Search results for: bar code medication administration

Authors: Neerav Kumar, Naumaan Nayyar, Sharath Kashyap

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Most companies see an increase in the adoption of machine learning (ML) applications across internal and external-facing use cases. ML applications vend output either in batch or real-time patterns. A complete batch ML pipeline architecture comprises data sourcing, feature engineering, model training, model deployment, model output vending into a data store for downstream application. Due to unclear role expectations, we have observed that scientists specializing in building and optimizing models are investing significant efforts into building the other components of the architecture, which we do not believe is the best use of scientists’ bandwidth. We propose a system architecture created using AWS services that bring industry best practices to managing the workflow and simplifies the process of model deployment and end-to-end data integration for an ML application. This narrows down the scope of scientists’ work to model building and refinement while specialized data engineers take over the deployment, pipeline orchestration, data quality, data permission system, etc. The pipeline infrastructure is built and deployed as code (using terraform, cdk, cloudformation, etc.) which makes it easy to replicate and/or extend the architecture to other models that are used in an organization.

Keywords: data pipeline, machine learning, AWS, architecture, batch machine learning

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Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

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Authors: Bhavesh N. Bhatt, Zozimus D. Labana

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This work is mainly focused on the analysis of heat transfer of blade by using internal cooling method. By using conjugate heat transfer technology we can effectively compute the cooling and heat transfer analysis of blade. Here blade temperature is limited by materials melting temperature. By using CFD code, we will analyze the blade cooling with the help of CHT method. There are two types of CHT methods. In the first method, we apply coupled CHT method in which all three domains modeled at once, and in the second method, we will first model external domain and then, internal domain of cooling channel. Ten circular cooling channels are used as a cooling method with different mass flow rate and temperature value. This numerical simulation is applied on NASA C3X turbine blade, and results are computed. Here results are showing good agreement with experimental results. Temperature and pressure are high at the leading edge of the blade on stagnation point due to its first faces the flow. On pressure side, shock wave is formed which also make a sudden change in HTC and other parameters. After applying internal cooling, we are succeeded in reducing the metal temperature of blade by some extends.

Keywords: gas turbine, conjugate heat transfer, NASA C3X Blade, circular film cooling channel

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Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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Authors: A. Sebti Bouzid, S. Igoud, L. Aoudjit, H. Lebik

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Mathematical modeling and numerical simulation have emerged over the past two decades as one of the key tools for design and optimize performances of physical and chemical processes intended to water disinfection. Water photolysis is an efficient and economical technique to reduce bacterial contamination. It exploits the germicidal effect of solar ultraviolet irradiation to inactivate pathogenic microorganisms. The design of photo-reactor operating in continuous disinfection system, required tacking in account the hydrodynamic behavior of water in the reactor. Since the kinetic of disinfection depends on irradiation intensity distribution, coupling the hydrodynamic and solar radiation distribution is of crucial importance. In this work we propose a numerical simulation study for hydrodynamic and solar irradiation distribution in a tubular photo-reactor. We have used the Computational Fluid Dynamic code Fluent under the assumption of three-dimensional incompressible flow in unsteady turbulent regimes. The results of simulation concerned radiation, temperature and velocity fields are discussed and the effect of inclination angle of reactor relative to the horizontal is investigated.

Keywords: solar water disinfection, hydrodynamic modeling, solar irradiation modeling, CFD Fluent

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Authors: Wajid Ali Khan

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Extensive experimentation and numerical investigation are performed to predict the machining-induced residual stresses in the end milling of AISI 1045 steel, and an optimization code has been developed using the particle swarm optimization technique. Experiments were conducted using a single factor at a time and design of experiments approach. Regression analysis was done, and a mathematical model of the cutting process was developed, thus predicting the machining-induced residual stress with reasonable accuracy. The mathematical model served as the objective function to be optimized using particle swarm optimization. The relationship between the different cutting parameters and the output variables, force, and residual stresses has been studied. The combined effect of the process parameters, speed, feed, and depth of cut was examined, and it is understood that 85% of the variation of these variables can be attributed to these machining parameters under research. A 3D finite element model is developed to predict the cutting forces and the machining-induced residual stresses in end milling operation. The results were validated experimentally and against the Johnson-cook model available in the literature.

