Search results for: river improvement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5271

Search results for: river improvement

4101 Effect of Muscle Energy Technique on Anterior Pelvic Tilt in Lumbar Spondylosis Patients

Authors: Enas El Sayed Abutaleb, Mohamed Taher Eldesoky, Shahenda Abd El Rasol

Abstract:

Background: Muscle energy techniques (MET) have been widely used by manual therapists over the past years, but still limited research validated its use and there was limited evidence to substantiate the theories used to explain its effects. Objective: To investigate the effect of muscle energy technique (MET) on anterior pelvic tilt in patients with lumbar spondylosis. Design: Randomized controlled trial. Subjects: Thirty patients with anterior pelvic tilt from both sexes were involved, aged between 35 to 50 years old and they were divided into MET and control groups with 15 patients in each. Methods: All patients received 3 sessions/week for 4 weeks where the study group received MET, Ultrasound and Infrared, and the control group received U.S and I.R only. Pelvic angle was measured by palpation meter, pain severity by the visual analogue scale and functional disabilities by the Oswestry disability index. Results: Both groups showed significant improvement in all measured variables. The MET group was significantly better than the control group in pelvic angle, pain severity, and functional disability as p-value were (0.001, 0.0001, 0.0001) respectively. Conclusion and implication: The study group fulfilled greater improvement in all measured variables than the control group which implies that application of MET in combination with U.S and I.R were more effective in improving pelvic tilting angle, pain severity and functional disabilities than using electrotherapy only.

Keywords: anterior pelvic tilt, lumbar spondylosis, muscle energy technique exercise, pelvic tilting angle

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4100 Development of Non-Structural Crushed Palm Kernel Shell Fine Aggregate Concrete

Authors: Kazeem K. Adewole, Ismail A. Yahya

Abstract:

In the published literature, Palm Kernel Shell (PKS), an agricultural waste has largely been used as a large aggregate in PKS concrete production. In this paper, the development of Crushed Palm Kernel Shell Fine Aggregate Concrete (CPKSFAC) with crushed PKS (CPKS) as the fine aggregate and granite as the coarse aggregate is presented. 100mm x 100mm x 100mm 1:11/2:3 and 1:2:4 CPKSFAC and River Sand Fine Aggregate Concrete (RSFAC) cubes were molded, cured for 28 days and subjected to a compressive strength test. The average wet densities of the 1:11/2:3 and 1:2:4 CPKSFAC cubes are 2240kg/m3 and 2335kg/m3 respectively. The average wet densities of the 1:11/2:3 and 1:2:4 RSFAC cubes are 2606kg/m3 and 2553kg/m3 respectively. The average compressive strengths of the 1:11/2:3 and 1:2:4 CPKSFAC cubes are 15.40MPa and 14.30MPa respectively. This study demonstrates that CPKSFA is suitable for the production of non-structural C8/10 and C12/15 concrete specified in BS EN 206-1:2000.

Keywords: crushed palm kernel shell, fine aggregate, lightweight concrete, non-structural concrete

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4099 Role of Zinc Adminstration in Improvement of Faltering Growth in Egyption Children at Risk of Environmental Enteric Dysfunction

Authors: Ghada Mahmoud El Kassas, Maged Atta El Wakeel

Abstract:

Background: Environmental enteric dysfunction (EED) is impending trouble that flared up in the last decades to be pervasive in infants and children. EED is asymptomatic villous atrophy of the small bowel that is prevalent in the developing world and is associated with altered intestinal function and integrity. Evidence has suggested that supplementary zinc might ameliorate this damage by reducing gastrointestinal inflammation and may also benefit cognitive development. Objective: We tested whether zinc supplementation improves intestinal integrity, growth, and cognitive function in stunted children predicted to have EED. Methodology: This case–control prospective interventional study was conducted on 120 Egyptian Stunted children aged 1-10 years who recruited from the Nutrition clinic, the National research center, and 100 age and gender-matched healthy children as controls. At the primary phase of the study, Full history taking, clinical examination, and anthropometric measurements were done. Standard deviation score (SDS) for all measurements were calculated. Serum markers as Zonulin, Endotoxin core antibody (EndoCab), highly sensitive C-reactive protein (hsCRP), alpha1-acid glycoprotein (AGP), Tumor necrosis factor (TNF), and fecal markers such as myeloperoxidase (MPO), neopterin (NEO), and alpha-1-anti-trypsin (AAT) (as predictors of EED) were measured. Cognitive development was assessed (Bayley or Wechsler scores). Oral zinc at a dosage of 20 mg/d was supplemented to all cases and followed up for 6 months, after which the 2ry phase of the study included the previous clinical, laboratory, and cognitive assessment. Results: Serum and fecal inflammatory markers were significantly higher in cases compared to controls. Zonulin (P < 0.01), (EndoCab) (P < 0.001) and (AGP) (P < 0.03) markedly decreased in cases at the end of 2ry phase. Also (MPO), (NEO), and (AAT) showed a significant decline in cases at the end of the study (P < 0.001 for all). A significant increase in mid-upper arm circumference (MUAC) (P < 0.01), weight for age z-score, and skinfold thicknesses (P< 0.05 for both) was detected at end of the study, while height was not significantly affected. Cases also showed significant improvement of cognitive function at phase 2 of the study. Conclusion: Intestinal inflammatory state related to EED showed marked recovery after zinc supplementation. As a result, anthropometric and cognitive parameters showed obvious improvement with zinc supplementation.

