Search results for: poor outcome of delayed breast cancer treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13430

Search results for: poor outcome of delayed breast cancer treatment

2990 Improved Traveling Wave Method Based Fault Location Algorithm for Multi-Terminal Transmission System of Wind Farm with Grounding Transformer

Authors: Ke Zhang, Yongli Zhu

Abstract:

Due to rapid load growths in today’s highly electrified societies and the requirement for green energy sources, large-scale wind farm power transmission system is constantly developing. This system is a typical multi-terminal power supply system, whose structure of the network topology of transmission lines is complex. What’s more, it locates in the complex terrain of mountains and grasslands, thus increasing the possibility of transmission line faults and finding the fault location with difficulty after the faults and resulting in an extremely serious phenomenon of abandoning the wind. In order to solve these problems, a fault location method for multi-terminal transmission line based on wind farm characteristics and improved single-ended traveling wave positioning method is proposed. Through studying the zero sequence current characteristics by using the characteristics of the grounding transformer(GT) in the existing large-scale wind farms, it is obtained that the criterion for judging the fault interval of the multi-terminal transmission line. When a ground short-circuit fault occurs, there is only zero sequence current on the path between GT and the fault point. Therefore, the interval where the fault point exists is obtained by determining the path of the zero sequence current. After determining the fault interval, The location of the short-circuit fault point is calculated by the traveling wave method. However, this article uses an improved traveling wave method. It makes the positioning accuracy more accurate by combining the single-ended traveling wave method with double-ended electrical data. What’s more, a method of calculating the traveling wave velocity is deduced according to the above improvements (it is the actual wave velocity in theory). The improvement of the traveling wave velocity calculation method further improves the positioning accuracy. Compared with the traditional positioning method, the average positioning error of this method is reduced by 30%.This method overcomes the shortcomings of the traditional method in poor fault location of wind farm transmission lines. In addition, it is more accurate than the traditional fixed wave velocity method in the calculation of the traveling wave velocity. It can calculate the wave velocity in real time according to the scene and solve the traveling wave velocity can’t be updated with the environment and real-time update. The method is verified in PSCAD/EMTDC.

Keywords: grounding transformer, multi-terminal transmission line, short circuit fault location, traveling wave velocity, wind farm

Procedia PDF Downloads 260
2989 The Effects of Vitamin D Supplementation on Anthropometric Indicators of Adiposity and Fat Distribution in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Simin Zarea Karizi, Somaye Fatahi, Amirhossein Hosseni

Abstract:

Background: There are conflicting findings regarding the effect of vitamin D supplementation on obesity-related factors. This study aimed to investigate the effect of vitamin D supplementation on changes in anthropometric indicators of adiposity and fat distribution in children and adolescents. Methods: Original databases were searched using standard keywords to identify all controlled trials investigating the effects of vitamin D supplementation on obesity-related factors in children and adolescents. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis. Results: Fourteen treatment arms were included in this systematic review and meta-analysis. The quantitative meta-analysis revealed no significant effect of vitamin D supplement on BMI (-0.01 kg/m2; 95% CI: -0.09, 0.12; p= 0.74; I2=0.0%), BMI z score (0.02; 95% CI: -0.04, 0.07; p= 0.53; I2=0.0%) and fat mass (0.07%; 95% CI: -0.09 to 0.24; p= 0.38; I2=31.2%). However, the quantitative meta-analysis displayed a significant effect of vitamin D supplementation on WC compared with the control group (WMD=-1.17 cm, 95% CI: -2.05, -0.29, p=0.009; I2=32.0 %). It seems that this effect was greater in healthy children with duration>12 weeks, dose<=400 IU and baseline less than 50 nmol/l vitamin D than others. Conclusions: Our findings suggest that vitamin D supplementation may be a protective factor of abdominal obesity and should be evaluated on an individual basis in clinical practice.

Keywords: weight loss, vitamin D, anthropometry, children, adolescent

Procedia PDF Downloads 22
2988 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

Abstract:

Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

Procedia PDF Downloads 214
2987 Study Biogas Produced by Strain Archaea Methanothrix soehngenii in Different Biodigesters UASB in Treating Brewery Effluent in Brazil

Authors: Ederaldo Godoy Junior, Ricardo O. Jesus, Pedro H. Jesus, José R. Camargo, Jorge Y. Oliveira, Nicoly Milhardo Lourenço

Abstract:

This work aimed at the comparative study of the quality and quantity of biogas produced by archaea strain Methanothrix soehngenii operating in different versions of anaerobic digesters upflow sludge bed in the brewery wastewater treatment in Brazil in the tropical region. Four types of UASB digesters were studied made of different geometries and materials which are: a UASB IC steel 20 meters high; a circular UASB steel 6 meters high; an UASB reinforced concrete lined with geomembrane PEAB with 6 meters high; and finally a UASB plug flow comprising two UASB in serious rotomolded HDPE 6 meters high.Observed clearly that the biogas produced in the digester UASB steel H2S concentrations had values lower than the HDPE. With respect to efficiency in short time, the UASB IC showed the best results to absorb overloads, as the UASB circular steel showed an efficiency of 90% removal of the organic load. The UASB system plug flow in HDPE showed the lowest cost of deployment, and its efficiency in removing the organic load was 80%.

