Search results for: terms and concepts

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

Abstract:

Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

Procedia PDF Downloads 89

Authors: Violina Angelova, Krasimir Ivanov, Stefan Krustev, Dimitar Dimitrov

Abstract:

Availability of a metal is characterised by its quantity transgressing from soil into different extractants or by its content in plants. In literature, the terms 'available forms of compounds' and 'mobile' are often considered as equivalents of the term 'accessible' to plants. Rapid and a sufficiently reliable method for defining the accessible for plants forms turns out to be their extraction through different extractants, imitating the functioning of the root system. As a criterion for the pertinence of the extractant to this purpose usually serves the significant statistic correlation between the extracted quantities of the element from soil and its content in plants. The aim of this work was to evaluate the effectiveness of various extractions (DTPA-TEA, AB-DTPA, Mehlich 3, 0.01 M CaCl₂, 1M NH₄NO₃) for the determination of bioavailability of heavy metals in industrially polluted soils from the metallurgical activity near Plovdiv and Kardjali, Bulgaria. Quantity measurements for contents of heavy metals were performed with ICP-OES. The results showed that extraction capacity was as follows: Mehlich 3>ABDTPA>DTPA-TEA>CaCl₂>NaNO₃. The content of the mobile form of heavy metals depends on the nature of metal ion, the nature of extractant and pH. The obtained results show that CaCl₂ extracts a greater quantity of mobile forms of heavy metals than NH₄NO₃. DTPA-TEA and AB-DTPA are capable of extracting from the soil not only the heavy metals participating in the exchange processes but also the heavy metals bound in carbonates and organic complexes, as well as bound and occluded in oxide and secondary clay minerals. AB-DTPA extracts a bit more heavy metals than DTPA-TEA. The darker color of the solutions obtained with AB-DTPA indicates that considerable quantities organic matter are being destructed. A comparison of the mobile forms of heavy metals extracted from clean and highly polluted soils has revealed that in the polluted soils the greater portion of heavy metals exists in a mobile form. High correlation coefficients are obtained between the metals extracted with different extractants and their total content in soil (r=0.9). A positive correlation between the pH, soil organic matter and the extracted quantities of heavy metals has been found. The results of correlation analysis revealed that the heavy metals extracted by DTPA-TEA, AB-DTPA, Mehlich 3, CaCl₂ and NaNO₃ correlated significantly with plant uptake. Significant correlation was found between DTPA-TEA, AB-DTPA, and CaCl₂ with heavy metals concentration in plants. Application of extracting methods contains chelating agents would be recommended in the future research onthe availabilityof heavy metals in polluted soils.

Keywords: availability, chemical extractants, heavy metals, mobile forms

Procedia PDF Downloads 334

Authors: Lacheheb Dhia Eddine Zakaria, Ballout Amor

Abstract:

Today, it is necessary to be thrifty for its planet, on one hand the space being a rare, nonrenewable resource, and on the other hand the ecological, economic and social cost of the urban sprawl. It is commonly asserted that the promotion of a more compact and dense city has a positive effect in terms of public costs of investment, functioning and costs for the citizens and the users of the city. It is clear that the modes urban development management have to evolve profoundly, in particular towards a densification favourable to the raising of the urban quality through an ideal urban density on the scale of the individual housing estate. The lot as an individual housing estate was adopted as an alternative development model to the collective housing, thought in an anthropocentric perspective to emerge as a quality model where the density plays an important role, by being included in operations of a global coherence, in an optimal organization without forgetting the main importance of the deadlines of construction and the finalization of the works. The image of eternal construction site inflicted to our cities explains the renewed interest for the application of the regulatory framework and the completion of these limited operations without global coherence, which are summed up in our case to a ground cut in plots of land, sold then built independently without being finished, and support the relevance of the essential question of the improvement of the outside aspect bound to the appearance which can be revealed as a so important factor for a better use and a better acceptance of its housing environment, that the ratio of a number of houses on a plot of land or the number of square meters by house. To demonstrate the impact of the completion degree of the subdivision dwellings, roads system and urban public utilities on the density or the densification and therefore on the urban quality, we studied two residential subdivisions, the private subdivision Sellam and the subdivision El Imane with a common situation, and a different land surface, density and cutting, being occupied by various social classes, with different needs and different household average size. The approach of this work is based on the typo morphological analysis to reveal the differences in the degrees of completions of the subdivision’s built environment and on the investigation, by a household’s survey, to demonstrate importance of the degree of completion and to reveal the conditions of qualitative densification favourable and convenient to a better subdivision’s appropriation.

Keywords: subdivision, degree of completion, densification, urban quality

Procedia PDF Downloads 358

Authors: Masilonyane Mokhele

Abstract:

Across the world, different planning models of the so-called airport-led developments are becoming bandwagons hailed as key to the future of cities. However, in the existing knowledge, there is paucity of empirically informed description and explanation of the economic fundamentals driving the forces of attraction of airports. This void is arguably a result of the absence of an appropriate theoretical framework to guide the analyses. Given this paucity, the aim of the paper is to contribute towards a theoretical framework that could be used to describe and explain forces that drive the location and mix of airport-centric developments. Towards achieving this aim, the objectives of the paper are: one, to establish the type of economic activities that are located on and around O.R. Tambo International Airport (ORTIA), and analyse the reasons for locating there; two, to establish changes that have occurred over time in the form of the airport-centric development of ORTIA; three, to identify the propulsive economic qualities of ORTIA; four, to analyse the spatial, economic and structural linkages within the airport-centric development of ORTIA, between the airport-centric development and the airport, as well as the airport-centric development’s linkages with their metropolitan area and other regional, national and international airport-centric developments and locations. To address the objectives above, the study adopted a case study approach, centred on ORTIA in South Africa: Africa’s busiest airport in terms of passengers and airfreight handled. Using a lens of location theory, a survey was adopted as a main research method, wherein telephonic interviews were conducted with a representative number of firms on and around ORTIA. Other data collection methods encompassed in-depth qualitative interviews (to augment the information obtained through the survey) and analysis of secondary information, particularly as regards establishing changes that have occurred in the form of ORTIA and surrounds. From the empirical findings, ORTIA was discovered to have propulsive economic qualities that act as significant forces of attraction in the clustering of firms. Together with its airport-centric development, ORTIA was discovered to have growth pole properties because of the linkages that occur within the study area, and the linkages that exist between the airport-centric firms and the airport. It was noted that the transport-oriented firms (typified by couriers and freight carriers) act as anchors in some fellow airport-centric firms making use of elements of urbanisation economies, particularly as regards the use of the airport for airfreight services. The empirical findings presented in the paper (in conjunction with results from other airport-centric development case studies) could be used as contribution towards extending theory that describes and explains forces that drive the location and mix of airport-centric developments.

Keywords: airports, airport-centric development, O. R. Tambo international airport, South Africa

Procedia PDF Downloads 245

Authors: Sandra Toledo

Abstract:

There is an increasing tendency in governments for a more evidence-based policy-making and a stricter auditing of public spheres. Especially when budgets are tight, and taxpayers demand a bigger scrutiny over the use of the available resources, statistics and numbers appeared as an effective tool to produce data that supports investments done, as well as evaluating public policy performance. This pressure has not exempted the cultural and art fields. Finland like the rest of Nordic countries has kept its principles from the welfare state, whilst UK seems to be going towards the opposite direction, relaying more and more in private sectors and foundations, as the state folds back. The boom of the creative industries along with a managerial trend introduced by Tatcher in the UK brought, as a result, a commodification of arts within a market logic, where sponsorship and commercial viability were the keynotes. Finland on its part, in spite of following a more protectionist approach of arts, seems to be heading in a similar direction. Additionally, there is an international growing interest in the application of cultural participation studies and the comparability between countries in their results. Nonetheless, the standardization in the application of cultural surveys has not happened yet. Not only there are differences in the application of these type of surveys in terms of time and frequency, but also regarding those conducting them. Therefore, one hypothesis considered in this research is that behind the differences between countries in the application of cultural surveys, production and utilization of cultural statistics is the cultural policy model adopted by the government. In other words, the main goal of this research is to answer the following: What are the differences and similarities between Finland and the UK regarding the role cultural surveys have in cultural policy making? Along with other secondary questions such as: How does the cultural policy model followed by each country influence the role of cultural surveys in cultural policy making? and what are the differences at the local level? In order to answer these questions, strategic cultural policy documents and interviews with key informants will be used and analyzed as source data, using content analysis methods. Cultural statistics per se will not be compared, but instead their use as instruments of governing, and its relation to the cultural policy model. Aspects such as execution of cultural surveys, funding, periodicity, and use of statistics in formal reports and publications, will be studied in the written documents while in the interviews other elements such as perceptions from those involved in collecting cultural statistics or policy making, distribution of tasks and hierarchies among cultural and statistical institutions, and a general view will be the target. A limitation identified beforehand and that it is expected to encounter throughout the process is the language barrier in the case of Finland when it comes to official documents, which will be tackled by interviewing the authors of such papers and choosing key extract of them for translation.