Keywords: stunting, cognitive function, environmental enteric dysfunction, zinc

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4098 Global Peace and Security: The Role of International Peace and Security Organizations and the Need for Institutional and Operational Reforms

Authors: Saint C. Nguedjip

Abstract:

This paper is an analytical review a set of 20 literatures as required by the assignment prompt. The review centers on global peace and security. What role do international organizations play in global peace and security? The review centers around three main points. First, I examine global peace and security impacts on global governance. Secondly, it highlights the role traditional international community and security organizations such as the United Nations (UN), the North Atlantic Treaty Organization (NATO), and others play in providing the globe with peace and collective security. Third, it suggests a way forward as those institutions seek betterment and improvement. The review begins by defining some concepts and addressing the ambivalent meaning of peace and war. Scholars and researchers have conducted extensive research on the importance of international organizations. Yet, there is still a lot to consider if betterment and improvement are on the agenda. The review will shed light on the failures and challenges that these organizations. Those challenges are continuously undermining peacebuilding and peacekeeping actions of a great number among those institutions created with an ultimate mission of keeping the world order organized and coordinated for peace and security regardless of differences, cultures, and backgrounds. Women face violence on a daily basis, while racism and discrimination cause klm; ]]];inflammations worldwide. The chaotic situation in Ukraine is a wake-up call on scholarship and practitioners alike to come up with suggestions as well as recommendations that help mitigate insecurity while promoting peace and security, not only for Ukrainians but also for all countries facing wars and others issues. This paper will point the audience toward the right direction.

Keywords: security, peace, global governance, global peace and security, peacekeeping, international organizations, human rights, multilateralism, and unilateralism, gender, women

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4097 Polycyclic Aromatic Hydrocarbons: Pollution and Ecological Risk Assessment in Surface Soil of the Tezpur Town, on the North Bank of the Brahmaputra River, Assam, India

Authors: Kali Prasad Sarma, Nibedita Baul, Jinu Deka

Abstract:

In the present study, pollution level of polycyclic aromatic hydrocarbon (PAH) in surface soil of historic Tezpur town located in the north bank of the River Brahmaputra were evaluated. In order to determine the seasonal distribution and concentration level of 16 USEPA priority PAHs surface soil samples were collected from 12 different sampling sites with various land use type. The total concentrations of 16 PAHs (∑16 PAHs) varied from 242.68µgkg-1to 7901.89µgkg-1. Concentration of total probable carcinogenic PAH ranged between 7.285µgkg-1 and 479.184 µgkg-1 in different seasons. However, the concentration of BaP, the most carcinogenic PAH, was found in the range of BDL to 50.01 µgkg-1. The composition profiles of PAHs in 3 different seasons were characterized by following two different types of ring: (1) 4-ring PAHs, contributed to highest percentage of total PAHs (43.75%) (2) while in pre- and post- monsoon season 3- ring compounds dominated the PAH profile, contributing 65.58% and 74.41% respectively. A high PAHs concentration with significant seasonality and high abundance of LMWPAHs was observed in Tezpur town. Soil PAHs toxicity was evaluated taking toxic equivalency factors (TEFs), which quantify the carcinogenic potential of other PAHs relative to BaP and estimate benzo[a]pyrene-equivalent concentration (BaPeq). The calculated BaPeq value signifies considerable risk to contact with soil PAHs. We applied cluster analysis and principal component analysis (PCA) with multivariate linear regression (MLR) to apportion sources of polycyclic aromatic hydrocarbons (PAHs) in surface soil of Tezpur town, based on the measured PAH concentrations. The results indicate that petrogenic and pyrogenic sources are the important sources of PAHs. A combination of chemometric and molecular indices were used to identify the sources of PAHs, which could be attributed to vehicle emissions, a mixed source input, natural gas combustion, wood or biomass burning and coal combustion. Source apportionment using absolute principle component scores–multiple linear regression showed that the main sources of PAHs are 22.3% mix sources comprising of diesel and biomass combustion and petroleum spill,13.55% from vehicle emission, 9.15% from diesel and natural gas burning, 38.05% from wood and biomass burning and 16.95% contribute coal combustion. Pyrogenic input was found to dominate source of PAHs origin with more contribution from vehicular exhaust. PAHs have often been found to co-emit with other environmental pollutants like heavy metals due to similar source of origin. A positive correlation was observed between PAH with Cr and Pb (r2 = 0.54 and 0.55 respectively) in monsoon season and PAH with Cd and Pb (r2 = 0.54 and 0.61 respectively) indicating their common source. Strong correlation was observed between PAH and OC during pre- and post- monsoon (r2=0.46 and r2=0.65 respectively) whereas during monsoon season no significant correlation was observed (r2=0.24).

Keywords: polycyclic aromatic hydrocarbon, Tezpur town, chemometric analysis, ecological risk assessment, pollution

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4096 Proposal of Blue and Green Infrastructure for the Jaguaré Stream Watershed, São Paulo, Brazil

Authors: Juliana C. Alencar, Monica Ferreira do Amaral Porto

Abstract:

The blue-green infrastructure in recent years has been pointed out as a possibility to increase the environmental quality of watersheds. The regulation ecosystem services brought by these areas are many, such as the improvement of the air quality of the air, water, soil, microclimate, besides helping to control the peak flows and to promote the quality of life of the population. This study proposes a blue-green infrastructure scenario for the Jaguaré watershed, located in the western zone of the São Paulo city in Brazil. Based on the proposed scenario, it was verified the impact of the adoption of the blue and green infrastructure in the control of the peak flow of the basin, the benefits for the avifauna that are also reflected in the flora and finally, the quantification of the regulation ecosystem services brought by the adoption of the scenario proposed. A survey of existing green areas and potential areas for expansion and connection of these areas to form a network in the watershed was carried out. Based on this proposed new network of green areas, the peak flow for the proposed scenario was calculated with the help of software, ABC6. Finally, a survey of the ecosystem services contemplated in the proposed scenario was made. It was possible to conclude that the blue and green infrastructure would provide several regulation ecosystem services for the watershed, such as the control of the peak flow, the connection frame between the forest fragments that promoted the environmental enrichment of these fragments, improvement of the microclimate and the provision of leisure areas for the population.

