Search results for: North American ice service
4032 The Impact of Institutional and Organizational Change on Social Housing Organizations and Their Stakeholders
Authors: Farnoosh Faal
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Institutional and organizational change in social housing organizations can have a significant impact on both the organizations themselves and their stakeholders. This paper provides an overview of the impact of institutional and organizational change on social housing organizations and their stakeholders, including tenants, employees, and other community members. The paper examines the different types of institutional and organizational change that can occur in social housing organizations, such as changes in management structure, funding models, and service delivery methods. It also explores the potential benefits and drawbacks of these changes, including changes in efficiency, service quality, and tenant satisfaction. The paper further discusses the impact of institutional and organizational change on social housing organization stakeholders, including the effects on employee morale, tenant engagement, and community relationships. The paper highlights the importance of effective stakeholder engagement and communication in ensuring a smooth transition to new organizational models and systems. Finally, the paper discusses the challenges and opportunities presented by institutional and organizational change in social housing organizations and provides recommendations for organizations looking to navigate these changes successfully. These recommendations include prioritizing stakeholder engagement, investing in staff training and development, and maintaining a focus on the needs and priorities of tenants and communities. Overall, this paper emphasizes the importance of considering the impact of institutional and organizational change on social housing organizations and their stakeholders and highlights strategies for managing these changes in a way that maximizes benefits and minimizes negative impacts.Keywords: social housing organizations, stakeholder engagement, institutional change, challenges, opportunities
Procedia PDF Downloads 864031 Of an 80 Gbps Passive Optical Network Using Time and Wavelength Division Multiplexing
Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Faizan Khan, Xiaodong Yang
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Internet Service Providers are driving endless demands for higher bandwidth and data throughput as new services and applications require higher bandwidth. Users want immediate and accurate data delivery. This article focuses on converting old conventional networks into passive optical networks based on time division and wavelength division multiplexing. The main focus of this research is to use a hybrid of time-division multiplexing and wavelength-division multiplexing to improve network efficiency and performance. In this paper, we design an 80 Gbps Passive Optical Network (PON), which meets the need of the Next Generation PON Stage 2 (NGPON2) proposed in this paper. The hybrid of the Time and Wavelength division multiplexing (TWDM) is said to be the best solution for the implementation of NGPON2, according to Full-Service Access Network (FSAN). To co-exist with or replace the current PON technologies, many wavelengths of the TWDM can be implemented simultaneously. By utilizing 8 pairs of wavelengths that are multiplexed and then transmitted over optical fiber for 40 Kms and on the receiving side, they are distributed among 256 users, which shows that the solution is reliable for implementation with an acceptable data rate. From the results, it can be concluded that the overall performance, Quality Factor, and bandwidth of the network are increased, and the Bit Error rate is minimized by the integration of this approach.Keywords: bit error rate, fiber to the home, passive optical network, time and wavelength division multiplexing
Procedia PDF Downloads 704030 Impact of Traffic Restrictions due to Covid19, on Emissions from Freight Transport in Mexico City
Authors: Oscar Nieto-Garzón, Angélica Lozano
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In urban areas, on-road freight transportation creates several social and environmental externalities. Then, it is crucial that freight transport considers not only economic aspects, like retailer distribution cost reduction and service improvement, but also environmental effects such as global CO2 and local emissions (e.g. Particulate Matter, NOX, CO) and noise. Inadequate infrastructure development, high rate of urbanization, the increase of motorization, and the lack of transportation planning are characteristics that urban areas from developing countries share. The Metropolitan Area of Mexico City (MAMC), the Metropolitan Area of São Paulo (MASP), and Bogota are three of the largest urban areas in Latin America where air pollution is often a problem associated with emissions from mobile sources. The effect of the lockdown due to COVID-19 was analyzedfor these urban areas, comparing the same period (January to August) of years 2016 – 2019 with 2020. A strong reduction in the concentration of primary criteria pollutants emitted by road traffic were observed at the beginning of 2020 and after the lockdown measures.Daily mean concentration of NOx decreased 40% in the MAMC, 34% in the MASP, and 62% in Bogota. Daily mean ozone levels increased after the lockdown measures in the three urban areas, 25% in MAMC, 30% in the MASP and 60% in Bogota. These changes in emission patterns from mobile sources drastically changed the ambient atmospheric concentrations of CO and NOX. The CO/NOX ratioat the morning hours is often used as an indicator of mobile sources emissions. In 2020, traffic from cars and light vehicles was significantly reduced due to the first lockdown, but buses and trucks had not restrictions. In theory, it implies a decrease in CO and NOX from cars or light vehicles, maintaining the levels of NOX by trucks(or lower levels due to the congestion reduction). At rush hours, traffic was reduced between 50% and 75%, so trucks could get higher speeds, which would reduce their emissions. By means an emission model, it was found that an increase in the average speed (75%) would reduce the emissions (CO, NOX, and PM) from diesel trucks by up to 30%. It was expected that the value of CO/NOXratio could change due to thelockdownrestrictions. However, although there was asignificant reduction of traffic, CO/NOX kept its trend, decreasing to 8-9 in 2020. Hence, traffic restrictions had no impact on the CO/NOX ratio, although they did reduce vehicle emissions of CO and NOX. Therefore, these emissions may not adequately represent the change in the vehicle emission patterns, or this ratio may not be a good indicator of emissions generated by vehicles. From the comparison of the theoretical data and those observed during the lockdown, results that the real NOX reduction was lower than the theoretical reduction. The reasons could be that there are other sources of NOX emissions, so there would be an over-representation of NOX emissions generated by diesel vehicles, or there is an underestimation of CO emissions. Further analysis needs to consider this ratioto evaluate the emission inventories and then to extend these results forthe determination of emission control policies to non-mobile sources.Keywords: COVID-19, emissions, freight transport, latin American metropolis
Procedia PDF Downloads 1364029 Architectural Heritage of Southern Portugal: Disruptive Practices and Sustainability Plans for its Preservation
Authors: Patrícia Alexandra Rodrigues Monteiro