Keywords: Finland, cultural statistics, cultural surveys, United Kingdom

Procedia PDF Downloads 216

Authors: Silvia Lucciarini, Antonio Corasaniti

Abstract:

The issue of democracy in capitalist countries has once again become the focus of debate in recent years. A number of socio-economic and political tensions have triggered discussion of this topic from various perspectives and disciplines. Political developments, the rise of both right-wing parties and populism and the constant growth of inequalities in a context of welfare downsizing, have led scholars to question if European capitalist countries are really capable of creating and redistributing resources and look for elements that might make democratic capital in European countries more dense. The aim of the work is to shed light on the trajectories, intensity and convergence or divergence between political and associative participation, on one hand, and organization, on the other, as these constitute two of the main points of connection between the norms, values and actions that bind citizens to the state. Using the European Social Survey database, some studies have sought to analyse degrees of unionization by investigating the relationship between systems of industrial relations and vulnerable groups (in terms of value-oriented practices or political participation). This paper instead aims to investigate the relationship between union participation and civil/political participation, comparing union members and non-members and then distinguishing between employees and self-employed professionals to better understand participatory behaviors among different workers. The first component of the research will employ a multilinear logistic model to examine a sample of 10 countries selected according to a grid that combines the industrial relations models identified by Visser (2006) and the Welfare State systems identified by Esping-Andersen (1990). On the basis of this sample, we propose to compare the choices made by workers and their propensity to join trade unions, together with their level of social and political participation, from 2002 to 2016. In the second component, we aim to verify whether workers within the same system of industrial relations and welfare show a similar propensity to engage in civil participation through political bodies and associations, or if instead these tendencies take on more specific and varied forms. The results will allow us to see: (1) if political participation is higher among unionized workers than it is among the non-unionized. (2) what are the differences in unionisation and civil/political participation between self-employed, temporary and full-time employees and (3) whether the trajectories within industrial relations and welfare models display greater inclusiveness and participation, thereby confirming or disproving the patterns that have been documented among the different European countries.

Keywords: union membership, participation, democracy, industrial relations, welfare systems

Procedia PDF Downloads 126

Authors: Ayat-Allah Bouramdane

Abstract:

Solar Photovoltaic (PV) and Concentrated Solar Power (CSP) do not burn fossil fuels and, therefore, could meet the world's needs for low-carbon power generation as they do not release greenhouse gases into the atmosphere as they generate electricity. The power output of the solar PV module and CSP collector is proportional to the temperature and the amount of solar radiation received by their surface. Hence, the determination of the most convenient locations of PV and CSP systems is crucial to maximizing their output power. This study aims to provide a hands-on and plausible approach to the multi-criteria evaluation of site suitability of PV and CSP plants using a combination of Geographic Referenced Information (GRI) and Analytic Hierarchy Process (AHP). Applying the GRI-based AHP approach is meant to specify the criteria and sub-criteria, to identify the unsuitable areas, the low-, moderate-, high- and very high suitable areas for each layer of GRI, to perform the pairwise comparison matrix at each level of the hierarchy structure based on experts' knowledge, and calculate the weights using AHP to create the final map of solar PV and CSP plants suitability in Morocco with a particular focus on the Dakhla city. The results recognize that solar irradiation is the main decision factor for the integration of these technologies on energy policy goals of Morocco but explicitly account for other factors that cannot only limit the potential of certain locations but can even exclude the Dakhla city classified as unsuitable area. We discuss the sensitivity of the PV and CSP site suitability to different aspects, such as the methodology, the climate conditions, and the technology used in each source, and provide the final recommendations to the Moroccan energy strategy by analyzing if actual Morocco's PV and CSP installations are located within areas deemed suitable and by discussing several cases to provide mutual benefits across the Food-Energy-Water nexus. The adapted methodology and conducted suitability map could be used by researchers or engineers to provide helpful information for decision-makers in terms of sites selection, design, and planning of future solar plants, especially in areas suffering from energy shortages, such as the Dakhla city, which is now one of Africa's most promising investment hubs and it is especially attractive to investors looking to root their operations in Africa and import to European markets.

Keywords: analytic hierarchy process, concentrated solar power, dakhla, geographic referenced information, Morocco, multi-criteria decision-making, photovoltaic, site suitability

Procedia PDF Downloads 151

Authors: Nicole Virgili, Marco Utili

Abstract:

The design of the Breeding Blanket in Tokamak fusion energy systems has to guarantee sufficient availability in addition to its functions, that are, tritium breeding self-sufficiency, power extraction and shielding (the magnets and the VV). All these function in the presence of extremely harsh operating conditions in terms of heat flux and neutron dose as well as chemical environment of the coolant and breeder that challenge structural materials (structural resistance and corrosion resistance). The movement and activation of fluids from the BB to the Ex-vessel components in a fusion power plant have an important radiological consideration because flowing material can carry radioactivity to safety-critical areas. This includes gamma-ray emission from activated fluid and activated corrosion products, and secondary activation resulting from neutron emission, with implication for the safety of maintenance personnel and damage to electrical and electronic equipment. In addition to the PbLi breeder activation, it is important to evaluate the contribution due to the activated corrosion products (ACPs) dissolved in the lead-lithium eutectic alloy, at different concentration levels. Therefore, the purpose of the study project is to evaluate the PbLi activity utilizing the FISPACT II inventory code. Emphasis is given on how the design of the EU-DEMO WCLL, and potential recycling of the breeder material will be impacted by the activation of PbLi and the associated active corrosion products (ACPs). For this scope the following Computational Tools, Data and Geometry have been considered: • Neutron source: EU-DEMO neutron flux < 1014/cm2/s • Neutron flux distribution in equatorial breeding blanket module (BBM) #13 in the WCLL BB outboard central zone, which is the most activated zone, with the aim to introduce a conservative component utilizing MNCP6. • The recommended geometry model: 2017 EU DEMO CAD model. • Blanket Module Material Specifications (Composition) • Activation calculations for different ACP concentration levels in the PbLi breeder, with a given chemistry in stationary equilibrium conditions, using FISPACT II code. Results suggest that there should be a waiting time of about 10 years from the shut-down (SD) to be able to safely manipulate the PbLi for recycling operations with simple shielding requirements. The dose rate is mainly given by the PbLi and the ACP concentration (x1 or x 100) does not shift the result. In conclusion, the results show that there is no impact on PbLi activation due to ACPs levels.