Keywords: biogas, achaeas, UASB, Brewery effluent

Procedia PDF Downloads 350
2986 Effects of Paroxetine on Biochemical Parameters and Reproductive Function in Male Rats

Authors: Rachid Mosbah, Aziez Chettoum, Zouhir Djerrou, Alberto Mantovani

Abstract:

Selective serotonin reuptake inhibitors (SSRI) are a class of molecules used in treating depression, anxiety, and mood disorders. Paroxetine (PRT) is one of the mostly prescribed antidepressant which has attracted great attention regarding its side effects in recent years. This study was planned to assess the adverse effects of PRT on the biochemical parameters and reproductive system. Fourteen male Wistar rats were randomly allocated into two groups (7 rats or each): control and treated with PRT at dose of 5mg/kg.bw for two weeks. At the end of the experiment, blood was collected from retro orbital plexus for measuring the biochemical parameters, whereas the reproductive organs were removed for measuring semen quality and the histological investigations. Results showed that PRT induced significant changes in some biochemical parameters and alteration of semen quality including sperm count, spermatids number and sperm viability, motility, and abnormalities. The histopathological examinations of testis and epididymis revealed an alteration of spermatogenesis, cellular disorganization and vacuolization, enlargement of interstitial space, shrinkage and degenerative changes in the epithelium of seminiferous and epididymal tubules with few to nil numbers of spermatozoa in their lumen. In conclusion, PRT treatment caused changes in some biochemical parameters and sperm profile as well as histopathologic effects of reproductive organs.

Keywords: antidepressant, biochemical parameters, reproductive function, paroxetine

Procedia PDF Downloads 122
2985 The Place of Herbal Teas Based on Medicinal Plants in the Treatment and Comfort of Infants

Authors: Metahri Leyla, Helali Amal, Dali Yahia Mustapha Kamel

Abstract:

Herbal medicine is one of the oldest medicines in the world. It constitutes an interesting alternative to treat and cure without creating new diseases. Despite the progress of medicine, the increase in the number of doctors, the creation of social security, many parents have resorted to herbal medicine for their children; they are increasingly asking for "natural remedies", "without risk" for their children. Herbal tea is a very accessible way to enjoy the benefits of herbal medicine. Accordingly; the objective of our study is to obtain detailed information on the composition and mode of administration of these herbal teas and to identify the different plants used; their beneficial effects, as well as their possible toxicity. The current research work represents an ethnobotanical survey spread over one month (from January 6, 2021 to February 19, 2021) carried out by means of an electronic questionnaire concerning 753 respondents, involving single or multiparous mothers. The obtained results reveal that a total of 684 mothers used herbal teas for their infants, which revealed the use of 55 herbal remedies for several indications, the most sought after are the carminative effect and relief of colic, and which 9% of users noticed undesirable effects linked to the administration of herbal teas to their infants. As a conclusion, it has been asserted that the use of herbal teas as a natural remedy by Algerian mothers is a widely accepted practice, however the "natural" nature of the plants does not mean that they are harmless.

Keywords: Keywords: Herbal medicine, Herbal teas, Children, Mothers, Medicinal plants.

Procedia PDF Downloads 92
2984 An Innovative Non-Invasive Method To Improve The Stability Of Orthodontic Implants: A Pilot Study

Authors: Dr., Suchita Daokar

Abstract:

Background: Successful orthodontic treatment has always relied on anchorage. The stability of the implants depends on bone quantity, mini-implant design, and placement conditions. Out of the various methods of gaining stability, Platelet concentrations are gaining popularity for various reasons. PRF is a minimally invasive method, and there are various studies that has shown its role in enhancing the stability of general implants. However, there is no literature found regarding the effect of PRF in enhancing the stability of the orthodontic implant. Therefore, this study aimed to evaluate and assess the efficacy of PRF on the stability of the orthodontic implant. Methods: The study comprised of 9 subjects aged above 18 years of age. The split mouth technique was used; Group A (where implants were coated before insertion) and group B (implant were normally inserted). The stability of the implant was measured using resonance frequency analysis at insertion (T0), 24 hours (T1), 2 weeks (T2), at 4 weeks (T3), at 6 weeks (T4), and 8 weeks (T5) after insertion. Result: Statistically significant findings were found when group A was compared to group B using ANOVA test (p<0.05). The stability of the implant of group A at each time interval was greater than group B. The implant stability was high at T0 and reduces at T2, and increasing through T3 to T5. The stability was highest at T5. Conclusion: A chairside, minimally invasive procedure ofPRF coating on implants have shown promising results in improving the stability of orthodontic implants and providing scope for future studies.

Keywords: Orthodontic implants, stablity, resonance Frequency Analysis, pre

Procedia PDF Downloads 197
2983 Comparative Analysis of Photosynthetic and Antioxidative Responses of Two Species of Anabaena under Ni and As(III) Stress

Authors: Shivam Yadav, Neelam Atri

Abstract:

Cyanobacteria, the photosynthetic prokaryotes are indispensable components of paddy soil contribute substantially to the nitrogen economy however often appended with metal load. They are well known to play crucial roles in maintenance of soil fertility and rice productivity. Nickel is one such metal that plays a vital role in the cellular physiology, however at higher concentrations it exerts adverse effects. Arsenic is another toxic metalloid that negatively affects the cyanobacterial proliferation. However species-specific comparative responses under As and Ni is largely unknown. The present study focuses on the comparative effects of nickel (Ni2+) and arsenite (As(III)) on two diazotrophic cyanobacterial species (Anabaena doliolum and Anabaena sp. PCC7120) in terms of antioxidative aspects. Oxidative damage measured in terms of lipid peroxidation and peroxide content was significantly higher after As(III) than Ni treatment as compared to control. Similarly, all the studied enzymatic and non-enzymatic parameters of antioxidative defense system except glutathione reductase (GR) showed greater induction against As(III) than Ni. Moreover, integrating comparative analysis of all studied parameters also demonstrated interspecies variation in terms of stress adaptive strategies reflected through higher sensitivity of Anabaena doliolum over Anabaena PCC7120.