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The way modern societies relate with their architectural heritage has become increasingly difficult. This fact is clearer in historic centres of Portuguese peripheral cities or villages, constantly on the balance between its growth needs and the restrictions imposed by the policies for the built heritage preservation. Nowadays, gentrification phenomenon has levelled the differences between architecture, from north to south of the country, under false pretences of modernity and promises of better living conditions for local populations who inhabit historic centres. With this essay, we will address some of the main problems of southern Portugal’s historic centres, reflecting on the concept of sustainability which, also in this context, has acquired an unavoidable relevance.Keywords: architecture, art, heritage, portugal
Procedia PDF Downloads 1744028 Seasonal Lambing in Crossbred of Katahdin Ewes in Tropical Regions of Chiapas, Mexico
Authors: Juan C. Martínez-Alfaro, Aracely Zúñiga, Fernando Ruíz-Zarate
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In recent years, the Katahdin sheep breeds have been one of the breeds with greater acceptance by sheep farmers in southwestern Mexico. The Hair Sheep breeds from tropical latitudes (16° to 21° North Latitude) show low estrus activity from January to May. By contrast, these breeds of sheep exhibit high estrus activity from August to December. However, the reproductive management of Hair Sheep crossbred is very limited, independently of the socioeconomic levels of sheep farmers. Thus, in crossbred of Hair Sheep, occurrence of lambing is greater in autumn (84%) than spring (16%). In this sense, the aim of this study was to determine the lambing in Crossbred of Katahdin sheep during different seasons of the year. The Hypothesis was that in crossbred of Katahdin sheep, the lambing period has a behavior seasonal in the Southwestern Mexico. The study design consisted in evaluating the lambing proportion in one herds of Katahdin ewes crossbred during one year (October 1st, 2015 to October 1st, 2016). The study was realized in a farm located in the municipality of Jiquipilas, in the State of Chiapas, Mexico (16° North Latitude). A total of 40 female sheep homogeneous in terms of physical condition, age and physiological state were selected; and they were fed in grazing continuous, mainly with Africa star grass (Cynodon lemfuensis) and they are provided with water and mineral salts ad libitum; during the dry season, the ewes were supplemented with a diet of maize and sorghum, and the reproductive management was continuous mating. The lambing proportion was analyzed by chi-squared test, using SAS statistical software. The proportion of Katahdin ewes crossbred that lambed during the study period was high (100%; 40/40), the prolificacy was 1.42 (lamb/lambing). The proportion of lambing was higher (P<0.05) in autumn (67.5%; 27/40), than winter, spring and summer (32.5%; 13/40; 0%; 0/40; 0%; 0/40; respectively). The proportion of lambing was greater (P<0.05) in November (50%; 20/40), compared to October, December and January (2.5%; 1/40; 27.5%; 11/40; 20%; 8/40, respectively). The results are consistent with the fact that in the Hair Sheep Breeds, the lambing appears behave seasonally. The most important finding is that the lambing period in the crossbred of Katahdin Sheep is similar to the crossbred of Hair Sheep in tropical regions of Mexico. Therefore, the period of greater sexual activity occurs in the spring season. In conclusion, the period of lambing in crossbred of Katahdin ewes appears behave seasonally. Further researches to assess the ovarian activity in different breeds of Hair Ewes are under assessment.Keywords: Katahdin ewes, lambing, prolificacy, seasonality
Procedia PDF Downloads 2634027 Improvements of the Difficulty in Hospital Acceptance at the Scene by the Introduction of Smartphone Application for Emergency-Medical-Service System: A Population-Based Before-And-After Observation Study in Osaka City, Japan
Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Sumito Hayashida, Taku Iwami, Takashi Kawamura, Takeshi Shimazu
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Background: Recently, the number of ambulance dispatches has been increasing in Japan and it is, therefore, difficult to accept emergency patients to hospitals smoothly and appropriately because of the limited hospital capacity. To facilitate the request for patient transport by ambulances and hospital acceptance, the emergency information system using information technology has been built up and introduced in various communities. However, its effectiveness has not been insufficiently revealed in Japan. In 2013, we developed a smartphone application system that enables the emergency-medical-service (EMS) personnel to share information about on-scene ambulance and hospital situation. The aim of this study was to assess the introduction effect of this application for EMS system in Osaka City, Japan. Methods: This study was a retrospective study with population-based ambulance records of Osaka Municipal Fire Department. This study period was six years from January 1, 2010 to December 31, 2015. In this study, we enrolled emergency patients that on-scene EMS personnel conducted the hospital selection for them. The main endpoint was difficulty in hospital acceptance at the scene. The definition of difficulty in hospital acceptance at the scene was to make >=5 phone calls by EMS personnel at the scene to each hospital until a decision to transport was determined. The definition of the smartphone application group was emergency patients transported in the period of 2013-2015 after the introduction of this application, and we assessed the introduction effect of smartphone application with multivariable logistic regression model. Results: A total of 600,526 emergency patients for whom EMS personnel selected hospitals were eligible for our analysis. There were 300,131 smartphone application group (50.0%) in 2010-2012 and 300,395 non-smartphone application group (50.0%) in 2013-2015. The proportion of the difficulty in hospital acceptance was 14.2% (42,585/300,131) in the smartphone application group and 10.9% (32,819/300,395) in the non-smartphone application group, and the difficulty in hospital acceptance significantly decreased by the introduction of the smartphone application (adjusted odds ration; 0.730, 95% confidence interval; 0.718-0.741, P<0.001). Conclusions: Sharing information between ambulance and hospital by introducing smartphone application at the scene was associated with decreasing the difficulty in hospital acceptance. Our findings may be considerable useful for developing emergency medical information system with using IT in other areas of the world.Keywords: difficulty in hospital acceptance, emergency medical service, infomation technology, smartphone application
Procedia PDF Downloads 2734026 CLEAN Jakarta Waste Bank Project: Alternative Solution in Urban Solid Waste Management by Community Based Total Sanitation (CBTS) Approach
Authors: Mita Sirait
