Search results for: early childhood education practices
3896 Rural Households' Sources of Water and Willingness to Pay for Improved Water Services in South-West, Nigeria
Authors: Alaba M. Dare, Idris A. Ayinde, Adebayo M. Shittu, Sam O. Sam-Wobo
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Households' source of water is one of the core development indicators recently gaining pre-eminence in Nigeria. This study examined rural households' sources of water, Willingness to Pay (WTP) and factors influencing mean WTP. A cross-sectional survey which involved the use of questionnaire was used. A dichotomous choice (DC) with follow up was used as elicitation method. A multi-stage random sampling technique was used to select 437 rural households. Descriptive statistics and Tobit model were used for data estimation. The result revealed that about 70% fetched from unimproved water sources. Most (74.4%) respondents showed WTP for improved water sources. Age (p < 0.01), sex (p < 0.01), education (p < 0.01), occupation (p < 0.01), income (p < 0.01), price of water (P < 0.01), quantity of water (p < 0.01), household size (p < 0.01) and distance (p < 0.01) to existing water sources significantly influenced rural households' WTP for these services. The inference from this study showed that rural dweller sources of water is highly primitive and deplorable. Governments and stakeholders should prioritize the provision of rural water at an affordable price by rural dwellers.Keywords: households, source of water, willingness to pay (WTP), tobit model
Procedia PDF Downloads 3833895 The Effectiveness of the South African Government Theory of Expanded Public Works Program: Infrastructure
Authors: Siziwe Monica Zuma
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The Expanded Public Works Program (EPWP) is an instrument that the South African Government uses to reduce unemployment and poverty and also stimulate economic growth. However, due to the limited budget and programs in the EPWP, the program has had challenges in reducing unemployment, poverty and stimulating economic growth. The EPWP Vuk’uphile program had positive outcomes in developing Black emerging contractors, in order for them to participate in the main stream economy far better than when the EPWP program was not introduced. The Skills component of the program particularly the EPWP Infrastructure, which is the most funded program under EPWP has had limited success in transferring appropriate skills to ensure labour participants can penetrate the labour market after participating in the EPWP. Education and skills are important attributes that can contribute to labour absorption, however, the EPWP particularly the infrastructure program needs to strengthen skills development over a longer period of time suggested a year with multi skills relevant to the labour market. Longer and more sustained employment provides a safety net and reduces poverty better that short term employment. The EPWP program can be expanded in the infrastructure sector, focusing on rural infrastructure, agricultural infrastructure, infrastructure related components like property, ownership, management, and other services. These can stimulate the Economic sector Infrastructure of EPWP, offer longer term and more sustained employment and rural enterprise development and further employment. The Expanded Public Works Program (EPWP) is an instrument that the South African Government uses to reduce unemployment and poverty and also stimulate economic growth. However, due to the limited budget and programs in the EPWP, the program has had challenges in reducing unemployment, poverty and stimulating economic growth. The EPWP Vuk’uphile program has had positive outcomes in developing Black emerging contractors, in order for them to participate in the main stream economy far better than when the EPWP program was not introduced. The Skills component of the program particularly the EPWP Infrastructure, which is the most funded program under EPWP has had limited success in transferring appropriate skills to ensure labour participants are able to penetrate the labour market after participating in the EPWP. Education and skills are important attributes that can contribute to labour absorption, however, the EPWP particularly the infrastructure program needs to strengthen skills development over a longer period of time suggested a year with multi skills relevant to the labour market. Longer and more sustained employment provides a safety net and reduces poverty better that short term employment. The EPWP program can be expanded in the infrastructure sector, focusing on rural infrastructure, agricultural infrastructure, infrastructure related components like property, ownership, management, and other services. These can stimulate the Economic sector Infrastructure of EPWP, offer longer term and more sustained employment and rural enterprise development and further employment.Keywords: Expanded Public Works Program (EPWP), VUKÚPHILE, youth, Public Works Programs (PWP), Infrastructure Sector of EPWP (EPWP Infrastructure)
Procedia PDF Downloads 2183894 Education in Personality Development and Grooming for Airline Business Program's Students of International College, Suan Sunandha Rajabhat University
Authors: Taksina Bunbut
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Personality and grooming are vital for creating professionalism and safety image for all staffs in the airline industry. Airline Business Program also has an aim to educate students through the subject Personality Development and Grooming in order to elevate the quality of students to meet standard requirements of the airline industry. However, students agree that there are many difficulties that cause unsuccessful learning experience in this subject. The research is to study problems that can afflict students from getting good results in the classroom. Furthermore, exploring possible solutions to overcome challenges are also included in this study. The research sample consists of 140 students who attended the class of Personality Development and Grooming. The employed research instrument is a questionnaire. Statistic for data analysis is t-test and Multiple Regression Analysis. The result found that although students are satisfied with teaching and learning of this subject, they considered that teaching in English and teaching topics in social etiquette in different cultures are difficult for them to understand.Keywords: personality development, grooming, Airline Business Program, soft skill
Procedia PDF Downloads 2383893 Excel-VBA as Modelling Platform for Thermodynamic Optimisation of an R290/R600a Cascade Refrigeration System
Authors: M. M. El-Awad
