Search results for: virulence factors.
8732 Healthcare Associated Infections in an Intensive Care Unit in Tunisia: Incidence and Risk Factors
Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah
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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.Keywords: healthcare associated infections, incidence, intensive care unit, risk factors
Procedia PDF Downloads 3638731 Application of Additive Manufacturing for Production of Optimum Topologies
Authors: Mahdi Mottahedi, Peter Zahn, Armin Lechler, Alexander Verl
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Optimal topology of components leads to the maximum stiffness with the minimum material use. For the generation of these topologies, normally algorithms are employed, which tackle manufacturing limitations, at the cost of the optimal result. The global optimum result with penalty factor one, however, cannot be fabricated with conventional methods. In this article, an additive manufacturing method is introduced, in order to enable the production of global topology optimization results. For a benchmark, topology optimization with higher and lower penalty factors are performed. Different algorithms are employed in order to interpret the results of topology optimization with lower factors in many microstructure layers. These layers are then joined to form the final geometry. The algorithms’ benefits are then compared experimentally and numerically for the best interpretation. The findings demonstrate that by implementation of the selected algorithm, the stiffness of the components produced with this method is higher than what could have been produced by conventional techniques.Keywords: topology optimization, additive manufacturing, 3D-printer, laminated object manufacturing
Procedia PDF Downloads 3348730 Adoption and Use of an Electronic Voting System in Ghana
Authors: Isaac Kofi Mensah
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The manual system of voting has been the most widely used system of electing representatives around the globe, particularly in Africa. Due to the known numerous problems and challenges associated with the manual system of voting, many countries are migrating to the electronic voting system as a suitable and credible means of electing representatives over the manual paper-based system. This research paper therefore investigated the factors influencing adoption and use of an electronic voting system in Ghana. A total of 400 Questionnaire Instruments (QI) were administered to potential respondents in Ghana, of which 387 responded representing a response rate of 96.75%. The Technology Acceptance Model was used as the theoretical framework for the study. The research model was tested using a simple linear regression analysis with SPSS. A little of over 71.1% of the respondents recommended the Electoral Commission (EC) of Ghana to adopt an electronic voting system in the conduct of public elections in Ghana. The results indicated that all the six predictors such as perceived usefulness (PU), perceived ease of use (PEOU), perceived free and fair elections (PFFF), perceived credible elections (PCE), perceived system integrity (PSI) and citizens trust in the election management body (CTEM) were all positively significant in predicting the readiness of citizens to adopt and use an electronic voting system in Ghana. However, jointly, the hypotheses tested revealed that apart from Perceived Free and Fair Elections and Perceived Credible and Transparent Elections, all the other factors such as PU, Perceived System Integrity and Security and Citizen Trust in the Election Management Body were found to be significant predictors of the Willingness of Ghanaians to use an electronic voting system. All the six factors considered in this study jointly account for about 53.1% of the reasons determining the readiness to adopt and use an electronic voting system in Ghana. The implications of this research finding on elections in Ghana are discussed.Keywords: credible elections, Election Management Body (EMB), electronic voting, Ghana, Technology Acceptance Model (TAM)
Procedia PDF Downloads 3858729 Predicting COVID-19 Severity Using a Simple Parameters in Resource-Limited Settings
Authors: Sireethorn Nimitvilai, Ussanee Poolvivatchaikarn, Nuchanart Tomeun
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Objective: To determine the simple laboratory parameters to predict disease severity among COVID-19 patients in resource-limited settings. Material and methods: A retrospective cohort study was conducted at Nakhonpathom Hospital, a 722-bed tertiary care hospital, with an average of 50,000 admissions per year, during April 15 and May 15, 2021. Eligible patients were adults aged ≥ 15 years who were hospitalized with COVID-19. Baseline characteristics, comorbid conditions ad laboratory findings at admission were collected. Predictive factors for severe COVID-19 infection were analyzed. Result: There were 207 patients (79 male and 128 female) and the mean age was 46.7 (16.8) years. Of these, 39 cases (18.8%) were severe and 168 (81.2%) cases were non-severe. Factors associated with severe COVID-19 were neutrophil to lymphocyte ratio ≥ 4 (OR 8.1, 95%CI 2.3-20.3, P < 0.001) and C-reactive protein to albumin ratio ≥ 10 (OR 3.49, 95%CI 1.3-9.1, p 0.01). Conclusions: Complete blood counts, C-reactive protein and albumin are simple, inexpensive, widely available tests and can be used to predict severe COVID-19 in resource-limited settings.Keywords: COVID-19, predictor of severity, resource-limiting settings, simple laboratory parameters
Procedia PDF Downloads 1748728 Influential Factors Affecting the Creativity Scientific Problem Finding Ability of Social Science Ph.D. Students
Authors: Yuanyuan Song
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For Ph.D. students, the skill of formulating incisive inquiries holds immense importance, as adept questioning can significantly unravel research complexities. Social Science Ph.D. students should possess specific abilities to formulate creative research questions, and identifying the most influential factors is essential. To respond to these questions, in this study, we engaged with Ph.D. candidates with social sciences backgrounds through interviews and questionnaires. Our objective was to identify the predominant determinants influencing their capacity to formulate inventive research queries, ultimately aiming to enhance the academic journey of social science doctoral candidates. Insights gleaned from semi-structured interviews and questionnaires with 15 doctoral scholars from different universities around the world highlighted that mentorship and scholarly exchanges, prior knowledge, positive mindset, and personal interests played pivotal roles in catalyzing these students' contemplation of research inquiries.Keywords: Ph.D. education, higher education, creativity cultivation, creativity scientific problem finding ability
