Search results for: intensive care unit
4668 Phase Equilibria in Zn-Al-Sn Alloy for Lead-free Solder Application
Authors: Ji Chan Kim, Seok Hong Min, Tae Kwon Ha
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The effect of Yttrium addition on the microstructure and mechanical properties of Sn-Zn eutectic alloy, which has been attracting intensive focus as a Pb-free solder material, was investigated in this study. Phase equilibrium has been calculated by using FactSage® to evaluate the composition and fraction of equilibrium intermetallic compounds and construct a phase diagram. In the case of Sn-8.8 Zn eutectic alloy, the as-cast microstructure was typical lamellar. With addition of 0.25 wt. %Y, a large amount of pro-eutectic phases have been observed and various YZnx intermetallic compounds were expected to successively form during cooling. Hardness of Sn-8.8 Zn alloy was not affected by Y-addition and both alloys could be rolled by 90% at room temperature.Keywords: lead-free solder, zn-al-sn alloy, phase equilibrium, rolling, microstructure, hardness
Procedia PDF Downloads 3084667 Improving the Uptake of Community-Based Multidrug-Resistant Tuberculosis Treatment Model in Nigeria
Authors: A. Abubakar, A. Parsa, S. Walker
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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach
Procedia PDF Downloads 1224666 Intelligent and Optimized Placement for CPLD Devices
Authors: Abdelkader Hadjoudja, Hajar Bouazza
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The PLD/CPLD devices are widely used for logic synthesis since several decades. Based on sum of product terms (PTs) architecture, the PLD/CPLD offer a high degree of flexibility to support various application requirements. They are suitable for large combinational logic, finite state machines as well as intensive I/O designs. CPLDs offer very predictable timing characteristics and are therefore ideal for critical control applications. This paper describes how the logic synthesis techniques, such as 1) XOR detection, 2) logic doubling, 3) complement of a Boolean function are combined, applied and used to optimize the CPLDs devices architecture that is based on PAL-like macrocells. Our goal is to use these techniques for minimizing the number of macrocells required to implement a circuit and minimize the delay of mapped circuit.Keywords: CPLD, doubling, optimization, XOR
Procedia PDF Downloads 2824665 Proton Irradiation Testing on Commercial Enhancement Mode GaN Power Transistor
Authors: L. Boyaci
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Two basic equipment of electrical power subsystem of space satellites are Power Conditioning Unit (PCU) and Power Distribution Unit (PDU). Today, the main switching element used in power equipment in satellites is silicon (Si) based radiation-hardened MOSFET. GaNFETs have superior performances over MOSFETs in terms of their conduction and switching characteristics. GaNFET has started to take MOSFET’s place in many applications in industry especially by virtue of its switching performances. If GaNFET can also be used in equipment for space applications, this would be great revolution for future space power subsystem designs. In this study, the effect of proton irradiation on Gallium Nitride based power transistors was investigated. Four commercial enhancement mode GaN power transistors from Efficient Power Conversion Corporation (EPC) are irradiated with 30MeV protons while devices are switching. Flux of 8.2x10⁹ protons/cm²/s is applied for 12.5 seconds to reach ultimate fluence of 10¹¹ protons/cm². Vgs-Ids characteristics are measured and recorded for each device before, during and after irradiation. It was observed that if there would be destructive events. Proton induced permanent damage on devices is not observed. All the devices remained healthy and continued to operate. For two of these devices, further irradiation is applied with same flux for 30 minutes up to a total fluence level of 1.476x10¹³ protons/cm². We observed that GaNFETs are fully functional under this high level of radiation and no destructive events and irreversible failures took place for transistors. Results reveal that irradiated GaNFET in this experiment has radiation tolerance under proton testing and very important candidate for being one of the future power switching element in space.Keywords: enhancement mode GaN power transistors, proton irradiation effects, radiation tolerance
Procedia PDF Downloads 1524664 Case Report: Peripartum Cardiomyopathy, a Rare but Fatal Condition in Pregnancy and Puerperium
Authors: Sadaf Abbas, HimGauri Sabnis
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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium
Procedia PDF Downloads 324663 ‘BEST BARK’ Dog Care and Owner Consultation System
Authors: Shalitha Jayasekara, Saluk Bawantha, Dinithi Anupama, Isuru Gunarathne, Pradeepa Bandara, Hansi De Silva
