Search results for: closest facility analysis
28270 Mathematical Modeling and Algorithms for the Capacitated Facility Location and Allocation Problem with Emission Restriction
Authors: Sagar Hedaoo, Fazle Baki, Ahmed Azab
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In supply chain management, network design for scalable manufacturing facilities is an emerging field of research. Facility location allocation assigns facilities to customers to optimize the overall cost of the supply chain. To further optimize the costs, capacities of these facilities can be changed in accordance with customer demands. A mathematical model is formulated to fully express the problem at hand and to solve small-to-mid range instances. A dedicated constraint has been developed to restrict emissions in line with the Kyoto protocol. This problem is NP-Hard; hence, a simulated annealing metaheuristic has been developed to solve larger instances. A case study on the USA-Canada cross border crossing is used.Keywords: emission, mixed integer linear programming, metaheuristic, simulated annealing
Procedia PDF Downloads 30828269 Post Occupancy Evaluation in Higher Education
Authors: Balogun Azeez Olawale, Azeez S. A.
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Post occupancy evaluation (POE) is a process of assessing building performance for its users and intended function during the occupation. User satisfaction impacts the performance of educational environments and their users: students, faculty, and staff. In addition, buildings are maintained and managed by teams that spend a large amount of time and capital on their long-term sustenance. By evaluating the feedback from users of higher education facilities, university planning departments are more prepared to understand the inputs for programming and future project planning. In addition, university buildings will be closer to meeting user and maintenance needs. This paper reports on a research team made up of academics, facility personnel, and users that have developed a plan to improve the quality of campus facilities through a POE exercise on a recently built project. This study utilized a process of focus group interviews representing the different users and subsequent surveys. The paper demonstrates both the theory and practice of POE in higher education and learning environment through the case example of four universities in Nigeria's POE exercise.Keywords: post occupancy evaluation, building performance, building analysis, building evaluation, quality control, building assessment, facility management, design quality
Procedia PDF Downloads 11128268 Medication Errors in a Juvenile Justice Youth Development Center
Authors: Tanja Salary
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This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies
Procedia PDF Downloads 6628267 Research Facility Assessment for Biomass Combustion in Moving Grate Furnaces
Authors: Francesco Gallucci, Mariangela Salerno, Ettore Guerriero, Manfredi Amalfi, Giancarlo Chiatti, Fulvio Palmieri
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The paper deals with the experimental activities on a biomass combustion test-bed. More in detail, experimental campaigns have been devoted to investigate the operation of a biomass moving grate furnace. A research-oriented facility based on a moving grate furnace (350kW) has been set up in order to perform experimental activities in a wide range of test configurations. The paper reports the description of the complete biomass-plant and the assessment of the system operation. As the first step, the chemical and physical properties of the used wooden biomass have been preliminarily investigated. Once the biomass fuel has been characterized, investigations have been devoted to point out the operation of the furnace. It has been operated at full load, highlighting the influence of biomass combustion parameters on particulate matter and gaseous emission.Keywords: biomass, combustion, experimental, pollutants
Procedia PDF Downloads 27828266 Protective Custody in Child Protection: Reflection of Residential Care Workers in the Philippines
Authors: Hazel S. Cometa-Lamberte
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This paper presents the residential care workers reflections in working with children who were under protective custody and placed in a residential care facility for children. Key informant interviews and focus group discussion were employed in this study to analyze the views of residential care workers on the programs and services and case management system in residential care for children. Results suggest that working in a residential care facility for children needs the interplay of both the worker’s personal and professional values, knowledge and skills in working with children. Analyzing the residential care workers experiences in handling children in residential care facilities is vital for the improvement of the policies, programs and services, the repertoire of techniques and facilitate the creation of a new social work practice framework/model in child protection specifically in residential care facilities.Keywords: child protection, residential care, residential care workers, social workers
Procedia PDF Downloads 17128265 Assessing the Effectiveness of Warehousing Facility Management: The Case of Mantrac Ghana Limited
Authors: Kuhorfah Emmanuel Mawuli
