Search results for: primary health care facilities
5221 Advancing Healthcare Excellence in China: Crafting a Strategic Operational Evaluation Index System for Chinese Hospital Departments amid Payment Reform Initiatives
Authors: Jing Jiang, Yuguang Gao, Yang Yu
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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients
Procedia PDF Downloads 555220 Intensity of Dyspnea and Anxiety in Seniors in the Terminal Phase of the Disease
Authors: Mariola Głowacka
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Aim: The aim of this study was to present the assessment of dyspnea and anxiety in seniors staying in the hospice in the context of the nurse's tasks. Materials and methods: The presented research was carried out at the "Hospicjum Płockie" Association of St. Urszula Ledóchowska in Płock, in a stationary ward, for adults. The research group consisted of 100 people, women, and men. In the study described in this paper, the method of diagnostic survey, the method of estimation and analysis of patient records were used, and the research tools were the numerical scale of the NRS assessment, the modified Borg scale to assess dyspnea, the Trait Anxiety scale to test the intensity of anxiety and the sociodemographic assessment of the respondent. Results: Among the patients, the greatest number were people without dyspnoea (38 people) and with average levels of dyspnoea (26 people). People with lung cancer had a higher level of breathlessness than people with other cancers. Half of the patients included in the study felt anxiety at a low level. On average, men had a higher level of anxiety than women. Conclusion: 1) Patients staying in the hospice require comprehensive nursing care due to the underlying disease, comorbidities, and a wide range of medications taken, which aggravate the feeling of dyspnea and anxiety. 2) The study showed that in patients staying in the hospice, the level of dyspnea was of varying severity. The greatest number of people were without dyspnea (38) and patients with a low level of dyspnea (34). There were 12 people experiencing an average level of dyspnea and a high level of dyspnea 15. 3) The main factor influencing the severity of dyspnea in patients was the location of cancer. There was no significant relationship between the intensity of dyspnea and the age, gender of the patient, and time from diagnosis. 4) The study showed that in patients staying in the hospice, the level of anxiety was of varying severity. Most people experience a low level of anxiety (51). There were 16 people with a high level of anxiety, while there were 33 people experiencing anxiety at an average level. 5) The patient's gender was the main factor influencing the increase in anxiety intensity. Men had higher levels of anxiety than women. There was no significant correlation between the intensity of anxiety and the age of the respondents, as well as the type of cancer and time since diagnosis. 6) The intensity of dyspnea depended on the type of cancer the subjects had. People with lung cancer had a higher level of breathlessness than those with breast cancer and bowel cancer. It was not found that the anxiety increased depending on the type of cancer and comorbidities of the examined person.Keywords: cancer, shortness of breath, anxiety, senior, hospice
Procedia PDF Downloads 865219 The Relationship between Demographic, Social and Economic Characteristics and the Level of Implementation of Rural Women’s Practices to Preserve the Environment in the Governorates of Sharkia and Beni Suef
Authors: Asmaa Ahmed Nasr El-Din
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The Egyptian countryside faces many environmental problems in the field of environmental pollution in a wide range due to the current bad behavior patterns towards the environment, where the rural people continued to follow unconscious environmental practices in addition to the lack of environmental awareness among the rural people in terms of legislation, and the damages resulting from those practices. Rural women play an important and vital role that cannot be neglected in the field of reducing environmental pollution and rationalizing environmental resources, and it is their responsibility to maintain the safety of environmental elements such as water, air, food, and soil from pollution, either through limiting their personal practice that leads to the pollution of these elements or from During the upbringing of her children on the right behaviors towards these elements to protect them from pollution and thus avoid the infection of family members with diseases arising from environmental pollution that may affect their health and production capacity. Therefore, the research aimed to identify the level of rural women’s implementation of environmental practices (land, water, air, public health, and food waste), as well as determining the nature of the relationship between the studied independent variables (demographic, social and economic characteristics) and the level of rural women’s implementation of their role in preserving the environment and identifying some women’s information sources rural environment to preserve the environment. The research was conducted in the villages of Tarout and Qam al-Arous in the governorates of Sharkia and BeniSuef, respectively, and a random sample of 333 rural women was selected using the Yamani equation. Statistical ratio analysis, arithmetic mean, Pearson simple correlation coefficient value, and T-test.Keywords: environment, rural women, EL-sharkia, banuef
Procedia PDF Downloads 1035218 Enhancing Early Detection of Coronary Heart Disease Through Cloud-Based AI and Novel Simulation Techniques
Authors: Md. Abu Sufian, Robiqul Islam, Imam Hossain Shajid, Mahesh Hanumanthu, Jarasree Varadarajan, Md. Sipon Miah, Mingbo Niu
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Coronary Heart Disease (CHD) remains a principal cause of global morbidity and mortality, characterized by atherosclerosis—the build-up of fatty deposits inside the arteries. The study introduces an innovative methodology that leverages cloud-based platforms like AWS Live Streaming and Artificial Intelligence (AI) to early detect and prevent CHD symptoms in web applications. By employing novel simulation processes and AI algorithms, this research aims to significantly mitigate the health and societal impacts of CHD. Methodology: This study introduces a novel simulation process alongside a multi-phased model development strategy. Initially, health-related data, including heart rate variability, blood pressure, lipid profiles, and ECG readings, were collected through user interactions with web-based applications as well as API Integration. The novel simulation process involved creating synthetic datasets that mimic early-stage CHD symptoms, allowing for the refinement and training of AI algorithms under controlled conditions without compromising patient privacy. AWS Live Streaming was utilized to capture real-time health data, which was then processed and analysed using advanced AI techniques. The novel aspect of our methodology lies in the simulation of CHD symptom progression, which provides a dynamic training environment for our AI models enhancing their predictive accuracy and robustness. Model Development: it developed a machine learning model trained on both real and simulated datasets. Incorporating a variety of algorithms including neural networks and ensemble learning model to identify early signs of CHD. The model's continuous learning mechanism allows it to evolve adapting to new data inputs and improving its predictive performance over time. Results and Findings: The deployment of our model yielded promising results. In the validation phase, it achieved an accuracy of 92% in predicting early CHD symptoms surpassing existing models. The precision and recall metrics stood at 89% and 91% respectively, indicating a high level of reliability in identifying at-risk individuals. These results underscore the effectiveness of combining live data streaming with AI in the early detection of CHD. Societal Implications: The implementation of cloud-based AI for CHD symptom detection represents a significant step forward in preventive healthcare. By facilitating early intervention, this approach has the potential to reduce the incidence of CHD-related complications, decrease healthcare costs, and improve patient outcomes. Moreover, the accessibility and scalability of cloud-based solutions democratize advanced health monitoring, making it available to a broader population. This study illustrates the transformative potential of integrating technology and healthcare, setting a new standard for the early detection and management of chronic diseases.Keywords: coronary heart disease, cloud-based ai, machine learning, novel simulation techniques, early detection, preventive healthcare
Procedia PDF Downloads 565217 Medical Authorizations for Cannabis-Based Products in Canada: Sante Cannabis Data on Patient’s Safety and Treatment Profiles
Authors: Rihab Gamaoun, Cynthia El Hage, Laura Ruiz, Erin Prosk, Antonio Vigano