Keywords: antioxidative system, arsenic, cyanobacteria, nickel

Procedia PDF Downloads 149
2982 A Multidimensional Exploration of Narcissistic Personality Disorder Through Psycholinguistic Analysis and Neuroscientific Correlates

Authors: Dalia Elleuch

Abstract:

Narcissistic Personality Disorder (NPD) manifests as a personality disorder marked by inflated self-importance, heightened sensitivity to criticism, a lack of empathy, a preoccupation with appearance over substance, and features such as arrogance, grandiosity, a constant need for admiration, a tendency to exploit others, and an inclination towards demanding special treatment due to a sense of excessive entitlement (APA, 2013). This interdisciplinary study delves into NPD through the systematic synthesis of psycholinguistic analysis and neuroscientific correlates. The cognitive and emotional dimensions of NPD reveal linguistic patterns, including grandiosity, entitlement, and manipulative communication. Neuroscientific investigations reveal structural brain differences and alterations in functional connectivity, further explaining the neural underpinnings of social cognition deficits observed in individuals with NPD. Genetic predispositions and neurotransmitter imbalances add a layer of complexity to the understanding of NPD. The necessity for linguistic intervention in diagnosing and treating Narcissistic Personality Disorder is underscored by an interdisciplinary study that intricately synthesizes psycholinguistic analysis and neuroscientific correlates, offering a comprehensive understanding of NPD’s cognitive, emotional, and neural dimensions and paving the way for future practical, theoretical, and pedagogical approaches to address the complexities of this personality disorder.

Keywords: Narcissistic Personality Disorder (NPD), psycholinguistic analysis, neuroscientific correlates, interpersonal dysfunction, cognitive empathy

Procedia PDF Downloads 60
2981 Appraisal of Conservation Strategies of Veligonda Forest Range of Eastern Ghats, Andhra Pradesh, India

Authors: Khasim Munir Bhasha Shaik

Abstract:

Veligonda and adjoining hill range spread along about 170 Km North to South in Kadapa and Nellore Districts stretching a little further into Prakasam District. The latitude in general ranges up to 1000m. The forests are generally dry deciduous type. Veligonda and adjoining hill ranges comprise of Palakonda, Seshachalam, Lankamala and the terminal part of Nallamalais from mid-region of Southern Eastern Ghats. The Veligonda range which separates the Nellore district from Kadapa and Kurnool is the backbone of the Eastern Ghats, starting from Nagari promontory in Chittoor district. It runs in a northerly direction along the western border of the Nellore district, with a raising elevation of 3,626 ft at Penchalakona in Raipur thaluk. Veligonda hill ranges are high in altitude and have deep valleys. Among the Veligondas range of hills the Durgam in Venkatagiri range and Penchalakona are the most prominent and are situated 914 meters above mean sea level. It has more than 3000 species of plants along with 500 animal species. The unique specialty of this region is the presence of Pterocarpus santalinus(endangered) and Santalum album (vulnerable). In the present study, an attempt is made to assess the efforts that are going on to conserve the biodiversity of flora and fauna of this region. Various conservation strategies were suggested to protect the biodiversity and richness of Veligonda forest, hill region of Eastern Ghats of Andhra Pradesh. The major threats and the reasons for the dwindling species richness are poor rainfall, adverse climatic conditions, robbery of Red sanders and poaching of animals by the local tribals. Efforts are to be made to conserve some of the animals by both in situ and ex-situ methods. More awareness is to be developed among the local communities who are dwelling in the vicinity and importance of conservation is to be emphasized to them. Anthropogenic attachments are to be made by introducing more numbers of sacred groves. Gross enforcement of law is to be made to protect the various forest resources in this area. The important species with the medicinal values are to be identified. It was found that two important wildlife sanctuaries named Sri Lankamalleswarawildlife sanctuary and Sripenusila Narasimha wildlife sanctuary are working for the comprehensive conservation of the environment in this area. Apart from this more than 38 important sacred grooves are there where the plants and animals are protected by local Yanadi and other communities.

Keywords: biodiversity, wild life sanctuary, habitat destruction, eastern Ghats

Procedia PDF Downloads 153
2980 Predictors of the Self-Reported Likelihood of Seeking Social Worker Help among People with Physical Disabilities

Authors: Maya Kagan, Michal Itzick, Patricia Tal-Katz

Abstract:

Social workers hold a variety of roles and practices, and one of these involves the care, treatment, and rehabilitation of disabled people. The current study assesses the association between demographic factors, attitudes towards social workers, the stigma attached to seeking social worker help, perceived social support, and psychological distress - and the self-reported likelihood of seeking social worker help, among people with physical disabilities (PWPD) in Israel. Data collection utilized structured questionnaires, administered to a sample of 435 PWPD. Statistical analyses were done using SPSS software. The findings suggest that women, older respondents, people with more positive attitudes towards social workers, with higher levels of psychological distress and of social support, and with a lower level of stigma, reported a greater likelihood of seeking social worker help. The study's conclusion is that there are certain avoidance factors among PWPD that might discourage them from seeking professional social worker help. Therefore, it is important that social workers identify these factors and develop interventions aimed at encouraging PWPD to seek professional social worker help in case of need, and also develop practices adjusted to PWPD's unique needs.

Keywords: attitudes towards social workers, people with physical disabilities, perceived social support, psychological distress, seeking help, stigma

Procedia PDF Downloads 334
2979 Oil-price Volatility and Economic Prosperity in Nigeria: Empirical Evidence

Authors: Yohanna Panshak

Abstract:

