Search results for: pediatric emergency department

Authors: Anastasia Constantinou, Stephen Morris

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Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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Authors: Jiří Barta

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The paper deals with simulation programs of spread of harmful substances. Air pollution has a direct impact on the quality of human life and environmental protection is currently a very hot topic. Therefore, the paper focuses on the simulation of release of harmful substances. The first part of article deals with perspectives and possibilities of implementation outputs of simulations programs into the system which is education and of practical training of the management staff during emergency events in the frame of critical infrastructure. The last part shows the practical testing and evaluation of simulation programs. Of the tested simulations software been selected Symos97. The tool offers advanced features for setting leakage. Gradually allows the user to model the terrain, location, and method of escape of harmful substances.

Keywords: Computer Simulation, Symos97, Spread, Simulation Software, Harmful Substances

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Authors: Minnie Y. Teng, Kathy Xie, Jarus Tal

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Rationale: The traditional approach to community programs for children with mental and/or developmental challenges often involves segregation from typically-developing peers. However, studies show that inclusive education improves children’s quality of life, self-concept, and long term health outcomes. Investigating factors that influence inclusion can thus have important implications in the design and facilitation of community programs such that all children - across a spectrum of needs and abilities - may benefit. Objectives: This study explores barriers and facilitators to inclusive community programming for children aged 0 to 12 with developmental/mental challenges. Methods: Using a participatory-action research methodology, semi-structured focus groups and interviews will be used to explore perspectives of sighted students, instructors, and staff. Data will be transcribed and coded thematically. Practice Implications or Results: By having a deeper understanding of the barriers and facilitators to inclusive programming in the community, researchers can work with the broader community to facilitate inclusion in children’s community programs. Conclusions: Expanding inclusive practices may improve the health and wellbeing of the pediatric populations with disabilities, which consistently reports lower levels of participation. These findings may help to identify gaps in existing practices and ways to approach them.

Keywords: aquatic programs, children, disabilities, inclusion, community programs

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Authors: Huawei Ma, Wencai Du, Shengbin Liang

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Smart Home Healthcare technologies for the elderly represent a transformative paradigm that leverages emerging technologies to provide the elderly’ health indicators and daily life monitoring, emergency calls, environmental monitoring, behavior perception, and other services to ensure the health and safety of the elderly who are aging in their own home. However, the excessive complexity in the main adopted framework has affected the acceptance and adoption of the elderly. Therefore, this paper proposes a lightweight synergy architecture of IoT data and service for elderly home smart health environment. It includes the modeling of IoT applications and their workflows, data interoperability, interaction, and storage paradigms to meet the growing needs of older people so that they can lead an active, fulfilling, and quality life.

Keywords: smart home healthcare, IoT, independent living, lightweight framework

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Authors: Michelle Ablian Mejica

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Female drop-outs due to teenage pregnancy and gender-based violence in schools are two of the most contentious and current gender-related issues faced by the Department of Education (DepEd) in the Philippines. The country adopted gender mainstreaming as the main strategy to eliminate gender inequalities in all aspects of the society including education since 1990. This research examines the extent and magnitude by which gender mainstreaming is implemented in the basic education from the national to the school level. It seeks to discover the challenges faced by the central and field offices, particularly by the principals who served as decision-makers in the schools where teaching and learning take place and where opportunities that may aggravate, conform and transform gender inequalities and hierarchies exist. The author conducted surveys and interviews among 120 elementary and secondary principals in the Division of Zambales as well as selected gender division and regional focal persons within Region III- Central Luzon. The study argues that DepEd needs to review, strengthen and revitalize its gender mainstreaming because the efforts do not penetrate the schools and are not enough to lessen or eliminate gender inequalities within the schools. The study found out some of the major challenges in the implementation of gender mainstreaming as follows: absence of a national gender-responsive education policy framework, lack of gender responsive assessment and monitoring tools, poor quality of gender and development related training programs and poor data collection and analysis mechanism. Furthermore, other constraints include poor coordination mechanism among implementing agencies, lack of clear implementation strategy, ineffective or poor utilization of GAD budget and lack of teacher and learner centered GAD activities. The paper recommends the review of the department’s gender mainstreaming efforts to align with the mandate of the agency and provide gender responsive teaching and learning environment. It suggests that the focus must be on formulation of gender responsive policies and programs, improvement of the existing mechanism and conduct of trainings focused on gender analysis, budgeting and impact assessment not only for principals and GAD focal point system but also to parents and other school stakeholders.