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Dogs have been known as "man's best friend" for generations, providing friendship and loyalty to their human counterparts. However, due to people's busy lives, they are unaware of the ailments that can affect their pets. However, in recent years, mobile technologies have had a significant impact on our lives, and with technological improvements, a rule-based expert system allows the end-user to enable new types of healthcare systems. The advent of Android OS-based smartphones with more user-friendly interfaces and lower pricing opens new possibilities for continuous monitoring of pets' health conditions, such as healthy dogs, dangerous ingestions, and swallowed objects. The proposed ‘Best Bark’ Dog care and owner consultation system is a mobile application for dog owners. Four main components for dog owners were implemented after a questionnaire was distributed to the target group of audience and the findings were evaluated. The proposed applications are widely used to provide health and clinical support to dog owners, including suggesting exercise and diet plans and answering queries about their dogs. Additionally, after the owner uploads a photo of the dog, the application provides immediate feedback and a description of the dog's skin disease.Keywords: Convolution Neural Networks, Artificial Neural Networks, Knowledgebase, Sentimental Analysis.
Procedia PDF Downloads 1534662 Fractal Analysis of Some Bifurcations of Discrete Dynamical Systems in Higher Dimensions
Authors: Lana Horvat Dmitrović
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The main purpose of this paper is to study the box dimension as fractal property of bifurcations of discrete dynamical systems in higher dimensions. The paper contains the fractal analysis of the orbits near the hyperbolic and non-hyperbolic fixed points in discrete dynamical systems. It is already known that in one-dimensional case the orbit near the hyperbolic fixed point has the box dimension equal to zero. On the other hand, the orbit near the non-hyperbolic fixed point has strictly positive box dimension which is connected to the non-degeneracy condition of certain bifurcation. One of the main results in this paper is the generalisation of results about box dimension near the hyperbolic and non-hyperbolic fixed points to higher dimensions. In the process of determining box dimension, the restriction of systems to stable, unstable and center manifolds, Lipschitz property of box dimension and the notion of projective box dimension are used. The analysis of the bifurcations in higher dimensions with one multiplier on the unit circle is done by using the normal forms on one-dimensional center manifolds. This specific change in box dimension of an orbit at the moment of bifurcation has already been explored for some bifurcations in one and two dimensions. It was shown that specific values of box dimension are connected to appropriate bifurcations such as fold, flip, cusp or Neimark-Sacker bifurcation. This paper further explores this connection of box dimension as fractal property to some specific bifurcations in higher dimensions, such as fold-flip and flip-Neimark-Sacker. Furthermore, the application of the results to the unit time map of continuous dynamical system near hyperbolic and non-hyperbolic singularities is presented. In that way, box dimensions which are specific for certain bifurcations of continuous systems can be obtained. The approach to bifurcation analysis by using the box dimension as specific fractal property of orbits can lead to better understanding of bifurcation phenomenon. It could also be useful in detecting the existence or nonexistence of bifurcations of discrete and continuous dynamical systems.Keywords: bifurcation, box dimension, invariant manifold, orbit near fixed point
Procedia PDF Downloads 2544661 Analysis of Labor Behavior Effect on Occupational Health and Safety Management by Multiple Linear Regression
Authors: Yulinda Rizky Pratiwi, Fuji Anugrah Emily
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Management of Occupational Safety and Health (OSH) are appropriately applied properly by all workers and pekarya in the company. K3 management application also has become very important to prevent accidents. Violation of the rules regarding the K3 has often occurred from time to time. By 2015 the number of occurrences of a violation of the K3 or so-called unsafe action tends to increase. Until finally in January 2016, the number increased drastically unsafe action. Trigger increase in the number of unsafe action is a decrease in the quality of management practices K3. While the application of K3 management performed by each individual thought to be influenced by the attitude and observation guide the actions of each of the individual. In addition to the decline in the quality of K3 management application may result in increased likelihood of accidents and losses for the company as well as the local co-workers. The big difference in the number of unsafe action is very significant in the month of January 2016, making the company Pertamina as the national oil company must do a lot of effort to keep track of how the implementation of K3 management on every worker and pekarya, one at PT Pertamina EP Cepu Field Asset IV. To consider the effort to control the implementation of K3 management can be seen from the attitude and observation guide the actions of the workers and pekarya. By using Multiple Linear Regression can be seen the influence of attitude and action observation guide workers and pekarya the K3 management application that has been done. The results showed that scores K3 management application of each worker and pekarya will increase by 0.764 if the score pekarya worker attitudes and increase one unit, whereas if the score Reassurance action guidelines and pekarya workers increased by one unit then the score management application K3 will increase by 0.754.Keywords: occupational safety and health, management of occupational safety and health, unsafe action, multiple linear regression
