Search results for: Hayatabad Medical Complex
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8482

Search results for: Hayatabad Medical Complex

7702 Visualising Charles Bonnet Syndrome: Digital Co-Creation of Pseudohallucinations

Authors: Victoria H. Hamilton

Abstract:

Charles Bonnet Syndrome (CBS) is when a person experiences pseudohallucinations that fill in visual information from any type of sight loss. CBS arises from an epiphenomenal process, with the physical actions of sight resulting in the mental formations of images. These pseudohallucinations—referred to as visions by the CBS community—manifest in a wide range of forms, from complex scenes to simple geometric shapes. To share these unique visual experiences, a remote co-creation website was created where CBS participants communicated their lived experiences. This created a reflexive process, and we worked to produce true representations of these interesting and little-known phenomena. Digital reconstruction of the visions is utilised as it echoes the vivid, experiential movie-like nature of what is being perceived. This paper critically analyses co-creation as a method for making digital assets. The implications of the participants' vision impairments and the application of ethical safeguards are examined in this context. Important to note, this research is of a medical syndrome for a non-medical, practice-based design. CBS research to date is primarily conducted by the ophthalmic, neurological, and psychiatric fields and approached with the primary concerns of these specialties. This research contributes a distinct approach incorporating practice-based digital design, autoethnography, and phenomenology. Autoethnography and phenomenology combine as a foundation, with the first bringing understanding and insights, balanced by the second philosophical, bigger picture, and established approach. With further refining, it is anticipated that the research may be applied to other conditions. Conditions where articulating internal experiences proves challenging and the use of digital methods could aid communication. Both the research and CBS communities will benefit from the insights regarding the relationship between cognitive perceptions and the vision process. This research combines the digital visualising of visions with interest in the link between metaphor, embodied cognition, and image. The argument for a link between CBS visions and metaphor may appear evident due to the cross-category mapping of images that is necessary for comprehension. They both are— CBS visions and metaphors—the experience of picturing images, often with lateral connections and imaginative associations.

Keywords: Charles Bonnet Syndrome, digital design, visual hallucinations, visual perception

Procedia PDF Downloads 46
7701 Data-Driven Approach to Predict Inpatient's Estimated Discharge Date

Authors: Ayliana Dharmawan, Heng Yong Sheng, Zhang Xiaojin, Tan Thai Lian

Abstract:

To facilitate discharge planning, doctors are presently required to assign an Estimated Discharge Date (EDD) for each patient admitted to the hospital. This assignment of the EDD is largely based on the doctor’s judgment. This can be difficult for cases which are complex or relatively new to the doctor. It is hypothesized that a data-driven approach would be able to facilitate the doctors to make accurate estimations of the discharge date. Making use of routinely collected data on inpatient discharges between January 2013 and May 2016, a predictive model was developed using machine learning techniques to predict the Length of Stay (and hence the EDD) of inpatients, at the point of admission. The predictive performance of the model was compared to that of the clinicians using accuracy measures. Overall, the best performing model was found to be able to predict EDD with an accuracy improvement in Average Squared Error (ASE) by -38% as compared to the first EDD determined by the present method. It was found that important predictors of the EDD include the provisional diagnosis code, patient’s age, attending doctor at admission, medical specialty at admission, accommodation type, and the mean length of stay of the patient in the past year. The predictive model can be used as a tool to accurately predict the EDD.

Keywords: inpatient, estimated discharge date, EDD, prediction, data-driven

Procedia PDF Downloads 174
7700 Capitalizing 'Ba' in a Knowledge Creation among Medical Researchers in Malaysian Higher Education Institution

Authors: Connie Edang, Siti Arpah Noordin, Shamila Mohamed Shuhidan

Abstract:

For the past few decades, there are growing numbers of knowledge based industries in Malaysia. As competitive edge has become so important nowadays, the consideration of research and development (R&D) should be put at the highest priority. Alike other industries, HEIs are also contributors to the nation’s development and wealth. Hence, to become a hub for creating a knowledge-based society, HEIs not only responsible for producing skillful human capital, but also to get involved in R&D. With the importance of R&D in today’s modern economy and the rise of Science and Technology, it gives opportunities for researchers to explore this sector as to place Malaysia as a provider in some key strategic industries, including medical and health sciences field. Academic researchers/medical researchers possess unique tacit and skills based in accordance with their experience and professional expert areas. In completing a collaborative research work, there must be platforms to enable the conversion of their knowledge hence beneficial towards creation of new knowledge. The objectives of this study are to: i) explore the knowledge creation activities of medical researchers in the Malaysian Higher Education Institution (HEI); ii) explore the driving forces for knowledge creation activities among the researchers; and iii) explore the interpretation of medical researchers on the establishment of ‘ba’ in the creation of knowledge. Based on the SECI model was introduced by Nonaka and Takeuchi and the Japanese concept of ‘ba’, a qualitative study whereby semi structured interview was used as to gather the informants’ viewpoints and insights based on their experience capitalizing ‘ba’ to support their knowledge creation activities. A single the study was conducted at one of the HEIs located in Sabah. From this study, both face to face and the ICT-assisted tools are found to be significant to support interaction of their knowledge. ICT seems to ease their interaction with other research collaborator. However, this study revealed that interaction conducted in physical settings is still be best preferred by the medical researchers especially situations of whereby their knowledge is hard to be externalized. Moreover, it revealed that motivational factors play important roles as for driving forces affecting their knowledge creation activities. Other than that, the medical researchers addressed that the mix interaction bring forth value in terms of facilitating knowledge creation. Therefore this study would benefit the institution to highly optimize the utilization of good platform so that knowledge can be transferred and be made used by others in appropriate ways.