Keywords: residual stresses, end milling, 1045 steel, optimization

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Authors: Rachel Talbot, Nasuh Malas

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Stigma in child and adolescent psychiatry continues to be a significant barrier for youth to receive much needed psychiatric care. Parents misperceptions regarding mental health may interfere with their child’s care and negatively influence their child’s view of mental health. For some children, their first experience with psychiatry may occur during medical hospitalization when they are seen by the Psychiatry Consultation-Liaison (C/L) Service. Despite this unique role, there is limited data on how to address mental health stigma with patients and families within the context of Child and Adolescent C/L Psychiatry. This study explores the use of a brief introductory video with messages from the psychiatry C/L team, families who have accessed mental health consultation in the hospital, as well as clips of family and C/L team interactions to address parental stigma of psychiatry. Common stigmatized concerns shared by parents include concerns about confidentiality, later ramifications of mental healthcare, outsider status, and parental self-blame. There are also stigmatized concerns about psychiatric medication use including overmedication, sedation, long-term effects, medicating ‘real problems’ and personality blunting. Each of these are addressed during the video parents will see with the intent of reducing negative parental perceptions relating to mental healthcare. For this study, families are given a survey highlighting these concerns, prior to and after watching the video. Pre-and post-video responses are compared with the hypothesis that watching the video will effectively reduce parental stigma about psychiatric care. Data collection is currently underway and will be completed by the end of November 2017 with data analysis completed by January 2018. This study will also give vital information about the demographic differences in perceptions of stigma so future interventions can be targeted towards those with higher perceived stigma. This study posits that use of an introductory video is an effective strategy to combat stigma and help educate and empower families. In this way, we will be reducing further barriers for patients and families to seek out mental health resources and supports that are often desperately needed for these youths.

Keywords: child and adolescent psychiatry, consult-liaison psychiatry, media, stigma

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Authors: Kidus Dawit Gedamu

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Addis Ababa City Road Authority is responsible for managing and setting performance evaluation of the city’s road network using the International Roughness Index (IRI). This helps the authority to conduct pavement condition assessments of asphalt roads each year to determine the health status or Level of service (LOS) of the roadway network and plan program improvements such as maintenance, resurfacing and rehabilitation. For a lower IRI limit economical and acceptable maintenance strategy may be selected among a number of maintenance alternatives. The Highway Development and Management (HDM-4) tool can do such measures to help decide which option is the best by evaluating the economic and structural conditions. This paper specifically addresses flexible pavement, including two principal arterial streets under the administration of the Addis Ababa City Roads Authority. The roads include the road from Megenagna Interchange to Ayat Square and from Ayat Square to Tafo RA. First, it was assessed the procedures followed by the city's road authority to develop the appropriate road maintenance strategies. Questionnaire surveys and interviews are used to collect information from the city's road maintenance departments. Second, the project analysis was performed for functional and economic comparison of different maintenance alternatives using HDM-4.

Keywords: appropriate maintenance strategy, cost stream, road deterioration, maintenance alternative

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Authors: R. Haoui

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The purpose of this work is to simulate the flow at the exit of Vulcan 1 engine of European launcher Ariane 5. The geometry of the propellant nozzle is already determined using the characteristics method. The pressure in the outlet section of the nozzle is less than atmospheric pressure on the ground, causing the existence of oblique and normal shock waves at the exit. During the rise of the launcher, the atmospheric pressure decreases and the shock wave disappears. The code allows the capture of shock wave at exit of nozzle. The numerical technique uses the Flux Vector Splitting method of Van Leer to ensure convergence and avoid the calculation instabilities. The Courant, Friedrichs and Lewy coefficient (CFL) and mesh size level are selected to ensure the numerical convergence. The nonlinear partial derivative equations system which governs this flow is solved by an explicit unsteady numerical scheme by the finite volume method. The accuracy of the solution depends on the size of the mesh and also the step of time used in the discretized equations. We have chosen in this study the mesh that gives us a stationary solution with good accuracy.