Keywords: green and blue infrastructure, sustainable drainage, urban waters, ecosystem services

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4095 Slope Stability Assessment of Himalayan Slope under Static and Seismic Conditions

Authors: P. Singh, S. Mittal

Abstract:

Stability of slope in Chamoli Distt. near River Alaknanda in Uttarakhand is essential to safeguard the infrastructure of the slope where a dam is proposed to be built near this slope. Every year the areas near the slope have been facing severe landslides (small or big) due to intensive precipitation inflicting substantial damages as per Geological Survey of India records. The stability analysis of the slope under static and pseudo static conditions are presented in this study by using FEM software PHASE2. As per the earthquake zonation map of India, the slope is found in zone V, and hence, pseudo static stability of slope has been performed considering pseudo static analysis. For analysing the slope Mohr-Coulomb shear strength criteria is adopted for soil material and self-drilling anchors are modelled as bolts with parameters like modulus of elasticity, diameter of anchors and peak pull-out resistance of the anchors with the soil present there. The slope is found to be unstable under pseudo static conditions with computed factor of safety= 0.93. Stability is provided to the slope by using Self Drilling Anchors (SDA) which gives factor of safety= 1.15 under pseudo static condition.

Keywords: FEM, pseudo static, self-drilling anchors, slope stability

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4094 Learning Communities and Collaborative Reflection for Teaching Improvement

Authors: Mariana Paz Sajon, Paula Cecilia Primogerio, Mariana Albarracin

Abstract:

This study recovers an experience of teacher training carried out in an Undergraduate Business School from a private university in Buenos Aires, Argentina. The purpose of the project was to provide teachers with an opportunity to reflect on their teaching practices at the university. The aim of the study is to systematize lessons and challenges that emerge from this teacher training experience. A group of teachers who showed a willingness to learn teaching abilities was selected to work. They completed a formative journey working in learning communities starting from the immersion in different aspects of teaching and learning, class observations, and an individual and collaborative reflection exercise in a systematic way among colleagues. In this study, the productions of the eight teachers who are members of the learning communities are analyzed, framed in an e-portfolio that they prepared during the training journey. The analysis shows that after the process of shared reflection, traits related to powerful teaching and meaningful learning have appeared in the classes. For their part, teachers reflect having reached an awareness of their own practices, identifying strengths and opportunities for improvement, and the experience of sharing their own way and knowing the successes and failures of others was valued. It is an educational journey of pedagogical transformation of the teachers, which is infrequent in business education, which could lead to a change in teaching practices for the entire Business School. The present study involves theoretical and pedagogic aspects of education in a business school in Argentina and its flow-on implications for the workplace that may be transferred to other educational contexts.

Keywords: Argentina, learning community, meaningful learning, powerful teaching, reflective practice

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4093 Identification of Superior Cowpea Mutant Genotypes, Their Adaptability, and Stability Under South African Conditions

Authors: M. Ntswane, N. Mbuma, M. Labuschagne, A. Mofokeng, M. Rantso

Abstract:

Cowpea is an essential legume for the nutrition and health of millions of people in different regions. The production and productivity of the crop are very limited in South Africa due to a lack of adapted and stable genotypes. The improvement of nutritional quality is made possible by manipulating the genes of diverse cowpea genotypes available around the world. Assessing the adaptability and stability of the cowpea mutant genotypes for yield and nutritional quality requires examining them in different environments. The objective of the study was to determine the adaptability and stability of cowpea mutant genotypes under South African conditions and to identify the superior genotypes that combine grain yield components, antioxidants, and nutritional quality. Thirty-one cowpea genotypes were obtained from the Agricultural Research Council grain crops (ARC-GC) and were planted in Glen, Mafikeng, Polokwane, Potchefstroom, Taung, and Vaalharts during the 2021/22 summer cropping season. Significant genotype by location interactions indicated the possibility of genetic improvement of these traits. The genotype plus genotype by environment indicated broad adaptability and stability of mutant genotypes. The principal component analysis identified the association of the genotypes with the traits. Phenotypic correlation analysis showed that Zn and protein content were significant and positively correlated and suggested the possibility of indirect selection of these traits. Results from this study could be used to help plant breeders in making informed decisions and developing nutritionally improved cowpea genotypes with the aim of addressing the challenges of poor nutritional quality.

Keywords: cowpea seeds, adaptability, stability, mineral elements, protein content

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4092 Postharvest Losses and Handling Improvement of Organic Pak-Choi and Choy Sum

Authors: Pichaya Poonlarp, Danai Boonyakiat, C. Chuamuangphan, M. Chanta

Abstract:

Current consumers’ behavior trends have changed towards more health awareness, the well-being of society and interest of nature and environment. The Royal Project Foundation is, therefore, well aware of organic agriculture. The project only focused on using natural products and utilizing its highland biological merits to increase resistance to diseases and insects for the produce grown. The project also brought in basic knowledge from a variety of available research information, including, but not limited to, improvement of soil fertility and a control of plant insects with biological methods in order to lay a foundation in developing and promoting farmers to grow quality produce with a high health safety. This will finally lead to sustainability for future highland agriculture and a decrease of chemical use on the highland area which is a source of natural watershed. However, there are still shortcomings of the postharvest management in term of quality and losses, such as bruising, rottenness, wilting and yellowish leaves. These losses negatively affect the maintenance and a shelf life of organic vegetables. Therefore, it is important that a research study of the appropriate and effective postharvest management is conducted for an individual organic vegetable to minimize product loss and find root causes of postharvest losses which would contribute to future postharvest management best practices. This can be achieved through surveys and data collection from postharvest processes in order to conduct analysis for causes of postharvest losses of organic pak-choi, baby pak-choi, and choy sum. Consequently, postharvest losses reduction strategies of organic vegetables can be achieved. In this study, postharvest losses of organic pak choi, baby pak-choi, and choy sum were determined at each stage of the supply chain starting from the field after harvesting, at the Development Center packinghouse, at Chiang Mai packinghouse, at Bangkok packing house and at the Royal Project retail shop in Chiang Mai. The results showed that postharvest losses of organic pak-choi, baby pak-choi, and choy sum were 86.05, 89.05 and 59.03 percent, respectively. The main factors contributing to losses of organic vegetables were due to mechanical damage and underutilized parts and/or short of minimum quality standard. Good practices had been developed after causes of losses were identified. Appropriate postharvest handling and management, for example, temperature control, hygienic cleaning, and reducing the duration of the supply chain, postharvest losses of all organic vegetables should be able to remarkably reduced postharvest losses in the supply chain.