Keywords: ‘ba’, knowledge creation dynamics, Malaysia, higher education institution, medical researchers

Procedia PDF Downloads 218
7699 Effects of Health Information Websites on Health Care Facility Visits

Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

Abstract:

Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

Procedia PDF Downloads 192
7698 Blockchain-Based Approach on Security Enhancement of Distributed System in Healthcare Sector

Authors: Loong Qing Zhe, Foo Jing Heng

Abstract:

A variety of data files are now available on the internet due to the advancement of technology across the globe today. As more and more data are being uploaded on the internet, people are becoming more concerned that their private data, particularly medical health records, are being compromised and sold to others for money. Hence, the accessibility and confidentiality of patients' medical records have to be protected through electronic means. Blockchain technology is introduced to offer patients security against adversaries or unauthorised parties. In the blockchain network, only authorised personnel or organisations that have been validated as nodes may share information and data. For any change within the network, including adding a new block or modifying existing information about the block, a majority of two-thirds of the vote is required to confirm its legitimacy. Additionally, a consortium permission blockchain will connect all the entities within the same community. Consequently, all medical data in the network can be safely shared with all authorised entities. Also, synchronization can be performed within the cloud since the data is real-time. This paper discusses an efficient method for storing and sharing electronic health records (EHRs). It also examines the framework of roles within the blockchain and proposes a new approach to maintain EHRs with keyword indexes to search for patients' medical records while ensuring data privacy.

Keywords: healthcare sectors, distributed system, blockchain, electronic health records (EHR)

Procedia PDF Downloads 192
7697 Referrals to Occupational Therapy Driving Assessors: A Qualitative Study of General Practitioners

Authors: Mary Butler

Abstract:

Background: Screening programmes for older drivers in Europe (though not the UK), and in many states in the US and in Australia are based on medical assessment of fitness to drive. These programmes require physicians (including general practitioners) to carry out an assessment of fitness to drive in their offices. In 2006, New Zealand changed from doing on-road driving tests with all older drivers from the age of 80, to a screening programme that uses medical assessment of fitness to drive only. Aim: This study set out to understand the experience of New Zealand GPs as they manage the process of medical assessment of fitness to drive assessments for older people. In particular, it aimed to establish how GPs understand the role of specialist driving assessment and rehabilitation carried out by occupational therapists. Design and setting: The study used an interpretive descriptive approach to analyze data from ten interviews with GPs in New Zealand. Results: The results indicated that GPs lack understanding about how occupational therapists can assist their patients, and tend to refer only when there is a disagreement with the patient. Conclusion: There are problems with the medical assessment of fitness to drive carried out by GPs, and there is a need for a more comprehensive community approach to driving cessation. Patients, families and the multidisciplinary team all have a role in deciding when driving cessation should occur. Occupational therapists have a particular responsibility for strategic leadership in this area of practice.

Keywords: assessment, driving, older people, occupational therapy

Procedia PDF Downloads 141
7696 Gas While Drilling (GWD) Classification in Betara Complex; An Effective Approachment to Optimize Future Candidate of Gumai Reservoir

Authors: I. Gusti Agung Aditya Surya Wibawa, Andri Syafriya, Beiruny Syam

Abstract:

Gumai Formation which acts as regional seal for Talang Akar Formation becomes one of the most prolific reservoir in South Sumatra Basin and the primary exploration target in this area. Marine conditions were eventually established during the continuation of transgression sequence leads an open marine facies deposition in Early Miocene. Marine clastic deposits where calcareous shales, claystone and siltstones interbedded with fine-grained calcareous and glauconitic sandstones are the domination of lithology which targeted as the hydrocarbon reservoir. All this time, the main objective of PetroChina’s exploration and production in Betara area is only from Lower Talang Akar Formation. Successful testing in some exploration wells which flowed gas & condensate from Gumai Formation, opened the opportunity to optimize new reservoir objective in Betara area. Limitation of conventional wireline logs data in Gumai interval is generating technical challenge in term of geological approach. A utilization of Gas While Drilling indicator initiated with the objective to determine the next Gumai reservoir candidate which capable to increase Jabung hydrocarbon discoveries. This paper describes how Gas While Drilling indicator is processed to generate potential and non-potential zone by cut-off analysis. Validation which performed by correlation and comparison with well logs, Drill Stem Test (DST), and Reservoir Performance Monitor (RPM) data succeed to observe Gumai reservoir in Betara Complex. After we integrated all of data, we are able to generate a Betara Complex potential map and overlaid with reservoir characterization distribution as a part of risk assessment in term of potential zone presence. Mud log utilization and geophysical data information successfully covered the geological challenges in this study.

Keywords: Gumai, gas while drilling, classification, reservoir, potential

Procedia PDF Downloads 356
7695 Incorporating Lexical-Semantic Knowledge into Convolutional Neural Network Framework for Pediatric Disease Diagnosis

Authors: Xiaocong Liu, Huazhen Wang, Ting He, Xiaozheng Li, Weihan Zhang, Jian Chen

Abstract:

The utilization of electronic medical record (EMR) data to establish the disease diagnosis model has become an important research content of biomedical informatics. Deep learning can automatically extract features from the massive data, which brings about breakthroughs in the study of EMR data. The challenge is that deep learning lacks semantic knowledge, which leads to impracticability in medical science. This research proposes a method of incorporating lexical-semantic knowledge from abundant entities into a convolutional neural network (CNN) framework for pediatric disease diagnosis. Firstly, medical terms are vectorized into Lexical Semantic Vectors (LSV), which are concatenated with the embedded word vectors of word2vec to enrich the feature representation. Secondly, the semantic distribution of medical terms serves as Semantic Decision Guide (SDG) for the optimization of deep learning models. The study evaluate the performance of LSV-SDG-CNN model on four kinds of Chinese EMR datasets. Additionally, CNN, LSV-CNN, and SDG-CNN are designed as baseline models for comparison. The experimental results show that LSV-SDG-CNN model outperforms baseline models on four kinds of Chinese EMR datasets. The best configuration of the model yielded an F1 score of 86.20%. The results clearly demonstrate that CNN has been effectively guided and optimized by lexical-semantic knowledge, and LSV-SDG-CNN model improves the disease classification accuracy with a clear margin.

