Search results for: advanced care planning
1464 Managing Work–Family Conflict in Today's Nursing Profession: The Role of Supervisors
Authors: Alshutwi Sitah
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Many countries around the world are struggling to maintain an adequate number of nurses. Inadequate nursing staffing could compromise the quality of patient care. Among many factors that contribute to registered nurses (RN) turnover, the influence of work–family conflict (WFC) has gained little attention. WFC was found to be significantly associated with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative consequences, including lower job satisfaction and organizational commitment, sleep insufficiency, insomnia symptoms, obesity, cardiovascular diseases, sleep insufficiency, and high cholesterol. In an effort to find strategies to manage the consequences of WFC, many behavioral, psychological, and career scholars have focused on the role of supervisor support. Family Supportive Supervisor Behaviors (FSSB) has been found to be a promising approach contributing to the reduction of TI in employees’ experiencing WFC. Despite the importance of work–family issues and the influence of FSSB, limited studies have been conducted among the nursing population and none were found that included a sample from Saudi Arabia. Therefore, the main Purpose of this study was to evaluate the influence of FSSB on the relationship among WFC, Stress, and TI in Saudi Arabian registered nurses. Method: A cross-sectional study. Sample: Convenience sampling; 113 Saudi female nurse. Result: Fifty percent of nurses intended to leave their workplace, 68 % of nurses reported having a conflict between work and family, and 44% reported having a high level of stress. A significant positive correlation was found between WFC and TI (r= .43, P < 0.01). A negative correlation was found between FSSB and TI (r= -.53, P < 0.01). Both WFC and stress were associated with TI; however, these associations were buffered (weaken), when nurses had higher FSSB. Conclusion: The FSSB could be seen as a tool to help married, female nurses to demonstrate their professional role without compromising their family responsibilities. Nurses’ turnover is a complex issue that may require multiple prevention strategies; however, enhancing FSSB could be a key resource for maintaining a positive workplace environment and reducing TI.Keywords: turnover intention, work-family conflict, supervisor support, nursing retention
Procedia PDF Downloads 2221463 Service Blueprint for Improving Clinical Guideline Adherence via Mobile Health Technology
Authors: Y. O’Connor, C. Heavin, S. O’ Connor, J. Gallagher, J. Wu, J. O’Donoghue
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Background: To improve the delivery of paediatric healthcare in resource-poor settings, Community Health Workers (CHW) have been provided with a paper-based set of protocols known as Community Case Management (CCM). Yet research has shown that CHW adherence to CCM guidelines is poor, ultimately impacting health service delivery. Digitising the CCM guidelines via mobile technology is argued in extant literature to improve CHW adherence. However, little research exist which outlines how (a) this process can be digitised and (b) adherence could be improved as a result. Aim: To explore how an electronic mobile version of CCM (eCCM) can overcome issues associated with the paper-based CCM protocol (poor adherence to guidelines) vis-à-vis service blueprinting. This service blueprint will outline how (a) the CCM process can be digitised using mobile Clinical Decision Support Systems software to support clinical decision-making and (b) adherence can be improved as a result. Method: Development of a single service blueprint for a standalone application which visually depicts the service processes (eCCM) when supporting the CHWs, using an application known as Supporting LIFE (Low cost Intervention For disEase control) as an exemplar. Results: A service blueprint is developed which illustrates how the eCCM solution can be utilised by CHWs to assist with the delivery of healthcare services to children. Leveraging smartphone technologies can (a) provide CHWs with just-in-time data to assist with their decision making at the point-of-care and (b) improve CHW adherence to CCM guidelines. Conclusions: The development of the eCCM opens up opportunities for the CHWs to leverage the inherent benefit of mobile devices to assist them with health service delivery in rural settings. To ensure that benefits are achieved, it is imperative to comprehend the functionality and form of the eCCM service process. By creating such a service blueprint for an eCCM approach, CHWs are provided with a clear picture regarding the role of the eCCM solution, often resulting in buy-in from the end-users.Keywords: adherence, community health workers, developing countries, mobile clinical decision support systems, CDSS, service blueprint
Procedia PDF Downloads 4151462 A Post-Occupancy Evaluation of Urban Landscape Greenway– A Case Study of the Taiyuan Greenway in Taichung City
Authors: A. Yu-Chen Chien, B. Ying-Ju Su
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Greenway is a type of linear park which links the planar parklands and connects the open spaces. In the urban environment, except for providing open spaces with recreational function as well as effectively improve the appearance of the surrounding environment, greenway and parkland also creates benefits to the social and psychological aspects of human. In 2014, the statistics of The Ministry of Home Affairs show that citizens in Taichung enjoy the green area at an average of 4.27 square kilometers per person. How to use the existing green space system effectively and enhance the quality of leisure life thus become the major issues today. The study here points out that greenway and parkland and other open spaces are closely related to the daily life of urban residents. Whether the operation could be executed in accordance with the design is our major concern. To explore the issue, we implemented the Post-Occupancy Evaluation of Taiyuan Greenway in Taichung City. In 1956, Taichung city carried out the urban plan according to Howard’s concept about “Garden City” and built the Taiyuan greenway to restrain the urban expansion. 50-year past, due to the population growth and new demands, the government started to reconstruct the program. It is a three stage modification project of “The Townspace Renaissance project in Taiwan” since 2009, of which the greenway construction is the main point. In this research, we mainly focus on the third stage of this program to investigate the user’s preference and degree of satisfaction based on the Post-Occupancy Evaluation about the finished, unfinished, and undergoing construction sectors as well as facilities. We collected and analyzed the data based on the questionnaires and explored the possible facts that might have affected the degree of satisfaction about the greenway modification project based on the chi-square test. We hope to inspect the purpose of the demonstration projects and provide reference to the Taichung government for the modification planning and the greenway design in the future.Keywords: greenway, landscape greenway, post-occupancy evaluation, Taichung city
Procedia PDF Downloads 3331461 Anaesthetic Management of Congenitally Corrected Transposition of Great Arteries with Complete Heart Block in a Parturient for Emergency Caesarean Section
Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala
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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia
Procedia PDF Downloads 1311460 Genetic Dissection of QTLs in Intraspecific Hybrids Derived from Muskmelon (Cucumis Melo L.) and Mangalore Melon (Cucumis Melo Var Acidulus) for Shelflife and Fruit Quality Traits
Authors: Virupakshi Hiremata, Ratnakar M. Shet, Raghavendra Gunnaiah, Prashantha A.