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Generally, for firms to enhance their operational efficiency of logistics, it is imperative to assess the logistics function. The cost of logistics conventionally represents a key consideration in the pricing decisions of firms, which suggests that cost efficiency in logistics can go a long way to improve margins. Warehousing, which is a key part of logistics operations, has the prospect of influencing operational efficiency in logistics management as well as customer value, but this potential has often not been recognized. It has been found that there is a paucity of research that evaluates the efficiency of warehouses. Indeed, limited research has been conducted to examine potential barriers to effective warehousing management. Due to this paucity of research, there is limited knowledge on how to address the obstacles associated with warehousing management. In order for warehousing management to become profitable, there is the need to integrate, balance, and manage the economic inputs and outputs of the entire warehouse operations, something that many firms tend to ignore. Management of warehousing is not solely related to storage functions. Instead, effective warehousing management requires such practices as maximum possible mechanization and automation of operations, optimal use of space and capacity of storage facilities, organization through "continuous flow" of goods, a planned system of storage operations, and safety of goods. For example, there is an important need for space utilization of the warehouse surface as it is a good way to evaluate the storing operation and pick items per hour. In the setting of Mantrac Ghana, not much knowledge regarding the management of the warehouses exists. The researcher has personally observed many gaps in the management of the warehouse facilities in the case organization Mantrac Ghana. It is important, therefore, to assess the warehouse facility management of the case company with the objective of identifying weaknesses for improvement. The study employs an in-depth qualitative research approach using interviews as a mode of data collection. Respondents in the study mainly comprised warehouse facility managers in the studied company. A total of 10 participants were selected for the study using a purposive sampling strategy. Results emanating from the study demonstrate limited warehousing effectiveness in the case company. Findings further reveal that the major barriers to effective warehousing facility management comprise poor layout, poor picking optimization, labour costs, and inaccurate orders; policy implications of the study findings are finally outlined.Keywords: assessing, warehousing, facility, management
Procedia PDF Downloads 6528264 The Importance of Fire Safety in Egypt
Authors: Omar Shakra
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This paper contains a huge number of benefits that we can use it in several places and times in fire safety protection in the Middle East especially in Egypt . People here in Egypt did not consider the safety and fire protection as important as it is. But on the other hand, its very important for them to contain the fire systems and safety in every facility, the companies , hospitals , police stations , and even the super markets must use the fire system. It makes the facility safe to the visitors while they are using it.From my point of view as the owner Fire Safety Company called Deluge Egypt , i can say that not all of the companies use the fire system protection according to the high cost they prefer to build their company without the protection, and this is make the building totally unsafe to be used from the visitors or client.So, i am looking for new methods and technology to invest in Egypt, and this is through attending this Conference and let the audiences know more about the services i provide and [to let them know about the importance of the Fire Safety in Egypt. The Objectives of my research 1- The system that i used in my Company. 2- The benefits of the Fire System Protection. 3-The importance of the Fire System and safety. 4-The use of the new Technologies. 5-The hardships that i found while having new deals with new clients.Keywords: fire, system, protection, fire hydrants, security, alarms
Procedia PDF Downloads 10928263 Analysis of the Factors of Local Acceptance of Wind Power Generation Facilities
Authors: Hyunjoo Park, Taehyun Kim, Taehyun Kim
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The government that declared 'de-nuclearization' pushes up renewable energy policies such as solar power and wind power as an alternative to nuclear power generation. However, local residents who are concerned about the development and natural disasters have been hit by opposition, and related businesses around the country are experiencing difficulties. There is also a voice saying that installing a large wind power generator will cause landslides, low frequencies and noise, which will have a bad influence. Renewal is only a harmful and disgusting facility for the residents. In this way, it is expected that extreme social conflicts will occur in the decision making process related to the locally unwanted land-use (LULU). The government's efforts to solve this problem have been steadily progressing, but the systematic methodology for bringing in active participation and opinion gathering of the residents has not yet been established except for the simple opinion poll or