Keywords: convolutional neural network, electronic medical record, feature representation, lexical semantics, semantic decision

Procedia PDF Downloads 126
7694 Potential and Development of Children with Atypical Rett Syndrome (CDKL5 Gene Mutation) and Augmentative and Alternative Communication

Authors: Anna Amato

Abstract:

Every child needs communication. If spoken language is not or not fully available due to congenital or acquired limitations, those affected need appropriate ways. These can be found in many possibilities of Augmentative and Alternative Communications (AAC). In the communication promotion of severely impaired children, who can use their own body communication forms only to a limited extent for the differentiated understanding, computers with eye control play an essential role. It takes some time to understand the individual forms of communication of the child. Children who depend on the AAC need competent support to learn to communicate in a motivated way in their everyday life. The aim of the present parents' survey (n = 4), which was evaluated descriptively, is to demonstrate the development of communicative abilities as well as the motivation to use complex communication aids with eye control by patients with atypical Rett Syndrome. An increase in communication skills, well-being, self-reliance, and self-esteem, an improvement in social participation, as well as a reduction in anger and screaming events, were noted. The complex visual communication tools were available daily for 3 out of 4 patients with atypical Rett Syndrome. It raises research questions regarding speech understanding and the ability to drive eye control technology in a larger group of atypical Rett Syndrome patients.

Keywords: augmentative and alternative communications, AAC, atypical Rett-syndrome, children, development

Procedia PDF Downloads 118
7693 Prototyping the Problem Oriented Medical Record for Connected Health Based on TypeGraphQL

Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

Abstract:

Data integration of health through connected services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. Such integration will support all wind of change in healthcare by being predictive, pre-emptive, personalized, problem-oriented and participatory. Prototyping a healthcare system that enables data integration has been a big challenge for healthcare for a long time. However, an innovative solution started to emerge by focusing on problem lists where everything can connect the problem list forming a growing graph. This notion was introduced by Dr. Lawrence Weed in early 70’s, but the enabling technologies weren’t mature enough to provide a successful implementation prototype. In this article, we are describing our efforts in prototyping Dr. Lawrence Weed's problem-oriented medical record (POMR) and his patient case schema (SOAP) to shape a prototype for connected health. For this, we are using the TypeGraphQL API and our enterprise-based QL4POMR to describe a Web-Based gateway for healthcare services connectivity. Our prototype has reported success in connecting to the HL7 FHIR medical record and the OpenTarget biomedical repositories.

Keywords: connected health, problem-oriented healthcare record, SOAP, QL4POMR, typegraphQL

Procedia PDF Downloads 99
7692 Nanoparticles-Protein Hybrid-Based Magnetic Liposome

Authors: Amlan Kumar Das, Avinash Marwal, Vikram Pareek

Abstract:

Liposome plays an important role in medical and pharmaceutical science as e.g. nano scale drug carriers. Liposomes are vesicles of varying size consisting of a spherical lipid bilayer and an aqueous inner compartment. Magnet-driven liposome used for the targeted delivery of drugs to organs and tissues1. These liposome preparations contain encapsulated drug components and finely dispersed magnetic particles. Liposomes are vesicles of varying size consisting of a spherical lipid bilayer and an aqueous inner compartment that are generated in vitro. These are useful in terms of biocompatibility, biodegradability, and low toxicity, and can control biodistribution by changing the size, lipid composition, and physical characteristics2. Furthermore, liposomes can entrap both hydrophobic and hydrophilic drugs and are able to continuously release the entrapped substrate, thus being useful drug carriers. Magnetic liposomes (MLs) are phospholipid vesicles that encapsulate magneticor paramagnetic nanoparticles. They are applied as contrast agents for magnetic resonance imaging (MRI)3. The biological synthesis of nanoparticles using plant extracts plays an important role in the field of nanotechnology4. Green-synthesized magnetite nanoparticles-protein hybrid has been produced by treating Iron (III)/Iron(II) chloride with the leaf extract of Dhatura Inoxia. The phytochemicals present in the leaf extracts act as a reducing as well stabilizing agents preventing agglomeration, which include flavonoids, phenolic compounds, cardiac glycosides, proteins and sugars. The magnetite nanoparticles-protein hybrid has been trapped inside the aqueous core of the liposome prepared by reversed phase evaporation (REV) method using oleic and linoleic acid which has been shown to be driven under magnetic field confirming the formation magnetic liposome (ML). Chemical characterization of stealth magnetic liposome has been performed by breaking the liposome and release of magnetic nanoparticles. The presence iron has been confirmed by colour complex formation with KSCN and UV-Vis study using spectrophotometer Cary 60, Agilent. This magnet driven liposome using nanoparticles-protein hybrid can be a smart vesicles for the targeted drug delivery.

Keywords: nanoparticles-protein hybrid, magnetic liposome, medical, pharmaceutical science

Procedia PDF Downloads 250
7691 Enhancing the Effectiveness of Air Defense Systems through Simulation Analysis

Authors: F. Felipe

Abstract:

Air Defense Systems contain high-value assets that are expected to fulfill their mission for several years - in many cases, even decades - while operating in a fast-changing, technology-driven environment. Thus, it is paramount that decision-makers can assess how effective an Air Defense System is in the face of new developing threats, as well as to identify the bottlenecks that could jeopardize the security of the airspace of a country. Given the broad extent of activities and the great variety of assets necessary to achieve the strategic objectives, a systems approach was taken in order to delineate the core requirements and the physical architecture of an Air Defense System. Then, value-focused thinking helped in the definition of the measures of effectiveness. Furthermore, analytical methods were applied to create a formal structure that preliminarily assesses such measures. To validate the proposed methodology, a powerful simulation was also used to determine the measures of effectiveness, now in more complex environments that incorporate both uncertainty and multiple interactions of the entities. The results regarding the validity of this methodology suggest that the approach can support decisions aimed at enhancing the capabilities of Air Defense Systems. In conclusion, this paper sheds some light on how consolidated approaches of Systems Engineering and Operations Research can be used as valid techniques for solving problems regarding a complex and yet vital matter.