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Muskmelon is a health-beneficial and refreshing dessert vegetable with a low shelf life. Mangalore melon, a genetic homeologue of muskmelon, has a shelf life of more than six months and is mostly used for culinary purposes. Understanding the genetics of shelf life, yield and yield-related traits and identification of markers linked to such traits is helpful in transfer of extended shelf life from Mangalore melon to the muskmelon through intra-specific hybridization. For QTL mapping, 276 F2 mapping population derived from the cross Arka Siri × SS-17 was genotyped with 40 polymorphic markers distributed across 12 chromosomes. The same population was also phenotyped for yield, shelf life and fruit quality traits. One major QTL (R2 >10) and fourteen minor QTLs (R2 <10) localized on four linkage groups, governing different traits were mapped in F2 mapping population developed from the intraspecific cross with a LOD > 5.5. The phenotypic varience explained by each locus varied from 3.63 to 10.97 %. One QTL was linked to shelf-life (qSHL-3-1), five QTLs were linked to TSS (qTSS-1-1, qTSS-3-3, qTSS-3-1, qTSS-3-2 and qTSS-1-2), two QTLs for flesh thickness (qFT-3-1, and qFT-3-2) and seven QTLs for fruit yield per vine (qFYV-3-1, qFYV-1-1, qFYV-3-1, qFYV1-1, qFYV-1-3, qFYV2-1 and qFYV6-1). QTL flanking markers may be used for marker assisted introgression of shelf life into muskmelon. Important QTL will be further fine-mapped for identifying candidate genes by QTLseq and RNAseq analysis. Fine-mapping of Important Quantitative Trait Loci (QTL) holds immense promise in elucidating the genetic basis of complex traits. Leveraging advanced techniques like QTLseq and RNA sequencing (RNA seq) is crucial for this endeavor. QTLseq combines next-generation sequencing with traditional QTL mapping, enabling precise identification of genomic regions associated with traits of interest. Through high-throughput sequencing, QTLseq provides a detailed map of genetic variations linked to phenotypic variations, facilitating targeted investigations. Moreover, RNA seq analysis offers a comprehensive view of gene expression patterns in response to specific traits or conditions. By comparing transcriptomes between contrasting phenotypes, RNA seq aids in pinpointing candidate genes underlying QTL regions. Integrating QTLseq with RNA seq allows for a multi-dimensional approach, coupling genetic variation with gene expression dynamics.Keywords: QTL, shelf life, TSS, muskmelon and Mangalore melon
Procedia PDF Downloads 541459 Green Organic Chemistry, a New Paradigm in Pharmaceutical Sciences
Authors: Pesaru Vigneshwar Reddy, Parvathaneni Pavan
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Green organic chemistry which is the latest and one of the most researched topics now-a- days has been in demand since 1990’s. Majority of the research in green organic chemistry chemicals are some of the important starting materials for greater number of major chemical industries. The production of organic chemicals has raw materials (or) reagents for other application is major sector of manufacturing polymers, pharmaceuticals, pesticides, paints, artificial fibers, food additives etc. organic synthesis on a large scale compound to the labratory scale, involves the use of energy, basic chemical ingredients from the petro chemical sectors, catalyst and after the end of the reaction, seperation, purification, storage, packing distribution etc. During these processes there are many problems of health and safety for workers in addition to the environmental problems caused there by use and deposition as waste. Green chemistry with its 12 principles would like to see changes in conventional way that were used for decades to make synthetic organic chemical and the use of less toxic starting materials. Green chemistry would like to increase the efficiency of synthetic methods, to use less toxic solvents, reduce the stage of synthetic routes and minimize waste as far as practically possible. In this way, organic synthesis will be part of the effort for sustainable development Green chemistry is also interested for research and alternatives innovations on many practical aspects of organic synthesis in the university and research labaratory of institutions. By changing the methodologies of organic synthesis, health and safety will be advanced in the small scale laboratory level but also will be extended to the industrial large scale production a process through new techniques. The three key developments in green chemistry include the use of super critical carbondioxide as green solvent, aqueous hydrogen peroxide as an oxidising agent and use of hydrogen in asymmetric synthesis. It also focuses on replacing traditional methods of heating with that of modern methods of heating like microwaves traditions, so that carbon foot print should reduces as far as possible. Another beneficiary of this green chemistry is that it will reduce environmental pollution through the use of less toxic reagents, minimizing of waste and more bio-degradable biproducts. In this present paper some of the basic principles, approaches, and early achievements of green chemistry has a branch of chemistry that studies the laws of passing of chemical reactions is also considered, with the summarization of green chemistry principles. A discussion about E-factor, old and new synthesis of ibuprofen, microwave techniques, and some of the recent advancements also considered.Keywords: energy, e-factor, carbon foot print, micro-wave, sono-chemistry, advancement
Procedia PDF Downloads 3071458 The Basin Management Methodology for Integrated Water Resources Management and Development
Authors: Julio Jesus Salazar, Max Jesus De Lama
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The challenges of water management are aggravated by global change, which implies high complexity and associated uncertainty; water management is difficult because water networks cross domains (natural, societal, and political), scales (space, time, jurisdictional, institutional, knowledge, etc.) and levels (area: patches to global; knowledge: a specific case to generalized principles). In this context, we need to apply natural and non-natural measures to manage water and soil. The Basin Management Methodology considers multifunctional measures of natural water retention and erosion control and soil formation to protect water resources and address the challenges related to the recovery or conservation of the ecosystem, as well as natural characteristics of water bodies, to improve the quantitative status of water bodies and reduce vulnerability to floods and droughts. This method of water management focuses on the positive impacts of the chemical and ecological status of water bodies, restoration of the functioning of the ecosystem and its natural services; thus, contributing to both adaptation and mitigation of climate change. This methodology was applied in 7 interventions in the sub-basin of the Shullcas River in Huancayo-Junín-Peru, obtaining great benefits in the framework of the participation of alliances of actors and integrated planning scenarios. To implement the methodology in the sub-basin of the Shullcas River, a process called Climate Smart Territories (CST) was used; with which the variables were characterized in a highly complex space. The diagnosis was then worked using risk management and adaptation to climate change. Finally, it was concluded with the selection of alternatives and projects of this type. Therefore, the CST approach and process face the challenges of climate change through integrated, systematic, interdisciplinary and collective responses at different scales that fit the needs of ecosystems and their services that are vital to human well-being. This methodology is now replicated at the level of the Mantaro river basin, improving with other initiatives that lead to the model of a resilient basin.Keywords: climate-smart territories, climate change, ecosystem services, natural measures, Climate Smart Territories (CST) approach
