Search results for: tertiary institutions staffers
889 Predictors for Success in Methadone Maintenance Treatment Clinic: 24 Years of Experience
Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson
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Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.Keywords: methadone maintenance treatment, epidemic, opioids, retention
Procedia PDF Downloads 192888 How Students Use WhatsApp to Access News
Authors: Emmanuel Habiyakare
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The COVID-19 pandemic has highlighted the significance of educational technologies in teaching and learning. The global pandemic led to the closure of educational institutions worldwide, prompting the widespread implementation of online learning as a substitute method for delivering curricula. The communication platform is known as WhatsApp has gained widespread adoption and extensive utilisation within the realm of education. The primary aims of this literature review are to examine the utilisation patterns and obstacles linked to the implementation of WhatsApp in the realm of education, assess the advantages and possibilities that students and facilitators can derive from utilising this platform for educational purposes, and comprehend the hindrances and restrictions that arise when employing WhatsApp in an academic environment. The literature was acquired through the utilisation of keywords that are linked to both WhatsApp and education from diverse databases. Having a thorough comprehension of current trends, potential advantages, obstacles, and gains linked to the use of WhatsApp is imperative for lecturers and administrators. Scholarly investigations have revealed a noticeable trend of lecturers and students increasingly utilising WhatsApp as a means of communication and collaboration. The objective of this literature review is to make a noteworthy contribution to the domain of education and technology through an investigation of the potential of WhatsApp as a learning tool. Additionally, this review seeks to offer valuable insights on how to effectively incorporate WhatsApp into pedagogical practices. The article underscores the significance of taking into account privacy and security concerns while utilising WhatsApp for educational objectives and puts forth recommendations for additional investigation.Keywords: tool, COVID-19, opportunities, challenges, learning, WhatsApp
Procedia PDF Downloads 25887 Society and Cinema in Iran
Authors: Seyedeh Rozhano Azimi Hashemi
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There is no doubt that ‘Art’ is a social phenomena and cinema is the most social kind of art. Hence, it’s clear that we can analyze the relation’s of cinema and art from different aspects. In this paper sociological cinema will be investigated which, is a subdivision of sociological art. This term will be discussed by two main approaches. One of these approaches is focused on the effects of cinema on the society, which is known as “Effects Theory” and the second one, which is dealing with the reflection of social issues in cinema is called ” Reflection Theory”. "Reflect theory" approach, unlike "Effects theory" is considering movies as documents, in which social life is reflected, and by analyzing them, the changes and tendencies of a society are understood. Criticizing these approaches to cinema and society doesn’t mean that they are not real. Conversely, it proves the fact that for better understanding of cinema and society’s relation, more complicated models are required, which should consider two aspects. First, they should be bilinear and they should provide a dynamic and active relation between cinema and society, as for the current concept social life and cinema have bi-linear effects on each other, and that’s how they fit in a dialectic and dynamic process. Second, it should pay attention to the role of inductor elements such as small social institutions, marketing, advertisements, cultural pattern, art’s genres and popular cinema in society. In the current study, image of middle class in cinema of Iran and changing the role of women in cinema and society which were two bold issue that cinema and society faced since 1979 revolution till 80s are analyzed. Films as an artwork on one hand, are reflections of social changes and with their effects on the society on the other hand, are trying to speed up the trends of these changes. Cinema by the illustration of changes in ideologies and approaches in exaggerated ways and through it’s normalizing functions, is preparing the audiences and public opinions for the acceptance of these changes. Consequently, audience takes effect from this process, which is a bi-linear and interactive process.Keywords: Iranian Cinema, Cinema and Society, Middle Class, Woman’s Role
Procedia PDF Downloads 340886 Framing a Turkish Campus Sustainability Indicator Set
Authors: Cansu Tari, Ute Poerschke