Procedia PDF Downloads 578727 Adoption of E-Governance: A Case Study of Higher Education Institutes in Pakistan
Authors: Shah Muhammad Butt
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The study aimed to investigate the factors influencing the adoption of e-governance in Pakistan's public universities and how that adoption has affected organizational performance. An online Likert scale survey was utilized to gather information from 350 participants from different public universities in Pakistan. The data were examined using descriptive statistics and correlation analysis. The findings suggest that organizational culture, infrastructure, and leadership support are among the elements impacting the adoption of e-governance at Pakistan's public sector universities. A further finding of the study was that e-governance adoption benefited organizational performance, including effectiveness, efficiency, and customer satisfaction. The study emphasizes the significance of e-governance adoption at public sector universities and the demand for successful policies and strategies to support its implementation. To increase organisational performance and raise the standard of higher education in Pakistan, policymakers and university administrators should use the study's findings to develop and practice e-governance policies and initiatives.Keywords: e-governance, adoption, public sector universities, Pakistan, organizational performance, higher education, technology, ICT, factors, comparative analysis
Procedia PDF Downloads 808726 Knowledge Management to Develop the Graduate Study Programs
Authors: Chuen-arom Janthimachai-amorn, Chirawadee Harnrittha
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This study aims to identify the factors facilitating the knowledge management to develop the graduate study programs to achieve success and to identify the approaches in developing the graduate study programs in the Rajbhat Suansunantha University. The 10 respondents were the administrators, the faculty, and the personnel of its Graduate School. The research methodology was based on Pla-too Model of the Knowledge Management Institute (KMI) by allocating the knowledge indicators, the knowledge creation and search, knowledge systematization, knowledge processing and filtering, knowledge access, knowledge sharing and exchanges and learning. The results revealed that major success factors were knowledge indicators, evident knowledge management planning, knowledge exchange and strong solidarity of the team and systematic and tenacious access of knowledge. The approaches allowing the researchers to critically develop the graduate study programs were the environmental data analyses, the local needs and general situations, data analyses of the previous programs, cost analyses of the resources, and the identification of the structure and the purposes to develop the new programs.Keywords: program development, knowledge management, graduate study programs, Rajbhat Suansunantha University
Procedia PDF Downloads 3028725 Assessing the Lifestyle Factors, Nutritional and Socioeconomic Status Associated with Peptic Ulcer Disease: A Cross-Sectional Study among Patients at the Tema General Hospital of Ghana
Authors: Marina Aferiba Tandoh, Elsie Odei
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Peptic Ulcer Disease (PUD) is amongst the commonest gastrointestinal problems that require emergency treatment in order to preserve life. The prevalence of PUD is increasing within the Ghanaian population, deepening the need to identify factors that are associated with its occurrence. This cross-sectional study assessed the nutritional status, socioeconomic and lifestyle factors associated with PUD among patients attending the Out-Patient Department of the Tema General Hospital of Ghana. A food frequency questionnaire and a three-day, 24-hour recall were used to assess the dietary intakes of study participants. A standardized questionnaire was used to obtain information on the participants’ socio-demographic characteristics, lifestyle as well as medical history. The data was analyzed using SPSS version 22. The mean age of study participants was 32.8±15.41years. Females were significantly higher (61.4%) than males (38.6%) (p < 0.001). All participants had received some form of education, with tertiary education being the highest (52.6%). The majority of them managed their condition with medications only (86%), while 10.5% managed it with a combination of medications and diet. The rest were either by dietary counseling only (1.8%), or surgery only (1.8%). or herbal medicines (29.3%), which were made from home (7.2%) or bought from a medical store (10.8%). Most of the participants experienced a recurrence of the disease (42.1%). For those who had ever experienced recurrences of the disease, it happened when they ate acidic foods (1.8%), ate bigger portions (1.8%), starved themselves (1.8%), or were stressed (1.8%). Others also had triggers when they took certain medications (1.8%) or ate too much pepper (1.8%). About 49% of the participants were either overweight or obese with a recurrence of PUD (p>0.05). Obese patients had the highest rate of PUD recurrences (41%). Drinking alcohol was significantly associated with the recurrence of PUD (χ2= 5.243, p=0.026). Other lifestyles, such as weed smoking, fasting, and use of herbal medicine and NSAIDs did not have any significant association with the disease recurrence. There was no significant correlation between the various dietary patterns and anthropometric parameters except dietary pattern one (salty snacks, regular soft drinks, milk, sweetened yogurt, ice cream, and cooked vegetables), which had a positive correlation with weight (p=0.002) and BMI (p=0.038). PUD patients should target weight reduction actions and reduce alcohol intake as measures to control the recurrence of the disease. Nutrition Education among this population must be promoted to minimize the recurrence of PUD.Keywords: Dietary patterns, lifestyle factors, nutritional status, peptic ulcer disease
Procedia PDF Downloads 768724 Multiclass Support Vector Machines with Simultaneous Multi-Factors Optimization for Corporate Credit Ratings
Authors: Hyunchul Ahn, William X. S. Wong