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The availability of computers and educational software nowadays helps engineering students acquire better understanding of engineering principles and their applications. With these facilities, students can perform sensitivity and optimisation analyses which were not possible in the past by using slide-rules and hand calculators. Standard textbooks in engineering thermodynamics also use software such as Engineering Equation Solver (EES) and Interactive Thermodynamics (IT) for solving calculation-intensive and design problems. Unfortunately, engineering students in most developing countries do not have access to such applications which are protected by intellectual-property rights. This paper shows how Microsoft ExcelTM and VBA (Visual Basic for Applications), which are normally distributed with personal computers and laptops, can be used as an alternative modelling platform for thermodynamic analyses and optimisation. The paper describes the VBA user-defined-functions developed for determining the refrigerants properties with Excel. For illustration, the combination is used to model and optimise the intermediate temperature for a propane/iso-butane cascade refrigeration system.Keywords: thermodynamic optimisation, engineering education, excel, VBA, cascade refrigeration system
Procedia PDF Downloads 4363892 Myocardial Reperfusion Injury during Percutaneous Coronary Intervention in Patient with Triple-Vessel Disease in Limited Resources Hospital: A Case Report
Authors: Fanniyah Anis, Bram Kilapong
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Myocardial reperfusion injury is defined as the cellular damage that results from a period of ischemia, followed by the reestablishment of the blood supply to the infarcted tissue. Ventricular tachycardia is one of the most commonly encountered reperfusion arrhythmia as one of the types of myocardial perfusion injury. Prompt and early treatment can reduce mortality, despite limited resources of the hospital in high risk patients with history of triple vessel disease. Case report, Male 53 years old has been diagnosed with NSTEMI with 3VD and comorbid disease of Hypertension and has undergone revascularization management with Percutaneous coronary intervention. Ventricular tachycardia leading to cardiac arrest occurred right after the stent was inserted. Resuscitation was performed for almost 2 hours until spontaneous circulation returned. Patient admitted in ICU with refractory cardiac shock despite using combination of ionotropic and vasopressor agents under standard non-invasive monitoring due to the limitation of the hospital. Angiography was performed again 5 hours later to exclude other possibilities of blockage of coronary arteries and conclude diagnosis of myocardial reperfusion injury. Patient continually managed with combination of antiplatelet agents and maintenance dose of anti-arrhythmia agents. The handling of the patient was to focus more on supportive and preventive from further deteriorating of the condition. Patient showed clinically improvement and regained consciousness within 24 hours. Patient was successfully discharged from ICU within 3 days without any neurological sequela and was discharge from hospital after 3 days observation in general ward. Limited Resource of hospital did not refrain the physician from attaining a good outcome for this myocardial reperfusion injury case and angiography alone can be used to confirm the diagnosis of myocardial reperfusion injury.Keywords: limited resources hospital, myocardial reperfusion injury, prolonged resuscitation, refractory cardiogenic shock, reperfusion arrhythmia, revascularization, triple-vessel disease
Procedia PDF Downloads 3043891 Dietary Intake, Serum Vitamin D Status, and Sun Exposure of Malaysian Women of Different Ethnicity
Authors: H. Z. M. Chong, M. E. Y. Leong, G. L. Khor, S. C. Loke
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Vitamin D insufficiency is reported to be prevalent among women living in different altitudes including the equator where sunshine is available throughout the year. Multiple factors for vitamin D insufficiency include poor intake of vitamin D rich food and inadequate sun exposure, especially among women working indoor with a sedentary lifestyle. Furthermore, Muslim women in Malaysia whose attire covers the entire body are likely to receive poor sun exposure. This research determined serum vitamin D status, vitamin D intake and sun exposure of women aged 20-45 years of different ethnicity in Kuala Lumpur, Malaysia. Blood samples were collected from 106 women for determination of serum 25(OH)D levels. Information about vitamin D intake and sun exposure were obtained by interviewing the subjects using pre-tested questionnaires. The overall mean serum 25(OH)D was found to be 29.9 ± 14 nmol/L. Vitamin D deficiency and insufficiency was prevalent and highest among the Malay women. Less than ten percent of the subjects in this study met the sufficient vitamin D level recommendation of ≥50 nmol/L. Intake of vitamin D rich food such as oily fishes was poor across the different ethnicity. Other dietary sources of vitamin D in the diet were fortified bread and skim milk. On the other hand, the median sunlight exposure of the subjects was 3.9 hours per week. The Malay women reported to have the highest duration being exposed to the sun. Nevertheless, due to cultural clothing practices, these women had the least body surface area exposed to sunlight, resulting in the lowest calculated sun index score compared to the Chinese and the Indians. Low intake of vitamin D rich foods and sun exposure were negatively correlated with serum 25(OH)D level. In conclusion, intake of food sources rich in vitamin D and adequate body surface area exposed to the sun are essential to ensure healthy vitamin D level. Supplementation of vitamin D may be recommended to women whom unable to meet these recommendations.Keywords: serum 25-OH, sun exposure, vitamin D food frequency, vitamin D deficiency
Procedia PDF Downloads 2663890 Health and Subjective Wellbeing: The Role of Inequalities
Authors: Francesco Colcerasa, Fabio Pisani
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We contribute to the subjective well-being literature testing the relationship between life satisfaction and inequality of opportunity in health, measured through the Human Opportunity Index calculated at the national level using individual socio-economic data from the cross-country European Social Survey sample. We compute several indexes of opportunity inequality in health, each obtained according to a different combination of circumstances (gender, immigrant status, parents’ education). We find a robust and significant relationship where life satisfaction is higher in correspondence with low levels of health opportunity inequality. The result is twofold. On the one hand, the importance of the well-being of other types of inequality than income inequality emerges. On the other hand, the socioeconomic roots of inequality in health are investigated, suggesting that circumstances at birth have a role in future well-being. Several rationales for the nexus between life satisfaction and inequality of opportunity in health are possible, which we investigate by splitting the sample. Among others, we find a prominent role of pro-social preferences – formalized as interest towards own offspring (which can be interpreted as intergenerational justice) – as a mediating factor of the relationship.Keywords: Inequality of opportunity, subjective wellbeing, health, health inequality, inequality of opportunity in health
Procedia PDF Downloads 853889 Exploring Students’ Satisfaction Levels with Online Facilitation Provided by National Open University of Nigeria’s Facilitators
Authors: Louis Okon Akpan