Keywords: postharvest losses, organic vegetables, handling improvement, shelf life, supply chain

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4091 Effects of Dietary Canola Oil and Vitamin E on Sperm Motility in Kurdish Ram

Authors: A. Pirestani, M. Alirezaie, S. Safavipour

Abstract:

The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter wasn’t significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram. The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter was not significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram. The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter wasn’t significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram. The present study was designed to investigate the effect of dietary canola oil and Vit E on sperm motility parameters. Sixteen Kurdish rams were selected with weight average 54.47±2.58 and with year of 3 to 4 approximately and divided to four experimental groups as randomly. Experimental groups were control, Vit E (20 IU in diet), canola oil (2.5% of DMI) and Vit E (20 IU in diet) + Canola oil (2.5% of DMI). Sperm was collected by electroejaculation at 6 week and 11 week after begging of experiment and sperm motility was analyzed by using CASA software. The results showed that motility parameter wasn’t significant difference between whole experimental groups at first time (week 6) but PM% and TM% was significant difference in canola oil and Vit E at second time (week 11), separately. It was concluded that Vit E and canola oil improvement sperm motility in Kurdish ram.

Keywords: canola oil, motility, ram, sperm, Vit E

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4090 Forest Fire Risk Mapping Using Analytic Hierarchy Process and GIS-Based Application: A Case Study in Hua Sai District, Thailand

Authors: Narissara Nuthammachot, Dimitris Stratoulias

Abstract:

Fire is one of the main causes of environmental and ecosystem change. Therefore, it is a challenging task for fire risk assessment fire potential mapping. The study area is Hua Sai district, Nakorn Sri Thammarat province, which covers in a part of peat swamp forest areas. 55 fire points in peat swamp areas were reported from 2012 to 2016. Analytic Hierarchy Process (AHP) and Geographic Information System (GIS) methods were selected for this study. The risk fire area map was arranged on these factors; elevation, slope, aspect, precipitation, distance from the river, distance from town, and land use. The results showed that the predicted fire risk areas are found to be in appreciable reliability with past fire events. The fire risk map can be used for the planning and management of fire areas in the future.

Keywords: analytic hierarchy process, fire risk assessment, geographic information system, peat swamp forest

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4089 Improvement of Visual Acuity in Patient Undergoing Occlusion Therapy

Authors: Rajib Husain, Mezbah Uddin, Mohammad Shamsal Islam, Rabeya Siddiquee

Abstract:

Purpose: To determine the improvement of visual acuity in patients undergoing occlusion therapy. Methods: This was a prospective hospital-based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 32 refractive amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 5 to 8 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over a month, then occlusion treatment was started. Occlusion was done daily for 6-8 h together with vision therapy. The occlusion was carried out for three months. Results: Out of study 32 children, 31 of them have a good compliance of amblyopic treatment whereas one child has poor compliance. About 6% Children have amblyopia from Myopia, 7% Hyperopia, 32% from myopic astigmatism, 42% from hyperopic astigmatism and 13% have mixed astigmatism. The mean and Standard deviation of present average VA was 0.452±0.275 Log MAR and after an intervention of amblyopia therapy with vision therapy mean and Standard deviation VA was 0.155±0.157 Log MAR. Out of total respondent 21.85% have BCVA in range from (0-.2) log MAR, 37.5% have BCVA in range from (0.22-0.5) log MAR, 35.95% have in range from (0.52-0.8) log MAR, 4.7% have in range from (0.82-1) log MAR and after intervention of occlusion therapy with vision therapy 76.6% have VA in range from (0-.2) log MAR, 21.85% have VA in range from (0.22-0.5) log MAR, 1.5% have in range from (0.52-0.8) log MAR. Conclusion: Amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Thus, this study concludes that occlusion therapy with vision therapy is probably one of the best treatment methods for amblyopic patients (age 5-8 years), and compliance and age were the most critical factor predicting a successful outcome.

Keywords: amblyopia, occlusion therapy, vision therapy, eccentric fixation, visuoscopy

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4088 The Effect of Potassium Hydroxide on Fine Soil Treated with Olivine

Authors: Abdelmaoula Mahamoud Tahir, Sedat Sert

Abstract:

The possibility of improving the shear strength of unsaturated clayey soil with the addition of olivine was investigated in this paper. Unconsolidated undrained triaxial tests (UU), under different cell pressures (namely: 100 kPa and 200 kPa), with varying percentages of olivine (10% and 20% by weight) and with one day, 28 days, and 56 days curing times, were performed to determine the shear strength of the soil. The increase in strength was observed as a function of the increase in olivine content. An olivine content of 25% was determined as the optimum value to achieve the targeted improvement for both cure times. A comparative study was also conducted between clay samples treated with only olivine and others in the presence of potassium hydroxide (KOH). Clay samples treated with olivine and activated with potassium hydroxide (KOH) had higher shear strength than non-activated olivine-treated samples. It was determined that the strength of the clay samples treated with only olivine did not increase over time and added resistance only with the high specific gravity of olivine. On the other hand, the samples activated with potassium hydroxide (KOH) added to the resistance with high specific gravity and the chemical bonds of olivine. Morphological and mineralogical analyzes were carried out in this study to see and analyze the chemical bonds formed after the reaction. The main components of this improvement were the formation of magnesium-aluminate-hydrate and magnesium-silicate-hydrate. Compared to older methods such as cement addition, these results show that in stabilizing clayey soils, olivine additive offers an energy-efficient alternative for reducing carbon dioxide emissions.