Keywords: activation, corrosion products, recycling, WCLL BB., PbLi

Procedia PDF Downloads 106

Authors: Amin Akbari, Dongcai Wang, Huiru Li, Xiaoping Du, Jie Chen

Abstract:

The effect of vibrational force (VF) on accelerating orthodontic tooth movement depends on the level of delivered stimulation to the tooth in terms of peak load (PL), which requires contacts between the tooth and the VF device. A personalized device ensures the contacts, but the resulting PL distribution on the teeth is unknown. Furthermore, it is unclear whether the PL on particular teeth can be adjusted to the prescribed values. The objective of this study was to investigate the efficacy of apersonalized VF device in controlling the level of stimulation on two teeth, the mandibular canines and 2nd molars. A 3-D finite element (FE) model of human dentition, including teeth, PDL, and alveolar bone, was created from the cone beam computed tomography images of an anonymous subject. The VF was applied to the teeth through a VFdevice consisting of a mouthpiece with engraved tooth profile of the subject and a VF source that applied 0.3 N force with the frequency of 30 Hz. The dentition and mouthpiece were meshed using 10-node tetrahedral elements. Interface elements were created at the interfaces between the teeth and the mouthpiece. The upper and lower teeth bite on the mouthpiece to receive the vibration. The depth of engraved individual tooth profile could be adjusted, which was accomplished by adding a layer of material as an interference or removing a layer of material as a clearance to change the PL on the tooth. The interference increases the PL while the clearance decreases it. Fivemouthpiece design cases were simulated, which included a mouthpiece without interference/clearance; the mouthpieces with bilateral interferences on both mandibular canines and 2nd molars with magnitudes of 0.1, 0.15, and 0.2-mm, respectively; and mouthpiece with bilateral 0.3-mm clearances on the four teeth. Then, the force distributions on the entire dentition were compared corresponding to these adjustments. The PL distribution on the teeth is uneven when there is no interference or clearance. Among all teeth, the anterior segment receives the highest level of PL. Adding 0.1, 0.15, and 0.2-mm interferences to the canines and 2nd molars bilaterally leads to increase of the PL on the canines by 10, 62, and 73 percent and on the 2nd molar by 14, 55, and 87 percent, respectively. Adding clearances to the canines and 2nd molars by removing the contactsbetween these teeth and the mouthpiece results in zero PL on them. Moreover, introducing interference to mandibular canines and 2nd molarsredistributes the PL on the entireteeth. The share of the PL on the anterior teeth are reduced. The use of the personalized mouthpiece ensures contactsof the teeth to the mouthpiece so that all teeth can be stimulated. However, the PL distribution is uneven. Adding interference between a tooth and the mouthpiece increases the PL while introducing clearance decreases the PL. As a result, the PL is redistributed. This study confirms that the level of VF stimulation on the individual tooth can be adjusted to a prescribed value.

Keywords: finite element method, orthodontic treatment, stress analysis, tooth movement, vibrational force

Procedia PDF Downloads 212

Authors: Bisemiire Anthony,

Abstract:

PESH Poultry is a business project proposed specifically to solve unemployment and income-related problems affecting the youths in the Busia district. The project is intended to transform the life of the youth in terms of economic, social and behavioral, as well as the domestic well-being of the community at large. PESH Poultry is a start-up poultry farm that will be engaged in the keeping of poultry birds, broilers and layers for the production of quality and affordable poultry meat and eggs respectively and other poultry derivatives targeting consumers in eastern Uganda, for example, hotels, restaurants, households and bakeries. We intend to use a semi-intensive system of farming, where water and some food are provided in a separate nighttime shelter for the birds; our location will be in Lumino, Busia district. The poultry project will be established and owned by Bisemiire Anthony, Nandera Patience, Naula Justine, Bwire Benjamin and other investors. The farm will be managed and directed by Nandera Patience, who has five years of work experience and business administration knowledge. We will sell poultry products, including poultry eggs, chicken meat, feathers and poultry manure. We also offer consultancy services for poultry farming. Our eggs and chicken meat are hygienic, rich in protein and high quality. We produce processes and packages to meet the standard organization of Uganda and international standards. The business project shall comprise five (5) workers on the key management team who will share various roles and responsibilities in the identified business functions such as marketing, finance and other related poultry farming activities. PESH Poultry seeks 30 million Ugandan shillings in long-term financing to cover start-up costs, equipment, building expenses and working capital. Funding for the launch of the business will be provided primarily by equity from the investors. The business will reach positive cash flow in its first year of operation, allowing for the expected repayment of its loan obligations. Revenue will top UGX 11,750,000, and net income will reach about UGX115 950,000 in the 1st year of operation. The payback period for our project is 2 years and 3 months. The farm plans on starting with 1000 layer birds and 1000 broiler birds, 20 workers in the first year of operation.

Keywords: chicken, pullets, turkey, ducks

Procedia PDF Downloads 69

Authors: Mayank Mishra

Abstract:

Market Economy can be broadly defined as economic system where supply and demand regulate the economy and in which decisions pertaining to production, consumption, allocation of resources, price and competition are made by collective actions of individuals or organisations with limited government intervention. On the other hand Market Society is one where instead of the economy being embedded in social relations, social relations are embedded in the economy. A market economy becomes a market society when all of land, labour and capital are commodified. This transition also has effect on people’s attitude and values. Such a transition commence impacting the non-material aspect of life such as public education, public health and the like. The inception of neoliberal policies in non-market norms altered the nature of social goods like public health that raised the following questions. What impact would the transition to a market society make on people in terms of accessibility to public health? Is healthcare a commodity that can be subjected to a competitive market place? What kind of private investments are being made in public health and how do private investments alter the nature of a public good like healthcare? This research problem will employ empirical-analytical approach that includes deductive reasoning which will be using the existing concept of market economy and market society as a foundation for the analytical framework and the hypotheses to be examined. The research also intends to inculcate the naturalistic elements of qualitative methodology which refers to studying of real world situations as they unfold. The research will analyse the existing literature available on the subject. Concomitantly the research intends to access the primary literature which includes reports from the World Bank, World Health Organisation (WHO) and the different departments of respective ministries of the countries for the analysis. This paper endeavours to highlight how the issue of commodification of public health would lead to perpetual increase in its inaccessibility leading to stratification of healthcare services where one can avail the better services depending on the extent of one’s ability to pay. Since the fundamental maxim of private investments is to churn out profits, these kinds of trends would pose a detrimental effect on the society at large perpetuating the lacuna between the have and the have-nots.The increasing private investments, both, domestic and foreign, in public health sector are leading to increasing inaccessibility of public health services. Despite the increase in various public health schemes the quality and impact of government public health services are on a continuous decline.

Keywords: commodity, India and Pakistan, market society, public health

Procedia PDF Downloads 292

Authors: Evrim Genc Kumtepe, Elif Toprak, Aylin Ozturk, Gamze Tuna, Hakan Kilinc, Irem Aydin Menderis

Abstract:

Support services are very significant elements for all educational institutions in general; however, for distance learners, these services are more essential than traditional (face-to-face) counterparts. One of the most important reasons for this is that learners and instructors do not share the same physical environment and that distance learning settings generally require intrapersonal interactions rather than interpersonal ones. Some learners in distance learning programs feel isolated. Furthermore, some fail to feel a sense of belonging to the institution because of lack of self-management skills, lack of motivation levels, and the need of being socialized, so that they are more likely to fail or drop out of an online class. In order to overcome all these problems, support services have emerged as a critical element for an effective and sustainable distance education system. Within the context of distance education support services, it is natural to include technology-based and web-based services and also the related materials. Moreover, institutions in education sector are expected to use information and communication technologies effectively in order to be successful in educational activities and programs. In terms of the sustainability of the system, an institution should provide distance education services through ICT enabled processes to support all stakeholders in the system, particularly distance learners. In this study, it is envisaged to develop a model based on the current support services literature in the field of open and distance learning and the applications of the distance higher education institutions. Specifically, content analysis technique is used to evaluate the existing literature in the distance education support services, the information published on websites, and applications of distance higher education institutions across the world. A total of 60 institutions met the inclusion criteria which are language option (English) and availability of materials in the websites. The six field experts contributed to brainstorming process to develop and extract codes for the coding scheme. During the coding process, these preset and emergent codes are used to conduct analyses. Two coders independently reviewed and coded each assigned website to ensure that all coders are interpreting the data the same way and to establish inter-coder reliability. Once each web page is included in descriptive and relational analysis, a model of support services is developed by examining the generated codes and themes. It is believed that such a model would serve as a quality guide for future institutions, as well as the current ones.

