Search results for: Erasmus intensive programme
502 Childhood Cataract: A Socio-Clinical Study at a Public Sector Tertiary Eye Care Centre in India
Authors: Deepak Jugran, Rajesh Gill
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Purpose: To study the demographic, sociological, gender and clinical profile of the children presented for childhood cataract at a public sector tertiary eye care centre in India. Methodology: The design of the study is retrospective, and hospital-based data is available with the Central Registration Department of the PGIMER, Chandigarh. The majority of the childhood cataract cases are being reported in this hospital, yet not each and every case of childhood cataract approaches PGI, Chandigarh. Nevertheless, this study is going to be pioneering research in India, covering five-year data of the childhood cataract patients who visited the Advanced Eye Centre, PGIMER, Chandigarh, from 1.1.2015 to 31.12.2019. The SPSS version 23 was used for all statistical calculations. Results: A Total of 354 children were presented for childhood cataract from 1.1.2015 to 31.12.2019. Out of 354 children, 248 (70%) were male, and 106 (30%) were female. In-spite of 2 flagship programmes, namely the National Programme for Control of Blindness (NPCB) and Aayushman Bharat (PM JAY) for eradication of cataract, no children received any financial assistance from these two programmes. A whopping 99% of these children belong to the poor families. In most of these families, the mothers were house-wives and did not employ anywhere. These interim results will soon be conveyed to the Govt. of India so that a suitable mechanism can be evolved to address this pertinent issue. Further, the disproportionate ratio of male and female children in this study is an area of concern as we don’t know whether the prevalence of childhood cataract is lower in female children or they are not being presented on time in the hospital by the families. Conclusion: The World Health Organization (WHO) has categorized Childhood blindness resulting from cataract as a priority area and urged all member countries to develop institutionalized mechanisms for its early detection, diagnosis and management. The childhood cataract is an emerging and major cause of preventable and avoidable childhood blindness, especially in low and middle-income countries. In the formative years, the children require a sound physical, mental and emotional state, and in the absence of either one of them, it can severely dent their future growth. The recent estimate suggests that India could suffer an economic loss of US$12 billion (Rs. 88,000 Crores) due to blindness, and almost 35% of cases of blindness are preventable and avoidable if detected at an early age. Besides reporting these results to the policy makers, synchronized efforts are needed for early detection and management of avoidable causes of childhood blindness such as childhood cataract.Keywords: childhood blindness, cataract, Who, Npcb
Procedia PDF Downloads 106501 Covid-19 Pandemic: Another Lesson Learned by a Military Hospital
Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu
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SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.Keywords: Covid-19, costs, hospital stay, military hospital
Procedia PDF Downloads 178500 An Exploratory Study on the Level of Awareness and Common Barriers of Physicians on Overweight and Obesity Management in Bangladesh
Authors: Kamrun Nahar Koly, Saimul Islam
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Overweight and obesity is increasing at an alarming rate and a leading risk factor for morbidity throughout the world. In a country like Bangladesh where under nutrition and overweight both co-exist at the same time, but this issue has been underexplored as expected. The aim of the present study was to assess the knowledge, attitudes and identify the barriers of the physicians regarding overweight and obesity management on an urban hospital of Dhaka city in Bangladesh. A simple cross sectional study was conducted at two selected government and two private hospital to assess the knowledge, attitude and common barriers regarding overweight and obesity management among healthcare professionals. One hundred and fifty five physicians were surveyed. A standard questionnaire was constructed in local language and interview was administrated. Among the 155 physicians, majority 53 (34.20%) were working on SMC, 36 (23.20%) from DMC, 33 (21.30%) were based on SSMC and the rest 33 (21.30%) were from HFRCMH. Mean age of the study physicians were 31.88±5.92. Majority of the physicians 80 (51.60%) were not able to answer the correct prevalence of obesity but also a substantial number of them 75(48.40%) could mark the right answer. Among the physicians 150 (96.77%) reported BMI as a diagnostic index for overweight and obesity, where as 43 (27.74%) waist circumference, 30 (19.35%) waist hip ratio and 26 (16.77%) marked mid-arm circumference. A substantial proportion 71 (46.70%) of the physicians thought that they do not have much to do controlling weight problem in Bangladesh context though it has been opposed by 42 (27.60%) of the physicians and 39(25.70%) was neutral to comment. The majority of them 147 (96.1%) thought that a family based education program would be beneficial followed by 145 (94.8%) physicians mentioned about raising awareness among mothers as she is the primary caregiver. The idea of a school based education program will also help to early intervene referred by 142 (92.8%) of the physicians. Community based education program was also appreciated by 136 (89.5%) of the physicians. About 74 (47.7%) of them think that the patients still lack in motivation to maintain their weight properly at the same time too many patients to deal with can be a barrier as well assumed by 73 (47.1%) of them. Lack of national policy or management guideline can act as an obstacle told by 60 (38.7%) of the physicians. The relationship of practicing as a part of the general examination and chronic disease management was statistically significant (p<0.05) with physician occupational status. As besides, perceived barriers like lack of parents support, lack of a national policy was statistically significant (p<0.05) with physician occupational status. For the young physician, more training programme will be needed to transform their knowledge and attitude into practice. However, several important barriers interface for the physician treatment efforts and need to address.Keywords: obesity management, physician, awareness, barriers, Bangladesh
Procedia PDF Downloads 164499 An Investigation into the Potential of Industrial Low Grade Heat in Membrane Distillation for Freshwater Production
Authors: Yehia Manawi, Ahmad Kayvanifard
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Membrane distillation is an emerging technology which has been used to produce freshwater and purify different types of aqueous mixtures. Qatar is an arid country where almost 100% of its freshwater demand is supplied through the energy-intensive thermal desalination process. The country’s need for water has reached an all-time high which stipulates finding an alternative way to augment freshwater without adding any drastic affect to the environment. The objective of this paper was to investigate the potential of using the industrial low grade waste heat to produce freshwater using membrane distillation. The main part of this work was conducting a heat audit on selected Qatari chemical industries to estimate the amounts of freshwater produced if such industrial waste heat were to be recovered. By the end of this work, the main objective was met and the heat audit conducted on the Qatari chemical industries enabled us to estimate both the amounts of waste heat which can be potentially recovered in addition to the amounts of freshwater which can be produced if such waste heat were to be recovered. By the end, the heat audit showed that around 605 Mega Watts of waste heat can be recovered from the studied Qatari chemical industries which resulted in a total daily production of 5078.7 cubic meter of freshwater. This water can be used in a wide variety of applications such as human consumption or industry. The amount of produced freshwater may look small when compared to that produced through thermal desalination plants; however, one must bear in mind that this water comes from waste and can be used to supply water for small cities or remote areas which are not connected to the water grid. The idea of producing freshwater from the two widely-available wastes (thermal rejected brine and waste heat) seems promising as less environmental and economic impacts will be associated with freshwater production which may in the near future augment the conventional way of producing freshwater currently being thermal desalination. This work has shown that low grade waste heat in the chemical industries in Qatar and perhaps the rest of the world can contribute to additional production of freshwater using membrane distillation without significantly adding to the environmental impact.Keywords: membrane distillation, desalination, heat recovery, environment
Procedia PDF Downloads 319498 Phenotypic Characterization of Desi Naked Neck Chicken and Its Association with Insulin-Like Growth Factor-I (IGF-I) Gene Polymorphism in Pakistan
Authors: Akbar Nawaz Khan, Abdul Ghaffar, Muhammad Naeem Riaz