Keywords: air defense, effectiveness, system, simulation, decision-support

Procedia PDF Downloads 158
7690 Implementation of Integer Sub-Decomposition Method on Elliptic Curves with J-Invariant 1728

Authors: Siti Noor Farwina Anwar, Hailiza Kamarulhaili

Abstract:

In this paper, we present the idea of implementing the Integer Sub-Decomposition (ISD) method on elliptic curves with j-invariant 1728. The ISD method was proposed in 2013 to compute scalar multiplication in elliptic curves, which remains to be the most expensive operation in Elliptic Curve Cryptography (ECC). However, the original ISD method only works on integer number field and solve integer scalar multiplication. By extending the method into the complex quadratic field, we are able to solve complex multiplication and implement the ISD method on elliptic curves with j-invariant 1728. The curve with j-invariant 1728 has a unique discriminant of the imaginary quadratic field. This unique discriminant of quadratic field yields a unique efficiently computable endomorphism, which later able to speed up the computations on this curve. However, the ISD method needs three endomorphisms to be accomplished. Hence, we choose all three endomorphisms to be from the same imaginary quadratic field as the curve itself, where the first endomorphism is the unique endomorphism yield from the discriminant of the imaginary quadratic field.

Keywords: efficiently computable endomorphism, elliptic scalar multiplication, j-invariant 1728, quadratic field

Procedia PDF Downloads 201
7689 Primary School Students’ Modeling Processes: Crime Problem

Authors: Neslihan Sahin Celik, Ali Eraslan

Abstract:

As a result of PISA (Program for International Student Assessments) survey that tests how well students can apply the knowledge and skills they have learned at school to real-life challenges, the new and redesigned mathematics education programs in many countries emphasize the necessity for the students to face complex and multifaceted problem situations and gain experience in this sense allowing them to develop new skills and mathematical thinking to prepare them for their future life after school. At this point, mathematical models and modeling approaches can be utilized in the analysis of complex problems which represent real-life situations in which students can actively participate. In particular, model eliciting activities that bring about situations which allow the students to create solutions to problems and which involve mathematical modeling must be used right from primary school years, allowing them to face such complex, real-life situations from early childhood period. A qualitative study was conducted in a university foundation primary school in the city center of a big province in 2013-2014 academic years. The participants were 4th grade students in a primary school. After a four-week preliminary study applied to a fourth-grade classroom, three students included in the focus group were selected using criterion sampling technique. A focus group of three students was videotaped as they worked on the Crime Problem. The conversation of the group was transcribed, examined with students’ written work and then analyzed through the lens of Blum and Ferri’s modeling processing cycle. The results showed that primary fourth-grade students can successfully work with model eliciting problem while they encounter some difficulties in the modeling processes. In particular, they developed new ideas based on different assumptions, identified the patterns among variables and established a variety of models. On the other hand, they had trouble focusing on problems and occasionally had breaks in the process.

Keywords: primary school, modeling, mathematical modeling, crime problem

Procedia PDF Downloads 407
7688 Biomechanics of Atalantoaxial Complex for Various Posterior Fixation Techniques

Authors: Arun C. O., Shrijith M. B., Thakur Rajesh Singh

Abstract:

The study aims to analyze and understand the biomechanical stability of the atlantoaxial complex under different posterior fixation techniques using the finite element method in the Indian context. The conventional cadaveric studies performed show heterogeneity in biomechanical properties. The finite element method being a versatile numerical tool, is being wisely used for biomechanics analysis of atlantoaxial complex. However, the biomechanics of posterior fixation techniques for an Indian subject is missing in the literature. It is essential to study in this context as the bone density and geometry of vertebrae vary from region to region, thereby requiring different screw lengths and it can affect the range of motion(ROM), stresses generated. The current study uses CT images for developing a 3D finite element model with C1-C2 geometry without ligaments. Instrumentation is added to this geometry to develop four models for four fixation techniques, namely C1-C2 TA, C1LM-C2PS, C1LM-C2Pars, C1LM-C2TL. To simulate Flexion, extension, lateral bending, axial rotation, 1.5 Nm is applied to C1 while the bottom nodes of C2 are fixed. Then Range of Motion (ROM) is compared with the unstable model(without ligaments). All the fixation techniques showed more than 97 percent reduction in the Range of Motion. The von-mises stresses developed in the screw constructs are obtained. From the studies, it is observed that Transarticular technique is most stable in Lateral Bending, C1LM-C2 Translaminar is found most stable in Flexion/extension. The Von-Mises stresses developed minimum in Trasarticular technique in lateral bending and axial rotation, whereas stress developed in C2 pars construct minimum in Flexion/ Extension. On average, the TA technique is stable in all motions and also stresses in constructs are less in TA. Tarnsarticular technique is found to be the best fixation technique for Indian subjects among the 4 methods.

Keywords: biomechanics, cervical spine, finite element model, posterior fixation

Procedia PDF Downloads 143
7687 Nonlinear Impact Responses for a Damped Frame Supported by Nonlinear Springs with Hysteresis Using Fast FEA

Authors: T. Yamaguchi, M. Watanabe, M. Sasajima, C. Yuan, S. Maruyama, T. B. Ibrahim, H. Tomita

Abstract:

This paper deals with nonlinear vibration analysis using finite element method for frame structures consisting of elastic and viscoelastic damping layers supported by multiple nonlinear concentrated springs with hysteresis damping. The frame is supported by four nonlinear concentrated springs near the four corners. The restoring forces of the springs have cubic non-linearity and linear component of the nonlinear springs has complex quantity to represent linear hysteresis damping. The damping layer of the frame structures has complex modulus of elasticity. Further, the discretized equations in physical coordinate are transformed into the nonlinear ordinary coupled differential equations using normal coordinate corresponding to linear natural modes. Comparing shares of strain energy of the elastic frame, the damping layer and the springs, we evaluate the influences of the damping couplings on the linear and nonlinear impact responses. We also investigate influences of damping changed by stiffness of the elastic frame on the nonlinear coupling in the damped impact responses.