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Introduction: Santé Cannabis (SC), a Canadian medical cannabis-specialized group of clinics based in Montreal and in the province of Québec, has served more than 5000 patients seeking cannabis-based treatment prescription for medical indications over the past five years. Within a research frame, data on the use of medical cannabis products from all the above patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to gather information on the profiles of both patients and prescribed medical cannabis products at SC clinics and to assess the safety of medical cannabis among Canadian patients. Methods: Using a retrospective analysis of the database, records of 2585 patients who were prescribed medical cannabis products for therapeutic purposes between 01-November 2017 and 04-September 2019 were included. Patients’ demographics, primary diagnosis, route of administration, and chemovars recorded at the initial visits were investigated. Results: At baseline: 9% of SC patients were female, with a mean age of 57 (SD= 15.8, range= [18-96]); Cannabis products were prescribed mainly for patients with a diagnosis of chronic pain (65.9% of patients), cancer (9.4%), neurological disorders (6.5%), mood disorders (5.8 %) and inflammatory diseases (4.1%). Route of administration and chemovars of prescribed cannabis products were the following: 96% of patients received cannabis oil (51% CBD rich, 42.5% CBD:THC); 32.1% dried cannabis (21.3% CBD:THC, 7.4% THC rich, 3.4 CBD rich), and 2.1% oral spray cannabis (1.1% CBD:THC, 0.8% CBD rich, 0.2% THC rich). Most patients were prescribed simultaneously, a combination of products with different administration routes and chemovars. Safety analysis is undergoing. Conclusion: Our results provided initial information on the profile of medical cannabis products prescribed in a Canadian population and the experienced adverse events over the past three years. The Santé Cannabis database represents a unique opportunity for comparing clinical practices in prescribing and titrating cannabis-based medications across different centers. Ultimately real-world data, including information about safety and effectiveness, will help to create standardized and validated guidelines for choosing dose, route of administration, and chemovars types for the cannabis-based medication in different diseases and indications.Keywords: medical cannabis, real-world data, safety, pharmacovigilance
Procedia PDF Downloads 1025216 Incident Management System: An Essential Tool for Oil Spill Response
Authors: Ali Heyder Alatas, D. Xin, L. Nai Ming
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An oil spill emergency can vary in size and complexity, subject to factors such as volume and characteristics of spilled oil, incident location, impacted sensitivities and resources required. A major incident typically involves numerous stakeholders; these include the responsible party, response organisations, government authorities across multiple jurisdictions, local communities, and a spectrum of technical experts. An incident management team will encounter numerous challenges. Factors such as limited access to location, adverse weather, poor communication, and lack of pre-identified resources can impede a response; delays caused by an inefficient response can exacerbate impacts caused to the wider environment, socio-economic and cultural resources. It is essential that all parties work based on defined roles, responsibilities and authority, and ensure the availability of sufficient resources. To promote steadfast coordination and overcome the challenges highlighted, an Incident Management System (IMS) offers an essential tool for oil spill response. It provides clarity in command and control, improves communication and coordination, facilitates the cooperation between stakeholders, and integrates resources committed. Following the preceding discussion, a comprehensive review of existing literature serves to illustrate the application of IMS in oil spill response to overcome common challenges faced in a major-scaled incident. With a primary audience comprising practitioners in mind, this study will discuss key principles of incident management which enables an effective response, along with pitfalls and challenges, particularly, the tension between government and industry; case studies will be used to frame learning and issues consolidated from previous research, and provide the context to link practice with theory. It will also feature the industry approach to incident management which was further crystallized as part of a review by the Joint Industry Project (JIP) established in the wake of the Macondo well control incident. The authors posit that a common IMS which can be adopted across the industry not only enhances response capacity towards a major oil spill incident but is essential to the global preparedness effort.Keywords: command and control, incident management system, oil spill response, response organisation
Procedia PDF Downloads 1475215 Estimation of the Dynamic Fragility of Padre Jacinto Zamora Bridge Due to Traffic Loads
Authors: Kimuel Suyat, Francis Aldrine Uy, John Paul Carreon
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The Philippines, composed of many islands, is connected with approximately 8030 bridges. Continuous evaluation of the structural condition of these bridges is needed to safeguard the safety of the general public. With most bridges reaching its design life, retrofitting and replacement may be needed. Concerned government agencies allocate huge costs for periodic monitoring and maintenance of these structures. The rising volume of traffic and aging of these infrastructures is challenging structural engineers to give rise for structural health monitoring techniques. Numerous techniques are already proposed and some are now being employed in other countries. Vibration Analysis is one way. The natural frequency and vibration of a bridge are design criteria in ensuring the stability, safety and economy of the structure. Its natural frequency must not be so high so as not to cause discomfort and not so low that the structure is so stiff causing it to be both costly and heavy. It is well known that the stiffer the member is, the more load it attracts. The frequency must not also match the vibration caused by the traffic loads. If this happens, a resonance occurs. Vibration that matches a systems frequency will generate excitation and when this exceeds the member’s limit, a structural failure will happen. This study presents a method for calculating dynamic fragility through the use of vibration-based monitoring system. Dynamic fragility is the probability that a structural system exceeds a limit state when subjected to dynamic loads. The bridge is modeled in SAP2000 based from the available construction drawings provided by the Department of Public Works and Highways. It was verified and adjusted based from the actual condition of the bridge. The bridge design specifications are also checked using nondestructive tests. The approach used in this method properly accounts the uncertainty of observed values and code-based structural assumptions. The vibration response of the structure due to actual loads is monitored using installed sensors on the bridge. From the determinacy of these dynamic characteristic of a system, threshold criteria can be established and fragility curves can be estimated. This study conducted in relation with the research project between Department of Science and Technology, Mapúa Institute of Technology, and the Department of Public Works and Highways also known as Mapúa-DOST Smart Bridge Project deploys Structural Health Monitoring Sensors at Zamora Bridge. The bridge is selected in coordination with the Department of Public Works and Highways. The structural plans for the bridge are also readily available.Keywords: structural health monitoring, dynamic characteristic, threshold criteria, traffic loads
Procedia PDF Downloads 2605214 Alternative Approaches to Community Involvement in Resettlement Schemes to Prevent Potential Conflicts: Case Study in Chibuto District, Mozambique
Authors: Constâncio Augusto Machanguana
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The world over, resettling communities, for whatever purpose (mining, dams, forestry and wildlife management, roads, or facilitating services delivery), often leads to tensions between those resettled, the investors, and the local and national governments involved in the process. Causes include unclear government legislation and regulations, confusing Corporate Social Responsibility policies and guidelines, and other social-economic policies leading to unrealistic expectations among those being resettled, causing frustrations within the community, shifting them to any imminent conflict against the investors (company). The exploitation of heavy mineral sands along Mozambique’s long coastline and hinterland has not been providing a benefit for the affected communities. A case in point is the exploration, since 2018, of heavy sands in Chibuto District in the Southern Province of Gaza. A likely contributing factor is the standard type of socio-economic surveys and community involvement processes that could smooth the relationship among the parties. This research aims to investigate alternative processes to plan, initiate and guide resettlement processes in such a way that tensions and conflicts are avoided. Based on the process already finished, compared to similar cases along with the country, mixed methods to collect primary data were adopted: three focus groups of 125 people, representing 324 resettled householders; five semi-structured interviews with relevant stakeholders such as the local government, NGO’s and local leaders to understand their role in all stages of the process. The preliminary results show that the community has limited or no understanding of the potential impacts of these large-scale explorations, and the apparent harmony between the parties (community and company) may hide the dissatisfaction of those resettled. So, rather than focusing on negative mining impacts, the research contributes to science by identifying the best resettlement approach that can be replicated in other contexts along with the country in the actual context of the new discovery of mineral resources.Keywords: conflict mitigation, resettlement, mining, Mozambique
Procedia PDF Downloads 1055213 Studies on the Effect of Bio-Methanated Distillery Spentwash on Soil Properties and Crop Yields
Authors: S. K. Gali