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The study was conducted to investigate the phenotypic features, morphometry and production potentialities of indigenous naked neck chicken (NN) of Pakistan under intensive management condition. A total of 35 NN chicks were randomly selected, and the experiment was performed at Poultry and wildlife research section NARC Islamabad for a period of 22 weeks. The predominant plumage color was black and golden while skin color was observed white. The average shank length, leg length, thigh length, keel length, chest breadth, head width, wing space, wing length, body length, body girth, body height and pubic bone width in adult males and females were 69.19 ± 3.34mm, 117.93 ± 4.42mm, 117.93 ± 4.42mm, 90.87 ± 6.53mm, 95.03 ± 4.56mm, 49.77 ± 2.53mm, 30.63 ± 1.50cm, 27.24 ± 2.71cm, 18.88 ± 0.65cm, 17.77 ± 1.01cm, 25.96 ± 0.56cm, 47.81 ± 1.41cm and 35.69 ± 4.09mm respectively. The average age and live body weight of NN chicken at sexual maturity were recorded as 165.85 days and 1269.38 g. While hen-day egg production of NN was recorded as 45%. The present study was aimed to investigate the existence of polymorphism at IGF-I gene in indigenous naked neck chicken through PCR based Restriction Fragment Length Polymorphism. Based on restriction analysis using Hinf I restriction enzyme, three genotypes were detected designated as AA, AC, and CC. Restriction analysis of PCR amplified product showed the presence of DNA fragments of 622, 378, 244 and 191, (genotypes). The PCR-RFLP analysis is easy, cost effective method which permits the easy characterization of IGF-I gene. This showed the investigated IGF-I genes can serve as good molecular markers for marker assisted selection (MAS) concerning growth related traits in chicken.Keywords: Desi chicken, naked neck, morphology, morphometry, production potential, egg traits, egg geometry, IGF-I, growth, PCR- RFLP, chicken
Procedia PDF Downloads 389497 The Impact of Gold Mining on Disability: Experiences from the Obuasi Municipal Area
Authors: Mavis Yaa Konadu Agyemang
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Despite provisions to uphold and safeguard the rights of persons with disability in Ghana, there is evidence that they still encounter several challenges which limit their full and effective involvement in mainstream society, including the gold mining sector. The study sought to explore how persons with physical disability (PWPDs) experience gold mining in the Obuasi Municipal Area. A qualitative research design was used to discover and understand the experiences of PWPDs regarding mining. The purposive sampling technique was used to select five key informants for the study with the age range of (24-52 years) while snowball sampling aided the selection of 16 persons with various forms of physical disability with the age range of (24-60 years). In-depth interviews were used to gather data. The interviews lasted from forty-five minutes to an hour. In relation to the setting, the interviews of thirteen (13) of the participants with disability were done in their houses, two (2) were done on the phone, and one (1) was done in the office. Whereas the interviews of the five (5) key informants were all done in their offices. Data were analyzed using Creswell’s (2009) concept of thematic analysis. The findings suggest that even though land degradation affected everyone in the area, persons with mobility and visual impairment experienced many difficulties trekking the undulating land for long distances in search of arable land. Also, although mining activities are mostly labour-intensive, PWPDs were not employed even in areas where they could work. Further, the cost of items, in general, was high, affecting PWPDs more due to their economic immobility and paying for other sources of water due to land degradation and water pollution. The study also discovered that the peculiar conditions of PWPDs were not factored into compensation payments, and neither were females with physical disability engaged in compensation negotiations. Also, although some of the infrastructure provided by the gold mining companies in the area was physically accessible to some extent, it was not accessible in terms of information delivery. There is a need to educate the public on the effects of mining on PWPDs, their needs as well as disability issues in general. The Minerals and Mining Act (703) should be amended to include provisions that would consider the peculiar needs of PWPDs in compensation payment.Keywords: mining, resettlement, compensation, environmental, social, disability
Procedia PDF Downloads 54496 On Cloud Computing: A Review of the Features
Authors: Assem Abdel Hamed Mousa
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The Internet of Things probably already influences your life. And if it doesn’t, it soon will, say computer scientists; Ubiquitous computing names the third wave in computing, just now beginning. First were mainframes, each shared by lots of people. Now we are in the personal computing era, person and machine staring uneasily at each other across the desktop. Next comes ubiquitous computing, or the age of calm technology, when technology recedes into the background of our lives. Alan Kay of Apple calls this "Third Paradigm" computing. Ubiquitous computing is essentially the term for human interaction with computers in virtually everything. Ubiquitous computing is roughly the opposite of virtual reality. Where virtual reality puts people inside a computer-generated world, ubiquitous computing forces the computer to live out here in the world with people. Virtual reality is primarily a horse power problem; ubiquitous computing is a very difficult integration of human factors, computer science, engineering, and social sciences. The approach: Activate the world. Provide hundreds of wireless computing devices per person per office, of all scales (from 1" displays to wall sized). This has required new work in operating systems, user interfaces, networks, wireless, displays, and many other areas. We call our work "ubiquitous computing". This is different from PDA's, dynabooks, or information at your fingertips. It is invisible; everywhere computing that does not live on a personal device of any sort, but is in the woodwork everywhere. The initial incarnation of ubiquitous computing was in the form of "tabs", "pads", and "boards" built at Xerox PARC, 1988-1994. Several papers describe this work, and there are web pages for the Tabs and for the Boards (which are a commercial product now): Ubiquitous computing will drastically reduce the cost of digital devices and tasks for the average consumer. With labor intensive components such as processors and hard drives stored in the remote data centers powering the cloud , and with pooled resources giving individual consumers the benefits of economies of scale, monthly fees similar to a cable bill for services that feed into a consumer’s phone.Keywords: internet, cloud computing, ubiquitous computing, big data
Procedia PDF Downloads 382495 Sedimentological and Geochemical Characteristics of Aeolian Sediments and Their Implication for Sand Origin in the Yarlung Zangbo River Valley, Southern Qinghai-Tibetan Plateau
Authors: Na Zhou, Chun-Lai Zhang, Qing Li, Bingqi Zhu, Xun-Ming Wang
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The understanding of the dynamics of aeolian sand in the Yarlung Zangbo River Valley (YLZBV), southern Qinghai-Tibetan Plateau, including its origins, transportation,and deposition, remains preliminary. In this study, we investigated the extensive origin of aeolian sediments in the YLZBV by analyzing the distribution and composition of sediment’s grain size and geochemical composition in dune sediments collected from the wide river terraces. The major purpose is to characterize the sedimentological and geochemical compositions of these aeolian sediments, trace back to their sources, and understand their influencing factors. As a result, the grain size and geochemistry variations, which showed a significant correlation between grain sizes distribution and element abundances, give a strong evidence that the important part of the aeolian sediments in the downstream areas was firstly derived from the upper reaches by intense fluvial processes. However, the sediments experienced significant mixing process with local inputs and reconstructed by regional wind transportation. The diverse compositions and tight associations in the major and trace element geochemistry between the up- and down-stream aeolian sediments and the local detrital rocks, which were collected from the surrounding mountains, suggest that the upstream aeolian sediments had originated from the various close-range rock types, and experienced intensive mixing processes via aeolian- fluvial dynamics. Sand mass transported by water and wind was roughly estimated to qualify the interplay between the aeolian and fluvial processes controlling the sediment transport, yield, and ultimately shaping the aeolian landforms in the mainstream of the YLZBV.Keywords: grain size distribution, geochemistry, wind and water load, sand source, Yarlung Zangbo River Valley
Procedia PDF Downloads 97494 Reliability Levels of Reinforced Concrete Bridges Obtained by Mixing Approaches
Authors: Adrián D. García-Soto, Alejandro Hernández-Martínez, Jesús G. Valdés-Vázquez, Reyna A. Vizguerra-Alvarez
