Search results for: fire probabilistic risk assessment

Authors: Mohammed A. Alhoot, Rathika A/P Nagarajan

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Climate change and variability are affecting human health and diseases direct or indirectly through many mechanisms. Change in rain pattern, an increase of temperature and humidity are showing an increased trend in Malaysia. This will affect the biological, physical and chemical component of water through different pathways and will enhance the risk of waterborne diseases. Besides, the warm temperature and humid climate provide very suitable conditions for the growth of pathogenic bacteria. This study is intended to highlight the relationship between the climate changes and the incidence food and water associated infections. Incidences of food and water associated infection and climate data were collected from Malaysian Ministry of health and Malaysian Metrological Department respectively. Maximum and minimum temperature showed high correlation with incidence of typhoid, hepatitis A, dysentery, food poisoning (P value <0.05 significant with 2 tailed / 0.5<[r]). Heavy rainfall does not associated with any outbreaks. Climate change brings out new challenges in controlling food and water associated infections. Adaptation strategies should involve all key stakeholders with a strong regional cooperation to prevent and deal with cross-boundary health crises. Moreover, the role of health care personnel at local, state and national levels is important to ensure the success of these programmes. As has been shown herein, climate variability is an important element influencing the food and water associated epidemiology in Malaysia. The results of this study are crucial to implementing climate changes as a factor to reduce any future outbreaks.

Keywords: climate change, typhoid, hepatitis A, dysentery, food poisoning

Procedia PDF Downloads 302

Authors: Rose-Michelle Smith, Musandji Fuamba, Salomon Salumu

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Water is vital for life. Access to drinking water and sanitation for humans is one of the Sustainable Development Goals (specifically the sixth) approved by United Nations Member States in September 2015. There are various problems identified relating to water: insufficient fresh water, inequitable distribution of water resources, poor water management in certain places on the planet, detection of water-borne diseases due to poor water quality, and the negative impacts of climate change on water. One of the major challenges in the world is finding ways to ensure that people and the environment have enough water resources to sustain and support their existence. Thus, this research project aims to develop a tool to assess the availability, quality and needs of water in current and future situations with regard to climate change. This tool was tested using threshold values for three regions in three countries: the Metropolitan Community of Montreal (Canada), Normandie Region (France) and North Department (Haiti). The WEAP software was used to evaluate the available quantity of water resources. For water quality, two models were performed: the Canadian Council of Ministers of the Environment (CCME) and the Malaysian Water Quality Index (WQI). Preliminary results showed that the ratio of the needs could be estimated at 155, 308 and 644 m3/capita in 2023 for Normandie, Cap-Haitian and CMM, respectively. Then, the Water Quality Index (WQI) varied from one country to another. Other simulations regarding the water availability and quality are still in progress. This tool will be very useful in decision-making on projects relating to water use in the future; it will make it possible to estimate whether the available resources will be able to satisfy the needs.

Keywords: climate change, water needs, balance sheet, water quality

Procedia PDF Downloads 67

Authors: Sadeq Al Yaari, Fayza Al Hammadi, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari, Salah Al Yami

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Background: When we further take Arabic grammatical issues into account in accordance with applied linguistic investigations on Arabic as Second Language (ASL) learners, a fundamental issue arises at this point as to the production of speech in Arabic: Oral grammatical errors committed by ASL learners. Aims: Using manual rating as well as computational analytic methodology to test a corpus of recorded speech by Second Language (ASL) learners of Arabic, this study aims to find the areas of difficulties in learning Arabic grammar. More specifically, it examines how and why ASL learners make grammatical errors in their oral speech. Methods: Tape recordings of four (4) Arabic as Second Language (ASL) learners who ranged in age from 23 to 30 were naturally collected. All participants have completed an intensive Arabic program (two years) and 20 minute-speech was recorded for each participant. Having the collected corpus, the next procedure was to rate them against Arabic standard grammar. The rating includes four processes: Description, analysis and assessment. Conclusions: Outcomes made from the issues addressed in this paper can be summarized in the fact that ASL learners face many grammatical difficulties when studying Arabic word order, tenses and aspects, function words, subject-verb agreement, verb form, active-passive voice, global and local errors, processes-based errors including addition, omission, substitution or a combination of any of them.

Keywords: grammar, error, oral, Arabic, second language, learner, applied linguistics.