Keywords: finite volume, lunchers, nozzles, shock wave

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Authors: Oktavia Eka Puspita

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The possibility of using Solid Lipid Nanoparticles (SLN) for topical use is an interesting feature concerning this system has occlusive properties on the skin surface therefore enhance the penetration of drugs through the stratum corneum by increased hydration. This advantage can be used to enhance the drug penetration of topical delivery such as Diclofenac sodium for the relief of signs and symptoms of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. The purpose of this study was focused on the preparation and physical characterization of Diclofenac sodium loaded SLN (D-SLN). D loaded SLN were prepared by hot homogenization followed by ultrasonication technique. Since the occlusion factor of SLN is related to its particle size the formulation of D-SLN in present study two formulations different in its surfactant contents were prepared to investigate the difference of the particle size resulted. Surfactants selected for preparation of formulation A (FA) were lecithin soya and Tween 80 whereas formulation B (FB) were lecithin soya, Tween 80, and Sodium Lauryl Sulphate. D-SLN were characterized for particle size and distribution, polydispersity index (PI), zeta potential using Beckman-Coulter Delsa™ Nano. Overall, the particle size obtained from FA was larger than FB. FA has 90% of the particles were above 1000 nm, while FB has 90% were below 100 nm.

Keywords: solid lipid nanoparticles, hot homogenization technique, particle size analysis, topical administration

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Authors: Hyeong-Gyu Park, Hak-Gon Noh, Beom-Soo Kang, Jeong Kim

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Electromagnetic forming (EMF) process is one of a high-speed forming process, which uses an electromagnetic body (Lorentz) force to deform work-piece. Advantages of EMF are summarized as improvement of formability, reduction in wrinkling, non-contact forming. In this study, the spiral coil is considered to evaluate formability in terms of pressure distribution of the forming process. It also is represented forming results of numerical analysis using ANSYS code. In the numerical simulation, RLC circuit coupled with spiral coil was made to consider the design parameters such as system input current and electromagnetic force. The simulation results show that even though input peak currents level are same level in each case, forming condition is certainly different because of frequency of input current and magnitude of current density and magnetic flux density. Finally, the simulation results appear that electromagnetic forming force apparently affected by input current frequency which determines magnitude of current density and magnetic flux density.

Keywords: electromagnetic forming, high-speed forming, RLC circuit, Lorentz force

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Authors: Alexandra K. Diem, Giles Richardson, Roxana O. Carare, Neil W. Bressloff

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Alzheimer's disease (AD) is the most common form of dementia and although it has been researched for over 100 years, there is still no cure or preventive medication. Its onset and progression is closely related to the accumulation of the neuronal metabolite Aβ. This raises the question of how metabolites and waste products are eliminated from the brain as the brain does not have a traditional lymphatic system. In recent years the rapid uptake of Aβ into cerebral artery walls and its clearance along those arteries towards the lymph nodes in the neck has been suggested and confirmed in mice studies, which has led to the hypothesis that interstitial fluid (ISF), in the basement membranes in the walls of cerebral arteries, provides the pathways for the lymphatic drainage of Aβ. This mechanism, however, requires a net reverse flow of ISF inside the blood vessel wall compared to the blood flow and the driving forces for such a mechanism remain unknown. While possible driving mechanisms have been studied using mathematical models in the past, a mechanism for net reverse flow has not been discovered yet. Here, we aim to address the question of the driving force of this reverse lymphatic drainage of Aβ (also called perivascular drainage) by using multi-scale numerical and analytical modelling. The numerical simulation software COMSOL Multiphysics 4.4 is used to develop a fluid-structure interaction model of a cerebral artery, which models blood flow and displacements in the artery wall due to blood pressure changes. An analytical model of a layer of basement membrane inside the wall governs the flow of ISF and, therefore, solute drainage based on the pressure changes and wall displacements obtained from the cerebral artery model. The findings suggest that an active role in facilitating a reverse flow is played by the components of the basement membrane and that stiffening of the artery wall during age is a major risk factor for the impairment of brain lymphatics. Additionally, our model supports the hypothesis of a close association between cerebrovascular diseases and the failure of perivascular drainage.