Keywords: dynamic response, nonlinear impact response, finite element analysis, numerical analysis

Procedia PDF Downloads 436
7686 Risk Management and Security Practice in Customs Supply Chain: Application of Cross ABC Method to the Moroccan Customs

Authors: Lamia Hammadi, Abdellah Ait Ouhman, Aomar Ibourk

Abstract:

It is widely assumed that the case of Customs Supply Chain is classified as a complex system, due to not only the variety and large number of actors, but also their complex structural links, and the interactions between these actors, that’s why this system is subject to various types of Risks. The economic, political and social impacts of those risks are highly detrimental to countries, businesses and the public, for this reason, Risk management in the customs supply chain is becoming a crucial issue to ensure the sustainability, security and safety. The main characteristic of customs risk management approach is determining which goods and means of transport should be examined? To what extend? And where future compliance resources should be directed? The purposes of this article are, firstly to deal with the concept of customs supply chain, secondly present our risk management approach based on Cross Activity Based Costing (ABC) Method as an interactive tool to support decision making in customs risk management. Finally, analysis of case study of Moroccan customs to putting theory into practice and will thus draw together the various elements of a structured and efficient risk management approach.

Keywords: cross ABC method, customs supply chain, risk, risk management

Procedia PDF Downloads 380
7685 Correlation between Sleeping Disturbance and Academic Achievement in University Female Students

Authors: Amel Fayed, Shaden AlSubaih, Nouf Al-Qahtani, Asmaa Gosty, Asma Aljuhaimi

Abstract:

Introduction: Sleep difficulties are vastly predominant among adults and affect different aspects of their life. Many literatures found out that females are more liable to suffer from sleeping problems. College students are typical example of people dealing with daily pressure and stress to fulfill the daily tasks and responsibilities. In addition to their ultimate goal of achieving excellent academic records which require their full concentration and effort. Consequently, many of them start complaining of sleep deprivations which can undesirably affect their academic achievements. This study was aiming to investigate how prevalent is sleeping disorders among different colleges in the university and its relation their academic achievements. Methods: A cross-sectional study of female university students at Princess Norah Bint Abdulrahman University using self-administered questionnaire was conducted. Insomnia Severity Index (ISI) was used to assess different grades of insomnia. Students were requested to answer the questions evaluating their sleeping habits over the last two weeks. Participants reported their latest Grade Point Average (GPA). According to ISI, insomnia severity is reported as ‘No clinically significant’, ‘Subthreshold ‘,’ Clinical moderate insomnia’ and ‘Clinical severe’. Results: In the current study, 228 students participated; 172(75.4%) from medical colleges and 56 (24.6%) from non-medical colleges. About 80% of them claimed to have never taken any medications to help them sleep while only three students confirmed their regular use of sleep-inducing medications. About 16% of the students drink milk or other hot drinks to help them fall asleep. None of the students was suspected of having obstructive sleep apnea or apparent psychiatric disorder. According to ISI, 182 (79.8%) students suffered from subthreshold insomnia, 37 (16.2%) had clinical insomnia (moderate severity) and 9 (3.9%) of students had sleeping problems of non-clinically significance level. However, none of students was found to have severe clinical insomnia. Clinical moderate insomnia was reported in 15.1% of medical students and 19.6% of non-medical students. Moreover, about 82% of medical students suffered from subthreshold insomnia compared to 73.2% of non-medical students. This difference was not statistically significant (P=0.24). About 63% of medical students and 48% of non-medical students believed that high percentage of their colleagues are suffering from insomnias (p-value 0.08) The association between GPA and insomnia revealed that; 19.5% of low GPA group compared to 9.3% of high GPA group had clinical moderate insomnia. This association was not statistically significant (p=0.15). The correlation between the GPA and the ISI score was negative but not conclusive (r=-0.08, p-value = 0.29). More than 92% of all students agreed that sleeping problems affect their academic achievement to varying degrees. Conclusion: our results suggest that insomnia is commonly prevalent among female university students and might affect the students’ achievement. This study provides preliminary data about the quality of sleep among medical and non-medical university students which may be used to promote the healthy sleeping habits among female students.

Keywords: academic achievement, females, insomnia, university student

Procedia PDF Downloads 331
7684 Virtual Reality Learning Environment in Embryology Education

Authors: Salsabeel F. M. Alfalah, Jannat F. Falah, Nadia Muhaidat, Amjad Hudaib, Diana Koshebye, Sawsan AlHourani

Abstract:

Educational technology is changing the way how students engage and interact with learning materials. This improved the learning process amongst various subjects. Virtual Reality (VR) applications are considered one of the evolving methods that have contributed to enhancing medical education. This paper utilizes VR to provide a solution to improve the delivery of the subject of Embryology to medical students, and facilitate the teaching process by providing a useful aid to lecturers, whilst proving the effectiveness of this new technology in this particular area. After evaluating the current teaching methods and identifying students ‘needs, a VR system was designed that demonstrates in an interactive fashion the development of the human embryo from fertilization to week ten of intrauterine development. This system aims to overcome some of the problems faced by the students’ in the current educational methods, and to increase the efficacy of the learning process.