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Corporate credit rating prediction is one of the most important topics, which has been studied by researchers in the last decade. Over the last decade, researchers are pushing the limit to enhance the exactness of the corporate credit rating prediction model by applying several data-driven tools including statistical and artificial intelligence methods. Among them, multiclass support vector machine (MSVM) has been widely applied due to its good predictability. However, heuristics, for example, parameters of a kernel function, appropriate feature and instance subset, has become the main reason for the critics on MSVM, as they have dictate the MSVM architectural variables. This study presents a hybrid MSVM model that is intended to optimize all the parameter such as feature selection, instance selection, and kernel parameter. Our model adopts genetic algorithm (GA) to simultaneously optimize multiple heterogeneous design factors of MSVM.Keywords: corporate credit rating prediction, Feature selection, genetic algorithms, instance selection, multiclass support vector machines
Procedia PDF Downloads 2898723 Development the Potential of Parking Tax and Parking Retribution Revenues: Case Study in Bekasi City
Authors: Ivan Yudianto
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The research objectives are to analyze the factors that impede the Parking Tax and Parking Retribution collection in Bekasi City Government, analyzing the factors that can increase local own revenue from the tax sector of parking tax and parking retribution, analyze monitoring the parking retribution collection by the Bekasi City Government, analyze strategies Bekasi City Government through the preparation of a roadmap and action plan to increase parking tax and parking retribution revenues. The approach used in this research is a qualitative approach. Qualitative research is used because the problem is not yet clear and the object to be studied will be holistic, complex, and dynamic, and the relationship will be interactive symptoms. Methods of data collection and technical analysis of the data was in-depth interviews, participant observation, documentary materials, literature, and triangulation, as well as new methods such as the methods of visual materials and internet browsing. The results showed that there are several factors that become an obstacle such as the parking taxpayer does not disclose the actual parking revenue, the parking taxpayer are late or do not pay Parking Tax, many parking locations controlled by illegal organizations, shortage of human resources in charge levy and supervise the parking tax and parking retribution collection in the Bekasi City Government, surveillance parking tax and parking retribution are not scheduled on a regular basis. Several strategic priorities in order to develop the potential of the Parking Tax and Parking Retribution in the Bekasi City Government, namely through increased controling and monitoring of the Parking Taxpayer, forming a team of auditors to audit the Parking Taxpayer, seek law enforcement persuasive and educative to reduce Parking Taxpayer wayward, providing strict sanctions against the Parking Taxpayer disobedient, revised regulations mayors about locations of parking in Bekasi City, rationalize revenues target of Parking Retribution, conducting takeover attempts parking location on the roadside of the individual or specific group, and drafting regional regulations on parking subscribe.Keywords: local own revenue, parking retribution, parking tax, parking taxpayer
Procedia PDF Downloads 3208722 A Study of the Challenges in Adoption of Renewable Energy in Nigeria
Authors: Farouq Sule Garo, Yahaya Yusuf
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The purpose of this study is to investigate why there is a general lack of successful adoption of sustainable energy in Nigeria. This is particularly important given the current global campaign for net-zero emissions. The 26th United Nations Conference of the Parties (COP26), held in 2021, was hosted by the UK, in Glasgow, where, amongst other things, countries including Nigeria agreed to a zero emissions pact. There is, therefore, an obligation on the part of Nigeria for transition from fossil fuel-based economy to a sustainable net-zero emissions economy. The adoption of renewable energy is fundamental to achieving this ambitious target if decarbonisation of economic activities were to become a reality. Nigeria has an abundance of sources of renewable energy and yet there has been poor uptake and where attempts have been made to develop and harness renewable energy resources, there has been limited success. It is not entirely clear why this is the case. When analysts allude to corruption as the reason for failure for successful adoption of renewable energy or project implementation, it is arguable that corruption alone cannot explain the situation. Therefore, there is the need for a thorough investigation into the underlying issues surrounding poor uptake of renewable energy in Nigeria. This pilot study, drawing upon stakeholders’ theory, adopts a multi-stakeholder’ perspectives to investigate the influence and impacts of economic, political, technological, social factors in adoption of renewable energy in Nigeria. The research will also investigate how these factors shape (or fail to shape) strategies for achieving successful adoption of renewable energy in the country. A qualitative research methodology has been adopted given the nature of the research requiring in-depth studies in specific settings rather than a general population survey. There will be a number of interviews and each interview will allow thorough probing of sources. This, in addition to the six interviews that have already been conducted, primarily focused on economic dimensions of the challenges in adoption of renewable energy. The six participants in these initial interviews were all connected to the Katsina Wind Farm Project that was conceived and built with the view to diversifying Nigeria's energy mix and capitalise on the vast wind energy resources in the northern region. The findings from the six interviews provide insights into how the economic factors impacts on the wind farm project. Some key drivers have been identified, including strong governmental support and the recognition of the need for energy diversification. These drivers have played crucial roles in initiating and advancing the Katsina Wind Farm Project. In addition, the initial analysis has highlighted various challenges encountered during the project's implementation, including financial, regulatory, and environmental aspects. These challenges provide valuable lessons that can inform strategies to mitigate risks and improve future wind energy projects.Keywords: challenges in adoption of renewable energy, economic factors, net-zero emission, political factors