Keywords: ground stabilization, clay, olivine additive, KOH, microstructure

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4087 Application and Verification of Regression Model to Landslide Susceptibility Mapping

Authors: Masood Beheshtirad

Abstract:

Identification of regions having potential for landslide occurrence is one of the basic measures in natural resources management. Different landslide hazard mapping models are proposed based on the environmental condition and goals. In this research landslide hazard map using multiple regression model were provided and applicability of this model is investigated in Baghdasht watershed. Dependent variable is landslide inventory map and independent variables consist of information layers as Geology, slope, aspect, distance from river, distance from road, fault and land use. For doing this, existing landslides have been identified and an inventory map made. The landslide hazard map is based on the multiple regression provided. The level of similarity potential hazard classes and figures of this model were compared with the landslide inventory map in the SPSS environments. Results of research showed that there is a significant correlation between the potential hazard classes and figures with area of the landslides. The multiple regression model is suitable for application in the Baghdasht Watershed.

Keywords: landslide, mapping, multiple model, regression

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4086 On-Site Coaching on Freshly-Graduated Nurses to Improves Quality of Clinical Handover and to Avoid Clinical Error

Authors: Sau Kam Adeline Chan

Abstract:

World Health Organization had listed ‘Communication during Patient Care Handovers’ as one of its highest 5 patient safety initiatives. Clinical handover means transfer of accountability and responsibility of clinical information from one health professional to another. The main goal of clinical handover is to convey patient’s current condition and treatment plan accurately. Ineffective communication at point of care is globally regarded as the main cause of the sentinel event. Situation, Background, Assessment and Recommendation (SBAR), a communication tool, is extensively regarded as an effective communication tool in healthcare setting. Nonetheless, just by scenario-based program in nursing school or attending workshops on SBAR would not be enough for freshly graduated nurses to apply it competently in a complex clinical practice. To what extend and in-depth of information should be conveyed during handover process is not easy to learn. As such, on-site coaching is essential to upgrade their expertise on the usage of SBAR and ultimately to avoid any clinical error. On-site coaching for all freshly graduated nurses on the usage of SBAR in clinical handover was commenced in August 2014. During the preceptorship period, freshly graduated nurses were coached by the preceptor. After that, they were gradually assigned to take care of a group of patients independently. Nurse leaders would join in their shift handover process at patient’s bedside. Feedback and support were given to them accordingly. Discrepancies on their clinical handover process were shared with them and documented for further improvement work. Owing to the constraint of manpower in nurse leader, about coaching for 30 times were provided to a nurse in a year. Staff satisfaction survey was conducted to gauge their feelings about the coaching and look into areas for further improvement. Number of clinical error avoided was documented as well. The nurses reported that there was a significant improvement particularly in their confidence and knowledge in clinical handover process. In addition, the sense of empowerment was developed when liaising with senior and experienced nurses. Their proficiency in applying SBAR was enhanced and they become more alert to the critical criteria of an effective clinical handover. Most importantly, accuracy of transferring patient’s condition was improved and repetition of information was avoided. Clinical errors were prevented and quality patient care was ensured. Using SBAR as a communication tool looks simple. The tool only provides a framework to guide the handover process. Nevertheless, without on-site training, loophole on clinical handover still exists, patient’s safety will be affected and clinical error still happens.

Keywords: freshly graduated nurse, competency of clinical handover, quality, clinical error

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4085 Effects of Whole-Body Vibration Training on Fibrinolytic and Coagulative Factors in Healthy Young Man

Authors: Farshad Ghazalian, Seyed Hossein Alavi

Abstract:

Background: Use of whole body vibration (WBV) as an exercise method has rapidly increased over the last decade. The aim of this study was to evaluate effects of five week whole-body vibration training with different amplitudes and progressive frequencies on fibrinolytic and coagulative factors. Methods: Twenty five healthy male students were divided randomly in three groups: high amplitude vibration group (n=10), low amplitude vibration group (n=10), and control group (n=5). The vibration training consisted of 5 week whole-body vibration 3 times a week with amplitudes 4 and 2 mm and progressive frequencies from 25Hz with increments of 5Hz weekly. Concentrations of fibrinogen, plasminogen, tPA, and PAI-1 before and after 5 weeks of training were measured in plasma samples. Statistical analysis was done using one way analysis of variance. In order to compare pre-test with post test we used Wilcoxon signed ranked test .P<0.05 was considered statistically significant. Results: The 5 week high amplitude vibration training caused a significant improvement in tissue plasminogen activator (tPA) (p=0.028), and PAI-1 (p=0.033), fibrinogen showed decrease albeit not significantly (p=0.052). Plasminogen showed decrease not significantly (p=0.508). Low-amplitude vibration training caused a significant improvement in tissue plasminogen activator (tPA) (p=0.006) and and PAI-1 showed decrease not significantly (p=0.907). Fibrinogen showed decrease albeit not significantly (p=0.19). Plasminogen showed decrease not significantly (p=0.095). However, between groups there was no significant effect on tissue plasminogen activator (tPA) (p = 0.50), PAI-1 (p=0.249), Plasminogen (p=0.742), and fibrinogen (p=0.299). Conclusion: Amplitude of vibrations training is a important variable that effect on fibrino lytic factors.

Keywords: vibration, fibrinolysis, blood coagulation, plasminogen

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4084 Transformations of Land Uses and Attitudes in Manavgat Region at South Turkey

Authors: Emrah Yildirim, Veli Ortacesme

Abstract:

Manavgat region, located in Antalya province at South Turkey, has hosted many civilizations throughout the centuries. All of these civilizations cultivated the land in their surroundings by engaging in agriculture, livestock production and hunting. In the last 50 years, there have been dramatic changes in the region. The economy of the region switched from the agriculture to tourism. Due to the increase in the irrigable agricultural lands, several dams were built on Manavgat River. Developments in the agricultural mechanization and new product needs have changed the pattern of agriculture and regional landscape. Coastal zone of the region has transformed to tourism areas, Manavgat Town Center has grown up and the urbanization in general has increased. The population and urbanization have increased by 257 % and 276 %, respectively. The tourism and commercial areas cover 561,8 hectares today. All these developments had some negative effects on the environment. In this study, land use/land cover transformations were studied in Manavgat region by using aerial photos. The reasons and consequences of the land use transformations were discussed, and some recommendations regarding the sustainable use of this region’s landscape will be shared.