Procedia PDF Downloads 1531457 Quality Assurance in Higher Education: Doha Institute for Graduate Studies as a Case Study
Authors: Ahmed Makhoukh
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Quality assurance (QA) has recently become a common practice, which is endorsed by most Higher Education (HE) institutions worldwide, due to the pressure of internal and external forces. One of the aims of this quality movement is to make the contribution of university education to socio-economic development highly significant. This entails that graduates are currently required have a high-quality profile, i.e., to be competent and master the 21st-century skills needed in the labor market. This wave of change, mostly imposed by globalization, has the effect that university education should be learner-centered in order to satisfy the different needs of students and meet the expectations of other stakeholders. Such a shift of focus on the student learning outcomes has led HE institutions to reconsider their strategic planning, their mission, the curriculum, the pedagogical competence of the academic staff, among other elements. To ensure that the overall institutional performance is on the right way, a QA system should be established to assume this task of checking regularly the extent to which the set of standards of evaluation are strictly respected as expected. This operation of QA has the advantage of proving the accountability of the institution, gaining the trust of the public with transparency and enjoying an international recognition. This is the case of Doha Institute (DI) for Graduate Studies, in Qatar, the object of the present study. The significance of this contribution is to show that the conception of quality has changed in this digital age, and the need to integrate a department responsible for QA in every HE institution to ensure educational quality, enhance learners and achieve academic leadership. Thus, to undertake the issue of QA in DI for Graduate Studies, an elite university (in the academic sense) that focuses on a small and selected number of students, a qualitative method will be adopted in the description and analysis of the data (document analysis). In an attempt to investigate the extent to which QA is achieved in Doha Institute for Graduate Studies, three broad indicators will be evaluated (input, process and learning outcomes). This investigation will be carried out in line with the UK Quality Code for Higher Education represented by Quality Assurance Agency (QAA).Keywords: accreditation, higher education, quality, quality assurance, standards
Procedia PDF Downloads 1481456 Antecedents and Impacts of Human Capital Flight in the Sub-Saharan Africa with Specific Reference to the Higher Education Sector: Conceptual Model
Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink
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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development
Procedia PDF Downloads 2601455 Review and Comparison of Iran`s Sixteenth Topic of the Building with the Ranking System of the Water Sector Lead to Improve the Criteria of the Sixteenth Topic
Authors: O. Fatemi
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Considering growing building construction industry in developing countries and sustainable development concept, as well as the importance of taking care of the future generations, codifying buildings scoring system based on environmental criteria, has always been a subject for discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables. In this article, the most important common LEED (Leadership in Energy and Environmental Design) and BREEAM (Building Research Establishment Environmental Assessment Method) common and Global environmental scoring systems, used in UK, USA, and Japan, respectively, have been discussed and compared with a special focus on CASBEE (Comprehensive Assessment System for Built Environment Efficiency), to credit assigning field (weighing and scores systems) as well as sustainable development criteria in each system. Then, converging and distinct fields of the foregoing systems are examined considering National Iranian Building Code. Furthermore, the common credits in the said systems not mentioned in National Iranian Building Code have been identified. These credits, which are generally included in well-known fundamental principles in sustainable development, may be considered as offered options for the Iranian building environmental scoring system. It is suggested that one of the globally and commonly accepted systems is chosen considering national priorities in order to offer an effective method for buildings environmental scoring, and then, a part of credits is added and/or removed, or a certain credit score is changed, and eventually, a new scoring system with a new title is developed for the country. Evidently, building construction industry highly affects the environment, economy, efficiency, and health of the relevant occupants. Considering the growing trend of cities and construction, achieving building scoring systems based on environmental criteria has always been a matter of discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables.Keywords: scoring system, sustainability assessment, water efficiency, national Iranian building code
Procedia PDF Downloads 1821454 GenAI Agents in Product Management: A Case Study from the Manufacturing Sector
Authors: Aron Witkowski, Andrzej Wodecki
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Purpose: This study aims to explore the feasibility and effectiveness of utilizing Generative Artificial Intelligence (GenAI) agents as product managers within the manufacturing sector. It seeks to evaluate whether current GenAI capabilities can fulfill the complex requirements of product management and deliver comparable outcomes to human counterparts. Study Design/Methodology/Approach: This research involved the creation of a support application for product managers, utilizing high-quality sources on product management and generative AI technologies. The application was designed to assist in various aspects of product management tasks. To evaluate its effectiveness, a study was conducted involving 10 experienced product managers from the manufacturing sector. These professionals were tasked with using the application and providing feedback on the tool's responses to common questions and challenges they encounter in their daily work. The study employed a mixed-methods approach, combining quantitative assessments of the tool's performance with qualitative interviews to gather detailed insights into the user experience and perceived value of the application. Findings: The findings reveal that GenAI-based product management agents exhibit significant potential in handling routine tasks, data analysis, and predictive modeling. However, there are notable limitations in areas requiring nuanced decision-making, creativity, and complex stakeholder interactions. The case study demonstrates that while GenAI can augment human capabilities, it is not yet fully equipped to independently manage the holistic responsibilities of a product manager in the manufacturing sector. Originality/Value: This research provides an analysis of GenAI's role in product management within the manufacturing industry, contributing to the limited body of literature on the application of GenAI agents in this domain. It offers practical insights into the current capabilities and limitations of GenAI, helping organizations make informed decisions about integrating AI into their product management strategies. Implications for Academic and Practical Fields: For academia, the study suggests new avenues for research in AI-human collaboration and the development of advanced AI systems capable of higher-level managerial functions. Practically, it provides industry professionals with a nuanced understanding of how GenAI can be leveraged to enhance product management, guiding investments in AI technologies and training programs to bridge identified gaps.Keywords: generative artificial intelligence, GenAI, NPD, new product development, product management, manufacturing
