Search results for: the double burden of malnutrition
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2152

Search results for: the double burden of malnutrition

802 Level of Grief, Emotional Impact and Coping Strategies of Internal Medicine Residents in Response to a Patient’s Death

Authors: Florge Francis A. Sy

Abstract:

Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

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801 Dermoscopy Compliance: Improving Melanoma Detection Pathways Through Quality Improvement

Authors: Max Butler

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Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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800 Analyze the Effect of TETRA, Terrestrial Trunked Radio, Signal on the Health of People Working in the Gas Refinery

Authors: Mohammad Bagher Heidari, Hefzollah Mohammadian

Abstract:

TETRA (Terrestrial Trunked Radio) is a digital radio communication standard, which has been implemented in several different parts of the gas refinery ninth (phase 12th) by South Pars Gas Complex. Studies on possible impacts on the users' health considering different exposure conditions are missing. Objectives: To investigate possible acute effects of electromagnetic fields (EMF) of two different levels of TETRA hand-held transmitter signals on cognitive function and well-being in healthy young males. Methods: In the present double-blind cross-over study possible effects of short-term (2.5 h) EMF exposure of handset-like signals of TETRA (450 - 470 MHz) were studied in 30 healthy male participants (mean ± SD: 25.4 ±2.6 years). Individuals were tested on nine study days, on which they were exposed to three different exposure conditions (Sham, TETRA 1.5 W/kg and TETRA 10.0 W/kg) in a randomly assigned and balanced order. Participants were tested in the afternoon at a fixed timeframe. Results: Attention remained unchanged in two out of three tasks. In the working memory, significant changes were observed in two out of four subtasks. Significant results were found in 5 out of 35 tested parameters, four of them led to an improvement in performance. Mood, well-being and subjective somatic complaints were not affected by TETRA exposure. Conclusions: The results of the present study do not indicate a negative impact of a short-term EMF- effect of TETRA on cognitive function and well-being in healthy young men.

Keywords: TETRA (terrestrial trunked radio), electromagnetic fields (EMF), mobile telecommunication health research (MTHR), antenna

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799 Proposed Algorithms to Assess Concussion Potential in Rear-End Motor Vehicle Collisions: A Meta-Analysis

Authors: Rami Hashish, Manon Limousis-Gayda, Caitlin McCleery

Abstract:

Introduction: Mild traumatic brain injuries, also referred to as concussions, represent an increasing burden to society. Due to limited objective diagnostic measures, concussions are diagnosed by assessing subjective symptoms, often leading to disputes to their presence. Common biomechanical measures associated with concussion are high linear and/or angular acceleration to the head. With regards to linear acceleration, approximately 80g’s has previously been shown to equate with a 50% probability of concussion. Motor vehicle collisions (MVCs) are a leading cause of concussion, due to high head accelerations experienced. The change in velocity (delta-V) of a vehicle in an MVC is an established metric for impact severity. As acceleration is the rate of delta-V with respect to time, the purpose of this paper is to determine the relation between delta-V (and occupant parameters) with linear head acceleration. Methods: A meta-analysis was conducted for manuscripts collected using the following keywords: head acceleration, concussion, brain injury, head kinematics, delta-V, change in velocity, motor vehicle collision, and rear-end. Ultimately, 280 studies were surveyed, 14 of which fulfilled the inclusion criteria as studies investigating the human response to impacts, reporting head acceleration, and delta-V of the occupant’s vehicle. Statistical analysis was conducted with SPSS and R. The best fit line analysis allowed for an initial understanding of the relation between head acceleration and delta-V. To further investigate the effect of occupant parameters on head acceleration, a quadratic model and a full linear mixed model was developed. Results: From the 14 selected studies, 139 crashes were analyzed with head accelerations and delta-V values ranging from 0.6 to 17.2g and 1.3 to 11.1 km/h, respectively. Initial analysis indicated that the best line of fit (Model 1) was defined as Head Acceleration = 0.465

Keywords: acceleration, brain injury, change in velocity, Delta-V, TBI

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798 Evaluation of Brca1/2 Mutational Status among Algerian Familial Breast Cancer

Authors: Arab M., Ait Abdallah M., Zeraoulia N., Boumaza H., Aoutia M., Griene L., Ait Abdelkader B.,

Abstract:

breast and ovarian cancer are respectively the first and fourth leading causes of cancer among women in Algeria. A family story of cancer in the most important risk factor, and in most cases of families with breast and /or ovarian cancer, the pattern of cancer family can be attributed to mutation in BRCA1/2genes. objectibes: the aim of our study in to investigate the spectrum of BRCA1/2 germiline mutation in familial breast and /or ovarian cancer and to determine the prevalence and the nature of BRCA1/2mutation in Algeria methods: we deremined the prevalence of BRCA1/2 mutation within a cohort of 161 probands selected according the eisinger score double stranded sanger sequencing of all coding exons of BRCA1/2including flanking intronic region were performed results: we identified a total of 23 distinct deleterious mutations (class5) 12 differents mutations in BRCA1(52%) and 11 in BRCA2(48%). 78% (18/23) were protein truncating and 22%(5/23) missens mutations.3 novel deleterious mutations have been identified, which have not been described in public mutation database. one new mutation were found in two unrelated patients. the overall mutation detection rate in our study is 28,5%(46/161).more over, an UVS c7783 located in BRCA2 is found in two unrelated probands and segregate in the 02 families/ conclusion: our results sugget of large spectrum of BRCA1/2 mutation in Algerian breast/ovarian cancer family. The nature and prevalence of BRCA1/2mutation in algerian families are ongoing in a larger study, 80 probands are to day under investigation. This study which may therefore identify the genetic particularity of Algerian breast /ovarian cancer.