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Sustainable campus design and planning in Higher Education requires an entire action plan and coordination of physical, educational, and social systems. Many institutions in the world are defining their sustainable development path and some are following existing green building and sustainable campus rating/ranking systems, guidelines. In the context of higher education, Turkish universities have limited academic, social and financial support related to sustainable living, building, and campus studies. While some research has been conducted in the last 60 years by farsighted academics, most of these works are based on individuals’ or small organizations’ own interests and efforts, and they are not known enough by the population of universities and possible prospective investors. Regarding the recent fast and uncontrolled growth in the Turkish Higher Education environment, setting a campus sustainability indicator set is a necessity for sustainable development of universities. The main objective of this paper is to specify the applicable sustainability indicators in the national context of Turkey, and propose a model guideline for sustainable Turkish university campuses. The analysis of Turkish legislation on environmental issues, special conditions of Turkish Higher Education system, and Turkey’s environmental risks and challenges set the backbone of the study and distinguish the set of indicators from generalized guidelines. Finally, the paper outlines some concrete suggestions for Turkish Universities to integrate sustainability efforts in their regional context. It will be useful for campus sustainability managers and planners, interested in developing action plans in their national and regional scope.Keywords: campus sustainability, sustainability indicators, Turkish universities, national campus sustainability action plan
Procedia PDF Downloads 258885 Dry Season Rice Production along Hadejia Valley Irrigation Scheme in Auyo Local Government Area in Jigawa State
Authors: Saifullahi Umar, Baba Mamman Yarima, Mohammed Bello Usman, Hassan Mohammed
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This study was conducted along with the Hadejia valley project irrigation under the Hadejia-Jama’are River Basin Development Authority (HRBDA) in Jigawa State. The multi-stage sampling procedure was used to select 72 rice farmers operating along with the Hadejia Valley Irrigation Project. Data for the study were collected using a structured questionnaire. The analytical tools employed for the study were descriptive statistics and Farm budget technique. The result shows that 55% of the farmers were between 31-40 years of age, 66.01% were male, and the result also revealed that the total cost of cultivation of an acre of land for rice production during the dry season was N73,900 with input cost accounting for 63.59% of the total cost of production. The gross return was N332,500, with a net return of N258,600 per acre. The estimated benefit-cost ratio of 3.449 indicates the strong performance of the dry season rice production. The leading constraints to dry season rice production were low access to quality extension services, low access to finance, poor quality fertilizers, and poor prices. The study, therefore, concludes that dry season rice production is a profitable enterprise in the study area hence, to productivity the farmers should be linked to effective extension service delivery institutions, expanding their access to productive sources of finances, the government should strengthen fertilizer quality control measures and comprehensive market linkages for the farmers.Keywords: Auyo, dry season, Hadejia Valley, rice
Procedia PDF Downloads 166884 Evaluating the Benefits of Intelligent Acoustic Technology in Classrooms: A Case Study
Authors: Megan Burfoot, Ali GhaffarianHoseini, Nicola Naismith, Amirhosein GhaffarianHoseini
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Intelligent Acoustic Technology (IAT) is a novel architectural device used in buildings to automatically vary the acoustic conditions of space. IAT is realized by integrating two components: Variable Acoustic Technology (VAT) and an intelligent system. The VAT passively alters the RT by changing the total sound absorption in a room. In doing so, the Reverberation Time (RT) is changed and thus, the sound strength and clarity are altered. The intelligent system detects sound waves in real-time to identify the aural situation, and the RT is adjusted accordingly based on pre-programmed algorithms. IAT - the synthesis of these two components - can dramatically improve acoustic comfort, as the acoustic condition is automatically optimized for any detected aural situation. This paper presents an evaluation of the improvements of acoustic comfort in an existing tertiary classroom located at Auckland University of Technology in New Zealand. This is a pilot case study, the first of its’ kind attempting to quantify the benefits of IAT. Naturally, the potential acoustic improvements from IAT can be actualized by only installing the VAT component of IAT and by manually adjusting it rather than utilizing an intelligent system. Such a simplified methodology is adopted for this case study to understand the potential significance of IAT without adopting a time and cost-intensive strategy. For this study, the VAT is built by overlaying reflective, rotating louvers over sound absorption panels. RT's are measured according to international standards before and after installing VAT in the classroom. The louvers are manually rotated in increments by the experimenter and further RT measurements are recorded. The results are compared with recommended guidelines and reference values from national standards for spaces intended for speech and communication. The results obtained from the measurements are used to quantify the potential improvements in classroom acoustic comfort, where IAT to be used. This evaluation reveals the current existence of poor acoustic conditions in the classroom caused by high RT's. The poor acoustics are also largely attributed to the classrooms’ inability to vary acoustic parameters for changing aural situations. The classroom experiences one static acoustic state, neglecting to recognize the nature of classrooms as flexible, dynamic spaces. Evidently, when using VAT the classroom is prescribed with a wide range of RTs it can achieve. Namely, acoustic requirements for varying teaching approaches are satisfied, and acoustic comfort is improved. By quantifying the benefits of using VAT, it can confidently suggest these same benefits are achieved with IAT. Nevertheless, it is encouraged that future studies continue this line of research toward the eventual development of IAT and its’ acceptance into mainstream architecture.Keywords: acoustic comfort, classroom acoustics, intelligent acoustics, variable acoustics