The impact of macroeconomic instability on economic growth and prosperity has been at forefront in many discourses among researchers and policy makers and has generated a lot of controversies over the years. This has generated series of research efforts towards understanding the remote causes of this phenomenon; its nature, determinants and how it can be targeted and mitigated. While others have opined that the root cause of macroeconomic flux in Nigeria is attributed to Oil-Price volatility, others viewed the issue as resulting from some constellation of structural constraints both within and outside the shores of the country. Research works of scholars such as [Akpan (2009), Aliyu (2009), Olomola (2006), etc] argue that oil volatility can determine economic growth or has the potential of doing so. On the contrary, [Darby (1982), Cerralo (2005) etc] share the opinion that it can slow down growth. The earlier argument rest on the understanding that for a net balance of oil exporting economies, price upbeat directly increases real national income through higher export earnings, whereas, the latter allude to the case of net-oil importing countries (which experience price rises, increased input costs, reduced non-oil demand, low investment, fall in tax revenues and ultimately an increase in budget deficit which will further reduce welfare level). Therefore, assessing the precise impact of oil price volatility on virtually any economy is a function of whether it is an oil-exporting or importing nation. Research on oil price volatility and its outcome on the growth of the Nigerian economy are evolving and in a march towards resolving Nigeria’s macroeconomic instability as long as oil revenue still remain the mainstay and driver of socio-economic engineering. Recently, a major importer of Nigeria’s oil- United States made a historic breakthrough in more efficient source of energy for her economy with the capacity of serving significant part of the world. This undoubtedly suggests a threat to the exchange earnings of the country. The need to understand fluctuation in its major export commodity is critical. This paper leans on the Renaissance growth theory with greater focus on theoretical work of Lee (1998); a leading proponent of this school who makes a clear cut of difference between oil price changes and oil price volatility. Based on the above background, the research seeks to empirically examine the impact oil-price volatility on government expenditure using quarterly time series data spanning 1986:1 to 2014:4. Vector Auto Regression (VAR) econometric approach shall be used. The structural properties of the model shall be tested using Augmented Dickey-Fuller and Phillips-Perron. Relevant diagnostics tests of heteroscedasticity, serial correlation and normality shall also be carried out. Policy recommendation shall be offered on the empirical findings and believes it assist policy makers not only in Nigeria but the world-over.

Keywords: oil-price, volatility, prosperity, budget, expenditure

Procedia PDF Downloads 264
2978 Effect of Different Ozone Doses on Antioxidant Activity in Different Tomato Tissues and at Different Stages of Ripening

Authors: Shalluf Milad

Abstract:

Tomatoes are widely produced and consumed due to their nutritional content and versatility. However, the tomato is a soft fruit liable to damage and flavour deterioration. Hence, the main challenge for the tomato producing industry is to prevent the high loss incurred during harvest, handling and transportation of the crops. The objective of this study was to investigate the overall nutritional implication of controlled storage of tomatoes using ozone on the basic nutritional components of tomatoes. This investigation was also designed to focus on the effect of different ozone doses on the basic components (antioxidant activity). Green, yellow and red stages of ripeness (elegance tomatoes), were harvested at different dates for each experiment. The tomatoes were cleaned and placed inside the glass reactors and ozonated at 0.25, 0.50 and 1 mg O3/g tomatoes and clean air respectively for 5 days at 15°C ± 2 and 90-95 % relative humidity respectively. The fruits were analysed for total antioxidant activity. Analysis of the fruits clearly showed that antioxidant activity in the pericarp tissue was the lowest (P<0.001) compared with the pulp tissue of tomatoes during storage in the red stage of maturity, after being treated with ozone in the atmosphere of storage in a dose of 1.00 mgO3/g tomatoes. It can be concluded from this study that the use of ozone in the atmospheres of storage and handling of fresh products maintains the important compounds of these products while maintaining the nutritional value and health quality.

Keywords: post-harvest treatment, controlled atmosphere storage, ozone, tomatoes, antioxidant activity

Procedia PDF Downloads 321
2977 Water Management in Rice Plants of Dry Season in the Rainfed Lowland

Authors: Zainal Arifin, Mohammad Saeri

Abstract:

The purpose of this study is to determine the efficiency of irrigation use on the growth and yield of two varieties of rice. Water management research on rainfed lowland rice was carried out in dry season (DS I) 2016 in an area of 10,000 m2 in Bunbarat Village, Rubaru Subdistrict, Sumenep Regency. The research was randomized block design factorial with 8 treatments and repeated 3 times, ie Factor I (varieties): (a) Inpago 9, and (b) Sidenuk; factor II (irrigation): (a) Alternate Wetting and Drying, (b) intermittent, (c) submerged, and (d) inundated. The results showed that dominant weed species such as purslane (Portulaca oleraceae L.) and barnyard grass (Echinochloa crusgalli) were mostly found in rice cultivation with Alternate Wetting and Drying, intermittent and submerged irrigation treatment, while the lowest was inundated irrigation. The use of Sidenuk variety with Alternate Wetting and Drying irrigation yielded 5.7 t/ha dry grain harvest (dgh) and was not significantly different from the inundated watering using the Sidenuk variety (6.2 t/ha dgh). With Alternate Wetting and Drying irrigation technique, water use is more efficient as much as 1,503 m3/ha so as to produce 1 kg of grain, it needs 459 liters of water compared to inundated irrigation (665 liters/kg of grain). Results of analysis of rice farming Sidenuk variety with Alternate Wetting and Drying irrigation has the highest B/C ratio (2.56) so that economically feasible.

Keywords: water management, varieties, rice, dry season, rainfed lowland

Procedia PDF Downloads 169
2976 The Biology of Persister Cells and Antibiotic Resistance

Authors: Zikora K. G. Anyaegbunam, Annabel A. Nnawuihe, Ngozi J. Anyaegbunam, Emmanuel A. Eze

Abstract:

The discovery and production of new antibiotics is unavoidable in the fight against drug-resistant bacteria. However, this is only part of the problem; we have never really had medications that could completely eradicate an infection. All pathogens create a limited number of dormant persister cells that are resistant to antibiotic treatment. When the concentration of antibiotics decreases, surviving persisters repopulate the population, resulting in a recurrent chronic infection. Bacterial populations have an alternative survival strategy to withstand harsh conditions or antibiotic exposure, in addition to the well-known methods of antibiotic resistance and biofilm formation. Persister cells are a limited subset of transiently antibiotic-tolerant phenotypic variations capable of surviving high-dose antibiotic therapy. Persisters that flip back to a normal phenotype can restart growth when antibiotic pressure drops, assuring the bacterial population's survival. Persister cells have been found in every major pathogen, and they play a role in antibiotic tolerance in biofilms as well as the recalcitrance of chronic infections. Persister cells has been implicated to play a role in the establishment of antibiotic resistance, according to growing research. Thusthe need to basically elucidate the biology of persisters and how they are linked to antibiotic resistance, and as well it's link to diseases.