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Everyday Jakarta produces 7,000 tons of solid waste and only about 5,200 tons delivered to landfill out of the city by 720 trucks, the rest are left yet manageable, as reported by Government of Clean Sector. CLEAN Jakarta Project is aimed at empowering community to achieve healthy environment for children and families in urban slum in Semper Barat and Penjaringan sub-district of North Jakarta that consisted of 20,584 people. The project applies Community Based Total Sanitation, an approach to empowering community to achieve total hygiene and sanitation behaviour by triggering activities. As regulated by Ministry of Health, it has 5 pillars: (1) open defecation free, (2) hand-washing with soaps, (3) drinking-water treatment, (4) solid-waste management and (5) waste-water management; and 3 strategic components: 1) demand creation, 2) supply creation and 3) enabling environment. Demand creation is generated by triggering community’s reaction to their daily sanitation habits by exposing them to their surrounding where they can see faeces, waste and other environmental pollutant to stimulate disgusting, embarrassing and responsibility sense. Triggered people then challenged to commit to improving their hygiene practice such as to stop littering and start waste separation. In order to support this commitment, and for supply creation component, the project initiated waste bank with community working group. It facilitated capacity-building trainings, waste bank system formulation and meetings with local authorities to solicit land permit and waste bank decree. As it is of a general banking system, waste bank has customer service, teller, manager, legal paper and provides saving book and money transaction. In 8 months, two waste banks have established with 148 customers, 17 million rupiah cash, and about 9 million of stored recyclables. Approximately 2.5 tons of 15-35 types of recyclable are managed in both waste banks per week. On enabling environment, the project has initiated sanitation working group in community and multi sectors government level, and advocated both parties. The former is expected to promote behaviour change and monitoring in the community, while the latter is expected to support sanitation with regulations, strategies, appraisal and awards; to coordinate partnering and networking, and to replicate best practices to other areas.Keywords: urban community, waste management, Jakarta, community based total sanitation (CBTS)
Procedia PDF Downloads 2944025 The Relationship between Employee Commitment, Job Satisfaction and External Market Orientation in Vietnamese Joint-Stock Commercial Banks
Authors: Nguyen Ngoc Que Tran
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Purpose: The purpose of this paper is to investigate the relationship between internal market orientation, external market orientation, employee commitment and job satisfaction. Design/methodology/approach: This study collected data through a survey and utilized simple linear regression and multiple regression analysis to determine if there was any support for the research hypotheses as presented in the previous chapter. Findings: Using data from 256 employees of four leading joint stock banks in Vietnam, the empirical results indicates that employee commitment is positively related with external market orientation, job satisfaction is positively related to employee commitment, and employee commitment and job satisfaction are positively related to external market orientation. However, job satisfaction has no significant positive effect on external market orientation. Theoretical contribution: The primary contribution to marketing theory arising from this study is the integration of job satisfaction, employee commitment, and external market orientation in a single research model. Practical implications: The major contribution to practice is an external market oriented bank has to respond rapidly to the future needs and preferences of its customers. This could result in high levels of commitment to the service process and in doing so provide Vietnamese joint-stock commercial banks with a competitive advantage. The finding is important for the banking service sector in general and the Vietnamese banking industry in particular.Keywords: employee commitment, job satisfaction and external market orientation, vietnam, bank
Procedia PDF Downloads 4144024 Language Transfer in Graduate Candidates’ Essays
Authors: Erika Martínez Lugo
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Candidates to some graduate studies are asked to write essays in English to prove their competence to write essays and to do it in English. In the present study, language transfer (LT) in 15 written essays is identified, documented, analyzed, and classified. The essays were written in 2019, and the graduate program is a Masters in Modern Languages in a North-Western Mexican city border with USA. This study is of interest since it is important to determine whether or not some errors have been fossilized and have become mistakes, or if it is part of the candidates’ interlanguage. The results show that most language transfer is negative and syntactic, where the influence of candidates L1 (Spanish) is evident in their use of L2 (English).Keywords: language transfer, cross-linguistic influence, interlanguage, error vs mistake
Procedia PDF Downloads 1774023 Assessment of Food Safety Culture in Select Restaurants and a Produce Market in Doha, Qatar
Authors: Ipek Goktepe, Israa Elnemr, Hammad Asim, Hao Feng, Mosbah Kushad, Hee Park, Sheikha Alzeyara, Mohammad Alhajri
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Food safety management in Qatar is under the shared oversight of multiple agencies in two government ministries (Ministry of Public Health and Ministry of Municipality and Environment). Despite the increasing number and diversity of the food service establishments, no systematic food surveillance system is in place in the country, which creates a gap in terms of determining the food safety attitudes and practices applied in the food service operations. Therefore, this study seeks to partially address this gap through determination of food safety knowledge among food handlers, specifically with respect to food preparation and handling practices, and sanitation methods applied in food service providers (FSPs) and a major market in Doha, Qatar. The study covered a sample of 53 FSPs randomly selected out of 200 FSPs. Face-to-face interviews with managers at participating FSPs were conducted using a 40-questions survey. Additionally, 120 produce handlers who are in direct contact with fresh produce at the major produce market in Doha were surveyed using a questionnaire containing 21 questions. A written informed consent was obtained from each survey participant. The survey data were analyzed using the chi-square test and correlation test. The significance was evaluated at p ˂ 0.05. The results from the FSPs surveys indicated that the average age of FSPs was 11 years, with the oldest and newest being established in 1982 and 2015, respectively. Most managers (66%) had college degree and 68% of them were trained on the food safety management system known as HACCP. These surveys revealed that FSP managers’ training and education level were highly correlated with the probability of their employees receiving food safety training while managers with lower education level had no formal training on food safety for themselves nor for their employees. Casual sit-in and fine dine-in restaurants consistently kept records (100%), followed by fast food (36%), and catering establishments (14%). The produce handlers’ survey results showed that none of the workers had any training on safe produce handling practices. The majority of the workers were in the age range of 31-40 years (37%) and only 38% of them had high-school degree. Over 64% of produce handlers claimed to wash their hands 4-5 times per day but field observations pointed limited handwashing as there was soap in the settings. This observation suggests potential food safety risks since a significant correlation (p ˂ 0.01) between the educational level and the hand-washing practices was determined. This assessment on food safety culture through determination of food and produce handlers' level of knowledge and practices, the first of its kind in Qatar, demonstrated that training and education are important factors which directly impact the food safety culture in FSPs and produce markets. These findings should help in identifying the need for on-site training of food handlers for effective food safety practices in food establishments in Qatar.Keywords: food safety, food safety culture, food service providers, food handlers