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Reinforced concrete bridges designed by code are intended to achieve target reliability levels adequate for the geographical environment where the code is applicable. Several methods can be used to estimate such reliability levels. Many of them require the establishment of an explicit limit state function (LSF). When such LSF is not available as a close-form expression, the simulation techniques are often employed. The simulation methods are computing intensive and time consuming. Note that if the reliability of real bridges designed by code is of interest, numerical schemes, the finite element method (FEM) or computational mechanics could be required. In these cases, it can be quite difficult (or impossible) to establish a close-form of the LSF, and the simulation techniques may be necessary to compute reliability levels. To overcome the need for a large number of simulations when no explicit LSF is available, the point estimate method (PEM) could be considered as an alternative. It has the advantage that only the probabilistic moments of the random variables are required. However, in the PEM, fitting of the resulting moments of the LSF to a probability density function (PDF) is needed. In the present study, a very simple alternative which allows the assessment of the reliability levels when no explicit LSF is available and without the need of extensive simulations is employed. The alternative includes the use of the PEM, and its applicability is shown by assessing reliability levels of reinforced concrete bridges in Mexico when a numerical scheme is required. Comparisons with results by using the Monte Carlo simulation (MCS) technique are included. To overcome the problem of approximating the probabilistic moments from the PEM to a PDF, a well-known distribution is employed. The approach mixes the PEM and other classic reliability method (first order reliability method, FORM). The results in the present study are in good agreement whit those computed with the MCS. Therefore, the alternative of mixing the reliability methods is a very valuable option to determine reliability levels when no close form of the LSF is available, or if numerical schemes, the FEM or computational mechanics are employed.Keywords: structural reliability, reinforced concrete bridges, combined approach, point estimate method, monte carlo simulation
Procedia PDF Downloads 346493 Bioefficacy of Ocimum sanctum on Survival, Development and Reproduction of Dengue Vector Aedes aegypti L. (Diptera: Culicidae)
Authors: Mohd Shazad, K. K. Gupta
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Vector borne diseases are a serious global concern. Aedes aegypti, the primary vector for viruses that cause dengue fever, dengue haemorrhagic fever, chikungunya and yellow fever is widespread over large areas of the tropics and subtropics. In last decade, diseases transmitted by Aedes aegypti are of serious concern. In past decade, number of cases of dengue fever, dengue hemorrhagic fever, and chikungunya has increased multifold. Present research work focused on impact of ethanol extract of Ocimum sanctum on dengue vector Aedes aegypti. 0-24 hr. old fourth instar larvae of lab-bred population of Aedes aegypti were exposed to ethanol leaf extract of Ocimum with concentrations ranging from 50 ppm to 400 ppm. Survival and development and the treated larvae and reproductive behaviour of the adults emerged from the treated larvae was evaluated. Our results indicated larvicidal potential of the leaf ethanol extract. The influence of the extract was dose dependent. 77.2% mortality was observed in the larvae exposed to 400 ppm for 24 hr. Treatment at lower concentrations revealed delayed toxicity. The larvae survived after treatment showed severe developmental anomalies. Consequently, there was the significant increase in duration of fourth instar larva. The L4 treated with 400-ppm extract moulted after 4.6 days; this was in sharp contrast to control where the larval period of the fourth instar lasts three days. The treated fourth instar larvae in many cases transformed into larva-pupa intermediates with the combination of larva, pupa characters. The larva-pupa intermediates had reduced life span and failed to moult successfully. The adults emerged from the larvae treated with lower doses had reduced reproductive potential. The females exhibited longer preoviposition period, reduced oviposition rate, abnormal oviposition behaviour and decreased fertility. Our studies indicated the possibility of the presence of JH mimic or JH analogue in the leaf ethanol extract of Ocimum. The present research work explored the potentials of Ocimum sanctum, also known as the queen of herbs, in integrated vector management programme of Aedes aegypti, which is a serious threat to human health.Keywords: Aedes aegypti, development, mortality, Ocimum sanctum reproduction
Procedia PDF Downloads 244492 Evaluating Multiple Diagnostic Tests: An Application to Cervical Intraepithelial Neoplasia
Authors: Areti Angeliki Veroniki, Sofia Tsokani, Evangelos Paraskevaidis, Dimitris Mavridis
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The plethora of diagnostic test accuracy (DTA) studies has led to the increased use of systematic reviews and meta-analysis of DTA studies. Clinicians and healthcare professionals often consult DTA meta-analyses to make informed decisions regarding the optimum test to choose and use for a given setting. For example, the human papilloma virus (HPV) DNA, mRNA, and cytology can be used for the cervical intraepithelial neoplasia grade 2+ (CIN2+) diagnosis. But which test is the most accurate? Studies directly comparing test accuracy are not always available, and comparisons between multiple tests create a network of DTA studies that can be synthesized through a network meta-analysis of diagnostic tests (DTA-NMA). The aim is to summarize the DTA-NMA methods for at least three index tests presented in the methodological literature. We illustrate the application of the methods using a real data set for the comparative accuracy of HPV DNA, HPV mRNA, and cytology tests for cervical cancer. A search was conducted in PubMed, Web of Science, and Scopus from inception until the end of July 2019 to identify full-text research articles that describe a DTA-NMA method for three or more index tests. Since the joint classification of the results from one index against the results of another index test amongst those with the target condition and amongst those without the target condition are rarely reported in DTA studies, only methods requiring the 2x2 tables of the results of each index test against the reference standard were included. Studies of any design published in English were eligible for inclusion. Relevant unpublished material was also included. Ten relevant studies were finally included to evaluate their methodology. DTA-NMA methods that have been presented in the literature together with their advantages and disadvantages are described. In addition, using 37 studies for cervical cancer obtained from a published Cochrane review as a case study, an application of the identified DTA-NMA methods to determine the most promising test (in terms of sensitivity and specificity) for use as the best screening test to detect CIN2+ is presented. As a conclusion, different approaches for the comparative DTA meta-analysis of multiple tests may conclude to different results and hence may influence decision-making. Acknowledgment: This research is co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme «Human Resources Development, Education and Lifelong Learning 2014-2020» in the context of the project “Extension of Network Meta-Analysis for the Comparison of Diagnostic Tests ” (MIS 5047640).Keywords: colposcopy, diagnostic test, HPV, network meta-analysis
Procedia PDF Downloads 139491 Mauriac Syndrome: A Rare Complicacation With an Easy Solution
Authors: Pablo Cid Galache, Laura Zamorano Bonilla
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Mauriac syndrome (MS) is a rare complication of type 1 diabetes mellitus (DM1). It is rela-ted to low insulin concentrations. Therefore is a complication mainly found in developing countries. The main clinical features are hepatomegaly, edema, growth and puberty delay, and the presence of elevated transaminases and serum lipids. The MS incidence is de-creasing due to the new types of insulin and intensive glycemic control. Therefore is a rare diagnosis in Europe nowadays, being described mainly in developing countries or with so-cioeconomic limitations to guarantee an adequate management of diabetes. Edema secondary to fluid retention is a rare complication of insulin treatment, especially in young patients. Its severity is variable and is mainly related to the start of a proper treatment and the improvement in glycemic control after diagnosis or after periods of poor metabolic control. Edema resolves spontaneously without requiring treatment in most cases. The Pediatric Endocrinology Unit of Hospital Motril could diagnose a 14-year-old girl who presented very poor metabolic control during the last 3 years as a consequence of the socioeconomic conditions of the country of origin during the last years. Presents up to 4 admissions for ketoacidosis during the last 12 months. After the family moved to Spain our patient began to be followed up in our Hospital. Initially presented glycated hemoglobin figures of 11%. One week after the start of treatment, the patient was admitted in the emergency room due to the appearance of generalized edema and pain in the limbs. The main laboratory abnormalities include: blood glucose 225mg/dl; HbA1C 10.8% triglycerides 543 mg/dl, total cholesterol 339 mg/dl (LDL 225) GOT 124 U/l, GPT 89U/l. Abdominal ultrasound shows mild hepatomegaly and no signs of ascites were shown. The patient presented a progressive improvement with resolution of the edema and analitical abnormalities during the next two weeks. During admission, the family received diabetes education, achieving adequate glycemic control at discharge. Nowadays the patient has a good glycemic control having glycated hemoglobin levels around 7%.Keywords: Mauriac, diabetes, complication, developing countries
Procedia PDF Downloads 54490 Pathway Linking Early Use of Electronic Device and Psychosocial Wellbeing in Early Childhood
Authors: Rosa S. Wong, Keith T.S. Tung, Winnie W. Y. Tso, King-Wa Fu, Nirmala Rao, Patrick Ip