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National Open University of Nigeria (NOUN) is an open and distance learning institution whose aim is to provide education for all and also promote lifelong learning in Nigeria. Before now, student-centred learning was adopted. In recent times, online facilitation has been introduced. Therefore, the study explores ways in which students are satisfied with online facilitation provided by NOUN lecturers. A qualitative approach was adopted. The interpretive paradigm was employed as a lens to interpret narratives from the participants. In order to gather information for the study, a semi-structured interview was developed for sixteen participants who were purposively selected from eight facilities of the university. After data gathering from the field, it was subjected to transcription and coding. The emergence of themes from the coded data was analysed using thematic analysis. Findings indicated that students found online learning, recently introduced by the university management, extremely fulfilling and rewarding.Keywords: online facilitation, lecturer, students’ satisfaction, National Open University of Nigeria
Procedia PDF Downloads 843888 A Case Report on Therapeutic Approach in Cases of Anasarca in Neonates Dogs
Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies
Procedia PDF Downloads 1823887 Credibility and Personal Social Media Use of Health Professionals: A Field Study
Authors: Abrar Al-Hasan
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Objectives: There is ongoing discourse regarding the potential risks to health professionals' reputations and credibility arising from their personal social media use. However, the specific impacts on professional credibility and the health professional-client relationship remain largely unexplored. This study aims to investigate the type and frequency of the content posted by health professionals on their Instagram accounts and its influence on their credibility and the professional-client relationship. Methodology: In a controlled field study, participants reviewed randomly assigned mock Instagram profiles of health professionals. Mock profiles were constructed according to gender (female/male), social media usage (high/low), and social media richness (high/ low), with richness increasing from posts to stories to reels and personal content type (high /low). Participants then rated the profile owners’ credibility on a visual analog scale. An analysis of variance compared these ratings, and mediation analyses assessed the influence of credibility ratings on participants' willingness to become clients of the mock health professional. Results: Results from 315 participants showed that health professionals with personal Instagram profiles displaying high social media richness were perceived as more credible than those with lower social media richness. Low social media usage is perceived as more credible than high social media usage. Personal content type is perceived as less credible as compared to those with low personal content type. Contributions: These findings provide initial evidence of the impact of health professionals' personal online disclosures on credibility and the health professional-client relationship. Understanding public perceptions of professionalism and credibility is essential for informing e-professionalism guidelines and promoting best practices in social media use among health professionals.Keywords: credibility, consumer behavior, social media, media richness, healthcare professionals
Procedia PDF Downloads 423886 Digital Female Entrepreneurs in South Africa: Drivers and Relationship to Economic Development
Authors: C. van den Berg, C. Pokpas
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Popular discourse touts entrepreneurship as a universal solution for underdevelopment, unemployment, and poverty. Moreover, claims are made that women and other disadvantaged groups can achieve material and personal success through digital entrepreneurship. This paper examines the potential of digital technology in entrepreneurial ventures to stimulate economic growth for marginalized groups and communities. Although digital entrepreneurship is hailed as a means to empower under-resourced and socially marginalized people, these opportunities still exist within the confines of existing social and cultural practices. The perspectives of female digital entrepreneurs in developing countries are sorely understudied, particularly concerning an understanding of the complex underlying socio-cultural factors impeding women’s entrepreneurial behaviors. This qualitative study, guided by a feminist phenomenological perspective, focused on the experiences of digital female entrepreneurs in the Western Cape of South Africa. Data were collected via semi-structured interviews and analyzed through the interpretative phenomenological analysis (IPA) approach to determine the relationships between digital entrepreneurship and structural and agential enabling conditions. Findings show that digital entrepreneurship is not a panacea for economic growth in marginalized groups and communities and highlight the importance of addressing socio-cultural gender inequality to enable successful entrepreneurial activity. The paper concludes with recommendations for specialized training initiatives aimed at female entrepreneurs that address internalized constraints and barriers that keep women subservient and measures to shift gender and power beliefs. The outcome will benefit the stimulation of gender-specific public policies to develop a successful digital start-up ecosystem further.Keywords: digital innovation, female digital entrepreneurs, feminist phenomenology, gender, marginalised communities
Procedia PDF Downloads 1353885 Integration of an Evidence-Based Medicine Curriculum into Physician Assistant Education: Teaching for Today and the Future
Authors: Martina I. Reinhold, Theresa Bacon-Baguley
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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students.Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant
Procedia PDF Downloads 1253884 The Impact of the COVID-19 Pandemic on the Nursing Workforce in Slovakia
Authors: Lukas Kober, Vladimir Littva, Vladimir Siska
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The pandemic has had a significant impact on our lives. One of the most affected professions is the nursing profession. Nurses are closest to the patient, spend the most time with him, support him, often replace the closest family members, and of course, are part of the whole treatment process. Current nurses have more competencies and roles than in the past. The healthcare system has reached a turning point, also in connection with the spreading Delta variant and the risk of the arrival of the third wave. The lack of nurses is a long-term problem, but it did not arise by itself. The reasons for the departure of nurses from the health care system are not only due to the increasing average age of nurses and midwives in Slovakia and their retirement. Thousands of nurses are leaving due to poor working conditions, low wages, and poor management of individual workplaces. We need to keep older nurses in the health care system, otherwise, we risk their early departure. The pandemic only exacerbates this situation, and the associated risks, such as occupational infections or enormous overload and exhaustion, only accelerate the exit from the profession. According to current data from the register of nurses and midwives, we canceled 772 registrations from January to September 2021, and 584 nurses requested the suspension of registration due to non-performance of the profession. During the same period, we registered only 240 new nurses graduate. We have had this significant disparity here for a long time. For the whole of 2020, we canceled 911 registrations and suspended 973 registrations. We registered a total of 389 graduates. Our system loses hundreds of graduates a year and loses experienced nurses with decades of experience who leave due to poor working conditions, wages and suffer from burnout. Such compensation should also be awarded to the families of health professionals who have lost their lives due to work and to COVID-19. These options can also be motivating for promising people interested in studying nursing, who can gradually replace the missing workforce. This purchase is supported by the KEGA project no. 015KU-4/2019.Keywords: pandemic, COVID-19, nursing, nursing workforce, lack of nurses