Keywords: support services, open education, distance learning, support model

Procedia PDF Downloads 183

Authors: Mustafa Metin Donma, Orkide Donma

Abstract:

Obesity in children particularly draws attention because it may threaten the individual’s future life due to many chronic diseases it may lead to. Most of these diseases, including obesity itself altogether are related to inflammation. For this reason, inflammation-related parameters gain importance. Within this context, complete blood cell counts, ratios or indices derived from these counts have recently found some platform to be used as inflammatory markers. So far, mostly adipokines were investigated within the field of obesity. The liver is at the center of the metabolic pathways network. Metabolic inflammation is closely associated with cellular dysfunction. In this study, hematologic inflammatory markers and two major hepatokines, cytokines produced predominantly by the liver, fibroblast growth factor-21 (FGF-21) and fetuin A were investigated in pediatric obesity. Two groups were constituted from seventy-six obese children based on World Health Organization criteria. Group 1 was composed of children whose age- and sex-adjusted body mass index (BMI) percentiles were between 95 and 99. Group 2 consists of children who are above the 99ᵗʰ percentile. The first and the latter groups were defined as obese (OB) and morbid obese (MO). Anthropometric measurements of the children were performed. Informed consent forms and the approval of the institutional ethics committee were obtained. Blood cell counts and ratios were determined by an automated hematology analyzer. The related ratios and indexes were calculated. Statistical evaluation of the data was performed by the SPSS program. There was no statistically significant difference in terms of neutrophil-to lymphocyte ratio, monocyte-to-high density lipoprotein cholesterol ratio and the platelet-to-lymphocyte ratio between the groups. Mean platelet volume and platelet distribution width values were decreased (p<0.05), total platelet count, red cell distribution width (RDW) and systemic immune inflammation index values were increased (p<0.01) in MO group. Both hepatokines were increased in the same group; however, increases were not statistically significant. In this group, also a strong correlation was calculated between FGF-21 and RDW when controlled by age, hematocrit, iron and ferritin (r=0.425; p<0.01). In conclusion, the association between RDW, a hematologic inflammatory marker, and FGF-21, an inflammation-related hepatokine, found in MO group is an important finding discriminating between OB and MO children. This association is even more powerful when controlled by age and iron-related parameters.

Keywords: childhood obesity, fetuin A , fibroblast growth factor-21, hematologic markers, red cell distribution width

Procedia PDF Downloads 176

Authors: Claudia García-García, Catalina B. García-García, Román Salmerón-Gómez

Abstract:

Much economic-environmental research includes the analysis of possible interactions by using Moderated Regression Analysis (MRA), which is a specific application of multiple linear regression analysis. This methodology allows analyzing how the effect of one of the independent variables is moderated by a second independent variable by adding a cross-product term between them as an additional explanatory variable. Due to the very specification of the methodology, the moderated factor is often highly correlated with the constitutive terms. Thus, great multicollinearity problems arise. The appearance of strong multicollinearity in a model has important consequences. Inflated variances of the estimators may appear, there is a tendency to consider non-significant regressors that they probably are together with a very high coefficient of determination, incorrect signs of our coefficients may appear and also the high sensibility of the results to small changes in the dataset. Finally, the high relationship among explanatory variables implies difficulties in fixing the individual effects of each one on the model under study. These consequences shifted to the moderated analysis may imply that it is not worth including an interaction term that may be distorting the model. Thus, it is important to manage the problem with some methodology that allows for obtaining reliable results. After a review of those works that applied the MRA among the ten top journals of the field, it is clear that multicollinearity is mostly disregarded. Less than 15% of the reviewed works take into account potential multicollinearity problems. To overcome the issue, this work studies the possible application of recent methodologies to MRA. Particularly, the raised regression is analyzed. This methodology mitigates collinearity from a geometrical point of view: the collinearity problem arises because the variables under study are very close geometrically, so by separating both variables, the problem can be mitigated. Raise regression maintains the available information and modifies the problematic variables instead of deleting variables, for example. Furthermore, the global characteristics of the initial model are also maintained (sum of squared residuals, estimated variance, coefficient of determination, global significance test and prediction). The proposal is implemented to data from countries of the European Union during the last year available regarding greenhouse gas emissions, per capita GDP and a dummy variable that represents the topography of the country. The use of a dummy variable as the moderator is a special variant of MRA, sometimes called “subgroup regression analysis.” The main conclusion of this work is that applying new techniques to the field can improve in a substantial way the results of the analysis. Particularly, the use of raised regression mitigates great multicollinearity problems, so the researcher is able to rely on the interaction term when interpreting the results of a particular study.

Keywords: multicollinearity, MRA, interaction, raise

Procedia PDF Downloads 86

Authors: Nabat Gojaeva, Mikayil Naghiyev, Sultan Jafarov, Gular Mikayilova

Abstract:

Chovdar ore area is located in the contact of Dashkesan caldera and Shamkir horst-graben uplift, which comprises the central part of Lok-Karabakh Island arcs of South Caucasus metallogenic province in terms of regional tectonics. One of the main structural features of formation of the Mereh and Aghyokhush group of low sulfidation epithermal gold deposits, locating in the north peripheric part of the ore area, is involving the crossing areas of ore-hosting and ore-forming Pan-Caucasian-direction structurally-compound faults with the meridional, rhombically shaped faults. In addition, another significant feature is the temporally two- or three-stage ore formation. In the first stage -an early phase of Upper Bathonian age, sulfides are the dominant minerals, in the second stage- late ‘productive’ phase of Upper Bathonian age, mainly gold mineralization is formed. Also, in the Upper Jurassic – Lower Cretaceous ages, rarely-encountered Cu-polymetallic ore formations are documented. Finally, in the last stage, the re-dislocation of ore-formation is foreseen in the previously-formed mineralization areas. The faults in the strike and dip directions formed shearing, brecciation, sulfide mineralization aureoles, and hydrothermal alteration zones in the wall rocks along with the local depression blocks. The geological-structural analysis of the area shows that multiple and various morphogenetic volcano-tectonically fault systems have developed in the area. These fault systems have played a trap role for ore-formation in the intersected parts of faults mentioned above. Thus, in the referred parts, mostly predominance of felsic volcanism and metasomatic alteration (silicification, argillitic, etc.) of wall rocks, as well as the products of this volcanism, account for the inclusion of hydrothermal ore-forming fluids along these faults. It is possible to determine temporally and lithological-structural connection between the ore-formation along with local depression blocks and faults as borders for products of felsic volcanism of Upper Cretaceous-Lesser Jurassic ages, in the results of the replacement of hydrothermal alteration zones with relatively low-temperature metasomatic alterations while moving from the felsic parts to the margins, and due to being non-ore bearing intermediate and intermediate-felsic magmatic facies.

Keywords: Aghyokhush, fault, gold deposit, Mereh

Procedia PDF Downloads 206

Authors: Angelo Garofalo, Laura Donato, Maria Concetta Carnevale, Enrico Drioli, Omar Alharbi, Saad Aljlil, Alessandra Criscuoli, Catia Algieri

Abstract:

Nowadays, water scarcity may be considered one of the most important and serious questions concerning our community: in fact, there is a remarkable mismatch between water supply and water demand. Exploitation of natural fresh water resources combined with higher water demand has led to an increased requirement for alternative water resources. In this context, desalination provides such an alternative source, offering water otherwise not accessible for irrigational, industrial and municipal use. Considering the various drawbacks of the polymeric membranes, zeolite membranes represent a potential device for water desalination owing to their high thermal and chemical stability. In this area wide attention was focused on the MFI (silicalite, ZSM-5) membranes, having a pore size lower (about 5.5 Å) than the major kinetic diameters of hydrated ions. In the present work, a scale-up for the preparation of supported silicalite membranes was performed. Therefore, tubular membranes 30 cm long were synthesized by using the secondary growth method coupled with the cross flow seeding procedure. The secondary growth presents two steps: seeding and growth of zeolite crystals on the support. This process, decoupling zeolite nucleation from crystals growth, permits to control the conditions of each step separately. The seeding procedure consists of a cross-flow filtration through a porous support coupled with the support rotation and tilting. The combination of these three different aspects allows a homogeneous and uniform coverage of the support with the zeolite seeds. After characterization by scanning electron microscope (SEM), X-ray diffractometry (XRD) and Energy-dispersive X-ray (EDX) analysis, the prepared membranes were tested by means of single gas permeation and then by Vacuum Membrane Distillation (VMD) using both deionized water and NaCl solutions. The experimental results evidenced the possibility to perform the scale up for the preparation of almost defect free silicalite membranes. VMD tests indicated the possibility to prepare membranes that exhibit interesting performance in terms of fluxes and salt rejections for concentrations from 0.2 M to 0.9 M. Furthermore, it was possible to restore the original performance of the membrane after an identified cleaning procedure. Acknowledgements: The authors gratefully acknowledge the support of the King Abdulaziz City for Science and Technology (KACST) for funding the research Project 895/33 entitled ‘Preparation and Characterization of Zeolite Membranes for Water Treatment’.