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Electronic devices have become an essential part of our lives. Various reports have highlighted the alarming usage of electronic devices at early ages and its long-term developmental consequences. More sedentary screen time was associated with increased adiposity, worse cognitive and motor development, and psychosocial health. Apart from the problems caused by children’s own screen time, parents today are often paying less attention to their children due to hand-held device. Some anecdotes suggest that distracted parenting has negative impact on parent-child relationship. This study examined whether distracted parenting detrimentally affected parent-child activities which may, in turn, impair children’s psychosocial health. In 2018/19, we recruited a cohort of preschoolers from 32 local kindergartens in Tin Shui Wai and Sham Shui Po for a 5-year programme aiming to build stronger foundations for children from disadvantaged backgrounds through an integrated support model involving medical, education and social service sectors. A comprehensive set of questionnaires were used to survey parents on their frequency of being distracted while parenting and their frequency of learning and recreational activities with children. Furthermore, they were asked to report children’s screen time amount and their psychosocial problems. Mediation analyses were performed to test the direct and indirect effects of electronic device-distracted parenting on children’s psychosocial problems. This study recruited 873 children (448 females and 425 males, average age: 3.42±0.35). Longer screen time was associated with more psychosocial difficulties (Adjusted B=0.37, 95%CI: 0.12 to 0.62, p=0.004). Children’s screen time positively correlated with electronic device-distracted parenting (r=0.369, p < 01). We also found that electronic device-distracted parenting was associated with more hyperactive/inattentive problems (Adjusted B=0.66, p < 0.01), fewer prosocial behavior (Adjusted B=-0.74, p < 0.01), and more emotional symptoms (Adjusted B=0.61, p < 0.001) in children. Further analyses showed that electronic device-distracted parenting exerted influences both directly and indirectly through parent-child interactions but to different extent depending upon the outcome under investigation (38.8% for hyperactivity/inattention, 31.3% for prosocial behavior, and 15.6% for emotional symptoms). We found that parents’ use of devices and children’s own screen time both have negative effects on children’s psychosocial health. It is important for parents to set “device-free times” each day so as to ensure enough relaxed downtime for connecting with children and responding to their needs.Keywords: early childhood, electronic device, psychosocial wellbeing, parenting
Procedia PDF Downloads 164489 AI/ML Atmospheric Parameters Retrieval Using the “Atmospheric Retrievals conditional Generative Adversarial Network (ARcGAN)”
Authors: Thomas Monahan, Nicolas Gorius, Thanh Nguyen
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Exoplanet atmospheric parameters retrieval is a complex, computationally intensive, inverse modeling problem in which an exoplanet’s atmospheric composition is extracted from an observed spectrum. Traditional Bayesian sampling methods require extensive time and computation, involving algorithms that compare large numbers of known atmospheric models to the input spectral data. Runtimes are directly proportional to the number of parameters under consideration. These increased power and runtime requirements are difficult to accommodate in space missions where model size, speed, and power consumption are of particular importance. The use of traditional Bayesian sampling methods, therefore, compromise model complexity or sampling accuracy. The Atmospheric Retrievals conditional Generative Adversarial Network (ARcGAN) is a deep convolutional generative adversarial network that improves on the previous model’s speed and accuracy. We demonstrate the efficacy of artificial intelligence to quickly and reliably predict atmospheric parameters and present it as a viable alternative to slow and computationally heavy Bayesian methods. In addition to its broad applicability across instruments and planetary types, ARcGAN has been designed to function on low power application-specific integrated circuits. The application of edge computing to atmospheric retrievals allows for real or near-real-time quantification of atmospheric constituents at the instrument level. Additionally, edge computing provides both high-performance and power-efficient computing for AI applications, both of which are critical for space missions. With the edge computing chip implementation, ArcGAN serves as a strong basis for the development of a similar machine-learning algorithm to reduce the downlinked data volume from the Compact Ultraviolet to Visible Imaging Spectrometer (CUVIS) onboard the DAVINCI mission to Venus.Keywords: deep learning, generative adversarial network, edge computing, atmospheric parameters retrieval
Procedia PDF Downloads 170488 Democratization, Market Liberalization and the Raise of Vested Interests and Its Impacts on Anti-Corruption Reform in Indonesia
Authors: Ahmad Khoirul Umam
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This paper investigates the role of vested interests and its impacts on anti-corruption agenda in Indonesia following the collapse of authoritarian regime in 1998. A pervasive and rampant corruption has been believed as the main cause of the state economy’s fragility. Hence, anti-corruption measures were implemented by applying democratization and market liberalization since the establishment of a consolidated democracy which go hand in hand with a liberal market economy is convinced to be an efficacious prescription for effective anti-corruption. The reform movement has also mandated the establishment of the independent, neutral and professional special anti-corruption agency namely Corruption Eradication Commission (KPK) to more intensify the fight against the systemic corruption. This paper will examine whether these anti-corruption measures have been effective to combat corruption, and investigate to what extend have the anti-corruption efforts, especially those conducted by KPK, been impeded by the emergence of a nexus of vested interests as the side-effect of democratization and market liberalization. Based on interviews with key stakeholders from KPK, other law enforcement agencies, government, prominent scholars, journalists and NGOs in Indonesia, it is found that since the overthrow of Soeharto, anti-corruption movement in the country have become more active and serious. After gradually winning the hearth of people, KPK successfully touched the untouchable corruption perpetrators who were previously protected by political immunity, legal protection and bureaucratic barriers. However, these changes have not necessarily reduced systemic and structural corruption practices. Ironically, intensive and devastating counterattacks were frequently posed by the alignment of business actors, elites of political parties, government, and also law enforcement agencies by hijacking state’s instruments to make KPK deflated, powerless, and surrender. This paper concludes that attempts of democratization, market liberalization and the establishment of anti-corruption agency may have helped Indonesia to reduce corruption. However, it is still difficult to imply that such anti-corruption measures have fostered the more effective anti-corruption works in the newly democratized and weakly regulated liberal economic system.Keywords: vested interests, democratization, market liberalization, anti-corruption, Indonesia
Procedia PDF Downloads 232487 Celebrating Community Heritage through the People’s Collection Wales: A Case Study in the Development of Collecting Traditions and Engagement
Authors: Gruffydd E. Jones
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The world’s largest collection of historical, cultural, and heritage material is unarchived and undocumented in the hands of the public. Not only does this material represent the missing collections in heritage sector archives today, but it is also the key to providing a diverse range of communities with the means to express their history in their own words and to celebrate their unique, personal heritage. The People’s Collection Wales (PCW) acts as a platform on which the heritage of Wales and her people can be collated and shared, at the heart of which is a thriving community engagement programme across a network of museums, archives, and libraries. By providing communities with the archival skillset commonly employed throughout the heritage sector, PCW enables local projects, societies, and individuals to express their understanding of local heritage with their own voices, empowering communities to embrace their diverse and complex identities around Wales. Drawing on key examples from the project’s history, this paper will demonstrate the successful way in which museums have been developed as hubs for community engagement where the public was at the heart of collection and documentation activities, informing collection and curatorial policies to benefit both the institute and its local community. This paper will also highlight how collections from marginalised, under-represented, and minority communities have been published and celebrated extensively around Wales, including adoption by the education system in classrooms today. Any activity within the heritage sector, whether of collection, preservation, digitisation, or accessibility, should be considerate of community engagement opportunities not only to remain relevant but in order to develop as community hubs, pivots around which local heritage is supported and preserved. Attention will be drawn to our digitisation workflow, which, through training and support from museums and libraries, has allowed the public not only to become involved but to actively lead the contemporary evolution of documentation strategies in Wales. This paper will demonstrate how the PCW online access archive is promoting museum collections, encouraging user interaction, and providing an invaluable platform on which a broader community can inform, preserve and celebrate their cultural heritage through their own archival material too. The continuing evolution of heritage engagement depends wholly on placing communities at the heart of the sector, recognising their wealth of cultural knowledge, and developing the archival skillset necessary for them to become archival practitioners of their own.Keywords: social history, cultural heritage, community heritage, museums, archives, libraries, community engagement, oral history, community archives