Procedia PDF Downloads 3394022 Constructing Evaluation Indicators for the Supply of Urban-Friendly Shelters from the Perspective of the Needs of the Elderly People in Taiwan
Authors: Chuan-Ming Tung, Tzu-Chiao Yuan
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This research aims to construct the supply indicators and weights of shelter space from a perspective of the needs of the elderly by virtue of literature review, a systematical compilation of related regulations, and the use of the Analytical Hierarchy Process method, the questionnaires regarding the indicators filled out by 16 experts and scholars. The researcher then used 3 schools and 2 activity centers in Banqiao District, New Taipei City, as study cases to evaluate the ‘friendliness’ degree/level for the supply of shelters meeting the needs of elderly people. The supply evaluation indicators of friendly shelters meeting the needs of the elderly include "Administrative Operations and Service Needs" and "Residence-related and Living Needs"; under the "Administrative Operations and Service Needs" are "Management Operations and Information Provision", "Shelter Space Preparedness and Logistics Support", "Medical Care and Social Support", and "Shelters and Medical Environment", a total of 17 assessment items in four indicators, while under the "Residence-related and Living Needs" are "Dietary Needs", "Sleep Needs", "Hygiene and Sanitation Needs", "Accessibility and Convenience Needs ", etc., a total of 18 assessment items in four indicators. The results show that "Residence-related and Living Needs" is the most important item in the main levels of the supply indicators of the needs for friendly shelters to elderly people (weigh value 0.5504), followed by "Administrative Operations and Service Needs" (0.4496). The order of importance of the supply indicators of friendly shelters for the needs of elderly people is as follows: "Hygiene and Sanitation Needs" (0.1721), "Dietary Needs" (0.1340), "Medical Care and Social Support" (0.1300), "Sleep Needs" (0.1277), "Accessibility and Convenience Needs" (0.1166), "Basic Environment of Shelters" (0.1145), "Shelter Space Preparedness and Logistics Support" (0.1115) and "Management Operations and Information Provision" (0.0936). In addition, it can be noticed from the results of the case evaluation that the provision of refuges and shelters, mainly from schools and activity centers, is extremely inadequate for the needs of the elderly. In a set of comprehensive comparisons and contrasts, the evaluation indicators of refuges and shelters that need to be improved are "Medical Care and Social Support", "Hygiene and Sanitation Needs", "Sleep Needs", "Dietary Needs", and "Shelter Space Preparedness and Logistics Support".Keywords: needs of the elderly people, urban shelters, evaluation indicators/indices., taiwan
Procedia PDF Downloads 804021 A Fast Calculation Approach for Position Identification in a Distance Space
Authors: Dawei Cai, Yuya Tokuda
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The market of localization based service (LBS) is expanding. The acquisition of physical location is the fundamental basis for LBS. GPS, the de facto standard for outdoor localization, does not work well in indoor environment due to the blocking of signals by walls and ceiling. To acquire high accurate localization in an indoor environment, many techniques have been developed. Triangulation approach is often used for identifying the location, but a heavy and complex computation is necessary to calculate the location of the distances between the object and several source points. This computation is also time and power consumption, and not favorable to a mobile device that needs a long action life with battery. To provide a low power consumption approach for a mobile device, this paper presents a fast calculation approach to identify the location of the object without online solving solutions to simultaneous quadratic equations. In our approach, we divide the location identification into two parts, one is offline, and other is online. In offline mode, we make a mapping process that maps the location area to distance space and find a simple formula that can be used to identify the location of the object online with very light computation. The characteristic of the approach is a good tradeoff between the accuracy and computational amount. Therefore, this approach can be used in smartphone and other mobile devices that need a long work time. To show the performance, some simulation experimental results are provided also in the paper.Keywords: indoor localization, location based service, triangulation, fast calculation, mobile device
Procedia PDF Downloads 1744020 Analysis of a Discrete-time Geo/G/1 Queue Integrated with (s, Q) Inventory Policy at a Service Facility
Authors: Akash Verma, Sujit Kumar Samanta
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This study examines a discrete-time Geo/G/1 queueing-inventory system attached with (s, Q) inventory policy. Assume that the customers follow the Bernoulli process on arrival. Each customer demands a single item with arbitrarily distributed service time. The inventory is replenished by an outside supplier, and the lead time for the replenishment is determined by a geometric distribution. There is a single server and infinite waiting space in this facility. Demands must wait in the specified waiting area during a stock-out period. The customers are served on a first-come-first-served basis. With the help of the embedded Markov chain technique, we determine the joint probability distributions of the number of customers in the system and the number of items in stock at the post-departure epoch using the Matrix Analytic approach. We relate the system length distribution at post-departure and outside observer's epochs to determine the joint probability distribution at the outside observer's epoch. We use probability distributions at random epochs to determine the waiting time distribution. We obtain the performance measures to construct the cost function. The optimum values of the order quantity and reordering point are found numerically for the variety of model parameters.Keywords: discrete-time queueing inventory model, matrix analytic method, waiting-time analysis, cost optimization
Procedia PDF Downloads 434019 The Magnitude and Associated Factors of Immune Hemolytic Anemia among Human Immuno Deficiency Virus Infected Adults Attending University of Gondar Comprehensive Specialized Hospital North West Ethiopia 2021 GC, Cross Sectional Study Design
Authors: Samul Sahile Kebede
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Back ground: -Immune hemolytic anemia commonly affects human immune deficiency, infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to the drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV, which accompanies the greatest percent from acquired hemolytic anemia. Objective: -The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at the university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. Methods: - An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination, and antihuman globulin test were performed to the diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. Result; - The overall prevalence of immune hemolytic anemia was 2.8 % (10 of 358 participants). Of these, 5 were males, and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40 % mild and 60 % moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). Conclusion and recommendation; Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.Keywords: anemia, hemolytic, immune, auto immune, HIV/AIDS
Procedia PDF Downloads 1084018 Heavy Metals among Female Adolescents Attending Secondary Schools in Kano, Nigeria
Authors: I. Yunusa, M. A. Ibrahim, A. H. Yakasai, L. U. S. Ezeanyika