Procedia PDF Downloads 2304660 Integration of an Evidence-Based Medicine Curriculum into Physician Assistant Education: Teaching for Today and the Future
Authors: Martina I. Reinhold, Theresa Bacon-Baguley
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Background: Medical knowledge continuously evolves and to help health care providers to stay up-to-date, evidence-based medicine (EBM) has emerged as a model. The practice of EBM requires new skills of the health care provider, including directed literature searches, the critical evaluation of research studies, and the direct application of the findings to patient care. This paper describes the integration and evaluation of an evidence-based medicine course sequence into a Physician Assistant curriculum. This course sequence teaches students to manage and use the best clinical research evidence to competently practice medicine. A survey was developed to assess the outcomes of the EBM course sequence. Methodology: The cornerstone of the three-semester sequence of EBM are interactive small group discussions that are designed to introduce students to the most clinically applicable skills to identify, manage and use the best clinical research evidence to improve the health of their patients. During the three-semester sequence, the students are assigned each semester to participate in small group discussions that are facilitated by faculty with varying background and expertise. Prior to the start of the first EBM course in the winter semester, PA students complete a knowledge-based survey that was developed by the authors to assess the effectiveness of the course series. The survey consists of 53 Likert scale questions that address the nine objectives for the course series. At the end of the three semester course series, the same survey was given to all students in the program and the results from before, and after the sequence of EBM courses are compared. Specific attention is paid to overall performance of students in the nine course objectives. Results: We find that students from the Class of 2016 and 2017 consistently improve (as measured by percent correct responses on the survey tool) after the EBM course series (Class of 2016: Pre- 62% Post- 75%; Class of 2017: Pre- 61 % Post-70%). The biggest increase in knowledge was observed in the areas of finding and evaluating the evidence, with asking concise clinical questions (Class of 2016: Pre- 61% Post- 81%; Class of 2017: Pre- 61 % Post-75%) and searching the medical database (Class of 2016: Pre- 24% Post- 65%; Class of 2017: Pre- 35 % Post-66 %). Questions requiring students to analyze, evaluate and report on the available clinical evidence regarding diagnosis showed improvement, but to a lesser extend (Class of 2016: Pre- 56% Post- 77%; Class of 2017: Pre- 56 % Post-61%). Conclusions: Outcomes identified that students did gain skills which will allow them to apply EBM principles. In addition, the outcomes of the knowledge-based survey allowed the faculty to focus on areas needing improvement, specifically the translation of best evidence into patient care. To address this area, the clinical faculty developed case scenarios that were incorporated into the lecture and discussion sessions, allowing students to better connect the research studies with patient care. Students commented that ‘class discussion and case examples’ contributed most to their learning and that ‘it was helpful to learn how to develop research questions and how to analyze studies and their significance to a potential client’. As evident by the outcomes, the EBM courses achieved the goals of the course and were well received by the students.Keywords: evidence-based medicine, clinical education, assessment tool, physician assistant
Procedia PDF Downloads 1254659 Decreased Non-Communicable Disease by Surveillance, Control, Prevention Systems, and Community Engagement Process in Phayao, Thailand
Authors: Vichai Tienthavorn
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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care
Procedia PDF Downloads 2504658 Experiencing the Shattered: Managing Countertransference Experiences with Anorexia Patients in Psychotherapy
Authors: M. Card