Keywords: desalination, MFI membranes, secondary growth, vacuum membrane distillation

Procedia PDF Downloads 242

Authors: Anu Shrestha, Krassi Rumchev, Ben Mullins, Yun Zhao, Linda Selvey

Abstract:

Cycling is often promoted as a means of reducing vehicular congestion, noise and greenhouse gas and air pollutant emissions in urban areas. It is also indorsed as a healthy means of transportation in terms of reducing the risk of developing a range of physical and psychological conditions. However, people who cycle regularly may not be aware that they can become exposed to high levels of Vehicular Air Pollutants (VAP) emitted by nearby traffics and therefore experience adverse health effects as a result. The study will highlight the present scenario of ambient air pollution level in different cycling routes in Perth and also highlight significant contribution to the understanding of health risks that cyclist may face from exposure to particulate air pollution. Methodology: This research was conducted in Perth, Western Austral and consisted of two groups of cyclists cycling near high (2 routes) and low (two routes) vehicular traffic roads, at high and low levels of exertion, during the cold and warm seasons. A sample size of 123 regular cyclists who cycled at least 80 km/week, aged 20-55, and non-smoker were selected for this study. There were altogether 100 male and 23 female who were asked to choose one or more routes among four different routes, and each participant cycled the route for warm or cold or both seasons. Cyclist who reported cardiovascular and other chronic health conditions (excluding asthma) were not invited into the study. Exposures to selected air pollutants were assessed by undertaking background and personal measurements alone with the measurement of heart and breathe rate of each participant. Finding: According to the preliminary study findings, the cyclists who used cycling route close to high traffic route were exposed to higher levels of measured air pollutants Nitrogen Oxide (NO₂) =0.12 ppm, sulfur dioxide (SO₂)=0.06 ppm and carbon monoxide (CO)=0.25 PPM compared to those who cycled away from busy roads. However, we measured high concentrations of particulate air pollution near one of the low traffic route which we associate with the close proximity to ferry station. Concluding Statement: As a conclusion, we recommend that cycling routes should be selected away from high traffic routes. If possible, we should also consider that if the cycling route is surrounded by the dense populated infrastructures, it can trap the pollutants and always facilitate in increasing inhalation of particle count among the cyclists.

Keywords: air pollution, carbon monoxide, cyclists' health, nitrogen dioxide, nitrogen oxide, respirable particulate matters

Procedia PDF Downloads 250

Authors: Hayat Omar

Abstract:

Languages provide speakers with a wide range of linguistic units to organize and deliver information. There are several ways to verbally express the mental representations of events. According to the linguistic tools they have acquired, speakers select the one that brings out the most communicative effect to convey their message. Our study focuses on two markers, -mm and dämmo, in Amharic (Ethiopian Semitic language). Our aim is to examine, from a developmental perspective, how they are used by speakers. We seek to distinguish the communicative and pragmatic functions indicated by means of these markers. To do so, we created a corpus of sixty narrative productions of children from 5-6, 7-8 to 10-12 years old and adult Amharic speakers. The experimental material we used to collect our data is a series of pictures without text 'Frog, Where are you?'. Although -mm and dämmo are each used in specific contexts, they are sometimes analyzed as being interchangeable. The suffix -mm is complex and multifunctional. It marks the end of the negative verbal structure, it is found in the relative structure of the imperfect, it creates new words such as adverbials or pronouns, it also serves to coordinate words, sentences and to mark the link between macro-propositions within a larger textual unit. -mm was analyzed as marker of insistence, topic shift marker, element of concatenation, contrastive focus marker, 'bisyndetic' coordinator. On the other hand, dämmo has limited function and did not attract the attention of many authors. The only approach we could find analyzes it in terms of 'monosyndetic' coordinator. The paralleling of these two elements made it possible to understand their distinctive functions and refine their description. When it comes to marking a referent, the choice of -mm or dämmo is not neutral, depending on whether the tagged argument is newly introduced, maintained, promoted or reintroduced. The presence of these morphemes explains the inter-phrastic link. The information is seized by anaphora or presupposition: -mm goes upstream while dämmo arrows downstream, the latter requires new information. The speaker uses -mm or dämmo according to what he assumes to be known to his interlocutors. The results show that -mm and dämmo, although all the speakers use them both, do not always have the same scope according to the speaker and vary according to the age. dämmo is mainly used to mark a contrastive topic to signal the concomitance of events. It is more commonly used in young children’s narratives (F(3,56) = 3,82, p < .01). Some values of -mm (additive) are acquired very early while others are rather late and increase with age (F(3,56) = 3,2, p < .03). The difficulty is due not only because of its synthetic structure but primarily because it is multi-purpose and requires a memory work. It highlights the constituent on which it operates to clarify how the message should be interpreted.

Keywords: acquisition, cohesion, connection, contrastive topic, contrastive focus, discourse marker, pragmatics

Procedia PDF Downloads 122

Authors: Alexsandro Bayestorff da Cunha, Dpebora Caline de Mello, Camila Alves Corrêa

Abstract:

In the production of fiberboards, an adhesive based on urea-formaldehyde resin is used, which has the advantages of low cost, homogeneity of distribution, solubility in water, high reactivity in an acid medium, and high adhesion to wood. On the other hand, as a disadvantage, there is low resistance to humidity and the release of formaldehyde. The objective of the study was to determine the viability of adding industrial boiler ash to the urea formaldehyde-based adhesive for the production of medium-density fiberboard. The raw material used was composed of Pinus spp fibers, urea-formaldehyde resin, paraffin emulsion, ammonium sulfate, and boiler ash. The experimental plan, consisting of 8 treatments, was completely randomized with a factorial arrangement, with 0%, 1%, 3%, and 5% ash added to the adhesive, with and without the application of a catalyst. In each treatment, 4 panels were produced with density of 750 kg.m⁻³, dimensions of 40 x 40 x 1,5 cm, 12% urea formaldehyde resin, 1% paraffin emulsion and hot pressing at a temperature of 180ºC, the pressure of 40 kgf/cm⁻² for a time of 10 minutes. The different compositions of the adhesive were characterized in terms of viscosity, pH, gel time and solids, and the panels by physical and mechanical properties, in addition to evaluation using the IMAL DPX300 X-ray densitometer and formaldehyde emission by the perforator method. The results showed a significant reduction of all adhesive properties with the use of the catalyst, regardless of the treatment; while the percentage increase of ashes provided an increase in the average values of viscosity, gel time, and solids and a reduction in pH for the panels with a catalyst; for panels without catalyst, the behavior was the opposite, with the exception of solids. For the physical properties, the results of the variables of density, compaction ratio, and thickness were equivalent and in accordance with the standard, while the moisture content was significantly reduced with the use of the catalyst but without the influence of the percentage of ash. The density profile for all treatments was characteristic of medium-density fiberboard, with more compacted and dense surfaces when compared to the central layer. For thickness, the swelling was not influenced by the catalyst and the use of ash, presenting average values within the normalized parameters. For mechanical properties, the influence of ashes on the adhesive was negatively observed in the modulus of rupture from 1% and in the traction test from 3%; however, only this last property, in the percentages of 3% and 5%, were below the minimum limit of the norm. The use of catalyst and ashes with percentages of 3% and 5% reduced the formaldehyde emission of the panels; however, only the panels that used adhesive with catalyst presented emissions below 8mg of formaldehyde / 100g of the panel. In this way, it can be said that boiler ash can be added to the adhesive with a catalyst without impairing the technological properties by up to 1%.

Keywords: reconstituted wood panels, formaldehyde emission, technological properties of panels, perforator

Procedia PDF Downloads 51

Authors: Jisun Mo, Paola Boarin

Abstract:

The impact of common buildings on climate and environment has prompted people to get involved in the green building standards aimed at implementing rating tools or certifications. Thus, green building rating systems were introduced to the construction industry, and the demand for certified green buildings has increased gradually and succeeded considerably in enhancing people’s environmental awareness. However, the existing certification process has been unsatisfactory in attracting stakeholders and/or professionals who are actively engaged in adopting a rating system. It is because they have faced recurring barriers regarding limited information in understanding the rating process, time-consuming procedures and higher costs, which have a direct influence on pursuing green building rating systems. To promote the achievement of green building certifications within the building industry more successfully, this paper aims at designing a Pre-Assessment Tool (PAT) framework that can help stakeholders and/or professionals engaged in the construction industry to clarify their basic knowledge, timeframe and extra costs needed to activate a green building certification. First, taking the first steps towards the rating tool seems to be complicated because of upfront commitment to understanding the overall rating procedure is required. This conceptual PAT framework can increase basic knowledge of the rating tool and the certification process, mainly in terms of all resources or information of each credit requirements. Second, the assessment process of rating tools is generally known as a “lengthy and time-consuming system”, contributing to unenthusiastic reactions concerning green building projects. The proposed framework can predict the timeframe needed to identify how long it will take for a green project to process each credit requirement and the documentation required from the beginning of the certification process to final approval. Finally, most people often have the initial perception that pursuing green building certification costs more than constructing a non-green building, which makes it more difficult to execute rating tools. To overcome this issue, this PAT will help users to estimate the extra expenses such as certification fees and third-party contributions based on the track of the amount of time it takes to implement the rating tool throughout all the related stages. Also, it can prevent unexpected or hidden costs occurring in the process of assessment. Therefore, this proposed PAT framework can be recommended as an effective method to support the decision-making of inexperienced users and play an important role in promoting green building certification.