Keywords: curriculum and instruction, gender analysis, gender budgeting, gender impact assessment

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Authors: Bouchekoua Myriam, Aloui Dorsaf, Trabelsi Sonia

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Introduction Food hygiene in hospitals is important, particularly among patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. The consumption of contaminated food may be responsible for foodborne diseases, which can be severe among hospitalized patients, especially those immunocompromised. The aim of our study was to assess the state of hygiene in the internal catering department of a Tunisian hospital. Methodology and major results: A prospective study was conducted for one year in the Parasitology-Mycology laboratory of Charles Nicolle Hospital. Samples were taken from the kitchen staff, worktops, and cooking utensils used in the internal catering department. Thirty one employees have benefited from stool exams and scotch tape in order to evaluate the degree of infestation of parasites. 35% of stool exams were positive. Protozoa were the only parasites detected. Blastocystis sp was the species mostly found in nine food handlers. Its role as a human pathogen is still controversial. Pathogenic protozoa were detected in two food handlers (Giardia intestinalis in one person and Dientamoeba fragilis in the other one. Non-pathogenic protozoa were found in two cases; among them, only one had digestive symptoms without a statistically significant association with the carriage of intestinal parasites. Moreover, samples were performed from the hands of the staff in order to search for a fungal carriage. Thus, 25 employees (81%) were colonized by fungi, including molds. Besides, mycological examination among food handlers with a suspected dermatomycosis for diagnostic confirmation concluded foot onychomycosis in 32% of cases and interdigital intertrigo in 26%. Only one person had hand onychomycosis. Among the 17 samples taken from worktops and kitchen utensils, fungal contamination was detected in 13 sites. Hot and cold equipment were the most contaminated. Molds were mainly identified as belonging to five different genera. Cladosporium sp was predominant. Conclusion: In the view of the importance of intestinal parasites among food handlers, the intensity of fungi hand carriage among these employees, and the high level of fungal contamination in worktops and kitchen utensils, a reinforcement of hygiene measures is more than essential in order to minimize the alimentary contamination-risk.

Keywords: hospital kitchen, environment, intestinal parasitosis, fungal carriage, fungal contamination

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Authors: Rapuane Eric Jan Pule

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Sport participation plays a significant role in learners’ well-being and lifestyle. Learners spend most of their time in the school environment, where they are monitored, guided and advised by teachers. Teachers have a good relationship with the learners, therefore they can play a major role in promoting and influencing learners to participate in physical activities, both competitive and recreational purposes. Their influence and involvement could assist in increasing the number learners' involvement in physical activities, sport and recreation at Township schools. The national sport and recreation plan in South Africa, recommends that promotion of sport and physical activities at primary and secondary schools should play an important role in helping learners commit to a live-long participation in sport, recreational and physical activities. Schoolteachers could play an influential role in ensuring that learners spent their leisure time productively through physical and recreational activities. However, the role and the influence of teachers in promoting physical and recreational activities have been previously overlooked in the literature. Part of this study focuses on the in-depth challenges encountered by primary and secondary school teachers at Township schools in promoting and influencing learners’ involvement in sport, recreation and physical activities. 109 primary and secondary teachers at Township schools agreed to participate in the study through the provision of informed consent. The participants consisted of 49 primary school teachers and 60 secondary school teachers. Quantitative approach was followed using validated structured questionnaire comprising 12 close-ended items were used. Findings indicated that teachers' can play a significant role in influencing and encouraging learners to participate in sport, recreation or physical activities. Teachers view physical activity as an important developmental component for learners. Primary school teachers believe that they have a significant role to play in encouraging and promoting physical activities, sport and recreation, as compared to the secondary school teachers. Both group of teachers at primary and secondary schools, believe that infrastructure development, financial support, and extra incentives could motivate them to promote physical, recreational and sporting activities at schools. Teachers also acknowledge that schools are facing challenges in implementing and coordinating physical activities and recreational programmes as required by the Department of sport and recreation South Africa. It is recommended that the Department of Basic Education and Sport and Recreation South Africa revise their policies regarding the role of teachers in promoting and administering physical and recreational activities at schools.

Keywords: township, physical activities, sport and recreation participation, learners, teachers, primary and secondary schools, physical education

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Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

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Authors: Getachew Demesa Bexa

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Building resilience to withstand extreme weather events through reduction and mitigation measures towards predicted disasters with appropriate contingency plans complemented by timely and effective emergency response demands committed and integrated/coordinated efforts. The 2006 flood disaster that claimed more than 200 people in Dire Dawa town shifted the paradigm from reactive to proactive engagement among government, NGOs and communities to contain future disasters through resilience building. Dire Dawa CMDRR Association is a model community organization that demonstrated the basic minimum and turning adversity into opportunity by mobilizing vulnerable community members. Meanwhile the birth of African Centre for Disaster Risk Management is a milestone in changing the image of the country and beyond in resilience building while linking relief and development.