Procedia PDF Downloads 308721 Investigating the Relative Priority of the Factors Affecting Customer Satisfaction in Gaining the Competitive Advantage in Pars-Khazar Company
Authors: Samaneh Pouyanfar, Michael Oliff
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The industry of home appliances may beone of theindustries which has the highest competition, and actually what can guarantee the survival of this industry is discovering the superior services. A trend to provide quality products and services plays an important role in this industry because discovering the services is counted as a vital affair for Manufacturing Organizations’ survival and profitability. Given the importance of the topic, this paper attempts to investigate the relative priority of the factors influencing the customer satisfaction in gaining the competitive advantage in Pars-Khazar Company. In sum, 96 executives of Pars-Khazar Company where investigated in a census. For this purpose, after reviewing the research literature and performing deep interviews between pundits and experts active in the industry, the research questionnaire was made based on variables affecting customer satisfaction and components determining business competitive advantage. Determining the content validity took place by judgement of the experts. The reliability of each structure was measured based on Cronbach’s alpha coefficient. Since the value of Cronbach's alpha was higher than 0.7 for each structure, internal consistency of statements was high and the reliability of the questionnaire was acceptable. The data analysis was also done with Kulmgrf-asmyrnf test and Friedman test using SPSS software. The results showed that in dimension of factors affecting customer satisfaction, the History of trade name (brand), Familiarity with the product brand, Brand reputation and Safety have the highest value of priority respectively, and the variable of firm growth has the highest value of priority among the components determining the performance of competitive advantage.Keywords: customer satisfaction, competitive advantage, brand history, safety, growth
Procedia PDF Downloads 2238720 Runoff Estimation in the Khiyav River Basin by Using the SCS_ CN Model
Authors: F. Esfandyari Darabad, Z. Samadi
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The volume of runoff caused by rainfall in the river basin has enticed the researchers in the fields of the water management resources. In this study, first of the hydrological data such as the rainfall and discharge of the Khiyav river basin of Meshkin city in the northwest of Iran collected and then the process of analyzing and reconstructing has been completed. The soil conservation service (scs) has developed a method for calculating the runoff, in which is based on the curve number specification (CN). This research implemented the following model in the Khiyav river basin of Meshkin city by the GIS techniques and concluded the following fact in which represents the usage of weight model in calculating the curve numbers that provides the possibility for the all efficient factors which is contributing to the runoff creation such as; the geometric characteristics of the basin, the basin soil characteristics, vegetation, geology, climate and human factors to be considered, so an accurate estimation of runoff from precipitation to be achieved as the result. The findings also exposed the accident-prone areas in the output of the Khiyav river basin so it was revealed that the Khiyav river basin embodies a high potential for the flood creation.Keywords: curve number, khiyav river basin, runoff estimation, SCS
Procedia PDF Downloads 6128719 Application of Artificial Neural Network Technique for Diagnosing Asthma
Authors: Azadeh Bashiri
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Introduction: Lack of proper diagnosis and inadequate treatment of asthma leads to physical and financial complications. This study aimed to use data mining techniques and creating a neural network intelligent system for diagnosis of asthma. Methods: The study population is the patients who had visited one of the Lung Clinics in Tehran. Data were analyzed using the SPSS statistical tool and the chi-square Pearson's coefficient was the basis of decision making for data ranking. The considered neural network is trained using back propagation learning technique. Results: According to the analysis performed by means of SPSS to select the top factors, 13 effective factors were selected, in different performances, data was mixed in various forms, so the different models were made for training the data and testing networks and in all different modes, the network was able to predict correctly 100% of all cases. Conclusion: Using data mining methods before the design structure of system, aimed to reduce the data dimension and the optimum choice of the data, will lead to a more accurate system. Therefore, considering the data mining approaches due to the nature of medical data is necessary.Keywords: asthma, data mining, Artificial Neural Network, intelligent system
Procedia PDF Downloads 2658718 Effects of Ground Motion Characteristics on Damage of RC Buildings: A Detailed Investiagation
Authors: Mohamed Elassaly
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The damage status of RC buildings is greatly influenced by the characteristics of the imposed ground motion. Peak Ground Acceleration and frequency contents are considered the main two factors that affect ground motion characteristics; hence, affecting the seismic response of RC structures and consequently their damage state. A detailed investigation on the combined effects of these two factors on damage assessment of RC buildings, is carried out. Twenty one earthquake records are analyzed and arranged into three groups, according to their frequency contents. These records are used in an investigation to define the expected damage state that would be attained by RC buildings, if subjected to varying ground motion characteristics. The damage assessment is conducted through examining drift ratios and damage indices of the overall structure and the significant structural components of RC building. Base and story shear of RC building model, are also investigated, for cases when the model is subjected to the chosen twenty one earthquake records. Nonlinear dynamic analyses are performed on a 2-dimensional model of a 12-story R.C. building.Keywords: damage, frequency content, ground motion, PGA, RC building, seismic
Procedia PDF Downloads 3998717 Physical Education Teacher's Interpretation toward Teaching Games for Understanding Model
Authors: Soni Nopembri