referendum. Therefore, it is time to identify the factors that concern the local residents about the wind power generation facilities, and to find ways to make policy decision-making possible. In this study, we analyze the perception of people about offshore and onshore wind power facilities through questionnaires or interviews, and examine quantitative and qualitative precedent studies to analyze them. In addition, the study evaluates what factors affect the local acceptance of wind power facilities. As a result of the factor analysis of the questionnaire items, factors affecting the residents' acceptance of the wind power facility were extracted from four factors such as environmental, economic, risk, social, and management factor. The study also found that the influence of the determinants of local acceptance on the regional acceptability differs according to the demographic characteristics such as gender and income level. This study will contribute to minimizing the conflict on the installation of wind power facilities through communication among the local residents.Keywords: factor analysis, local acceptance, locally unwanted land-use, LULU, wind power generation facilities
Procedia PDF Downloads 15628262 Seismicity and Source Parameter of Some Events in Abu Dabbab Area, Red Sea Coast
Authors: Hamed Mohamed Haggag
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Prior to 12 November 1955, no earthquakes have been reported from the Abu Dabbab area in the International Seismological Center catalogue (ISC). The largest earthquake in Abu Dabbab area occurred on November 12, 1955 with magnitude Mb 6.0. The closest station from the epicenter was at Helwan (about 700 km to the north), so the depth of this event is not constrained and no foreshocks or aftershocks were recorded. Two other earthquakes of magnitude Mb 4.5 and 5.2 took place in the same area on March 02, 1982 and July 02, 1984, respectively. Since the installation of Aswan Seismic Network stations in 1982, (250-300 km to the south-west of Abu Dabbab area) then the Egyptian Natoinal Seismic Network stations, it was possible to record some activity from Abu Dabbab area. The recorded earthquakes at Abu Dabbab area as recorded from 1982 to 2014 shows that the earthquake epicenters are distributed in the same direction of the main trends of the faults in the area, which is parallel to the Red Sea coast. The spectral analysis was made for some earthquakes. The source parameters, seismic moment (Mo), source dimension (r), stress drop (Δδ), and apparent stress (δ) are determined for these events. The spectral analysis technique was completed using MAG software program.Keywords: Abu Dabbab, seismicity, seismic moment, source parameter
Procedia PDF Downloads 46228261 Social Medical Club: A Social Business Policy to Ensure Quality Health Services to the Underprivileged Areas of Underdeveloped Countries
Authors: Hasan Al Banna, Nazmus Sakib, Anjan Roy
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From the perspective of the underdeveloped countries such as Bangladesh, health issue can readily be pointed out as the most demanding but the least promoted concern due to lack of initiatives from both government and NGOs. Furthermore an worldwide scenario is that most death and suffering from various pathogenic and non-pathogenic diseases occur due to delay diagnosis, and this happen for the lacking of regular health check-up facility or tradition. In this epistle, an innovative proposal on social business can be introduced to ensure the one-stop medical facility to the door-step of the rural society and create jobs for the educated rural youths to serve their own people. To illustrate the policy, this newly proposed organization will work as a health club which will offer a life-time membership to villagers within a very affordable fee of 250 BDT (2.63 Euro) per month. In this package the members will get the facility of tri-monthly full health check-up by specialist doctors, a health record book and computerized health database for each member and anytime medical consultancy for the members only. We will also organize free medical campaign and workshops on nutrition, sanitation, adulteration, pregnancy-care, child-health etc with the assistance of different sponsors. Among other services that will be provided on payment include emergency ambulance facility in low rents, quality diagnostic lab and 24-hour dispensary facility. Likewise, this policy will involve local educated people by recruiting them after providing intensive courses on nursing and other medical instrumental skills. Henceforth, the engagement of local youth will make the program more acceptable to the rural community. In the later part of this paper, a survey report on Daragram union of Manikganj district, Bangladesh, having population above 25000, will be presented to delineate the scenario how this policy can repay the initial capital expense of BDT 7 million (around 73381 Euro) within 5 years and how I can realistically earn handsome revenue from the first month of business. To recapitulate, this policy is very promising to enlighten the underprivileged community by providing health assurance, and alleviating unemployment besides the investor’s financial profit.Keywords: create job for the rural people, handsome financial profit, quality health services, underprivileged areas of underdeveloped countries
Procedia PDF Downloads 42628260 Avoiding Medication Errors in Juvenile Facilities