Keywords: BRCA1/2 mutations, hereditary breast cancer, algerian women, prvalence

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797 Optimising Participation in Physical Activity Research for Adults with Intellectual Disabilities

Authors: Yetunde M. Dairo, Johnny Collett, Helen Dawes

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Background and Aim: Engagement with physical activity (PA) research is poor among adults with intellectual disabilities (ID), particularly in those from residential homes. This study explored why, by asking managers of residential homes, adults with ID and their carers. Methods: Participants: A convenient sample of 23 individuals from two UK local authorities, including a group of ID residential home managers, adults with ID and their support staff. Procedures: A) Residential home managers (n=6) were asked questions about their willingness to allow their residents to participate in PA research; B) eleven adults with ID and their support workers (n=6) were asked questions about their willingness to accept 7-day accelerometer monitoring and/or the International Physical Activity Questionnaire-short version (IPAQ-s) as PA measures. The IPAQ-s was administered by the researcher and they were each provided with samples of accelerometers to try on. Results: A) Five out of six managers said that the burden of wearing the accelerometer for seven days would be too high for the people they support, the majority of whom might be unable to express their wishes. They also said they would be unwilling to act as proxy respondents for the same reason. Additionally, they cited time pressure, understaffing, and reluctance to spend time on the research paperwork as further reasons for non-participation. B) All 11 individuals with ID completed the IPAQ-s while only three accepted the accelerometer, one of whom was deemed inappropriate to wear it. Reasons for rejecting accelerometers included statements from participants of: ‘too expensive’, ‘too heavy’, ‘uncomfortable’, and two people said they would not want to wear it for more than one day. All adults with ID (11) and their support workers (6) provided information about their physical activity levels through the IPAQ-s. Conclusions: Care home managers are a barrier to research participation. However, adults with ID would be happy for the IPAQ-s as a PA measure, but less so for the 7-day accelerometer monitoring. In order to improve participation in this population, the choice of PA measure is considered important. Moreover, there is a need for studies exploring how best to engage ID residential home managers in PA research.

Keywords: intellectual disability, physical activity measurement, research engagement, research participation

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796 An Overview of Technology Availability to Support Remote Decentralized Clinical Trials

Authors: Simone Huber, Bianca Schnalzer, Baptiste Alcalde, Sten Hanke, Lampros Mpaltadoros, Thanos G. Stavropoulos, Spiros Nikolopoulos, Ioannis Kompatsiaris, Lina Pérez- Breva, Vallivana Rodrigo-Casares, Jaime Fons-Martínez, Jeroen de Bruin

Abstract:

Developing new medicine and health solutions and improving patient health currently rely on the successful execution of clinical trials, which generate relevant safety and efficacy data. For their success, recruitment and retention of participants are some of the most challenging aspects of protocol adherence. Main barriers include: i) lack of awareness of clinical trials; ii) long distance from the clinical site; iii) the burden on participants, including the duration and number of clinical visits and iv) high dropout rate. Most of these aspects could be addressed with a new paradigm, namely the Remote Decentralized Clinical Trials (RDCTs). Furthermore, the COVID-19 pandemic has highlighted additional advantages and challenges for RDCTs in practice, allowing participants to join trials from home and not depend on site visits, etc. Nevertheless, RDCTs should follow the process and the quality assurance of conventional clinical trials, which involve several processes. For each part of the trial, the Building Blocks, existing software and technologies were assessed through a systematic search. The technology needed to perform RDCTs is widely available and validated but is yet segmented and developed in silos, as different software solutions address different parts of the trial and at various levels. The current paper is analyzing the availability of technology to perform RDCTs, identifying gaps and providing an overview of Basic Building Blocks and functionalities that need to be covered to support the described processes.

Keywords: architectures and frameworks for health informatics systems, clinical trials, information and communications technology, remote decentralized clinical trials, technology availability

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795 The Strategic Entering Time of a Commerce Platform

Authors: Chia-li Wang

Abstract:

The surge of service and commerce platforms, such as e-commerce and internet-of-things, have rapidly changed our lives. How to avoid the congestion and get the job done in the platform is now a common problem that many people encounter every day. This requires platform users to make decisions about when to enter the platform. To that end, we investigate the strategic entering time of a simple platform containing random numbers of buyers and sellers of some item. Upon a trade, the buyer and the seller gain respective profits, yet they pay the cost of waiting in the platform. To maximize their expected payoffs from trading, both buyers and sellers can choose their entering times. This creates an interesting and practical framework of a game that is played among buyers, among sellers, and between them. That is, a strategy employed by a player is not only against players of its type but also a response to those of the other type, and, thus, a strategy profile is composed of strategies of buyers and sellers. The players' best response, the Nash equilibrium (NE) strategy profile, is derived by a pair of differential equations, which, in turn, are used to establish its existence and uniqueness. More importantly, its structure sheds valuable insights of how the entering strategy of one side (buyers or sellers) is affected by the entering behavior of the other side. These results provide a base for the study of dynamic pricing for stochastic demand-supply imbalances. Finally, comparisons between the social welfares (the sum of the payoffs incurred by individual participants) obtained by the optimal strategy and by the NE strategy are conducted for showing the efficiency loss relative to the socially optimal solution. That should help to manage the platform better.