Keywords: persister cells, phenotypic variations, repopulation, mobile genetic transfers, antibiotic resistance

Procedia PDF Downloads 204
2975 The City Narrated from the Hill, Evaluation of Natural Fabric in Urban Plans: A Case Study of Santiago de Chile

Authors: Monica Sanchez

Abstract:

What responsibility does urban planning have on climate changes? How does the territory give us answers of resilience? Historically, urban plans have civilized territories: waters are channeled, grounds are sealed, foreign species are incorporated, native ones are extinguished, and/or enclosed spaces are heated or cooled. Socially this facilitates coexistence, but in turn brings negative environmental consequences. The past fifty years, mankind has tried to redirect these consequences through different strategies. Research studies produced strategies designed to alleviate climate change. Exploring the nature of territories has been incorporated in urban planning to discover natures response. The case to be studied is Santiago, Chile: for its combined impacts of climate change and the significant response by this city on climate governance in the last decades. Warmer areas in Santiago are seen in the areas of high-density buildings such as the commune of Recoleta, while the coldest are characterized by the predominance of low residential densities as the commune of Providencia. These two communes are separated and complemented by an undulating body that comes from the Andes mountains called San Cristobal Hill. What if the hill were taken into account when making roads, zoning and buildings? Was it difficult to prolong in the urban plans the hill characteristics to the city solving the intersection with other natural areas? Apparently it was, because the projected-profile informs us that the planned strategies used correspond to the same operations used in the flat areas of Santiago. This research focuses on: explaining the geographic relationships between city-hill; explaining the planning process around the hill with a morphological analysis; evaluating how the hill has been considered the in the city in the plans that intended to cushion the environmental impacts and studying what is missing on the hill and city to strengthen their integration. Therefore, the research will have different scales of understanding: addressing territorial scale -understanding the vegetation, topography and hydrology; a city scale -analyzing urban plans that Santiago has dealt with the environment and city; and a local scale -studying the integration and public spaces and coverage- norms of the adjacent communes. The expected outcome is to decipher possible deficits and capabilities of the current urban plans for climate change. It is anticipated that the hill and valley is now trying to reconcile after such a long separation. Yet it seems that never will prevail all the Rules of Nature, but the Urban Rules. The plans will require pruning, irrigation, control of invasive alien species and public safety standards, but will be rejoining a dose of nature with the building environment -this will protect us better from it from the time that we feared from it and knew little about it. Today we know a little more, enough to adapt to the process. Although nature is not perceived and we ignore it, it has a remarkable ability to respond.

Keywords: resilience, climate change, urban plans, land use, hills and cities, heat islands, morphology

Procedia PDF Downloads 361
2974 The Protective Effect of Grape Seed Oil with Use of Ciprofloxacin Induced Germ Cell Toxicity in Male Albino Mice

Authors: Galawezh Obaid Othman

Abstract:

The present investigation was undertaken to evaluate the germ cell toxicity induced by ciprofloxacin antibiotic and the Protective effect of grape seed oil, Ciproflaxin uses include treatment of genitor-urinary and some reproductive tract bacterial infections. One of the most attractive approaches to disease prevention involves the use of natural antioxidants to protect tissue against toxic injury, the possible protective effect of grape seed oil, against ciprofloxacin induced reproductive toxicity on mouse .the animals were randomly divided into four groups consisting of five mice. Group (1) was orally given distilled water (solvent of the used drugs) and kept as a control. Group (2) was administered 6ml/kg. b.w of grape seed oil orally 15 days .Group (3) was administered 206mg/kg. b.w of ciprofloxacin orally for 15 days.. Last group was treated orally with Grape seed oil (6mg/kg b.w. /day) prior to an orally administered ciprofloxacin (CPX) at a dose of 206 mg⁄kg. b.w. by three hours for fifteen days. Ciproflaxin have ability to induce various types of sperm abnormalities such as (Sperm without head, sperm without tail, defective head spearm,swollen head sperm ), The results explored that Grape seed oil possesses statistically significant (p<0.05) protective potential against Ciproflaxin by decreasing sperm abnormalities frequency in mouse.

Keywords: antimutagen, ciprofloxacin, grape seed oil, germ cell

Procedia PDF Downloads 434
2973 Investigation of the Acoustic Properties of Recycled Felt Panels and Their Application in Classrooms and Multi-Purpose Halls

Authors: Ivanova B. Natalia, Djambova Т. Svetlana, Hristev S. Ivailo

Abstract:

The acoustic properties of recycled felt panels have been investigated using various methods. Experimentally, the sound insulation of the panels has been evaluated for frequencies in the range of 600 Hz to 4000 Hz, utilizing a small-sized acoustic chamber. Additionally, the sound absorption coefficient for the frequency range of 63 Hz to 4000 Hz was measured according to the EN ISO 354 standard in a laboratory reverberation room. This research was deemed necessary after conducting reverberation time measurements of a university classroom following the EN ISO 3382-2 standard. The measurements indicated values of 2.86 s at 500 Hz, 3.23 s at 1000 Hz, and 2.53 s at 2000 Hz, which significantly exceeded the requirements set by the national regulatory framework (0.6s) for such premises. For this reason, recycled felt panels have been investigated in the laboratory, showing very good acoustic properties at high frequencies. To enhance performance in the low frequencies, the influence of the distance of the panel spacing was examined. Furthermore, the sound insulation of the panels was studied to expand the possibilities of their application, both for the acoustic treatment of educational and multifunctional halls and for sound insulation purposes (e.g., a suspended ceiling with an air gap passing from room to room). As a conclusion, a theoretical acoustic design of the classroom has been carried out with suggestions for improvements to achieve the necessary acoustic and aesthetic parameters for such rooms.

