as 'seeking information', 'adapting', 'seeking social support', 'problem solving'. There was a tendency in the group of Egyptians to engage in more collectivist coping strategies (with the predominant coping strategy 'religious coping'), in contrast to the Ukrainians who displayed more individualistic coping strategies (with 'planning' and 'active coping' as the mostly used coping strategies). At the same time, it was obvious that Ukrainians should not be unambiguously attributed to the individualistic coping behavior due to their reliance on 'seeking social support' and 'social contact'. The final conclusion was also drawn from the peculiarities of developing religious identity, including religiosity, in Egyptians (formal religious education of both Muslims and Christians) and Ukrainians (more spontaneous process): Egyptians seem to learn to resort to the religious coping, which could be an indication that, in principle, it is possible and necessary to train individuals in desirable coping behavior.

Keywords: coping behavior, cross-cultural research, ethnic and religious identity, hierarchical pattern of coping

Procedia PDF Downloads 151

Authors: Njoroge Margaret W., Johnson Deborah

Abstract:

Gender-specific risk factors for common mental disorders that disproportionately affect women include but are not limited to gender-based violence, socioeconomic disadvantage, sociocultural factors and unrelenting responsibility for the care of others. The overall objective of this study was to assess mental health conditions and their risk factors among women in Garissa County, Kenya. The study adopted both quantitative and qualitative research designs. The study participants were 100 adult women and 20 key informants from different sectors in the region. Data was collected using DSM-5 (PCL-5) and Kessler Psychological Distress, interviews schedule and focus group discussions. Analysis of quantitative data was done using univariate analysis, while qualitative data was analyzed using thematic analysis. The results revealed that about 60% of women presented with moderate to severe psychological distress (PD), while 53% presented with PTSD. Additionally, women who have undergone female genital mutilation had higher PTSD and PD scores. They also presented with low self-esteem, depressive symptoms, sex anxiety, avoidance of reminders and intrusive memories of the event, especially those who developed fistula. The risk factors for poor mental health outcomes include lack of awareness/knowledge of mental health, retrogressive cultural practices (child marriage and female genital mutilation), as well as beliefs about the causes of mental disorders. The study also established that people with mental illness are neglected, abused and stigmatized. Preferred treatment approaches include prayers and the use of witch doctors and traditional healers. The study recommends gendered and culturally responsive interventions geared towards increasing community awareness and knowledge on mental health, reducing stigma and improving mental-health-seeking behaviors for women and girls in the region. Supported by the Ministry of Health, the approach should be spearheaded by trained community lay counselors.

Keywords: women, mental health conditions, cultural beliefs/practices, stigma, poverty, psychological distress, PTSD

Procedia PDF Downloads 36

Authors: Thea Freese, Michael Gille, Andrew Hursthouse, John Struthers

Abstract:

Ship operators on the North and Baltic Sea have been experiencing increased political interest in marine environmental protection and cleaner vessel operations. Stricter legislation on SO2 and NOx emissions, ballast water management and other measures of protection are currently being phased in or will come into force in the coming years. These measures benefit the health of the marine environment, while increasing company’s operational costs. In times of excess shipping capacity and linked consolidation in the industry non-compliance with environmental rules is one way companies might hope to stay competitive with both intra- and inter-modal trade. Around 5-15% of industry participants are believed to neglect laws on vessel-source pollution willingly or unwillingly. Exploratory in-depth interviews conducted with 12 experts from various stakeholder groups informed the researchers about variables influencing compliance levels, including awareness and apprehension, willingness to comply, ability to comply and effectiveness of controls. Semi-structured expert interviews were evaluated using qualitative content analysis. A model of determinants of compliance was developed and is presented here. While most vessel operators endeavour to achieve full compliance with environmental rules, a lack of availability of technical solutions, expediency of implementation and operation and economic feasibility might prove a hindrance. Ineffective control systems on the other hand foster willing non-compliance. With respect to motivations, lacking time, lacking financials and the absence of commercial advantages decrease compliance levels. These and other variables were inductively developed from qualitative data and integrated into a model on environmental compliance. The outcomes presented here form part of a wider research project on economic effects of maritime environmental legislation. Research on determinants of compliance might inform policy-makers about actual behavioural effects of shipping companies and might further the development of a comprehensive legal system for environmental protection.