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Spentwash, An effluent of distillery is an environmental pollutant because of its high load of pollutants (pH: 2-4; BOD>40,000 mg/l, COD>100,000mg/l and TDS >70,000mg/l). But However, after subjecting it to primary treatment (bio-methanation), Its pollutant load gets drastically reduced (pH: 7.5-8.5, BOD<10,000 mg/l) and could be disposed off safely as a source of organic matter and plant nutrients for crop production. With the consent of State Pollution Control Board, the distilleries in Karnataka are taking up ‘one time controlled land application’ of bio-methanated spentwash in farmers’ fields. A monitoring study was undertaken in Belgaum district of Karnataka State with an objective of studying the effect of land application of bio-methanated spent wash of a distillery on soil properties and crop growth. The treated spentwash was applied uniformly to the fallow dry lands in different farmers’ fields during summer, 2012 at recommended rate (based on nitrogen requirement of crops). The application was made at least a fortnight before sowing/planting operations. The analysis of soils collected before land application of spentwash and after harvest of crops revealed that there was no adverse effect of applied spentwash on soil characteristics. A slight build up in soluble salts was observed but, however all the soils recorded EC of less than 2.0 dSm-1. An increase in soil organic carbon (SOC) and available nitrogen (N) by about 10 to 30 % was observed in the spentwash applied soils. The presence of good amount of biodegradable organics in the treated spentwash (BOD of 6550 mg/l) contributed for increase in SOC and N. A substantial build up in available potassium (K) status (50 to 200%) was observed due to spentwash application. This was attributed to the high K content in spentwash (6950 mg/l). The growth of crops in the spentwash applied fields was higher and farmers could get nearly 10 to 20 per cent higher yields, especially in sugarcane and corn. The analysis of ground water samples showed that the quality of water was not affected due to land application of treated spentwash. Apart from realizing higher crop yields, the farmers were able to save money on N and K fertilisers as the applied spentwash met the crop requirement. Hence, it could be concluded that the bio-methanated distillery spentwash can be gainfully utilized in crop production without polluting the environment.Keywords: bio-methanation, pollutant, potassium status, soil organic carbon
Procedia PDF Downloads 3845212 Interactive Teaching and Learning Resources for Bilingual Education
Authors: Sarolta Lipóczi, Ildikó Szabó
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The use of ICT in European Schools has increased over the last decade but there is still room for improvement. Also interactive technology is often used below its technical and pedagogical potentials. The pedagogical potential of interactive technology in classrooms has not yet reached classrooms in different countries and in a substantial way. To develop these materials cooperation between educational researchers and teachers from different backgrounds is necessary. INTACT project brings together experts from science education, mathematics education, social science education and foreign language education – with a focus on bilingual education – and teachers in secondary and primary schools to develop a variety of pedagogically qualitative interactive teaching and learning resources. Because of the backgrounds of the consortium members INTACT project focuses on the areas of science, mathematics and social sciences. To combine these two features (science/math and foreign language) the project focuses on bilingual education. A big issue supported by ‘interactiveness’ is social and collaborative learning. The easy way to communicate and collaborate offered by web 2.0 tools, mobile devices connected to the learning material allows students to work and learn together. There will be a wide range of possibilities for school co-operations at regional, national and also international level that allows students to communicate and cooperate with other students beyond the classroom boarders while using these interactive teaching materials. Opening up the learning scenario enhance the social, civic and cultural competences of the students by advocating their social skills and improving their cultural appreciation for other nations in Europe. To enable teachers to use the materials in indented ways descriptions of successful learning scenarios (i.e. using design patterns) will be provided as well. These materials and description will be made available to teachers by teacher trainings, teacher journals, booklets and online materials. The resources can also be used in different settings including the use of a projector and a touchpad or other technical interactive devices for the input i.e. mobile phones. Kecskemét College as a partner of INTACT project has developed two teaching and learning resources in the area of foreign language teaching. This article introduces these resources as well.Keywords: bilingual educational settings, international cooperation, interactive teaching and learning resources, work across culture
Procedia PDF Downloads 3905211 Mental Health of Female Runners - Results of a Pilot Study
Authors: Katalin Gocze, Gabriella Kiss, Zsuzsanna Gurdan, Krisztian Kvell, Attila Trabert
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Introduction: On a worldwide scale running has become an increasingly popular leisure time activity during the past decade. Since the participation rate of women has risen significantly the aim of our study was to analyze the mental status, sleeping habits and the prevalence of depression among female runners. Methods: Cross-sectional analysis included the use of validated and globally used surveys for the comprehensive evaluation of insomnia (AIS), depression (BDI), exercise dependence (EDS) and exercise addiction (EAI). Recreational and amateur female runners participating at half-marathon events in Hungary were asked to take part in our pilot study. Results: Participants mean age was 42.03±9.03 years. The prevalence of imsomnia was 18.87%. 60.34% has worries regarding their weight and 43.1% think that they have an actual weight problem. 77.6% stated that their body weight has an influence on their mood. 2.7% displayed borderline clinical depression, the prevalence of mild mood disorders was 10.81%. 17.2% had previously problems with disordered eating. Participants had a mean total EDS score of 46.94±15.55 and a mean total of 13.49±3.80 on EAI. Component scores were the highest for tolerance (a need for increased amounts of exercise to achieve the desired effect or a diminished effect occurs with continued use of the same amount of exercise). Conclusion: Even tough running can help improve mental health, tackle depression and overcome adversity, athletes are at risk of experiencing psychological difficulties which have an impact on their physical perfomance as well. Further research can help initiate targeted educational and screening programs to ensure that female athletes find a path to emotional well-being.Keywords: depression, eating disorder, exercise addiction, exercise dependence, insomnia, running
Procedia PDF Downloads 1205210 A Review on the Vulnerability of Rural-Small Scale Farmers to Insect Pest Attacks in the Eastern Cape Province, South Africa
Authors: Nolitha L. Skenjana, Bongani P. Kubheka, Maxwell A. Poswal
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The Eastern Cape Province of South Africa is characterized by subsistence farming, which is mostly distributed in the rural areas of the province. It is estimated that cereal crops such as maize and sorghum, and vegetables such as cabbage are grown in more than 400.000 rural households, with maize being the most dominant crop. However, compared to commercial agriculture, small-scale farmers receive minimal support from research and development, limited technology transfer on the latest production practices and systems and have poor production infrastructure and equipment. Similarly, there is limited farmers' appreciation on best practices in insect pest management and control. The paper presents findings from the primary literature and personal observations on insect pest management practices of small-scale farmers in the province. Inferences from literature and personal experiences in the production areas have led to a number of deductions regarding the level of exposure and extent of vulnerability. Farmers' pest management practices, which included not controlling at all though there is a pest problem, resulted in their crop stands to be more vulnerable to pest attacks. This became more evident with the recent brown locust, African armyworm, and Fall armyworm outbreaks, and with the incidences of opportunistic phytophagous insects previously collected on wild hosts only, found causing serious damages on crops. In most of these occurrences, damage to crops resulted in low or no yield. Improvements on farmers' reaction and response to pest problems were only observed in areas where focused awareness campaigns and trainings on specific pests and their management techniques were done. This then calls for a concerted effort from all role players in the sphere of small-scale crop production, to train and equip farmers with relevant skills, and provide them with information on affordable and climate-smart strategies and technologies in order to create a state of preparedness. This is necessary for the prevention of substantial crop losses that may exacerbate food insecurity in the province.Keywords: Eastern Cape Province, small-scale farmers, insect pest management, vulnerability
Procedia PDF Downloads 1325209 Causes of Non-Compliance With Public Procurement Act, 2007 Among Some Selected State Own Public Tertiary Education Institutions in Southwest, Nigeria
Authors: Ibitoye Olabode Clement