Procedia PDF Downloads 2173883 Rethinking the Languages for Specific Purposes Syllabus in the 21st Century: Topic-Centered or Skills-Centered
Authors: A. Knezović
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21st century has transformed the labor market landscape in a way of posing new and different demands on university graduates as well as university lecturers, which means that the knowledge and academic skills students acquire in the course of their studies should be applicable and transferable from the higher education context to their future professional careers. Given the context of the Languages for Specific Purposes (LSP) classroom, the teachers’ objective is not only to teach the language itself, but also to prepare students to use that language as a medium to develop generic skills and competences. These include media and information literacy, critical and creative thinking, problem-solving and analytical skills, effective written and oral communication, as well as collaborative work and social skills, all of which are necessary to make university graduates more competitive in everyday professional environments. On the other hand, due to limitations of time and large numbers of students in classes, the frequently topic-centered syllabus of LSP courses places considerable focus on acquiring the subject matter and specialist vocabulary instead of sufficient development of skills and competences required by students’ prospective employers. This paper intends to explore some of those issues as viewed both by LSP lecturers and by business professionals in their respective surveys. The surveys were conducted among more than 50 LSP lecturers at higher education institutions in Croatia, more than 40 HR professionals and more than 60 university graduates with degrees in economics and/or business working in management positions in mainly large and medium-sized companies in Croatia. Various elements of LSP course content have been taken into consideration in this research, including reading and listening comprehension of specialist texts, acquisition of specialist vocabulary and grammatical structures, as well as presentation and negotiation skills. The ability to hold meetings, conduct business correspondence, write reports, academic texts, case studies and take part in debates were also taken into consideration, as well as informal business communication, business etiquette and core courses delivered in a foreign language. The results of the surveys conducted among LSP lecturers will be analyzed with reference to what extent those elements are included in their courses and how consistently and thoroughly they are evaluated according to their course requirements. Their opinions will be compared to the results of the surveys conducted among professionals from a range of industries in Croatia so as to examine how useful and important they perceive the same elements of the LSP course content in their working environments. Such comparative analysis will thus show to what extent the syllabi of LSP courses meet the demands of the employment market when it comes to the students’ language skills and competences, as well as transferable skills. Finally, the findings will also be compared to the observations based on practical teaching experience and the relevant sources that have been used in this research. In conclusion, the ideas and observations in this paper are merely open-ended questions that do not have conclusive answers, but might prompt LSP lecturers to re-evaluate the content and objectives of their course syllabi.Keywords: languages for specific purposes (LSP), language skills, topic-centred syllabus, transferable skills
Procedia PDF Downloads 3083882 Patient-Reported Adverse Reactions to Adolescent Non-Suicidal Self-Injury Disclosures and Implications for Clinical Practice
Authors: Renee Fabian, Jordan Davidson
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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions
Procedia PDF Downloads 1153881 A Case of Iatrogenic Esophageal Perforation in an Extremely Low Birth Weight Neonate
Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong
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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.Keywords: esophageal perforation, preterm, newborn, feeding tube
Procedia PDF Downloads 2713880 Acquisition of Overt Pronoun Constraint in L2 Turkish by Adult Korean Speakers
Authors: Oktay Cinar
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The aim of this study is to investigate the acquisition of Overt Pronoun Constraint (OPC) by adult Korean L2 Turkish speakers in order to find out how constraints regulating the syntax of null and overt subjects are acquired. OPC is claimed to be a universal feature of all null subject languages restricting the co-indexation between overt embedded pronoun and quantified or wh-question antecedents. However, there is no such restriction when the embedded subject is null or the antecedent is a referential subject. Considered as a principle of Universal Grammar (UG), OPC knowledge of L2 speakers has been widely tested with different language pairs. In the light of previous studies on OPC, it can be argued that L2 learners display early sensitivity to OPC constraints during their interlanguage grammar development. Concerning this, the co-indexation between overt embedded pronoun o (third person pronoun) and referential matrix subject is claimed to be controversial in Turkish, which poses problems with the universality of OPC. However, the current study argues against this claim by providing evidence from advanced Korean speakers that OPC is universal to all null subject languages and OPC knowledge can be accessed with direct access to UG. In other words, the performances of adult Korean speakers on the syntax of null and overt subjects are tested to support this claim. In order to test this, OPC task is used. 15 advanced speakers and a control group of adult native Turkish participants are instructed to determine the co-reference relationship between the subject of embedded clause, either overt pronominal o or null, and the subject of the matrix clause, either quantified pronoun and wh-question or referential antecedent. They are asked to select the interpretation of the embedded subject, either as the same person as in the matrix subject or another person who is not the same person in the matrix subject. These relations are represented with four conditions, and each condition has four questions (16 questions in total). The results claim that both control group and Korean L2 Turkish speakers display sensitivity to all constraints that OPC has, which suggests that OPC works in Turkish as well.Keywords: adult Korean speakers, binding theory, generative second language acquisition, overt pronoun constraint
