Search results for: structural healthcare monitoring
1002 Pharmacovigilance in Hospitals: Retrospective Study at the Pharmacovigilance Service of UHE-Oran, Algeria
Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi
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Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification
Procedia PDF Downloads 1751001 Fly ash Contamination in Groundwater and its Implications on Local Climate Change
Authors: Rajkumar Ghosh
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Fly ash, a byproduct of coal combustion, has become a prevalent environmental concern due to its potential impact on both groundwater quality and local climate change. This study aims to provide an in-depth analysis of the various mechanisms through which fly ash contaminates groundwater, as well as the possible consequences of this contamination on local climate change. The presence of fly ash in groundwater not only poses a risk to human health but also has the potential to influence local climate change through complex interactions. Although fly ash has various applications in construction and other industries, improper disposal and lack of containment measures have led to its infiltration into groundwater systems. Through a comprehensive review of existing literature and case studies, the interactions between fly ash and groundwater systems, assess the effects on hydrology, and discuss the implications for the broader climate. This section reviews the pathways through which fly ash enters groundwater, including leaching from disposal sites, infiltration through soil, and migration from surface water bodies. The physical and chemical characteristics of fly ash that contribute to its mobility and persistence in groundwater. The introduction of fly ash into groundwater can alter its chemical composition, leading to an increase in the concentration of heavy metals, metalloids, and other potentially toxic elements. The mechanisms of contaminant transport and highlight the potential risks to human health and ecosystems. Fly ash contamination in groundwater may influence the hydrological cycle through changes in groundwater recharge, discharge, and flow dynamics. This section examines the implications of altered hydrology on local water availability, aquatic habitats, and overall ecosystem health. The presence of fly ash in groundwater may have direct and indirect effects on local climate change. The role of fly ash as a potent greenhouse gas absorber and its contribution to radiative forcing. Additionally, investigation of the possible feedback mechanisms between groundwater contamination and climate change, such as altered vegetation patterns and changes in local temperature and precipitation patterns. In this section, potential mitigation and remediation techniques to minimize fly ash contamination in groundwater are analyzed. These may include improved waste management practices, engineered barriers, groundwater remediation technologies, and sustainable fly ash utilization. This paper highlights the critical link between fly ash contamination in groundwater and its potential contribution to local climate change. It emphasizes the importance of addressing this issue promptly through a combination of preventive measures, effective management strategies, and continuous monitoring. By understanding the interconnections between fly ash contamination, groundwater quality, and local climate, towards creating a more resilient and sustainable environment for future generations. The findings of this research can assist policymakers and environmental managers in formulating sustainable strategies to mitigate fly ash contamination and minimize its contribution to climate change.Keywords: groundwater, climate, sustainable environment, fly ash contamination
Procedia PDF Downloads 871000 Algorithms Inspired from Human Behavior Applied to Optimization of a Complex Process
Authors: S. Curteanu, F. Leon, M. Gavrilescu, S. A. Floria
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Optimization algorithms inspired from human behavior were applied in this approach, associated with neural networks models. The algorithms belong to human behaviors of learning and cooperation and human competitive behavior classes. For the first class, the main strategies include: random learning, individual learning, and social learning, and the selected algorithms are: simplified human learning optimization (SHLO), social learning optimization (SLO), and teaching-learning based optimization (TLBO). For the second class, the concept of learning is associated with competitiveness, and the selected algorithms are sports-inspired algorithms (with Football Game Algorithm, FGA and Volleyball Premier League, VPL) and Imperialist Competitive Algorithm (ICA). A real process, the synthesis of polyacrylamide-based multicomponent hydrogels, where some parameters are difficult to obtain experimentally, is considered as a case study. Reaction yield and swelling degree are predicted as a function of reaction conditions (acrylamide concentration, initiator concentration, crosslinking agent concentration, temperature, reaction time, and amount of inclusion polymer, which could be starch, poly(vinyl alcohol) or gelatin). The experimental results contain 175 data. Artificial neural networks are obtained in optimal form with biologically inspired algorithm; the optimization being perform at two level: structural and parametric. Feedforward neural networks with one or two hidden layers and no more than 25 neurons in intermediate layers were obtained with values of correlation coefficient in the validation phase over 0.90. The best results were obtained with TLBO algorithm, correlation coefficient being 0.94 for an MLP(6:9:20:2) – a feedforward neural network with two hidden layers and 9 and 20, respectively, intermediate neurons. Good results obtained prove the efficiency of the optimization algorithms. More than the good results, what is important in this approach is the simulation methodology, including neural networks and optimization biologically inspired algorithms, which provide satisfactory results. In addition, the methodology developed in this approach is general and has flexibility so that it can be easily adapted to other processes in association with different types of models.Keywords: artificial neural networks, human behaviors of learning and cooperation, human competitive behavior, optimization algorithms
Procedia PDF Downloads 108999 Developing of Ecological Internal Insulation Composite Boards for Innovative Retrofitting of Heritage Buildings
Authors: J. N. Nackler, K. Saleh Pascha, W. Winter
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WHISCERS™ (Whole House In-Situ Carbon and Energy Reduction Solution) is an innovative process for Internal Wall Insulation (IWI) for energy-efficient retrofitting of heritage building, which uses laser measuring to determine the dimensions of a room, off-site insulation board cutting and rapid installation to complete the process. As part of a multinational investigation consortium the Austrian part adapted the WHISCERS system to local conditions of Vienna where most historical buildings have valuable stucco facades, precluding the application of an external insulation. The Austrian project contribution addresses the replacement of commonly used extruded polystyrene foam (XPS) with renewable materials such as wood and wood products to develop a more sustainable IWI system. As the timber industry is a major industry in Austria, a new innovative and more sustainable IWI solution could also open up new markets. The first approach of investigation was the Life Cycle Assessment (LCA) to define the performance of wood fibre board as insulation material in comparison to normally used XPS-boards. As one of the results the global-warming potential (GWP) of wood-fibre-board is 15 times less the equivalent to carbon dioxide while in the case of XPS it´s 72 times more. The hygrothermal simulation program WUFI was used to evaluate and simulate heat and moisture transport in multi-layer building components of the developed IWI solution. The results of the simulations prove in examined boundary conditions of selected representative brickwork constructions to be functional and usable without risk regarding vapour diffusion and liquid transport in proposed IWI. In a further stage three different solutions were developed and tested (1 - glued/mortared, 2 - with soft board, connected to wall with gypsum board as top layer, 3 - with soft board and clay board as top layer). All three solutions presents a flexible insulation layer out of wood fibre towards the existing wall, thus compensating irregularities of the wall surface. From first considerations at the beginning of the development phase, three different systems had been developed and optimized according to assembly technology and tested as small specimen in real object conditions. The built prototypes are monitored to detect performance and building physics problems and to validate the results of the computer simulation model. This paper illustrates the development and application of the Internal Wall Insulation system.Keywords: internal insulation, wood fibre, hygrothermal simulations, monitoring, clay, condensate