Keywords: land use, Manavgat region, south Turkey, transformation

Procedia PDF Downloads 398
4083 Effects of Folic Acid, Alone or in Combination with Other Nutrients on Homocysteine Level and Cognitive Function in Older People: A Systematic Review

Authors: Jiayan Gou, Kexin He, Xin Zhang, Fei Wang, Liuni Zou

Abstract:

Background: Homocysteine is a high-risk factor for cognitive decline, and folic acid supplementation can lower homocysteine levels. However, current clinical research results are inconsistent, and the effects of folic acid on homocysteine levels and cognitive function in older people are inconsistent. Objective: The objective of this study is to systematically evaluate the effects of folic acid alone or in combination with other nutrients on homocysteine levels and cognitive function in older adults. Methods: Systematic searches were conducted in five databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL, from inception to June 1, 2023. Randomized controlled trials were included investigating the effects of folic acid alone or in combination with other nutrients on cognitive function in older people. Results: 17 articles were included, with six focusing on the effects of folic acid alone and 11 examining folic acid in combination with other nutrients. The study included 3,100 individuals aged 60 to 83.2 years, with a relatively equal gender distribution (approximately 51.82% male). Conclusion: Folic acid alone or combined with other nutrients can effectively lower homocysteine level and improve cognitive function in patients with mild cognitive impairment. But for patients with Alzheimer's disease and dementia, the intervention only can reduce the homocysteine level, but the improvement in cognitive function is not significant. In healthy older people, high baseline homocysteine levels (>11.3 μmol/L) and good ω-3 fatty acid status (>590 μmol/L) can enhance the improvement effect of folic acid on cognitive function. This trial has been registered on PROSPERO as CRD42023433096.

Keywords: B-complex vitamins, cognitive function, folic acid, homocysteine

Procedia PDF Downloads 65
4082 Modeling Sediment Yield Using the SWAT Model: A Case Study of Upper Ankara River Basin, Turkey

Authors: Umit Duru

Abstract:

The Soil and Water Assessment Tool (SWAT) was tested for prediction of water balance and sediment yield in the Ankara gauged basin, Turkey. The overall objective of this study was to evaluate the performance and applicability of the SWAT in this region of Turkey. Thirteen years of monthly stream flow, and suspended sediment, data were used for calibration and validation. This research assessed model performance based on differences between observed and predicted suspended sediment yield during calibration (1987-1996) and validation (1982-1984) periods. Statistical comparisons of suspended sediment produced values for NSE (Nash Sutcliffe efficiency), RE (relative error), and R² (coefficient of determination), of 0.81, -1.55, and 0.93, respectively, during the calibration period, and NSE, RE (%), and R² of 0.77, -2.61, and 0.87, respectively, during the validation period. Based on the analyses, SWAT satisfactorily simulated observed hydrology and sediment yields and can be used as a tool in decision making for water resources planning and management in the basin.

Keywords: calibration, GIS, sediment yield, SWAT, validation

Procedia PDF Downloads 278
4081 The Rehabilitation Solutions for the Hydraulic Jump Sweepout: A Case Study from India

Authors: Ali Heidari, Hany Saleem

Abstract:

The tailwater requirements are important criteria in the design of the stilling basins as energy dissipation of the spillways. The adequate tailwater level that ensures the hydraulic jump inside the basin should be fulfilled by the river's natural water level and the apron depth downstream of the chute. The requirements of the hydraulic jump should mainly be checked for the design flood, however, the drawn jump condition should not be critical in the discharges lesser than the design flood. The tailwater requirement is not met in Almatti dam, built in 2005 in India, and the jump sweep out from the basin, resulting in significant scour in the apron and end sill of the basin. This paper discusses different hydraulic solutions as sustainable solutions for the rehabilitation program. The deep apron alternative is proposed for the fewer bays of the spillway as the most cost-effective, sustainable solution. The apron level of 15 gates out of 26 gates should decrease by 5.4 m compared to the existing design to ensure a safe hydraulic jump up to the discharge of 10,000 m3/s i.e. 30% of the updated PMF.

Keywords: dam, spillway, stilling basin, Almatti

Procedia PDF Downloads 54
4080 Limited Component Evaluation of the Effect of Regular Cavities on the Sheet Metal Element of the Steel Plate Shear Wall

Authors: Seyyed Abbas Mojtabavi, Mojtaba Fatzaneh Moghadam, Masoud Mahdavi

Abstract:

Steel Metal Shear Wall is one of the most common and widely used energy dissipation systems in structures, which is used today as a damping system due to the increase in the construction of metal structures. In the present study, the shear wall of the steel plate with dimensions of 5×3 m and thickness of 0.024 m was modeled with 2 floors of total height from the base level with finite element method in Abaqus software. The loading is done as a concentrated load at the upper point of the shear wall on the second floor based on step type buckle. The mesh in the model is applied in two directions of length and width of the shear wall, equal to 0.02 and 0.033, respectively, and the mesh in the models is of sweep type. Finally, it was found that the steel plate shear wall with cavity (CSPSW) compared to the SPSW model, S (Mises), Smax (In-Plane Principal), Smax (In-Plane Principal-ABS), Smax (Min Principal) increased by 53%, 70%, 68% and 43%, respectively. The presence of cavities has led to an increase in the estimated stresses, but their presence has caused critical stresses and critical deformations created to be removed from the inner surface of the shear wall and transferred to the desired sections (regular cavities) which can be suggested as a solution in seismic design and improvement of the structure to transfer possible damage during the earthquake and storm to the desired and pre-designed location in the structure.