Keywords: Alzheimer's disease, artery wall mechanics, cerebral blood flow, cerebral lymphatics

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Authors: Maryam Tajadod

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The treatment of cancer is one of the main challenges of nuclear medicine; while cancer begins in an organ, such as the breast or prostate, it spreads to the bone, resulting in metastatic bone. In the treatment of cancer with radiotherapy, the determination of the involved tissues’ dose is one of the important steps in the treatment protocol. Comparing absorbed doses for Lu-177 and Ra-223 and Ac-225 in the bone marrow and soft tissue of bone phantom with evaluating energetic emitted particles of these radionuclides is the important aim of this research. By the use of MCNPX computer code, a model for bone phantom was designed and the values of absorbed dose for Ra-223 and Ac-225, which are Alpha emitters & Lu-177, which is a beta emitter, were calculated. As a result of research, in comparing gamma radiation for three radionuclides, Lu-177 released the highest dose in the bone marrow and Ra-223 achieved the lowest level. On the other hand, the result showed that although the figures of absorbed dose for Ra and Ac in the bone marrow are near to each other, Ra spread more energy in cortical bone. Moreover, The alpha component of the Ra-223 and Ac-225 have very little effect on bone marrow and soft tissue than a beta component of the lu-177 and it leaves the highest absorbed dose in the bone where the source is located.

Keywords: bone metastases, lutetium-177, radium-223, actinium-225, absorbed dose

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Authors: L. Rakesh, T. Y. Heblekar

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This study entails the development and optimization of a mathematical model for a floating drum biogas reactor from first principles using thermal and empirical considerations. The model was derived on the basis of mass conservation, lumped mass heat transfer formulations and empirical biogas formation laws. The treatment leads to a system of coupled nonlinear ordinary differential equations whose solution mapped four-time independent controllable parameters to five output variables which adequately serve to describe the reactor performance. These equations were solved numerically using fourth order Runge-Kutta method for a range of input parameter values. Using the data so obtained an Artificial Neural Network with a single hidden layer was trained using Levenberg-Marquardt Damped Least Squares (DLS) algorithm. This network was then fine-tuned for optimal mapping by varying hidden layer size. This fast forward model was then employed as a health score generator in the Bacterial Foraging Optimization code. The optimal operating state of the simplified Biogas reactor was thus obtained.

Keywords: biogas, floating drum reactor, neural network model, optimization

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Authors: Jean Rosemond Dora, Karol Nemoga

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In this work, we tackle a frequent problem that frequently occurs in the cybersecurity field which is the exploitation of websites by XSS attacks, which are nowadays considered a complicated attack. These types of attacks aim to execute malicious scripts in a web browser of the client by including code in a legitimate web page. A serious matter is when a website accepts the “user-input” option. Attackers can exploit the web application (if vulnerable), and then steal sensitive data (session cookies, passwords, credit cards, etc.) from the server and/or from the client. However, the difficulty of the exploitation varies from website to website. Our focus is on the usage of ontology in cybersecurity against XSS attacks, on the importance of the ontology, and its core meaning for cybersecurity. We explain how a vulnerable website can be exploited, and how different JavaScript payloads can be used to detect vulnerabilities. We also enumerate some tools to use for an efficient analysis. We present detailed reasoning on what can be done to improve the security of a website in order to resist attacks, and we provide supportive examples. Then, we apply an ontology model against XSS attacks to strengthen the protection of a web application. However, we note that the existence of ontology does not improve the security itself, but it has to be properly used and should require a maximum of security layers to be taken into account.

Keywords: cybersecurity, web application vulnerabilities, cyber threats, ontology model

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Authors: Natural Frequency Analysis of a Porous Functionally Graded Shaft System

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The vibration characteristics of a functionally graded (FG) rotor model having porosities and micro-voids is investigated using three-dimensional finite element analysis. The FG shaft is mounted with a steel disc located at the midspan. The shaft ends are supported on isotropic bearings. The FG material is composed of a metallic (stainless-steel) and ceramic phase (zirconium oxide) as its constituent phases. The layer wise material property variation is governed by power law. Material property equations are developed for the porosity modelling. Python code is developed to assign the material properties to each layer including the effect of porosities. ANSYS commercial software is used to extract the natural frequencies and whirl frequencies for the FG shaft system. The obtained results show the influence of porosity volume fraction and power-law index, on the vibration characteristics of the ceramic-based FG shaft system.