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Authors: Megersa Olumana Dinka, Kassahun Birhanu Tadesse

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Irrigation suitability of shallow groundwater (SGW) was investigated by taking thirty groundwater samples from piezometers and hand-dug wells in Wonji Shoa Sugar Estate (WSSE) (Ethiopia). Many physicochemical parameters (Mg²⁺, Na⁺, Ca²⁺, K⁺, CO₃-, SO4²⁻, HCO₃⁻, Cl⁻, TH, EC, TDS and pH) were analyzed following standard procedures. Different irrigation indices (MAR, SSP, SAR, RSC, KR, and PI) were also used for SGW suitability assessment. If all SGW are blended and used for irrigation, the salinity problem would be slight to moderate, and 100% of potential sugarcane yield could be obtained. The infiltration and sodium ion toxicity problems of the blended water would be none to moderate, and slight to moderate, respectively. As sugarcane is semi-tolerant to sodium toxicity, no significant sodium toxicity problem would be expected from the use of blended water. Blending SGW would also reduce each chloride and boron ion toxicity to none. In general, the rating of SGW was good to excellent for irrigation in terms of average EC (salinity), and excellent in terms of average SAR (infiltration). The SGW of the WSSE was categorized under C3S1 (high salinity and low sodium hazard). In conclusion, the conjunctive use of groundwater for irrigation would help to reduce the potential effect of waterlogging and salinization and their associated problems on soil and sugarcane production and productivity. However, a high value of SSP and RSC indicate a high possibility of infiltration problem. Hence, it is advisable to use the SGW for irrigation after blending with surface water. In this case, the optimum blending ratio of the surface to SGW sources has to be determined for sustainable sugarcane productivity.

Keywords: blending, infiltration, salinity, sodicity, sugarcane, toxicity

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Authors: Volker Koch, Sigrid Swobodnik, Bernd M. Zunk

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The success of companies on globalized markets is significantly influenced by the performance of purchasing departments and, of course, the individuals employed as professional purchasers. Nonetheless, this is generally accepted in practice, in literature as well as in empirical research, only insufficient attention was given to the assessment of this relationship between the personality of professional purchasers and their individual performance. This paper aims to describe the relationship against the background of the 'Big Five Inventory'. Based on the five dimensions of a personality (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism) a research model was designed. The research model divides the individual performance of professional purchasers into two major dimensions: operational and strategic. The operational dimension consists of the items 'cost', 'quality delivery' and 'flexibility'; the strategic dimension comprises the positions 'innovation', 'supplier satisfaction' as wells as 'purchasing and supply management integration in the organization'. To test the research model, a survey study was performed, and an online questionnaire was sent out to purchasing professionals in Austrian companies. The data collected from 78 responses was used to test the research model applying a group comparison. The comparison points out that there is (i) an influence of the purchasers’ personality on the individual performance of professional purchasers and (ii) a link between purchasers’ personality to a high or a low individual performance of professional purchasers. The findings of this study may help human resource managers during staff recruitment processes to identify the 'right performing personality' for an operational and/or a strategic position in purchasing departments.

Keywords: big five inventory, individual performance, personality, purchasing professionals

Procedia PDF Downloads 164

Authors: María-Dolores Afonso-Suárez, Nayra Pumar-Carreras, Juan Ruiz-Alzola

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This research addresses the use of an e-Learning creation methodology for learning objects. Throughout the process, indicators are being gathered, to determine if it responds to the main objectives of an engineering discipline. These parameters will also indicate if it is necessary to review the creation cycle and readjust any phase. Within the project developed for this study, apart from the use of structured methods, there has been a central objective: the establishment of a learning atmosphere. A place where all the professionals involved are able to collaborate, plan, solve problems and determine guides to follow in order to develop creative and innovative solutions. It has been outlined as a blended learning program with an assessment plan that proposes face to face lessons, coaching, collaboration, multimedia and web based learning objects as well as support resources. The project has been drawn as a long term task, the pilot teaching actions designed provide the preliminary results object of study. This methodology is been used in the creation of learning content for the African countries of Senegal, Mauritania and Cape Verde. It has been developed within the framework of the MACbioIDi, an Interreg European project for the International cooperation and development. The educational area of this project is focused in the training and advice of professionals of the medicine as well as engineers in the use of applications of medical imaging technology, specifically the 3DSlicer application and the Open Anatomy Browser.