Keywords: double-sided queue, non-cooperative game, nash equilibrium, price of anarchy

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794 Technological Ensuring of the Space Reflector Antennas Manufacturing Process from Carbon Fiber Reinforced Plastics

Authors: Pyi Phyo Maung

Abstract:

In the study, the calculations of the permeability coefficient, values of the volume and porosity of a unit cell of a woven fabric before and after deformation based on the geometrical parameters are presented. Two types of carbon woven fabric structures were investigated: standard type, which integrated the filament, has a cross sectional shape of a cylinder and spread tow type, which has a rectangular cross sectional shape. The space antennas reflector, which distinctive feature is the presence of the surface of double curvature, is considered as the object of the research. Modeling of the kinetics of the process of impregnation of the reflector for the two types of carbon fabric’s unit cell structures was performed using software RAM-RTM. This work also investigated the influence of the grid angle between warp and welt of the unit cell on the duration of impregnation process. The results showed that decreasing the angle between warp and welt of the unit cell, the decreasing of the permeability values were occurred. Based on the results of calculation samples of the reflectors, their quality was determined. The comparisons of the theoretical and experimental results have been carried out. Comparison of the two textile structures (standard and spread tow) showed that the standard textiles with circular cross section were impregnated faster than spread tows, which have a rectangular cross section.

Keywords: vacuum assistant resin infusion, impregnation time, shear angle, reflector and modeling

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793 Lattice Boltzmann Simulation of Fluid Flow and Heat Transfer Through Porous Media by Means of Pore-Scale Approach: Effect of Obstacles Size and Arrangement on Tortuosity and Heat Transfer for a Porosity Degree

Authors: Annunziata D’Orazio, Arash Karimipour, Iman Moradi

Abstract:

The size and arrangement of the obstacles in the porous media has an influential effect on the fluid flow and heat transfer, even in the same porosity. Regarding to this, in the present study, several different amounts of obstacles, in both regular and stagger arrangements, in the analogous porosity have been simulated through a channel. In order to compare the effect of stagger and regular arrangements, as well as different quantity of obstacles in the same porosity, on fluid flow and heat transfer. In the present study, the Single Relaxation Time Lattice Boltzmann Method, with Bhatnagar-Gross-Ktook (BGK) approximation and D2Q9 model, is implemented for the numerical simulation. Also, the temperature field is modeled through a Double Distribution Function (DDF) approach. Results are presented in terms of velocity and temperature fields, streamlines, percentage of pressure drop and Nusselt number of the obstacles walls. Also, the correlation between tortuosity and Nusselt number of the obstacles walls, for both regular and staggered arrangements, has been proposed. On the other hand, the results illustrated that by increasing the amount of obstacles, as well as changing their arrangement from regular to staggered, in the same porosity, the rate of tortuosity and Nusselt number of the obstacles walls increased.

Keywords: lattice boltzmann method, heat transfer, porous media, pore-scale, porosity, tortuosity

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792 Development of a Plug-In Hybrid Powertrain System with Double Continuously Variable Transmissions

Authors: Cheng-Chi Yu, Chi-Shiun Chiou

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This study developed a plug-in hybrid powertrain system which consisted of two continuous variable transmissions. By matching between the engine, motor, generator, and dual continuous variable transmissions, this integrated power system can take advantages of the components. The hybrid vehicle can be driven by the internal combustion engine, or electric motor alone, or by these two power sources together when the vehicle is driven in hard acceleration or high load. The energy management of this integrated hybrid system controls the power systems based on rule-based control strategy to achieve better fuel economy. When the vehicle driving power demand is low, the internal combustion engine is operating in the low efficiency region, so the internal combustion engine is shut down, and the vehicle is driven by motor only. When the vehicle driving power demand is high, internal combustion engine would operate in the high efficiency region; then the vehicle could be driven by internal combustion engine. This strategy would operate internal combustion engine only in optimal efficiency region to improve the fuel economy. In this research, the vehicle simulation model was built in MATLAB/ Simulink environment. The analysis results showed that the power coupled efficiency of the hybrid powertrain system with dual continuous variable transmissions was better than that of the Honda hybrid system on the market.

Keywords: plug-in hybrid power system, fuel economy, performance, continuously variable transmission

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791 Evaluation of the Effects of Some Medicinal Plants Extracts on Seed

Authors: Areej Ali Baeshen, Hanaa Kamal Galal, Batoul Mohamed Abdullatif

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In the present study, the allelopathic effects of Eruca sativa, Mentha peprinta, and Coriandrum sativum aqueous extracts, prepared by 25 gm and 50 gm of fresh leaves dissolved in 100 ml of double distilled water in addition to the crude extract (100%). The final concentrations were 100 %, 50%, 25% and 0% as control. The extracts were tested for their allelopathic effects on seed germination and other growth parameters of Phaseolous vulgaris. Laboratory experiments were conducted in sterilizes Petri dishes with 5 and 10 day time interval for seed germination and 24 h, 48 h and 72 h for radicle length on an average of 25°C. The effects of different concentrations of aqueous extract were compared to distilled water (0%). 25% and 50% aqueous extracts of Eruca sativa and Coriandrum sativum caused a pronounced inhibitory effect on seed germination and the tested growth parameters of the receptor plant. The inhibitory effect was proportional to the concentration of the extract. Mentha peprinta extracts, on the other hand, caused an increase in germination percentage and other growth parameters in Phaseolous vulgaris. Hence, it could be concluded that the aqueous extracts of Eruca sativa and Coriandrum sativum might contain water-soluble allelochemicals, which could inhibit the seed germination and reduce radicle length of Phaseolous vulgaris. Mentha peprinta has beneficial allelopathic effects on the receptor plant.