Procedia PDF Downloads 94486 Analyzing Industry-University Collaboration Using Complex Networks and Game Theory
Authors: Elnaz Kanani-Kuchesfehani, Andrea Schiffauerova
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Due to the novelty of the nanotechnology science, its highly knowledge intensive content, and its invaluable application in almost all technological fields, the close interaction between university and industry is essential. A possible gap between academic strengths to generate good nanotechnology ideas and industrial capacity to receive them can thus have far-reaching consequences. In order to be able to enhance the collaboration between the two parties, a better understanding of knowledge transfer within the university-industry relationship is needed. The objective of this research is to investigate the research collaboration between academia and industry in Canadian nanotechnology and to propose the best cooperative strategy to maximize the quality of the produced knowledge. First, a network of all Canadian academic and industrial nanotechnology inventors is constructed using the patent data from the USPTO (United States Patent and Trademark Office), and it is analyzed with social network analysis software. The actual level of university-industry collaboration in Canadian nanotechnology is determined and the significance of each group of actors in the network (academic vs. industrial inventors) is assessed. Second, a novel methodology is proposed, in which the network of nanotechnology inventors is assessed from a game theoretic perspective. It involves studying a cooperative game with n players each having at most n-1 decisions to choose from. The equilibrium leads to a strategy for all the players to choose their co-worker in the next period in order to maximize the correlated payoff of the game. The payoffs of the game represent the quality of the produced knowledge based on the citations of the patents. The best suggestion for the next collaborative relationship is provided for each actor from a game theoretic point of view in order to maximize the quality of the produced knowledge. One of the major contributions of this work is the novel approach which combines game theory and social network analysis for the case of large networks. This approach can serve as a powerful tool in the analysis of the strategic interactions of the network actors within the innovation systems and other large scale networks.Keywords: cooperative strategy, game theory, industry-university collaboration, knowledge production, social network analysis
Procedia PDF Downloads 258485 Informal Green Infrastructure as Mobility Enabler in Informal Settlements of Quito
Authors: Ignacio W. Loor
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In the context of informal settlements in Quito, this paper provides evidence that slopes and deep ravines typical of Andean cities, around which marginalized urban communities sit, constitute a platform for green infrastructure that supports mobility for pedestrians in an incremental fashion. This is informally shaped green infrastructure that provides connectivity to other mobility infrastructures such as roads and public transport, which permits relegated dwellers reach their daily destinations and reclaim their rights to the city. This is relevant in that walking has been increasingly neglected as a viable mean of transport in Latin American cities, in favor of rather motorized means, for which the mobility benefits of green infrastructure have remained invisible to policymakers, contributing to the progressive isolation of informal settlements. This research leverages greatly on an ecological rejuvenation programme led by the municipality of Quito and the Andean Corporation for Development (CAN) intended for rehabilitating the ecological functionalities of ravines. Accordingly, four ravines in different stages of rejuvenation were chosen, in order to through ethnographic methods, capture the practices they support to dwellers of informal settlements across different stages, particularly in terms of issues of mobility. Then, by presenting fragments of interviews, description of observed phenomena, photographs and narratives published in institutional reports and media, the production process of mobility infrastructure over unoccupied slopes and ravines, and the roles that this infrastructure plays in the mobility of dwellers and their quotidian practices are explained. For informal settlements, which normally feature scant urban infrastructure, mobility embodies an unfavourable driver for the possibilities of dwellers to actively participate in the social, economic and political dimensions of the city, for which their rights to the city are widely neglected. Nevertheless, informal green infrastructure for mobility provides some alleviation. This infrastructure is incremental, since its features and usability gradually evolves as users put into it knowledge, labour, devices, and connectivity to other infrastructures in different dimensions which increment its dependability. This is evidenced in the diffusion of knowledge of trails and routes of footpaths among users, the implementation of linking stairs and bridges, the improved access by producing public spaces adjacent to the ravines, the illuminating of surrounding roads, and ultimately, the restoring of ecological functions of ravines. However, the perpetuity of this type of infrastructure is also fragile and vulnerable to the course of urbanisation, densification, and expansion of gated privatised spaces.Keywords: green infrastructure, informal settlements, urban mobility, walkability
Procedia PDF Downloads 164484 A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program
Authors: Jacqueline M. Dias, Amina A Khowaja
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Clinical education is one of the most important components of a nursing curriculum as it develops the students’ cognitive, psychomotor and affective skills. Clinical teaching ensures the integration of knowledge into practice. As the numbers of students increase in the field of nursing coupled with the faculty shortage, clinical preceptors are the best choice to ensure student learning in the clinical settings. The clinical preceptor role has been introduced in the undergraduate nursing programme. In Pakistan, this role emerged due to a faculty shortage. Initially, two clinical preceptors were hired. This study will explore clinical preceptors views and experiences of precepting Bachelor of Science in Nursing (BScN) students in an undergraduate program. A case study design was used. As case studies explore a single unit of study such as a person or very small number of subjects; the two clinical preceptors were fundamental to the study and served as a single case. Qualitative data were obtained through an iterative process using in depth interviews and written accounts from reflective journals that were kept by the clinical preceptors. The findings revealed that the clinical preceptors were dedicated to their roles and responsibilities. Another, key finding was that clinical preceptors’ prior knowledge and clinical experience were valuable assets to perform their role effectively. The clinical preceptors found their new role innovative and challenging; it was stressful at the same time. Findings also revealed that in the clinical agencies there were unclear expectations and role ambiguity. Furthermore, clinical preceptors had difficulty integrating theory into practice in the clinical area and they had difficulty in giving feedback to the students. Although this study is localized to one university, generalizations can be drawn from the results. The key findings indicate that the role of a clinical preceptor is demanding and stressful. Clinical preceptors need preparation prior to precepting students on clinicals. Also, institutional support is fundamental for their acceptance. This paper focuses on the views and experiences of clinical preceptors undertaking a newly established role and resonates with the literature. The following recommendations are drawn to strengthen the role of the clinical preceptors: A structured program for clinical preceptors is needed along with mentorship. Clinical preceptors should be provided with formal training in teaching and learning with emphasis on clinical teaching and giving feedback to students. Additionally, for improving integration of theory into practice, clinical modules should be provided ahead of the clinical. In spite of all the challenges, ten more clinical preceptors have been hired as the faculty shortage continues to persist.Keywords: baccalaureate nursing education, clinical education, clinical preceptors, nursing curriculum
Procedia PDF Downloads 174483 Value Clusters of Grade 9 Teachers in the District of Trece Martires City, Division of Cavite: Basis for a Revised Values Education Program (RVEP)"
Authors: Juland D. Salayo