Keywords: Dire Dawa, disaster, resilience, risk management

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Authors: YangHui

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Foreign teachers play an important role in the process of internationalization of higher education in China. Based on the method of literature analysis, firstly study the contents about the mechanism of the foreign teachers’ administration in our country, then secondly analyze the main barriers of the foreign teacher’s administration mechanism. Finally, it is suggested that the international exchange department in universities should constantly improve the employment mechanism, training mechanism, appraisal mechanism and incentive mechanism to promote the internationalization of higher education.

Keywords: internationalization of higher education, mechanism, administration of foreign teachers, colleges and universities, China

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Authors: Leila Noori, Rosario Barone, Francesca Rappa, Antonella Marino Gammazza, Alessandra Maria Vitale, Giuseppe Donato Mangano, Giusy Sentiero, Filippo Macaluso, Kathryn H. Myburgh, Francesco Cappello, Federica Scalia

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The neuromuscular system controls, directs, and allows movement of the body through the action of neural circuits, which include motor neurons, sensory neurons, and skeletal muscle fibers. Protein homeostasis of the involved cytotypes appears crucial to maintain the correct and prolonged functions of the neuromuscular system, and both neuronal cells and skeletal muscle fibers express significant quantities of protein chaperones, the molecular machinery responsible to maintain the protein turnover. Genetic mutations or defective post-translational modifications of molecular chaperones (i.e., genetic or acquired chaperonopathies) may lead to neuromuscular disorders called as neurochaperonopathies. The limited knowledge of the effects of the defective chaperones on skeletal muscle fibers and neurons impedes the progression of therapeutic approaches. A distinct genetic variation of CCT5 gene encoding for the subunit 5 of the chaperonin CCT (Chaperonin Containing TCP1; also known as TRiC, TCP1 Ring Complex) was recently described associated with severe distal motor neuropathy by our team. In this study, we investigated the histopathological abnormalities of the skeletal muscle biopsy of the pediatric patient affected by the mutation Leu224Val in the CCT5 subunit. We provide molecular and structural features of the diseased skeletal muscle tissue that we believe may be useful to identify undiagnosed cases of this rare genetic disorder. We investigated the histological abnormalities of the affected tissue via hematoxylin and eosin staining. Then we used immunofluorescence and qPCR techniques to explore the expression and distribution of CCT5 in diseased and healthy skeletal muscle tissue. Immunofluorescence and immunohistochemistry assays were performed to study the sarcomeric and structural proteins of skeletal muscle, including actin, myosin, tubulin, troponin-T, telethonin, and titin. We performed Western blot to examine the protein expression of CCT5 and some heat shock proteins, Hsp90, Hsp60, Hsp27, and α-B crystallin, along with the main client proteins of the CCT5, actin, and tubulin. Our findings revealed muscular atrophy, abnormal morphology, and different sizes of muscle fibers in affected tissue. The swollen nuclei and wide interfiber spaces were seen. Expression of CCT5 had been decreased and showed a different distribution pattern in the affected tissue. Altered expression, distribution, and bandage pattern were detected by confocal microscopy for the interested muscular proteins in tissue from the patient compared to the healthy control. Protein levels of the studied Hsps normally located at the Z-disk were reduced. Western blot results showed increased levels of the actin and tubulin proteins in the diseased skeletal muscle biopsy compared to healthy tissue. Chaperones must be expressed at high levels in skeletal muscle to counteract various stressors such as mechanical, oxidative, and thermal crises; therefore, it seems relevant that defects of molecular chaperones may result in damaged skeletal muscle fibers. So far, several chaperones or cochaperones involved in neuromuscular disorders have been defined. Our study shows that alteration of the CCT5 subunit is associated with the damaged structure of skeletal muscle fibers and alterations of chaperone system components and paves the way to explore possible alternative substrates of chaperonin CCT. However, further studies are underway to investigate the CCT mechanisms of action to design applicable therapeutic strategies.

Keywords: molecular chaperones, neurochaperonopathy, neuromuscular system, protein homeostasis

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Authors: P. H. Le, J. Molina, S. Hirai

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In this work, we propose the application of Japanese “Origami” art for a floating function of a small aerial vehicle such as a hexarotor. A preliminary experiment was conducted using Origami magic balls mounted under a hexarotor. This magic ball can expand and shrink using an air pump during free flying. Using this interesting and functional concept, it promises to reduce the resistance of wind as well as reduce the energy consumption when the Origami balls are deflated. This approach can be particularly useful in rescue emergency situations. Furthermore, there are many unexpected reasons that may cause the multi-rotor has to land on the surface of water due to problems with the communication between the aircraft and the ground station. In addition, a complementary experiment was designed to prove that the hexarotor can fly maintaining the stability and also, takes off and lands on the surface of water using air balloons.