Keywords: Phaseolus vulgaris, Eruca sativa, Mentha peperinta, Coriandrum sativum, medicinal plants, seed germination

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790 Numerical Investigation of Material Behavior During Non-Equal Channel Multi Angular Extrusion

Authors: Mohamed S. El-Asfoury, Ahmed Abdel-Moneim, Mohamed N. A. Nasr

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The current study uses finite element modeling to investigate and analyze a modified form of the from the conventional equal channel multi-angular pressing (ECMAP), using non-equal channels, on the workpiece material plastic deformation. The modified process non-equal channel multi-angular extrusion (NECMAE) is modeled using two-dimensional plane strain finite element model built using the commercial software ABAQUS. The workpiece material used is pure aluminum. The model was first validated by comparing its results to analytical solutions for single-pass equal channel angular extrusion (ECAP), as well as previously published data. After that, the model was used to examine the effects of different % of reductions of the area (for the second stage) on material plastic deformation, corner gap, and required the load. Three levels of reduction in the area were modeled; 10%, 30%, and 50%, and compared to single-pass and double-pass ECAP. Cases with a higher reduction in the area were found to have smaller corner gaps, higher and much uniform plastic deformation, as well as higher required loads. The current results are mainly attributed to the back pressure effects exerted by the second stage, as well as strain hardening effects experienced during the first stage.

Keywords: non-equal channel angular extrusion, multi-pass, sever plastic deformation, back pressure, Finite Element Modelling (FEM)

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789 Marine Fishing and Climate Change: A China’s Perspective on Fisheries Economic Development and Greenhouse Gas Emissions

Authors: Yidan Xu, Pim Martens, Thomas Krafft

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Marine fishing, an energy-intensive activity, directly emits greenhouse gases through fuel combustion, making it a significant contributor to oceanic greenhouse gas (GHG) emissions and worsening climate change. China is the world’s second-largest economy and the top emitter of GHG emissions, and it carries a significant energy conservation and emission reduction burden. However, the increasing GHG emissions from marine fishing is an easily overlooked but essential issue in China. This study offers a diverse perspective by integrating the concepts of total carbon emissions, carbon intensity, and per capita carbon emissions as indicators into calculation and discussion. To better understand the GHG emissions-Gross marine fishery product (GFP) relationship and influencing factors in Chinese marine fishing, the relationship between GHG emissions and economic development in marine fishing, a comprehensive framework is developed by combining the environmental Kuznets curve, the Tapio elasticity index, and the decomposition model. Results indicated that (1) The GHG emissions increased from 16.479 to 18.601 million tons in 2001-2020, in which trawlers and gillnetter are the main source in fishing operation. (2) Total carbon emissions (TC) and CI presented the same decline as GHG emissions, while per capita carbon emissions (PC) displayed an uptrend. (32) GHG emissions and gross marine fishery product (GFP) presented an inverted U-shaped relationship in China; the turning point came in the 13th Five-year Plan period (2016-2020). (43) Most provinces strongly decoupled GFP and CI. Still, PC and TC need more effort to decouple. (54) GHG emissions promoted by an industry structure driven, though carbon intensity and industry scale aid in GHG emissions reduced. (5) Compare with TC and PC, CI has been relatively affected by COVID-19 in 2020. The rise in fish and seafood prices during COVID-19 has boosted the GFP.

Keywords: marine fishing economy, greenhouse gas emission, fishery management, green development

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788 Public Debt and Fiscal Stability in Nigeria

Authors: Abdulkarim Yusuf

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Motivation: The Nigerian economy has seen significant macroeconomic instability, fuelled mostly by an overreliance on fluctuating oil revenues. The rising disparity between tax receipts and government spending in Nigeria necessitates government borrowing to fund the anticipated pace of economic growth. Rising public debt and fiscal sustainability are limiting the government's ability to invest in key infrastructure that promotes private investment and growth in Nigeria. Objective: This paper fills an empirical research vacuum by examining the impact of public debt on fiscal sustainability in Nigeria, given the significance of fiscal stability in decreasing poverty and the constraints that an unsustainable debt burden imposes on it. Data and method: Annual time series data covering the period 1980 to 2022 exposed to conventional and structural breaks stationarity tests and the Autoregressive Distributed Lag estimation approach were adopted for this study. Results: The results reveal that domestic debt stock, debt service payment, foreign reserve stock, exchange rate, and private investment all had a major adverse effect on fiscal stability in the long and short run, corroborating the debt overhang and crowding-out hypothesis. External debt stock, prime lending rate, and degree of trade openness, which boosted fiscal stability in the long run, had a major detrimental effect on fiscal stability in the short run, whereas foreign direct investment inflows had an important beneficial impact on fiscal stability in both the long and short run. Implications: The results indicate that fiscal measures that inspire domestic resource mobilization, sustainable debt management techniques, and dependence on external debt to boost deficit financing will improve fiscal stability and drive growth.

Keywords: ARDL co-integration, debt overhang, debt servicing, fiscal stability, public debt

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787 Condensation Heat Transfer and Pressure Drop of R-134a Flowing inside Dimpled Tubes

Authors: Kanit Aroonrat, Somchai Wongwises

Abstract:

A heat exchanger is one of the vital parts in a wide variety of applications. The tube with surface modification is generally referred to as an enhanced tube. With this, the thermal performance of the heat exchanger is improved. A dimpled tube is one of many kinds of enhanced tube. The heat transfer and pressure drop of two-phase flow inside dimpled tubes have received little attention in the literature, despite of having an important role in the development of refrigeration and air conditioning systems. As a result, the main aim of this study is to investigate the condensation heat transfer and pressure drop of refrigerant-134a flowing inside dimpled tubes. The test section is a counter-flow double-tube heat exchanger, which the refrigerant flows in the inner tube and water flows in the annulus. The inner tubes are one smooth tube and three dimpled tubes with different helical pitches. All test tubes are made from copper with an inside diameter of 8.1 mm and length of 1500 mm. The experiments are conducted over mass fluxes ranging from 300 to 500 kg/m²s, heat flux ranging from 10 to 20 kW/m², and condensing temperature ranging from 40 to 50 ˚C. The results show that all dimpled tubes provide higher heat transfer coefficient and frictional pressure drop compared to the smooth tube. In addition, the heat transfer coefficient and frictional pressure drop increase with decreasing of helical pitch. It can be observed that the dimpled tube with lowest helical pitch yields the heat transfer enhancement in the range of 60-89% with the frictional pressure drop increase of 289-674% in comparison to the smooth tube.