Procedia PDF Downloads 219998 Developing Effective Strategies to Reduce Hiv, Aids and Sexually Transmitted Infections, Nakuru, Kenya
Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi
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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach
Procedia PDF Downloads 88997 Recurrent Neural Networks for Classifying Outliers in Electronic Health Record Clinical Text
Authors: Duncan Wallace, M-Tahar Kechadi
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In recent years, Machine Learning (ML) approaches have been successfully applied to an analysis of patient symptom data in the context of disease diagnosis, at least where such data is well codified. However, much of the data present in Electronic Health Records (EHR) are unlikely to prove suitable for classic ML approaches. Furthermore, as scores of data are widely spread across both hospitals and individuals, a decentralized, computationally scalable methodology is a priority. The focus of this paper is to develop a method to predict outliers in an out-of-hours healthcare provision center (OOHC). In particular, our research is based upon the early identification of patients who have underlying conditions which will cause them to repeatedly require medical attention. OOHC act as an ad-hoc delivery of triage and treatment, where interactions occur without recourse to a full medical history of the patient in question. Medical histories, relating to patients contacting an OOHC, may reside in several distinct EHR systems in multiple hospitals or surgeries, which are unavailable to the OOHC in question. As such, although a local solution is optimal for this problem, it follows that the data under investigation is incomplete, heterogeneous, and comprised mostly of noisy textual notes compiled during routine OOHC activities. Through the use of Deep Learning methodologies, the aim of this paper is to provide the means to identify patient cases, upon initial contact, which are likely to relate to such outliers. To this end, we compare the performance of Long Short-Term Memory, Gated Recurrent Units, and combinations of both with Convolutional Neural Networks. A further aim of this paper is to elucidate the discovery of such outliers by examining the exact terms which provide a strong indication of positive and negative case entries. While free-text is the principal data extracted from EHRs for classification, EHRs also contain normalized features. Although the specific demographical features treated within our corpus are relatively limited in scope, we examine whether it is beneficial to include such features among the inputs to our neural network, or whether these features are more successfully exploited in conjunction with a different form of a classifier. In this section, we compare the performance of randomly generated regression trees and support vector machines and determine the extent to which our classification program can be improved upon by using either of these machine learning approaches in conjunction with the output of our Recurrent Neural Network application. The output of our neural network is also used to help determine the most significant lexemes present within the corpus for determining high-risk patients. By combining the confidence of our classification program in relation to lexemes within true positive and true negative cases, with an inverse document frequency of the lexemes related to these cases, we can determine what features act as the primary indicators of frequent-attender and non-frequent-attender cases, providing a human interpretable appreciation of how our program classifies cases.Keywords: artificial neural networks, data-mining, machine learning, medical informatics
Procedia PDF Downloads 131996 Harsh Discipline and Later Disruptive Behavior Disorder in Two Contexts
Authors: Olga Santesteban, Glorisa Canino, Hector R. Bird, Cristiane S. Duarte
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Objective: To address whether harsh discipline is associated with disruptive behavior disorders (DBD) in Puerto Rican children over time. Background: Both cross-sectional and longitudinal studies report that rates of DBD vary by gender, age and other demographics, being more frequent among boys, later in life and among those who live in urban areas. Also, the literature supports the direct, positive association between harsh discipline and externalizing behaviors. Nevertheless, scholars have underscored the important role of race and ethnicity in understanding discipline effects on children. The impact of harsh discipline in a Puerto Rican population remains to be studied. Methods: Sample: This is a secondary analysis of the Boricua Youth Study which assessed yearly (3 times) Puerto Rican children aged 5-15 in two different sites: San Juan (Puerto Rico) and the South Bronx (NY), N=2951. Participants that did not have scores of harsh discipline in the 3 waves were excluded for this analysis (N=2091). Main Measures: a) Harsh Discipline (Parent report) was measured using 6 items from the “Parental Discipline Scale” that measures various forms of punishment, including physical and verbal abuse, and withholding affection; b) Disruptive Behavior Disorder (Parent report): Parent version of the Diagnostic Interview Schedule for Children-IV (DISC-IV) was used to asses children’s conduct disorders; c) Demographic factors: Child gender, child age, family income, marital status; d) Parental factors: parental psychopathology, parental monitoring, familism, parent support; e) Children characteristics: Controlling for any diagnostic at wave 1 (internalizing or externalizing). Data Analysis: Logistic regression was carried out relating the likelihood of DBD to harsh discipline along waves controlling for potential confounders as demographics, child and parent characteristics. Results: There were no significant differences in harsh discipline by site in wave 1 and wave 2 but there was a significant difference in wave 3. Also, there were no significant differences in DBD by site in wave 1 and wave 2 but there was a significant difference in wave 3. There was a significant difference of discipline by gender and age in all the waves. We calculated unadjusted (OR) and adjusted (AOD) and 95% confidence intervals (95%CI) showing the relation between harsh discipline at wave 1 and the presence of child disruptive behavior disorder at wave 3 for both South Bronx and Puerto Rico. There was an association between harsh discipline and the likelihood of having DBD in The Bronx (AOR=1.76; 95%CI=1.13-2.74, p.013) and in Puerto Rico (AOR=2.17; 95%CI=1.28-3.67, p.004) having controlled for demographic, parental and individual factors. Conclusions: Context may be an important differential factor shaping the potential risk of harsh discipline toward DBD for Puerto Rican children.Keywords: disruptive behavior disorders, harsh discipline, puerto rican, psychological education
Procedia PDF Downloads 472995 The Study of the Physical, Chemical and Mechanical Properties of Recycled Thermoplastic Polypropylene and Polyamide Materials Used in the Automotive Industry
Authors: Sevim Gecici, Erdinc Doganci
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Thermoplastic materials are widely used in the automotive industry due to their lightweight nature, durability, recyclability and versatility in shaping. They serve various purposes in the automotive sector, including interior and exterior components, vehicle body parts and insulation. The recycling of thermoplastic polymer materials used in the automotive industry helps reduce waste and mitigate environmental impacts. The aim of this study is to facilitate the recycling of thermoplastic materials used in the automotive industry. Recycled materials, such as sprues and defective parts, are generated from thermoplastic polymer materials used in the automotive sector after the injection process. In this study, the physical, chemical and mechanical properties of the recycled parts obtained from the reprocessing of these materials were determined through various tests. Thermoplastic products (PP and PA) that were recycled after the injection process were processed through a grinding unit and then subjected to a second injection process with physical, chemical and mechanical tests applied to the resulting products. This is a result of the initial grinding process. The same procedures were applied to each thermoplastic material through a series of steps first injection, first grinding, second injection, second grinding, third injection, third grinding, fourth injection and fourth grinding, followed by product testing. Subsequently, the test results of the original raw material's Technical Data Sheet (TDS) were compared with the results obtained from the products after the injection process to determine the raw material based on physical, chemical and mechanical changes. The study included tests for Density, Melt Flow Rate, Tensile Modulus, Tensile Stress, Flexural Modulus (Injection Molded), Charpy Notched Impact Strength, Notched Izod Impact Strength, Shore Hardness, Heat Deflection Temperature, Vicat Softening Temperature and UV tests. Additionally, more specific tests such as Thermogravimetric Analysis (TGA), Differential Scanning Calorimetry (DSC), Heat Aging, FTIR, SEM and TEM analyses were conducted to examine structural changes in thermoplastic materials subjected to multiple recycling processes. In the later stages of the study, injection molding process trials will be conducted with raw materials such as ABS, PC, PC-ABS and PE.Keywords: injection molding, recycling, automotive, polypropylene, thermoplastic