Keywords: teaching contents engineering, e-learning, blended learning, international cooperation, 3dslicer, open anatomy browser

Procedia PDF Downloads 164

Authors: Lourdita Llanto

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This study described and assessed the implementation of artificial insemination (AI) for cattle and carabaos in the Bicol Region, Philippines: Albay, Sorsogon and Camarines Sur. Three hundred respondents were interviewed. Results were analyzed using frequency counts, means, percentages and chi-square test. Semen samples from different stations were analyzed for motility, viability and morphology. T-test was used in semen quality evaluation. Provincial AI coordinators (PAIC) were male, averaging 59 years old, married, had college education, served in government service for 34 years, but as PAIC for 5.7 years. All had other designations. Mean AI operation was 11.33 years with annual support from the local government unit of Php76,666.67. AI technicians were males, married, with college education, and trained on AI. Problems were on mobility; inadequate knowledge of farmers in animal raising and AI; and lack of liquid nitrogen and frozen semen supply. There was 2.95 municipalities and breedable cattle/carabaos of 3,091.25 per AI technician. Mean number of artificially inseminated animals per AI technician for 2011 was 28.57 heads for carabaos and 8.64 heads for cattle. There was very low participation rate among farmers. Carabaos were 6.52 years with parity 1.53. Cattle were 5.61 years, with parity of 1.51. Semen quality significantly (p ≤ 0.05) deteriorated in normal and live sperm with storage and handling at the provincial and field stations. Breed, AI technicians practices and AI operation significantly affected conception rate. Mean conception rate was 57.62%.

Keywords: artificial insemination, carabao, parity, mother tanks, frozen semen

Procedia PDF Downloads 433

Authors: Anaissia Franca, Julian Fernandez, Curran Crawford, Ned Djilali

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A methodology to estimate the state-of-charge (SOC) of battery electric buses, including degradation effects, for a given driving cycle is presented to support long-term techno-economic analysis integrating electric buses and charging infrastructure. The degradation mechanisms, characterized by both capacity and power fade with time, have been modeled using an electrochemical model for Li-ion batteries. Iterative changes in the negative electrode film resistance and decrease in available lithium as a function of utilization is simulated for every cycle. The cycles are formulated to follow typical transit bus driving patterns. The power and capacity decay resulting from the degradation model are introduced as inputs to a longitudinal chassis dynamic analysis that calculates the power consumption of the bus for a given driving cycle to find the state-of-charge of the battery as a function of time. The method is applied to an in-depot charging scenario, for which the bus is charged exclusively at the depot, overnight and to its full capacity. This scenario is run both with and without including degradation effects over time to illustrate the significant impact of degradation mechanisms on bus performance when doing feasibility studies for a fleet of electric buses. The impact of battery degradation on battery lifetime is also assessed. The modeling tool can be further used to optimize component sizing and charging locations for electric bus deployment projects.

Keywords: battery electric bus, E-bus, in-depot charging, lithium-ion battery, battery degradation, capacity fade, power fade, electric vehicle, SEI, electrochemical models

Procedia PDF Downloads 316

Authors: Mohammed Sani Abdulai

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Ghana’s Public Financial Management reforms have been going on for some two decades now (1997/98 to 2017/18). Given this long period of reforms, Ghana in 2019 is putting together both a Public Financial Management (PFM) strategy and a Ghana Integrated Financial Management Information System (GIFMIS) strategy for the next 5-years (2020-2024). The primary aim of these dual strategies is assisting the country in moving beyond reforms to consolidation and sustainability. In this paper we, first, examined the evolution of Ghana’s PFM reforms. We, secondly, reviewed the legal and institutional reforms undertaken to strengthen the country’s key PFM institutions. Thirdly, we summarized the strengths and weaknesses identified by the 2018 Public Expenditure and Financial Accountability (PEFA) assessment of Ghana’s PFM system relating to its macro-fiscal framework, budget preparation and approval, budget execution, accounting and fiscal reporting as well as external scrutiny and audit. We, finally, considered what the country should be doing to achieve its intended goal of PFM consolidation and sustainability. Using a qualitative method of review and analysis of existing documents, we, through this paper, brought to the fore the lessons that could be learnt by other developing countries from Ghana’s PFM reforms experiences. These lessons included the need to: (a) undergird any PFM reform with a comprehensive PFM reform strategy; (b) undertake a legal and institutional reforms of the key PFM institutions; (c) assess the strengths and weaknesses of those reforms using PFM performance evaluation tools such as PEFA framework; and (d) move beyond reforms to consolidation and sustainability.