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The huge amount of grants for infrastructures development in Tertiary Institutions in Nigeria calls for transparency and accountability in the procurement process. However, questions have been raised concerning the judicious and appropriate use of the funds, and it was doubtful if the institutions complied with due process. This paper examined the causes of non-compliance with the Public Procurement Act (2007) in the procurement of Goods, Works, and Services through either direct or indirect processes of procurement, mostly in Tertiary Institutions of State government subvention institutions in Nigeria. Nigeria has over 120 public universities, polytechnics, and colleges of Education. This paper will take samples of some selected Institutions in southwest Nigeria. The institutions comprise 5 Universities, 5 Polytechnics, and 5 Colleges of Education / Health and Technology. The opinions of the institutions’ Procurement Officers on the tremendous investment through grants and interventions for infrastructure development in Tertiary Education Institutions (TEI) in Nigeria call for transparency and accountability in the procurement process. However, there are a lot of questions have been raised as to the judicious use of the funds, and it was doubtful if the institutions complied with due process. This study examined the causes of non-compliance with the Public Procurement Act (2007) in the procurement of Goods, Works, and Services in most State Government Public Institutions in Southwest Nigeria. Over, 120 public institutions comprising 5 Universities, 5 Polytechnics, and 5 Colleges of Education / Health and Technology were used for the study. The opinions of the institutions’ Procurement Officers on the causes of non-compliance with the Act in their procurement process were sought using a structured questionnaire. The results revealed that non-independent of Procurement Officers, non-compliance with the Act by some at the managerial level, claiming inadequate knowledge of the Act, non-employment of qualified and experienced Procurement officers, insufficient publicity of the Act, and non-existence of corporate governance led to poor management of procurement record and non-provision of incentive, Inability to separate the duties of Internal Auditors and Procurement Officers, Inability to translate procurement entity at large which makes nearly all at departmental level believe they procurement officers. Conclusively, on taking the Procurement Officers through interviewing having it that: the right educational and professional qualifications, understanding of the Act, sufficient cognate working experience, recruiting most professionals needed if not all, and occupying management position will enhance compliance. Hence, in addition, adopting an external empowered department from the Bureau should raise for monitoring the compliance mostly in State Government Tertiary Education Institution. Also, an organizational culture with a corporate governance structure that supports the engagement of the right and qualified personnel to handle procurement, encourages them to perform at their best and rewards excellent service by giving incentives, and operates within an administrative environment devoid of corruption.Keywords: non compliance of procurement act, tertiary education institution, university, polytechnic and college of education/ health science and technology, Nigeria
Procedia PDF Downloads 985208 Visual Preferences of Elementary School Children with Autism Spectrum Disorder: An Experimental Study
Authors: Larissa Pliska, Isabel Neitzel, Michael Buschermöhle, Olga Kunina-Habenicht, Ute Ritterfeld
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Visual preferences, which can be assessed using eye tracking technologies, are considered one of the defining hallmarks of Autism Spectrum Disorder (ASD). Specifically, children with ASD show a decreased preference for social images rather than geometric images compared to typically developed (TD) children. Such differences are already prevalent at a very early age and indicate the severity of the disorder: toddlers with ASD who preferred geometric images when confronted with social and geometric images showed higher ASD symptom severity than toddlers with ASD who showed higher social attention. Furthermore, the complexity of social pictures (one child playing vs. two children playing together) as well as the mode of stimulus presentation (video or image), are not decisive for the marker. The average age of diagnosis for ASD in Germany is 6.5 years, and visual preference data on this age group is missing. In the present study, we therefore investigated whether visual preferences persist into school age. We examined the visual preferences of 16 boys aged 6 to 11 with ASD and unimpaired cognition as well as TD children (1:1 matching based on children's age and the parent's level of education) within an experimental setting. Different stimulus presentation formats (images vs. videos) and different levels of stimulus complexity were included. Children with and without ASD received pairs of social and non-social images and video stimuli on a screen while eye movements (i.e., eye position and gaze direction) were recorded. For this specific use case, KIZMO GmbH developed a customized, native iOS app (KIZMO Face-Analyzer) for use on iPads. Neither the format of stimulus presentation nor the complexity of the social images had a significant effect on the visual preference of children with and without ASD in this study. Despite the tendency for a difference between the groups for the video stimuli, there were no significant differences. Overall, no statistical differences in visual preference occurred between boys with and without ASD, suggesting that gaze preference in these groups is similar at primary school age. One limitation is that the children with ASD were already receiving Autism-specific intervention. The potential of a visual preference task as an indicator of ASD can be emphasized. The article discusses the clinical relevance of this marker in elementary school children.Keywords: autism spectrum disorder, eye tracking, hallmark, visual preference
Procedia PDF Downloads 545207 Mesenteric Ischemia Presenting as Acalculous Cholecystitis: A Case Review of a Rare Complication and Aberrant Anatomy
Authors: Joshua Russell, Omar Zubair, Reuben Ndegwa
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Introduction: Mesenteric ischemia is an uncommon condition that can be challenging to diagnose in the acute setting, with the potential for significant morbidity and mortality. Very rarely has acute acalculous cholecystitis been described in the setting of mesenteric ischemia. Case: This was the case in a 78-year-old male, who initially presented with clinical and radiological evidence of small bowel obstruction, thought likely secondary to malignancy. The patient had a 6-week history of anorexia, worsening lower abdominal pain, and ~30kg of unintentional weight loss over a 12-month period and a CT- scan demonstrated a transition point in the distal ileum. The patient became increasingly hemodynamically unstable and peritonitic, and an emergency laparotomy was performed. Intra-operatively, however, no obvious transition point was identified, and instead, the gallbladder was markedly gangrenous and oedematous, consistent with acalculous cholecystitis. An open total cholecystectomy was subsequently performed. The patient was admitted to the Intensive Care Unit post-operatively and continued to deteriorate over the proceeding 48 hours, with two re-look laparotomies demonstrating progressively worsening bowel ischemia, initially in the distribution of the superior mesenteric artery and then the coeliac trunk. On review, the patient was found to have an aberrant right hepatic artery arising from the superior mesenteric artery. The extent of ischemia was considered non-survivable, and the patient was palliated. Discussion: Multiple theories currently exist for the underlying pathophysiology of acalculous cholecystitis, including biliary stasis, sepsis, and ischemia. This case lends further support to ischemia as the underlying etiology of acalculous cholecystitis. This is particularly the case when considered in the context of the patient’s aberrant right hepatic artery arising from the superior mesenteric artery, which occurs in 11-14% of patients. Conclusion: This case report adds further insight to the debate surrounding the pathophysiology of acalculous cholecystitis. It also presents acalculous cholecystitis as a complication of mesenteric ischemia that should always be considered, especially in the elderly patient and in the context of relatively common anatomical variations. Furthermore, the case brings to attention the importance of maintaining dynamic working diagnoses in the setting of evolving pathophysiology and clinical presentations.Keywords: acalculous cholecystitis, anatomical variation, general surgery, mesenteric ischemia
Procedia PDF Downloads 1835206 Estimates of (Co)Variance Components and Genetic Parameters for Body Weights and Growth Efficiency Traits in the New Zealand White Rabbits
Authors: M. Sakthivel, A. Devaki, D. Balasubramanyam, P. Kumarasamy, A. Raja, R. Anilkumar, H. Gopi