Keywords: helicopter, Japanese origami ball, floating, aerial robots, rescue

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Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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Authors: Sheillah Hlamalani Mboweni, Lufuno Makhado

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Background: The increasing number of people who tested HIV positive and who demand antiretroviral therapy (ART) prompted the National Department of Health to adopt WHO recommendations of task shifting where Professional Nurses(PNs) initiate ART rather than doctors in the hospital. This resulted in the decentralization of services to primary health care(PHC), generating a need to capacitate PNs on NIMART. After years of training, the impact of NIMART was assessed where it was established that even though there was an increased number who accessed ART, the quality of care is of serious concern. The study aims to answer the following question: What are the challenges influencing NIMART implementation in primary health care. Objectives: This study explores challenges influencing NIMART training and implementation and makes recommendations to improve patient and HIV program outcomes. Methods: A qualitative explorative program evaluation research design. The study was conducted in the rural districts of North West province. Purposive sampling was used to sample PNs trained on NIMART. FGDs were used to collect data with 6-9 participants and data was analysed using ATLAS ti. Results: Five FGDs, n=28 PNs and three program managers were interviewed. The study results revealed two themes: inadequacy in NIMART training and the health care system challenges. Conclusion: The deficiency in NIMART training and health care system challenges is a public health concern as it compromises the quality of HIV management resulting in poor patients’ outcomes and retard the goal of ending the HIV epidemic. These should be dealt with decisively by all stakeholders. Recommendations: The national department of health should improve NIMART training and HIV management: standardization of NIMART training curriculum through the involvement of all relevant stakeholders skilled facilitators, the introduction of pre-service NIMART training in institutions of higher learning, support of PNs by district and program managers, plan on how to deal with the shortage of staff, negative attitude to ensure compliance to guidelines. There is a need to develop a conceptual framework that provides guidance and strengthens NIMART implementation in PHC facilities.

Keywords: antiretroviral therapy, nurse initiated management of retroviral therapy, primary health care, professional nurses

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Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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Authors: Soumita Banerjee

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The State of West Bengal is mostly watered by innumerable rivers, and they are different in nature in both the northern and the southern part of the state. The southern part of West Bengal is mainly drained with the river Bhagirathi-Hooghly, and its major distributaries and tributaries have divided this major river basin into many subparts like the Ichamati-Bidyadhari, Pagla-Bansloi, Mayurakshi-Babla, Ajay, Damodar, Kangsabati Sub-basin to name a few. These rivers basically drain the Districts of Bankura, Burdwan, Hooghly, Nadia and Purulia, Birbhum, Midnapore, Murshidabad, North 24-Parganas, Kolkata, Howrah and South 24-Parganas. West Bengal has a huge number of flood-prone blocks in the southern part of the state of West Bengal, the responsible factors for flood situation are the shape and size of the catchment area, its steep gradient starting from plateau to flat terrain, the river bank erosion and its siltation, tidal condition especially in the lower Ganga Basin and very low maintenance of the embankments which are mostly used as communication links. Along with these factors, DVC (Damodar Valley Corporation) plays an important role in the generation (with the release of water) and controlling the flood situation. This year the whole Gangetic West Bengal is being flooded due to high intensity and long duration rainfall, and the release of water from the Durgapur Barrage As most of the rivers are interstate in nature at times floods also take place with release of water from the dams of the neighbouring states like Jharkhand. Other than Embankments, there is no such structural measures for combatting flood in West Bengal. This paper tries to analyse the reasons behind the flood situation this year especially with the help of climatic data collected from the Indian Metrological Department, flood related data from the Irrigation and Waterways Department, West Bengal and GPM (General Precipitation Measurement) data for rainfall analysis. Based on the threshold value derived from the calculation of the past available flood data, it is possible to predict the flood events which may occur in the near future and with the help of social media it can be spread out within a very short span of time to aware the mass. On a larger or a governmental scale, heightening the settlements situated on the either banks of the river can yield a better result than building up embankments.