Keywords: public financial management, public expenditure and financial accountability, reforms, consolidation, sustainability

Procedia PDF Downloads 222

Authors: Preethi Grace Theva Neethi Dhas

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A healthy human gut microbiome has commensal and symbiotic functions in digestion and is a decisive factor for human health. The soil microbiome is a crucial component in the ecosystem of soils and their health and resilience. Changes in soil microbiome are linked to human health. Ever since the industrial era, the human and the soil microbiome have been going through drastic changes. The soil microbiome has changed due to industrialization and extensive agricultural practices, whereas humans have less contact with soil and increased intake of highly processed foods, leading to changes in the human gut microbiome. Regenerating the soil becomes crucial in maintaining a healthy ecosystem. The nutrients, once obtained from the soil, need to be given back to the soil. Soil degradation needs to be addressed in effective ways, like adding organic nutrients back to the soil. Manure from animals and humans needs to be returned to the soil, which can complete the nutrient cycle in the soil. On the other hand, fecal sludge management (FSM) is a growing concern in many parts of the developing world. Hence, it becomes crucial to treat and reuse fecal sludge in a safe manner, i.e., low in risk to human health. Co-composting fecal sludge with organic wastes is a practice that allows the safe management of fecal sludge and the safe application of nutrients to the soil. This paper will discuss the possible impact of co-composting fecal sludge with coconut choir waste on the soil, water, and ecosystem at large. Impact parameters like nitrogen, phosphorus, and fecal coliforms will be analyzed. The overall impact of fecal sludge application on the soil will be researched and presented in this study.

Keywords: fecal sludge management, nutrient cycle, soil health, composting

Procedia PDF Downloads 56

Authors: Jiahui Yang, John Quigley, Lesley Walls

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In this paper, the authors develop a stochastic model regarding the investment in supplier delivery performance development from a buyer’s perspective. The authors propose a multivariate model through a Multinomial-Dirichlet distribution within an Empirical Bayesian inference framework, representing both the epistemic and aleatory uncertainties in deliveries. A closed form solution is obtained and the lower and upper bound for both optimal investment level and expected profit under uncertainty are derived. The theoretical properties provide decision makers with useful insights regarding supplier delivery performance improvement problems where multiple delivery statuses are involved. The authors also extend the model from a single supplier investment into a supplier portfolio, using a Lagrangian method to obtain a theoretical expression for an optimal investment level and overall expected profit. The model enables a buyer to know how the marginal expected profit/investment level of each supplier changes with respect to the budget and which supplier should be invested in when additional budget is available. An application of this model is illustrated in a simulation study. Overall, the main contribution of this study is to provide an optimal investment decision making framework for supplier development, taking into account multiple delivery statuses as well as multiple projects.

Keywords: decision making, empirical bayesian, portfolio optimization, supplier development, supply chain management

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Authors: Megha Ramnik Kotecha

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To study whether there is any clinical correlation between pterygium and dry eye and to evaluate the status of tear film in patients with pterygium. Methods: 100 eyes with pterygium were compared with 100 control eyes without pterygium. Patients between 20 – 70 years were included in the study. Detailed history was taken and Schirmer’s test and TBUT were performed on all to evaluate the status of dry eye. Schirmer’s test ˂10 mm and TBUT ˂10 seconds was considered abnormal. Results: Maximum number (52) of patients affected with dry eye in both the groups were in the age group 31-40 years which statistically showed age as a significant factor of association for both pterygium and dry eye (P<0.01).Schirmer’s test was slightly reduced in patients with pterygium(18.73±5.69 mm). TBUT was significantly reduced in the case group (12.26±2.24sec).TBUT decreased maximally in 51-60 yrs age group (13.00±2.77sec) with pterygium showing a tear film unstability. On comparision of pterygia and controls with normal and abnormal tear film, Odd’s Ratio was 1.14 showing risk of dry eye in pterygia patients to be 1.14 times higher than controls. Conclusion: Whether tear dysfunction is a precursor to pterygium growth or pterygium causes tear dysfunction is still not clear. Research and clinical evidence, however, suggest that there is a relationship between the two. This study is, therefore, undertaken to investigate the correlation between pterygium and dry eye. The patients with pterygia were compared with normals to evaluate their status regarding dryness. A close relationship exists between ocular irritation symptoms and functional evidence of tear instability. Schirmer’s test and TBUT should routinely be used in the outpatient department to diagnose dry eye in patients with pterygium and these patients should be promptly treated to prevent any sight threatening complications.