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The genetic parameters of growth traits in the New Zealand White rabbits maintained at Sheep Breeding and Research Station, Sandynallah, The Nilgiris, India were estimated by partitioning the variance and covariance components. The (co)variance components of body weights at weaning (W42), post-weaning (W70) and marketing (W135) age and growth efficiency traits viz., average daily gain (ADG), relative growth rate (RGR) and Kleiber ratio (KR) estimated on a daily basis at different age intervals (1=42 to 70 days; 2=70 to 135 days and 3=42 to 135 days) from weaning to marketing were estimated by restricted maximum likelihood, fitting six animal models with various combinations of direct and maternal effects. Data were collected over a period of 15 years (1998 to 2012). A log-likelihood ratio test was used to select the most appropriate univariate model for each trait, which was subsequently used in bivariate analysis. Heritability estimates for W42, W70 and W135 were 0.42 ± 0.07, 0.40 ± 0.08 and 0.27 ± 0.07, respectively. Heritability estimates of growth efficiency traits were moderate to high (0.18 to 0.42). Of the total phenotypic variation, maternal genetic effect contributed 14 to 32% for early body weight traits (W42 and W70) and ADG1. The contribution of maternal permanent environmental effect varied from 6 to 18% for W42 and for all the growth efficiency traits except for KR2. Maternal permanent environmental effect on most of the growth efficiency traits was a carryover effect of maternal care during weaning. Direct maternal genetic correlations, for the traits in which maternal genetic effect was significant, were moderate to high in magnitude and negative in direction. Maternal effect declined as the age of the animal increased. The estimates of total heritability and maternal across year repeatability for growth traits were moderate and an optimum rate of genetic progress seems possible in the herd by mass selection. The estimates of genetic and phenotypic correlations among body weight traits were moderate to high and positive; among growth efficiency traits were low to high with varying directions; between body weights and growth efficiency traits were very low to high in magnitude and mostly negative in direction. Moderate to high heritability and higher genetic correlation in body weight traits promise good scope for genetic improvement provided measures are taken to keep the inbreeding at the lowest level.Keywords: genetic parameters, growth traits, maternal effects, rabbit genetics
Procedia PDF Downloads 4445205 A Post-Occupancy Evaluation of LEED-Certified Residential Communities Using Structural Equation Modeling
Authors: Mohsen Goodarzi, George Berghorn
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Despite the rapid growth in the number of green building and community development projects, the long-term performance of these projects has not yet been sufficiently evaluated from the users’ points of view. This is partially due to the lack of post-occupancy evaluation tools available for this type of project. In this study, a post-construction evaluation model is developed to evaluate the relationship between the perceived performance and satisfaction of residents in LEED-certified residential buildings and communities. To develop this evaluation model, a primary five-factor model was developed based on the existing models and residential satisfaction theories. Each factor of the model included several measures that were adopted from LEED certification systems such as LEED-BD+C New Construction, LEED-BD+C Multifamily Midrise, LEED-ND, as well as the UC Berkeley’s Center for the Built Environment survey tool. The model included four predictor variables (factors), including perceived building performance (8 measures), perceived infrastructure performance (9 measures), perceived neighborhood design (6 measures), and perceived economic performance (4 measures), and one dependent variable (factor), which was residential satisfaction (6 measures). An online survey was then conducted to collect the data from the residents of LEED-certified residential communities (n=192) and the validity of the model was tested through Confirmatory Factor Analysis (CFA). After modifying the CFA model, 26 measures, out of the initial 33 measures, were retained to enter into a Structural Equation Model (SEM) and to find the relationships between the perceived buildings performance, infrastructure performance, neighborhood design, economic performance and residential Satisfaction. The results of the SEM showed that the perceived building performance was the most influential factor in determining residential satisfaction in LEED-certified communities, followed by the perceived neighborhood design. On the other hand, perceived infrastructure performance and perceived economic performance did not show any significant relationship with residential satisfaction in these communities. This study can benefit green building researchers by providing a model for the evaluation of the long-term performance of these projects. It can also provide opportunities for green building practitioners to determine priorities for future residential development projects.Keywords: green building, residential satisfaction, perceived performance, confirmatory factor analysis, structural equation modeling
Procedia PDF Downloads 2305204 The Effect of Affirmative Action in Private Schools on Education Expenditure in India: A Quasi-Experimental Approach
Authors: Athira Vinod
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Under the Right to Education Act (2009), the Indian government introduced an affirmative action policy aimed at the reservation of seats in private schools at the entry-level and free primary education for children from lower socio-economic backgrounds. Using exogenous variation in the status of being in a lower social category (disadvantaged groups) and the year of starting school, this study investigates the effect of exposure to the policy on the expenditure on private education. It employs a difference-in-difference strategy with the help of repeated cross-sectional household data from the National Sample Survey (NSS) of India. It also exploits regional variation in exposure by combining the household data with administrative data on schools from the District Information System for Education (DISE). The study compares the outcome across two age cohorts of disadvantaged groups, starting school at different times, that is, before and after the policy. Regional variation in exposure is proxied with a measure of enrolment rate under the policy, calculated at the district level. The study finds that exposure to the policy led to an average reduction in annual private school fees of ₹223. Similarly, a 5% increase in the rate of enrolment under the policy in a district was associated with a reduction in annual private school fees of ₹240. Furthermore, there was a larger effect of the policy among households with a higher demand for private education. However, the effect is not due to fees waived through direct enrolment under the policy but rather an increase in the supply of low-fee private schools in India. The study finds that after the policy, 79,870 more private schools entered the market due to an increased demand for private education. The new schools, on average, charged a lower fee than existing schools and had a higher enrolment of children exposed to the policy. Additionally, the district-level variation in the enrolment under the policy was very strongly correlated with the entry of new schools, which not only charged a low fee but also had a higher enrolment under the policy. Results suggest that few disadvantaged children were admitted directly under the policy, but many were attending private schools, which were largely low-fee. This implies that disadvantaged households were willing to pay a lower fee to secure a place in a private school even if they did not receive a free place under the policy.Keywords: affirmative action, disadvantaged groups, private schools, right to education act, school fees
Procedia PDF Downloads 1075203 Is Maternity Discrimination Pushing Women out of Work? A Case Study of Maternity Experiences of Working Women in Malaysia
Authors: Nor Hafizah Selamat, Intan Hashima Mohd Hashim, Noraida Endut, Shariffah Suraya Syed Jamaludin, Sharifah Zahhura Syed Abdullah, Suziana Mat Yasin, Nurul Jannah Ambak
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In Malaysia, report on discrimination against pregnant women at work does exist, and this issue should be taken seriously as large proportion of women in the workforce in Malaysia are of reproductive age. It has been well established that women tend to leave the workforce because of their responsibility in raising the family, to care for family members and, also due to lack of work-life balance. In this case, women find themselves disadvantaged in career and job advancements due to gender roles and expectations connected with maternity. This maternity discrimination have pushed women out of work although The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), to which Malaysia is a party, considers discrimination on the ground of maternity is a form of gender discrimination because it hinders women of their effective right to work and requires that special protection be provided for women during maternity to ensure their ability to enjoy the right to work (Article 11(2). What factors prevent women from returning to work and at the same time performing their gender roles expectations? Using semi-structured in-depth interviews this paper explores the experiences of maternity discrimination and their perspectives towards their work employment. 15 women employees who were pregnant or had given birth during her employment period in public and private organizations in Malaysia were participated in this study. While data were analyzed using narrative analysis, respondents were asked on issues related to managing pregnancy, maternity leave and returning to work. The findings revealed that several respondents from private companies stated that they were either dismissed or forced to take unpaid leave due to the company policies. In some cases, respondents also shared how they were treated poorly that they felt that they had to leave their jobs. However, in public organization, the maternity policy implemented showed the support that the employees received from their employer. Study shows that supportive family and employers will encourage employees to return to work. Reasonable adjustments in terms of maternity policies at workplace such as allowing sufficient time in postnatal appointments, offering clear explanation on maternity issues at workplace are something that employees expected from their employers.Keywords: maternity discrimination, women and work, gender, maternity protection, Malaysia
Procedia PDF Downloads 1105202 Motherhood Constrained: The Minotaur Legend Reimagined Through the Perspective of Marginalized Mothers
Authors: Gevorgianiene Violeta, Sumskiene Egle
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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.Keywords: motherhood, disability, child removal, support.