Keywords: dam failure, embankments, flood, rainfall

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Authors: Parker Townes, Prabdeep Panesar, Chunlin Liu, Soo Youn Lee, Dan Devoe, Paul D. Arnold, Jennifer Crosbie, Russell Schachar

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Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are impairing childhood neurodevelopmental disorders with problems in executive functions. Executive functions are higher-level mental processes essential for daily functioning and goal attainment. There is genetic and neural overlap between ADHD and ASD. The aim of this meta-analysis was to evaluate if pediatric ASD and ADHD have distinct executive function profiles. This review was completed following Cochrane guidelines. Fifty-eight articles were identified through database searching, followed by a blinded screening in duplicate. A meta-analysis was performed for all task performance metrics evaluated by at least two articles. Forty-five metrics from 24 individual tasks underwent analysis. No differences were found between youth with ASD and ADHD in any domain under direct comparison. However, individuals with ASD and ADHD exhibited deficient attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition compared to controls. No deficits in planning were noted in either disorder. Only 11 studies included a group with comorbid ASD+ADHD, making it difficult to determine whether common executive function deficits are a function of comorbidity. Further research is needed to determine if comorbidity accounts for the apparent commonality in executive function between ASD and ADHD.

Keywords: autism spectrum disorder, ADHD, neurocognition, executive function, youth

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Authors: Zsofia Patyi

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While empirical studies under socialism in Hungary focused on the lawyer society as a whole, current research deals with law students in specific. The change of regime and the mutation of legal education have influenced the motivation, efficiency, social background and self-concept of law students. This shift needs to be acknowledged, and the education system improved for students and together with students. A new law student society requires a different legal education system, different legal studies, or, at the minimum, a different approach to teaching law. This is to ensure that competitive lawyers be trained who understand the constantly changing nature of the law and, as a result, can potentially transform or create legislation themselves. A number of developments can affect law students’ awareness of legal relations in a democratic state. In today’s Hungary, these decisive factors are primarily the new regulation of the financing of law students, and secondly, the new Hungarian constitution (henceforth: Alaptörvény), which has modified the base of the Hungarian legal system. These circumstances necessitate a new, comprehensive, and empirical, investigation of law students. To this end, our research team (comprising a professor, a Ph.D. student, and two law students), is conducting a new type of study in February 2017. The first stage of the research project uses the desktop method to open up the research antecedents. Afterward, a structured questionnaire draft will be designed and sent to the Head of Department of Sociology and the Associate Professor of the Department of Constitutional Law at the University of Szeged to have the draft checked and amended. Next, an open workshop for students and teachers will be organized with the aim to discuss the draft and create the final questionnaire. The research team will then contact each Hungarian university with a Faculty of Law to reach all 1st- and 4th-year law students. 1st-year students have not yet studied the Alaptörvény, while 4th-year students have. All students will be asked to fill in the questionnaire (in February). Results are expected to be in at the end of February. In March, the research team will report the results and present the conclusions. In addition, the results will be compared to previous researches. The outcome will help us answer the following research question: How should legal studies and legal education in Hungary be reformed in accordance with law students and the future lawyer society? The aim of the research is to (1) help create a new student- and career-centered teaching method of legal studies, (2) offer a new perspective on legal education, and (3) create a helpful and useful de lege ferenda proposal for the attorney general as regards legal education as part of higher education.

Keywords: change, constitution, investigation, law students, lawyer society, legal education, legal studies, motivation, reform

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Pelin Atav, Gözen Güner Aktaş, Nur Ayalp

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Today’s world has started to develop design process within an interdisciplinary working environment. There is an aim of creating the most permanent design for the future. While satisfying people’s needs, environment and people relationships should be considered. When this relationship was considered for the future, the sustainability term comes to mind. The term Sustainability has been adapted very well by designer and architects. It is also one of the main and significant parts of the design process. As the education process cultivates the future professionals, the awareness of those concepts in the education process has a vital importance. The question is stated as thus: Are the 3rd and 4th year design studio students, familiar and sensitive to the concept of sustainability in the TOBB ETU University Interior Design Studio. Design studios and the instructors should be taken into consideration while this sustainability term is taught. The term "Sustainability" can not be learned without making any application in the actual real world. While students make this study, They can have the chance to search the topic of sustainability step by step. Due to having various extent, sustainability term becomes quite a comprehensive issue. In order not to create negative consequences, designers and architects work by adapting this term. In terms of material, construction process, lighting, building service, furniture, systems that are used, energy consumption issues that are considered and creating positive drawbacks for the future are aimed. This research is aimed at how university education shapes designer’s works in terms of sustainability. By giving a project that is a main interest in the field of sustainability, students are expected to reach well-thought-of results and analysis. Project process were conducted with instructor and student studies together. According to critics from their instructors, students try to product well- designed results. TOBB University was choosen as a research area situated in Ankara in Turkey. Third and fourth class (interior designer/architect department) students who are from the Faculty of Fine Arts Design and Architecture are the subject group selected for this study. Aim of this study is demonstrating sustainability as a term having application in design studio. Thus, awareness of sustainability terms will be evaluated and its development process in the university education will be observed. Consequently, results that are expected is how sustainability term is conducted in project and for the sustainability term awareness in design studios and their projects have been sufficient or not.