Keywords: condensation, dimpled tube, heat transfer, pressure drop

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786 Thermo-Mechanical Behavior of Steel-Wood Connections of Wooden Structures Under the Effect of a Fire

Authors: Ahmed Alagha, Belkacem Lamri, Abdelhak Kada.

Abstract:

Steel-wood assemblies often have complex geometric configurations whose overall behavior under the effect of a fire is conditioned by the thermal response, by combining the two materials steel and wood, whose thermal characteristics are greatly influenced by high temperatures. The objective of this work is to study the thermal behavior of a steel-wood connection, with or without insulating material, subjected to an ISO834 standard fire model. The analysis is developed by the analytical approach using the Eurocode, and numerically, by the finite element method, through the ANSYS calculation code. The design of the connections is evaluated at room temperature taking the cases of single shear and double shear. The thermal behavior of the connections is simulated in transient state while taking into account the modes of heat transfer by convection and by radiation. The variation of temperature as a function of time is evaluated in different positions of the connections while talking about the heat produced and the formation of the carbon layer. The results relate to the temperature distributions in the connection elements as a function of the duration of the fire. The results of the thermal analysis show that the temperature increases rapidly and reaches more than 260 °C in the steel material for an hour of exposure to fire. The temperature development in wood material is different from that in steel because of its thermal properties. Wood heats up on the outside and burns, its surface can reach very high temperatures in points on the surface.

Keywords: Eurocode 5, finite elements, ISO834, simple shear, thermal behaviour, wood-steel connection

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785 Anti-Parasite Targeting with Amino Acid-Capped Nanoparticles Modulates Multiple Cellular Processes in Host

Authors: Oluyomi Stephen Adeyemi, Kentaro Kato

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Toxoplasma gondii is the etiological agent of toxoplasmosis, a common parasitic disease capable of infecting a range of hosts, including nearly one-third of the human population. Current treatment options for toxoplasmosis patients are limited. In consequence, toxoplasmosis represents a large global burden that is further enhanced by the shortcomings of the current therapeutic options. These factors underscore the need for better anti-T. gondii agents and/or new treatment approach. In the present study, we sought to find out whether preparing and capping nanoparticles (NPs) in amino acids, would enhance specificity toward the parasite versus the host cell. The selection of amino acids was premised on the fact that T. gondii is auxotrophic for some amino acids. The amino acid-nanoparticles (amino-NPs) were synthesized, purified and characterized following established protocols. Next, we tested to determine the anti-T. gondii activity of the amino-NPs using in vitro experimental model of infection. Overall, our data show evidence that supports enhanced and excellent selective action against the parasite versus the host cells by amino-NPs. The findings are promising and provide additional support that warrants exploring the prospects of NPs as alternative anti-parasite agents. In addition, the anti-parasite action by amino-NPs indicates that nutritional requirement of parasite may represent a viable target in the development of better alternative anti-parasite agents. Furthermore, data suggest the anti-parasite mechanism of the amino-NPs involves multiple cellular processes including the production of reactive oxygen species (ROS), modulation of hypoxia-inducing factor-1 alpha (HIF-1α) as well as the activation of kynurenine pathway. Taken together, findings highlight further, the prospects of NPs as alternative source of anti-parasite agents.

Keywords: drug discovery, infectious diseases, mode of action, nanomedicine

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784 Impact of Ethiopia's Productive Safety Net Program on Household Dietary Diversity and Child Nutrition in Rural Ethiopia

Authors: Tagel Gebrehiwot, Carolina Castilla

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Food insecurity and child malnutrition are among the most critical issues in Ethiopia. Accordingly, different reform programs have been carried to improve household food security. The Food Security Program (FSP) (among others) was introduced to combat the persistent food insecurity problem in the country. The FSP combines a safety net component called the Productive Safety Net Program (PSNP) started in 2005. The goal of PSNP is to offer multi-annual transfers, such as food, cash or a combination of both to chronically food insecure households to break the cycle of food aid. Food or cash transfers are the main elements of PSNP. The case for cash transfers builds on the Sen’s analysis of ‘entitlement to food’, where he argues that restoring access to food by improving demand is a more effective and sustainable response to food insecurity than food aid. Cash-based schemes offer a greater choice of use of the transfer and can allow a greater diversity of food choice. It has been proven that dietary diversity is positively associated with the key pillars of food security. Thus, dietary diversity is considered as a measure of household’s capacity to access a variety of food groups. Studies of dietary diversity among Ethiopian rural households are somewhat rare and there is still a dearth of evidence on the impact of PSNP on household dietary diversity. In this paper, we examine the impact of the Ethiopia’s PSNP on household dietary diversity and child nutrition using panel household surveys. We employed different methodologies for identification. We exploit the exogenous increase in kebeles’ PSNP budget to identify the effect of the change in the amount of money households received in transfers between 2012 and 2014 on the change in dietary diversity. We use three different approaches to identify this effect: two-stage least squares, reduced form IV, and generalized propensity score matching using a continuous treatment. The results indicate the increase in PSNP transfers between 2012 and 2014 had no effect on household dietary diversity. Estimates for different household dietary indicators reveal that the effect of the change in the cash transfer received by the household is statistically and economically insignificant. This finding is robust to different identification strategies and the inclusion of control variables that determine eligibility to become a PSNP beneficiary. To identify the effect of PSNP participation on children height-for-age and stunting we use a difference-in-difference approach. We use children between 2 and 5 in 2012 as a baseline because by then they have achieved long-term failure to grow. The treatment group comprises children ages 2 to 5 in 2014 in PSNP participant households. While changes in height-for-age take time, two years of additional transfers among children who were not born or under the age of 2-3 in 2012 have the potential to make a considerable impact on reducing the prevalence of stunting. The results indicate that participation in PSNP had no effect on child nutrition measured as height-for-age or probability of beings stunted, suggesting that PSNP should be designed in a more nutrition-sensitive way.