Procedia PDF Downloads 3093879 Maori Primary Industries Responses to Climate Change and Freshwater Policy Reforms in Aotearoa New Zealand
Authors: Tanira Kingi, Oscar Montes Oca, Reina Tamepo
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The introduction of the Climate Change Response (Zero Carbon) Amendment Act (2019) and the National Policy Statement for Freshwater Management (2020) both contain underpinning statements that refer to the principles of the Treaty of Waitangi and cultural concepts of stewardship and environmental protection. Maori interests in New Zealand’s agricultural, forestry, fishing and horticultural sectors are significant. The organizations that manage these investments do so on behalf of extended family groups that hold inherited interests based on genealogical connections (whakapapa) to particular tribal units (iwi and hapu) and areas of land (whenua) and freshwater bodies (wai). This paper draws on the findings of current research programmes funded by the New Zealand Agricultural Greenhouse Gas Research Centre (NZAGRC) and the Our Land & Water National Science Challenge (OLW NSC) to understand the impact of cultural knowledge and imperatives on agricultural GHG and freshwater mitigation and land-use change decisions. In particular, the research outlines mitigation and land-use change scenario decision support frameworks that model changes in emissions profiles (reductions in biogenic methane, nitrous oxide and nutrient emissions to freshwater) of agricultural and forestry production systems along with impacts on key economic indicators and socio-cultural factors. The paper also assesses the effectiveness of newly introduced partnership arrangements between Maori groups/organizations and key government agencies on policy co-design and implementation, and in particular, decisions to adopt mitigation practices and to diversify land use.Keywords: co-design and implementation of environmental policy, indigenous environmental knowledge, Māori land tenure and agribusiness, mitigation and land use change decision support frameworks
Procedia PDF Downloads 2153878 Health Promotion Intervention to Enhance Health Outcomes for Older Adults
Authors: Elizabeth Waleola Afolabi-Soyemi
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As the population of older adults continues to grow, improving health outcomes for this demographic has become an increasingly important public health goal. Health promotion interventions have been developed to address the unique health needs and challenges faced by older adults. This abstract reviews the literature on health promotion interventions for older adults and their effectiveness in improving health outcomes. Various interventions have been found to be effective, including physical activity programs, nutrition education, medication management, and social support programs. These interventions have been shown to improve outcomes such as functional status, quality of life, and disease management. Despite the success of these interventions, there are still barriers to their implementation, such as a lack of access to resources and inadequate funding. Further research is needed to identify effective strategies for overcoming these barriers and to develop more tailored interventions for specific populations of older adults. Overall, health promotion interventions have great potential to improve the health outcomes and quality of life of older adults and should be a priority for public health efforts.Keywords: health, humanity, health promotion, older adults
Procedia PDF Downloads 993877 Freedom and Resentment in Plato’s Phaedo
Authors: Chad Van Schoelandt, Chara Kokkiou
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This paper discusses Socrates’ fundamental views of morality and freedom in Plato’s Phaedo through examining the fittingness of resentment and related emotional responses. In different parts of the dialogue there seems to be two kinds of emotional justification, which seem to explain different types of appeal that Socrates makes in order to defend his own emotional responses and make recommendations to others. The upshot of this paper is to bring out the connection between different emotional responses and beliefs. In particular, it focuses on the unfittingness of the Strawsonian resentment. If one, taking a rationalistic approach, agrees that some emotions, such as resentment, have a cognitive or belief-like component, then people reacting differently to the same situation suggests differences in their judgments and beliefs. However, at times, including in Socrates’s direction to his friends in the Phaedo, emotions are justified by pragmatic appeal, independent of the beliefs associated with the emotion. In any case, there are both fittingness-based and pragmatic factors that determine and condition the warrant of an emotional response. Overall, an emotion is fitting when the agent’s beliefs indicate that the conditions of appropriatedness are met. Socrates views resentment and sorrow as unfitting due to the mismatch with his own moral beliefs and his teaching to others. At the same time, Socrates argues that his friends’ expression of sorrow at his last moments is unseemly because it is not included in the widely accepted social practices, though the emotion itself is not necessarily unfitting. Socrates’s unexpected emotional response to his death, namely his lack of resentment and sorrow, implies a different belief system and indicates his students’ lack of understanding of the actual implications of his views. Thus, the paper will bring out how complicated Socrates’s ideas were even for people who had a sustained engagement with his ideas. Overall, the paper will illuminate how these two parties (Socrates – friends) view different moral duties, namely the individual duty to philosophy, which signifies a meaningful life, and the civic duty to obey the law, which signals Socrates’ death.Keywords: Emotions, freedom, morality, Plato
Procedia PDF Downloads 813876 Reducing Road Traffic Accident: Rapid Evidence Synthesis for Low and Middle Income Countries
Authors: Tesfaye Dagne, Dagmawit Solomon, Firmaye Bogale, Yosef Gebreyohannes, Samson Mideksa, Mamuye Hadis, Desalegn Ararso, Ermias Woldie, Tsegaye Getachew, Sabit Ababor, Zelalem Kebede