Procedia PDF Downloads 515201 Feasibility Study for Implementation of Geothermal Energy Technology as a Means of Thermal Energy Supply for Medium Size Community Building
Authors: Sreto Boljevic
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Heating systems based on geothermal energy sources are becoming increasingly popular among commercial/community buildings as management of these buildings looks for a more efficient and environmentally friendly way to manage the heating system. The thermal energy supply of most European commercial/community buildings at present is provided mainly by energy extracted from natural gas. In order to reduce greenhouse gas emissions and achieve climate change targets set by the EU, restructuring in the area of thermal energy supply is essential. At present, heating and cooling account for approx... 50% of the EU primary energy supply. Due to its physical characteristics, thermal energy cannot be distributed or exchange over long distances, contrary to electricity and gas energy carriers. Compared to electricity and the gas sectors, heating remains a generally black box, with large unknowns to a researcher and policymaker. Ain literature number of documents address policies for promoting renewable energy technology to facilitate heating for residential/community/commercial buildings and assess the balance between heat supply and heat savings. Ground source heat pump (GSHP) technology has been an extremely attractive alternative to traditional electric and fossil fuel space heating equipment used to supply thermal energy for residential/community/commercial buildings. The main purpose of this paper is to create an algorithm using an analytical approach that could enable a feasibility study regarding the implementation of GSHP technology in community building with existing fossil-fueled heating systems. The main results obtained by the algorithm will enable building management and GSHP system designers to define the optimal size of the system regarding technical, environmental, and economic impacts of the system implementation, including payback period time. In addition, an algorithm is created to be utilized for a feasibility study for many different types of buildings. The algorithm is tested on a building that was built in 1930 and is used as a church located in Cork city. The heating of the building is currently provided by a 105kW gas boiler.Keywords: GSHP, greenhouse gas emission, low-enthalpy, renewable energy
Procedia PDF Downloads 2105200 The Financial Impact of Covid 19 on the Hospitality Industry in New Zealand
Authors: Kay Fielden, Eelin Tan, Lan Nguyen
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In this research project, data was gathered at a Covid 19 Conference held in June 2021 from industry leaders who discussed the impact of the global pandemic on the status of the New Zealand hospitality industry. Panel discussions on financials, human resources, health and safety, and recovery were conducted. The themes explored for the finance panel were customer demographics, hospitality sectors, financial practices, government impact, and cost of compliance. The aim was to see how the hospitality industry has responded to the global pandemic and the steps that have been taken for the industry to recover or sustain their business. The main research question for this qualitative study is: What are the factors that have impacted on finance for the hospitality industry in New Zealand due to Covid 19? For financials, literature has been gathered to study global effects, and this is being compared with the data gathered from the discussion panel through the lens of resilience theory. Resilience theory applied to the hospitality industry suggests that the challenges imposed by Covid 19 have been the catalyst for government initiatives, technical innovation, engaging local communities, and boosting confidence. Transformation arising from these ground shifts have been a move towards sustainability, wellbeing, more awareness of climate change, and community engagement. Initial findings suggest that there has been a shift in customer base that has prompted regional accommodation providers to realign offers and to become more flexible to attract and maintain this realigned customer base. Dynamic pricing structures have been required to meet changing customer demographics. Flexible staffing arrangements include sharing staff between different accommodation providers, owners with multiple properties adopting different staffing arrangements, maintaining a good working relationship with the bank, and conserving cash. Uncertain times necessitate changing revenue strategies to cope with external factors. Financial support offered by the government has cushioned the financial downturn for many in the hospitality industry, and managed isolation and quarantine (MIQ) arrangements have offered immediate financial relief for those hotels involved. However, there is concern over the long-term effects. Compliance with mandated health and safety requirements has meant that the hospitality industry has streamlined its approach to meeting those requirements and has invested in customer relations to keep paying customers informed of the health measures in place. Initial findings from this study lie within the resilience theory framework and are consistent with findings from the literature.Keywords: global pandemic, hospitality industry, new Zealand, resilience
Procedia PDF Downloads 915199 Paternalistic Leadership and Organizational Citizenship Behavior: Moderating Role of Employee Loyalty to Supervisor
Authors: Obiajulu Anthony Ugochukwu Nnedum, Bernard Chukwukelue Chine, Jerome Ogochukwu Ezisi
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A notable challenge of organizational citizenship behavior in Nigerian organizations is the prevalence of individualistic work cultures among employees, as this mindset can result in employees being less willing to go beyond their formal job requirements to contribute to the organization overall success. However, the dearth and scarce research on the antecedents of organizational citizenship behavior, such as paternalistic leadership and employee loyalty to supervisors in sub-Saharan African cultures such as Nigeria, motivated the current study to take a deep investigation into the moderating role of employee loyalty to supervisor on the relationship between paternalistic leadership and organizational citizenship behavior. The relevance of the current study ensures that when employees are loyal to their paternalistic leaders who show care and support, they are more likely to exhibit organizational citizenship behavior. The current study employed a sample size of four hundred and twenty participants (one hundred and five managers and three hundred and five subordinates) from eleven large organizations randomly selected through lucky dip from twenty-two large organizations from the directory of the Chamber of Commerce and Industry in Anambra state, south-eastern Nigeria. Also, a twelve-item organizational citizenship behavior scale, a thirty-nine-item paternalistic leadership scale, and a six-item loyalty to supervisor scale were employed for the collection of data for the current study. Adopting a one manager/Leader by triad subordinates cross-sectional survey design, Hayes process micro model and statistical package for social sciences (SPSS) version twenty-five, the findings from the result of the analysis of the hypotheses demonstrated that loyalty to supervisor moderated the relationship between paternalistic leadership and organizational citizenship behavior-conscientiousness. Also, the findings from the result revealed that loyalty to the supervisor moderated the relationship between authoritative leadership and organizational citizenship behavior identification. Furthermore, the findings from the result showed that loyalty to the supervisor moderated the relationship between moral leadership and organizational citizenship behavior. Accordingly, the result from the analysis implies that when employees are loyal to their supervisors, they are more likely to exhibit organizational citizenship behavior by going above and beyond their formal job requirements, as this loyalty can be fostered through a paternalistic leadership style that emphasizes a supportive and caring relationship between supervisors and subordinates.Keywords: authoritative leadership, moral leadership, loyalty to supervisor, organizational citizenship behavior