Keywords: dry eye, pterygium, Schirmer's test, tear break up time (TBUT)

Procedia PDF Downloads 294

Authors: Majid Farsadrooh, Mehran Feizi-Dehnayebi

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Serum albumin is the most abundant protein that is present in the circulatory system of a wide variety of organisms. Although it is a significant macromolecule, it can contribute to osmotic blood pressure and also, plays a superior role in drug disposition and efficiency. Molecular docking simulation can improve in silico drug design and discovery procedures to propound a lead compound and develop it from the discovery step to the clinic. In this study, the molecular docking simulation was applied to select a lead molecule through an investigation of the interaction of the two anticancer drugs (Alitretinoin and Abemaciclib) with Human Serum Albumin (HSA). Then, a series of new compounds (a-e) were suggested using lead molecule modification. Density functional theory (DFT) including MEP map and HOMO-LUMO analysis were used for the newly proposed compounds to predict the reactivity zones on the molecules, stability, and chemical reactivity. DFT calculation illustrated that these new compounds were stable. The estimated binding free energy (ΔG) values for a-e compounds were obtained as -5.78, -5.81, -5.95, -5,98, and -6.11 kcal/mol, respectively. Finally, the pharmaceutical properties and toxicity of these new compounds were estimated through OSIRIS DataWarrior software. The results indicated no risk of tumorigenic, irritant, or reproductive effects and mutagenicity for compounds d and e. As a result, compounds d and e, could be selected for further study as potential therapeutic candidates. Moreover, employing molecular docking simulation with the prediction of pharmaceutical properties helps to discover new potential drug compounds.

Keywords: drug design, anticancer, computational studies, DFT analysis

Procedia PDF Downloads 69

Authors: Kateryna Kulyk

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Anti-corruption education is an integral element of the corruption prevention mechanism of any state. Effective implementation of anti-corruption policy is impossible without awareness-raising activities. Information campaigns should target different social groups and aim to reduce tolerance to any form of corruption. Today, Ukraine and Lithuania have all the necessary infrastructure to actively work in this direction. Anti-corruption measures and building a society resistant to corruption are particularly important in the context of martial law in Ukraine and the state of emergency in Lithuania, as these conditions increase the risks of corrupt practices. To implement this area of activity, it is recommended to actively involve all state and local authorities, business representatives, non-governmental organisations, and all interested citizens. As of today, educational institutions, specialised anti-corruption bodies, and the public are already involved in this process. The purpose of the research is to draw public attention to the need and importance of obtaining basic knowledge on combating and preventing corruption, even in a state of emergency or martial law. This topic remains relevant even during the period of a state of emergency or martial law, as the risk of corrupt practices increases during these periods. The research is based on a comprehensive analysis of the anti-corruption policies of Ukraine and Lithuania, sociological research, and the author's own survey of anti-corruption experts. The main contribution of the research is to draw attention to the problem of low awareness of the population of countries about the importance of anti-corruption education as one of the necessary conditions for reducing corruption practices.

Keywords: corruption, prevention and combating of corruption, education, anti-corruption education, martial law, state of emergency

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Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

Procedia PDF Downloads 344

Authors: John Michael Russo

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Honeybees are important to our food system and continue to suffer from high rates of colony loss. Precision feed has brought many benefits to livestock cultivation and these should transfer to apiculture. However, apiculture has unique challenges. The objective of this research is to understand how principles of precision agriculture, applied to apiculture and feed specifically, might effectively improve state-of-the-art cultivation. The methodology surveys apicultural practice to build a model for assessment. First, a review of apicultural motivators is made. Feed method is then evaluated. Finally, precision feed methods are examined as accelerants with potential to advance the effectiveness of feed practice. Six important motivators emerge: colony loss, disease, climate change, site variance, operational costs, and competition. Feed practice itself is used to compensate for environmental variables. The research finds that the current state-of-the-art in apiculture feed focuses on critical challenges in the management of feed schedules which satisfy requirements of the bees, preserve potency, optimize environmental variables, and manage costs. Many of the challenges are most acute when feed is used to dispense medication. Technology such as RNA treatments have even more rigorous demands. Precision feed solutions focus on strategies which accommodate specific needs of individual livestock. A major component is data; they integrate precise data with methods that respond to individual needs. There is enormous opportunity for precision feed to improve apiculture through the integration of precision data with policies to translate data into optimized action in the apiary, particularly through automation.