Keywords: green building rating tools, Pre-Occupancy Evaluation (PrOE), client’s decision-making, certification

Procedia PDF Downloads 233

Authors: Leja Salciute

Abstract:

Mental health difficulties are one of the reasons for abnormal feeding behaviour. This is especially evident in a crisis situation. Abnormal feeding behaviour occurs when individuals use food as a method to provide relief for these negative emotions. The study aimed to discover an association between emotional regulation, mental health difficulties and disruption in feeding behaviours in the UK in times of crisis. A mixed-methods design was used. Abnormal feeding behaviour was measured using the Binge Eating Disorder Screener-7, SCOFF scale, Crisis impact scale, Difficulties in Emotion Regulation Scale and demographics. The sample comprised 342 participants with a history of excessive overeating. The participants (male= 198, female= 141 and other= 3) came from the general population and they were aged 16 and over. Participants ranged in age from 16 to 89. Findings from the survey concluded that difficulties with emotion regulation were found to be associated with abnormal feeding behaviours. Mental health difficulties correlated significantly with changes in individuals’ lives, such as work or routines. Individuals differed in their abnormal feeding behaviour in terms of their age, that is, younger individuals showed less struggle with their eating patterns while older individuals faced greater struggles with their abnormal feeding behaviour. Emotion regulation significantly influenced abnormal feeding behaviour. Results from qualitative data suggest four common themes that were identified: demonstration of gratitude, negative emotions, disruptions to social life, and financial loss. For example, participants developed and gained an awareness of being grateful for the simple things in life even when participants experienced hardships. The results also suggested that emotional eating acted like a sedative that allowed the participant to run away from their painful reality. Crisis situation negatively affected relationships among participants and induced negativity related to social interaction. Finally, the respondents highlighted that the presence of uncertainty made it hard to plan ahead and look forward to the future. Although respondents experienced negative emotions and financial losses, some of them still managed to allocate time for themselves and enjoy their time off during crisis. However, majority of respondents referred to their inability to control their external circumstances and turned to and relied upon food overconsumption instead. This had a negative effect on their mental health and presented disruptions in feeding behaviour. It was recommended for individuals in times of crisis to seek psychological support in the form of Cognitive Behavioural Therapy (CBT).

Keywords: binge eating, maladaptive eating behaviours, mental health, negative emotions in crisis

Procedia PDF Downloads 57

Authors: Xiaojing Wang, Ann-Marie Ward, Tony Wall

Abstract:

The problem of over-indebtedness has increased since deregulation of the banking industry in the 1980s, and now it has become a major problem for most countries in Europe, including Germany. Consumer debt issues have attracted not only the attention of academics but also government and debt counselling institutions. Overall, this research aims to contribute to the knowledge gap regarding the causes of consumer over-indebtedness in Germany and to develop predictive models for assessing consumer over-indebtedness risk at consumer level. The situation of consumer over-indebtedness is serious in Germany. The relatively high level of social welfare support in Germany suggests that consumer debt problems are caused by other factors, other than just over-spending and income volatility. Prior literature suggests that the overall stability of the economy and level of welfare support for individuals from the structural environment contributes to consumers’ debt problems. In terms of cultural influence, the conspicuous consumption theory in consumer behaviour suggests that consumers would spend more than their means to be seen as similar profiles to consumers in a higher socio-economic class. This results in consumers taking on more debt than they can afford, and eventually becoming over-indebted. Studies have also shown that financial literacy is negatively related to consumer over-indebtedness risk. Whilst prior literature has examined structural and cultural influences respectively, no study has taken a collective approach. To address this gap, a model is developed to investigate the association between consumer over-indebtedness and proxies for influences from the structural and cultural environment based on the above theories. The model also controls for consumer demographic characteristics identified as being of influence in prior literature, such as gender and age, and adverse shocks, such as divorce or bereavement in the household. Benefiting from SOEP regional data, this study is able to conduct quantitative empirical analysis to test both structural and cultural influences at a localised level. Using German Socio-Economic Panel (SOEP) study data from 2006 to 2016, this study finds that social benefits, financial literacy and the existence of conspicuous consumption all contribute to being over-indebted. Generally speaking, the risk of becoming over-indebted is high when consumers are in a low-welfare community, have little awareness of their own financial situation and always over-spend. In order to tackle the problem of over-indebtedness, countermeasures can be taken, for example, increasing consumers’ financial awareness, and the level of welfare support. By analysing causes of consumer over-indebtedness in Germany, this study also provides new insights on the nature and underlying causes of consumer debt issues in Europe.

Keywords: consumer, debt, financial literacy, socio-economic

Procedia PDF Downloads 189

Authors: Eliza Torrigue, Efrelyn Iellamo

Abstract:

Maternal death is one of the rising health issues in the Philippines. It is alarming to know that in every hour of each day, a mother gives birth to a child who may not live to see the next day. Statistics shows that intrapartum period and third stage of labor are the very crucial periods for the expectant mother, as well as the first six hours of life for the newborn. To address the issue, The Essential Intrapartum Newborn Care (EINC) was developed. Through this, Obstetric Delivery Room (OB-DR) Nurses shall be updated with the evidence-based maternal and newborn care to ensure patient safety, thus, reducing maternal and child mortality. This study aims to describe the compliance of hospitals, especially of OB-DR nurses, to the EINC Protocols. The researcher aims to link the profile variables of the respondents in terms of age, length of service and formal training to their compliance on the EINC Protocols. The outcome of the study is geared towards the development of appropriate training program for OB-DR Nurses assigned in the delivery room of the hospitals based on the study’s results to sustain the EINC standards. A descriptive correlational method was used. The sample consists of 75 Obstetric Delivery Room (OB-DR) Nurses from three government hospitals in the City of Manila namely, Ospital ng Maynila Medical Center, Tondo Medical Center, and Gat Andres Bonifacio Memorial Medical Center. Data were collected using an evaluative checklist. Ranking, weighted mean, Chi-square and Pearson’s R were used to analyze data. The level of compliance to the EINC Protocols by the respondents was evaluated with an overall mean score of 4.768 implying that OB-DR Nurses have a high regard in complying with the step by step procedure of the EINC. Furthermore, data shows that formal training on EINC have a significant relationship with OB-DR Nurses’ level of compliance during cord care, AMTSL, and immediate newborn care until the first ninety minutes to six hours of life. However, the respondents’ age and length of service do not have a significant relationship with the compliance of OB-DR Nurses on EINC Protocols. In the pursuit of decreasing the maternal mortality in the Philippines, EINC Protocols have been widely implemented in the country especially in the government hospitals where most of the deliveries happen. In this study, it was found out that OB-DR Nurses adhere and are highly compliant to the standards in order to assure that optimum level of care is delivered to the mother and newborn. Formal training on EINC, on the other hand, create the most impact on the compliance of nurses. It is therefore recommended that there must be a structured enhancement training program to plan, implement and evaluate the EINC protocols in these government hospitals.