Keywords: acoustic panels, recycled felt, sound absorption, sound insulation, classroom acoustics

Procedia PDF Downloads 85
2972 Sexual Risk Behaviours among Patients Living with HIV/AIDS in Douala in 2012

Authors: Etienne Sugewe

Abstract:

Purpose: The establishment of a positive HIV serologic status of an individual could have been an inhibitory factor to prevent risk behaviours in people living with HIV/AIDS. We conducted a cross-sectional study in order to assess the prevalence and predictors of risk behaviors among HIV-positive people in Douala-Cameroon. Methods: We used pre-checked questionnaires to systematically collect data from four HIV treatment centers in Douala. This was done to some of them during the distribution of drugs and to others during their classical rendezvous between the months of May and July 2012. The Chi-Square and Student t-test were used for cross tabulation of variables; multiple regression analysis was performed to identify predictors of risky sexual behaviours. Results: Of the 330 persons interviewed, sixty percent were reported to have had sexual intercourse after the diagnosis of HIV. We obtained 37% HIV-positive partners, and 63% had HIV- negative partners or partners with unknown status. Among our patients, 45% of the subjects with regular partners reported to have had anal or vaginal sex. Those whose score on the knowledge about HIV/AIDS was < 50% and where 90% of them were less susceptible to the condom during intercourse (p: 0.01). About 74% of patients on ARV were less susceptible to the use of condoms during sexual intercourse (p: 0.03). Conclusion: Risk sexual behaviours among people living with HIV/AIDS are common and potentially expose their partners. For HIV-positive partners, these habits pose a real risk of suprainfection by other strains of HIV. The need to increase awareness and education among people living with HIV is therefore highly recommended.

Keywords: HIV/AIDS, behaviours, HIV positive, Douala, 2012

Procedia PDF Downloads 80
2971 An Appraisal of Blended Learning Approach for English Language Teaching in Saudi Arabia

Authors: H. Alqunayeer, S. Zamir

Abstract:

Blended learning, an ideal amalgamation of online learning and face to face traditional approach is a new approach that may result in outstanding outcomes in the realm of teaching and learning. The dexterity and effectiveness offered by e-learning experience cannot be guaranteed in a traditional classroom, whereas one-to-one interaction the essential element of learning that can only be found in a traditional classroom. In recent years, a spectacular expansion in the incorporation of technology in language teaching and learning is observed in many universities of Saudi Arabia. Some universities recognize the importance of blending face-to-face with online instruction in language pedagogy, Qassim University is one of the many universities adopting Blackboard Learning Management system (LMS). The university has adopted this new mode of teaching/learning in year 2015. Although the experience is immature; however great pedagogical transformations are anticipated in the university through this new approach. This paper examines the role of blended language learning with particular reference to the influence of Blackboard Learning Management System on the development of English language learning for EFL learners registered in Bachelors of English language program. This paper aims at exploring three main areas: (i) the present status of Blended learning in the educational process in Saudi Arabia especially in Qassim University by providing a survey report on the number of training courses on Blackboard LMS conducted for the male and female teachers at various colleges of Qassim University, (ii) a survey on teachers perception about the utility, application and the outcome of using blended Learning approach in teaching English language skills courses, (iii) the students’ views on the efficiency of Blended learning approach in learning English language skills courses. Besides, analysis of students’ limitations and challenges related to the experience of blended learning via Blackboard, the suggestion and recommendations offered by the language learners have also been thought-out. The study is empirical in nature. In order to gather data on the afore mentioned areas survey questionnaire method has been used: in order to study students’ perception, a 5 point Likert-scale questionnaire has been distributed to 200 students of English department registered in Bachelors in English program (level 5 through level 8). Teachers’ views have been surveyed with the help of interviewing 25 EFL teachers skilled in using Blackboard LMS in their lectures. In order to ensure the validity and reliability of questionnaire, the inter-rater approach and Cronbach’s Alpha analysis have been used respectively. Analysis of variance (ANOVA) has been used to analyze the students’ perception about the productivity of the Blended approach in learning English language skills. The analysis of feedback by Saudi teachers and students about the usefulness, ingenuity, and productivity of Blended Learning via Blackboard LMS highlights the need of encouraging and expanding the implementation of this new approach into the field of English language teaching in Saudi Arabia, in order to augment congenial learning aura. Furthermore, it is hoped that the propositions and practical suggestions offered by the study will be functional for other similar learning environments.

Keywords: blended learning, black board learning management system, English as foreign language (EFL) learners, EFL teachers

Procedia PDF Downloads 151
2970 Simulation of Solar Assisted Absorption Cooling and Electricity Generation along with Thermal Storage

Authors: Faezeh Mosallat, Eric L. Bibeau, Tarek El Mekkawy

Abstract:

Availability of a wide variety of renewable resources, such as large reserves of hydro, biomass, solar and wind in Canada provides significant potential to improve the sustainability of energy uses. As buildings represent a considerable portion of energy use in Canada, application of distributed solar energy systems for heating and cooling may increase the amount of renewable energy use. Parabolic solar trough systems have seen limited deployments in cold northern climates as they are more suitable for electricity production in southern latitudes. Heat production by concentrating solar rays using parabolic troughs can overcome the poor efficiencies of flat panels and evacuated tubes in cold climates. A numerical dynamic model is developed to simulate an installed parabolic solar trough facility in Winnipeg. The results of the numerical model are validated using the experimental data obtained from this system. The model is developed in Simulink and will be utilized to simulate a tri-generation system for heating, cooling and electricity generation in remote northern communities. The main objective of this simulation is to obtain operational data of solar troughs in cold climates as this is lacking in the literature. In this paper, the validated Simulink model is applied to simulate a solar assisted absorption cooling system along with electricity generation using organic Rankine cycle (ORC) and thermal storage. A control strategy is employed to distribute the heated oil from solar collectors among the above three systems considering the temperature requirements. This modeling provides dynamic performance results using real time minutely meteorological data which are collected at the same location the solar system is installed. This is a big step ahead of the current models by accurately calculating the available solar energy at each time step considering the solar radiation fluctuations due to passing clouds. The solar absorption cooling is modeled to use the generated heat from the solar trough system and provide cooling in summer for a greenhouse which is located next to the solar field. A natural gas water heater provides the required excess heat for the absorption cooling at low or no solar radiation periods. The results of the simulation are presented for a summer month in Winnipeg which includes the amount of generated electric power from ORC and contribution of solar energy in the cooling load provision

Keywords: absorption cooling, parabolic solar trough, remote community, validated model

Procedia PDF Downloads 211
2969 Effects of Excess-Iron Stress on Symbiotic Nitrogen Fixation Efficiency of Yardlong-Bean Plants

Authors: Hong Li, Tingxian Li, Xudong Wang, Qinghuo Lin

Abstract:

Excess-iron (Fe) stresses involved in legume symbiotic nitrogen fixation are not understood. Our objectives were to investigate the tolerance of yardlong-bean plants to soil excess-Fe stress and antagonistic effects of organic amendments and rhizobial inoculants on plant root nodulation and stem ureide formation. The study was conducted in the tropical Hainan Island during 2012-2013. The soil was strongly acidic (pH 5.3±0.4) and highly variable in Fe concentrations(596±79 mg/kg). The treatments were arranged in a split-plot design with three blocks. The treatment effects were significant on root nodulation, stem ureide, amino acids, plant N/Fe accumulation and bean yields (P<0.05). The yardlong-bean stem allantoin, amino acids and nitrate concentrations and relative ureide % declined with high soil Fe concentrations (>300 mg/kg). It was concluded that the co-variance of excess Fe stress could inhibit legume symbiotic N fixation efficiency. Organic amendments and rhizobial inoculants could help improve crop tolerance to excess Fe stress.

Keywords: atmospheric N fixation, root nodulation, soil Fe co-variance, stem ureide, yardlong-bean plants

Procedia PDF Downloads 278
2968 The Application of Local Wisdom in Health Care of Early Childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province

Authors: Supalak Fakkhum, Wannita Pochanakul

Abstract:

This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

Procedia PDF Downloads 476
2967 In vivo Evidence of Protective Effect of Hyparrhenia Hirta against Nitrate-Induced Genotoxicity

Authors: H. Bouaziz-Ketata, G. Ben Salah, Z. Aidi, C. Kallel, H. Kammoun, F. Fakhfakh, N. Zeghal

Abstract:

The present study was performed to evaluate the potential protective effect of Hyparrhenia hirta methanolic extract in NaNO3-induced genotoxic and hematotoxic effects. Male Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered at a dose of 400 mg kg-1 bw either alone in drinking water or co-administered with Hyparrhenia hirta at a dose of 200 mg kg-1 bw. NaNO3 treatment showed a significant increase in the frequencies of total chromosomal aberrations, aberrant metaphases and micronucleus in bone-marrow cells. In parallel, the NaNO3-treated group showed a significant decrease in red blood cell count, hemoglobin and hematocrit and a significant increase in total white blood cell, in neutrophil and eosinophil counts. Platelet count, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration remained unchanged in treated groups compared to those of controls. Hyparrhenia hirta methanolic extract appeared to be effective against genotoxic and hematotoxic changes induced by nitrate, as evidenced by the improvement of the markers cited above.

Keywords: Hyparrhenia hirta, sodium nitrate, erythrocytes, genotoxicity

Procedia PDF Downloads 255
2966 Preventive Effects of Silymarin in Retinal Intoxication with Methanol in Rat: Transmission Electron Microscope Study

Authors: A. Zarenezhad, A. Esfandiari, E. Zarenezhad, M. Mardkhoshnood

Abstract:

The aim of this study was to investigate the ultra-structure of the photoreceptor layer of male rats under the effect of methanol intoxication and protective effect of silymarin against the methanol toxicity. Fifteen adult male rats were divided into three groups: Control group, Experimental group I (received 4g/kg methanol by intraperitoneal injection for five days), Experimental group II (received 4 g/kg methanol by intraperitoneal injection for five days and received 250 mg/kg silymarin orally for three months). At the end of the experiment, the eyes were removed; retina was separated near the optic disc and studied by transmission electron microscope. Results showed that the retina in the experimental group I exhibited loss of outer segments and disorganization in inner segment. Increased extra cellular space, disappearance of outer limiting membrane and pyknotic nuclei were seen in this group. But normal outer segment, organized inner segment and normal outer limiting membrane were obvious after treatment with silymarin in experimental group II. These findings show that methanol causes damage in the photoreceptor layer of the rat retina and silymarin can protect the damage to retina against the methanol intoxication.