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This study was conducted to examine the level of heavy metals among 192 apparently healthy female adolescents randomly selected from three different boarding secondary schools in the urban area of the most populated city in north-western part of Nigeria. Atomic absorption spectrometry (AAS) was used to determine the plasma levels of the heavy metals which include cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), nickel (Ni), lead (Pb) and zinc (Zn). Our findings revealed the following mean±SD values for each of the heavy metal; 0.11±0.01µg Cd/L, 0.09 ± 0.02µg Co/L, 0.19 ± 0.02 µg Cr/L, 0.91 ± 0.02 µg Cu/L, 1.53 ± 0.31 µg Fe/L, 0.01 ± 0.04 µg Mn/L, 0.3.8 ± 0.04µg Mo/L, 0.04±0.01µg Ni/L, 0.04 ± 0.01µg Pb/L and 2.80 ± 0.24µg Zn/L respectively. It was concluded that toxicity from heavy metals did not exist among female adolescents.Keywords: heavy metals, female, adolescents, Nigeria
Procedia PDF Downloads 3894017 Human Rights as Part of the Core Values System of International Organisations: A Comparative Study
Authors: Ayyoub Jamali, Jennie Edlund, Alena Kozlová
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This paper evaluates the monitoring, prevention, and enforcing mechanisms of the core values of international organisations (IOs) in a comparative human rights perspective. The IOs in focus are the European Union, the Council of Europe, the African Union, and the Organization of American States. The paper will take the founding treaties of these IOs and their relevant protocols as a starting point to identify the values and the mechanisms used for their implementation. It will explore the scope of violations, the procedures in place and evaluate what type of response to those breaches seems to work best in terms of achieving its declared objectives. The study will identify and compare the weaknesses and strengths of each mechanism used by the IOs and recognize common challenges and means, thereby drawing inter-organizational comparisons. Consequently, the findings of this paper can be used among the IOs to improve their system and thus enhance their effectiveness.Keywords: international organizations, core values, human rights, enforcement mechanism, compliance
Procedia PDF Downloads 1804016 Analysis of Ozone Episodes in the Forest and Vegetation Areas with Using HYSPLIT Model: A Case Study of the North-West Side of Biga Peninsula, Turkey
Authors: Deniz Sari, Selahattin İncecik, Nesimi Ozkurt
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Surface ozone, which named as one of the most critical pollutants in the 21th century, threats to human health, forest and vegetation. Specifically, in rural areas surface ozone cause significant influences on agricultural productions and trees. In this study, in order to understand to the surface ozone levels in rural areas we focus on the north-western side of Biga Peninsula which covers by the mountainous and forested area. Ozone concentrations were measured for the first time with passive sampling at 10 sites and two online monitoring stations in this rural area from 2013 and 2015. Using with the daytime hourly O3 measurements during light hours (08:00–20:00) exceeding the threshold of 40 ppb over the 3 months (May, June and July) for agricultural crops, and over the six months (April to September) for forest trees AOT40 (Accumulated hourly O3 concentrations Over a Threshold of 40 ppb) cumulative index was calculated. AOT40 is defined by EU Directive 2008/50/EC to evaluate whether ozone pollution is a risk for vegetation, and is calculated by using hourly ozone concentrations from monitoring systems. In the present study, we performed the trajectory analysis by The Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model to follow the long-range transport sources contributing to the high ozone levels in the region. The ozone episodes observed between 2013 and 2015 were analysed using the HYSPLIT model developed by the NOAA-ARL. In addition, the cluster analysis is used to identify homogeneous groups of air mass transport patterns can be conducted through air trajectory clustering by grouping similar trajectories in terms of air mass movement. Backward trajectories produced for 3 years by HYSPLIT model were assigned to different clusters according to their moving speed and direction using a k-means clustering algorithm. According to cluster analysis results, northerly flows to study area cause to high ozone levels in the region. The results present that the ozone values in the study area are above the critical levels for forest and vegetation based on EU Directive 2008/50/EC.Keywords: AOT40, Biga Peninsula, HYSPLIT, surface ozone
Procedia PDF Downloads 2554015 The Tiv Oral Poet and Taraba Crisis: Anger, Frustration and Uncotrollable Emotionalism in Obadia Kehemen Orkor's Ballads
Authors: Peter Nave Shirga
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Obadia Kehemen Orkor’s songs that focus on the predicament of the Tiv man in Taraba in North Central Nigeria handle themes such as poverty, social inequality, discrimination and tyranny perpetrated by Jukun against the Tiv. The major thrust of his focus in the songs is the overriding longing for mutual understanding between the Jukun and Tiv that would usher in love, equality, peace and harmonious co-existence for the two antagonistic ethnic groups. This paper examines Obadia’s hard-hitting lyrics that reveal the anger, frustration and boiling emotionalism of Tiv people in Taraba state of Nigeria.Keywords: poet, crisis, emotionalism, frustration
Procedia PDF Downloads 3084014 Next-Gen Solutions: How Generative AI Will Reshape Businesses
Authors: Aishwarya Rai
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This study explores the transformative influence of generative AI on startups, businesses, and industries. We will explore how large businesses can benefit in the area of customer operations, where AI-powered chatbots can improve self-service and agent effectiveness, greatly increasing efficiency. In marketing and sales, generative AI could transform businesses by automating content development, data utilization, and personalization, resulting in a substantial increase in marketing and sales productivity. In software engineering-focused startups, generative AI can streamline activities, significantly impacting coding processes and work experiences. It can be extremely useful in product R&D for market analysis, virtual design, simulations, and test preparation, altering old workflows and increasing efficiency. Zooming into the retail and CPG industry, industry findings suggest a 1-2% increase in annual revenues, equating to $400 billion to $660 billion. By automating customer service, marketing, sales, and supply chain management, generative AI can streamline operations, optimizing personalized offerings and presenting itself as a disruptive force. While celebrating economic potential, we acknowledge challenges like external inference and adversarial attacks. Human involvement remains crucial for quality control and security in the era of generative AI-driven transformative innovation. This talk provides a comprehensive exploration of generative AI's pivotal role in reshaping businesses, recognizing its strategic impact on customer interactions, productivity, and operational efficiency.Keywords: generative AI, digital transformation, LLM, artificial intelligence, startups, businesses
Procedia PDF Downloads 764013 SIM (Subscriber Identity Module) Banking
Authors: Okanta Andrew, Richmond Kweku Frempong