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Globally, road traffic accident (RTA) is causing millions of deaths and injuries every year. It is one of the leading causes of death among people of all age groups and the problem is worse among young reproductive age group. Moreover the problem is increasing with an increasing number of vehicles. The majority of the problem happen in low and middle income countries (LMIC), even if the number of vehicles in these countries is low compared to their population. So, the objective of this paper is to summarize the best available evidence on interventions that can reduce road traffic accidents in low and middle income countries (LMIC). Method: A rapid evidence synthesis approach adapted from the SURE Rapid Response Service was applied to search, appraise and summarize the best available evidence on effective intervention in reducing road traffic injury. To answer the question under review, we searched for relevant studies from databases including PubMed, the Cochrane Library, TRANSPORT, Health system evidence, Epistemonikos, and SUPPORT summary. The following key terms were used for searching: Road traffic accident, RTA, Injury, Reduc*, Prevent*, Minimiz*, “Low and middle-income country”, LMIC. We found 18 articles through a search of different databases mentioned above. After screening for the titles and abstracts of the articles, four of them which satisfy the inclusion criteria were included in the final review. Then we appraised and graded the methodological quality of systematic reviews that are deemed to be highly relevant using AMSTAR. Finding: The identified interventions to reduce road traffic accidents were legislation and enforcement, public awareness/education, speed control/ rumble strips, road improvement, mandatory motorcycle helmet, graduated driver license, street lighting. Legislation and Enforcement: Legislation focusing on mandatory motorcycle helmet usage, banning cellular phone usage when driving, seat belt laws, decreasing the legal blood alcohol content (BAC) level from 0.06 g/L to 0.02 g/L bring the best result where enforcement is there. Public Awareness/Education: focusing on seat belt use, child restraint use, educational training in health centers and schools/universities, and public awareness with media through the distribution of videos, posters/souvenirs, and pamphlets are effective in the short run. Speed Control: through traffic calming bumps, or speed bumps, rumbled strips are effective in reducing accidents and fatality. Mandatory Motorcycle Helmet: is associated with reduction in mortality. Graduated driver’s license (GDL): reduce road traffic injury by 19%. Street lighting: is a low-cost intervention which may reduce road traffic accidents.Keywords: evidence synthesis, injury, rapid review, reducing, road traffic accident
Procedia PDF Downloads 1643875 A Study on the Application of Machine Learning and Deep Learning Techniques for Skin Cancer Detection
Authors: Hritwik Ghosh, Irfan Sadiq Rahat, Sachi Nandan Mohanty, J. V. R. Ravindra
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In the rapidly evolving landscape of medical diagnostics, the early detection and accurate classification of skin cancer remain paramount for effective treatment outcomes. This research delves into the transformative potential of Artificial Intelligence (AI), specifically Deep Learning (DL), as a tool for discerning and categorizing various skin conditions. Utilizing a diverse dataset of 3,000 images representing nine distinct skin conditions, we confront the inherent challenge of class imbalance. This imbalance, where conditions like melanomas are over-represented, is addressed by incorporating class weights during the model training phase, ensuring an equitable representation of all conditions in the learning process. Our pioneering approach introduces a hybrid model, amalgamating the strengths of two renowned Convolutional Neural Networks (CNNs), VGG16 and ResNet50. These networks, pre-trained on the ImageNet dataset, are adept at extracting intricate features from images. By synergizing these models, our research aims to capture a holistic set of features, thereby bolstering classification performance. Preliminary findings underscore the hybrid model's superiority over individual models, showcasing its prowess in feature extraction and classification. Moreover, the research emphasizes the significance of rigorous data pre-processing, including image resizing, color normalization, and segmentation, in ensuring data quality and model reliability. In essence, this study illuminates the promising role of AI and DL in revolutionizing skin cancer diagnostics, offering insights into its potential applications in broader medical domains.Keywords: artificial intelligence, machine learning, deep learning, skin cancer, dermatology, convolutional neural networks, image classification, computer vision, healthcare technology, cancer detection, medical imaging
Procedia PDF Downloads 873874 Effect of Crystallographic Characteristics on Toughness of Coarse Grain Heat Affected Zone for Different Heat Inputs
Authors: Trishita Ray, Ashok Perka, Arnab Karani, M. Shome, Saurabh Kundu
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Line pipe steels are used for long distance transportation of crude oil and gas under extreme environmental conditions. Welding is necessary to lay large scale pipelines. Coarse Grain Heat Affected Zone (CGHAZ) of a welded joint exhibits worst toughness because of excessive grain growth and brittle microstructures like bainite and martensite, leading to early failure. Therefore, it is necessary to investigate microstructures and properties of the CGHAZ for different welding heat inputs. In the present study, CGHAZ for two heat inputs of 10 kJ/cm and 50 kJ/cm were simulated in Gleeble 3800, and the microstructures were investigated in detail by means of Scanning Electron Microscopy (SEM) and Electron Backscattered Diffraction (EBSD). Charpy Impact Tests were also done to evaluate the impact properties. High heat input was characterized with very low toughness and massive prior austenite grains. With the crystallographic information from EBSD, the area of a single prior austenite grain was traced out for both the welding conditions. Analysis of the prior austenite grains showed the formation of high angle boundaries between the crystallographic packets. Effect of these packet boundaries on secondary cleavage crack propagation was discussed. It was observed that in the low heat input condition, formation of finer packets with a criss-cross morphology inside prior austenite grains was effective in crack arrest whereas, in the high heat input condition, formation of larger packets with higher volume of low angle boundaries failed to resist crack propagation resulting in a brittle fracture. Thus, the characteristics in a crystallographic packet and impact properties are related and should be controlled to obtain optimum properties.Keywords: coarse grain heat affected zone, crystallographic packet, toughness, line pipe steel
Procedia PDF Downloads 2453873 Accessing Properties of Alkali Activated Ground Granulated Blast Furnace Slag Based Self Compacting Geopolymer Concrete Incorporating Nano Silica
Authors: Guneet Saini, Uthej Vattipalli