Keywords: Finite element method, Functionally graded material, Porosity volume fraction, Power law

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Authors: Mustapha Shitu Suleiman, Francis Neshamba, Nestor Valero-Silva

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Small businesses are considered as engine of economic growth, contributing to employment generation, wealth creation, and poverty alleviation and food security in both developed and developing countries. Nigeria is facing many socio-economic problems and it is believed that by supporting small business development, as propellers of new ideas and more effective users of resources, often driven by individual creativity and innovation, Nigeria would be able to address some of its economic and social challenges, such as unemployment and economic diversification. Using secondary literature, this paper examines the role small businesses can play in the creation of jobs in North-West Nigeria to overcome issues of unemployment, which is the most devastating economic challenge facing the region. Most studies in this area have focused on Nigeria as a whole and only a few studies provide a regional focus, hence, this study will contribute to knowledge by filling this gap by concentrating on North-West Nigeria. It is hoped that with the present administration’s determination to improve the economy, small businesses would be used as vehicles for diversification of the economy away from crude oil to create jobs that would lead to a reduction in the country’s high unemployment level.

Keywords: job creation, north-west, Nigeria, small business, unemployment

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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Authors: Nitu Marilena Cristina

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Decentralization of the education system is an educational policy option necessary from the perspective of democratizing internal life and streamlining service administration public. The experience of recent years has shown that decisions taken at central level do not to take into account all situations and especially all the specific needs and interests of the various institutions and individuals. A democratic society implies that the decision-making process is brought closer to the place of application, allowing citizens to take part in the decision-making that affects them directly or indirectly. Essentially decentralization of pre-university education is the transfer of authority, responsibility and resources in decision-making and general management, and financially to the educational units and the local community. This creates a frame of an effective collaboration between school and community. Modern theories on the leadership of education advocate the adoption of decentralization measures and participatory strategies. Numerous countries confronted with the educational impasse has appealed to these strategies. Reforming projects have begun application diversified and nuanced social decentralization models according to the specific social and educational situation. Analysis of legal provisions and measures adopted in the framework of the reform process indicates that, at least formally, decentralization is the solution chosen.

Keywords: decentralization, educational, management, reforming

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Authors: S. Thangapandiyan, S. Miltonprabu

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Fl (Fl) exposure engenders neurodegeneration and induces oxidative stress in the brain. The Neuroprotective role of EGCG on oxidative stress-mediated neurotoxicity in Fl intoxicated rat hippocampus has not yet been explored so far. Hence, the present study is focused on witnessing whether EGCG (40mg/kg) supplementation prevents Fl induced oxidative stress in the brain of rats with special emphasis on the hippocampus. Fl (25mg/kg) intoxication for four weeks in rats showed an increase in Fl concentration along with the decrease the AChE, NP, DA, and 5-HT activity in the brain. The oxidative stress markers (ROS, TBARS, NO, and PC) were significantly increased with decreased enzymatic (SOD, CAT, GPx, GR, GST, and G6PD) and non-enzymatic antioxidants (GSH, TSH, and Vit.C) in Fl intoxicated rat hippocampus. Moreover, Fl intoxicated rats exhibited an intrinsic and extrinsic pathway mediated apoptosis in the hippocampus of rats. Fl intoxication significantly increased the DNA damage as evidenced by increased DNA fragmentation. Furthermore, the toxic impact of Fl on hippocampus was also proved by the immunohistochemical, histological, and ultrastructural studies. Pre-administration of EGCG has significantly protected the Fl induced oxidative stress, biochemical changes, cellular apoptotic, and histological alternations in the hippocampus of rats. In conclusion, EGCG supplementation significantly attenuated the Fl induced oxidative stress mediated neurotoxicity via its free radical scavenging and antioxidant activity.