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As mobile networks are upgraded with technologies like WAP, GPRS and UMTS to deliver next-generation multimedia services, so are the banks and other financial institutions also getting ready to unleash the financial products on the mobile platform to meet growing demand for mobile based application services. Hence, the onset of Unstructured Supplementary Services (USSD) Banking which would make banking services available at anywhere, anytime through a string of interactive SMS sessions between a mobile device and an application server of a service provider. The aim of this studies was to find out whether the public will accept the sim banking service when it is implemented. Our target group includes: Working class. E. g. Businessmen/women, office workers, fishermen, market women, teachers etc. Nonworking class. E. g. Students (Tertiary, Senior High School), housewives. etc. The survey was in the form of a questionnaire and a verbal interview (video) which was to investigate their idea about the current banking system and the yet to be introduced sim banking concept. Meanwhile, some challenges accompanied the progression of data gathering because some populace showed reluctance in freeing their information. One other suggestion was that government should put measures against foremost challenges obstructing sim banking in Ghana counter to computers hackers. Government and individual have a key role to undertake to give suitable support to facelift the sim banking industry in the country. It was also suggested that Government put strong regulations on the use of sim banking products and services to streamline all the activities and also create awareness of the need for sim banking and emphasize its relevance in the aspect of national GDP.Keywords: banking, mobile banking, SIM banking, mobile banking in Ghana
Procedia PDF Downloads 4844012 Empirical Orthogonal Functions Analysis of Hydrophysical Characteristics in the Shira Lake in Southern Siberia
Authors: Olga S. Volodko, Lidiya A. Kompaniets, Ludmila V. Gavrilova
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The method of empirical orthogonal functions is the method of data analysis with a complex spatial-temporal structure. This method allows us to decompose the data into a finite number of modes determined by empirically finding the eigenfunctions of data correlation matrix. The modes have different scales and can be associated with various physical processes. The empirical orthogonal function method has been widely used for the analysis of hydrophysical characteristics, for example, the analysis of sea surface temperatures in the Western North Atlantic, ocean surface currents in the North Carolina, the study of tropical wave disturbances etc. The method used in this study has been applied to the analysis of temperature and velocity measurements in saline Lake Shira (Southern Siberia, Russia). Shira is a shallow lake with the maximum depth of 25 m. The lake Shira can be considered as a closed water site because of it has one small river providing inflow and but it has no outflows. The main factor that causes the motion of fluid is variable wind flows. In summer the lake is strongly stratified by temperature and saline. Long-term measurements of the temperatures and currents were conducted at several points during summer 2014-2015. The temperature has been measured with an accuracy of 0.1 ºC. The data were analyzed using the empirical orthogonal function method in the real version. The first empirical eigenmode accounts for 70-80 % of the energy and can be interpreted as temperature distribution with a thermocline. A thermocline is a thermal layer where the temperature decreases rapidly from the mixed upper layer of the lake to much colder deep water. The higher order modes can be interpreted as oscillations induced by internal waves. The currents measurements were recorded using Acoustic Doppler Current Profilers 600 kHz and 1200 kHz. The data were analyzed using the empirical orthogonal function method in the complex version. The first empirical eigenmode accounts for about 40 % of the energy and corresponds to the Ekman spiral occurring in the case of a stationary homogeneous fluid. Other modes describe the effects associated with the stratification of fluids. The second and next empirical eigenmodes were associated with dynamical modes. These modes were obtained for a simplified model of inhomogeneous three-level fluid at a water site with a flat bottom.Keywords: Ekman spiral, empirical orthogonal functions, data analysis, stratified fluid, thermocline
Procedia PDF Downloads 1364011 The Role of Technology in Entrepreneurship: Key Findings from Women Start-Ups in Kaduna
Authors: Ogola Lois Kange
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The study looked at the role technology had previously played and now plays in small and medium scale women-owned businesses starting up in Kaduna, which is an emerging entrepreneurship hub state in Nigeria. The study selected a random population of 20 businesses drawn from the north and south of Kaduna. The selection was based on a survey administered to 100 Women-owned businesses that had started up within the last 3-5years. Questionnaires were administered and analyzed based on the participants’ backgrounds, upbringing, exposure and access to technology. One of the key findings is that women-owned businesses can no longer thrive without the application of basic technology.Keywords: business, entrepreneurship, start-up, technology, women
Procedia PDF Downloads 1914010 Recommendations to Improve Classification of Grade Crossings in Urban Areas of Mexico
Authors: Javier Alfonso Bonilla-Chávez, Angélica Lozano
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In North America, more than 2,000 people annually die in accidents related to railroad tracks. In 2020, collisions at grade crossings were the main cause of deaths related to railway accidents in Mexico. Railway networks have constant interaction with motor transport users, cyclists, and pedestrians, mainly in grade crossings, where is the greatest vulnerability and risk of accidents. Usually, accidents at grade crossings are directly related to risky behavior and non-compliance with regulations by motorists, cyclists, and pedestrians, especially in developing countries. Around the world, countries classify these crossings in different ways. In Mexico, according to their dangerousness (high, medium, or low), types A, B and C have been established, recommending for each one different type of auditive and visual signaling and gates, as well as horizontal and vertical signaling. This classification is based in a weighting, but regrettably, it is not explained how the weight values were obtained. A review of the variables and the current approach for the grade crossing classification is required, since it is inadequate for some crossings. In contrast, North America (USA and Canada) and European countries consider a broader classification so that attention to each crossing is addressed more precisely and equipment costs are adjusted. Lack of a proper classification, could lead to cost overruns in the equipment and a deficient operation. To exemplify the lack of a good classification, six crossings are studied, three located in the rural area of Mexico and three in Mexico City. These cases show the need of: improving the current regulations, improving the existing infrastructure, and implementing technological systems, including informative signals with nomenclature of the involved crossing and direct telephone line for reporting emergencies. This implementation is unaffordable for most municipal governments. Also, an inventory of the most dangerous grade crossings in urban and rural areas must be obtained. Then, an approach for improving the classification of grade crossings is suggested. This approach must be based on criteria design, characteristics of adjacent roads or intersections which can influence traffic flow through the crossing, accidents related to motorized and non-motorized vehicles, land use and land management, type of area, and services and economic activities in the zone where the grade crossings is located. An expanded classification of grade crossing in Mexico could reduce accidents and improve the efficiency of the railroad.Keywords: accidents, grade crossing, railroad, traffic safety