Keywords: compliance, intrapartum, newborn care, nurses

Procedia PDF Downloads 377

Authors: J. Hakula

Abstract:

Discussion on euthanasia is a continuous process. Euthanasia is defined as 'deliberately ending a patient's life by administering life-ending drugs at the patient's explicit request'. With few exceptions, worldwide in most countries human societies have not been able to agree on some fundamental issues concerning ultimate decisions of life and death. Outranking methods in voting oriented social choice theory and multicriteria decision-making (MCDM) can be applied to issues in medical ethics. There is a wide range of voting methods, and using different methods the same group of voters can end up with different outcomes. In the MCDM context, decision alternatives can be substituted for candidates, and criteria for voters. The view chosen here is that of a single decision-maker. Initially, three alternatives and three criteria are chosen. Pairwise and basic positional voting rules - plurality, anti-plurality and the Borda count - are applied. In the MCDM solution, criteria are put weights by giving them the more 'votes'; the more important the decision-maker ranks them. A hypothetical example on evaluating properties of euthanasia consists of three alternatives A, B, and C, which are ranked according to three criteria - the patient’s willingness to cooperate, general action orientation (active/passive), and cost-effectiveness - the criteria having weights 7, 5, and 4, respectively. Using the plurality rule and the weights given to criteria, A is the best alternative, B and C thereafter. In pairwise comparisons, both B and C defeat A with weight scores 7 to 9. On the other hand, B is defeated by C with weights 11 to 5. Thus, C (i.e. the so-called Condorcet winner) defeats both A and B. The best alternative using the plurality principle is not necessarily the best in the pairwise sense, the conflict remaining unsolved with or without additional weights. Positional rules are sensitive to variations in alternative sets. In the example above, the plurality rule gives the rank ABC. If we leave out C, the plurality ranking between A and B results in BA. Withdrawing B or A the ranking is CA and CB, respectively. In pairwise comparisons an analogous problem emerges when the number of criteria is varied. Cyclic preferences may lead to a total tie, and no (rational) choice between the alternatives can be made. In conclusion, the choice of the best commitment to re-evaluate euthanasia, with criteria left unchanged, depends entirely on the evaluation method used. The right strategies matter, too. Future studies might concern the problem of an abstention - a situation where voters do not vote - and still their best candidate may win. Or vice versa, actively giving the ballot to their first rank choice might lead to a total loss. In MCDM terms, a decision might occur where some central criteria are not actively involved in the best choice made.

Keywords: medical ethics, euthanasia, voting methods, multicriteria decision-making

Procedia PDF Downloads 135

Authors: Sanjay K. Behera, Debasish Saha, Paramesh Gadige, Ranjini Bandyopadhyay

Abstract:

The zero shear viscosity (η₀) of a suspension of hard sphere colloids characterized by a significant polydispersity (≈10%) increases with increase in volume fraction (ϕ) and shows a dramatic increase at ϕ=ϕg with the system entering a colloidal glassy state. Fragility which is the measure of the rapidity of approach of these suspensions towards the glassy state is sensitive to its size polydispersity and stiffness of the particles. Soft poly(N-isopropylacrylamide) (PNIPAM) particles deform in the presence of neighboring particles at volume fraction above the random close packing volume fraction of undeformed monodisperse spheres. Softness, therefore, enhances the packing efficiency of these particles. In this study PNIPAM particles of a nearly constant swelling ratio and with polydispersities varying over a wide range (7.4%-48.9%) are synthesized to study the effects of polydispersity on the dynamics of suspensions of soft PNIPAM colloidal particles. The size and polydispersity of these particles are characterized using dynamic light scattering (DLS) and scanning electron microscopy (SEM). As these particles are deformable, their packing in aqueous suspensions is quantified in terms of effective volume fraction (ϕeff). The zero shear viscosity (η₀) data of these colloidal suspensions, estimated from rheometric experiments as a function of the effective volume fraction ϕeff of the suspensions, increases with increase in ϕeff and shows a dramatic increase at ϕeff = ϕ₀. The data for η₀ as a function of ϕeff fits well to the Vogel-Fulcher-Tammann equation. It is observed that increasing polydispersity results in increasingly fragile supercooled liquid-like behavior, with the parameter ϕ₀, extracted from the fits to the VFT equation shifting towards higher ϕeff. The observed increase in fragility is attributed to the prevalence of dynamical heterogeneities (DHs) in these polydisperse suspensions, while the simultaneous shift in ϕ₀ is ascribed to the decoupling of the dynamics of the smallest and largest particles. Finally, it is observed that the intrinsic nonlinearity of these suspensions, estimated at the third harmonic near ϕ₀ in Fourier transform oscillatory rheological experiments, increases with increase in polydispersity. These results are in agreement with theoretical predictions and simulation results for polydisperse hard sphere colloidal glasses and clearly demonstrate that jammed suspensions of polydisperse colloidal particles can be effectively fluidized with increasing polydispersity. Suspensions of these particles are therefore excellent candidates for detailed experimental studies of the effects of polydispersity on the dynamics of glass formation.

Keywords: dynamical heterogeneity, effective volume fraction, fragility, intrinsic nonlinearity

Procedia PDF Downloads 149

Authors: Teresa Sarmento de Beires, Sofia Padilha, Pedro Arantes, Joana Ribeiro, Andreia Eiras

Abstract:

Background: Trichotillomania is a psychiatric condition that is very challenging to treat, with no first-line medications approved by any medical agency. It is defined as a recurrent compulsive habit of pulling out one's own hair, usually from the scalp and eyebrows area, but it can also affect eyelashes or any other hair-bearing area. N-acetylcysteine, a glutamate modulator, has been studied as a possible treatment for several psychiatric and neurological disorders, considering its role in attenuating pathophysiological processes responsible for compulsive behaviors and, therefore, trichotillomania. Objective: This study aims to determine the efficacy of N-acetylcysteine in the treatment of adults with trichotillomania. Methodology: The authors researched guidelines, standards of clinical guidance, systematic reviews, meta-analyses, and randomized clinical trials, published in the last 20 years using the MeSH terms: "Trichotillomania” and “N-acetylcysteine” in the following databases: PubMed, Cochrane library, National Guideline Clearing House, National Institute of Health and Care Excellence (NICE), Canadian Medical Association Practice Guidelines and Database of Abstracts of Reviews of Effectiveness (DARE). The Strength of Recommendation Taxonomy (SORT) Scale, from the American Family Physician, was used to evaluate the level of evidence and assign the strength of recommendation. Results: The research found fifteen articles, among which only three were eligible according to the inclusion criteria: 1. systematic review and 2. meta-analyses. There was evidence of a probable beneficial effect of N-acetylcysteine on treatment response and reduction of trichotillomania symptom severity in adults, with moderate certainty in the effect estimate. There was no evidence of effectiveness with the use of inositol, antioxidants, naltrexone, or selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with trichotillomania. Clomipramine and Olanzapine showed potential treatment benefits, with low certainty. N-acetylcysteine had the least severe side effect profile in adults compared with the other potentially beneficial pharmacological treatments. Conclusion: Evidence points towards the effectiveness of N-acetylcysteine in the treatment of adults with trichotillomania, which exhibits a good tolerability profile with minimal adverse effects. Therefore, the authors attribute a level of evidence 2, the strength of recommendation B, to the prescription of N-acetylcysteine in the treatment of adults suffering from trichotillomania (SORT analysis). Further investigation is needed in order to extract high-quality conclusions from the meta-analysis.

Keywords: trichotillomania, hair pulling, treatment, n-acetylcysteine

Procedia PDF Downloads 90

Authors: Satendra Pal Singh, Dalip Kr. Kakru, Jyoti Mishra, Rajesh Thakur, Tarana Sarwat

Abstract:

COVID-19 is still an intrigue as far as morbidity or mortality is concerned. The rate of recovery varies from person to person, & it depends upon the accessibility of the healthcare system and the roles played by the physicians and caregivers. It is envisaged that with the passage of time, people would become immune to this virus, and those who are vulnerable would sustain themselves with the help of vaccines. The proposed study deals with the severeness of COVID-19 is associated with some specific biomarkers linked to correlate age and gender. We will be assessing the overall homeostasis of the persons who were affected by the coronavirus infection and also of those who recovered from it. Some people show more severe effects, while others show very mild symptoms, however, they show low CT values. Thus far, it is unclear why the new strain of Covid has different effects on different people in terms of age, gender, and ABO blood typing. According to data, the fatality rate with heart disease was 10.5 percent, 7.3 percent were diabetic, and 6 percent who are already infected from other comorbidities. However, some COVID-19 cases are worse than others & it is not fully explainable as of date. Overall data show that the ABO blood group is effective or prone to the risk of SARS-COV2 infection, while another study also shows the phenotypic effects of the blood group related to covid. It is an accepted fact that females have more strong immune systems than males, which may be related to the fact that females have two ‘X’ chromosomes, which might contain a more effective immunity booster gene on the X chromosome, and are capable to protect the female. Also specific sex hormones also induce a better immune response in a specific gender. This calls for in-depth analysis to be able to gain insight into this dilemma. COVID-19 is still not fully characterized, and thus we are not very familiar with its biology, mode of infection, susceptibility, and overall viral load in the human body. How many virus particles are needed to infect a person? How, then, comorbidity contribute to coronavirus infection? Since the emergence of this virus in 2020, a large number of papers have been published, and seemingly, vaccines have been prepared. But still, a large number of questions remain unanswered. The proneness of humans for infection by covid-19 needs to be established to be able to develop a better strategy to fight this virus. Our study will be on the Impact of demography on the Severity of covid-19 infection & at the same time, will look into gender-specific sensitivity of Covid-19 and the Operational variation of different biochemical markers in Covid-19 positive patients. Besides, we will be studying the co-relation, if any, of COVID severity & ABO Blood group type and the occurrence of the most common blood group type amongst positive patience.