Procedia PDF Downloads 14994 Spatial Pattern of Environmental Noise Levels and Auditory Ailments in Abeokuta Metropolis, Southwestern Nigeria
Authors: Olusegun Oguntoke, Aramide Y. Tijani, Olayide R. Adetunji
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Environmental noise has become a major threat to the quality of human life, and it is generally more severe in cities. This study assessed the level of environmental noise, mapped the spatial pattern at different times of the day and examined the association with morbidity of auditory ailments in Abeokuta metropolis. The entire metropolis was divided into 80 cells (areas) of 1000 m by 1000 m; out of which 33 were randomly selected for noise levels assessment. Portable noise meter (AR824) was used to measure noise level, and Global Positioning System (Garmin GPS-72H) was employed to take the coordinates of the sample sites for mapping. Risk map of the noise levels was produced using Kriging interpolation techniques based on the spatial spread of measured noise values across the study area. Data on cases of hearing impairments were collected from four major hospitals in the city. Data collected from field measurements and medical records were subjected to descriptive (frequency and percentage) and inferential (mean, ANOVA and correlation) statistics using SPSS (version 20.0). ArcMap 10.1 was employed for spatial analysis and mapping. Results showed mean noise levels range at morning (42.4 ± 4.14 – 88.2 ± 15.1 dBA), afternoon (45.0 ± 6.72– 86.4 ± 12.5 dBA) and evening (51.0 ± 6.55–84.4 ± 5.19 dBA) across the study area. The interpolated maps identified Kuto, Okelowo, Isale-Igbein, and Sapon as high noise risk areas. These are the central business district and nucleus of Abeokuta metropolis where commercial activities, high traffic volume, and clustered buildings exist. The monitored noise levels varied significantly among the sampled areas in the morning, afternoon and evening (p < 0.05). A significant correlation was found between diagnosed cases of auditory ailments and noise levels measured in the morning (r=0.39 at p < 0.05). Common auditory ailments found across the metropolis included impaired hearing (25.8%), tinnitus (16.4%) and otitis (15.0%). The most affected age groups were between 11-30 years while the male gender had more cases of hearing impairments (51.2%) than the females. The study revealed that environmental noise levels exceeded the recommended standards in the morning, afternoon and evening in 60.6%, 61% and 72.7% of the sampled areas respectively. Summarily, environmental noise in the study area is high and contributes to the morbidity of auditory ailments. Areas identified as hot spots of noise pollution should be avoided in the location of noise sensitive activities while environmental noise monitoring should be included as part of the mandate of the regulatory agencies in Nigeria.Keywords: noise pollution, associative analysis, auditory impairment, urban, human exposure
Procedia PDF Downloads 144993 Transmedia and Platformized Political Discourse in a Growing Democracy: A Study of Nigeria’s 2023 General Elections
Authors: Tunde Ope-Davies
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Transmediality and platformization as online content-sharing protocols have continued to accentuate the growing impact of the unprecedented digital revolution across the world. The rapid transformation across all sectors as a result of this revolution has continued to spotlight the increasing importance of new media technologies in redefining and reshaping the rhythm and dynamics of our private and public discursive practices. Equally, social and political activities are being impacted daily through the creation and transmission of political discourse content through multi-channel platforms such as mobile telephone communication, social media networks and the internet. It has been observed that digital platforms have become central to the production, processing, and distribution of multimodal social data and cultural content. The platformization paradigm thus underpins our understanding of how digital platforms enhance the production and heterogenous distribution of media and cultural content through these platforms and how this process facilitates socioeconomic and political activities. The use of multiple digital platforms to share and transmit political discourse material synchronously and asynchronously has gained some exciting momentum in the last few years. Nigeria’s 2023 general elections amplified the usage of social media and other online platforms as tools for electioneering campaigns, socio-political mobilizations and civic engagement. The study, therefore, focuses on transmedia and platformed political discourse as a new strategy to promote political candidates and their manifesto in order to mobilize support and woo voters. This innovative transmedia digital discourse model involves a constellation of online texts and images transmitted through different online platforms almost simultaneously. The data for the study was extracted from the 2023 general elections campaigns in Nigeria between January- March 2023 through media monitoring, manual download and the use of software to harvest the online electioneering campaign material. I adopted a discursive-analytic qualitative technique with toolkits drawn from a computer-mediated multimodal discourse paradigm. The study maps the progressive development of digital political discourse in this young democracy. The findings also demonstrate the inevitable transformation of modern democratic practice through platform-dependent and transmedia political discourse. Political actors and media practitioners now deploy layers of social media network platforms to convey messages and mobilize supporters in order to aggregate and maximize the impact of their media campaign projects and audience reach.Keywords: social media, digital humanities, political discourse, platformized discourse, multimodal discourse
Procedia PDF Downloads 85992 Dengue Prevention and Control in Kaohsiung City
Authors: Chiu-Wen Chang, I-Yun Chang, Wei-Ting Chen, Hui-Ping Ho, Ruei-Hun Chang, Joh-Jong Huang
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Kaohsiung City is located in the tropical region where has Aedes aegypti and Aedes albopictus distributed; once the virus invades, it’s can easily trigger local epidemic. Besides, Kaohsiung City has a world-class airport and harbor, trade and tourism are close and frequently with every country, especially with the Southeast Asian countries which also suffer from dengue. Therefore, Kaohsiung City faces the difficult challenge of dengue every year. The objectives of this study was to enhance dengue clinical care, border management and vector surveillance in Kaohsiung City by establishing an larger scale, innovatively and more coordinated dengue prevention and control strategies in 2016, including (1) Integrated medical programs: facilitated 657 contract medical institutions, widely set up NS1 rapid test in clinics, enhanced triage and referrals system, dengue case daily-monitoring management (2) Border quarantine: comprehensive NS1 screening for foreign workers and fisheries when immigration, hospitalization and isolation for suspected cases, health education for high risk groups (foreign students, other tourists) (3) Mosquito control: Widely use Gravitrap to monitor mosquito density in environment, use NS1 rapid screening test to detect community dengue virus (4) Health education: create a dengue app for people to immediately inquire the risk map and nearby medical resources, routine health education to all districts to strengthen public’s dengue knowledge, neighborhood cleaning awards program. The results showed that after new integration of dengue prevention and control strategies fully implemented in Kaohsiung City, the number of confirmed cases in 2016 declined to 342 cases, the majority of these cases are the continuation epidemic in 2015; in fact, only two cases confirmed after the 2016 summer. Besides, the dengue mortality rate successfully decreased to 0% in 2016. Moreover, according to the reporting rate from medical institutions in 2014 and 2016, it dropped from 27.07% to 19.45% from medical center, and it decreased from 36.55% to 29.79% from regional hospital; however, the reporting rate of district hospital increased from 11.88% to 15.87% and also increased from 24.51% to 34.89% in general practice clinics. Obviously, it showed that under the action of strengthening medical management, it reduced the medical center’s notification ratio and improved the notification ratio of general clinics which achieved the great effect of dengue clinical management and dengue control.Keywords: dengue control, integrated control strategies, clinical management, NS1