Keywords: steel plate shear wall, abacus software, finite element method, , boundary element, seismic structural improvement, von misses stress

Procedia PDF Downloads 93
4079 Response of Subfossile Diatoms, Cladocera, and Chironomidae in Sediments of Small Ponds to Changes in Wastewater Discharges from a Zn–Pb Mine

Authors: Ewa Szarek-Gwiazda, Agata Z. Wojtal, Agnieszka Pociecha, Andrzej Kownacki, Dariusz Ciszewski

Abstract:

Mining of metal ores is one of the largest sources of heavy metals, which deteriorate aquatic systems. The response of organisms to environmental changes can be well recorded in sediments of the affected water bodies and may be reconstructed based on analyses of organisms' remains. The present study aimed at the response of diatoms (Bacillariophyta), Cladocera, and Chironomidae communities to the impact of Zn-Pb mine water discharge recorded in sediment cores of small subsidence ponds on the Chechło River floodplain (Silesia–Krakow Region, southern Poland). We hypothesize various responses of the above groups to high metal concentrations (Cd, Pb, Zn, and Cu). The investigated ponds were formed either during the peak of the ore exploitation (DOWN) or after mining cessation (UP). Currently, the concentrations of dissolved metals (in µg g⁻¹) in water reached up to 0.53 for Cd, 7.3 for Pb, and up to 47.1 for Zn. All the sediment cores from subsidence ponds were heavily polluted with Cd 6.7–612 μg g⁻¹, Pb 0.1–10.2 mg g⁻¹, and Zn 0.5–23.1 mg g⁻¹. Core sediments varied also in respect to pH 5.8-7.1 and concentrations of organic matter (5.7-39.8%). The impact of high metal concentrations was expressed by the occurrence of metal-tolerant taxa like diatoms – Nitzschia amphibia, Sellaphora nigri, and Surirella brebisonii var. kuetzingii; Cladocera – Chydorus sphaericus (dominated in cores from all ponds), and Chironomidae – Chironomus and Cricotopus especially in the DOWN ponds. Statistical analysis exhibited a negative impact of metals on some taxa of diatoms and Cladocera but only on Polypedilum sp. from Chironomidae. The abundance of such diatoms like Gomphonema utae, Staurosirella pinnata, Eunotia bilunaris, and Cladocera like Alona, Chydorus, Graptoleberis, and Pleuroxus decreased with increasing Pb concentration. However, the occurrence or dominance of more sensitive species of diatoms and Cladocera indicates their adaptation to higher metal loads, which was facilitated by neutral pH and slightly alkaline waters. Diatom assemblages were generally resistant to Zn, Pb, Cu, and Cd pollution, as indicated by their large similarity to populations from non-contaminated waters. Comparison with reference objects clearly indicates the dominance of Achnanthidium minutissimum, Staurosira venter, and Fragilaria gracilis in very diverse assemblages of unpolluted waters. The distribution of the Cladocera and Chironomidae taxa depended on the habitat type. The DOWN ponds with stagnant water and overgrown with macrophytes were more suitable for cladocerans (14 taxa, higher diversity) than the UP ponds with river water flowing through their centre and with a small share of macrophytes (8 taxa). The Chironominae, mainly Chironomus and Microspectra, were abundant in cores from the UP ponds with muddy bottoms. Inversely, the density of Orthocladiinae, especially genus Cricotopus, was related to the organic matter content and dominated in cores from the DOWN ponds. The presence of diatoms like Nitzschia amphibia, Sellaphora nigri, and Surirella brebisonii var. kuetzingii, cladocerans: Bosmina longirostris, Chydorus sphaericus, Alona affinis, and A. rectangularis as well as Chironomidae Chironomus sp. (UP ponds) and Psecrotanypus varius (DOWN ponds) indicate the influence of the water trophy on their distribution.

Keywords: Chironomidae, Cladocera, diatoms, metals, Zn-Pb mine, sediment cores, subsidence ponds

Procedia PDF Downloads 71
4078 Coastal Hydraulic Modelling to Ascertain Stability of Rubble Mound Breakwater

Authors: Safari Mat Desa, Othman A. Karim, Mohd Kamarulhuda Samion, Saiful Bahri Hamzah

Abstract:

Rubble mound breakwater was one of the most popular designs in Malaysia, constructed at the river mouth to dissipate the incoming wave energy from the seaward. Geometrically characteristics in trapezoid, crest width, and bottom width will determine the hypotonus stability, whilst structural height was designed for wave overtopping consideration. Physical hydraulic modelling in two-dimensional facilities was instigated in the flume to test the stability as well as the overtopping rate complied with the method of similarity, namely kinematic, dynamic, and geometric. Scaling effects of wave characteristics were carried out in order to acquire significant interaction of wave height, wave period, and water depth. Results showed two-dimensional physical modelling has proven reliable capability to ascertain breakwater stability significantly.

Keywords: breakwater, geometrical characteristic, wave overtopping, physical hydraulic modelling, method of similarity, wave characteristic

Procedia PDF Downloads 112
4077 Management of Municipal Solid Waste in Baghdad, Iraq

Authors: Ayad Sleibi Mustafa, Ahmed Abdulkadhim Mohsin, Layth Noori Ali

Abstract:

The deterioration of solid waste management in Baghdad city is considered as a great challenge in terms of human health and environment. Baghdad city is divided into thirteen districts which are distributed on both Tigris River banks. The west bank is Al-Karkh and the east bank is Al-Rusafa. Municipal Solid Waste Management is one of the most complicated problems facing the environment in Iraq. Population growth led to increase waste production and more load of the waste to the limited capacity infrastructure. The problems of municipal solid waste become more serious after the war in 2003. More waste is disposed in underground landfills in Baghdad with little or no concern for both human health and environment. The results showed that the total annually predicted solid waste is increasing for the period 2015-2030. Municipal solid waste in 2030 will be 6,427,773 tons in Baghdad city according to the population growth rate of 2.4%. This increase is estimated to be approximately 30%.