Keywords: design education, design process, interior design studios, sustainability

Procedia PDF Downloads 281

Authors: Meduranda Marco

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This paper aimed to discuss the Integrative Assessment (IA) initiative of the Schools Division Office - Navotas City. The introduction provided a brief landscape analysis of the current state of education, the context of SDO Navotas, and the rationale for the administration of Integrative Assessment (IA) in schools. The IA methodology, procedure, and implementation activities were also shared. Feedback and reports on IA showed positive results as all schools in the Division were able to operationalize IA and consequently foster academic ease for learners and parents. Challenges met after compliance were also documented and strategies to continuously improve the Integrative Assessment process were proposed.

Keywords: distance learning assessment, integrative assessment, academic ease, learning outcomes evaluation

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Authors: Joel Carlos Vieira Reinhardt, Mariana de Freitas Dewes, Odair Lelis Gonçalez

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This paper proposes a method to implement a strategic framework for the quality management system that considers the analysis of prospective scenarios in the determination of policy, mission, vision, objectives, processes, monitoring, and goals. Semantic categorization of qualitative testimonial research on employee perception shows it was possible to implement an effective change in the organizations at the Department of Aerospace Science and Technology through the focus on the organization's needs management, producing a rupture with the historical managerial practice.

Keywords: management of company needs, mission, prospective scenarios, quality management, quality policy, vision

Procedia PDF Downloads 117

Authors: N. K. Bhute, B. B. Bhosle, D. G. More, B. V. Bhede

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The field experiments were conducted during kharif season of the year 2007-08 at the experimental farm of the Department of Agricultural Entomology, Vasantrao Naik Marathwada Krishi Vidyapeeth, Studies on evaluation of different IPM modules for Bt cotton in relation to yield economics and ICBR revealed that MAU and CICR IPM modules proved superior. It was, however, on par with chemical control. Considering the ICBR and safety to natural enemies, an inference can be drawn that Bt cotton with IPM module is the most ideal combination. Besides reduction in insecticide use, it is also expected to ensure favourable ecological and economic returns in contrast to the adverse effects due to conventional insecticides. The IPM approach, which takes care of varying pest situation, appears to be essential for gaining higher advantage from Bt cotton.

Keywords: yield, economics, ICBR, IPM Modules, Bt cotton

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Authors: Raju Chhetri

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Agroforestry is one of the main sources of livelihood among the people of Nepal. In particular, this is the only one mode of livelihood among the Chepangs. The monster earthquake (7.3 MW) that hit the country on the 25th of April in 2015 and many of its aftershocks had devastating effects. As a result, not only the big structures collapsed, it incurred great losses on fabrication, collection centers, schools, markets and other necessary service centers. Although there were a large number of aftershocks after the monster earthquake, the most devastating aftershock took place on 12th May, 2015, which measured 6.3 richter scale. Consequently, it caused more destruction of houses, further calamity to the lives of people, and public life got further perdition. This study was mainly carried out to find out the food security and market situation of Agroforestry product of the Chepang community in Raksirang VDC (one of the severely affected VDCs of Makwanpur district) due to the earthquake. A total of 40 households (12 percent) were randomly selected as a sample in ward number 7 only. Questionnaires and focus groups were used to gather primary data. Additional, two Focus Group Discussions (FGD) were convened in the study area to get some descriptive information on this study. Estimated 370 hectares of land, which was full of Agroforestry plantation, ruptured by the earthquake. It caused severe damages to the households, and a serious loss of food-stock, up to 60-80 percent (maize, millet, and rice). Instead of regular cereal intake, banana (Muas Paradisca) consumption was found ‘high scale’ in the emergency period. The market price of rice (37-44 NRS/Kg) increased by 18.9 percent. Some difference in the income range before and after the earthquake was observed. Before earthquake, sale of Agroforestry, and livestock products were continuing, but after the earthquake, Agroforestry product sale is the only one means of livelihood among Chepangs. Nearly 50-60 percent Agroforestry production of banana (Mass Paradisca), citrus (Citrus Lemon), pineapple (Ananus comosus) and broom grass (Thysanolaena maxima) declined, excepting for cash income from the residual. Heavy demands of Agroforestry product mentioned above lay high farm gate prices (50-100 percent) helps surveyed the community to continue livelihood from its sale. Out of the survey samples, 30 households (75 percent) respondents migrated to safe location due to land rupture, ongoing aftershocks, and landslides. Overall food security situation in this community is acute and challenging for the days to come. Immediate and long term both response from a relief agency concerning food, shelter and safe stocking of Agroforestry product is required to keep secured livelihood in Chepang community.