Keywords: virtual reality, student assessment, medical education, 3D, embryology

Procedia PDF Downloads 191
7683 Walking the Tightrope: Balancing Project Governance, Complexity, and Servant Leadership for Megaproject Success

Authors: Muhammad Shoaib Iqbal, Shih Ping Ho

Abstract:

Megaprojects are large-scale, complex ventures with significant financial investments, numerous stakeholders, and extended timelines, requiring meticulous management for successful completion. This study explores the interplay between project governance, project complexity, and servant leadership and their combined effects on project success, specifically within the context of Pakistani megaprojects. The primary objectives are to examine the direct impact of project governance on project success, understand the negative influence of project complexity, assess the positive role of servant leadership, explore the moderating effect of servant leadership on the relationship between governance and success, and investigate how servant leadership mitigates the adverse effects of complexity. Using a quantitative approach, survey data were collected from project managers and team members involved in Pakistani megaprojects. Using a Comprehensive empirical model, 257 Valid responses were analyzed. Multiple regression analysis tested the hypothesized relationships and interaction effects using PLS-SEM. Findings reveal that project governance significantly enhances project success, emphasizing the need for robust governance structures. Conversely, project complexity negatively impacts success, highlighting the challenges of managing complex projects. Servant leadership significantly boosts project success by prioritizing team support and empowerment. Although the interaction between governance and servant leadership is not significant, suggesting no significant change in project success, servant leadership significantly mitigates the negative effects of project complexity, enhancing team resilience and adaptability. These results underscore the necessity for a balanced approach integrating strong governance with flexible, supportive leadership. The study offers valuable insights for practitioners, recommending adaptive governance frameworks and promoting servant leadership to improve the management and success rates of megaprojects. This research contributes to the broader understanding of effective project management practices in complex environments.

Keywords: project governance, project complexity, servant leadership, project success, megaprojects, Pakistan

Procedia PDF Downloads 39
7682 Infestation of Aphid on Wheat Triticum aestivum L. (Poaceae) and Its Possible Management with Naturally Existing Beneficial Fauna

Authors: Ghulam Abbas, Ikramul Haq, Ghulam Ghouse

Abstract:

Bread wheat Triticum aestivum L. (Poaceae) is the major source of the staple food for a number of countries of the world including Pakistan. Since it is the staple food of the country, it has been desired, and efforts have been made, that it does not undergo application of pesticides to ensure the food safety. Luckily, wheat does not face a serious threat of insect pests, in ecological conditions of Pakistan, except aphids and armyworm which infest the wheat prior to maturity. It has been observed that almost 5 species of aphid have been reported to attack wheat ie. Ropalosiphum maidi, R. Padi, Schizaphis graminum, Diuraphis noxia, and Sitibion miscanthi but due to natural rise in temperature in terminal season of wheat, the population of aphid gradually decreases and wheat has a safe escape from its infestation. In case, mild temperatures 15ºC to 30ºC prolong, the infestation of aphids also prolongs and it can severely damage wheat in patches, and it has potential to substantially reduce the yield of wheat in infested patch. In years 2013, 2014, and 2015 the studies were undertaken to determine the potential of damage caused by aphid complex in 10 fields in infested patches. The damage caused by aphid complex was calculated on the basis of 1000 grain weight of wheat grains taken from the infested patch and were compared with 1000 grain weight of the healthy plants of the same fields. It was observed that there was 26 to 42% decrease in the weight of grain in infested patches. This patch also escaped from general harvesting by combine harvester and enhanced the loss 13 to 46%. The quality of the wheat straw was also reduced and its acceptance to the animals was also affected up to 50 to 100%. Moreover, the population of naturally existing beneficial fauna was recorded and factors promoting establishment and manipulation of beneficial fauna were studied and analysed.

Keywords: Triticum aestivum, wheat, Pakistan, beneficial fauna, aphid complex

Procedia PDF Downloads 282
7681 Experimental and Theoretical Characterization of Supramolecular Complexes between 7-(Diethylamino)Quinoline-2(1H)-One and Cucurbit[7] Uril

Authors: Kevin A. Droguett, Edwin G. Pérez, Denis Fuentealba, Margarita E. Aliaga, Angélica M. Fierro

Abstract:

Supramolecular chemistry is a field of growing interest. Moreover, studying the formation of host-guest complexes between macrocycles and dyes is highly attractive due to their potential applications. Examples of the above are drug delivery, catalytic process, and sensing, among others. There are different dyes of interest in the literature; one example is the quinolinone derivatives. Those molecules have good optical properties and chemical and thermal stability, making them suitable for developing fluorescent probes. Secondly, several macrocycles can be seen in the literature. One example is the cucurbiturils. This water-soluble macromolecule family has a hydrophobic cavity and two identical carbonyl portals. Additionally, the thermodynamic analysis of those supramolecular systems could help understand the affinity between the host and guest, their interaction, and the main stabilization energy of the complex. In this work, two 7-(diethylamino) quinoline-2 (1H)-one derivative (QD1-2) and their interaction with cucurbit[7]uril (CB[7]) were studied from an experimental and in-silico point of view. For the experimental section, the complexes showed a 1:1 stoichiometry by HRMS-ESI and isothermal titration calorimetry (ITC). The inclusion of the derivatives on the macrocycle lends to an upward shift in the fluorescence intensity, and the pKa value of QD1-2 exhibits almost no variation after the formation of the complex. The thermodynamics of the inclusion complexes was investigated using ITC; the results demonstrate a non-classical hydrophobic effect with a minimum contribution from the entropy term and a constant binding on the order of 106 for both ligands. Additionally, dynamic molecular studies were carried out during 300 ns in an explicit solvent at NTP conditions. Our finding shows that the complex remains stable during the simulation (RMSD ~1 Å), and hydrogen bonds contribute to the stabilization of the systems. Finally, thermodynamic parameters from MMPBSA calculations were obtained to generate new computational insights to compare with experimental results.

Keywords: host-guest complexes, molecular dynamics, quinolin-2(1H)-one derivatives dyes, thermodynamics

Procedia PDF Downloads 92
7680 Boots Chatbot: AI Virtual Customer Assistance Service

Authors: Ruba Bajri, Danah Bukhari, Ruba Tuhaif

Abstract:

This report delves into the application called chatbot and specifically the Boots chatbot, this tool uses artificial intelligence to assist customers with any inquiries about Boots products and services, any issues they're facing , or even just helping customers without the unnecessary wait time that comes with waiting for a customer representative. -powered chatbots are very innovative and have impacted the Boots business very positively by satisfying their customers' needs in real time. By using artificial intelligence, specifically advancements in natural language processing, chatbots are becoming more intuitive and understanding of what the customer needs. The report shows us the significance of the Boots chatbot and how it enhances customer service and support as they have instant answers to questions, help customers navigate the services, and can even personalize recommendations for the customers based on allergies or any past medical history all in real time as it's available 24/7. This is useful to everyone as customers can have their common questions answered immediately while leaving the more complex issues and matters to the human agents. We also reviewed the results of a survey conducted to assess public opinions on the chatbot which has provided us insight into the customer satisfaction levels, furthermore identifying any areas for potential improvement. Al chatbots are changing customer service for the better and improving customer experiences by making it more effective and efficient than ever.