Procedia PDF Downloads 545198 Synthesis of Multi-Functional Iron Oxide Nanoparticles for Targeted Drug Delivery in Cancer Treatment
Authors: Masome Moeni, Roya Abedizadeh, Elham Aram, Hamid Sadeghi-Abandansari, Davood Sabour, Robert Menzel, Ali Hassanpour
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Significant number of studies and preclinical research in formulation of cancer nano-pharmaceutics have led to an improvement in cancer care. Nonetheless, the antineoplastic agents have ‘failed to live up to its promise’ since their clinical performance is moderately low. For almost ninety years, iron oxide nanoparticles (IONPS) have managed to keep its reputation in clinical application due to their low toxicity, versatility and multi-modal capabilities. Drug Administration approved utilization of IONPs for diagnosis of cancer as contrast media in magnetic resonance imaging, as heat mediator in magnetic hyperthermia and for the treatment of iron deficiency. Furthermore, IONPs have high drug-loading capacity, which makes them good candidates as therapeutic agent transporters. There are yet challenges to overcome for successful clinical application of IONPs, including stability of drug and poor delivery, which might lead to (i) drug resistance, (ii) shorter blood circulation time, and (iii) rapid elimination and adverse side effects from the system. In this study, highly stable and super paramagnetic IONPs were prepared for efficient and targeted drug delivery in cancer treatment. The synthesis procedure was briefly involved the production of IONPs via co-precipitation followed by coating with tetraethyl orthosilicate and 3-aminopropylethoxysilane and grafting with folic acid for stability targeted purposes and controlled drug release. Physiochemical and morphological properties of modified IONPs were characterised using different analytical techniques. The resultant IONPs exhibited clusters of 10 nm spherical shape crystals with less than 100 nm size suitable for drug delivery. The functionalized IONP showed mesoporous features, high stability, dispersibility and crystallinity. Subsequently, the functionalized IONPs were successfully loaded with oxaliplatin, a chemotherapeutic agent, for a controlled drug release in an actively targeting cancer cells. FT-IR observations confirmed presence of oxaliplatin functional groups, while ICP-MS results verified the drug loading was ~ 1.3%.Keywords: cancer treatment, chemotherapeutic agent, drug delivery, iron oxide, multi-functional nanoparticle
Procedia PDF Downloads 765197 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka
Authors: Ayami Umemura
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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.Keywords: audit cultures, indigenous medicine, singularity, verbalization
Procedia PDF Downloads 755196 Mg Doped CuCrO₂ Thin Oxides Films for Thermoelectric Properties
Authors: I. Sinnarasa, Y. Thimont, L. Presmanes, A. Barnabé
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The thermoelectricity is a promising technique to overcome the issues in recovering waste heat to electricity without using moving parts. In fact, the thermoelectric (TE) effect defines as the conversion of a temperature gradient directly into electricity and vice versa. To optimize TE materials, the power factor (PF = σS² where σ is electrical conductivity and S is Seebeck coefficient) must be increased by adjusting the carrier concentration, and/or the lattice thermal conductivity Kₜₕ must be reduced by introducing scattering centers with point defects, interfaces, and nanostructuration. The PF does not show the advantages of the thin film because it does not take into account the thermal conductivity. In general, the thermal conductivity of the thin film is lower than the bulk material due to their microstructure and increasing scattering effects with decreasing thickness. Delafossite type oxides CuᴵMᴵᴵᴵO₂ received main attention for their optoelectronic properties as a p-type semiconductor they exhibit also interesting thermoelectric (TE) properties due to their high electrical conductivity and their stability in room atmosphere. As there are few proper studies on the TE properties of Mg-doped CuCrO₂ thin films, we have investigated, the influence of the annealing temperature on the electrical conductivity and the Seebeck coefficient of Mg-doped CuCrO₂ thin films and calculated the PF in the temperature range from 40 °C to 220 °C. For it, we have deposited Mg-doped CuCrO₂ thin films on fused silica substrates by RF magnetron sputtering. This study was carried out on 300 nm thin films. The as-deposited Mg doped CuCrO₂ thin films have been annealed at different temperatures (from 450 to 650 °C) under primary vacuum. Electrical conductivity and Seebeck coefficient of the thin films have been measured from 40 to 220 °C. The highest electrical conductivity of 0.60 S.cm⁻¹ with a Seebeck coefficient of +329 µV.K⁻¹ at 40 °C have been obtained for the sample annealed at 550 °C. The calculated power factor of optimized CuCrO₂:Mg thin film was 6 µW.m⁻¹K⁻² at 40 °C. Due to the constant Seebeck coefficient and the increasing electrical conductivity with temperature it reached 38 µW.m⁻¹K⁻² at 220 °C that was a quite good result for an oxide thin film. Moreover, the degenerate behavior and the hopping mechanism of CuCrO₂:Mg thin film were elucidated. Their high and constant Seebeck coefficient in temperature and their stability in room atmosphere could be a great advantage for an application of this material in a high accuracy temperature measurement devices.Keywords: thermoelectric, oxides, delafossite, thin film, power factor, degenerated semiconductor, hopping mode
Procedia PDF Downloads 1925195 Improving Access and Quality of Patient Information Resources for Orthognathic Treatment: A Quality Improvement Project
Authors: Evelyn Marie Richmond, Andrew McBride, Chris Johnston, John Marley
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Background: Good quality patient information resources for orthognathic treatment help to reinforce information delivered during the initial consultation and help patients make informed decisions about their care. The Consultant Orthodontists and a Dental Core Trainee noted limited patient engagement with the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources and that the existing BOS patient information leaflet (PIL) could be customised and developed to meet local requirements. Aim: The quality improvement project (QIP) aimed to improve patients' understanding of orthognathic treatment by ensuring at least 90% of patients had read the new in-house patient information leaflet (PIL) and a minimum of 50% of patients had accessed the British Orthodontic Society (BOS) 'Your Jaw Surgery' online resources before attending the joint orthognathic multidisciplinary clinic by June 2023. Methods: The QIP was undertaken in the orthodontic department of the School of Dentistry, Belfast. Data was collected prospectively during a 6-month period from January 2023 to June 2023 over 3 Plan, Do, Study, Act (PDSA) cycles. Suitable patients were identified at consultant orthodontic new patient clinics. Following initial consultation for orthognathic treatment, patients were contacted to complete a patient questionnaire. Design: The change ideas were a poster with a QR code directing patients to the BOS 'Your Jaw Surgery' website in consultation areas and a new in-house PIL with a QR code directing patients to the BOS 'Your Jaw Surgery' website. Results: In PDSA cycle 1, 86.7% of patients were verbally directed to the BOS 'Your Jaw Surgery' website, and 53.3% accessed the online resources after their initial consultation. Although 100% of patients reported reading the existing PIL, only 64.3% felt it discussed the risks of orthognathic treatment in sufficient detail. By PDSA cycle 3, 100% of patients reported being directed to the BOS 'Your Jaw Surgery' website, however, only 58.3% engaged with the website. 100% of patients who read the new PIL felt that it discussed the risks of orthognathic treatment in sufficient detail. Conclusion: The slight improvement in access to the BOS 'Your Jaw Surgery' website shows that patients do not necessarily choose to access information online despite its availability. The uptake of the new PIL was greater than reported patient engagement with the BOS 'Your Jaw Surgery' website, which indicates patients still value written information despite the availability of online resources.Keywords: orthognathic surgery, patient information resources, quality improvement project, risks