Keywords: earthquake, rupture, agroforestry, livelihood, indigenous, food security

Procedia PDF Downloads 322

Authors: A. G. Akhundov

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Issues of obtaining unbiased data on the status of pipeline systems of oil- and oil product transportation become especially important when laying and operating pipelines under severe nature and climatic conditions. The essential attention is paid here to researching exogenous processes and their impact on linear facilities of the pipeline system. Reliable operation of pipelines under severe nature and climatic conditions, timely planning and implementation of compensating measures are only possible if operation conditions of pipeline systems are regularly monitored, and changes of permafrost soil and hydrological operation conditions are accounted for. One of the main reasons for emergency situations to appear is the geodynamic factor. Emergency situations are proved by the experience to occur within areas characterized by certain conditions of the environment and to develop according to similar scenarios depending on active processes. The analysis of natural and technical systems of main pipelines at different stages of monitoring gives a possibility of making a forecast of the change dynamics. The integration of GIS technologies, traditional means of geotechnical monitoring (in-line inspection, geodetic methods, field observations), and remote methods (aero-visual inspection, aero photo shooting, air and ground laser scanning) provides the most efficient solution of the problem. The united environment of geo information system (GIS) is a comfortable way to implement the monitoring system on the main pipelines since it provides means to describe a complex natural and technical system and every element thereof with any set of parameters. Such GIS enables a comfortable simulation of main pipelines (both in 2D and 3D), the analysis of situations and selection of recommendations to prevent negative natural or man-made processes and to mitigate their consequences. The specifics of such systems include: a multi-dimensions simulation of facilities in the pipeline system, math modelling of the processes to be observed, and the use of efficient numeric algorithms and software packets for forecasting and analyzing. We see one of the most interesting possibilities of using the monitoring results as generating of up-to-date 3D models of a facility and the surrounding area on the basis of aero laser scanning, data of aerophotoshooting, and data of in-line inspection and instrument measurements. The resulting 3D model shall be the basis of the information system providing means to store and process data of geotechnical observations with references to the facilities of the main pipeline; to plan compensating measures, and to control their implementation. The use of GISs for geotechnical monitoring of pipeline systems is aimed at improving the reliability of their operation, reducing the probability of negative events (accidents and disasters), and at mitigation of consequences thereof if they still are to occur.

Keywords: databases, 3D GIS, geotechnical monitoring, pipelines, laser scaning

Procedia PDF Downloads 188

Authors: Amirreza Razzaghipour, Mahdi Khalili

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References from the World Health Organization and the Center for Disease Control for deceleration the spread of the Novel COVID-19, comprises social estrangement, frequent handwashing, and covering your mouth when around others. As hearing healthcare specialists, the influence of existenceinvoluntary to boundary social interactions on persons with hearing impairment was significant for us to understand. We found ourselves delaying cochlear implant (CI) surgeries. All children, and chiefly those with hearing loss, are susceptible to reductions in spoken communication. Hearing plans, such as cochlear implants, provide children with hearing loss access to spoken communication and provision language development. when provided early and used consistently, these supplies help children with hearing loss to engage in spoken connections. Cochlear implant (CI) is a standard medical-surgical treatment for bilateral severe to profound hearing loss with no advantage with the hearing aid. Hearing is one of the most important senses in humans. Pediatric hearing loss establishes one of the most important public health challenges. Children with hearing loss are recognized early and habilitated via hearing aids or with cochlear implants (CIs). Suitable care and maintenance as well as continuous auditory verbal therapy (AVT) are also essential in reaching for the successful attainment of language acquisition. Children with hearing loss posture important challenges to their parents, particularly when there is limited admission to their hearing care providers. The disruption in the routine of their hearing and therapy follow-up services has had substantial effects on the children as well as their parents.