Keywords: ultra-structure, photoreceptor layer, methanol intoxication, silymarin, rat

Procedia PDF Downloads 287
2965 Comparative Analysis of Three Types of Recycled Aggregates and its Use in Masonry Mortar Fabrication

Authors: Mariano Gonzalez Cortina, Pablo Saiz Martinez, Francisco Fernandez Martinez, Antonio Rodriguez Sanchez

Abstract:

Construction sector incessant activity of the last years preceding the crisis has originated a high waste generation and an increased use of raw materials. The main aim of this research is to compare three types of recycled aggregates and the feasibility to incorporate them into masonry mortar fabrication. The tests were developed using two types of binders: CEM II/B-L 32.5 N and CEM IV/B (V) 32.5 N. 50%, 75% and 100% of natural sand were replaced with three types of recycled aggregates. Cement-to-aggregate by dry weight proportions were 1:3 and 1:4. Physical and chemical characterization of recycled aggregates showed continues particle size distribution curve, lower density and higher absorption, which was the reason to use additive to obtain required mortar consistency. Main crystalline phases determined in the X-Ray diffraction test were calcite, quartz, and gypsum. Performed tests show that cement-based mortars fabricated with CEM IV/B (V) 32. 5 N can incorporate recycled aggregates coming from ceramic, concrete and mixed recycling processes, using 1:3 and 1:4 cement-to-aggregate proportions, complying with the limits established by the Spanish standards. It was concluded that recycled mortar coming from concrete recycling process is the one which presents better characteristics.

Keywords: construction and demolition waste, masonry mortar, mechanical properties, recycled aggregate, waste treatment

Procedia PDF Downloads 417
2964 Experimental and Finite Element Analysis of Large Deformation Characteristics of Magnetic Responsive Hydrogel Nanocomposites Membranes

Authors: Mallikarjunachari Gangapuram

Abstract:

Stimuli-responsive hydrogel nanocomposite membranes are gaining significant attention these days due to their potential applications in various engineering fields. For example, sensors, soft actuators, drug delivery, remote controlled therapy, water treatment, shape morphing, and magnetic refrigeration are few advanced applications of hydrogel nanocomposite membranes. In this work, hydrogel nanocomposite membranes are synthesized by embedding nanometer-sized (diameter - 300 nm) Fe₃O₄ magnetic particles into the polyvinyl alcohol (PVA) polymer. To understand the large deformation characteristics of these membranes, a well-known experimental method ball indentation technique is used. Different designing parameters such as membrane thickness, the concentration of magnetic particles and ball diameter on the viscoelastic properties are studied. All the experiments are carried out without and with a static magnetic field. Finite element simulations are carried out to validate the experimental results. It is observed, the creep response decreases and Young’s modulus increases as the thickness and concentration of magnetic particles increases. Image analysis revealed the hydrogel membranes are undergone global deformation for ball diameter 18 mm and local deformation when the diameter decreases from 18 mm to 0.5 mm.

Keywords: ball indentation, hydrogel membranes, nanocomposites, Young's modulus

Procedia PDF Downloads 119
2963 Oral Toxicity of Low Doses of Fungicides, Propinebe, Propiconazole and Their Mixtures in the Male Rat

Authors: Mallem Leila, Aiche Mohamed Amine, Boulakoud Mohamed Salah

Abstract:

A number of chemical compounds are being used to protect agricultural crops from diseases. Residues of these chemicals lead to environmental pollution and pose some threat to non target organisms, human and animal. The aim of this study is to detect the toxicity of these fungicides and their mixtures in the fertility and biochemical’s parameters in the rat. The male of rats (28) were used, they were divided in four groups (7 rats of each group) and one group was used as control. Rats were dosed orally with propiconazole (60 mg/kg body weight/day), propinebe (100 mg/Kg body weight/day) and their mixture (50:50) for 4 weeks. Animals were observed for clinical toxicity. At the end of treatment period, animals of all groups were scarified and samples of different organs were fixed in the formol 10% for histopathological study, and blood was collected for hematological and biochemical’s analysis. The results indicated that the fungicide and their mixture of fungicides were toxic in the treated animals. The semen study showed a decrease in the count, mobility and speed of spermatozoa in all treated group especially those dosed with the mixture and Propiconazole, it was also a decrease in the weight of the testis and epidydimis in the treated group as compared with control. Remarquable histological changes were observed in the testis and epidydimis and liver in the group treated with mixture.

Keywords: fungicides, mixture, fertility, hematological, biochemical's parameters

Procedia PDF Downloads 564
2962 Understanding Lacan’s ‘Name of the Father’ Concept, the Original Introject, and Personality Functioning

Authors: Chloe T. Cohen, Sarah Johnson

Abstract:

Psychoanalytic literature has traditionally focused on the theoretical explanations of psychological phenomena rather than empirical research to support those ideas. Many clinicians assume a lack of empirical verification of the theories that underpin psychoanalytic treatment disqualifies psychoanalytic psychotherapy as an effective clinical technique. One such theory is Lacan’s ‘Name of the Father’, which extended Freud’s idea of the importance of a successful resolution of the Oedipal problem, situating it even earlier in psychological development. Lacan posited that the Name of the Father construct (establishing psychological structure and preventing psychosis) was best represented in language use, metaphor, and linguistic structure. However, no study to date has empirically examined the Name of the Father construct. The current study attempts to measure Lacan’s ‘Name of the Father’ construct through linguistic structure and metaphor use and to compare it with Freud’s ‘original introject’. We will then investigate whether they relate to adult personality functioning (measured using the Rorschach Inkblot Test). We aim to contribute to the empirical study of psychoanalytic concepts by operationalizing and validating the Name of the Father empirically. We also aim to examine the relationship of the Name of the Father construct to Freud’s concept of the original introject and to adult pathology. We hypothesize that measures of the original introject will mediate the pathway between linguistic indicators of Lacan’s Name of the Father construct and personality functioning.

Keywords: Lacan, Name of the Father, original introject, personality functioning, psychoanalysis

Procedia PDF Downloads 193
2961 A Quality Improvement Approach for Reducing Stigma and Discrimination against Young Key Populations in the Delivery of Sexual Reproductive Health and Rights Services

Authors: Atucungwiire Rwebiita

Abstract:

Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

Procedia PDF Downloads 167