Keywords: brain, hippocampal, NaF, ROS, EGCG

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Authors: Diana Gibson

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Aim: The first aim of the study was to ascertain the percentage of people who had been diagnosed with High Blood Pressure and/ or Type2 Diabetes Mellitus in Matzikama municipal district, Western Cape, South Africa. These two conditions are reportedly very high in this particular province, even though few statistics are available. A second aim was to gain insight into the understanding of these two conditions among sufferers. A third aim was to determine their allopathic use as well as indigenous medicinal plants to manage these conditions. A fourth aim was to understand how users of medicinal plants attend to their materiality and relationality as a continuum between humans and plants. The final aim was to ascertain the conservation status of medicinal plants utilised. Methods: One thousand one hundred and eighty-four (1184) respondents were interviewed. Semi-structured surveys were utilised to gather data on the percentage of people who had been medically diagnosed with High Blood Pressure and/or Type 2 Diabetes Mellitus. Local healers and knowledgeable old people were subsequently selected through a non-probability snowball sampling method. They were helped with plant collection. The plants were botanically identified. Results: The study found that people who have been diagnosed with High Blood Pressure or Type 2 Diabetes Mellitus drew on and continuously moved between biomedical and local understandings of these conditions. While they followed biomedical treatment regimens as far as possible they also drew on alternative ways of managing it through the use of medicinal plants. The most commonly used plant species overall were Lessertia frutescens, Tulbaghia violacea, Artemisia afra and Leonotus leonurus. For the users, medicinal plants were not mere material entities, they were actants in social networks where knowledge was produced through particular practices in specific places. None of the identified plants are currently threatened. Significance: Sufferers had a good understanding of the symptoms of and biomedical treatment regime for both conditions, but in everyday life they adhered to their local understandings and medicinal plants for treatment. The majority used reportedly used prescribed medication as well as plant alternatives.

Keywords: diabetes, high blood pressure, medicine, plants

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Authors: Surendra Bodakhe

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In this investigation, anticataract activity was determined using cataract formation in developing chick embryo by hydrocortisone. Lenses were evaluated firstly for the extent of opacity and secondly, for lens glutathione (GSH) levels. Betulinic acid was isolated from the chloroform fraction of the crude ethanolic extract of Bauhinia variegata bark (SBE). Fourteen days old Australorp fertilized eggs were divided into different groups of six eggs each. After 24 hrs incubation in a humidified incubator (37οC), at 15 days of age; hydrocortisone (0.25µM/0.2ml/egg) was administered to the chorioallantoic membrane of chick embryos through a small hole in the egg shell on the air sack. Ascorbic acid (standard) or Betulinic acid (test) were administered at 3, 10 and 20 hr after hydrocortisone administration at a specified dose. The puncture was sealed with a cellophane tape and eggs were incubated for 48 hrs in a humidified incubator at 37οC. After 48 hrs, the lenses were isolated for the determination of the extent of opacity and Glutathione level. The betulinic acid prevented the opacification of the chick embryo lenses induced by hydrocortisone. The betulinic acid also prevented the decline of GSH content caused by hydrocortisone. The results indicate that betulinic acid protect the cataract formation in chick embryo lenses induced by hydrocortisone.

Keywords: betulinic acid, cataract, cloudiness, ovine

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Authors: Shaker A. Aladwan

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This paper aims to explore the Barriers to innovation leadership in Jordanian public sector organizations. Qualitative approach was adopted, and content analysis was used to analyze the 18 assessment reports which are extracted from the public innovation award in Jordan, then, 20 semi-structured interviews were conducted with the key persons who are involved with innovation initiatives in the public sector organizations in Jordan. Several Barriersthat face the innovation leadership in the Jordanian public sector organizations. Managerially, the challenges include lack of innovation vision, implementation lack of innovation core values, lack of strategic planning for innovation, bad bureaucracy culture, and excessive centralization. Technically, the challenges include lack of task assignment for employees, lack of resources, lack of innovative training programs, lack of knowledge sharing, and the failure of governments to formulate policies and regulations. most of the studies focused on innovation in the non-public sector organizations, and most of them were conducted in the American and Western countries, which are different in terms of culture, kinds of innovation, barriers, and drivers. Thus, this paper provides new insights into barriers to innovation leadership in the public sector and in a new research context. This paper also provides a theoretical contribution by diagnosing the barriers facing innovation within the context of public administration in developing countries.