Keywords: precision agriculture, precision feed, apiculture, honeybees

Procedia PDF Downloads 70

Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Background/Purpose: Previous preclinical and clinical data suggest that increased lymphocytic infiltration would be associated with good prognosis and benefit from immunogenic chemotherapy especially in triple-negative breast cancer (TNBC). We investigated a single-center experience of TNBC and relationship with lymphocytic infiltration. Methods: From January 2004 to December 2012, at the Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, we retrospectively reviewed 897 breast cancer patients-clinical outcomes, clinicopathological characteristics, breast cancer subtypes. And we reviewed lymphocytic infiltration of TNBC specimens by two pathologists. Statistical analysis of risk factors associated with recurrence was performed. Results: A total of 897 patients, 76 were TNBC (8.47%). Mean age of TNBC patients were 50.95 (SD10.42) years, mean follow-up periods was 40.06 months. We reviewed 49 slides, and there were 8 recurrent breast cancer patients (16.32%), and 4 patients were expired (8.16%). There were 9 lymphocytic predominant breast cancers (LPBC)-carcinomas with either intratumoral lymphocytes in >60% of tumor cell nests. 1 patient of LPBC was recurred and 8 were not. In multivariate logistic regression, the odds ratio of lymphocytic infiltration was 0.59 (p=0.643). Conclusion: In a single-center experience of TNBC, the lymphocytic infiltration in tumor cell nest might be a good trend on the prognosis but there was not statistically significant.

Keywords: tumor-infiltrating lymphocytes, triple negative breast cancer, medical and health sciences

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Authors: Sumia Fatima, Tayyaba Idrees

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Cardiac Arrest and Heart Failures are an important causes of mortality in developed and developing countries and even a second spent without Cardiopulmonary Resuscitation (CPR) increases the risk of mortality. Youngs doctors are expected to partake in CPR from the first day and if they are not taught basic life support (BLS) skills during their studies. They have next to no opportunity to learn them in clinical settings. To determine the exact level of knowledge of Basic Life Support among medical students. To compare the degree of knowledge among 1st and 2nd year medical students of RMU (Rawalpindi Medical University), using self-structured questionnaires. A cross sectional, qualitative primary study was conducted in March 2020 in order to analyse theoretical and practical knowledge of Basic Life Support among Medical Students of 1st and 2nd year MBBS. Self-Structured Questionnaires were distributed among 300 students, 150 from 1st year and 150 from 2nd year. Data was analysed using SPSS v 22. Chi Square test was employed. The results showed that only 13 (4%) students had received formal BLS training.129 (42%) students had encountered accidents in real life but had not known how to react. Majority responded that Basic Life Support should be made part of medical college curriculum (189 students), 194 participants (64%) had moderate knowledge of both theoretical and practical aspects of BLS. 75-80% students of both 1st and 2nd year had only moderate knowledge, which must be improved for them to be better healthcare providers in future. It was also found that male students had more practical knowledge than females, but both had almost the same proficiency in theoretical knowledge. The study concluded that the level of knowledge of BLS among the students was not up to the mark, and there is a dire need to include BLS training in the medical colleges’ curriculum.

Keywords: basic cardiac life support, cardiac arrest, awareness, medical students

Procedia PDF Downloads 87

Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

Procedia PDF Downloads 125

Authors: Raju Ranjha, Surbhi Aggarwal

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Background: Inflammation plays an important role in infectious and non-infectious diseases. MiRNA is also reported to play role in inflammation and associated cancers. Chemokine CXCL12 is also known to play role in inflammation and various cancers. CXCL12/CXCR4 chemokine axis was involved in pathogenesis of IBD specially UC. Supplementation of CXCL12 induces homing of dendritic cells to spleen and enhances control of plasmodium parasite in BALB/c mice. We looked at the regulation of CXCL12β by miRNA in UC colitis. Prolonged inflammation of colon in UC patient increases the risk of developing colorectal cancer. We looked at the expression differences of CXCl12β and its targeting miRNA in cancer susceptible area of colon of UC patients. Aim: Aim of this study was to find out the expression regulation of CXCL12β by miRNA in inflammation. Materials and Methods: Biopsy samples and blood samples were collected from UC patients and non-IBD controls. mRNA expression was analyzed using microarray and real-time PCR. CXCL12β targeting miRNA were looked by using online target prediction tools. Expression of CXCL12β in blood samples and cell line supernatant was analyzed using ELISA. miRNA target was validated using dual luciferase assay. Results and conclusion: We found miR-200a regulate the expression of CXCL12β in UC. Expression of CXCL12β was increased in cancer susceptible part of colon and expression of its targeting miRNA was decreased in the same part of colon. miR-200a regulate CXCL12β expression in inflammation and may be an important therapeutic target in inflammation associated cancer.