Keywords: healthcare, covid-19, cochlear implants, spoken communication, hearing loss

Procedia PDF Downloads 165

Authors: Samina Nazli, Nadia Qamar, Quratulain, Akasha, Saman Jamal

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Objective: The objective is to determine the frequency of iron deficiency anemia among children having febrile seizures. A descriptive Cross-Sectional Study was done in the Pediatric Unit of Allama Iqbal Memorial Teaching Hospital Sialkot from September 2020 to February 2021. Material & Methods: A total of 70 children were studied aged six months to 10 years, with either gender presenting with febrile seizures. All data of the patients was documented, including demographic data like age, gender, residential area, educational status, socioeconomic status and clinical findings at the time of presentation like fever, fits and duration of symptoms etc. Blood hemoglobin and ferritin levels were tested for each patient to evaluate iron deficiency anemia. Results: There were 65.7% male and 34.3% female cases in this study. The age range of the patients was 6 months to 10 years, with a mean age of 4.36 ± 2.71 years. Most of the children (60%) were below three years of age. Most children belonged to low and middle socioeconomic status with a frequency of 42.8% and 45.7%, respectively. Iron deficiency anemia was found in 38.6% of cases. The majority of the mothers were illiterate (65%). There were 44.3% cases from rural areas and 55.7% from urban areas. Conclusion: Iron deficiency anemia is a common problem among children with febrile seizures, younger than 03 years and belonging to rural areas. Illiterate mothers are an important risk factor for iron deficiency anemia in their children.

Keywords: febrile seizure, iron deficiency anemia, illetrate mother, low scioeconomic status, febrile siezure

Procedia PDF Downloads 71

Authors: Seyed Kian Haji Seyed Javadi, Aisan Nouri

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Patient satisfaction in dental care is shaped by experiences throughout the treatment journey. Challenges such as fear, lack of trust and poor communication can impact patient contentment and willingness to seek dental care. This narrative review explores these issues and presents innovative solutions to address them by searching PubMed and Scopus data sources. It examines factors affecting patient satisfaction and adherence across three phases—before, during and after treatment—emphasizing the roles of effective communication, payment and follow-up systems, appointment scheduling, welcoming reception and the treatment environment. The factors discussed in this study motivate patients to return for routine check-ups and preventive care, even if their initial visit was for an emergency.

Keywords: patient satisfaction, dentistry, dental access, dental care services

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Authors: Sathapath Kilaso

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Thailand has a large range of geographic diversity. Thailand can be divided into 5 regions which are North Region, East Region, West Region, South Region and North-East Region which each region has a different geographic and climate. Especially in North Region, the geographic is mountain and intermontane plateau which will be a reason that the roads in the North Region have a lot of bends. So the driver in the North Region road will have to have a very high skill of driving. If the accident is occurred, the emergency rescue will have a hard time to reach the accident area and rescue the victim of the accident as the long distance and steep road. This article will apply the concept of the wireless sensor network with the micro-controller to alert the driver when the driver reaches the very dangerous bend.

Keywords: wireless sensor network, motion sensor, smart alert, dangerous bend

Procedia PDF Downloads 274

Authors: Ross J. Maestas

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Biofuels are derived from multiple renewable bioenergy feedstocks including animal fats, wood, starchy grains, and oil seeds. Transportation agencies have considered growing the latter two on underutilized and nontraditional lands that they manage, such as in the Right of Way (ROW), abandoned weigh stations, and at maintenance yards. These crops provide the opportunity to generate revenue or supplement fuel once converted and offer a solution to increasing fuel costs and instability by creating a ‘home-grown’ alternative. Biofuels are non-toxic, biodegradable, and emit less Green House Gasses (GHG) than fossil fuels, therefore allowing agencies to meet sustainability goals and regulations. Furthermore, they enable land managers to achieve soil erosion and roadside aesthetic strategies. The research sought to understand if the cultivation of a biofuel feedstock within the Arkansas State Highway Transportation Department’s (AHTD) managed and marginalized lands is feasible by identifying potential land areas and crops. To determine potential plots the parcel data was downloaded from Arkansas’s GIS office. ArcGIS was used to query the data for all variations of the names of property owned by AHTD and a KML file was created that identifies the queried parcel data in Google Earth. Furthermore, biofuel refineries in the state were identified to optimize the harvest to transesterification process. Agricultural data was collected from federal and state agencies and universities to assess various oil seed crops suitable for conversion and suited to grow in Arkansas’s climate and ROW conditions. Research data determined that soybean is the best adapted biofuel feedstock for Arkansas with camelina and canola showing possibilities as well. Agriculture is Arkansas’s largest industry and soybean is grown in over half of the state’s counties. Successful cultivation of a feedstock in the aforementioned areas could potentially offer significant employment opportunity for which the skilled farmers already exist. Based on compiled data, AHTD manages 21,489 acres of marginalized land. The result of the feasibility assessment offer suggestions and guidance should AHTD decide to further investigate this type of initiative.

Keywords: Arkansas highways, biofuels, renewable energy initiative, marginalized lands

Procedia PDF Downloads 327