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Working with anorexia patients can be a challenging experience for mental and health care professionals. The reasons for not wanting to work with this patient population stems from the numerous concerns surrounding the patient’s health – physically and mentally. Many health care professionals reported having strong negative feelings, such as; anger, hopelessness and helplessness when working with anorexia patients. These feelings often impaired their judgement to treatment and affected how they related to the patient. This research focused on psychotherapists who preferred to work with anorexia patients; what countertransference feelings were evoked in them during sessions with patients and most importantly, how they managed the feelings. The research used interpretative phenomenological analysis (IPA) as the theoretical framework and data analysis method. Semi-structured interviews were used with ten experienced psychotherapists to obtain their countertransference experiences with anorexia patients and how they manage it. There were three main themes discovered; (1) the use of supervision, (2) their own personal therapy and finally (3) experience and evolution. The research unearthed that experienced psychotherapists also experienced strong countertransference feelings towards their patients; some positive and some negative. However, these feelings could actually be interpreted as co-transference with their anorexia patients. The psychotherapists were able to own their part in the evocative unconscious nature of a relational therapeutic space, where their personal issues may be entangled in their anorexia patient’s symptomatology.Keywords: anorexia nervosa, countertransference, co-transference, psychotherapy, relational psychotherapy
Procedia PDF Downloads 1654657 Nutritional Education in Health Resort Institutions in the Face of Demographic and Epidemiological Changes in Poland
Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga
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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.Keywords: health care system, nutritional education, public health, spa and treatment
Procedia PDF Downloads 1144656 Public Health Emergency Management (PHEM) to COVID-19 Pandemic in North-Eastern Part of Thailand
Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya
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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.Keywords: public health, emergency management, covid-19, pandemic
Procedia PDF Downloads 814655 Levels of Family Empowerment and Parenting Skills of Parents with Children with Developmental Disabilities Who Are Users of Early Intervention Services
Authors: S. Bagur, S. Verger, B. Mut
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Early childhood intervention (ECI) is understood as the set of interventions aimed at the child population with developmental disorders or disabilities from 0 to 6 years of age, the family, and the environment. Under the principles of family-centred practices, the members of the family nucleus are direct agents of intervention. Thus, the multidisciplinary team of professionals should work to improve family empowerment and the level of parenting skills. The aim of the present study is to analyse descriptively and differentially the level of parenting skills and family empowerment of parents using ECI services during the foster care phase. There were 135 families participating in the study. Three questionnaires were completed. The results show that the employment situation, the age of the child receiving an intervention, and the number of children in the family nucleus or the professional carrying out the intervention are variables that have a differential impact on different items of empowerment and parenting skills. The results are discussed and future lines of research are proposed, with the understanding that the initial analysis of the variables of empowerment and parenting skills may be predictors for the improvement of child development and family well-being. In addition, it is proposed to identify and analyse professional training in order to be able to adapt early care practices without depending on the discipline of the professional of reference.Keywords: developmental disabilities, early childhood intervention, family empowerment, parenting skills
Procedia PDF Downloads 1114654 Aromatic Medicinal Plant Classification Using Deep Learning
Authors: Tsega Asresa Mengistu, Getahun Tigistu
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Computer vision is an artificial intelligence subfield that allows computers and systems to retrieve meaning from digital images. It is applied in various fields of study self-driving cars, video surveillance, agriculture, Quality control, Health care, construction, military, and everyday life. Aromatic and medicinal plants are botanical raw materials used in cosmetics, medicines, health foods, and other natural health products for therapeutic and Aromatic culinary purposes. Herbal industries depend on these special plants. These plants and their products not only serve as a valuable source of income for farmers and entrepreneurs, and going to export not only industrial raw materials but also valuable foreign exchange. There is a lack of technologies for the classification and identification