Keywords: innovation, excellence award, challenges, public sector, jordan

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Andriana E. Tran, Anna Chur-Hansen

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Sexual health is an important aspect of overall wellbeing. This study aimed to explore the sexual health experiences of men aged 50 years and over from the perspective of health care professional participants who were specializing in sexual health care and who consulted with older men. A total of ten interviews were conducted. Eleven themes were identified regarding men’s experiences with sexual health care as reported by participants. 1) Biologically focused: older male clients focus largely on the biological aspect of their sexual health without consideration of other factors which might affect their functioning. 2) Psychological concerns: there is an interaction between mental and sexual health but older male clients do not necessarily see this. 3) Medicalization of sexual functioning: advances in medicine that aid with erectile difficulties which consequently mean that older men tend to favor a medical solution to their sexual concerns. 4) Masculine identity: sexual health concerns are linked to older male clients’ sense of masculinity. 5) Penile functionality: most concerns that older male clients have center on their penile functionality. 6) Relationships: many male clients seek sexual help as they believe it improves relationships. Conversely, having supportive partners may mean older male clients focus less on the physicality of sex. 7) Grief and loss: men experience grief and loss – the loss of their sexual functioning, grief from loss of a long-term partner, and loss of intimacy and privacy when moving from independent living to residential care. 8) Social stigma: older male clients experience stigma around aging sexuality and sex in general. 9) Help-seeking behavior: older male clients will usually seek mechanistic solution for biological sexual concerns, such as medication used for penile dysfunction. 10) Dismissed by health care professionals: many older male clients seek specialist sexual health care without the knowledge of their doctors as they feel dismissed due to lack of expertise, lack of time, and the doctor’s personal attitudes and characteristics. Finally, 11) Lack of resources: there is a distinct lack of resources and training to understand sexuality for healthy older men. These findings may inform future research, professional training, public health campaigns and policies for sexual health in older men.

Keywords: ageing, biopsychosocial model, men's health, sexual health

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Authors: Catherine Oluyemo

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In Africa, patriarchy has manifested itself in the socio-cultural, political, economic and legal institutions. The decree of the father as the male head of the family has contributed to the powerlessness of women in African nations. To buttress this perception, in his work Meno, Plato made a declaration in the platonic dialogue that the desirable quality of a man should be the capacity to administer the state, and in the administration of it to benefit his friends and harm his enemies; and he must also be careful not to suffer harm himself. Furthermore, he said: a woman's good worth may also be easily described as ordering her house, keep what is indoors, and obey her husband. The works of Aristotle portrayed women as morally, intellectually, and physically inferior to men; they saw women as the property of men; claimed that women's role in society was to reproduce and serve men in the household; and saw male domination of women as natural and virtuous. This has been sustained for ages and is incessantly impinging on the involvement of women in African leadership positions. The purpose of this paper is to make sense of the concept of patriarchy in relations to women participation in Africa leadership, and its challenges in the participation of women in the leadership positions of Africa. It seeks to discover what women should do to make their voices heard, to participate in leadership arrangements so as to actualize their potentials in contributing to the development of Africa.