Procedia PDF Downloads 521453 Prioritization of Sub-Watersheds in Semi Arid Region: A Case Study of Shevgaon and Pathardi Tahsils in Maharashtra
Authors: Dadasaheb R. Jawre, Maya G. Unde
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Prioritization of sub-watershed plays important role in watershed management. It shows the requirement of watershed to give a treatment for the green growth of the region and conservation of the sub-watersheds. There is a number of factors like topography of the region, climatic characteristics like rainfall and runoff, land-use land-cover, social factors which are related to the development of watershed for agricultural uses and domestic purposes in the region. The present research is throwing a focus on how morphometric parameters in association with GIS analysis will help in identifying the ranking of the sub-watersheds for further development which help of suggested watershed structures. Shevgaon and Pathardi tahsils are drought prone tahsils of Ahmednagar district in Maharashtra. These tahsils come under the semi-arid region. Sub-watershed prioritization is necessary for proper planning and management of natural resources for sustainable development of the study area. Less rainfall and increasing population pressure on the land as well as water resources lead to scarcity of the water in the region. Hence, researcher has selected Shevgaon and Pathardi tahsils for sub-watershed prioritization. There are seven sub-watersheds which selected for the present research paper. In the morphological analysis linear aspects, aerial aspects and relief aspects are considered for the prioritization. The largest sub-watershed is Erdha which is located at Karanji in Pathardi tahsil having an area of 145.06 km2 and smallest sub-watershed is Erandgaon which is located in Shevgaon tahsil having an area of 40.143 km2. For all seven sub-watersheds, seven morphometric parameters were considered for calculating the compound parameter values. Finally, compound parameter values are grouped into three groups such as, high priority (below 4.0), moderate priority (4.0 to 5.0) and low priority (above 5.0) according to the compound value Erandgaon, Chapadgaon and Tarak sub-watersheds comes under high priority group, Erdha and Domeshwar sub-watersheds come under moderate priority group and Chandani and Kasichi sub-watershed come under low priority group. Both the tahsils falls in drought prone area, after getting the watershed structure overall development of the region will take place.Keywords: sub-watersheds, GIS and remote sensing, morphometric analysis, compound parameter value, prioritization
Procedia PDF Downloads 1551452 Factors Associated with Recurrence and Long-Term Survival in Younger and Postmenopausal Women with Breast Cancer
Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn
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Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.Keywords: breast cancer, menopause status, recurrence-free survival, overall survival
Procedia PDF Downloads 1631451 Application of Principal Component Analysis and Ordered Logit Model in Diabetic Kidney Disease Progression in People with Type 2 Diabetes
Authors: Mequanent Wale Mekonen, Edoardo Otranto, Angela Alibrandi
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Diabetic kidney disease is one of the main microvascular complications caused by diabetes. Several clinical and biochemical variables are reported to be associated with diabetic kidney disease in people with type 2 diabetes. However, their interrelations could distort the effect estimation of these variables for the disease's progression. The objective of the study is to determine how the biochemical and clinical variables in people with type 2 diabetes are interrelated with each other and their effects on kidney disease progression through advanced statistical methods. First, principal component analysis was used to explore how the biochemical and clinical variables intercorrelate with each other, which helped us reduce a set of correlated biochemical variables to a smaller number of uncorrelated variables. Then, ordered logit regression models (cumulative, stage, and adjacent) were employed to assess the effect of biochemical and clinical variables on the order-level response variable (progression of kidney function) by considering the proportionality assumption for more robust effect estimation. This retrospective cross-sectional study retrieved data from a type 2 diabetic cohort in a polyclinic hospital at the University of Messina, Italy. The principal component analysis yielded three uncorrelated components. These are principal component 1, with negative loading of glycosylated haemoglobin, glycemia, and creatinine; principal component 2, with negative loading of total cholesterol and low-density lipoprotein; and principal component 3, with negative loading of high-density lipoprotein and a positive load of triglycerides. The ordered logit models (cumulative, stage, and adjacent) showed that the first component (glycosylated haemoglobin, glycemia, and creatinine) had a significant effect on the progression of kidney disease. For instance, the cumulative odds model indicated that the first principal component (linear combination of glycosylated haemoglobin, glycemia, and creatinine) had a strong and significant effect on the progression of kidney disease, with an effect or odds ratio of 0.423 (P value = 0.000). However, this effect was inconsistent across levels of kidney disease because the first principal component did not meet the proportionality assumption. To address the proportionality problem and provide robust effect estimates, alternative ordered logit models, such as the partial cumulative odds model, the partial adjacent category model, and the partial continuation ratio model, were used. These models suggested that clinical variables such as age, sex, body mass index, medication (metformin), and biochemical variables such as glycosylated haemoglobin, glycemia, and creatinine have a significant effect on the progression of kidney disease.Keywords: diabetic kidney disease, ordered logit model, principal component analysis, type 2 diabetes
Procedia PDF Downloads 421450 Research on the Conservation Strategy of Territorial Landscape Based on Characteristics: The Case of Fujian, China
Authors: Tingting Huang, Sha Li, Geoffrey Griffiths, Martin Lukac, Jianning Zhu