Procedia PDF Downloads 545194 Rasagiline Improves Metabolic Function and Reduces Tissue Injury in the Substantia Nigra in Parkinson's Disease: A Longitudinal In-Vivo Advanced MRI Study
Authors: Omar Khan, Shana Krstevska, Edwin George, Veronica Gorden, Fen Bao, Christina Caon, NP-C, Carla Santiago, Imad Zak, Navid Seraji-Bozorgzad
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Objective: To quantify cellular injury in the substantia nigra (SN) in patients with Parkinson's disease (PD) and to examine the effect of rasagiline of tissue injury in the SN in patients with PD. Background: N-acetylaspartate (NAA) quantified with MRS is a reliable marker of neuronal metabolic function. Fractional anisotropy (FA) and mean diffusivity (MD) obtained with DTI, characterize tissue alignment and integrity. Rasagline, has been shown to exert anti-apototic effect. We applied these advanced MRI techniques to examine: (i) the effect of rasagiline on cellular injury and metabolism in patients with early PD, and (ii) longitudinal changes seen over time in PD. Methods: We conducted a prospective longitudinal study in patients with mild PD, naive to dopaminergic treatment. The imaging protocol included multi-voxel proton-MRS and DTI of the SN, acquired on a 3T scanner. Scans were performed at baseline and month 3, during which the patient was on no treatment. At that point, rasagiline 1 mg orally daily was initiated and MRI scans are were obtained at 6 and 12 months after starting rasagiline. The primary objective was to compare changes during the 3-month period of “no treatment” to the changes observed “on treatment” with rasagiline at month 12. Age-matched healthy controls were also imaged. Image analysis was performed blinded to treatment allocation and period. Results: 25 patients were enrolled in this study. Compared to the period of “no treatment”, there was significant increase in the NAA “on treatment” period (-3.04 % vs +10.95 %, p= 0.0006). Compared to the period of “no treatment”, there was significant increase in following 12 month in the FA “on treatment” (-4.8% vs +15.3%, p<0.0001). The MD increased during “no treatment” and decreased in “on treatment” (+2.8% vs -7.5%, p=0.0056). Further analysis and clinical correlation are ongoing. Conclusions: Advanced MRI techniques quantifying cellular injury in the SN in PD is a feasible approach to investigate dopaminergic neuronal injury and could be developed as an outcome in exploratory studies. Rasagiline appears to have a stabilizing effect on dopaminergic cell loss and metabolism in the SN in PD, that warrants further investigation in long-term studies.Keywords: substantia nigra, Parkinson's disease, MRI, neuronal loss, biomarker
Procedia PDF Downloads 3075193 Global and Domestic Response to Boko Haram Terrorism on Cameroon 2014-2018
Authors: David Nchinda Keming
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The present study is focused on both the national and international collective fight against Boko Haram terrorism on Cameroon and the rule played by the Lake Chad Basin Countries (LCBCs) and the global community to suffocate the sect’s activities in the region. Although countries of the Lake Chad Basin include: Cameroon, Chad, Nigeria and Niger others like Benin also joined the course. The justification for the internationalisation of the fight against Boko Haram could be explained by the ecological and international climatic importance of the Lake Chad and the danger posed by the sect not only to the Lake Chad member countries but to global armed, civil servants and the international political economy. The study, therefore, kick start with Cameroon’s reaction to Boko Haram’s terrorist attacks on its territory. It further expounds on Cameroon’s request on bilateral diplomacy from members of the UN Security Council for an international collective support to staple the winds of the challenging sect. The study relies on the hypothesis that Boko Haram advanced terrorism on Cameroon was more challenging to the domestic military intelligence thus forcing the government to seek for bilateral and multilateral international collective support to secure its territory from the powerful sect. This premise is tested internationally via (multilateral cooperation, bilateral response, regional cooperation) and domestically through (solidarity parade, religious discourse, political manifestations, war efforts, the vigilantes and the way forward). To accomplish our study, we made used of the mixed research methodologies to interpret the primary, secondary and tertiary sources consulted. Our results reveal that the collective response was effectively positive justified by the drastic drop in the sect’s operations in Cameroon and the whole LCBCs. Although the sect was incapacitated, terrorism remains an international malaise and Cameroon hosts a fertile ground for terrorists’ activism. Boko Haram was just weakened and not completely defeated and could reappear someday even under a different appellation. Therefore, to absolutely eradicate terrorism in general and Boko Haram in particular, LCBCs must improve their military intelligence on terrorism and continue to collaborate with advanced experienced countries in fighting terrorism.Keywords: Boko Haram, terrorism, domestic, international, response
Procedia PDF Downloads 1475192 Heuristic Approaches for Injury Reductions by Reduced Car Use in Urban Areas
Authors: Stig H. Jørgensen, Trond Nordfjærn, Øyvind Teige Hedenstrøm, Torbjørn Rundmo
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The aim of the paper is to estimate and forecast road traffic injuries in the coming 10-15 years given new targets in urban transport policy and shifts of mode of transport, including injury cross-effects of mode changes. The paper discusses possibilities and limitations in measuring and quantifying possible injury reductions. Injury data (killed and seriously injured road users) from six urban areas in Norway from 1998-2012 (N= 4709 casualties) form the basis for estimates of changing injury patterns. For the coming period calculation of number of injuries and injury rates by type of road user (categories of motorized versus non-motorized) by sex, age and type of road are made. A prognosticated population increase (25 %) in total population within 2025 in the six urban areas will curb the proceeded fall in injury figures. However, policy strategies and measures geared towards a stronger modal shift from use of private vehicles to safer public transport (bus, train) will modify this effect. On the other side will door to door transport (pedestrians on their way to/from public transport nodes) imply a higher exposure for pedestrians (bikers) converting from private vehicle use (including fall accidents not registered as traffic accidents). The overall effect is the sum of these modal shifts in the increasing urban population and in addition diminishing return to the majority of road safety countermeasures has also to be taken into account. The paper demonstrates how uncertainties in the various estimates (prediction factors) on increasing injuries as well as decreasing injury figures may partly offset each other. The paper discusses road safety policy and welfare consequences of transport mode shift, including reduced use of private vehicles, and further environmental impacts. In this regard, safety and environmental issues will as a rule concur. However pursuing environmental goals (e.g. improved air quality, reduced co2 emissions) encouraging more biking may generate more biking injuries. The study was given financial grants from the Norwegian Research Council’s Transport Safety Program.Keywords: road injuries, forecasting, reduced private care use, urban, Norway
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