Keywords: municipal solid waste, solid waste composition and characteristics, Baghdad city, environment, human health

Procedia PDF Downloads 292
4076 Evaluating Accuracy of Foetal Weight Estimation by Clinicians in Christian Medical College Hospital, India and Its Correlation to Actual Birth Weight: A Clinical Audit

Authors: Aarati Susan Mathew, Radhika Narendra Patel, Jiji Mathew

Abstract:

A retrospective study conducted at Christian Medical College (CMC) Teaching Hospital, Vellore, India on 14th August 2014 to assess the accuracy of clinically estimated foetal weight upon labour admission. Estimating foetal weight is a crucial factor in assessing maternal and foetal complications during and after labour. Medical notes of ninety-eight postnatal women who fulfilled the inclusion criteria were studied to evaluate the correlation between their recorded Estimated Foetal Weight (EFW) on admission and actual birth weight (ABW) of the newborn after delivery. Data concerning maternal and foetal demographics was also noted. Accuracy was determined by absolute percentage error and proportion of estimates within 10% of ABW. Actual birth weights ranged from 950-4080g. A strong positive correlation between EFW and ABW (r=0.904) was noted. Term deliveries (≥40 weeks) in the normal weight range (2500-4000g) had a 59.5% estimation accuracy (n=74) compared to pre-term (<40 weeks) with an estimation accuracy of 0% (n=2). Out of the term deliveries, macrosomic babies (>4000g) were underestimated by 25% (n=3) and low birthweight (LBW) babies were overestimated by 12.7% (n=9). Registrars who estimated foetal weight were accurate in babies within normal weight ranges. However, there needs to be an improvement in predicting weight of macrosomic and LBW foetuses. We have suggested the use of an amended version of the Johnson’s formula for the Indian population for improvement and a need to re-audit once implemented.

Keywords: clinical palpation, estimated foetal weight, pregnancy, India, Johnson’s formula

Procedia PDF Downloads 360
4075 Training the Competences for the 'Expert Teacher': A Framework of Skills for Teachers

Authors: Sofia Cramerotti, Angela Cattoni, Laura Biancato, Dario Ianes

Abstract:

The recognition of specific standards for new professionals, within the teaching profile, is a necessary process in order to foster an innovative school vision in accordance with the change that school is experiencing. In line with the reform of the national education and training system and with the National Training Plan for teachers, our Research and Development department developed a training project based on a framework (Syllabus) of skills that each 'Expert Teacher' should master in order to fulfill what the different specific profiles request. The syllabus is a fundamental tool for a training process consistent with the teaching profiles, both to guide the to-become teachers entering in service and to provide the in-service teachers with a system of evaluation and improvement of their skills. According to the national and international literature about professional standards for teachers, we aggregated the skills of the syllabus in three macro areas: (1) Area of professional skills related to the teacher profile and their continuous training; (2) area of teaching skills related to the school innovation; (3) area of organizing skills related to school participation for its improvement. The syllabus is a framework that identifies and describes the skills of the expert teacher in all of their roles. However, the various skills take on different importance in the different profiles involved in the school; some of those skills are determining a role, others could be secondary. Therefore, the characterization of the different profiles is represented by suitably weighted skills sets. In this way, the same skill could differently characterize each profile. In the future, we hope that the skills development and training for the teacher could evolve in a skills development and training for the whole school staff ('Expert Team'). In this perspective, the school will, therefore, benefit from a solid team, in which the skills of the various profiles are all properly developed and well represented.

Keywords: framework, skills, teachers, training

Procedia PDF Downloads 177
4074 Revolution Biopolibag System Based on Water Hyacinth's Fiber as a Solution for Environmental Friendly Seeding and Seedling

Authors: Supriady R. P. Siregar, Rizki Barkah Aulia, Dhiya Fadilla Dewi

Abstract:

Polybag is a plastic that is used to seed plants. The common type that used for polybag is a synthetic that made from petroleum such as polyethylene. Beside the character of the raw material that are non-renewable and limited, synthetic polybag ability to disintegrate in the environment is very low. According to that situation, we need a solution to overcome these problems by creating an environmentally friendly polybag. In this research, using the water hyacinth plant fibers (Eichornia crassipes) as a major component in manufacturing the environmentally friendly polybag, the water hyacinth (Eichornia crassipes) contains approximately 60% cellulose. The research method used is an experiment by testing the mechanical characters and biodegradability bio-polybag water hyacinth fibers (Eichornia crassipes) on three medium that is dissolved in water, river water and buried in soil. The research shows bio-polybag of hyacinth fibers can rapidly degraded. This study is expected to be the beginning of the creation bio-polybag of water hyacinth fiber (Eichornia crassipes) and can be applied in agriculture.

Keywords: revolution, biopolybag, renewable, environment

Procedia PDF Downloads 239
4073 Dambreak Flood Analysis Using HEC-RAS and GIS Technologies

Authors: Oussama Derdous, Lakhdar Djemili, Hamza Bouchehed

Abstract:

The potential risks associated with dam break flooding could be considerable and result in major damage, including loss of life and property destruction. In the past, Algeria experienced such flood disasters; let’s recall the failure of Fergoug dam in 1881, this accident cost 200 lives, many houses and bridges were destroyed by the flooding. Recently the Algerian government have obligated to dam owners the development of detailed dam break Emergency Action Plans for its 64 major dams. The research presented here was conducted within this framework, Zardezas dam which is located in the city of Skikda in the North East of Algeria was the case of study. The model HEC-RAS was used for the hydrodynamic routing of the dam break flood wave. In addition, Geographic Information System (GIS) was used to create inundation maps and produce a visualization of the flood propagation in the Saf-Saf River.The simulation results that demonstrate the significance of Zardezas dam break flooding; constitute a real tool for developing emergency response plans and assisting territorial communities in land use planning.

Keywords: dam break, HEC-RAS, GIS, inundation maps, Emergency Action Plan

Procedia PDF Downloads 388
4072 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 170