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Territorial landscapes have experienced a gradual loss of their typical characteristics during long-term human activities. In order to protect the integrity of regional landscapes, it is necessary to characterize, evaluate and protect them in a graded manner. The study takes Fujian, China, as an example and classifies the landscape characters of the site at the regional scale, middle scale, and detailed scale. A multi-scale approach combining parametric and holistic approaches is used to classify and partition the landscape character types (LCTs) and landscape character areas (LCAs) at different scales, and a multi-element landscape assessment approach is adopted to explore the conservation strategies of the landscape character. Firstly, multiple fields and multiple elements of geography, nature and humanities were selected as the basis of assessment according to the scales. Secondly, the study takes a parametric approach to the classification and partitioning of landscape character, Principal Component Analysis, and two-stage cluster analysis (K-means and GMM) in MATLAB software to obtain LCTs, combines with Canny Operator Edge Detection Algorithm to obtain landscape character contours and corrects LCTs and LCAs by field survey and manual identification methods. Finally, the study adopts the Landscape Sensitivity Assessment method to perform landscape character conservation analysis and formulates five strategies for different LCAs: conservation, enhancement, restoration, creation, and combination. This multi-scale identification approach can efficiently integrate multiple types of landscape character elements, reduce the difficulty of broad-scale operations in the process of landscape character conservation, and provide a basis for landscape character conservation strategies. Based on the natural background and the restoration of regional characteristics, the results of landscape character assessment are scientific and objective and can provide a strong reference in regional and national scale territorial spatial planning.Keywords: parameterization, multi-scale, landscape character identify, landscape character assessment
Procedia PDF Downloads 1001449 Leveraging Remote Sensing Information for Drought Disaster Risk Management
Authors: Israel Ropo Orimoloye, Johanes A. Belle, Olusola Adeyemi, Olusola O. Ololade
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With more than 100,000 orbits during the past 20 years, Terra has significantly improved our knowledge of the Earth's climate and its implications on societies and ecosystems of human activity and natural disasters, including drought events. With Terra instrument's performance and the free distribution of its products, this study utilised Terra MOD13Q1 satellite data to assess drought disaster events and its spatiotemporal patterns over the Free State Province of South Africa between 2001 and 2019 for summer, autumn, winter, and spring seasons. The study also used high-resolution downscaled climate change projections under three representative concentration pathways (RCP). Three future periods comprising the short (the 2030s), medium (2040s), and long term (2050s) compared to the current period are analysed to understand the potential magnitude of projected climate change-related drought. The study revealed that the year 2001 and 2016 witnessed extreme drought conditions where the drought index is between 0 and 20% across the entire province during summer, while the year 2003, 2004, 2007, and 2015 observed severe drought conditions across the region with variation from one part to the another. The result shows that from -24.5 to -25.5 latitude, the area witnessed a decrease in precipitation (80 to 120mm) across the time slice and an increase in the latitude -26° to -28° S for summer seasons, which is more prominent in the year 2041 to 2050. This study emphasizes the strong spatio-environmental impacts within the province and highlights the associated factors that characterise high drought stress risk, especially on the environment and ecosystems. This study contributes to a disaster risk framework to identify areas for specific research and adaptation activities on drought disaster risk and for environmental planning in the study area, which is characterised by both rural and urban contexts, to address climate change-related drought impacts.Keywords: remote sensing, drought disaster, climate scenario, assessment
Procedia PDF Downloads 1881448 The Impact of Protein Content on Athletes’ Body Composition
Authors: G. Vici, L. Cesanelli, L. Belli, R. Ceci, V. Polzonetti
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Several factors contribute to success in sport and diet is one of them. Evidence-based sport nutrition guidelines underline the importance of macro- and micro-nutrients’ balance and timing in order to improve athlete’s physical status and performance. Nevertheless, a high content of proteins is commonly found in resistance training athletes’ diet with carbohydrate intake that is not enough or not well planned. The aim of the study was to evaluate the impact of different protein and carbohydrate diet contents on body composition and sport performance on a group of resistance training athletes. Subjects were divided as study group (n=16) and control group (n=14). For a period of 4 months, both groups were subjected to the same resistance training fitness program with study group following a specific diet and control group following an ab libitum diet. Body compositions were evaluated trough anthropometric measurement (weight, height, body circumferences and skinfolds) and Bioimpedence Analysis. Physical strength and training status of individuals were evaluated through the One Repetition Maximum test (RM1). Protein intake in studied group was found to be lower than in control group. There was a statistically significant increase of body weight, free fat mass and body mass cell of studied group respect to the control group. Fat mass remains almost constant. Statistically significant changes were observed in quadriceps and biceps circumferences, with an increase in studied group. The MR1 test showed improvement in study group’s strength but no changes in control group. Usually people consume hyper-proteic diet to achieve muscle mass development. Through this study, it was possible to show that protein intake fixed at 1,7 g/kg/d can meet the individual's needs. In parallel, the increased intake of carbohydrates, focusing on quality and timing of assumption, has enabled the obtainment of desired results with a training protocol supporting a hypertrophic strategy. Therefore, the key point seems related to the planning of a structured program both from a nutritional and training point of view.Keywords: body composition, diet, exercise, protein
Procedia PDF Downloads 2261447 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova
Authors: Balkibekova Venera Serikpaevna
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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications
Procedia PDF Downloads 671446 Role of Education on Shaping the Personality of the Students in Rural Areas: A Case Study of Daund Taluka in Pune District of Maharashtra, India
Authors: L. K. Shitole
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Usually on the face of it, personality is regarded as the external appearance of an individual. In psychology, the personality is not viewed merely as self or external appears, but it adds much more. Human resources development encompasses the personality development of the students. The student’s development starts right from the childhood and gradually continues right up to the completion of education in professional courses. This paper attempts to find out the role of the educational institutions in shaping the personality of the students from the rural area. Schools and colleges have infrastructural limitations, obtaining good quality and devoted teaching staff poses problems and even outside the school environment there are no private classes which may take care of this deficiency. The researcher has used the standardized test namely “Vyaktitva Shodhika” developed by Gyan Prabodhini, Pune for the students in Daund Taluka. There are 68 objective types of questions in the said questionnaire. Totally a sample size of 4191 students was selected. The sample was quite representative. It is observed that by and large the response indicates that the educational institutions are taking sincere efforts in shaping the personality of the students. In the semi-urban area i.e. at educational institutions of all levels, the performance on this front is excellent and at rest of Daund Taluka there is scope for improvement. Educational institutions of all levels are showing excellent performance in ensuring availability of the requisite infrastructure conducive for the development of the personality of the students. In rest of Daund Taluka there is ample scope for improving the situation. As far as data relating to role of co-curricular activities and sports programs in mental and physical development at various educational institutions is concerned Daund educational institutions have repeated their performance in securing “A” category, while in the rural area of Daund Taluka, there is need to step up the efforts in this regard. In today’s world of knowledge industry, one cannot ignore the importance of education and thereby the personality growth of the students. Accordingly, the educational institutions should undertake consistent research and extension activities in the area of personality development.Keywords: personality, attitude, infrastructure, quality of education, learning environment, teacher’s contribution, family and society’s role