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The objective of this research is to evaluate the implementation of teaching games for Understanding model by conducting action to physical education teacher who have got long teaching experience. The research applied Participatory Action Research. The subjects of this research were 19 physical education teachers who had got training of Teaching Games for Understanding. Data collection was conducted intensively through a questionnaire, in-depth interview, Focus Group Discussion (FGD), observation, and documentation. The collected data was analysis zed qualitatively and quantitatively. The result showed that physical education teachers had got an appropriate interpretation on TGfU model. Some indicators that were the focus of this research indicated this points; they are: (1) physical education teachers had good understanding toward TGfU model, (2) PE teachers’ competence in applying TGfU model on Physical Education at school were adequate, though some improvement were needed, (3) the influence factors in the implementation of TGfU model, in sequence, were teacher, facilities, environment, and students factors, (4) PE teachers’ perspective toward TGfU model were positively good, although some teachers were less optimistic toward the development of TGfU model in the future.Keywords: TGfU, physical education teacher, teaching games, FGD
Procedia PDF Downloads 5388716 Prevalence of Mycobacterium Tuberculosis Infection and Rifampicin Resistance among Presumptive Tuberculosis Cases Visiting Tuberculosis Clinic of Adare General Hospital, Southern Ethiopia
Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali
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Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB
Procedia PDF Downloads 1048715 Leisure Time Physical Activity during Pregnancy and the Associated Factors Based on Health Belief Model: A Cross Sectional Study
Authors: Xin Chen, Xiao Yang, Rongrong Han, Lu Chen, Lingling Gao
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Background: Leisure time physical activity (LTPA) benefits both pregnant women and their fetuses. The guidelines recommended that pregnant women should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week. The aim of this study was to investigate the rate of LTPA participation among Chinese pregnant women and to identify its predictors based on the health belief model. Methods: A cross-sectional study was conducted from June 2019 to September 2019 in Changchun, China. A total of 225 pregnant women aged 18 years or older with no severe physical or mental disease were recruited in the obstetric clinic. Self-administered questionnaires were used to collect data. LTPA was assessed by a pregnant physical activity questionnaire (PPAQ). A revised pregnancy physical activity health belief scale and social-demographic and perinatal characteristics factors were collected and used to predict LTPA participation. Data were analyzed using descriptive statistics and multivariate logistic regression. Results: The participants had a high level of perceived susceptibility, perceived severity, perceived benefits, and action clues, with mean item scores above 3.5. The predictors of LTPA in Chinese pregnant women were pre-pregnancy exercise habits [OR 3.236 (95% CI:1.632, 6.416)], perceived susceptibility score [OR 2.083 (95% CI:1.002, 4.331)], and perceived barriers score [OR 3.113 (95%CI:1.462, 6.626)]. Conclusions: The results of this study will lead to better identification of pregnant women who may not participate in LTPA. Healthcare professionals should be cognizant of issues that may affect LTPA participation among pregnant women, including pre-pregnancy exercise habits, perceived susceptibility, and perceived barriers.Keywords: pregnancy, health belief model., leisure time physical activity, factors
Procedia PDF Downloads 718714 Factors Associated with the Acceptance and Rejection of Rural Livestock Insurance in Garmsar: Semnan Province
Authors: Ali Ashraf Hamedi Oghul Beyk
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The main objective of the study is to determine the factors which influence the acceptance or rejection of rural livestock insurance in Garmsar. The research method is descriptive one. There are two groups of research populations: 1467 cases in acceptance group and 7000 cases in rejection group. The sample population is 320 cases among 8467 ones. Data collection instrument is questionnaire. The validity of the questionnaire was measured by faculty members and other agriculture experts and also reliability of it determined through Cronbach alpha which was %83. Correlation between acceptance and rejection of investigated population. According to the findings of the research, between educational level, basic income from farm-related communication channels, contacts of experts and acceptance and rejection of livestock insurance at %5 & the mortality rate, loan awareness of the objectives of the livestock insurance benefits %1 there is a meaningful relationship. Mann-Whitney test shows the different educational levels, different awareness and interest to livestock insurance between the two groups. Besides, the T-test shows the livestock losses rate in two groups.Keywords: insurance, livestock, Garmsar, Semnan
Procedia PDF Downloads 3468713 A Critical-Quantitative Approach to Examine the Effects of Systemic Factors on Education Outcomes
Authors: Sireen Irsheid
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Despite concerted efforts to improve education attainment with progress in recent years, student achievement and attainment remain among the most significant challenges for school districts across the United States. Many scholars have argued that students who do not complete high school do not drop out of school voluntarily but are ‘pushed out’ of schools through multiple mechanisms related to structural and socioeconomic barriers, behavioral health challenges, pedagogical practices, and administrative procedures. Extant literature has shown that living in historically disadvantaged neighborhoods or attending under-resourced schools exacerbates student-level risk factors for grade retention and school pushout. Most efforts to respond to the school pushout phenomenon have focused on individual characteristics of students, with relatively little attention to addressing these multiple system-level characteristics related to perpetuating inequities. This study is built on a growing body of social justice-oriented research concerned with the systemic influences that shape the experiences and mental health challenges of young people. Specifically, this study examined how young people who have been experiencing education inequities make meaning and navigate the structural factors related to neighborhood and school disinvestment and access to resources and supports, and their risk for school pushout. Furthermore, schools as political, cultural, and ideologically reproductive spaces often serve as sites of resistance and can support students who are impacted by educational inequity. Study findings provide education, neighborhood, school psychology, social work practice, and policy considerations.Keywords: education policy, mental health, school prison nexus, school pushout, structural trauma