Procedia PDF Downloads 269991 Artificial Intelligence in Ethiopian Higher Education: The Impact of Digital Readiness Support, Acceptance, Risk, and Trust on Adoption
Authors: Merih Welay Welesilassie
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Understanding educators' readiness to incorporate AI tools into their teaching methods requires comprehensively examining the influencing factors. This understanding is crucial, given the potential of these technologies to personalise learning experiences, improve instructional effectiveness, and foster innovative pedagogical approaches. This study evaluated factors affecting teachers' adoption of AI tools in their English language instruction by extending the Technology Acceptance Model (TAM) to encompass digital readiness support, perceived risk, and trust. A cross-sectional quantitative survey was conducted with 128 English language teachers, supplemented by qualitative data collection from 15 English teachers. The structural mode analysis indicated that implementing AI tools in Ethiopian higher education was notably influenced by digital readiness support, perceived ease of use, perceived usefulness, perceived risk, and trust. Digital readiness support positively impacted perceived ease of use, usefulness, and trust while reducing safety and privacy risks. Perceived ease of use positively correlated with perceived usefulness but negatively influenced trust. Furthermore, perceived usefulness strengthened trust in AI tools, while perceived safety and privacy risks significantly undermined trust. Trust was crucial in increasing educators' willingness to adopt AI technologies. The qualitative analysis revealed that the teachers exhibited strong content and pedagogical knowledge but needed more technology-related knowledge. Moreover, It was found that the teachers did not utilise digital tools to teach English. The study identified several obstacles to incorporating digital tools into English lessons, such as insufficient digital infrastructure, a shortage of educational resources, inadequate professional development opportunities, and challenging policies and governance. The findings provide valuable guidance for educators, inform policymakers about creating supportive digital environments, and offer a foundation for further investigation into technology adoption in educational settings in Ethiopia and similar contexts.Keywords: digital readiness support, AI acceptance, perceived risc, AI trust
Procedia PDF Downloads 18990 Surgical Skills in Mulanje
Authors: Nick Toossi, Joseph Hartland
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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.Keywords: clinical officers, education, Malawi, surgical skills
Procedia PDF Downloads 183989 Home-Based Care with Follow-Up at Outpatient Unit or Community-Follow-Up Center with/without Food Supplementation and/or Psychosocial Stimulation of Children with Moderate Acute Malnutrition in Bangladesh
Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown
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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food
Procedia PDF Downloads 440988 CLEAN Jakarta Waste Bank Project: Alternative Solution in Urban Solid Waste Management by Community Based Total Sanitation (CBTS) Approach
Authors: Mita Sirait
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Everyday Jakarta produces 7,000 tons of solid waste and only about 5,200 tons delivered to landfill out of the city by 720 trucks, the rest are left yet manageable, as reported by Government of Clean Sector. CLEAN Jakarta Project is aimed at empowering community to achieve healthy environment for children and families in urban slum in Semper Barat and Penjaringan sub-district of North Jakarta that consisted of 20,584 people. The project applies Community Based Total Sanitation, an approach to empowering community to achieve total hygiene and sanitation behaviour by triggering activities. As regulated by Ministry of Health, it has 5 pillars: (1) open defecation free, (2) hand-washing with soaps, (3) drinking-water treatment, (4) solid-waste management and (5) waste-water management; and 3 strategic components: 1) demand creation, 2) supply creation and 3) enabling environment. Demand creation is generated by triggering community’s reaction to their daily sanitation habits by exposing them to their surrounding where they can see faeces, waste and other environmental pollutant to stimulate disgusting, embarrassing and responsibility sense. Triggered people then challenged to commit to improving their hygiene practice such as to stop littering and start waste separation. In order to support this commitment, and for supply creation component, the project initiated waste bank with community working group. It facilitated capacity-building trainings, waste bank system formulation and meetings with local authorities to solicit land permit and waste bank decree. As it is of a general banking system, waste bank has customer service, teller, manager, legal paper and provides saving book and money transaction. In 8 months, two waste banks have established with 148 customers, 17 million rupiah cash, and about 9 million of stored recyclables. Approximately 2.5 tons of 15-35 types of recyclable are managed in both waste banks per week. On enabling environment, the project has initiated sanitation working group in community and multi sectors government level, and advocated both parties. The former is expected to promote behaviour change and monitoring in the community, while the latter is expected to support sanitation with regulations, strategies, appraisal and awards; to coordinate partnering and networking, and to replicate best practices to other areas.Keywords: urban community, waste management, Jakarta, community based total sanitation (CBTS)
Procedia PDF Downloads 294987 Unsupervised Detection of Burned Area from Remote Sensing Images Using Spatial Correlation and Fuzzy Clustering
Authors: Tauqir A. Moughal, Fusheng Yu, Abeer Mazher
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Land-cover and land-use change information are important because of their practical uses in various applications, including deforestation, damage assessment, disasters monitoring, urban expansion, planning, and land management. Therefore, developing change detection methods for remote sensing images is an important ongoing research agenda. However, detection of change through optical remote sensing images is not a trivial task due to many factors including the vagueness between the boundaries of changed and unchanged regions and spatial dependence of the pixels to its neighborhood. In this paper, we propose a binary change detection technique for bi-temporal optical remote sensing images. As in most of the optical remote sensing images, the transition between the two clusters (change and no change) is overlapping and the existing methods are incapable of providing the accurate cluster boundaries. In this regard, a methodology has been proposed which uses the fuzzy c-means clustering to tackle the problem of vagueness in the changed and unchanged class by formulating the soft boundaries between them. Furthermore, in order to exploit the neighborhood information of the pixels, the input patterns are generated corresponding to each pixel from bi-temporal images using 3×3, 5×5 and 7×7 window. The between images and within image spatial dependence of the pixels to its neighborhood is quantified by using Pearson product moment correlation and Moran’s I statistics, respectively. The proposed technique consists of two phases. At first, between images and within image spatial correlation is calculated to utilize the information that the pixels at different locations may not be independent. Second, fuzzy c-means technique is used to produce two clusters from input feature by not only taking care of vagueness between the changed and unchanged class but also by exploiting the spatial correlation of the pixels. To show the effectiveness of the proposed technique, experiments are conducted on multispectral and bi-temporal remote sensing images. A subset (2100×1212 pixels) of a pan-sharpened, bi-temporal Landsat 5 thematic mapper optical image of Los Angeles, California, is used in this study which shows a long period of the forest fire continued from July until October 2009. Early forest fire and later forest fire optical remote sensing images were acquired on July 5, 2009 and October 25, 2009, respectively. The proposed technique is used to detect the fire (which causes change on earth’s surface) and compared with the existing K-means clustering technique. Experimental results showed that proposed technique performs better than the already existing technique. The proposed technique can be easily extendable for optical hyperspectral images and is suitable for many practical applications.Keywords: burned area, change detection, correlation, fuzzy clustering, optical remote sensing