Keywords: continuous treatment, dietary diversity, impact, nutrition security

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783 Biotechnological Interventions for Crop Improvement in Nutricereal Pearl Millet

Authors: Supriya Ambawat, Subaran Singh, C. Tara Satyavathi, B. S. Rajpurohit, Ummed Singh, Balraj Singh

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Pearl millet [Pennisetum glaucum (L.) R. Br.] is an important staple food of the arid and semiarid tropical regions of Asia, Africa, and Latin America. It is rightly termed as nutricereal as it has high nutrition value and a good source of carbohydrate, protein, fat, ash, dietary fiber, potassium, magnesium, iron, zinc, etc. Pearl millet has low prolamine fraction and is gluten free which is useful for people having a gluten allergy. It has several health benefits like reduction in blood pressure, thyroid, diabe¬tes, cardiovascular and celiac diseases but its direct consumption as food has significantly declined due to several reasons. Keeping this in view, it is important to reorient the ef¬forts to generate demand through value-addition and quality improvement and create awareness on the nutritional merits of pearl millet. In India, through Indian Council of Agricultural Research-All India Coordinated Research Project on Pearl millet, multilocational coordinated trials for developed hybrids were conducted at various centers. The gene banks of pearl millet contain varieties with high levels of iron and zinc which were used to produce new pearl millet varieties with elevated iron levels bred with the high‐yielding varieties. Thus, using breeding approaches and biochemical analysis, a total of 167 hybrids and 61 varieties were identified and released for cultivation in different agro-ecological zones of the country which also includes some biofortified hybrids rich in Fe and Zn. Further, using several biotechnological interventions such as molecular markers, next-generation sequencing (NGS), association mapping, nested association mapping (NAM), MAGIC populations, genome editing, genotyping by sequencing (GBS), genome wide association studies (GWAS) advancement in millet improvement has become possible by identifying and tagging of genes underlying a trait in the genome. Using DArT markers very high density linkage maps were constructed for pearl millet. Improved HHB67 has been released using marker assisted selection (MAS) strategies, and genomic tools were used to identify Fe-Zn Quantitative Trait Loci (QTL). The draft genome sequence of millet has also opened various ways to explore pearl millet. Further, genomic positions of significantly associated simple sequence repeat (SSR) markers with iron and zinc content in the consensus map is being identified and research is in progress towards mapping QTLs for flour rancidity. The sequence information is being used to explore genes and enzymatic pathways responsible for rancidity of flour. Thus, development and application of several biotechnological approaches along with biofortification can accelerate the genetic gain targets for pearl millet improvement and help improve its quality.

Keywords: Biotechnological approaches, genomic tools, malnutrition, MAS, nutricereal, pearl millet, sequencing.

Procedia PDF Downloads 178
782 A Systematic Review on Prevalence, Serotypes and Antibiotic Resistance of Salmonella in Ethiopia

Authors: Atsebaha Gebrekidan Kahsay, Tsehaye Asmelash, Enquebaher Kassaye

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Background: Salmonella remains a global public health problem with a significant burden in sub-Saharan African countries. Human restricted cause of typhoid and paratyphoid fever are S. Typhi and S. Paratyphi, whereas S. Enteritidis and S. Typhimurium is the causative agent of invasive nontyphoidal diseases among humans and animals are their reservoir. The antibiotic resistance of Salmonella is another public health threat around the globe. To come up with full information about human and animal salmonellosis, we made a systematic review of the prevalence, serotypes, and antibiotic resistance of Salmonella in Ethiopia. Methods: This systematic review used Google Scholar and PubMed search engines to search articles from Ethiopia that were published in English in peer-reviewed international journals from 2010 to 2022. We used keywords to identify the intended research articles and used a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the inclusion and exclusion criteria. Frequencies and percentages were analyzed using Microsoft Excel. Results: Two hundred seven published articles were searched, and 43 were selected for a systematic review, human (28) and animals (15). The prevalence of Salmonella in humans and animals was 434 (5.2%) and 641(10.1%), respectively. Fourteen serotypes were identified from animals, and S. Typhimurium was among the top five. Among the ciprofloxacin-resistant isolates in human studies, 16.7% was the highest, whereas, for ceftriaxone, 100% resistance was reported. Conclusions: The prevalence of Salmonella among diarrheic patients and food handlers (5.2%) was lower than the prevalence in food animals (10.1%). We did not find serotypes of Salmonella in human studies, although fourteen serotypes were included in food-animal studies, and S. Typhimurium was among the top five. Salmonella species from some human studies revealed a non-susceptibility to ceftriaxone. We recommend further study about invasive nontyphoidal Salmonella and predisposing factors among humans and animals in Ethiopia.