Keywords: inflammation, miRNA, regulation, CXCL12

Procedia PDF Downloads 267

Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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Authors: Menouni Aziza, Chbihi Kaoutar, Duca Radu Corneliu, Gilissen Liesbeth, Bounou Salim, Godderis Lode, El Jaafari Samir

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In Africa, environmental and occupational health risks are mostly underreported. The aim of this research is to develop and implement a sentinel surveillance system comprising training and guidance of occupational physicians (OC) who will report new work-related diseases in African countries. A group of 30 OC are recruited and trained in each of the partner countries (Morocco, Benin and Ethiopia). Each committed OC is asked to recruit 50 workers during a consultation in a time-frame of 6 months (1500 workers per country). Workers are asked to fill out an online questionnaire about their health status and work conditions, including exposure to 20 chemicals. Urine and blood samples are then collected for human biomonitoring of common exposures. Some preliminary results showed that 92% of the employees surveyed are exposed to physical constraints, 44% to chemical agents, and 24% to biological agents. The most common physical constraints are manual handling of loads, noise pollution and thermal pollution. The most frequent chemical risks are exposure to pesticides and fuels. This project will allow a better understanding of effective sentinel systems as a promising method to gather high quality data, which can support policy-making in terms of preventing emerging work-related diseases.

Keywords: sentinel system, occupational diseases, human biomonitoring, Africa

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Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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Authors: N. Dlamini, Mpumelelo G. Ndlela, Philisiwe Dlamini, Nicholus Kisyeri, Bhekizitha Sithole

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Accessing health services during the COVID-19 pandemic have exacerbated scarcity to routine medication. To ensure continuous accessibility to services, Eswatini launched Community Health Commodities Distribution (CHCD). Eligible Antiretroviral Therapy(ART) stable clients (VL<1,000) and patients on Non-Communicable Disease (NCD) medications were attended at community pick up points (PUP) based on distance between clients’ residence and the public health facility. Services provided includes ART and Pre-Exposure prophylaxis (PrEP) refills and NCD drug refills). The number of community PUP was 14% higher than health facility visits. Among all medications and commodities distributed between April and October 2020 at the PUP, 64% were HIV-related (HIV rapid test, HIVST, VL test, PrEP meds), and 36% were NCD related. The rapid roll out of CHCD during COVID-19 pandemic reduced the risk of COVID-19 transmission to clients as travel to health facilities was eliminated. It Additionally increased access to commodities during COVID-19-driven lockdown, decongested health facilities, integrated model of care, and increase service coverage. It was also noted that CHCD added different curative and HIV related services based on client specific needs and availability of the commodities.

Keywords: community health commodities distribution, pick up points, antiretroviral therapy, pre-exposure prophylaxis

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Authors: Benzerara Mohammed, Redjel Bachir, Kebaili Bachir

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The cracking of the concrete is a more crucial problem with the development of the complex structures related to technological progress. The projections in the knowledge of the breaking process make it possible today for better prevention of the risk of the fracture. The breaking strength brutal of a quasi-fragile material like the concrete called Toughness, is measured by a breaking value of the factor of intensity of the constraints K1C for which the crack is propagated, it is an intrinsic property of material. Many studies reported in the literature treating of the concrete were carried out on specimens which are in fact inadequate compared to the intrinsic characteristic to identify. We started from this established fact, in order to compare the evolution of the parameter of toughness K1C measured by calling upon ordinary concrete specimens of three prismatics geometries different (10*10*84) cm³ and (5*20*120) cm³ &(12*20*120) cm³ containing from the side notches various depths simulating of the cracks was set up. The notches are carried out using triangular pyramidal plates into manufactured out of sheet coated placed at the centre of the specimens at the time of the casting, then withdrawn to leave the trace of a crack. The tests are carried out in 3 points bending test in mode 1 of fracture, by using the techniques of mechanical fracture. The evolution of the parameter of toughness K1C measured with the three geometries specimens gives almost the same results. They are acceptable and return in the beach of the results determined by various researchers (toughness of the ordinary concrete turns to the turn of the 1 MPa √m). These results inform us about the presence of an economy on the level of the geometrie specimen (5*20*120) cm³, therefore to use plates specimens later if one wants to master the toughness of this material complexes, astonishing but always essential that is the concrete.