Keywords: coronavirus, ABO blood group, age, gender

Procedia PDF Downloads 79

Authors: Umut Kokbas, Mustafa Nisari

Abstract:

Immunoglobulins, also known as antibodies, are glycoprotein molecules produced by activated B cells that transform into plasma cells and result in them. Antibodies are critical molecules of the immune response to fight, which help the immune system specifically recognize and destroy antigens such as bacteria, viruses, and toxins. Immunoglobulin classes differ in their biological properties, structures, targets, functions, and distributions. Five major classes of antibodies have been identified in mammals: IgA, IgD, IgE, IgG, and IgM. Evaluation of the immunoglobulin isotype can provide a useful insight into the complex humoral immune response. Evaluation and knowledge of immunoglobulin structure and classes are also important for the selection and preparation of antibodies for immunoassays and other detection applications. The immunoglobulin test measures the level of certain immunoglobulins in the blood. IgA, IgG, and IgM are usually measured together. In this way, they can provide doctors with important information, especially regarding immune deficiency diseases. Hypogammaglobulinemia (HGG) is one of the main groups of primary immunodeficiency disorders. HGG is caused by various defects in B cell lineage or function that result in low levels of immunoglobulins in the bloodstream. This affects the body's immune response, causing a wide range of clinical features, from asymptomatic diseases to severe and recurrent infections, chronic inflammation and autoimmunity Transient infant hypogammaglobulinemia (THGI), IgM deficiency (IgMD), Bruton agammaglobulinemia, IgA deficiency (SIgAD) HGG samples are a few. Most patients can continue their normal lives by taking prophylactic antibiotics. However, patients with severe infections require intravenous immune serum globulin (IVIG) therapy. The IgE level may rise to fight off parasitic infections, as well as a sign that the body is overreacting to allergens. Also, since the immune response can vary with different antigens, measuring specific antibody levels also aids in the interpretation of the immune response after immunization or vaccination. Immune deficiencies usually occur in childhood. In Immunology and Allergy clinics, apart from the classical methods, it will be more useful in terms of diagnosis and follow-up of diseases, if it is fast, reliable and especially in childhood hypogammaglobulinemia, sampling from children with a method that is more convenient and uncomplicated. The antibodies were attached to the electrode surface via the poly hydroxyethyl methacrylamide cysteine nanopolymer. It was used to evaluate the anodic peak results obtained in the electrochemical study. According to the data obtained, immunoglobulin determination can be made with a biosensor. However, in further studies, it will be useful to develop a medical diagnostic kit with biomedical engineering and to increase its sensitivity.

Keywords: biosensor, immunosensor, immunoglobulin, infection

Procedia PDF Downloads 76

Authors: Salamah Ansari

Abstract:

In absence of a comprehensive international legal regime for sovereign debt restructuring, majority of the complications arising from sovereign debt restructuring are frequently left to the uncertain market forces. The resort to market forces for sovereign debt restructuring has led to a phenomenal increase in litigations targeting assets of defaulting sovereign nations, internationally across jurisdictions with the first major wave of lawsuits against sovereigns in the 1980s with the Latin American crisis. Recent experiences substantiate that majority of obstacles faced during sovereign debt restructuring process are caused by inefficient creditor coordination and collective action problems. Collective action problems manifest as grab race, rush to exits, holdouts, the free rider problem and the rush to the courthouse. On defaulting, for a nation to successfully restructure its debt, all the creditors involved must accept some reduction in the value of their claims. As a single holdout creditor has the potential to undermine the restructuring process, hold-out creditors are snowballing with the increasing probability of earning high returns through litigations. This necessitates a mechanism to avoid holdout litigations and reinforce collective action on the part of the creditor. This can be done either through a statutory reform or through market-based contractual approach. In absence of an international sovereign bankruptcy regime, the impetus is mostly on inclusion of collective action clauses in debt contracts. The preference to contractual mechanisms vis- a vis a statutory approach can be explained with numerous reasons, but that's only part of the puzzle in trying to understand the economics of the underlying system. The contractual approach proposals advocate the inclusion of certain clauses in the debt contract for an orderly debt restructuring. These include clauses such as majority voting clauses, sharing clauses, non- acceleration clauses, initiation clauses, aggregation clauses, temporary stay on litigation clauses, priority financing clauses, and complete revelation of relevant information. However, voluntary market based contractual approach to debt workouts has its own complexities. It is a herculean task to enshrine clauses in debt contracts that are detailed enough to create an orderly debt restructuring mechanism while remaining attractive enough for creditors. Introduction of collective action clauses into debt contracts can reduce the barriers in efficient debt restructuring and also have the potential to improve the terms on which sovereigns are able to borrow. However, it should be borne in mind that such clauses are not a panacea to the huge institutional inadequacy that persists and may lead to worse restructuring outcomes.

Keywords: sovereign debt restructuring, collective action clauses, hold out creditors, litigations

Procedia PDF Downloads 142

Authors: Carlos M. Goncalves, Luisa Duarte, Teresa Cartaxo

Abstract:

The aim of this work was to understand the reasons behind the underutilization of electroconvulsive therapy (ECT) in the younger population and raise possible solutions. We conducted a non-systematic review of literature throughout a search on PubMed, using the terms ‘children’, ‘adolescents’ and ‘electroconvulsive’, ‘therapy’. Candidate articles written in languages other than English were excluded. Articles were selected according to title and/or abstract’s content relevance, resulting in a total of 5 articles. ECT is a recognized effective treatment in adults for several psychiatric conditions. As in adults, ECT in children and adolescents is proven most beneficial in the treatment of severe mood disorders, catatonia, and, to a lesser extent, schizophrenia. ECT in adults has also been used to treat autism’s self-injurious behaviours, Tourette’s syndrome and resistant first-episode schizophrenia disorder. Despite growing evidence on its safety and effectiveness in children and adolescents, like those found in adults, ECT remains a controversial and underused treatment in patients this age, even when it is clearly indicated. There are various possible reasons to this; limited awareness among professionals (lack of knowledge and experience among child psychiatrists), stigmatic public opinion (despite positive feedback from patients and families, there is an unfavourable and inaccurate representation in the media, contributing to a negative public opinion), legal restrictions and ethical controversies (restrictive regulations such as a minimum age for administration), lack of randomized trials (the currently available studies are retrospective, with small size samples, and most of the publications are either case reports or case series). This shows the need to raise awareness and knowledge, not only for mental health professionals, but also to the general population, through the media, regarding indications, methods and safety of ECT in order to provide reliable information to the patient and families. Large-scale longitudinal studies are also useful to further demonstrate the efficacy and safety of ECT and can aid in the formulation of algorithms and guidelines as without these changes, the availability of ECT to the younger population will remain restricted by regulations and social stigma. In conclusion, these results highlight that lack of adequate knowledge and accurate information are the most important factors behind the underutilization of ECT in younger population. Mental healthcare professionals occupy a cornerstone position; if data is given by a well-informed healthcare professional instead of the media, general population (including patients and their families) will probably regard the procedure in a more favourable way. So, the starting point should be to improve health care professional’s knowledge and experience on this choice of treatment.

Keywords: adolescents, children, electroconvulsive, therapy

Procedia PDF Downloads 110