Keywords: compliance, marine environmental protection, exploratory qualitative research study, clean vessel operations, North and Baltic Sea area

Procedia PDF Downloads 371

Authors: Orly Sela

Abstract:

The lecture discusses a Language Teaching program in a Teacher Education College in northern Israel. An on-line course was added to the program in order to keep on-campus attendance at a minimum, thus allowing the students to keep their full-time jobs in school. In addition, the use of educational technology to allow students to study anytime anywhere, in keeping with 21st-century innovative teaching-learning practices, was also an issue, as was the wish for this course to serve as a model which the students could then possibly use in their K-12 teaching. On the other hand, there were strong considerations against including an online course in the program. The students in the program were mostly Israeli-Arab married women with young children, living in a traditional society which places a strong emphasis on the place of the woman as a wife, mother, and home-maker. In addition, as teachers, they used much of their free time on school-related tasks. Having careers at the same time as studying was ground-breaking for these women, and using their time at home for studying rather than taking care of their families may have been simply too much to ask of them. At the end of the course, feedback was collected through an online questionnaire including both open and closed questions. The data collected shows that the students believed in online teaching-learning in principle, but had trouble implementing it in practice. This evidence raised the question of whether or not such a course should be included in a graduate program for mature, professional students, particular women with families living in a traditional society. This issue is not relevant to Israel alone, but also to academic institutions worldwide serving such populations. The lecture discusses this issue, sharing the researcher’s conclusions with the audience. Based on the evidence offered, it is the researcher’s conclusion that online education should, indeed, be offered to such audiences. However, the courses should be designed with the students’ special needs in mind, with emphasis placed on initial planning and course organization based on acknowledgment of the teaching context; modeling of online teaching/learning suited for in-service teacher education, and special attention paid to social-constructivist aspects of learning.

Keywords: course design, in-service teacher-education, mature students, online teaching/learning

Procedia PDF Downloads 223

Authors: Sabin Aslam, Sultan Habibullah Khan, James G. Thomson, Abhaya M. Dandekar

Abstract:

Losses due to viral diseases are posing a serious threat to crop production. A quick breakdown of resistance to viruses like Cotton Leaf Curl Virus (CLCuV) demands the application of a proficient technology to engineer durable resistance. Gene stacking has recently emerged as a potential approach for integrating multiple genes in crop plants. In the present study, recombinase technology has been used for site-specific gene stacking. A target vector (pG-Rec) was designed for engineering a predetermined specific site in the plant genome whereby genes can be stacked repeatedly. Using Agrobacterium-mediated transformation, the pG-Rec was transformed into Coker-312 along with Nicotiana tabacum L. cv. Xanthi and Nicotiana benthamiana. The transgene analysis of target lines was conducted through junction PCR. The transgene positive target lines were used for further transformations to site-specifically stack two genes of interest using Bxb1 and PhiC31 recombinases. In the first instance, Cas9 driven by multiplex gRNAs (for Rep gene of CLCuV) was site-specifically integrated into the target lines and determined by the junction PCR and real-time PCR. The resulting plants were subsequently used to stack the second gene of interest (AVP3 gene from Arabidopsis for enhancing cotton plant growth). The addition of the genes is simultaneously achieved with the removal of marker genes for recycling with the next round of gene stacking. Consequently, transgenic marker-free plants were produced with two genes stacked at the specific site. These transgenic plants can be potential germplasm to introduce resistance against various strains of cotton leaf curl virus (CLCuV) and abiotic stresses. The results of the research demonstrate gene stacking in crop plants, a technology that can be used to introduce multiple genes sequentially at predefined genomic sites. The current climate change scenario highlights the use of such technologies so that gigantic environmental issues can be tackled by several traits in a single step. After evaluating virus resistance in the resulting plants, the lines can be a primer to initiate stacking of further genes in Cotton for other traits as well as molecular breeding with elite cotton lines.