Procedia PDF Downloads 1084009 An Empirical Study for the Data-Driven Digital Transformation of the Indian Telecommunication Service Providers
Authors: S. Jigna, K. Nanda Kumar, T. Anna
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Being a major contributor to the Indian economy and a critical facilitator for the country’s digital India vision, the Indian telecommunications industry is also a major source of employment for the country. Since the last few years, the Indian telecommunication service providers (TSPs), however, are facing business challenges related to increasing competition, losses, debts, and decreasing revenue. The strategic use of digital technologies for a successful digital transformation has the potential to equip organizations to meet these business challenges. Despite an increased focus on digital transformation, the telecom service providers globally, including Indian TSPs, have seen limited success so far. The purpose of this research was thus to identify the factors that are critical for the digital transformation and to what extent they influence the successful digital transformation of the Indian TSPs. The literature review of more than 300 digital transformation-related articles, mostly from 2013-2019, demonstrated a lack of an empirical model consisting of factors for the successful digital transformation of the TSPs. This study theorizes a research framework grounded in multiple theories, and a research model consisting of 7 constructs that may be influencing business success during the digital transformation of the organization was proposed. The questionnaire survey of senior managers in the Indian telecommunications industry was seeking to validate the research model. Based on 294 survey responses, the validation of the Structural equation model using the statistical tool ADANCO 2.1.1 was found to be robust. Results indicate that Digital Capabilities, Digital Strategy, and Corporate Level Data Strategy in that order has a strong influence on the successful Business Performance, followed by IT Function Transformation, Digital Innovation, and Transformation Management respectively. Even though Digital Organization did not have a direct significance on Business Performance outcomes, it had a strong influence on IT Function Transformation, thus affecting the Business Performance outcomes indirectly. Amongst numerous practical and theoretical contributions of the study, the main contribution for the Indian TSPs is a validated reference for prioritizing the transformation initiatives in their strategic roadmap. Also, the main contribution to the theory is the possibility to use the research framework artifact of the present research for quantitative validation in different industries and geographies.Keywords: corporate level data strategy, digital capabilities, digital innovation, digital strategy
Procedia PDF Downloads 1294008 Choice Analysis of Ground Access to São Paulo/Guarulhos International Airport Using Adaptive Choice-Based Conjoint Analysis (ACBC)
Authors: Carolina Silva Ansélmo
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Airports are demand-generating poles that affect the flow of traffic around them. The airport access system must be fast, convenient, and adequately planned, considering its potential users. An airport with good ground access conditions can provide the user with a more satisfactory access experience. When several transport options are available, service providers must understand users' preferences and the expected quality of service. The present study focuses on airport access in a comparative scenario between bus, private vehicle, subway, taxi and urban mobility transport applications to São Paulo/Guarulhos International Airport. The objectives are (i) to identify the factors that influence the choice, (ii) to measure Willingness to Pay (WTP), and (iii) to estimate the market share for each modal. The applied method was Adaptive Choice-based Conjoint Analysis (ACBC) technique using Sawtooth Software. Conjoint analysis, rooted in Utility Theory, is a survey technique that quantifies the customer's perceived utility when choosing alternatives. Assessing user preferences provides insights into their priorities for product or service attributes. An additional advantage of conjoint analysis is its requirement for a smaller sample size compared to other methods. Furthermore, ACBC provides valuable insights into consumers' preferences, willingness to pay, and market dynamics, aiding strategic decision-making to provide a better customer experience, pricing, and market segmentation. In the present research, the ACBC questionnaire had the following variables: (i) access time to the boarding point, (ii) comfort in the vehicle, (iii) number of travelers together, (iv) price, (v) supply power, and (vi) type of vehicle. The case study questionnaire reached 213 valid responses considering the scenario of access from the São Paulo city center to São Paulo/Guarulhos International Airport. As a result, the price and the number of travelers are the most relevant attributes for the sample when choosing airport access. The market share of the selection is mainly urban mobility transport applications, followed by buses, private vehicles, taxis and subways.Keywords: adaptive choice-based conjoint analysis, ground access to airport, market share, willingness to pay
Procedia PDF Downloads 784007 The Power of Words: A Corpus Analysis of Campaign Speeches of President Donald J. Trump
Authors: Aiza Dalman
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Words are powerful when these are used wisely and strategically. In this study, twelve (12) campaign speeches of President Donald J. Trump were analyzed as to frequently used words and ethos, pathos and logos being employed. The speeches were read thoroughly, analyzed and interpreted. With the use of Word Counter Tool and Text Analyzer software accessible online, it was found out that the word ‘will’ has the highest frequency of 121, followed by Hillary (58), American (38), going (35), plan and Clinton (32), illegal (30), government (28), corruption (26) and criminal (24). When the speeches were analyzed as to ethos, pathos and logos, on the other hand, it revealed that these were all employed in his speeches. The statements under these pointed out against Hillary or in his favor. The unique strategy of President Donald J. Trump as to frequently used words and ethos, pathos and logos in persuading people perhaps lead the way to his victory.Keywords: campaign speeches, corpus analysis, ethos, logos and pathos, power of words
Procedia PDF Downloads 2804006 Education for Sustainable Development and the Eco School Initiative in Two Primary Schools in The North East of England
Authors: Athanasia Chatzifotiou, Karen Tait