Authors: Tanja Salary
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This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety
Procedia PDF Downloads 8028259 Exploring the Techniques of Achieving Structural Electrical Continuity for Gas Plant Facilities
Authors: Abdulmohsen Alghadeer, Fahad Al Mahashir, Loai Al Owa, Najim Alshahrani
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Electrical continuity of steel structure members is an essential condition to ensure equipotential and ultimately to protect personnel and assets in industrial facilities. The steel structure is electrically connected to provide a low resistance path to earth through equipotential bonding to prevent sparks and fires in the event of fault currents and avoid malfunction of the plant with detrimental consequences to the local and global environment. The oil and gas industry is commonly establishing steel structure electrical continuity by bare surface connection of coated steel members. This paper presents information pertaining to a real case of exploring and applying different techniques to achieve the electrical continuity in erecting steel structures at a gas plant facility. A project was supplied with fully coated steel members even at the surface connection members that cause electrical discontinuity. This was observed while a considerable number of steel members had already been received at the job site and erected. This made the resolution of the case to use different techniques such as bolt tightening and torqueing, chemical paint stripping and single point jumpers. These techniques are studied with comparative analysis related to their applicability, workability, time and cost advantages and disadvantages.Keywords: coated Steel, electrical continuity, equipotential bonding, galvanized steel, gas plant facility, lightning protection, steel structure
Procedia PDF Downloads 12728258 90-Day Strength Training Intervention Decreases Incidence of Sarcopenia: A Pre- and Posttest Pilot Study of Older Adults in a Skilled Nursing Facility
Authors: Donna-Marie Phyllis Lanton
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Sarcopenia is a well-known geriatric syndrome characterized by the progressive and generalized loss of muscle quantity or quality. The incidence of sarcopenia increases with age and is associated with adverse outcomes such as the increased risk of falls, cognitive impairment, loss of independence, diminished quality of life, increased health costs, need for care in a skilled nursing facility, and increased mortality. Physical activity, including resistance training, is the most prevalent recommendation for treating and preventing sarcopenia. Residents (N = 23) of a skilled nursing facility in East Orlando, Florida, participated in a 90-day strength training program designed using the PARIHS framework to improve measures of muscle mass, muscle strength, physical performance, and quality of life. Residents engaged in both resistance and balance exercises for 1 hour two times a week. Baseline data were collected and compared to data at Days 30, 60, and 90. T tests indicated significant gains on all measures from baseline to 90 days: muscle mass increased by 1.2 (t[22] = 2.85, p = .009), grip strength increased by 4.02 (t[22] = 8.15, p < .001), balance increased by 2.13 (t[22] = 18.64, p < .001), gait speed increased by 1.83 (t[22] = 17.84, p < .001), chair speed increased 1.87 (t[22] = 16.36, p < .001), and quality of life score increased by 17.5 (t[22] = 19.26, p < .001). For residents with sarcopenia in skilled nursing facilities, a 90-day strength training program with resistance and balance exercises may provide an option for decreasing the incidence of sarcopenia among that populationKeywords: muscle mass, muscle strength, older adults, PARIHS framework
Procedia PDF Downloads 8828257 Comparative Analysis of Effect of Capital Structure to Profitability in Manufacturing Sector in Indonesia and Malaysia in 2009 - 2014
Authors: Hatane Semuel, Hartmann H. Ngono, Sautma R. Basana
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The effect of capital structure on profitability is often debated by many financial investigators. The application of the trade-off theory and pecking order theory to analyze this relationship may generate different views. Each company has its own strategies to achieve its objectives and the external environment, such as state policy has a broad impact on the relationship with the capital structure of the company's profitability. Malaysia is the country closest to Indonesia that had a similar growth rate of GDP and industrial production with Indonesia, but Malaysia has lower inflation rate than Indonesia. This study was conducted to compare the performance of manufacturing sector between two countries when entering the era of the ASEAN Economic Community (AEC). The samples for this study were 69 companies in Indonesia and 242 companies in Malaysia that engaged in manufacturing sector. The study uses panel data analysis. The study found that the capital structure have positive effect on profitability of manufacturing company in Indonesia, and it turns to negative effect on manufacturing companies in Malaysia. The results also showed that there are significant differences in short-term debt towards profitability of manufacturing companies in the two countries Indonesia and Malaysia.Keywords: capital structure, Indonesia, Malaysia, manufacturing, profitability