Procedia PDF Downloads 169986 Meta-Magnetic Properties of LaFe₁₂B₆ Type Compounds
Authors: Baptiste Vallet-Simond, Léopold V. B. Diop, Olivier Isnard
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The antiferromagnetic itinerant-electron compound LaFe₁₂B₆ occupies a special place among rare-earth iron-rich intermetallic; it presents exotic magnetic and physical properties. The unusual amplitude-modulated spin configuration defined by a propagation vector k = (¼, ¼, ¼), remarkably weak Fe magnetic moment (0.43 μB) in the antiferromagnetic ground state, especially low magnetic ordering temperature TN = 36 K for an Fe-rich phase, a multicritical point in the complex magnetic phase diagram, both normal and inverse magnetocaloric effects, and huge hydrostatic pressure effects can be highlighted as the most relevant. Both antiferromagnetic (AFM) and paramagnetic (PM) states can be transformed into the ferromagnetic (FM) state via a field-induced first-order metamagnetic transition. Of particular interest is the low-temperature magnetization process. This process is discontinuous and evolves unexpected huge metamagnetic transitions consisting of a succession of steep magnetization jumps separated by plateaus, giving rise to an unusual avalanche-like behavior. The metamagnetic transition is accompanied by giant magnetoresistance and large magnetostriction. In the present work, we report on the intrinsic magnetic properties of the La₁₋ₓPrₓFe₁₂B₆ series of compounds exhibiting sharp metamagnetic transitions. The study of the structural, magnetic, magneto-transport, and magnetostrictive properties of the La₁₋ₓPrₓFe₁₂B₆ system was performed by combining a wide variety of measurement techniques. Magnetic measurements were performed up to µ0H = 10 T. It was found that the proportion of Pr had a strong influence on the magnetic properties of this series of compounds. At x=0.05, the ground state at 2K is that of an antiferromagnet, but the critical transition field Hc has been lowered from Hc = 6T at x = 0 to Hc = 2.5 Tat x=0.05. And starting from x=0.10, the ground state of this series of compounds is a coexistence of AFM and FM parts. At x=0.30, the AFM order has completely vanished, and only the FM part is left. However, we still observe meta-magnetic transitions at higher temperatures (above 100 K for x=0.30) from the paramagnetic (P) state to a forced FM state. And, of course, such transitions are accompanied by strong magneto-caloric, magnetostrictive, and magnetoresistance effects. The Curie temperatures for the probed compositions going from x=0.05 to x=0.30 were spread over the temperature range of 40 K up to 100 K.Keywords: metamagnetism, RMB intermetallic, magneto-transport effect, metamagnetic transitions
Procedia PDF Downloads 68985 Socio-cultural Dimensions Inhibiting Female Condom Use by the Female Students: Experiences from a University in Rural South Africa
Authors: Christina Tafadzwa
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Global HIV and AIDS trends show that Sub-Saharan Africa is the hardest-hit region, and women are disproportionately affected and infected by HIV. The trend is conspicuous in South Africa, where adolescent girls and young women (AGYW), female university students included, bear the burden of HIV infection. Although the female condom (FC) is the only female-oriented HIV and AIDS technology that provides dual protection against unwanted pregnancy and HIV, its uptake and use remain erratic, especially among the youth and young women in institutions of higher learning. This paper explores empirical evidence from the University of Venda (UniVen), which is in the rural areas of Limpopo Province in South Africa, and also among higher learning institutions experiencing low uptake and use of the FC. A phenomenological approach consisting of in-depth interviews was utilized to collect data from a total of 20 female university students at UniVen who were purposively sampled based on their participation in HIV and AIDS dialogues and campaigns conducted on campus. The findings that were analysed thematically revealed that notions of rurality and sociocultural beliefs surrounding women's sexual and reproductive health are key structural factors that influence the low use and uptake of the FC at the rural university. The evidence thus far revealed that female students are discouraged from collecting or initiating FC because of cultural dictates or prescripts which place the responsibility to collect and initiate condom use on men. Hence the inference that UniVen female students' realities are compounded by notions of rurality and society's patriarchal nature that intersect and limit women's autonomy in matters of sex. Guided by the women empowerment theory, this paper argues that such practices take away UniVen female students' agency to decide on their sexual and reproductive health. The normalisation of socio-cultural and harmful gender practices is also a retrogression in the women's health agenda. The paper recommends a holistic approach that engages traditional and community leaders, particularly men, to unlearn and uproot harmful gender norms and patriarchal elements that hinder the promotion and use of the FC.Keywords: female condom, UniVen, socio-cultural factors, female students, HIV and AIDS
Procedia PDF Downloads 88984 Ethnobotanical and Laboratory Investigations of Plants Used for the Treatment of Typhoid Fever in Gombe State, North-Eastern Nigeria
Authors: Abubakar Bello Usman, Alhassan Muhammad Gani, Kolo Ibrahim
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The use of botanical raw materials to produce pharmaceuticals, herbal remedies, teas, spirits, cosmetics, sweets, dietary supplements, special industrial compounds and crude materials constitute an important global resource in terms of healthcare and economy. In Nigeria and other developing countries, the indigenous knowledge on the uses of plants lies with the older generation and the traditional healers. However, these custodians are decreasing in number due to death and other unforeseen occurrences. An Ethno-botanical survey was carried out to obtain information on the ethno medical values of wide range of plants used by the people of Gombe State, North-Eastern Nigeria, in the practice of healing and cure of typhoid (enteric) fever. Oral interviews were conducted so as to consider those with low literacy level who are involved in the practice of traditional medicine and thirty four (34) informants availed themselves for the interview and were consulted. All relevant information obtained from the respondents was recorded. A recent and valid nomenclature, along with local names, family names, part of the plant(s) used, methods of preparation and administration and fifty four (54) plant species belonging to 27 families as well as 7 unidentified species that are commonly used by the people of the state in ethnomedical treatment of the ailment were tabulated. Those interviewed included traditional practitioners, local herb sellers, traditional rulers, hunters, farmers and patients. Specific questions were asked and information supplied by informants was promptly documented. Results showed that the people of Gombe State are knowledgeable on herbal medicine in the treatment of diseases and ailments. Furthermore, the aqueous leaf extracts of Senna siamea, the plant species with the highest PPK (percentage of people who have knowledge about the use of a species for treating typhoid fever) in this ethnobotanical survey, was tested for its activity against clinical isolates of Salmonella typhi using the agar well diffusion method. The aqueous extracts showed some activity (zones of inhibition 11, 9, 7.5, 3.5, 1.3 mm) at 2000, 1800, 1600, 1400, 1200 µg/ml concentrations respectively. Preliminary phytochemical studies of the aqueous leaf extracts of the plant revealed the presence of secondary metabolites such as alkaloids, saponins, tannins, flavonoids and cardiac glycosides. Though a large number of traditionally used plants for the treatment of enteric fever were identified, further scientific validation of the traditional claims of anti-typhoid properties is imperative. This would establish their candidature for any possible future research for active principles and the possible development of new cheaper and more effective anti-typhoid drugs, as well as in the conservation of this rich diversity of medicinal plants.Keywords: antimicrobial activities, ethnobotany, gombe state, north-eastern Nigeria, phytochemical screening, senna siamea, typhoid fever