of Aromatic and medicinal plants in Ethiopia. The manual identification system of plants is a tedious, time-consuming, labor, and lengthy process. For farmers, industry personnel, academics, and pharmacists, it is still difficult to identify parts and usage of plants before ingredient extraction. In order to solve this problem, the researcher uses a deep learning approach for the efficient identification of aromatic and medicinal plants by using a convolutional neural network. The objective of the proposed study is to identify the aromatic and medicinal plant Parts and usages using computer vision technology. Therefore, this research initiated a model for the automatic classification of aromatic and medicinal plants by exploring computer vision technology. Morphological characteristics are still the most important tools for the identification of plants. Leaves are the most widely used parts of plants besides the root, flower and fruit, latex, and barks. The study was conducted on aromatic and medicinal plants available in the Ethiopian Institute of Agricultural Research center. An experimental research design is proposed for this study. This is conducted in Convolutional neural networks and Transfer learning. The Researcher employs sigmoid Activation as the last layer and Rectifier liner unit in the hidden layers. Finally, the researcher got a classification accuracy of 66.4 in convolutional neural networks and 67.3 in mobile networks, and 64 in the Visual Geometry Group.Keywords: aromatic and medicinal plants, computer vision, deep convolutional neural network
Procedia PDF Downloads 4384653 Navigating the Nexus of HIV/AIDS Care: Leveraging Statistical Insight to Transform Clinical Practice and Patient Outcomes
Authors: Nahashon Mwirigi
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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling
Procedia PDF Downloads 84652 Pulmonary Complication of Chronic Liver Disease and the Challenges Identifying and Managing Three Patients
Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh
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Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome
Procedia PDF Downloads 1214651 Simplified INS\GPS Integration Algorithm in Land Vehicle Navigation
Authors: Othman Maklouf, Abdunnaser Tresh
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Land vehicle navigation is subject of great interest today. Global Positioning System (GPS) is the main navigation system for positioning in such systems. GPS alone is incapable of providing continuous and reliable positioning, because of its inherent dependency on external electromagnetic signals. Inertial Navigation (INS) is the implementation of inertial sensors to determine the position and orientation of a vehicle. The availability of low-cost Micro-Electro-Mechanical-System (MEMS) inertial sensors is now making it feasible to develop INS using an inertial measurement unit (IMU). INS has unbounded error growth since the error accumulates at each step. Usually, GPS and INS are integrated with a loosely coupled scheme. With the development of low-cost, MEMS inertial sensors and GPS technology, integrated INS/GPS systems are beginning to meet the growing demands of lower cost, smaller size, and seamless navigation solutions for land vehicles. Although MEMS inertial sensors are very inexpensive compared to conventional sensors, their cost (especially MEMS gyros) is still not acceptable for many low-end civilian applications (for example, commercial car navigation or personal location systems). An efficient way to reduce the expense of these systems is to reduce the number of gyros and accelerometers, therefore, to use a partial IMU (ParIMU) configuration. For land vehicular use, the most important gyroscope is the vertical gyro that senses the heading of the vehicle and two horizontal accelerometers for determining the velocity of the vehicle. This paper presents a field experiment for a low-cost strap down (ParIMU)\GPS combination, with data post processing for the determination of 2-D components of position (trajectory), velocity and heading. In the present approach, we have neglected earth rotation and gravity variations, because of the poor gyroscope sensitivities of our low-cost IMU (Inertial Measurement Unit) and because of the relatively small area of the trajectory.Keywords: GPS, IMU, Kalman filter, materials engineering
Procedia PDF Downloads 4224650 Multi-Labeled Aromatic Medicinal Plant Image Classification Using Deep Learning
Authors: Tsega Asresa, Getahun Tigistu, Melaku Bayih