Keywords: antibiotic resistance, prevalence, systematic review, serotypes, Salmonella, Ethiopia

Procedia PDF Downloads 75
781 Change Detection Analysis on Support Vector Machine Classifier of Land Use and Land Cover Changes: Case Study on Yangon

Authors: Khin Mar Yee, Mu Mu Than, Kyi Lint, Aye Aye Oo, Chan Mya Hmway, Khin Zar Chi Winn

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The dynamic changes of Land Use and Land Cover (LULC) changes in Yangon have generally resulted the improvement of human welfare and economic development since the last twenty years. Making map of LULC is crucially important for the sustainable development of the environment. However, the exactly data on how environmental factors influence the LULC situation at the various scales because the nature of the natural environment is naturally composed of non-homogeneous surface features, so the features in the satellite data also have the mixed pixels. The main objective of this study is to the calculation of accuracy based on change detection of LULC changes by Support Vector Machines (SVMs). For this research work, the main data was satellite images of 1996, 2006 and 2015. Computing change detection statistics use change detection statistics to compile a detailed tabulation of changes between two classification images and Support Vector Machines (SVMs) process was applied with a soft approach at allocation as well as at a testing stage and to higher accuracy. The results of this paper showed that vegetation and cultivated area were decreased (average total 29 % from 1996 to 2015) because of conversion to the replacing over double of the built up area (average total 30 % from 1996 to 2015). The error matrix and confidence limits led to the validation of the result for LULC mapping.

Keywords: land use and land cover change, change detection, image processing, support vector machines

Procedia PDF Downloads 126
780 In-Farm Wood Gasification Energy Micro-Generation System in Brazil: A Monte Carlo Viability Simulation

Authors: Erich Gomes Schaitza, Antônio Francisco Savi, Glaucia Aparecida Prates

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The penetration of renewable energy into the electricity supply in Brazil is high, one of the highest in the World. Centralized hydroelectric generation is the main source of energy, followed by biomass and wind. Surprisingly, mini and micro-generation are negligible, with less than 2,000 connections to the national grid. In 2015, a new regulatory framework was put in place to change this situation. In the agricultural sector, the framework was complemented by the offer of low interest rate loans to in-farm renewable generation. Brazil proposed to more than double its area of planted forests as part of its INDC- Intended Nationally Determined Contributions to the UNFCCC-U.N. Framework Convention on Climate Change (UNFCCC). This is an ambitious target which will be achieved only if forests are attractive to farmers. Therefore, this paper analyses whether planting forests for in-farm energy generation with a with a woodchip gasifier is economically viable for microgeneration under the new framework and at if they could be an economic driver for forest plantation. At first, a static case was analyzed with data from Eucalyptus plantations in five farms. Then, a broader analysis developed with the use of Monte Carlo technique. Planting short rotation forests to generate energy could be a viable alternative and the low interest loans contribute to that. There are some barriers to such systems such as the inexistence of a mature market for small scale equipment and of a reference network of good practices and examples.

Keywords: biomass, distribuited generation, small-scale, Monte Carlo

Procedia PDF Downloads 281
779 Ten Patterns of Organizational Misconduct and a Descriptive Model of Interactions

Authors: Ali Abbas

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This paper presents a descriptive model of organizational misconduct based on observed patterns that occur before and after an ethical collapse. The patterns were classified by categorizing media articles in both "for-profit" and "not-for-profit" organizations. Based on the model parameters, the paper provides a descriptive model of various organizational deflection strategies under numerous scenarios, including situations where ethical complaints build-up, situations under which whistleblowers become more prevalent, situations where large scandals that relate to leadership occur, and strategies by which organizations deflect blame when pressure builds up or when media finds out. The model parameters start with the premise of a tolerance to double standards in unethical acts when conducted by leadership or by members of corporate governance. Following this premise, the model explains how organizations engage in discursive strategies to cover up the potential conflicts that arise, including secret agreements and weakening stakeholders who may oppose the organizational acts. Deflection strategies include "preemptive" and "post-complaint" secret agreements, absence of (or vague) documented procedures, engaging in blame and scapegoating, remaining silent on complaints until the media finds out, as well as being slow (if at all) to acknowledge misconduct and fast to cover it up. The results of this paper may be used to guide organizational leaders into the implications of such shortsighted strategies toward unethical acts, even if they are deemed legal. Validation of the model assumptions through numerous media articles is provided.

Keywords: ethical decision making, prediction, scandals, organizational strategies

Procedia PDF Downloads 116
778 Evaluation of Security and Performance of Master Node Protocol in the Bitcoin Peer-To-Peer Network

Authors: Muntadher Sallal, Gareth Owenson, Mo Adda, Safa Shubbar

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Bitcoin is a digital currency based on a peer-to-peer network to propagate and verify transactions. Bitcoin is gaining wider adoption than any previous crypto-currency. However, the mechanism of peers randomly choosing logical neighbors without any knowledge about underlying physical topology can cause a delay overhead in information propagation, which makes the system vulnerable to double-spend attacks. Aiming at alleviating the propagation delay problem, this paper introduces proximity-aware extensions to the current Bitcoin protocol, named Master Node Based Clustering (MNBC). The ultimate purpose of the proposed protocol, that are based on how clusters are formulated and how nodes can define their membership, is to improve the information propagation delay in the Bitcoin network. In MNBC protocol, physical internet connectivity increases, as well as the number of hops between nodes, decreases through assigning nodes to be responsible for maintaining clusters based on physical internet proximity. We show, through simulations, that the proposed protocol defines better clustering structures that optimize the performance of the transaction propagation over the Bitcoin protocol. The evaluation of partition attacks in the MNBC protocol, as well as the Bitcoin network, was done in this paper. Evaluation results prove that even though the Bitcoin network is more resistant against the partitioning attack than the MNBC protocol, more resources are needed to be spent to split the network in the MNBC protocol, especially with a higher number of nodes.