Keywords: cotton, CRISPR/Cas9, gene stacking, genome editing, recombinases

Procedia PDF Downloads 137

Authors: Stelvin Sebastian, Andriya Annie Tom, Joyalanna Babu, Merin Joshy

Abstract:

Introduction: The worldwide increase in the use of antibiotics in poultry and livestock industry to treat and prevent bacterial diseases and as growth promoters in feeds has led to the problem of development of antibiotic resistance both in animals and human population. Aim: To study the pattern of antibiotic use and prevalence of multidrug-resistant Escherichia coli in poultry chickens in selected farms in Muvattupuzha and to compare the spread of multidrug-resistant bacteria from poultry environment to UTI patients. Methodology: Two farms from each of 6 localities in Muvattupuzha were selected. A questionnaire on the pattern of antibiotic use and various farming practices were surveyed from farms. From each farm, 60samples of fresh fecal matter, litter from inside, litter from the outside shed, agricultural soil and control soil were collected, and antimicrobial susceptibility testing of E. coli was done. Antibiogram of UTI patients was collected from the secondary care hospital included in the study, and those were compared with resistance patterns of poultry samples. Results: From survey response antibiotics such as ofloxacin, enrofloxacin, levofloxacin, ciprofloxacin, colistin, ceftriaxone, neomycin, cephalexin, and oxytetracycline were used for treatment and prevention of infections in poultry. 31of 48 samples (51.66%) showed E. coli growth. 7 of 15 antibiotics (46.6%) showed resistance. Ampicillin, amoxicillin, meropenem, tetracycline showed 100% resistance to all samples. Statistical analysis confirmed similar resistance pattern in the poultry environment and UTI patients for antibiotics such as ampicillin, amoxicillin, amikacin, and ofloxacin. Conclusion: E. coli were resistant not only to extended-spectrum beta-lactams but also to carbapenems, which may be disseminated to the environment where litter was used as manure. This may due to irrational use of antibiotics in chicken or from their use in poultry feed as growth promoters. The study concludes the presence of multidrug-resistant E.coli in poultry and its spread to environment and humans, which may cause potentially serious implications for human health.

Keywords: multidrug resistance, escherichia coli, urinary tract infection, poultry

Procedia PDF Downloads 139

Authors: Urasri Imsomboon, Sopita Areerob, Kanchaporn Kongchauy, Tuchapong Ngarmukos

Abstract:

Objective: The Trans-telephonic Electrocardiography (ECG) monitoring is used to diagnose of infrequent cardiac arrhythmias and improve outcome of early detection and treatment on suspected cardiac patients. The objectives of this study were to explore incidence of cardiac arrhythmia using Trans-Telephonic and to explore time to first symptomatic episode and documented cardiac arrhythmia in outpatients. Methods: Descriptive research study was conducted between February 1, 2016, and December 31, 2016. A total of 117 patients who visited outpatient clinic were purposively selected. Research instruments in this study were the personal data questionnaire and the record form of incidence of cardiac arrhythmias using Trans-Telephonic ECG recorder. Results: A total of 117 patients aged between 15-92 years old (mean age 52.7 ±17.1 years), majority of studied sample was women (64.1%). The results revealed that 387 ECGs (Average 2.88 ECGs/person, SD = 3.55, Range 0 – 21) were sent to Cardiac Monitoring Center at Coronary Care Unit. Of these, normal sinus rhythm was found mostly 46%. Top 5 of cardiac arrhythmias were documented at the time of symptoms: sinus tachycardia 43.5%, premature atrial contraction 17.7%, premature ventricular contraction 14.3%, sinus bradycardia 11.5% and atrial fibrillation 8.6%. Presenting symptom were tachycardia 94%, palpitation 83.8%, dyspnea 51.3%, chest pain 19.6%, and syncope 14.5%. Mostly activities during symptom were no activity 64.8%, sleep 55.6% and work 25.6%.The mean time until the first symptomatic episode occurred on average after 6.88 ± 7.72 days (median 3 days). The first documented cardiac arrhythmia occurred on average after 9 ± 7.92 days (median 7 day). The treatments after patients known actual cardiac arrhythmias were observe themselves 68%, continue same medications 15%, got further investigations (7 patients), and corrected causes of cardiac arrhythmias via invasive cardiac procedures (5 patients). Conclusion: Trans-telephonic: portable ECGs recorder is effective in the diagnosis of suspected symptomatic cardiac arrhythmias in outpatient clinic.

Keywords: cardiac arrhythmias, diagnosis, outpatient clinic, trans-telephonic: portable ECG recorder

Procedia PDF Downloads 186