Procedia PDF Downloads 38228256 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh
Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen
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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers
Procedia PDF Downloads 19128255 A Study on the Nostalgia Contents Analysis of Hometown Alumni in the Online Community
Authors: Heejin Yun, Juanjuan Zang
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This study aims to analyze the text terms posted on an online community of people from the same hometown and to understand the topic and trend of nostalgia composed online. For this purpose, this study collected 144 writings which the natives of Yeongjong Island, Incheon, South-Korea have posted on an online community. And it analyzed association relations. As a result, online community texts means that just defining nostalgia as ‘a mind longing for hometown’ is not an enough explanation. Second, texts composed online have abstractness rather than persons’ individual stories. This study figured out the relationship that had the most critical and closest mutual association among the terms that constituted nostalgia through literature research and association rule concerning nostalgia. The result of this study has a characteristic that it summed up the core terms and emotions related to nostalgia.Keywords: nostalgia, cultural memory, data mining, association rule
Procedia PDF Downloads 22928254 Facility Detection from Image Using Mathematical Morphology
Authors: In-Geun Lim, Sung-Woong Ra
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As high resolution satellite images can be used, lots of studies are carried out for exploiting these images in various fields. This paper proposes the method based on mathematical morphology for extracting the ‘horse's hoof shaped object’. This proposed method can make an automatic object detection system to track the meaningful object in a large satellite image rapidly. Mathematical morphology process can apply in binary image, so this method is very simple. Therefore this method can easily extract the ‘horse's hoof shaped object’ from any images which have indistinct edges of the tracking object and have different image qualities depending on filming location, filming time, and filming environment. Using the proposed method by which ‘horse's hoof shaped object’ can be rapidly extracted, the performance of the automatic object detection system can be improved dramatically.Keywords: facility detection, satellite image, object, mathematical morphology
Procedia PDF Downloads 38128253 Young Adult Gay Men's Healthcare Access in the Era of the Affordable Care Act
Authors: Marybec Griffin
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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act
Procedia PDF Downloads 23928252 Protection of Patients and Staff in External Beam Radiotherapy Using Linac in Kenya
Authors: Calvince Okome Odeny
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There is a current action to increase radiotherapy services in Kenya. The National government of Kenya, in collaboration with the county governments, has embarked on building radiotherapy centers in all 47 regions of the country. As these new centers are established in Kenya, it has to be ensured that minimum radiation safety standards are in place prior to operation. For full implementation of this, it is imperative that more Research and training for regulators are done on radiation protection, and safety and national regulatory infrastructure is geared towards ensuring radiation protection and safety in all aspects of the use of external radiotherapy practices. The present work aims at reviewing the level of protection and safety for patients and staff during external beam radiotherapy using Linac in Kenya and provides relevant guidance to improve protection and safety. A retrospective evaluation was done to verify whether those occupationally exposed workers and patients are adequately protected from the harmful effect of radiation exposure during the treatment procedures using Linac. The project was experimental Research, also including an analysis of resource documents obtained from the literature and international organizations. The critical findings of the work revealed that the key elements of protection of occupationally exposed workers and patients include a comprehensive quality Management system governing all planned activities from siting, safety, and design of the Facility, construction, acceptance testing, commissioning, operation, and decommissioning of the Facility; Government empowering the Regulatory Authority to license Medical Linear facilities and to enforce the applicable regulations to ensure adequate protection; A comprehensive Radiation Protection and Safety program must be established to ensure adequate safety and protection of workers and patients during treatment planning and treatment delivery of patients and categories of staff associated with the Facility must be well educated and trained to perform professionally with a commitment to sound safety culture. Relevant recommendations from the findings are shared with the Medical Linear Accelerator facilities and the regulatory authority to provide guidance and continuous improvement of protection and safety to improve regulatory oversight.Keywords: oncology, radiotherapy, protection, staff