Procedia PDF Downloads 568712 Tuberculosis (TB) and Lung Cancer
Authors: Asghar Arif
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Lung cancer has been recognized as one of the greatest common cancers, causing the annual mortality rate of about 1.2 million people in the world. Lung cancer is the most prevalent cancer in men and the third-most common cancer among women (after breast and digestive cancers).Recent evidences have shown the inflammatory process as one of the potential factors of cancer. Tuberculosis (TB), pneumonia, and chronic bronchitis are among the most important inflammation-inducing factors in the lungs, among which TB has a more profound role in the emergence of cancer.TB is one of the important mortality factors throughout the world, and 205,000 death cases are reported annually due to this disease. Chronic inflammation and fibrosis due to TB can induce genetic mutation and alternations. Parenchyma tissue of lung is involved in both diseases of TB and lung cancer, and continuous cough in lung cancer, morphological vascular variations, lymphocytosis processes, and generation of immune system mediators such as interleukins, are all among the factors leading to the hypothesis regarding the role of TB in lung cancer Some reports have shown that the induction of necrosis and apoptosis or TB reactivation, especially in patients with immune-deficiency, may result in increasing IL-17 and TNF_α, which will either decrease P53 activity or increase the expression of Bcl-2, decrease Bax-T, and cause the inhibition of caspase-3 expression due to decreasing the expression of mitochondria cytochrome oxidase. It has been also indicated that following the injection of BCG vaccine, the host immune system will be reinforced, and in particular, the rates of gamma interferon, nitric oxide, and interleukin-2 are increased. Therefore, CD4 + lymphocyte function will be improved, and the person will be immune against cancer.Numerous prospective studies have so far been conducted on the role of TB in lung cancer, and it seems that this disease is effective in that particular cancer.One of the main challenges of lung cancer is its correct and timely diagnosis. Unfortunately, clinical symptoms (such as continuous cough, hemoptysis, weight loss, fever, chest pain, dyspnea, and loss of appetite) and radiological images are similar in TB and lung cancer. Therefore, anti-TB drugs are routinely prescribed for the patients in the countries with high prevalence of TB, like Pakistan. Regarding the similarity in clinical symptoms and radiological findings of lung cancer, proper diagnosis is necessary for TB and respiratory infections due to nontuberculousmycobacteria (NTM). Some of the drug resistive TB cases are, in fact, lung cancer or NTM lung infections. Acid-fast staining and histological study of phlegm and bronchial washing, culturing and polymerase chain reaction TB are among the most important solutions for differential diagnosis of these diseases. Briefly, it is assumed that TB is one of the risk factors for cancer. Numerous studies have been conducted in this regard throughout the world, and it has been observed that there is a significant relationship between previous TB infection and lung cancer. However, to prove this hypothesis, further and more extensive studies are required. In addition, as the clinical symptoms and radiological findings of TB, lung cancer, and non-TB mycobacteria lung infections are similar, they can be misdiagnosed as TB.Keywords: TB and lung cancer, TB people, TB servivers, TB and HIV aids
Procedia PDF Downloads 688711 The Utility of Sonographic Features of Lymph Nodes during EBUS-TBNA for Predicting Malignancy
Authors: Atefeh Abedini, Fatemeh Razavi, Mihan Pourabdollah Toutkaboni, Hossein Mehravaran, Arda Kiani
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In countries with the highest prevalence of tuberculosis, such as Iran, the differentiation of malignant tumors from non-malignant is very important. In this study, which was conducted for the first time among the Iranian population, the utility of the ultrasonographic morphological characteristics in patients undergoing EBUS was used to distinguish the non-malignant versus malignant lymph nodes. The morphological characteristics of lymph nodes, which consist of size, shape, vascular pattern, echogenicity, margin, coagulation necrosis sign, calcification, and central hilar structure, were obtained during Endobronchial Ultrasound-Guided Trans-Bronchial Needle Aspiration and were compared with the final pathology results. During this study period, a total of 253 lymph nodes were evaluated in 93 cases. Round shape, non-hilar vascular pattern, heterogeneous echogenicity, hyperechogenicity, distinct margin, and the presence of necrosis sign were significantly higher in malignant nodes. On the other hand, the presence of calcification and also central hilar structure were significantly higher in the benign nodes (p-value ˂ 0.05). Multivariate logistic regression showed that size>1 cm, heterogeneous echogenicity, hyperechogenicity, the presence of necrosis signs and, the absence of central hilar structure are independent predictive factors for malignancy. The accuracy of each of the aforementioned factors is 42.29 %, 71.54 %, 71.90 %, 73.51 %, and 65.61 %, respectively. Of 74 malignant lymph nodes, 100% had at least one of these independent factors. According to our results, the morphological characteristics of lymph nodes based on Endobronchial Ultrasound-Guided Trans-Bronchial Needle Aspiration can play a role in the prediction of malignancy.Keywords: EBUS-TBNA, malignancy, nodal characteristics, pathology
Procedia PDF Downloads 1288710 Impact of Flexibility on Residential Buildings in Egypt
Authors: Aly Mohamed El Husseiny, Azza Ezz Abdelkader