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In a world with increased demand for sustainable construction, waste product of one industry could be a boon to the other in reducing the carbon footprint. Usage of industrial waste such as fly ash and ground granulated blast furnace slag have become the epicenter of curbing the use of cement, one of the major contributors of greenhouse gases. In this paper, empirical studies have been done to develop alkali activated self-compacting geopolymer concrete (GPC) using ground granulated blast furnace slag (GGBS), incorporated with 2% nano-silica by weight, through evaluation of its fresh and hardening properties. Experimental investigation on 6 mix designs of varying molarity of 10M, 12M and 16M of the alkaline solution and a binder content of 450 kg/m³ and 500 kg/m³ has been done and juxtaposed with GPC mix design composed of 16M alkaline solution concentration and 500 kg/m³ binder content without nano-silica. The sodium silicate to sodium hydroxide ratio (SS/SH), alkaline activator liquid to binder ratio (AAL/B) and water to binder ratio (W/B), which significantly affect the performance and mechanical properties of GPC, were fixed at 2.5, 0.45 and 0.4 respectively. To catalyze the early stage geopolymerisation, oven curing is done maintaining the temperature at 60˚C. This paper also elucidates the test results for fresh self-compacting concrete (SCC) done as per EFNARC guidelines. The mechanical properties tests conducted were: compressive strength test after 7 days, 28 days, 56 days and 90 days; flexure test; split tensile strength test after 28 days, 56 days and 90 days; X-ray diffraction test to analyze the mechanical performance and sorptivity test for testing of permeability. The study revealed that the sample of 16M concentration of alkaline solution with 500 Kg/m³ binder content containing 2% nano silica produced the highest compressive, flexural and split tensile strength of 81.33 MPa, 7.875 MPa, and 6.398 MPa respectively, at the end of 90 days.Keywords: alkaline activator liquid, geopolymer concrete, ground granulated blast furnace slag, nano silica, self compacting
Procedia PDF Downloads 1473872 Sustainable Accommodation Design: Improving Residential Property Shortage for Low-Income People in Nigeria
Authors: Paulinus W. Ihuah, Iyenemi Ibimina Kakulu, Victor A. Akujuru
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The development of the residential property is very expensive in Nigeria, especially as it is observed in Port Harcourt, although it is also investment costly in the other cities of Nigeria. The costly development nature incidentally reasons to the high deficits in residential property availability and affordability for the low-income people. Therefore, the main purpose of this paper is to provide sustainable accommodation design, which should improve residential property expensiveness and shortages for the low-income people. This is achieved through investigation of the tangible requirements and needs of the end-user of the property (low-income people), which thereafter would enhance sustainable and affordable residential property accommodation design for the end-users. Both the quantitative and qualitative instruments of data collection were utilised. The quantitative instrument via questionnaires was designed to examine the real needs and r requirement of the low-income people. However, the qualitative instrument via structured interview was espoused for the gathering of professionals’ opinions on the three predicted sustainable accommodation design alternatives. The analysis employed content analysis parameters, which offered a sustainable accommodation design and designed alternatives minimises costs and environmental impacts whereas exploiting the social satisfaction in residential accommodation developments. The finding underscores that sustainable accommodation design and development is practicable in Nigeria, so that cost of residential accommodation provided through this system is cheap to the low-income people. Further, erection of multi-storey residential accommodation units such as bedsit structure by utilising the concrete frame structure and building the internal and external walls with hollow concrete blocks within areas 60-130 square meters is encouraged. This paper philosophy indicates that by using sustainable accommodation design practices in Nigeria, improvements in the costs and shortages of residential accommodation can be attained for low-income people. However, policies support the government cannot be overemphasised for proper implementation of the suggested scheme.Keywords: sustainable accommodation, housing design, residential property, low-income people
Procedia PDF Downloads 2703871 Absolute Lymphocyte Count as Predictor of Pneumocystis Pneumonia in Patients With Unknown HIV Status at a Private Tertiary Hospital
Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura
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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP
Procedia PDF Downloads 3493870 Prediction of Fillet Weight and Fillet Yield from Body Measurements and Genetic Parameters in a Complete Diallel Cross of Three Nile Tilapia (Oreochromis niloticus) Strains
Authors: Kassaye Balkew Workagegn, Gunnar Klemetsdal, Hans Magnus Gjøen
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In this study, the first objective was to investigate whether non-lethal or non-invasive methods, utilizing body measurements, could be used to efficiently predict fillet weight and fillet yield for a complete diallel cross of three Nile tilapia (Oreochromis niloticus) strains collected from three Ethiopian Rift Valley lakes, Lakes Ziway, Koka and Chamo. The second objective was to estimate heritability of body weight, actual and predicted fillet traits, as well as genetic correlations between these traits. A third goal was to estimate additive, reciprocal, and heterosis effects for body weight and the various fillet traits. As in females, early sexual maturation was widespread, only 958 male fish from 81 full-sib families were used, both for the prediction of fillet traits and in genetic analysis. The prediction equations from body measurements were established by forward regression analysis, choosing models with the least predicted residual error sums of squares (PRESS). The results revealed that body measurements on live Nile tilapia is well suited to predict fillet weight but not fillet yield (R²= 0.945 and 0.209, respectively), but both models were seemingly unbiased. The genetic analyses were carried out with bivariate, multibreed models. Body weight, fillet weight, and predicted fillet weight were all estimated with a heritability ranged from 0.23 to 0.28, and with genetic correlations close to one. Contrary, fillet yield was only to a minor degree heritable (0.05), while predicted fillet yield obtained a heritability of 0.19, being a resultant of two body weight variables known to have high heritability. The latter trait was estimated with genetic correlations to body weight and fillet weight traits larger than 0.82. No significant differences among strains were found for their additive genetic, reciprocal, or heterosis effects, while total heterosis effects were estimated as positive and significant (P < 0.05). As a conclusion, prediction of prediction of fillet weight based on body measurements is possible, but not for fillet yield.Keywords: additive, fillet traits, genetic correlation, heritability, heterosis, prediction, reciprocal
Procedia PDF Downloads 1883869 Treatment of Non-Small Cell Lung Cancer (NSCLC) With Activating Mutations Considering ctDNA Fluctuations
Authors: Moiseenko F. V., Volkov N. M., Zhabina A. S., Stepanova E. O., Kirillov A. V., Myslik A. V., Artemieva E. V., Agranov I. R., Oganesyan A. P., Egorenkov V. V., Abduloeva N. H., Aleksakhina S. Yu., Ivantsov A. O., Kuligina E. S., Imyanitov E. N., Moiseyenko V. M.