Keywords: boots chatbot, natural language processing, artificial intelligence, AI chatbots

Procedia PDF Downloads 6
7679 Evaluation of the Incidence of Mycobacterium Tuberculosis Complex Associated with Soil, Hayfeed and Water in Three Agricultural Facilities in Amathole District Municipality in the Eastern Cape Province

Authors: Athini Ntloko

Abstract:

Mycobacterium bovis and other species of Mycobacterium tuberculosis complex (MTBC) can result to a zoonotic infection known as Bovine tuberculosis (bTB). MTBC has members that may contaminate an extensive range of hosts, including wildlife. Diverse wild species are known to cause disease in domestic livestock and are acknowledged as TB reservoirs. It has been a main study worldwide to deliberate on bTB risk factors as a result and some studies focused on particular parts of risk factors such as wildlife and herd management. The significance of the study was to determine the incidence of Mycobacterium tuberculosis complex that is associated with soil, hayfeed and water. Questionnaires were administered to thirty (30) smallholding farm owners in the two villages (kwaMasele and Qungqwala) and three (3) three commercial farms (Fort Hare dairy farm, Middledrift dairy farm and Seven star dairy farm). Detection of M. tuberculosis complex was achieved by Polymerase Chain Reaction using primers for IS6110; whereas a genotypic drug resistance mutation was detected using Genotype MTBDRplus assays. Nine percent (9%) of respondents had more than 40 cows in their herd, while 60% reported between 10 and 20 cows in their herd. Relationship between farm size and vaccination for TB differed from forty one percent (41%) being the highest to the least five percent (5%). The highest number of respondents who knew about relationship between TB cases and cattle location was ninety one percent (91%). Approximately fifty one percent (51%) of respondents had knowledge about wild life access to the farms. Relationship between import of cattle and farm size ranged from nine percent (9%) to thirty five percent (35%). Cattle sickness in relation to farm size differed from forty three (43%) being the highest to the least three percent (3%); while thirty three percent (33%) of respondents had knowledge about health management. Respondents with knowledge about the occurrence of TB infections in farms were forty-eight percent (48%). The frequency of DNA isolation from samples ranged from the highest forty-five percent (45%) from water to the least twenty two percent (22%) from soil. Fort Hare dairy farm had the highest number of positive samples, forty four percent (44%) from water samples; whereas Middledrift dairy farm had the lowest positive from water, seventeen percent (17%). Twelve (22%) out of 55 isolates showed resistance to INH and RIF that is, multi-drug resistance (MDR) and nine percent (9%) were sensitive to either INH or RIF. The mutations at rpoB gene differed from 58% being the highest to the least (23%). Fifty seven percent (57%) of samples showed a S315T1 mutation while only 14% possessed a S531L in the katG gene. The highest inhA mutations were detected in T8A (80 %) and the least was observed in A16G (17%). The results of this study reveal that risk factors for bTB in cattle and dairy farm workers are a serious issue abound in the Eastern Cape of South Africa; with the possibility of widespread dissemination of multidrug resistant determinants in MTBC from the environment.

Keywords: hayfeed, isoniazid, multi-drug resistance, mycobacterium tuberculosis complex, polymerase chain reaction, rifampicin, soil, water

Procedia PDF Downloads 339
7678 Filler Elastomers Abrasion at Steady State: Optimal Use Conditions

Authors: Djeridi Rachid, Ould Ouali Mohand

Abstract:

The search of a mechanism for the elastomer abrasive wear study is an open issue. The practice difficulties are complex due to the complexity of deformation mechanism, to the complex mechanism of the material tearing and to the marked interactions between the tribological parameters. In this work, we present an experimental technique to study the elastomers abrasive wear. The interaction 'elastomer/indenter' implicate dependant ant temporary of different tribological parameters. Consequently, the phenomenon that governs this interaction is not easy to explain. An optimal elastomers compounding and an adequate utilization conditions of these materials that define its resistance at the abrasion is discussed. The results are confronted to theoretical models: the weight loss variation in function of blade angle or in function of cycle number is in agreement with rupture models and with the mechanism of fissures propagation during the material tearing in abrasive wear of filler elastomers. The weight loss in function of the sliding velocity shows the existence of a critical velocity that corresponds to the maximal wear. The adding of silica or black carbon influences in a different manner on wear abrasive behavior of filler elastomers.

Keywords: abrasion wear, filler elastomer, tribology, hyperelastic

Procedia PDF Downloads 324
7677 Resveratrol-Phospholipid Complex for Sustained Delivery of Resveratrol via the Skin for the Treatment of Inflammatory Diseases

Authors: Malay K. Das, Bhupen Kalita

Abstract:

The poor oral bioavailability of resveratrol (RSV) due to presystemic metabolism can be avoided via dermal route of administration. The hydrophilic-lipophilic nature of resveratrol-phospholipid complex (RSVPs) favors the delivery of resveratrol via the skin. The RSVPs embedded polymeric patch with moderate adhesiveness was developed for dermal application for sustained anti-inflammatory effect. The prepared patches were evaluated for various physicochemical properties, surface morphology by SEM, TEM, and compatibility of patch components by FT-IR and DSC studies. The dermal flux of the optimized patch formulation was found to be at 4.28 ± 0.48 mg/cm2/24 h. The analysis of skin extract after permeation study revealed the presence of resveratrol, which confirmed the localization of RSVPs in the skin. The stability of RSVPs in the polymeric patch and the physiologic environment was confirmed by FE-SEM studies on the patches after drug release and skin permeation studies. The RSVPs particles released from the polymer matrix maintaining the structural integrity and permeate the keratinized horney layer of skin. The optimized patch formulation showed sustained anti-inflammatory effect (84.10% inhibition of inflammation at 24 h) in carrageenan-induced rat paw edema model compared to marketed diclofenac sodium gel (39.58% inhibition of inflammation at 24 h). The CLSM study confirmed the localization of RSVPs for a longer period, thus enabling drug targeting to the dermis for sustained anti-inflammatory effect. Histological studies with phase contrast trinocular microscope suggested no alteration of skin integrity and no evidence of the presence of inflammatory cells after exposure to the permeants. The patch was found to be safe for skin application as evaluated by Draize method for skin irritation scoring in a rabbit model. These results suggest the therapeutic efficacy of the developed patch in both acute and chronic inflammatory diseases.