Procedia PDF Downloads 4661445 Impact of Positive Psychology Education and Interventions on Well-Being: A Study of Students Engaged in Pastoral Care
Authors: Inna R. Edara, Haw-Lin Wu
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Positive psychology investigates human strengths and virtues and promotes well-being. Relying on this assumption, positive interventions have been continuously designed to build pleasure and happiness, joy and contentment, engagement and meaning, hope and optimism, satisfaction and gratitude, spirituality, and various other positive measures of well-being. In line with this model of positive psychology and interventions, this study investigated certain measures of well-being in a group of 45 students enrolled in an 18-week positive psychology course and simultaneously engaged in service-oriented interventions that they chose for themselves based on the course content and individual interests. Students’ well-being was measured at the beginning and end of the course. The well-being indicators included positive automatic thoughts, optimism and hope, satisfaction with life, and spirituality. A paired-samples t-test conducted to evaluate the impact of class content and service-oriented interventions on students’ scores of well-being indicators indicated statistically significant increase from pre-class to post-class scores. There were also significant gender differences in post-course well-being scores, with females having higher levels of well-being than males. A two-way between groups analysis of variance indicated a significant interaction effect of age by gender on the post-course well-being scores, with females in the age group of 56-65 having the highest scores of well-being in comparison to the males in the same age group. Regression analyses indicated that positive automatic thought significantly predicted hope and satisfaction with life in the pre-course analysis. In the post-course regression analysis, spiritual transcendence made a significant contribution to optimism, and positive automatic thought made a significant contribution to both hope and satisfaction with life. Finally, a significant test between pre-course and post-course regression coefficients indicated that the regression coefficients at pre-course were significantly different from post-course coefficients, suggesting that the positive psychology course and the interventions were helpful in raising the levels of well-being. The overall results suggest a substantial increase in the participants’ well-being scores after engaging in the positive-oriented interventions, implying a need for designing more positive interventions in education to promote well-being.Keywords: hope, optimism, positive automatic thoughts, satisfaction with life, spirituality, well-being
Procedia PDF Downloads 2191444 Analysis and Design Modeling for Next Generation Network Intrusion Detection and Prevention System
Authors: Nareshkumar Harale, B. B. Meshram
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The continued exponential growth of successful cyber intrusions against today’s businesses has made it abundantly clear that traditional perimeter security measures are no longer adequate and effective. We evolved the network trust architecture from trust-untrust to Zero-Trust, With Zero Trust, essential security capabilities are deployed in a way that provides policy enforcement and protection for all users, devices, applications, data resources, and the communications traffic between them, regardless of their location. Information exchange over the Internet, in spite of inclusion of advanced security controls, is always under innovative, inventive and prone to cyberattacks. TCP/IP protocol stack, the adapted standard for communication over network, suffers from inherent design vulnerabilities such as communication and session management protocols, routing protocols and security protocols are the major cause of major attacks. With the explosion of cyber security threats, such as viruses, worms, rootkits, malwares, Denial of Service attacks, accomplishing efficient and effective intrusion detection and prevention is become crucial and challenging too. In this paper, we propose a design and analysis model for next generation network intrusion detection and protection system as part of layered security strategy. The proposed system design provides intrusion detection for wide range of attacks with layered architecture and framework. The proposed network intrusion classification framework deals with cyberattacks on standard TCP/IP protocol, routing protocols and security protocols. It thereby forms the basis for detection of attack classes and applies signature based matching for known cyberattacks and data mining based machine learning approaches for unknown cyberattacks. Our proposed implemented software can effectively detect attacks even when malicious connections are hidden within normal events. The unsupervised learning algorithm applied to network audit data trails results in unknown intrusion detection. Association rule mining algorithms generate new rules from collected audit trail data resulting in increased intrusion prevention though integrated firewall systems. Intrusion response mechanisms can be initiated in real-time thereby minimizing the impact of network intrusions. Finally, we have shown that our approach can be validated and how the analysis results can be used for detecting and protection from the new network anomalies.Keywords: network intrusion detection, network intrusion prevention, association rule mining, system analysis and design
Procedia PDF Downloads 2281443 Kinematic Analysis of Human Gait for Typical Postures of Walking, Running and Cart Pulling
Authors: Nupur Karmaker, Hasin Aupama Azhari, Abdul Al Mortuza, Abhijit Chanda, Golam Abu Zakaria
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Purpose: The purpose of gait analysis is to determine the biomechanics of the joint, phases of gait cycle, graphical and analytical analysis of degree of rotation, analysis of the electrical activity of muscles and force exerted on the hip joint at different locomotion during walking, running and cart pulling. Methods and Materials: Visual gait analysis and electromyography method has been used to detect the degree of rotation of joints and electrical activity of muscles. In cinematography method an object is observed from different sides and takes its video. Cart pulling length has been divided into frames with respect to time by using video splitter software. Phases of gait cycle, degree of rotation of joints, EMG profile and force analysis during walking and running has been taken from different papers. Gait cycle and degree of rotation of joints during cart pulling has been prepared by using video camera, stop watch, video splitter software and Microsoft Excel. Results and Discussion: During the cart pulling the force exerted on hip is the resultant of various forces. The force on hip is the vector sum of the force Fg= mg, due the body of weight of the person and Fa= ma, due to the velocity. Maximum stance phase shows during cart pulling and minimum shows during running. During cart pulling shows maximum degree of rotation of hip joint, knee: running, and ankle: cart pulling. During walking, it has been observed minimum degree of rotation of hip, ankle: during running. During cart pulling, dynamic force depends on the walking velocity, body weight and load weight. Conclusions: 80% people suffer gait related disease with increasing their age. Proper care should take during cart pulling. It will be better to establish the gait laboratory to determine the gait related diseases. If the way of cart pulling is changed i.e the design of cart pulling machine, load bearing system is changed then it would possible to reduce the risk of limb loss, flat foot syndrome and varicose vein in lower limb.Keywords: kinematic, gait, gait lab, phase, force analysis