Keywords: Bitcoin network, propagation delay, clustering, scalability

Procedia PDF Downloads 111
777 Epidemiology of Cutaneous Malignant Melanoma in Pakistan: Incidence, Clinical Subtypes, Tumor Stage and Localization

Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

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Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

Procedia PDF Downloads 133
776 Adaptive Response of Plants to Environmental Stress: Natural Oil Seepage; The Living Laboratory in Tramutola, Basilicata Region

Authors: Maria Francesca Scannone, Martina Bochicchio

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One of the major environmental problems today is hydrocarbon contamination. The promising sustainable technologies for the treatment of these contaminated sites involves the use of biological organisms. In Agri Valley (Basilicata Region) there is a living laboratory (natural oil seeps) where the selective pressure has enriched the environmental matrices with microorganisms, fungi and plant species able to use the hydrocarbons as a source of metabolic energy, to degrade or tolerate hydrocarbons. Observers visiting this area are fascinated by its unspoiled nature, and the condition of the ecosystem does not appear to has been damaged. The amazing resiliency observed in Tramutola site is of key importance to try to bring green remediation technologies, but no research has been done to identify high-performing native species. The aim of this research was to study how natural processes affect the fate of released oil or how individual species or communities of plants and animals are capable of dealing with the burden of otherwise toxic chemicals. The survey of vegetation was carried out, more than 60 species have been identified and divided into tree, shrub and herb layer. Plant data sheets have been completed only for the species that showed the most appropriate properties for phytoremediation. In general, members of the Salicales, Cyperales, Poales, Fagales, Cornales, Equisetales orders were the most commonly identified orders. They are pioneer plants with high adaptive capacity and vegetative propagation. The literature review has highlighted the existence of rhizosphere effect and a green liver model on selected plants. The study provides significant information on the environmental stress adaptation processes of many indigenous plants that are living and growing on a natural leak of crude oil and gas that migrates up through subsurface.

Keywords: green liver, hydrocarbon degradation, oil seeps, phytoremediation

Procedia PDF Downloads 170
775 Zoonotic Risk Practices in Rural Households in the Penka-Michel Health District (West Cameroon)

Authors: Namekong Fokeng Armand

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Background: Zoonoses are nowadays a serious public health problem in both developing and developed countries. They contribute to increase the economic burden. In case of emergence, rural populations are the most affected, hence the need to investigate risk practices in rural households of Penka-Michel (West Cameroon). Methods: This cross-sectional study was conducted from October to November 2021 among 200 heads of households living in the Penka-Michel health district (West Cameroon). It was done using a pre-tested and validated questionnaire, allowing to obtain socio-demographic, economic data, and data on zoonotic risk practices. Results: The participants [women (56%), men (44%)] worked mainly in the informal private sector (53%) and practiced agriculture secondarily (90%). Their highest level of education, for the most part, was a secondary school (50%); the average household size was 06 persons with a monthly income > 36270 FCFA (72%). 74% of household heads thought that animals can transmit diseases, and 17% had heard about zoonotic diseases through the media (65%). Rats caught in households (60%) were consumed there (74%), as was bush meat (61%) or dog meat (18%). For family food (90%), animals were slaughtered within the household (97%), rarely preceded by a veterinary inspection (6%). 87% of households practiced traditional rites with animal blood, 65% shared the same habitat as their animals, 41% did not systematically wash their hands after handling animals. More than 50% of households owned one or more dogs, usually strays (41%) and 48% of which were vaccinated (rabies). Many households had at least one: poultry (98%); pig (50%); dog (57%), cat (52%). 25% of households slaughtered sick animals for consumption, and 27% ate dead animals. Conclusion: This study identified numerous zoonotic risk practices in households in the Penka-Michel health district (West Cameroon). Concerted, multisectoral communication / awareness-raising actions are needed to break with these practices.

Keywords: zoonoses, risky practices, rural households, penka-michel, cameroon

Procedia PDF Downloads 166
774 Isotretinoin and Psychiatric Adverse Events: A Review of the Evidence

Authors: Thodoris Tsagkaris, Marios Stavropoulos, Panagiotis Theodosis-Nobelos, Charalampos Triantis

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Isotretinoin is a widely used therapeutic for the treatment of acne vulgaris and various other skin disorders. However, since its approval, many side effects and contraindications have been described, particularly important, such as teratogenicity as well as liver disease and dermal deterioration. In a very important allegation, isotretinoin has been linked with psychiatric symptoms like depression, suicidal ideation, schizophrenia, and hypervitaminosis A syndrome characteristics. These adverse effects have raised significant concerns regarding the safety of isotretinoin. Numerous studies and research have associated isotretinoin with side effects on the mental health of patients and have proposed plausible mechanisms regarding this suspected causative relationship. However, the evidence is still contradicting, and the data disperse, making their validity less valuable. Thus, in the present study, we aim to analyze further the available literature and present a complete analysis of the side effects of isotretinoin, with particular emphasis on the effects it may have on the mental health of patients. The review is based on international articles from broad scientific electronic databases like PubMed and Scopus. This review concludes that although many studies have associated isotretinoin with mental effects like depression, bipolar disorder, schizophrenia, and suicidal ideation, the data are still insufficient and often contradictory. In fact, additional studies with accurate data and larger double-blinded samples, and more analytic systematic reviews are required. It is especially important to monitor the dose and the intervals that isotretinoin has to be administered in order to potentially cause mental health problems, as well as the duration of treatment and the role that the patient's medical and pharmaceutical history may play.

Keywords: acne, depression, isotretinoin, mental health

Procedia PDF Downloads 155
773 Strategic Interventions to Address Health Workforce and Current Disease Trends, Nakuru, Kenya

Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

Procedia PDF Downloads 107