Procedia PDF Downloads 334983 Delineation of Subsurface Tectonic Structures Using Gravity, Magnetic and Geological Data, in the Sarir-Hameimat Arm of the Sirt Basin, NE Libya
Authors: Mohamed Abdalla Saleem, Hana Ellafi
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The study area is located in the eastern part of the Sirt Basin, in the Sarir-Hameimat arm of the basin, south of Amal High. The area covers the northern part of the Hamemat Trough and the Rakb High. All of these tectonic elements are part of the major and common tectonics that were created when the old Sirt Arch collapsed, and most of them are trending NW-SE. This study has been conducted to investigate the subsurface structures and the sedimentology characterization of the area and attempt to define its development tectonically and stratigraphically. About 7600 land gravity measurements, 22500 gridded magnetic data, and petrographic core data from some wells were used to investigate the subsurface structural features both vertically and laterally. A third-order separation of the regional trends from the original Bouguer gravity data has been chosen. The residual gravity map reveals a significant number of high anomalies distributed in the area, separated by a group of thick sediment centers. The reduction to the pole magnetic map also shows nearly the same major trends and anomalies in the area. Applying the further interpretation filters reveals that these high anomalies are sourced from different depth levels; some are deep-rooted, and others are intruded igneous bodies within the sediment layers. The petrographic sedimentology study for some wells in the area confirmed the presence of these igneous bodies and defined their composition as most likely to be gabbro hosted by marine shale layers. Depth investigation of these anomalies by the average depth spectrum shows that the average basement depth is about 7.7 km, while the top of the intrusions is about 2.65 km, and some near-surface magnetic sources are about 1.86 km. The depth values of the magnetic anomalies and their location were estimated specifically using the 3D Euler deconvolution technique. The obtained results suggest that the maximum depth of the sources is about 4938m. The total horizontal gradient of the magnetic data shows that the trends are mostly extending NW-SE, others are NE-SW, and a third group has an N-S extension. This variety in trend direction shows that the area experienced different tectonic regimes throughout its geological history.Keywords: sirt basin, tectonics, gravity, magnetic
Procedia PDF Downloads 66982 Tourist Satisfaction: An Experience Study Applied to Tourism Attractions in China
Authors: Min Wei
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Objectives: Experience tourism represents an advanced stage of tourism compared with sightseeing tourism and relaxation tourism. Experience tourism reflects the full respect of experience economy to the human natures. This paper chose one of the most popular ocean tourism products in Zhoushan, as a subject and investigated the constructive elements in tourist experience based on the needs of tourists. Methods: This paper started with the influences of tourism product innovation on tourist experience, then proposed a model of the relationship between tourist experience, tourist satisfaction, and the following behavior of tourists, and concluded that tourist experience improves tourist satisfaction and thereby enhances tourist loyalty based on the developmental pathway of experience tourism. To ensure the accuracy of the collected data of the research results, the sample of this questionnaire survey is chosen by the method of occasional sampling, combined with the judgment of the investigators and the convenience of the questionnaire survey, the survey objects are selected from the scenic spots of Putuo Mountain, Zhujiajian, Taohua Island, waiting room of passenger terminal, etc. Before filling in the questionnaire, the author and the respondents have a short communication. On the premise that the respondents can fully understand the purpose and content of the questionnaire, tourists fill in the questionnaire independently and collect it on the spot. Results: The research results of this paper are mainly embodied in the following aspects: it is concluded that there are many constructive factors of tourists' experience in Zhoushan tourism products. Based on Zhoushan tourism products, this paper explores the constructive factors of tourists' experience in Zhoushan tourism products from three aspects: attracting object experience, facility experience and service experience. At present, there are still big differences between Zhoushan tourism products, tourists’ expectations and tourists' experience, mainly in the aspects of transportation, publicity and tour guide service. Corresponding measures should be taken to improve tourists' experience quality and satisfaction. Conclusions: The influence factors of island tourism products are discriminated, and established a structural model of tourist experience, which includes three basic elements: attractions, facilities, and services. This model was further verified by questionnaires and analyses in Putuo Shan, Zhujia Jian, and Taohua Island. Finally, we combined this model and made some suggestions on boost the satisfaction of Zhoushan islands.Keywords: experience tourism, tourists’ expectations, tourists' experience, tourism products
Procedia PDF Downloads 130981 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review
Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish
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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education
Procedia PDF Downloads 84980 Parametric Non-Linear Analysis of Reinforced Concrete Frames with Supplemental Damping Systems
Authors: Daniele Losanno, Giorgio Serino
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This paper focuses on parametric analysis of reinforced concrete structures equipped with supplemental damping braces. Practitioners still luck sufficient data for current design of damper added structures and often reduce the real model to a pure damper braced structure even if this assumption is neither realistic nor conservative. In the present study, the damping brace is modelled as made by a linear supporting brace connected in series with the viscous/hysteretic damper. Deformation capacity of existing structures is usually not adequate to undergo the design earthquake. In spite of this, additional dampers could be introduced strongly limiting structural damage to acceptable values, or in some cases, reducing frame response to elastic behavior. This work is aimed at providing useful considerations for retrofit of existing buildings by means of supplemental damping braces. The study explicitly takes into consideration variability of (a) relative frame to supporting brace stiffness, (b) dampers’ coefficient (viscous coefficient or yielding force) and (c) non-linear frame behavior. Non-linear time history analysis has been run to account for both dampers’ behavior and non-linear plastic hinges modelled by Pivot hysteretic type. Parametric analysis based on previous studies on SDOF or MDOF linear frames provide reference values for nearly optimal damping systems design. With respect to bare frame configuration, seismic response of the damper-added frame is strongly improved, limiting deformations to acceptable values far below ultimate capacity. Results of the analysis also demonstrated the beneficial effect of stiffer supporting braces, thus highlighting inadequacy of simplified pure damper models. At the same time, the effect of variable damping coefficient and yielding force has to be treated as an optimization problem.Keywords: brace stiffness, dissipative braces, non-linear analysis, plastic hinges, reinforced concrete frames
Procedia PDF Downloads 290979 Implementation of Performance Management and Development System: The Case of the Eastern Cape Provincial Department of Health, South Africa
Authors: Thanduxolo Elford Fana