Procedia PDF Downloads 7528251 Long-term Care Facility for the Elderly and Its Relationship with Energy Efficiency
Authors: Gabriela Sardinha Pacheco
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In a context of elderly population growth, the need to provide high quality infrastructure and services to these people becomes even more evident. The act of designing a space dedicated to elderly people goes beyond the concept of well-being and reaches to a point of evaluating and changing the way which society sees this part of the population as well as how it can build a relationship with energy efficiency. In this context, the care facilities for elderly have an extremely important role to provide this infrastructure to the population. A common issue is that, for many times, these facilities face financial issues, and the full operation of the establishment can be impacted. The intention of this work is to develop a project in which the energy efficiency measures can be lived daily and that the residents of the institution can participate actively, directly, or indirectly in the construction of this relationship. The use of energy efficiency strategies should become a natural process when thinking about buildings as it is an essential step to provide increased well-being, climate change mitigation, and cost reduction.Keywords: energy efficiency, environmental comfort, long-term care facility, well-being
Procedia PDF Downloads 5728250 Challenges of Management of Acute Pancreatitis in Low Resource Setting
Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali
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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.Keywords: acute pancreatitis, challenges of management, severity, prognosis
Procedia PDF Downloads 12928249 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia
Authors: Dinka Fikadu, Mulugeta Shegaze
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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.Keywords: utilization, human immune deficiency, testing, provider, initiate
Procedia PDF Downloads 30328248 Evidence Theory Based Emergency Multi-Attribute Group Decision-Making: Application in Facility Location Problem
Authors: Bidzina Matsaberidze
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It is known that, in emergency situations, multi-attribute group decision-making (MAGDM) models are characterized by insufficient objective data and a lack of time to respond to the task. Evidence theory is an effective tool for describing such incomplete information in decision-making models when the expert and his knowledge are involved in the estimations of the MAGDM parameters. We consider an emergency decision-making model, where expert assessments on humanitarian aid from distribution centers (HADC) are represented in q-rung ortho-pair fuzzy numbers, and the data structure is described within the data body theory. Based on focal probability construction and experts’ evaluations, an objective function-distribution centers’ selection ranking index is constructed. Our approach for solving the constructed bicriteria partitioning problem consists of two phases. In the first phase, based on the covering’s matrix, we generate a matrix, the columns of which allow us to find all possible partitionings of the HADCs with the service centers. Some constraints are also taken into consideration while generating the matrix. In the second phase, based on the matrix and using our exact algorithm, we find the partitionings -allocations of the HADCs to the centers- which correspond to the Pareto-optimal solutions. For an illustration of the obtained results, a numerical example is given for the facility location-selection problem.Keywords: emergency MAGDM, q-rung orthopair fuzzy sets, evidence theory, HADC, facility location problem, multi-objective combinatorial optimization problem, Pareto-optimal solutions
Procedia PDF Downloads 9228247 Multilevel Modelling of Modern Contraceptive Use in Nigeria: Analysis of the 2013 NDHS
Authors: Akiode Ayobami, Akiode Akinsewa, Odeku Mojisola, Salako Busola, Odutolu Omobola, Nuhu Khadija
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Purpose: Evidence exists that family planning use can contribute to reduction in infant and maternal mortality in any country. Despite these benefits, contraceptive use in Nigeria still remains very low, only 10% among married women. Understanding factors that predict contraceptive use is very important in order to improve the situation. In this paper, we analysed data from the 2013 Nigerian Demographic and Health Survey (NDHS) to better understand predictors of contraceptive use in Nigeria. The use of logistics regression and other traditional models in this type of situation is not appropriate as they do not account for social structure influence brought about by the hierarchical nature of the data on response variable. We therefore used multilevel modelling to explore the determinants of contraceptive use in order to account for the significant variation in modern contraceptive use by socio-demographic, and other proximate variables across the different Nigerian states. Method: This data has a two-level hierarchical structure. We considered the data of 26, 403 married women of reproductive age at level 1 and nested them within the 36 states and the Federal Capital Territory, Abuja at level 2. We modelled use of modern contraceptive against demographic variables, being told about FP at health facility, heard