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There is a critical thin line between freedom of choice and randomness. The distance between imagination and perception and between perception and execution varies depending on numerous factors. While in developed areas residents have the opportunity and abilities to build flexible homes, residents in developing areas create their own dwellings in informal settlements, even though none of them is comfortable at home in the long run. This paper explores three factors: What residents really need, what they do with limited flexibility, and what they do when there are no limits, as in the case of informal settlements. This paper studies alteration to residential buildings and how they connect to the changes in people’s lifecycle in all past cases. This study also examines all approaches to flexibility, focusing on a social approach. The results of this study are based on three practical studies: Interviews with residents in an informal settlement (Eshash Mahfouz in Minya in Egypt), a civil study of buildings in a middle-class district, and a survey of residents from many countries, including Egypt, and interviews with a number of them to determine residents’ needs and the extent of renovations they made or would like to make to their homes.Keywords: flexibility, housing, freedom of choice, social, changes, residents
Procedia PDF Downloads 2918709 Using Design Thinking Principles to Improve Patients Experiences in Two Outpatient Pharmacies in Asir Region, Saudi Arabia
Authors: Dalia Almaghaslah
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Design thinking approach; empathize, define, ideate prototype, test, implement, was used to assess outpatient experiences in two hospital pharmacies in the Asir region, Saudi Arabia. Semi-structured interviews were conducted with 40 patients. The data were analyzed using thematic analysis. The findings suggested that patients were generally satisfied with pharmaceutical services provided in both pharmacies. Pharmacists were found to have enough knowledge, good attitude, and efficient communication and counselling skills. Non-pharmacy-related factors such as cultural factors (gender segregation), long waiting times, uncomfortable waiting areas, lack of electronic prescribing, number waiting system were found to have a negative impact on patients' experiences and satisfaction. Prototypes will be used to test the effects of implementing the electronic system in Al -mahal hospital and to test changing the physical layout of the waiting area in Asir hospital.Keywords: design thinking, hospital pharmacy, patient satisfaction, Saudi Arabia
Procedia PDF Downloads 1308708 Reliability Analysis of Construction Schedule Plan Based on Building Information Modelling
Authors: Lu Ren, You-Liang Fang, Yan-Gang Zhao
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In recent years, the application of BIM (Building Information Modelling) to construction schedule plan has been the focus of more and more researchers. In order to assess the reasonable level of the BIM-based construction schedule plan, that is whether the schedule can be completed on time, some researchers have introduced reliability theory to evaluate. In the process of evaluation, the uncertain factors affecting the construction schedule plan are regarded as random variables, and probability distributions of the random variables are assumed to be normal distribution, which is determined using two parameters evaluated from the mean and standard deviation of statistical data. However, in practical engineering, most of the uncertain influence factors are not normal random variables. So the evaluation results of the construction schedule plan will be unreasonable under the assumption that probability distributions of random variables submitted to the normal distribution. Therefore, in order to get a more reasonable evaluation result, it is necessary to describe the distribution of random variables more comprehensively. For this purpose, cubic normal distribution is introduced in this paper to describe the distribution of arbitrary random variables, which is determined by the first four moments (mean, standard deviation, skewness and kurtosis). In this paper, building the BIM model firstly according to the design messages of the structure and making the construction schedule plan based on BIM, then the cubic normal distribution is used to describe the distribution of the random variables due to the collecting statistical data of the random factors influencing construction schedule plan. Next the reliability analysis of the construction schedule plan based on BIM can be carried out more reasonably. Finally, the more accurate evaluation results can be given providing reference for the implementation of the actual construction schedule plan. In the last part of this paper, the more efficiency and accuracy of the proposed methodology for the reliability analysis of the construction schedule plan based on BIM are conducted through practical engineering case.Keywords: BIM, construction schedule plan, cubic normal distribution, reliability analysis
Procedia PDF Downloads 1348707 Factors Affecting the Success of Premarital Screening Service in Middle Eastern Islamic Countries
Authors: Wafa Al Jabri
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Background: In Middle Eastern Islamic Countries (MEICs), there is a high prevalence of genetic blood disorders (GBDs), particularly sickle cell disease and thalassemia. The GBDs are considered a major public health concern, especially with the increase in affected populations along with the associated psychological, social, and financial cost of management. Despite the availability of premarital screening services (PSS) that aim to identify the asymptomatic carriers of GBDs and provide genetic counseling to couples in order toreduce the prevalence of these diseases; yet, the success rate of PSS is very low due to religious and socio-cultural concerns. Purpose: This paper aims to highlight the factors that affect the success of PSS in MEICs. Methods: A literature review of articles located in CINAHL, PubMed, SCOPUS, and MedLinewas carried out using the following terms: “premarital screening,” “success,” “effectiveness,” and “ genetic blood disorders.” Second, a hand search of the reference lists and Google searches were conducted to find studies that did not exist in the primary database searches. Only studies which are conducted in MEICs countries and published in the last five years were included. Studies that were not published in English were excluded. Results: Fourteen articles were included in the review. The results showed that PSS in most of the MEICs was successful in achieving its objective of identifying high-risk marriages; however, the service failed to meetitsultimate goal of reducing the prevalence of GBDs. Various factors seem to hinder the success of PSS, including poor public awareness, late timing of the screening, culture and social stigma, religious beliefs, availability of prenatal diagnosis and therapeutic abortion, emotional factors, and availability of genetic counseling services. However, poor public awareness, late timing of the screening, and unavailability of adequate counseling services were the most common barriers identified. Conclusion: Overcoming the identified barriers by providing effective health education programs, offering the screening test to young adults at an earlier stage, and tailoring the genetic counseling would be crucial steps to provide a framework for an effective PSS in MEICs.Keywords: premarital screening, success, effectiveness, and genetic blood disorders