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Computer vision is a subfield of artificial intelligence that allows computers and systems to extract meaning from digital images and video. It is used in a wide range of fields of study, including self-driving cars, video surveillance, medical diagnosis, manufacturing, law, agriculture, quality control, health care, facial recognition, and military applications. Aromatic medicinal plants are botanical raw materials used in cosmetics, medicines, health foods, essential oils, decoration, cleaning, and other natural health products for therapeutic and Aromatic culinary purposes. These plants and their products not only serve as a valuable source of income for farmers and entrepreneurs but also going to export for valuable foreign currency exchange. In Ethiopia, there is a lack of technologies for the classification and identification of Aromatic medicinal plant parts and disease type cured by aromatic medicinal plants. Farmers, industry personnel, academicians, and pharmacists find it difficult to identify plant parts and disease types cured by plants before ingredient extraction in the laboratory. Manual plant identification is a time-consuming, labor-intensive, and lengthy process. To alleviate these challenges, few studies have been conducted in the area to address these issues. One way to overcome these problems is to develop a deep learning model for efficient identification of Aromatic medicinal plant parts with their corresponding disease type. The objective of the proposed study is to identify the aromatic medicinal plant parts and their disease type classification using computer vision technology. Therefore, this research initiated a model for the classification of aromatic medicinal plant parts and their disease type by exploring computer vision technology. Morphological characteristics are still the most important tools for the identification of plants. Leaves are the most widely used parts of plants besides roots, flowers, fruits, and latex. For this study, the researcher used RGB leaf images with a size of 128x128 x3. In this study, the researchers trained five cutting-edge models: convolutional neural network, Inception V3, Residual Neural Network, Mobile Network, and Visual Geometry Group. Those models were chosen after a comprehensive review of the best-performing models. The 80/20 percentage split is used to evaluate the model, and classification metrics are used to compare models. The pre-trained Inception V3 model outperforms well, with training and validation accuracy of 99.8% and 98.7%, respectively.Keywords: aromatic medicinal plant, computer vision, convolutional neural network, deep learning, plant classification, residual neural network
Procedia PDF Downloads 1874649 Method of Nursing Education: History Review
Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán
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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education
Procedia PDF Downloads 1134648 Nurse’s Role in Early Detection of Breast Cancer through Mammography and Genetic Screening and Its Impact on Patient's Outcome
Authors: Salwa Hagag Abdelaziz, Dorria Salem, Hoda Zaki, Suzan Atteya
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Early detection of breast cancer saves many thousands of lives each year via application of mammography and genetic screening and many more lives could be saved if nurses are involved in breast care screening practices. So, the aim of the study was to identify nurse's role in early detection of breast cancer through mammography and genetic screening and its impact on patient's outcome. In order to achieve this aim, 400 women above 40 years, asymptomatic were recruited for mammography and genetic screening. In addition, 50 nurses and 6 technologists were involved in the study. A descriptive analytical design was used. Five tools were utilized: sociodemographic, mammographic examination and risk factors, women's before, during and after mammography, items relaying to technologists, and items related to nurses were also obtained. The study finding revealed that 3% of women detected for malignancy and 7.25% for fibroadenoma. Statistically, significant differences were found between mammography results and age, family history, genetic screening, exposure to smoke, and using contraceptive pills. Nurses have insufficient knowledge about screening tests. Based on these findings the present study recommended involvement of nurses in breast care which is very important to in force population about screening practices.Keywords: mammography, early detection, genetic screening, breast cancer
Procedia PDF Downloads 5624647 Expectation for Professionalism Effects Reality Shock: A Qualitative And Quantitative Study of Reality Shock among New Human Service Professionals
Authors: Hiromi Takafuji
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It is a well-known fact that health care and welfare are the foundation of human activities, and human service professionals such as nurses and child care workers support these activities. COVID-19 pandemic has made the severity of the working environment in these fields even more known. It is high time to discuss the work of human service workers for the sustainable development of the human environment. Early turnover has been recognized as a long-standing issue in these fields. In Japan, the attrition rate within three years of graduation for these occupations has remained high at about 40% for more than 20 years. One of the reasons for this is Reality Shock: RS, which refers to the stress caused by the gap between pre-employment expectations and the post-employment reality experienced by new workers. The purpose of