Keywords: resveratrol-phospholipid complex, skin delivery, sustained anti-inflammatory effect, inflammatory diseases, dermal patch

Procedia PDF Downloads 232
7676 The Role of Land Consolidation to Reduce Soil Degradation in the Czech Republic

Authors: Miroslav Dumbrovsky

Abstract:

The paper deals with positive impacts of land consolidation on decreasing soil degradation with the main emphasis on soil and water conservation in the landscape. The importance of land degradation is very high because of its impact on crop productivity and many other adverse effects. Soil degradation through soil erosion is causing losses in crop productivity and quality of the environment, through decreasing quality of soil and water (especially water resources). Negative effects of conventional farming practices are increased water erosion, as well as crusting and compaction of the topsoil and subsoil. Soil erosion caused by water destructs the soil’s structure, reduces crop productivity due to deterioration in soil physical and chemical properties such as infiltration rate, water holding capacity, loss of nutrients needed for crop production, and loss of soil carbon. Recently, a new process of complex land consolidation in the Czech Republic has provided a unique opportunity for improving the quality of the environment and sustainability of the crop production by means a better soil and water conservation. The present process of the complex land consolidation is not only a reallocation of plots, but this system consists of a new layout of plots within a certain territory, aimed at establishing the integrated land-use economic units, based on the needs of individual landowners and land users. On the other hand, the interests of the general public and the environmental protection have to be solved, too. From the general point of view, a large part of the Czech landscape shall be reconstructed in the course of complex land consolidation projects. These projects will be based on new integrated soil-economic units, spatially arranged in a designed multifunctional system of soil and water conservation measures, such as path network and a territorial system of ecological stability, according to structural changes in agriculture. This new approach will be the basis of a rational economic utilization of the region which will comply with the present ecological and aesthetic demands at present.

Keywords: soil degradation, land consolidation, soil erosion, soil conservation

Procedia PDF Downloads 357
7675 Comprehending the Relationship between the Red Blood Cells of a Protein 4.1 -/- Patient and Those of Healthy Controls: A Comprehensive Analysis of Tandem Mass Spectrometry Data

Authors: Ahmed M. Hjazi, Bader M. Hjazi

Abstract:

Protein 4.1 is a crucial component of complex interactions between the cytoskeleton and other junctional complex proteins. When the gene encoding this protein is altered, resulting in reduced expression, or when the protein is absent, the red cell undergoes a significant structural change. This research aims to achieve a deeper comprehension of the biochemical effects of red cell protein deficiency. A Tandem Mass Spectrometry Analysis (TMT-MS/MS) of patient cells lacking protein 4.1 compared to three healthy controls was achieved by the Proteomics Institute of the University of Bristol. The SDS-PAGE and Western blotting were utilized on the original patient sample and controls to partially confirm TMT MS/MS data analysis of the protein-4.1-deficient cells. Compared to healthy controls, protein levels in samples lacking protein 4.1 had a significantly higher concentration of proteins that probably originated from reticulocytes. This could occur if the patient has an elevated reticulocyte count. The increase in chaperone and reticulocyte-associated proteins was most notable in this study. This may result from elevated quantities of reticulocytes in patients with hereditary elliptocytosis.

Keywords: hereditary elliptocytosis, protein 4.1, red cells, tandem mass spectrometry data.

Procedia PDF Downloads 79
7674 AI for Efficient Geothermal Exploration and Utilization

Authors: Velimir Monty Vesselinov, Trais Kliplhuis, Hope Jasperson

Abstract:

Artificial intelligence (AI) is a powerful tool in the geothermal energy sector, aiding in both exploration and utilization. Identifying promising geothermal sites can be challenging due to limited surface indicators and the need for expensive drilling to confirm subsurface resources. Geothermal reservoirs can be located deep underground and exhibit complex geological structures, making traditional exploration methods time-consuming and imprecise. AI algorithms can analyze vast datasets of geological, geophysical, and remote sensing data, including satellite imagery, seismic surveys, geochemistry, geology, etc. Machine learning algorithms can identify subtle patterns and relationships within this data, potentially revealing hidden geothermal potential in areas previously overlooked. To address these challenges, a SIML (Science-Informed Machine Learning) technology has been developed. SIML methods are different from traditional ML techniques. In both cases, the ML models are trained to predict the spatial distribution of an output (e.g., pressure, temperature, heat flux) based on a series of inputs (e.g., permeability, porosity, etc.). The traditional ML (a) relies on deep and wide neural networks (NNs) based on simple algebraic mappings to represent complex processes. In contrast, the SIML neurons incorporate complex mappings (including constitutive relationships and physics/chemistry models). This results in ML models that have a physical meaning and satisfy physics laws and constraints. The prototype of the developed software, called GeoTGO, is accessible through the cloud. Our software prototype demonstrates how different data sources can be made available for processing, executed demonstrative SIML analyses, and presents the results in a table and graphic form.

Keywords: science-informed machine learning, artificial inteligence, exploration, utilization, hidden geothermal

Procedia PDF Downloads 56
7673 Quality of Care of Medical Male Circumcisions: A Non-Negotiable for Right to Care

Authors: Nelson Igaba, C. Onaga, S. Hlongwane

Abstract:

Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.

Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement

Procedia PDF Downloads 178