Procedia PDF Downloads 888706 Elements of Successful Commercial Streets: A Socio-Spatial Analysis of Commercial Streets in Cairo
Authors: Toka Aly
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Historically, marketplaces were the most important nodes and focal points of cities, where different activities took place. Commercial streets offer more than just spaces for shopping; they also offer choices for social activities and cultural exchange. They are considered the backbone of the city’s vibrancy and vitality. Despite that, the public life in Cairo’s commercial streets has deteriorated, where the shopping activities became reliant mainly on 'planned formal places', mainly in privatized or indoor spaces like shopping malls. The main aim of this paper is to explore the key elements and tools of assessing the successfulness of commercial streets in Cairo. The methodology followed in this paper is based on a case study methodology (multiple cases) that is based on assessing and analyzing the physical and social elements in historical and contemporary commercial streets in El Muiz Street and Baghdad Street in Cairo. The data collection is based on personal observations, photographs, maps and street sections. Findings indicate that the key factors of analyzing commercial streets are factors affecting the sensory experience, factors affecting the social behavior, and general aspects that attract people. Findings also indicate that urban features have clear influence on shopping pedestrian activities in both streets. Moreover, in order for a commercial street to be successful, shopping patterns must provide people with a quality public space that can provide easy navigation and accessibility, good visual continuity, and well-designed urban features and social gathering. Outcomes of this study will be a significant endeavor in providing a good background for urban designers on analyzing and assessing successfulness of commercial streets. The study will also help in understanding the different physical and social pattern of vending activities taking place in Cairo.Keywords: activities, commercial street, marketplace, successful, vending
Procedia PDF Downloads 2898705 Competition for Talent: Retaining Graduates in the Euregio Meuse-Rhine
Authors: Julia Reinold, Inge Hooijen, Christoph Meng, Melissa Siegel
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This paper investigates whether or not students intend to stay in the Euregio Meuse-Rhine (EMR) after graduation taking into account the role of hard and soft locational factors, social factors as well as demographic aspects in shaping their mobility preferences. Since graduates are considered a convenient source of human capital in today’s knowledge based economy, it is crucial to understand what drives their mobility intentions in order to retain larger numbers of graduates. This is particularly true for peripheral regions, which need to compete with assumed more attractive economic centres. This paper adds a euregional perspective to the existing literature on graduate migration. Using survey data from 2015 from five higher education institutions in the EMR, this paper finds that mobility intentions are determined by students’ perceptions of the quality of life, openness and career opportunities in the euroregion. In addition, distance to the partner and other social ties such as family and friends influence migration intentions.Keywords: Euroregion, graduate migration, highly skilled migration, human capital
Procedia PDF Downloads 2728704 Strategic Business Solutions for an Ageing SME
Authors: N. G. Teik Hiang, Fathyah Hashim
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This is a case of how strategic management techniques can be used to help resolving problems faced by an ageing Small and Medium Enterprise (SME). Strategic way of resolving problems had been proven to be possible in this case despite general thought that strategic management is useful mostly for large corporations. Small and Medium Enterprises (SMEs) can also use strategic management in managing their business and determining their future cause of action and strategies in order to survive in this ever competent world. Strategic orientation is the key to survival and development of small and medium enterprises. In order to adapt to the fierce market competition, ageing SMEs should improve competitiveness and operational efficiency. They must therefore establish a sense of strategic management to improve the strategic management skills, combined with its own unique characteristics, and work out practical strategies to develop core competitiveness of enterprises in the fierce market competition in order to be sustainable. In this case, internal strengths and weaknesses of an SME had been identified. Strategic internal factors and external factors had been classified and further utilized to formulate potential strategies to encounter various problems faced by the SME. These strategies had been further match to take advantages of the opportunities and to overcome the weaknesses and minimize the threats it is facing. Tan, a consultant who was given the opportunity to formulate a plan for the business started with the environmental scanning (internal and external environmental analysis), assessing strengths and weaknesses for the company, strategies generation, analysis and evaluation. He had numerous discussions with the owner of the business and the senior management in order to match the key internal and external factors to formulate alternative strategies for solving the problems that the company facing. Some of the recommendations or solutions are generated from the inspiration of the owner of the business who is a very enterprising and experience businessman.Keywords: strategic orientation, strategic management, SME, core competitiveness, sustainable
Procedia PDF Downloads 4118703 Community Engagement: Experience from the SIREN Study in Sub-Saharan Africa
Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia
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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke
Procedia PDF Downloads 421