Procedia PDF Downloads 5761442 Influence of Microparticles in the Contact Region of Quartz Sand Grains: A Micro-Mechanical Experimental Study
Authors: Sathwik Sarvadevabhatla Kasyap, Kostas Senetakis
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The mechanical behavior of geological materials is very complex, and this complexity is related to the discrete nature of soils and rocks. Characteristics of a material at the grain scale such as particle size and shape, surface roughness and morphology, and particle contact interface are critical to evaluate and better understand the behavior of discrete materials. This study investigates experimentally the micro-mechanical behavior of quartz sand grains with emphasis on the influence of the presence of microparticles in their contact region. The outputs of the study provide some fundamental insights on the contact mechanics behavior of artificially coated grains and can provide useful input parameters in the discrete element modeling (DEM) of soils. In nature, the contact interfaces between real soil grains are commonly observed with microparticles. This is usually the case of sand-silt and sand-clay mixtures, where the finer particles may create a coating on the surface of the coarser grains, altering in this way the micro-, and thus the macro-scale response of geological materials. In this study, the micro-mechanical behavior of Leighton Buzzard Sand (LBS) quartz grains, with interference of different microparticles at their contact interfaces is studied in the laboratory using an advanced custom-built inter-particle loading apparatus. Special techniques were adopted to develop the coating on the surfaces of the quartz sand grains so that to establish repeatability of the coating technique. The characterization of the microstructure of coated particles on their surfaces was based on element composition analyses, microscopic images, surface roughness measurements, and single particle crushing strength tests. The mechanical responses such as normal and tangential load – displacement behavior, tangential stiffness behavior, and normal contact behavior under cyclic loading were studied. The behavior of coated LBS particles is compared among different classes of them and with pure LBS (i.e. surface cleaned to remove any microparticles). The damage on the surface of the particles was analyzed using microscopic images. Extended displacements in both normal and tangential directions were observed for coated LBS particles due to the plastic nature of the coating material and this varied with the variation of the amount of coating. The tangential displacement required to reach steady state was delayed due to the presence of microparticles in the contact region of grains under shearing. Increased tangential loads and coefficient of friction were observed for the coated grains in comparison to the uncoated quartz grains.Keywords: contact interface, microparticles, micro-mechanical behavior, quartz sand
Procedia PDF Downloads 1921441 Analysis of Fuel Adulteration Consequences in Bangladesh
Authors: Mahadehe Hassan
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In most countries manufacturing, trading and distribution of gasoline and diesel fuels belongs to the most important sectors of national economy. For Bangladesh, a robust, well-functioning, secure and smartly managed national fuel distribution chain is an essential precondition for achieving Government top priorities in development and modernization of transportation infrastructure, protection of national environment and population health as well as, very importantly, securing due tax revenue for the State Budget. Bangladesh is a developing country with complex fuel supply network, high fuel taxes incidence and – till now - limited possibilities in application of modern, automated technologies for Government national fuel market control. Such environment allows dishonest physical and legal persons and organized criminals to build and profit from illegal fuel distribution schemes and fuel illicit trade. As a result, the market transparency and the country attractiveness for foreign investments, law-abiding economic operators, national consumers, State Budget and the Government ability to finance development projects, and the country at large suffer significantly. Research shows that over 50% of retail petrol stations in major agglomerations of Bangladesh sell adulterated fuels and/or cheat customers on the real volume of the fuel pumped into their vehicles. Other forms of detected fuel illicit trade practices include misdeclaration of fuel quantitative and qualitative parameters during internal transit and selling of non-declared and smuggled fuels. The aim of the study is to recommend the implementation of a National Fuel Distribution Integrity Program (FDIP) in Bangladesh to address and resolve fuel adulteration and illicit trade problems. The program should be customized according to the specific needs of the country and implemented in partnership with providers of advanced technologies. FDIP should enable and further enhance capacity of respective Bangladesh Government authorities in identification and elimination of all forms of fuel illicit trade swiftly and resolutely. FDIP high-technology, IT and automation systems and secure infrastructures should be aimed at the following areas (1) fuel adulteration, misdeclaration and non-declaration; (2) fuel quality and; (3) fuel volume manipulation at retail level. Furthermore, overall concept of FDIP delivery and its interaction with the reporting and management systems used by the Government shall be aligned with and support objectives of the Vision 2041 and Smart Bangladesh Government programs.Keywords: fuel adulteration, octane, kerosene, diesel, petrol, pollution, carbon emissions
Procedia PDF Downloads 781440 Predictors of Lost to Follow-Up among HIV Patients Attending Anti-Retroviral Therapy Treatment Centers in Nigeria
Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer
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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up
Procedia PDF Downloads 3041439 Prevalence of Urinary Tract Infections and Risk Factors among Pregnant Women Attending Ante Natal Clinics in Government Primary Health Care Centres in Akure
Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya
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Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.Keywords: pregnant women, prevalence, risk factor, UTIs
Procedia PDF Downloads 1471438 Integrated Management System Applied in Dismantling and Waste Management of the Primary Cooling System from the VVR-S Nuclear Reactor Magurele, Bucharest
Authors: Radu Deju, Carmen Mustata