of FP on TV, Magazine or radio, husband desire for more children nested within the state. Results: Our results showed that the independent variables in the model were significant predictors of modern contraceptive use. The estimated variance component for the null model, random intercept, and random slope models were significant (p=0.00), indicating that the variation in contraceptive use across the Nigerian states is significant, and needs to be accounted for in order to accurately determine the predictors of contraceptive use, hence the data is best fitted by the multilevel model. Only being told about family planning at the health facility and religion have a significant random effect, implying that their predictability of contraceptive use varies across the states. Conclusion and Recommendation: Results showed that providing FP information at the health facility and religion needs to be considered when programming to improve contraceptive use at the state levels.Keywords: multilevel modelling, family planning, predictors, Nigeria
Procedia PDF Downloads 41828246 The Political Economy of the Global Climate Change Adaptation Initiatives: A Case Study on the Global Environmental Facility
Authors: Anar Koli
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After the Paris agreement in 2015, a comprehensive initiative both from the developed and developing countries towards the adaptation to climate change is emerging. The Global Environmental Facility (GEF), which is financing a global portfolio of adaptation projects and programs in over 124 countries is playing a significant role to a new financing framework that included the concept of “climate-resilient development”. However, both the adaptation and sustainable development paradigms remain continuously contested, especially the role of the multilateral institutions with their technical and financial assistance to the developing world. Focusing on the adaptation initiatives of the GEF, this study aims to understand to what extent the global multilateral institutions, particularly the GEF is contributing to the climate-resilient development. From the political ecology perspective, the argument of this study is that the global financial framework is highly politicized, and understanding the contribution of the global institutions of the global climate change needs to be related both from the response and causal perspectives. A holistic perspective, which includes the contribution of the GEF as a response to the climate change and as well the cause of global climate change, are needed to understand the broader environment- political economic relation. The study intends to make a critical analysis of the way in which the political economy structure and the environment are related along with the social and ecological implications. It does not provide a narrow description of institutional responses to climate change, rather it looks at how the global institutions are influencing the relationship of the global ecologies and economies. This study thus developed a framework combining the global governance and the political economy perspective. This framework includes environment-society relation, environment-political economy linkage, global institutions as the orchestra, and division between the North and the South. Through the analysis of the GEF as the orchestra of the global governance, this study helps to understand how GEF is coordinating the interactions between the North and the South and responding the global climate resilient development. Through the other components of the framework, the study explains how the role of the global institutions is related to the cause of the human induced global climate change. The study employs a case study based on both the quantitative and qualitative data. Along with the GEF reports and data sets, this study draws from an eclectic range of literature from a range of disciplines to explain the broader relation of the environment and political economy. Based on a case study on GEF, the study found that the GEF has positive contributions in bringing developing countries’ capacity in terms of sustainable development goal, local institutional development. However, through a critical holistic analysis, this study found that this contribution to the resilient development helps the developing countries to conform the fossil fuel based capitalist political economy. The global governance institution is contributing both to the pro market based environment society relation and, to the consequences of this relation.Keywords: climate change adaptation, global environmental facility (GEF), political economy, the north -south relation
Procedia PDF Downloads 22728245 Proposal for a Generic Context Meta-Model
Authors: Jaouadi Imen, Ben Djemaa Raoudha, Ben Abdallah Hanene
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The access to relevant information that is adapted to users’ needs, preferences and environment is a challenge in many applications running. That causes an appearance of context-aware systems. To facilitate the development of this class of applications, it is necessary that these applications share a common context meta-model. In this article, we will present our context meta-model that is defined using the OMG Meta Object facility (MOF). This meta-model is based on the analysis and synthesis of context concepts proposed in literature.Keywords: context, meta-model, MOF, awareness system