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With numerous innovations introduced in the Philippine educational system, the country’s struggle of materializing its national goal of transforming lives ends with great loss. Many agree that the failure to emerge the integral values of the program, framework and the implementers impedes realization. Employing a descriptive-correlational method, it aimed to determine the value clusters of the Grade 9 teachers as assessed by themselves and by the students, the significant difference of the assessed values and the significant difference on the values based on their profile. Respondents were composed of sixty-nine (69) teachers and three hundred forty (340) students using simple random sampling. Through a survey-questionnaire, the study revealed that the teachers have high regards on their self-reliance, honesty and trustworthiness, obedience, politeness and respect and self-discipline and spirituality. In contrast, they have ranked the following values fairly: justice and fairness, courage, responsibility and punctuality and nationalism and patriotism. Having assessed by the students, they have highly regarded their teachers’ self-reliance, responsibility and punctuality, obedience, politeness and respect and fair play and sportsmanship. On the other hand, the student-respondents made a low assessment on the level of the teachers’ justice and fairness, nationalism and patriotism, honesty and trustworthiness and excellence. Using t-test, it showed that there is a significant difference between the assessments of the respondents. Finally, among the demographic profiles, only civil status and age rejected the hypothesis. The following were recommended: provide educators value-enhancement trainings and conferences, organize value-oriented organizations and activities, and make intensive value-campaigns heightening the low-assessed values. Thus, a Revised Values Education Program (RVEP) was made to further meet the objectives of the program, address the needs of its clienteles, and responding to the demands of both education and society towards excellence in service, social and economic revolution, and constructive national goals which are based from integral values.Keywords: values, value clusters, values education program, values education, teachers' assessed values
Procedia PDF Downloads 286482 The Diverse Experiences of Men Living with Disabilities Participating in Violence Prevention Interventions in Africa and Asia: Men as Victims; Men as Perpetrators
Authors: Ingrid van der Heijden, Kristen Dunkle, Rachel Jewkes
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Background: Emerging literature on prevalence shows that men with disabilities are four more times likely than men without disabilities to experience sexual violence during their lifetime. However, compared to women with disabilities, men with disabilities still have lesser experiences of violence. While empirical evidence on the prevalence of victimization of men with disabilities is emerging, there is scarcer evidence highlighting disabled men’s perpetration of different forms of violence, particularly intimate partner violence. We can assume that men are likely to be both perpetrators and victims of violence, making more complex the causes and risks of violence. Gender norms and disability stigma play important roles in men’s experiences of violence. Men may be stigmatized because of their inability to attain hegemonic masculine ideals of strength, control over women and sexual conquest, which makes them more susceptible to emotional, physical and sexual abuse. Little to no evidence exists of men with disabilities’ experiences of perpetration of intimate partner violence, family violence or community violence. So far studies on male victimization do not succeed to offer contextual evidence that would highlight why and how men with disabilities perpetrate and/or are victims of sexual or other forms of violence. Objective: The overall aim to highlight men with disabilities’ experiences of both victimization and perpetration, and how living up to normative and hegemonic ideals of masculinity and ‘ability’ shape their experiences. It will include: identifying how gender and impairments intersect and shape their experiences of violence; identifying the contexts of and risks for violence; identifying the impacts and consequences of violence on their lives (including mental health impacts), and identifying obstacles and enablers to support and interventions to prevent violence. Methodology: In-depth qualitative interviews with 20 men with disabilities participating in interventions conducted by the What Works Global Programme for violence prevention (DIFD) in Africa and Asia. Men with a range of disabilities will be invited to share their lifetime experiences of violence. Implications for Practice: The data from this study will be used to start thinking about strategies to include men with disabilities in violence prevention strategies for both men and women. Limitations: Because men will be participating in interventions, it is assumed that they will not have severe impairments that hamper their cognitive or physical ability to participate in the intervention activities - and therefore will be able to participate in the in-depth interviews. Of course, this is a limitation of the study as it does not include those men with severe disabilities – measured by the World Health Organization’s International Classification of Functioning - who may be more vulnerable and at higher risk of experiencing violence, and who are less likely to be able to access services and interventions.Keywords: gender, men with disabilities, perpetration of violence, victimization
Procedia PDF Downloads 323481 Algae for Wastewater Treatment and CO₂ Sequestration along with Recovery of Bio-Oil and Value Added Products
Authors: P. Kiran Kumar, S. Vijaya Krishna, Kavita Verma1, V. Himabindu
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Concern about global warming and energy security has led to increased biomass utilization as an alternative feedstock to fossil fuels. Biomass is a promising feedstock since it is abundant and cheap and can be transformed into fuels and chemical products. Microalgae biofuels are likely to have a much lower impact on the environment. Microalgae cultivation using sewage with industrial flue gases is a promising concept for integrated biodiesel production, CO₂ sequestration, and nutrients recovery. Autotrophic, Mixotrophic, and Heterotrophic are the three modes of cultivation for microalgae biomass. Several mechanical and chemical processes are available for the extraction of lipids/oily components from microalgae biomass. In organic solvent extraction methods, a prior drying of biomass and recovery of the solvent is required, which are energy-intensive. Thus, the hydrothermal process overcomes the drawbacks of conventional solvent extraction methods. In the hydrothermal process, the biomass is converted into oily components by processing in a hot, pressurized water environment. In this process, in addition to the lipid fraction of microalgae, other value-added products such as proteins, carbohydrates, and nutrients can also be recovered. In the present study was (Scenedesmus quadricauda) was isolated and cultivated in autotrophic, heterotrophic, and mixotrophically using sewage wastewater and industrial flue gas in batch and continuous mode. The harvested algae biomass from S. quadricauda was used for the recovery of lipids and bio-oil. The lipids were extracted from the algal biomass using sonication as a cell disruption method followed by solvent (Hexane) extraction, and the lipid yield obtained was 8.3 wt% with Palmitic acid, Oleic acid, and Octadeonoic acid as fatty acids. The hydrothermal process was also carried out for extraction of bio-oil, and the yield obtained was 18wt%. The bio-oil compounds such as nitrogenous compounds, organic acids, and esters, phenolics, hydrocarbons, and alkanes were obtained by the hydrothermal process of algal biomass. Nutrients such as NO₃⁻ (68%) and PO₄⁻ (15%) were also recovered along with bio-oil in the hydrothermal process.Keywords: flue gas, hydrothermal process, microalgae, sewage wastewater, sonication
Procedia PDF Downloads 140480 The Relationship between Environmental Factors and Purchasing Decisions in the Residential Market in Sweden
Authors: Agnieszka Zalejska-Jonsson
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The Swedish Green Building Council (SGBC) was established in 2009. Since then, over 1000 buildings have been certified, of which approximately 600 are newly produced and 340 are residential buildings. During that time, approximately 2000 apartment buildings have been built in Sweden. This means that over a five- year period 17% of residential buildings have been certified according to the environmental building scheme. The certification of the building is not a guarantee of environmental progress but it gives us an indication of the extent of the progress. The overarching aim of this study is to investigate the factors behind the relatively slow evolution of the green residential housing market in Sweden. The intention is to examine stated willingness to pay (WTP) for green and low energy apartments, and to explore which factors have a significant effect on stated WTP among apartment owners. A green building was defined as a building certified according to the environmental scheme and a low energy building as a building designed and constructed with high energy efficiency goals. Data for this study were collected through a survey conducted among occupants of comparable apartment buildings: two green and one conventional. The total number of received responses was 429: green A (N=160), response rate 42%; green B (N=138) response rate 35%, and conventional (N=131) response rate 43%. The study applied a quasi-experimental method. Survey responses regarding factors affecting purchase of apartment, stated WTP and environmental literacy have been analysed using descriptive statistics, the Mann–Whitney (rank sum) test and logistic models. Comments received from respondents have been used for further interpretation of results. Results indicate that environmental education has a significant effect on stated WTP. Occupants who declared higher WTP showed a higher level of environmental literacy and indicated that energy efficiency was one of the important factors that affected their decision to buy an apartment. Generally, the respondents were more likely to pay more for low energy buildings than for green buildings. This is to a great extent a consequence of rational customer behaviour and difficulty in apprehending the meaning of green building certification. The analysis shows that people living in green buildings indicate higher WTP for both green and low energy buildings, the difference being statistically significant. It is concluded that growth in the green housing market in Sweden might be achieved if policymakers and developers engage in active education in the environmental labelling system. The demand for green buildings is more likely to increase when the difference between green and conventional buildings is easily understood and information is not only delivered by the estate agent, but is part of an environmental education programme.Keywords: consumer, environmental education, housing market, stated WTP, Sweden