this study was to academically elucidate the mechanism of RS among human service professionals and to contribute to countermeasures against it. Firstly, to explore the structure of the relationship between professionalism and workers' RS, an exploratory interview survey was conducted and analyzed by text mining and content analysis. The results showed that the expectation of professionalism influences RS as a pre-employment job expectation. Next, the expectations of professionalism were quantified and categorized, and the responses of a total of 282 human service work professionals, nurses, child care workers, and caregivers; were finalized for data analysis. The data were analyzed using exploratory factor analysis, confirmatory factor analysis, multiple regression analysis, and structural equation modeling techniques. The results revealed that self-control orientation and authority orientation by qualification had a direct positive significant impact on RS. On the other hand, interpersonal helping orientation and altruistic orientation were found to have a direct negative significant impact and an indirect positive significant impact on RS.; we were able to clarify the structure of work expectations that affect the RS of welfare professionals, which had not been clarified in previous studies. We also explained the limitations, practical implications, and directions for future research.Keywords: human service professional, new hire turnover, SEM, reality shock
Procedia PDF Downloads 994646 Peer-Assisted Learning of Ebm in, a UK Medical School: Evaluation of the NICE Evidence Search Student Champion Scheme
Authors: Emily Jin, Harry Sharples, Anne Weist
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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning
Procedia PDF Downloads 1304645 Additional Usage of Remdesivir with the Standard of Care in Patients with Moderate And Severe COVID-19: A Tertiary Hospital’s Experience
Authors: Pugazhenthan Thangaraju
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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia
Procedia PDF Downloads 654644 Disability Prevalence and Health among 60+ Population in India
Authors: Surendra Kumar Patel
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Disability is not just a health problem; it is a complex phenomenon, reflecting the interaction between features of a person’s age and physiology. Population ageing is a major demographic issue for India in the 21st century. Older population of India constituted 8% of total population, while 5.19% has affected by disability of older age group. Objective of the present research paper is to examine the state wise differential in disability among 60+ population and to access the health care of disabled population especially the 60+ disabled persons. The data sources of the present paper are census 2001 and 2011. For analyzing the state wise differentials by disability types and comparative advantage of data, rate, ratio, and percentage have been used. The Standardized Index of Diversity of Disability (SIDD) studies differential and diversity in disability. The results show that there are 5.19% persons have disability among 60+ population and sex differential not very significant, as it is 5.3 % of male and 5.05% in female in India but place of residence shows significant variation from 2001 to 2011 census. There is huge diversity in disability prevalence among 60+ in India, highest in Sikkim followed by Rajasthan, approximately, they comprise 11%, and the lowest found in Tamil Nadu as 2.53%. This huge gap in prevalence percentage shows the health care needs of highly prevailing states.Keywords: disability, Standardized Index of Diversity of Disability (SIDD), differential and diversity in disability, 60+ population
Procedia PDF Downloads 3804643 The Study of Blood Consumption for Stem Cell Transplant Patients in Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran
Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani
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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran
Procedia PDF Downloads 1274642 Patient Understanding of Health Information: Implications for Organizational Health Literacy in Germany
Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer
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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3
Procedia PDF Downloads 1664641 An Ethnographic Study on How Namibian Sex Workers Experience Their Violation of Rights
Authors: Tessa Verhallen, Mama Africa