Procedia PDF Downloads 56028244 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 21628243 Smart Safari: Safari Guidance Mobile Application
Authors: D. P. Lawrence, T. M. M. D. Ariyarathna, W. N. K. De Silva, M. D. S. C. De Silva, Lasantha Abeysiri, Pradeep Abeygunawardhna
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Safari traveling is one of the most famous hobbies all over the world. In Sri Lanka, 'Yala' is the second-largest national park, which is a better place to go for a safari. Many number of local and foreign travelers are coming to go for a safari in 'Yala'. But 'Yala' does not have a mobile application that is made to facilitate the traveler with some important features that the traveler wants to achieve in the safari experience. To overcome these difficulties, the proposed mobile application by adding those identified features to make travelers, guiders, and administration's works easier. The proposed safari traveling guidance mobile application is called 'SMART SAFARI' for the 'Yala' National Park in Sri Lanka. There are four facilities in this mobile application that provide for travelers as well as the guiders. As the first facility, the guider and traveler can view the created map of the park, and the guider can add temporary locations of animals and special locations on the map. This is a Geographic Information System (GIS) to capture, analyze, and display geographical data. And as the second facility is to generate optimal paths according to the travelers' requirements through the park by using machine learning techniques. In the third part, the traveler can get information about animals using an animal identification system by capturing the animal. As in the other facility, the traveler will be facilitated to add reviews and a rate and view those comments under categorized sections and pre-defined score range. With those facilities, this user-friendly mobile application provides the user to get a better experience in safari traveling, and it will probably help to develop tourism culture in Sri Lanka.Keywords: animal identification system, geographic information system, machine learning techniques, pre defined score range
Procedia PDF Downloads 13328242 Fusion Neutron Generator Dosimetry and Applications for Medical, Security, and Industry
Authors: Kaouther Bergaui, Nafaa Reguigui, Charles Gary
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Characterization and the applications of deuterium-deuterium (DD) neutron generator developed by Adelphie technology and acquired by the National Centre of Nuclear Science and Technology (NCNST) were presented in this work. We study the performance of the neutron generator in terms of neutron yield, production efficiency, and the ionic current as a function of the acceleration voltage at various RF powers. We provide the design and optimization of the PGNAA chamber and thus give insight into the capabilities of the planned PGNAA facility. Additional non-destructive techniques were studied employing the DD neutron generator, such as PGNAA and neutron radiography: The PGNAA is used for determining the concentration of 10B in Si and SiO2 matrices by using a germanium detector HPGe and the results obtained are compared with PGNAA system using a Sodium Iodide detector (NaI (Tl)); Neutron radiography facility was tested and simulated, using a camera device CCD and simulated by the Monte Carlo code; and the explosive detection system (EDS) also simulated using the Monte Carlo code. The study allows us to show that the new models of DD neutron generators are feasible and that superior-quality neutron beams could be produced and used for various applications. The feasibility of Boron neutron capture therapy (BNCT) for cancer treatment using a neutron generator was assessed by optimizing Beam Shaping Assembly (BSA) on a phantom using Monte-Carlo (MCNP6) simulations.Keywords: neutron generator deuterium-deuterium, Monte Carlo method, radiation, neutron flux, neutron activation analysis, born, neutron radiography, explosive detection, BNCT
Procedia PDF Downloads 19328241 Pattern of Stress Distribution in Different Ligature-Wire-Brackets Systems: A FE and Experimental Analysis
Authors: Afef Dridi, Salah Mezlini
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Since experimental devices cannot calculate stress and deformation of complex structures. The Finite Element Method FEM has been widely used in several fields of research. One of these fields is orthodontics. The advantage of using such a method is the use of an accurate and non invasive method that allows us to have a sufficient data about the physiological reactions can happening in soft tissues. Most of researches done in this field were interested in the study of stresses and deformations induced by orthodontic apparatus in soft tissues (alveolar tissues). Only few studies were interested in the distribution of stress and strain in the orthodontic brackets. These studies, although they tried to be as close as possible to real conditions, their models did not reproduce the clinical cases. For this reason, the model generated by our research is the closest one to reality. In this study, a numerical model was developed to explore the stress and strain distribution under the application of real conditions. A comparison between different material properties was also done.Keywords: visco-hyperelasticity, FEM, orthodontic treatment, inverse method
Procedia PDF Downloads 259