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The VVR-S nuclear research reactor owned by Horia Hubulei National Institute of Physics and Nuclear Engineering (IFIN-HH) was designed for research and radioisotope production, being permanently shut-down in 2002, after 40 years of operation. All amount of the nuclear spent fuel S-36 and EK-10 type was returned to Russian Federation (first in 2009 and last in 2012), and the radioactive waste resulted from the reprocessing of it will remain permanently in the Russian Federation. The decommissioning strategy chosen is immediate dismantling. At this moment, the radionuclides with half-life shorter than 1 year have a minor contribution to the contamination of materials and equipment used in reactor department. The decommissioning of the reactor has started in 2010 and is planned to be finalized in 2020, being the first nuclear research reactor that has started the decommissioning project from the South-East of Europe. The management system applied in the decommissioning of the VVR-S research reactor integrates all common elements of management: nuclear safety, occupational health and safety, environment, quality- compliance with the requirements for decommissioning activities, physical protection and economic elements. This paper presents the application of integrated management system in decommissioning of systems, structures, equipment and components (SSEC) from pumps room, including the management of the resulted radioactive waste. The primary cooling system of this type of reactor includes circulation pumps, heat exchangers, degasser, filter ion exchangers, piping connection, drainage system and radioactive leaks. All the decommissioning activities of primary circuit were performed in stage 2 (year 2014), and they were developed and recorded according to the applicable documents, within the requirements of the Regulatory Body Licenses. In the presentation there will be emphasized how the integrated management system provisions are applied in the dismantling of the primary cooling system, for elaboration, approval, application of necessary documentation, records keeping before, during and after the dismantling activities. Radiation protection and economics are the key factors for the selection of the proper technology. Dedicated and advanced technologies were chosen to perform specific tasks. Safety aspects have been taken into consideration. Resource constraints have also been an important issue considered in defining the decommissioning strategy. Important aspects like radiological monitoring of the personnel and areas, decontamination, waste management and final characterization of the released site are demonstrated and documented.Keywords: decommissioning, integrated management system, nuclear reactor, waste management
Procedia PDF Downloads 2911437 Impact of Climate Change on Forest Ecosystem Services: In situ Biodiversity Conservation and Sustainable Management of Forest Resources in Tropical Forests
Authors: Rajendra Kumar Pandey
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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation
Procedia PDF Downloads 2981436 An Overview of Suicidality in American Indians and Alaska Natives
Authors: Christopher S. Perez, Kendal C. Boyd
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global suicide rates have decreased in recent decades, rates in the United States have increased by 35.2 percent since 1999.American Indians and Alaska Natives (AI/AN) have the highest rates of suicide in the U.S., with approximately 22 suicides per 100,000 people as of 2019. AI/AN have experienced significant historical trauma resulting in disproportionate rates of substance abuse and mental disorders. This literature review aimed to identify the demographic and clinical risk and protective factors for American Indians and Alaska Natives and provide an overview of suicidality in this population. The literature reflected varying definitions of suicidality depending on region, with some AI/AN tribesconceptualizing suicide through a spiritual framework, while others defined suicide in the biomedical sense. Furthermore, AI/AN adults and adolescents experienced higher rates of suicidal ideation when compared to other racial groups. Religious preference, sexual orientation, prior suicidal behavior, psychiatric admission, history of abuse, substance abuse, family history of mental illness, family history of substance abuse, family history of suicidal behaviors, domestic violence, and trauma were discussed as factors related to suicidality. Recommendations included increasing access to and utilization of mental health and medical services, culturally adapting suicide prevention programs to AI/AN communities, increasing support for LGBTQ+ AI/AN, providing opportunities that reinforce ethnic identity, and post-hospitalization follow-up care. The following databases were utilized to obtain peer-reviewed articles for this literature review: Complementary Index, Academic Search Premier, Science Direct, PsycInfo, Social Sciences Citation Index, PsycArticles, PubMed, EbscoHost, and PsycBooks. Articles that examined Native populations outside of the United States did not cite a primary source and/or were published before 1990 were excluded.Keywords: alaska native, american indian, protective factors, risk factors, suicidality, suicide
Procedia PDF Downloads 1011435 Enhancing Athlete Training using Real Time Pose Estimation with Neural Networks
Authors: Jeh Patel, Chandrahas Paidi, Ahmed Hambaba
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Traditional methods for analyzing athlete movement often lack the detail and immediacy required for optimal training. This project aims to address this limitation by developing a Real-time human pose estimation system specifically designed to enhance athlete training across various sports. This system leverages the power of convolutional neural networks (CNNs) to provide a comprehensive and immediate analysis of an athlete’s movement patterns during training sessions. The core architecture utilizes dilated convolutions to capture crucial long-range dependencies within video frames. Combining this with the robust encoder-decoder architecture to further refine pose estimation accuracy. This capability is essential for precise joint localization across the diverse range of athletic poses encountered in different sports. Furthermore, by quantifying movement efficiency, power output, and range of motion, the system provides data-driven insights that can be used to optimize training programs. Pose estimation data analysis can also be used to develop personalized training plans that target specific weaknesses identified in an athlete’s movement patterns. To overcome the limitations posed by outdoor environments, the project employs strategies such as multi-camera configurations or depth sensing techniques. These approaches can enhance pose estimation accuracy in challenging lighting and occlusion scenarios, where pose estimation accuracy in challenging lighting and occlusion scenarios. A dataset is collected From the labs of Martin Luther King at San Jose State University. The system is evaluated through a series of tests that measure its efficiency and accuracy in real-world scenarios. Results indicate a high level of precision in recognizing different poses, substantiating the potential of this technology in practical applications. Challenges such as enhancing the system’s ability to operate in varied environmental conditions and further expanding the dataset for training were identified and discussed. Future work will refine the model’s adaptability and incorporate haptic feedback to enhance the interactivity and richness of the user experience. This project demonstrates the feasibility of an advanced pose detection model and lays the groundwork for future innovations in assistive enhancement technologies.Keywords: computer vision, deep learning, human pose estimation, U-NET, CNN
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