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Analysis of ctDNA in patients with NSCLC is an emerging biomarker. Multiple research efforts of quantitative or at least qualitative analysis before and during the first periods of treatment with TKI showed the prognostic value of ctDNA clearance. Still, these important results are not incorporated in clinical standards. We evaluated the role of ctDNA in EGFR-mutated NSCLC receiving first-line TKI. Firstly, we analyzed sequential plasma samples from 30 patients that were collected before intake of the first tablet (at baseline) and at 6, 12, 24, 36, and 48 hours after the “starting point.” EGFR-M+ allele was measured by ddPCR. Afterward, we included sequential qualitative analysis of ctDNA with cobas® EGFR Mutation Test v2 from 99 NSCLC patients before the first dose, after 2 and 4 months of treatment, and on progression. Early response analysis showed the decline of EGFR-M+ level in plasma within the first 48 hours of treatment in 11 subjects. All these patients showed objective tumor response. 10 patients showed either elevation of EGFR-M+ plasma concentration (n = 5) or stable content of circulating EGFR-M+ after the start of the therapy (n = 5); only 3 of these patients achieved an objective response (p = 0.026) when compared to the former group). The rapid decline of plasma EGFR-M+ DNA concentration also predicted for longer PFS (13.7 vs. 11.4 months, p = 0.030). Long-term ctDNA monitoring showed clinically significant heterogeneity of EGFR-mutated NSCLC treated with 1st line TKIs in terms of progression-free and overall survival. Patients without detectable ctDNA at baseline (N = 32) possess the best prognosis on the duration of treatment (PFS: 24.07 [16.8-31.3] and OS: 56.2 [21.8-90.7] months). Those who achieve clearance after two months of TKI (N = 42) have indistinguishably good PFS (19.0 [13.7 – 24.2]). Individuals who retain ctDNA after 2 months (N = 25) have the worst prognosis (PFS: 10.3 [7.0 – 13.5], p = 0.000). 9/25 patients did not develop ctDNA clearance at 4 months with no statistical difference in PFS from those without clearance at 2 months. Prognostic heterogeneity of EGFR-mutated NSCLC should be taken into consideration in planning further clinical trials and optimizing the outcomes of patients.Keywords: NSCLC, EGFR, targeted therapy, ctDNA, prognosis
Procedia PDF Downloads 553868 Integrated Safety Net Program for High-Risk Families in New Taipei City
Authors: Peifang Hsieh
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New Taipei city faces increasing number of migrant families, in which the needs of children are sometimes neglected due to insufficient support from communities. Moreover, the traditional mindset of disengagement discourages citizens from preemptively identifying families in need in their communities, resulting in delay of prompt intervention from authorities concerned. To safeguard these vulnerable families, New Taipei city develops the 'Integrated Safety-Net Program for High-Risk Families' from 2011 by implementing the following measures: (A) New attitude and action: Instead of passively receiving reported case of high-risk families, the program takes proactive and preemptive approach to detect and respond at early stage, so the cases are prevented from worsening. In addition, cross-departmental integration mechanism is established to meet multiple needs of high-risk families. The children number added to the government care network is greatly increased to over 10,000, which is around 4.4 times the original number before the program. (B) New service points: 2000 city-wide convenience stores are added as service stations so that children in less privileged families can go to any of 24-hour convenience stores across the city to pick up free meals. This greatly increases the approachability to high-risk families. Moreover, the social welfare institutes will be notified with information left in convenience stores by children and follow up with further assistance, greatly enhancing chances of less privileged families being identified. (C) New Key Figures: Mobilize community officers and volunteers to detect and offer on-site assistance. Volunteer organizations within communities are connected to report and offer follow-up services in a more active manner. In total, from 2011 to 2015, 54,789 cases are identified through active care, benefiting 82,124 children. In addition, 87.49% family-cases in the program receiving comprehensive social assistance are no longer at high risk.Keywords: cross department, high-risk families, public-private partnership, integrated safety net
Procedia PDF Downloads 2993867 Effect of Oil Viscosity and Brine Salinity/Viscosity on Water/Oil Relative Permeability and Residual Saturations
Authors: Sami Aboujafar
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Oil recovery in petroleum reservoirs is greatly affected by fluid-rock and fluid-fluid interactions. These interactions directly control rock wettability, capillary pressure and relative permeability curves. Laboratory core-floods and centrifuge experiments were conducted on sandstone and carbonate cores to study the effect of low and high brine salinity and viscosity and oil viscosity on residual saturations and relative permeability. Drainage and imbibition relative permeability in two phase system were measured, refined lab oils with different viscosities, heavy and light, and several brine salinities were used. Sensitivity analysis with different values for the salinity and viscosity of the fluids,, oil and water, were done to investigate the effect of these properties on water/oil relative permeability, residual oil saturation and oil recovery. Experiments were conducted on core material from viscous/heavy and light oil fields. History matching core flood simulator was used to study how the relative permeability curves and end point saturations were affected by different fluid properties using several correlations. Results were compared with field data and literature data. The results indicate that there is a correlation between the oil viscosity and/or brine salinity and residual oil saturation and water relative permeability end point. Increasing oil viscosity reduces the Krw@Sor and increases Sor. The remaining oil saturation from laboratory measurements might be too high due to experimental procedures, capillary end effect and early termination of the experiment, especially when using heavy/viscous oil. Similarly the Krw@Sor may be too low. The effect of wettability on the observed results is also discussed. A consistent relationship has been drawn between the fluid parameters, water/oil relative permeability and residual saturations, and a descriptor may be derived to define different flow behaviors. The results of this work will have application to producing fields and the methodologies developed could have wider application to sandstone and carbonate reservoirs worldwide.Keywords: history matching core flood simulator, oil recovery, relative permeability, residual saturations
Procedia PDF Downloads 337