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Eco-school is an international initiative that offers schools the opportunity to develop practices on education for sustainable development (EfSD). Such practices need to focus on nine areas, namely: energy, water, biodiversity, school grounds, healthy living, transport, litter, waste and global citizenship. Acquiring the green flag status is the ultimate stage (silver and bronze are the other two) that is awarded by a committee external to the school and it lasts for two years. Our project focused on two such primary schools that had acquired the green flag status. The aim of our project is to describe the schools’ approach of becoming an eco-school, the practitioners’ role in promoting the values and principles of such endeavors, thus identifying the impact of EfSD. We chose the eco-schools initiative as it gives a clear and straightforward way to identify a school with an interest in EfSD. The project is important because even though EfSD attracts high attention in rhetoric, there is evidence indicating that EfSD may be neglected in practice. This paper presents part of a bigger project that aims to compare how primary schools and early years settings have approached EfSD via the eco-school initiative in the North East of England. This is a qualitative project that used a case study design to focus on the practices of two particular primary schools to gain a green flag status. A semi-structured interview was used with the lead teachers/practitioners of the schools; an audit was also conducted as part of a tour of the schools’ premises highlighting the initiatives, curriculum work, projects undertaken as well as resources available to school. A content analysis of the interview transcripts was conducted with the creation of response categories and response narratives by the two researchers first working individually and then collaboratively; the findings of the project reflected issues that concerned: a) pupils’ cognitive, physical and socio-emotional development, b) the wider community and c) the lead practitioners’ role and status in school. In relation to EfSD, our findings indicated that its impact upon these two eco-schools was rather minimal; a mismatch was identified between the eco-school practices and a holistic understanding of issues that EfSD aims to achieve. This mismatch between eco-school practices and EfSD is discussed with regard to: a) pupils’ understanding of the sustainability dimension in the topics they addressed; and b) teachers’ knowledge of sustainability and willingness to keep on such work in schools.Keywords: eco-schools, environment, primary schools, sustainability education
Procedia PDF Downloads 2464005 Smart Water Main Inspection and Condition Assessment Using a Systematic Approach for Pipes Selection
Authors: Reza Moslemi, Sebastien Perrier
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Water infrastructure deterioration can result in increased operational costs owing to increased repair needs and non-revenue water and consequently cause a reduced level of service and customer service satisfaction. Various water main condition assessment technologies have been introduced to the market in order to evaluate the level of pipe deterioration and to develop appropriate asset management and pipe renewal plans. One of the challenges for any condition assessment and inspection program is to determine the percentage of the water network and the combination of pipe segments to be inspected in order to obtain a meaningful representation of the status of the entire water network with a desirable level of accuracy. Traditionally, condition assessment has been conducted by selecting pipes based on age or location. However, this may not necessarily offer the best approach, and it is believed that by using a smart sampling methodology, a better and more reliable estimate of the condition of a water network can be achieved. This research investigates three different sampling methodologies, including random, stratified, and systematic. It is demonstrated that selecting pipes based on the proposed clustering and sampling scheme can considerably improve the ability of the inspected subset to represent the condition of a wider network. With a smart sampling methodology, a smaller data sample can provide the same insight as a larger sample. This methodology offers increased efficiency and cost savings for condition assessment processes and projects.Keywords: condition assessment, pipe degradation, sampling, water main
Procedia PDF Downloads 1504004 Fear of Falling and Subjective Cognitive Decline Are Predictors of Fall Risk in Community-dwelling Older Adults Living in Low-income Settings
Authors: Ladda Thiamwong, Renata Komalasari
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Falls are the leading cause of disability and hospitalization in low-income older adults. Fear of falling is present in 20% to 85 % of older adults and has been identified as an independent risk factor of fall risk, activity restriction, and loss of independence. About 12% of American older adults have subjective cognitive decline. Cognitive impairment is also an established factor of fall risk. However, it is unclear whether measures of fear of falling and subjective cognitive decline have the greatest association with fall risk in low-income older adults. The aim of this study was to evaluate the association between fear of falling, subjective cognitive decline-functional performance (SCD-FP), and fall risk using simple screening tools. In this cross-section study, we collected data from community-dwelling older adults 60 years or older in low-income settings in Central Florida, and 86 participants were included in the data analysis. Fear of falling was assessed by the Short Fall Efficacy Scale- International (Short FES-I) with seven items. Subjective cognitive decline-functional performance (SCD-FP) was assessed by a self-reported experience of worsening or more frequent confusion or memory loss in the past 12 months and its functional implications. Fall risk was evaluated by the Centers for Disease Control and Prevention (CDC)'s Stay Independent checklist with 12 items. The majority of participants were female, and more than half of the participants were African American. More than half of the participants had a higher school degree or higher, and less than 20% had no financial problems. Less than 30% of the participants perceived their general health as very good- excellent. More than half of the participants lived alone, and less than 15% lived with a partner or spouse. About 60% of the participants had hypertension, 40% had diabetes, 16% had cancer, and 50% had arthritis. About 30% of the participants had difficulty walking up ten steps without resting, more than 40% felt unsteady when walking, and 30% had been advised to use a cane or walker to get around safely. Regression analysis showed that fall risk was associated with fear of falling ( = .524, p <.001) and subjective cognitive decline-functional performance ( = .465, p =.027). The structure coefficient showed that fear of falling (rs2 = .922) was a stronger predictor of fall risk than subjective cognitive decline-functional performance (rs2= .200). Fear of falling and subjective cognitive decline-functional performance are growing public health issues, and addressing those issues is a public priority. Proactive screening for fear of falling and subjective cognitive decline-functional performance is critical in fall prevention. A combination of all three self-reported tools (Short FES-I, SCD-FP, and CDC's Stay Independent checklist) takes less than 5 minutes to complete. Primary care providers or public health professionals should consider including these tools to screen fear of falling and subjective cognitive decline-functional performance as part of fall risk assessment, especially in low-income settings. Thus, encouraging older adults and healthcare professionals to discuss fear of falling, subjective cognitive decline, and fall risk during routine medical office visits.Keywords: falls, fall risk, fear of falling, cognition, subjective cognitive decline, low-income, older adults, community, screening, nursing, primary care
Procedia PDF Downloads 744003 We Have Never Seen a Dermatologist. Reaching the Unreachable Through Teledermatology
Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri
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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one yearKeywords: teledermatology, prisoners, reaching, un-reachable
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