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Rationale and Purpose: Performance management and development system are central to effective and efficient service delivery, especially in highly labour intensive sectors such as South African public health. Performance management and development systems seek to ensure that good employee performance is rewarded accordingly, while those who underperform are developed so that they can reach their full potential. An effective and efficiently implemented performance management system motivates and improves employee engagement. The purpose of this study is to examine the implementation of the performance management and development system and the challenges that are encountered during its implementation in the Eastern Cape Provincial Department of Health. Methods: A qualitative research approach and a case study design was adopted in this study. The primary data were collected through observations, focus group discussions with employees, a group interview with shop stewards, and in-depth interviews with supervisors and managers, from April 2019 to September 2019. There were 45 study participants. In-depth interviews were held with 10 managers at facility level, which included chief executive officer, chief medical officer, assistant director’s in human resources management, patient admin, operations, finance, and two area manager and two operation managers nursing. A group interview was conducted with five shop stewards and an in-depth interview with one shop steward from the group. Five focus group discussions were conducted with clinical and non-clinical staff. The focus group discussions were supplemented with an in-depth interview with one person from each group in order to counter the group effect. Observations included moderation committee, contracting, and assessment meetings. Findings: The study shows that the performance management and development system was not properly implemented. There was non-compliance to performance management and development system policy guidelines in terms of time lines for contracting, evaluation, payment of incentives to good performers, and management of poor performance. The study revealed that the system is ineffective in raising the performance of employees and unable to assist employees to grow. The performance bonuses were no longer paid to qualifying employees. The study also revealed that lack of capacity and commitment, poor communication, constant policy changes, financial constraints, weak and highly bureaucratic management structures, union interference were challenges that were encountered during the implementation of the performance management and development system. Lastly, employees and supervisors were rating themselves three irrespective of how well or bad they performed. Conclusion: Performance management is regarded as vital to improved performance of the health workforce and healthcare service delivery among populations. Effective implementation of performance management and development system depends on well-capacitated and unbiased management at facility levels. Therefore, there is an urgent need to improve communication, link performance management to rewards, and capacitate staff on performance management and development system, as it is key to improved public health sector outcomes or performance.Keywords: challenges, implementation, performance management and development system, public hospital
Procedia PDF Downloads 135978 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit
Authors: Gokulan Vethanayakam, Daniel Aston
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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation
Procedia PDF Downloads 66977 Investigations on Geopolymer Concrete Slabs
Authors: Akhila Jose
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The cement industry is one of the major contributors to the global warming due to the release of greenhouse gases. The primary binder in conventional concrete is Ordinary Portland cement (OPC) and billions of tons are produced annually all over the world. An alternative binding material to OPC is needed to reduce the environmental impact caused during the cement manufacturing process. Geopolymer concrete is an ideal material to substitute cement-based binder. Geopolymer is an inorganic alumino-silicate polymer. Geopolymer Concrete (GPC) is formed by the polymerization of aluminates and silicates formed by the reaction of solid aluminosilicates with alkali hydroxides or alkali silicates. Various Industrial bye- products like Fly Ash (FA), Rice Husk Ash (RHA), Ground granulated Blast Furnace Slag (GGBFS), Silica Fume (SF), Red mud (RM) etc. are rich in aluminates and silicates. Using by-products from other industries reduces the carbon dioxide emission and thus giving a sustainable way of reducing greenhouse gas emissions and also a way to dispose the huge wastes generated from the major industries like thermal plants, steel plants, etc. The earlier research about geopolymer were focused on heat cured fly ash based precast members and this limited its applications. The heat curing mechanism itself is highly cumbersome and costly even though they possess high compressive strength, low drying shrinkage and creep, and good resistance to sulphate and acid environments. GPC having comparable strength and durability characteristics of OPC were able to develop under ambient cured conditions is the solution making it a sustainable alternative in future. In this paper an attempt has been made to review and compare the feasibility of ambient cured GPC over heat cured geopolymer concrete with respect to strength and serviceability characteristics. The variation on the behavior of structural members is also reviewed to identify the research gaps for future development of ambient cured geopolymer concrete. The comparison and analysis of studies showed that GPC most importantly ambient cured type has a comparable behavior with respect to OPC based concrete in terms strength and durability criteria.Keywords: geopolymer concrete, oven heated, durability properties, mechanical properties
Procedia PDF Downloads 183976 Analyzing the Use of Augmented and Virtual Reality to Teach Social Skills to Students with Autism
Authors: Maggie Mosher, Adam Carreon, Sean Smith
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A systematic literature review was conducted to explore the evidence base on the use of augmented reality (AR), virtual reality (VR), mixed reality (MR), and extended reality (XR) to present social skill instruction to school-age students with autism spectrum disorder (ASD). Specifically, the systematic review focus was on a. the participants and intervention agents using AR, VR, MR, and XR for social skill acquisition b. the social skills taught through these mediums and c. the social validity measures (i.e., goals, procedures, and outcomes) reported in these studies. Forty-one articles met the inclusion criteria. Researchers in six studies taught social skills to students through AR, in 27 studies through non-immersive VR, and in 10 studies through immersive VR. No studies used MR or XR. The primary targeted social skills were relationship skills, emotion recognition, social awareness, cooperation, and executive functioning. An intervention to improve many social skills was implemented by 73% of researchers, 17% taught a single skill, and 10% did not clearly state the targeted skill. The intervention was considered effective in 26 of the 41 studies (63%), not effective in four studies (10%), and 11 studies (27%) reported mixed results. No researchers reported information for all 17 social validity indicators. The social validity indicators reported by researchers ranged from two to 14. Social validity measures on the feelings toward and use of the technology were provided in 22 studies (54%). Findings indicated both AR and VR are promising platforms for providing social skill instruction to students with ASD. Studies utilizing this technology show a number of social validity indicators. However, the limited information provided on the various interventions, participant characteristics, and validity measures, offers insufficient evidence of the impact of these technologies in teaching social skills to students with ASD. Future research should develop a protocol for training treatment agents to assess the role of different variables (i.e., whether agents are customizing content, monitoring student learning, using intervention specific vocabulary in their day to day instruction). Sustainability may be increased by providing training in the technology to both treatment agents and participants. Providing scripts of instruction occurring within the intervention would provide the needed information to determine the primary method of teaching within the intervention. These variables play a role in maintenance and generalization of the social skills. Understanding the type of feedback provided would help researchers determine if students were able to feel rewarded for progressing through the scenarios or if students require rewarding aspects within the intervention (i.e., badges, trophies). AR has the potential to generalize instruction and VR has the potential for providing a practice environment for performance deficits. Combining these two technologies into a mixed reality intervention may provide a more cohesive and effective intervention.Keywords: autism, augmented reality, social and emotional learning, social skills, virtual reality