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By co-constructing personal narratives of sex workers in Namibia this paper represents how sex workers experience their violation of rights in Namibia. It is written from an emic (as an advisor for a sex worker-led organization named Rights not Rescue Trust) and an etic (as an ethnographer) point of view, in collaboration with the staff of the organization Rights not Rescue Trust. This organization represents circa 3000 members. The paper describes the current deplorable situation of sex workers in Namibia, encompassing the stigma and discrimination they face, their struggle to have their work decriminalized and their urge to advocate for human rights and the end of violations. Based on a triangular research design (ethnography, narratives, literature study, human rights’ training and counseling sessions) the authors show that sex workers, particularly LGBTI sex workers, are extremely vulnerable to emotional, physical, and sexual violence in Namibia. The main perpetrators of violence turn out to be not only clients and intimate partners but also law enforcement officers and health care workers who are supposed to protect and support sex workers. The sex workers’ narratives voice their disgraceful circumstances regarding how their rights are violated. It also highlights their importance to fight for their rights and access to health care, legal services and education in order to improve the sexual reproductive health of sex workers.Keywords: HIV/aids, LGBTI, methodological innovative, sex work
Procedia PDF Downloads 3124640 Adopted Method of Information System Strategy for Knowledge Management System: A Literature Review
Authors: Elin Cahyaningsih, Dana Indra Sensuse, Wahyu Catur Wibowo, Sofiyanti Indriasari
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Bureaucracy reform program drives Indonesian government to change their management and supporting unit in order to enhance their organization performance. Information technology as one of supporting unit became one of strategic plan that organization tried to improve, because IT can automate and speed up process, reduce business process life cycle become more effective and efficient. Knowledge management system is a technology application for supporting knowledge management implementation in government which is requirement based on problem and potential functionality of each knowledge management process. Define knowledge management that suitable for each organization it is difficult, that why we should make the knowledge management system strategy as an alignment of knowledge management process in the organization. Knowledge management system is one of information system development in people perspective, because this system has high dependency in human interaction and participation. Strategic plan for developing knowledge management system can be determine using some of information system strategic methods. This research conducted to define type of strategic method of information system, stage of activity each method, the strategic method strength and weakness. The author use literature review methods for identify and classify strategic methods of information system for differentiate method type, categorize common activities, strength and weakness. Result of this research are determine and compare six strategic information system methods, there are Balanced Scorecard, Five Force Porter, SWOT analysis, Value Chain Analysis, Risk Analysis and Gap Analysis. Balanced Scorecard and Risk Analysis believe as common strategic method that usually used and have the highest excellence strength.Keywords: knowledge management system, balanced scorecard, five force, risk analysis, gap analysis, value chain analysis, SWOT analysis
Procedia PDF Downloads 4784639 COVID-19 Pandemic Influence on Toddlers and Preschoolers’ Screen Time
Authors: Juliana da Silva Cardoso, Cláudia Correia, Rita Gomes, Carolina Fraga, Inês Cascais, Sara Monteiro, Beatriz Teixeira, Sandra Ribeiro, Carolina Andrade, Cláudia Oliveira, Diana Gonzaga, Catarina Prior, Inês Vaz Matos
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The average daily screen time (ST) has been increasing in children, even at young ages. This seems to be associated with a higher incidence of neurodevelopmental disorders, and as the time of exposure increases, the greater is the functional impact. This study aims to compare the daily ST of toddlers and preschoolers previously and during the COVID-19 pandemic. A questionnaire was applied by telephone to parents/caregivers of children between 1 and 5 years old, followed up at 4 primary care units belonging to the Group of Primary Health Care Centers of Western Porto, Portugal. 520 children were included: 52.9% male, mean age 39.4 ± 13.9 months. The mean age of first exposure to screens was 13.9 ± 8.0 months, and most of the children were exposed to more than one screen daily. Considering the WHO recommendations, before the COVID-19 pandemic, 385 (74.0%) and 408 (78.5%) children had excessive ST during the week and the weekend, respectively; during the lockdown, these values increased to 495 (95.2%) and 482 (92.7%). Maternal education and both the child's median age and the median age of first exposure to screens had a statistically significant association with excessive ST, with OR 0.2 (p = 0.03, CI 95% 0.07-0.86), OR 1.1 (p = 0.01, 95% CI 1.05-1.14) and OR 0.9 (p = 0.05, 95% CI 0. 87-0.98), respectively. Most children in this sample had a higher than recommended ST, which increased with the onset of the COVID-19 pandemic. These results are worrisome and point to the need for urgent intervention.Keywords: COVID-19 pandemic, preschoolers, screen time, toddlers
Procedia PDF Downloads 216