Procedia PDF Downloads 241479 Cost-Effectiveness of Laparoscopic Common Bile Duct Exploration vs. Endoscopic Retrograde Cholangiopancreatography in the Emergency Management of Common Bile Duct Stones
Authors: Tess Howard, Lily Owens, Maneesha De Silva, Russell Hodgson
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Purpose: This study aims to evaluate the cost-effectiveness of laparoscopic common bile duct exploration (CBDE) compared to endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy for the emergency management of common bile duct (CBD) stones. Methodology: A retrospective case note review was conducted on consecutive patients undergoing emergency management of CBD stones using either CBDE, or ERCP and cholecystectomy at a single centre between January 2014-October 2014. Data on admission and procedural costs, length of hospital stay, postoperative complications and further stone related interventions were analysed. Results: A total of 350 patients were analysed. Among them, 299 patients underwent CBDE at the time of cholecystectomy, while the remaining 51 underwent ERCP either pre-, intra- or post cholecystectomy. CBDE was associated with lower overall costs compared to ERCP with an average hospital stay cost of $13,093 vs $22,930 respectively. This was largely attributed to shorter hospital stays (6.5 vs 10.3 days), decreased need for intensive care unit admission and fewer postoperative interventions within the CBDE group. Notably, single procedure laparoscopic cholecystectomy with CBDE demonstrated decreased operative costs compared to laparoscopic cholecystectomy combined with ERCP pre-/intra- or post-operatively ($3,747 vs. $4,641). Conclusion: Emergent CBDE is a cost-effective alternative to ERCP for managing CBD stones when combined with cholecystectomy. The upfront investment in equipment for CBDE and increased cholecystectomy procedural time is counterbalanced by reduced hospital stay, fewer procedures and subsequent cost savings. Economic considerations, in conjunction with clinical outcomes, should inform the selection of the optimal approach for CBD stone management in emergency settings.Keywords: choledocolithiasis, management, cost-effectiveness, endoscopic retrograde cholangiopancreatography, ERCP, CBDE, common bile duct exploration
Procedia PDF Downloads 19478 The Experiences and Needs of Fathers’ of Children With Cancer in Coping With the Child's Illness
Authors: Karina Lõbus, Silver Muld, Kadri Kööp, Mare Tupits
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Aim: The aim of the research is to describe the experiences and needs of fathers’ of children with cancer in coping with the child's disease. Background: Today, about 80% of children diagnosed with malignancy in developed countries survive. Despite the positive statistics, recovery is not always certain, treatment is often very intensive and long-term. Cancer is affecting an increasing number of the population, which is increasing the demand for quality care, but the nature of expected care is currently unclear. This topic is important for the development of professional practice, as nurses complain that their knowledge to deal with the relatives of a patient with a difficult diagnosis is limited and would therefore like additional information to deal with the situation. Design: Qualitative, empirical, descriptive research. Method: The data were collected through semi-structured interviews and analysed by inductive content analysis method. Interviews were conducted during Autumn 2020. 4 subjects participated in the research. Results and Conclusions: The thesis revealed that fathers had different experiences and needs in dealing with the child's illness. Fathers' experiences of coping with child's diseases encompassed experiences with information, social relationships, healthcare, changes in personal health and experiences regarding the child. Regarding information, the respondents pointed out bad experiences with the availability of information and the ability to convey the necessary information. Experiences regarding social relationships included experiences with relatives and strangers. Regarding healthcare, fathers mentioned experiences related to the child's health and healthcare professionals. In regards to personal health, fathers pointed out negative changes in their mental and physical health. In relation to the child, the subjects revealed experiences regarding changed values, way of life and raising the child. According to the research, fathers’ needs in relation to dealing with child's cancer included material, social, and spiritual needs. In regard to material needs, fathers pointed out the need for state assistance and the needs related to the surrounding environment. The needs concerning social belonging involved needs for a driving force and involvement in the treatment process. Regarding spiritual needs, fathers expressed mixed feelings towards the need for outside and professional help.Keywords: father, coping, cancer, child, experience, need
Procedia PDF Downloads 135477 Comparison of Maternal and Perinatal Outcomes of Obstetric Population Diagnosed with Covid-19 in Reference to Influenza A/H1N1: A Systematic Review and Meta-Analysis
Authors: Maria Vargas Hernandez, Jose Rojas Suarez, Carmelo Dueñas Castell, Sandra Contreras, Camilo Bello, Diana Borre, Walter Anichiarico, Harold Vasquez, Eduard Perez, Jose Santacruz
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In the last two decades, there have been outbreaks of emerging infectious diseases, with an impact on both the general population and the obstetric population. These infections, which affect the general population, pose a high risk for adverse maternal and perinatal outcomes, taking into account that physiological and immunological changes that occur during pregnancy can increase their risk or severity. Among these, the pandemics of viral infections, Influenza A/H1N1 and SARS-CoV-2/COVID-19, stand out. In 2009, Influenza A/H1N1 infection (H1N1 2009pdm) affected approximately 3,110 obstetric patients, with data reported from 29 countries, including 1,625 (52.3%) cases that were hospitalized, 378 (23.3%) admissions to ICU and 130 (8%) deaths; and since the end of 2019, the Severe Acute Respiratory Syndrome - 2 (SARS-CoV-2) has been identified, causing the COVID-19 pandemic, with global mortality that is around 2-4% for the general population, and higher mortality in patients requiring admission to the intensive care unit. Its impact on the obstetric population is still unknown. Objectives: To evaluate the impact on maternal and perinatal outcomes of COVID-19 infection in reference to influenza A/H1N1 infection in the obstetric population. Methodology: Systematic review of the literature and meta-analysis. Results: Mortality from maternal infection with influenza A/H1N1 appears to be higher (8%) than mortality due to maternal infection with COVID-19 (3%). The rates of ICU admission, hospitalization, the requirement for invasive mechanical ventilation, and fetal death also appear to be higher in the maternal population with A/H1N1 infection, in reference to the maternal population with COVID-19 infection. Within perinatal outcomes, the admission to the neonatal ICU appears to be higher in the infants born to mothers with COVID-19 infection (28% vs. 15% for COVID-19 and A/H1N1, respectively). Conclusion: A/H1N1 infection in the obstetric population seems to be associated with a higher proportion of adverse outcomes in relation to COVID-19 infection. The actual impact of maternal influenza A/H1N1 infection on perinatal outcomes is unknown. More COVID-19 studies are needed to understand the impact of maternal infection on perinatal outcomes in this population.Keywords: A/H1N1, COVID-19, maternal outcomes, perinatal outcomes
Procedia PDF Downloads 224476 Assessing the Competence of Oral Surgery Trainees: A Systematic Review
Authors: Chana Pavneet