Keywords: women, leadership, patriarchy, development, actualize, potentials

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity is associated with significant personal impacts on health and has a substantial economic burden on payers due to increased healthcare use. A contemporary estimate of the healthcare costs associated with obesity at the population level are lacking. This evidence may provide further rationale for weight management strategies. Methods: Adults who underwent a medical procedure between 2012 and 2019 in Alberta, Canada were categorized into the investigational cohort (had body mass index [BMI]-defined class 2 or 3 obesity based on a procedure-associated code) and the control cohort (did not have the BMI procedure-associated code); those who had bariatric surgery were excluded. Characteristics were presented and healthcare costs ($CDN) determined over a 1-year observation period (2019/2020). Logistic regression and a generalized linear model with log link and gamma distribution were used to assess total healthcare costs (comprised of hospitalizations, emergency department visits, ambulatory care visits, physician visits, and outpatient prescription drugs); potential confounders included age, sex, region of residence, and whether the medical procedure was performed within 6-months before the observation period in the partial adjustment, and also the type of procedure performed, socioeconomic status, Charlson Comorbidity Index (CCI), and seven obesity-related health conditions in the full adjustment. Cost ratios and estimated cost differences with 95% confidence intervals (CI) were reported; incremental cost differences within the adjusted models represent referent cases. Results: The investigational cohort (n=220,190) was older (mean age: 53 standard deviation [SD]±17 vs 50 SD±17 years), had more females (71% vs 57%), lived in rural areas to a greater extent (20% vs 14%), experienced a higher overall burden of disease (CCI: 0.6 SD±1.3 vs 0.3 SD±0.9), and were less socioeconomically well-off (material/social deprivation was lower [14%/14%] in the most well-off quintile vs 20%/19%) compared with controls (n=1,955,548). Unadjusted total healthcare costs were estimated to be 1.77-times (95% CI: 1.76, 1.78) higher in the investigational versus control cohort; each healthcare resource contributed to the higher cost ratio. After adjusting for potential confounders, the total healthcare cost ratio decreased, but remained higher in the investigational versus control cohort (partial adjustment: 1.57 [95% CI: 1.57, 1.58]; full adjustment: 1.21 [95% CI: 1.20, 1.21]); each healthcare resource contributed to the higher cost ratio. Among urban-dwelling 50-year old females who previously had non-operative procedures, no procedures performed within 6-months before the observation period, a social deprivation index score of 3, a CCI score of 0.32, and no history of select obesity-related health conditions, the predicted cost difference between those living with and without obesity was $386 (95% CI: $376, $397). Conclusions: If these findings hold for the Canadian population, one would expect an estimated additional $3.0 billion per year in healthcare costs nationally related to BMI-defined obesity (based on an adult obesity rate of 26% and an estimated annual incremental cost of $386 [21%]); incremental costs are higher when obesity-related health conditions are not adjusted for. Results of this study provide additional rationale for investment in interventions that are effective in preventing and treating obesity and its complications.

Keywords: administrative data, body mass index-defined obesity, healthcare cost, real world evidence

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Authors: Fatai Shola Afolabi

Abstract:

The study identified and evaluates the causes of building failure and examined the effects of building failure with respect to cost in Lagos State, Nigeria. The method employed in the collection of data includes the administration of questionnaire to professionals in the construction industry and case studies for the sites. A purposive sampling technique was used for selecting the sites visited, and selecting the construction professionals. Descriptive statistical techniques such as frequency distribution and percentages and mean response analysis were used to analyze data. The study revealed that the major causes of building failures were bad design, faulty construction, over loading, non-possession of approved drawings, Possession of approved drawings but non-compliance, and the use of quarks. In the two case studies considered, the total direct loss to the building owners was thirty eight million three hundred and eight five thousand, seven hundred and twenty one naira (38,385,721) which is about One hundred and ninety four thousand, eighty hundred and fifty one dollars ($194,851) at one hundred and ninety seven naira to one US dollars, central bank Nigeria of exchange rate as at 14th March, 2015.

Keywords: building structures, building failure, building collapse, structural failure, cost, direct loss

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Authors: Isaac Kofi Mensah, Jianing Mi, Feng Cheng

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This research paper seeks to investigate the factors determining the continuance usage of online mobile payment applications among WECHAT users in China. Technology Acceptance Model (TAM) and the Diffusion of Innovation (DOI) theory would both be applied as the theoretical foundation for this study. A developed instrument would be administered to the targeted sample of 1000 WECHAT Users in the City of Harbin, China, through an online questionnaire administration platform. Factors such as perceived usefulness, perceived ease of use, perceived service quality, social influence, trust in the internet, internet self-efficacy, relative advantage, compatibility, and complexity would be explored to determine its significant impact on the continuance intention to use mobile payment apps. This study is at the development and implementation stage. The successful completion of this research article would not only provide an insightful understanding of the factors influencing the decision of WECHAT users in China to use mobile payment applications but also enrich the e-commerce adoption literature.

Keywords: diffusion of innovation (DOI), e-commerce, mobile payment, technology acceptance model (TAM), WECHAT

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Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

Procedia PDF Downloads 293