Keywords: elementary representative volume, concrete, fissure, toughness

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Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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Authors: Paulina Pietrzyk-Kowalec

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This paper presents the phenomenon of multilingualism becoming the norm rather than the exception in the European Union. It also seeks to describe the correlation between the command of foreign languages and employability. It is evident that the challenges of today's societies when it comes to employability and to the reality of the current labor market are more and more diversified. Thus, it is one of the crucial tasks of higher education to prepare its students to face this kind of complexity, understand its nuances, and have the capacity to adapt effectively to situations that are common in corporations based in the countries belonging to the EU. From this point of view, the assessment of the impact that the command of foreign languages of European university students could have on the numerous business sectors becomes vital. It also involves raising awareness of future professionals to make them understand the importance of mastering communicative skills in foreign languages that will meet the requirements of students' prospective employers. The direct connection between higher education institutions and the world of business also allows companies to realize that they should rethink their recruitment and human resources procedures in order to take into account the importance of foreign languages. This article focuses on the objective of the multilingualism policy developed by the European Commission, which is to enable young people to master at least two foreign languages, which is crucial in their future careers. The article puts emphasis on the existence of a crucial connection between the research conducted in higher education institutions and the business sector in order to reduce current qualification gaps.

Keywords: cross-cultural communication, employability, human resources, language attitudes, multilingualism

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Authors: Jasper Kevin C. Dionisio, Denise Mae M. Unsay

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In a manufacturing firm, controlling the process ensures that optimum efficiency, productivity, and quality in an organization are achieved. An operation with no standardized procedure yields a poor productivity, inefficiency, and an out of control process. This study focuses on controlling the small intestine processing of a chicken dressing plant through the use of Statistical Process Control (SPC). Since the operation does not employ a standard procedure and does not have an established standard time, the process through the assessment of the observed time of the overall operation of small intestine processing, through the use of X-Bar R Control Chart, is found to be out of control. In the solution of this problem, the researchers conduct a motion and time study aiming to establish a standard procedure for the operation. The normal operator was picked through the use of Westinghouse Rating System. Instead of utilizing the traditional motion and time study, the researchers used the X-Bar R Control Chart in determining the process average of the process that is used for establishing the standard time. The observed time of the normal operator was noted and plotted to the X-Bar R Control Chart. Out of control points that are due to assignable cause were removed and the process average, or the average time the normal operator conducted the process, which was already in control and free form any outliers, was obtained. The process average was then used in determining the standard time of small intestine processing. As a recommendation, the researchers suggest the implementation of the standard time established which is with consonance to the standard procedure which was adopted from the normal operator. With that recommendation, the whole operation will induce a 45.54 % increase in their productivity.

Keywords: motion and time study, process controlling, statistical process control, X-Bar R Control chart

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Authors: Elias K. Maragos, Petros E. Maravelakis, Apostolos I. Linardis

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Health2020 is a promising framework of policies provided by the World Health Organization (WHO) and aiming to diminish the health and well-being inequalities among the citizens of the European Union (EU) countries. The major demographic, social and environmental changes, in addition to the resent economic crisis prevent the unobstructed and successful implementation of this framework. The unemployment rates and the percentage of people at risk of poverty have increased among the citizens of EU countries. At the same time, the adopted fiscal, economic policies do not help governments to serve their social role and mitigate social and health inequalities. In those circumstances, there is a strong pressure to organize all health system resources efficiently and wisely. In order to provide a unified and value-based framework of valuation, we propose a valuation framework using data envelopment analysis (DEA) and dynamic DEA. We believe that the adopted methodology could provide a robust tool which can capture the degree of success with which policies have been implemented and is capable to determine which of the countries developed the requested policies efficiently and which of the countries have been lagged. Using the proposed methodology, we evaluated the performance of 28 EU member-countries in relation to the Health2020 peripheral targets. We adopted several versions of evaluation, measuring the effectiveness and the efficiency of EU countries from 2011 to 2016. Our results showed stability in technological changes and revealed a group of countries which were benchmarks in most of the years for the inefficient countries.

Keywords: DEA, Health2020, health inequalities, malmquist index, policies evaluation, well-being

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Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

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