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Background: In more recent years in dentistry, a greater emphasis has been placed on competency-based education (CBE) programmes. Undergraduate and postgraduate curriculums have been reformed to reflect these changes, and adopting a CBE approach has shown to be beneficial to trainees and places an emphasis on continuous lifelong learning. The literature is vast; however, very little work has been done specifically to the assessment of competence in dentistry and even less so in oral surgery. The majority of the literature tends to opinion pieces. Some small-scale studies have been undertaken in this area researching assessment tools which can be used to assess competence in oral surgery. However, there is a lack of general consensus on the preferable assessment methods. The aim of this review is to identify the assessment methods available and their usefulness. Methods: Electronic databases (Medline, Embase, and the Cochrane Database of systematic reviews) were searched. PRISMA guidelines were followed to identify relevant papers. Abstracts of studies were reviewed, and if they met the inclusion criteria, they were included in the review. Papers were reviewed against the critical appraisal skills programme (CASP) checklist and medical education research quality instrument (MERQSI) to assess their quality and identify any bias in a systematic manner. The validity and reliability of each assessment method or tool were assessed. Results: A number of assessment methods were identified, including self-assessment, peer assessment, and direct observation of skills by someone senior. Senior assessment tended to be the preferred method, followed by self-assessment and, finally, peer assessment. The level of training was shown to affect the preferred assessment method, with one study finding peer assessment more useful in postgraduate trainees as opposed to undergraduate trainees. Numerous tools for assessment were identified, including a checklist scale and a global rating scale. Both had their strengths and weaknesses, but the evidence was more favourable for global rating scales in terms of reliability, applicability to more clinical situations, and easier to use for examiners. Studies also looked into trainees’ opinions on assessment tools. Logbooks were not found to be significant in measuring the competence of trainees. Conclusion: There is limited literature exploring the methods and tools which assess the competence of oral surgery trainees. Current evidence shows that the most favourable assessment method and tool may differ depending on the stage of training. More research is required in this area to streamline assessment methods and tools.Keywords: competence, oral surgery, assessment, trainees, education
Procedia PDF Downloads 134475 A Shift-Share Analysis: Manufacturing Employment Specialisation at uMhlathuze Local Municipality, South Africa
Authors: Mlondi Ndovela
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Globally, the manufacturing employment has been declining and the South African manufacturing sector experiences the very same trend. Despite the commonality between the global and South African manufacturing trend, there is an understanding that local areas provide distinct contributions to the provincial/national economy. Therefore, the growth/decline of a particular manufacturing division in one local area may not be evident in another area since economic performances vary from region to region. In view of the above, the study employed the Esteban-Marquillas model of shift-share analysis (SSA) to conduct an empirical analysis of manufacturing employment performance at uMhlathuze Local Municipality in the KwaZulu-Natal province. The study set out two objectives; those are, to quantify uMhlathuze manufacturing jobs that are attributed to the provincial manufacturing employment trends and identify manufacturing divisions are growing/declining in terms of employment. To achieve these objectives, the study sampled manufacturing employment data from 2010 to 2017 and this data was categorised into ten manufacturing divisions. Furthermore, the Esteban-Marquillas model calculated manufacturing employment in terms of two effects, namely; provincial growth effect (PGE) and industrial mix effect (IME). The results show that even though uMhlathuze manufacturing sector has a positive PGE (+230), the municipality performed poorly in terms of IME (-291). A further analysis included other economic sectors of the municipality to draw employment performance comparison and the study found that agriculture; construction; trade, catering and accommodation; and transport, storage and communication, performed well above manufacturing sector in terms of PGE (+826) and IME (+532). This suggests that uMhlathuze manufacturing sector is not necessarily declining; however, other economic sectors are growing faster and bigger than it is, therefore, reducing the employment share of the manufacturing sector. To promote manufacturing growth from a policy standpoint, the government could create favourable macroeconomic policies such as import substitution policies and support labour-intensive manufacturing divisions. As a result, these macroeconomic policies can help to protect local manufacturing firms and stimulate the growth of manufacturing employment.Keywords: allocation effect, Esteban-Marquillas model, manufacturing employment, regional competitive effect, shift-share analysis
Procedia PDF Downloads 141474 Tale of Massive Distressed Migration from Rural to Urban Areas: A Study of Mumbai City
Authors: Vidya Yadav
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Migration is the demographic process that links rural to urban areas, generating or spurring the growth of cities. Evidence shows the role of the city as a production processes. It looks the city as a power of centre, and a centre of change. It has been observed that not only the professionals want to settle down in an urban area but rural labourers are also coming to cities for employment. These are the people who are compelled to migrate to metropolises because of lack of employment opportunities in their place of residence. However, the cities also fail to provide adequate employment because of limited job opportunity creation and capital-intensive industrialization. So these masses of incoming migrants are force to take up whatever employment absorption is available to them particularly in urban informal activities. Ultimately with this informal job they are compelled to stay in the slum areas, which is another form of deprived housing colonies. The paper seeks to examine the evidences of poverty induced migration from rural to urban areas (particularly in urban agglomeration). The present paper utilizes an abundant rich source of census migration data (D-Series) of 1991-2001. Result shows that Mumbai remain as the most attractive place to migrate. The migrants are mainly from the major states like Uttar Pradesh, Bihar, West Bengal, Jharkhand, Odisha, and Rajasthan. Male dominated migration is related mostly for employment and females due to marriages. The picture of occupational absorption of migrants who moved for employment, cross classified with educational status. Result shows that illiterate males are primarily engaged in low grade production processing work. Illiterate’s females engaged in service sectors; but these are actually very low grade services in urban informal sectors in India like maid servants, domestic help, hawkers, vendors or vegetables sellers. Among the higher educational level, a small percentage of males and females got absorbed in professional or clerical work but the percentage has been increased in the period 1991-2001.Keywords: informal, job, migration, urban
Procedia PDF Downloads 283473 Link Between Intensity-trajectories Of Acute Postoperative Pain And Risk Of Chronicization After Breast And Thoracopulmonary Surgery
Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila
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Introduction: The risk factors for the chronicization of postoperative pain are numerous and often intricately intertwined. Among these, the severity of acute postoperative pain is currently recognized as one of the most determining factors. Mastectomy and thoracotomy are described as among the most painful surgeries and the most likely to lead to chronic post-surgical pain (CPSP). Objective: To examine the aspects of acute postoperative pain potentially involved in the development of chronic pain following breast and thoracic surgery. Patients and Methods: A prospective study involving 164 patients was conducted over a six-month period. Postoperative pain (during mobilization) was assessed using a Visual Analog Scale (VAS) at various time points after surgery: Day 0, 1st, 2nd, 5th days, 1st and 6th months. Moderate to severe pain was defined as a VAS score ≥ 4. A comparative analysis (univariate analysis) of postoperative pain intensities at different evaluation phases was performed on patients with and without CPSP to identify potential associations with the risk of chronicization six months after surgery. Results: At the 6th month post-surgery, the incidence of CPSP was 43.0%. Moderate to severe acute postoperative pain (in the first five days) was observed in 64% of patients. The highest pain scores were reported among thoracic surgery patients. Comparative measures revealed a highly significant association between the presence of moderate to severe acute pain, especially lasting for ≥ 48 hours, and the occurrence of CPSP (p-value <0.0001). Likewise, the persistence of subacute pain (up to 4 to 6 weeks after surgery), especially of moderate to severe intensity, was significantly associated with the risk of chronicization at six months (p-value <0.0001). Conclusion: CPSP after breast and thoracic surgery remains a fairly common morbidity that profoundly affects the quality of life. Severe acute postoperative pain, especially if it is prolonged and/or with a slow decline in intensity, can be an important predictive factor for the risk of chronicization. Therefore, more effective and intensive management of acute postoperative pain, as well as longitudinal monitoring of its trajectory over time, should be an essential component of strategies for preventing chronic pain after surgery.Keywords: chronic post-surgical pain, acute postoperative pain, breast and thoracic surgery, subacute postoperative pain, pain trajectory, predictive factor
Procedia PDF Downloads 73