Procedia PDF Downloads 109975 Different Response of Pure Arctic Char Salvelinus alpinus and Hybrid (Salvelinus alpinus vs. Salvelinus fontinalis Mitchill) to Various Hyperoxic Regimes
Authors: V. Stejskal, K. Lundova, R. Sebesta, T. Vanina, S. Roje
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Pure strain of Arctic char (AC) Salvelinus alpinus and hybrid (HB) Salvelinus alpinus vs. Salvelinus fontinalis Mitchill belong to fish, which with great potential for culture in recirculating aquaculture systems (RAS). Aquaculture of these fish currently use flow-through systems (FTS), especially in Nordic countries such as Iceland (biggest producer), Norway, Sweden, and Canada. Four different water saturation regimes included normoxia (NOR), permanent hyperoxia (HYP), intermittent hyperoxia (HYP ± ) and regimes where one day of normoxia was followed by one day of hyperoxia (HYP1/1) were tested during 63 days of experiment in both species in two parallel experiments. Fish were reared in two identical RAS system consisted of 24 plastic round tanks (300 L each), drum filter, biological filter with moving beads and submerged biofilter. The temperature was maintained using flow-through cooler during at level of 13.6 ± 0.8 °C. Different water saturation regimes were achieved by mixing of pure oxygen (O₂) with water in three (one for each hyperoxic regime) mixing tower equipped with flowmeter for regulation of gas inflow. The water in groups HYP, HYP1/1 and HYP± was enriched with oxygen up to saturation of 120-130%. In HYP group was this level kept during whole day. In HYP ± group was hyperoxia kept for daylight phase (08:00-20:00) only and during night time was applied normoxia in this group. The oxygen saturation of 80-90% in NOR group was created using intensive aeration in header tank. The fish were fed with commercial feed to slight excess at 2 h intervals within the light phase of the day. Water quality parameters like pH, temperature and level of oxygen was monitoring three times (7 am, 10 am and 6 pm) per day using handy multimeter. Ammonium, nitrite and nitrate were measured in two day interval using spectrophotometry. Initial body weight (BW) was 40.9 ± 8.7 g and 70.6 ± 14.8 in AC and HB group, respectively. Final survival of AC ranged from 96.3 ± 4.6 (HYP) to 100 ± 0.0% in all other groups without significant differences among these groups. Similarly very high survival was reached in trial with HB with levels from 99.2 ± 1.3 (HYP, HYP1/1 and NOR) to 100 ± 0.0% (HYP ± ). HB fish showed best growth performance in NOR group reached final body weight (BW) 180.4 ± 2.3 g. Fish growth under different hyperoxic regimes was significantly reduced and final BW was 164.4 ± 7.6, 162.1 ± 12.2 and 151.7 ± 6.8 g in groups HY1/1, HYP ± and HYP, respectively. AC showed different preference for hyperoxic regimes as there were no significant difference in BW among NOR, HY1/1 and HYP± group with final values of 72.3 ± 11.3, 68.3 ± 8.4 and 77.1 ± 6.1g. Significantly reduced growth (BW 61.8 ± 6.8 g) was observed in HYP group. It is evident from present study that there are differences between pure bred Arctic char and hybrid in relation to hyperoxic regimes. The study was supported by projects 'CENAKVA' (No. CZ.1.05/2.1.00/01.0024), 'CENAKVA II' (No. LO1205 under the NPU I program), NAZV (QJ1510077) and GAJU (No. 060/2016/Z).Keywords: recirculating aquaculture systems, Salmonidae, hyperoxia, abiotic factors
Procedia PDF Downloads 182974 Biodiesel Production from Edible Oil Wastewater Sludge with Bioethanol Using Nano-Magnetic Catalysis
Authors: Wighens Ngoie Ilunga, Pamela J. Welz, Olewaseun O. Oyekola, Daniel Ikhu-Omoregbe
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Currently, most sludge from the wastewater treatment plants of edible oil factories is disposed to landfills, but landfill sites are finite and potential sources of environmental pollution. Production of biodiesel from wastewater sludge can contribute to energy production and waste minimization. However, conventional biodiesel production is energy and waste intensive. Generally, biodiesel is produced from the transesterification reaction of oils with alcohol (i.e., Methanol, ethanol) in the presence of a catalyst. Homogeneously catalysed transesterification is the conventional approach for large-scale production of biodiesel as reaction times are relatively short. Nevertheless, homogenous catalysis presents several challenges such as high probability of soap. The current study aimed to reuse wastewater sludge from the edible oil industry as a novel feedstock for both monounsaturated fats and bioethanol for the production of biodiesel. Preliminary results have shown that the fatty acid profile of the oilseed wastewater sludge is favourable for biodiesel production with 48% (w/w) monounsaturated fats and that the residue left after the extraction of fats from the sludge contains sufficient fermentable sugars after steam explosion followed by an enzymatic hydrolysis for the successful production of bioethanol [29% (w/w)] using a commercial strain of Saccharomyces cerevisiae. A novel nano-magnetic catalyst was synthesised from mineral processing alkaline tailings, mainly containing dolomite originating from cupriferous ores using a modified sol-gel. The catalyst elemental chemical compositions and structural properties were characterised by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infra-red (FTIR) and the BET for the surface area with 14.3 m²/g and 34.1 nm average pore diameter. The mass magnetization of the nano-magnetic catalyst was 170 emu/g. Both the catalytic properties and reusability of the catalyst were investigated. A maximum biodiesel yield of 78% was obtained, which dropped to 52% after the fourth transesterification reaction cycle. The proposed approach has the potential to reduce material costs, energy consumption and water usage associated with conventional biodiesel production technologies. It may also mitigate the impact of conventional biodiesel production on food and land security, while simultaneously reducing waste.Keywords: biodiesel, bioethanol, edible oil wastewater sludge, nano-magnetism
Procedia PDF Downloads 145973 Dendrimer-Encapsulated N, Pt Co-Doped TiO₂ for the Photodegration of Contaminated Wastewater
Authors: S. K. M. Nzaba, H. H. Nyoni, B. Ntsendwana, B. B. Mamba, A. T. Kuvarega
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Azo dye effluents, released into water bodies are not only toxic to the ecosystem but also pose a serious impact on human health due to the carcinogenic and mutagenic effects of the compounds present in the dye discharge. Conventional water treatment methods such as adsorption, flocculation/coagulation and biological processes are not effective in completely removing most of the dyes and their natural degradation by-products. Advanced oxidation processes (AOPs) have proven to be effective technologies for complete mineralization of these recalcitrant pollutants. Therefore, there is a need for new technology that can solve the problem. Thus, this study examined the photocatalytic degradation of an azo dye brilliant black (BB) using non-metal/metal codoped TiO₂. N, Pt co-doped TiO₂ photocatalysts were prepared by a modified sol-gel method using amine-terminated polyamidoamine dendrimer generation 0 (PAMAM G0), amine-terminated polyamidoamine dendrimer generation 1 ( PAMAM G1) and hyperbranched polyethyleneimine (HPEI) as templates and source of nitrogen. Structural, morphological, and textural properties were evaluated using scanning electron microscopy coupled to energy dispersive X-ray spectroscopy (SEM/EDX), high-resolution transmission electron microscopy (HRTEM), X-ray diffraction spectroscopy (XRD), X-ray photoelectron spectroscopy (XPS), thermal gravimetric analysis (TGA), Fourier- transform infrared (FTIR), Raman spectroscopy (RS), photoluminescence (PL) and ultra-violet /visible spectroscopy (UV-Vis). The synthesized photocatalysts exhibited lower band gap energies as compared to the Degussa P-25 revealing a red shift in band gap towards the visible light absorption region. Photocatalytic activity of N, Pt co-doped TiO₂ was measured by the reaction of photocatalytic degradation of brilliant black (BB) dye. The N, metal codoped TiO₂ containing 0.5 wt. % of the metal consisted mainly of the anatase phase as confirmed by XRD results of all three samples, with a particle size range of 13–30 nm. The particles were largely spherical and shifted the absorption edge well into the visible region. Band gap reduction was more pronounced for the N, Pt HPEI (Pt 0.5 wt. %) codoped TiO₂ compared to PAMAM G0 and PAMAM G1. Consequently, codoping led to an enhancement in the photocatalytic activity of the materials for the degradation of brilliant black (BB).Keywords: codoped TiO₂, dendrimer, photodegradation, wastewater
Procedia PDF Downloads 173