Procedia PDF Downloads 189883 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating
Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton
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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.Keywords: adolescent, binge eating, mental illness, obesity
Procedia PDF Downloads 357882 Determinants of Access to Finance to All Enterprise
Authors: Dilang Thouk Tharjiath
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This study seeks to examine determinants of access to finance: the case of micro and small enterprises in bonga town. It identifies the sector as the key to unlocking the economic potentials of the country. For the achievement of the objective of the study simple random and stratified sampling has been used to select 179 respondents, primary and secondary data were used, primary data were collected through face to face interview and preparing questionnaire and secondary data were collected through reviewing firms record and reports, quantitative research approach were used and the data obtained were analyzed using descriptive research design. Access to finance is one of the key obstacles of MSE’s not only when starting the business project but also when operating. Identifying the major determinants of access to finance is therefore quite crucial. Based on descriptive result the financiers specially formal financiers tend to grant credit easily for enterprises which are located near to town, having operators with higher educational level, experienced and with a positive attitudes towards or fulfill their lending procedures, and a firm having collateralized asset, prepare business plan, maintain accounting practice ,large and old enough. Finally the study recommended that As Educational level of entrepreneurs has significant effect on access to credit from bank and the managers or owners education level is low in Bonga town the concerned bodies of both the government and non-governmental institutions in collaboration with Bonga town MSE development office are recommended to create awareness and facilitate the provision of additional training for those with lower educational level.Keywords: credit, entrepreneur, enterprise, manager
Procedia PDF Downloads 91881 OptiBaha: Design of a Web Based Analytical Tool for Enhancing Quality of Education at AlBaha University
Authors: Nadeem Hassan, Farooq Ahmad
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The quality of education has a direct impact on individual, family, society, economy in general and the mankind as a whole. Because of that thousands of research papers and articles are written on the quality of education, billions of dollars are spent and continuously being spent on research and enhancing the quality of education. Academic programs accredited agencies define the various criterion of quality of education; academic institutions obtain accreditation from these agencies to ensure degree programs offered at their institution are of international standards. This R&D aims to build a web based analytical tool (OptiBaha) that finds the gaps in AlBaha University education system by taking input from stakeholders, including students, faculty, staff and management. The input/online-data collected by this tool will be analyzed on core areas of education as proposed by accredited agencies, CAC of ABET and NCAAA of KSA, including student background, language, culture, motivation, curriculum, teaching methodology, assessment and evaluation, performance and progress, facilities, availability of teaching materials, faculty qualification, monitoring, policies and procedures, and more. Based on different analytical reports, gaps will be highlighted, and remedial actions will be proposed. If the tool is implemented and made available through a continuous process the quality of education at AlBaha University can be enhanced, it will also help in fulfilling criterion of accreditation agencies. The tool will be generic in nature and ultimately can be used by any academic institution.Keywords: academic quality, accreditation agencies, higher education, policies and procedures
Procedia PDF Downloads 301880 Using Customer Satisfaction to Help Achieve Sustainable Development Goals in the Islamic Economy: A Quantitative Case Study from Amman, Jordan
Authors: Sarah A. Tobin
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Social justice outcomes, derived from customer satisfaction, serve as a main pathway and conduit for achieving Sustainable Development Goals (SDGs) because they prompt democratizing and socially-inclusive effects that are consistent with Islamic economic values. This paper argues that achieving higher levels of social justice and the SGDs is possible only through the realization of Islamic banking and finance customer satisfaction that aligns with Islamic values in the tradition of the Shari`a (or Islamic law). Through this key manifestation of Shari`a in the banks, social justice aims of achieving SDGs become possible. This paper utilizes a case study of a large-scale survey (N=127) comparing customer satisfaction between a conventional and an Islamic bank in Amman, Jordan. Based on a series of linear regressions, the statistically-significant findings suggest that when overall customer satisfaction is high, customers are more likely to become empowered citizens demanding inclusive, quality services and corruption-free management, as well as attribute their experiences to the Islamic nature of the financial endeavors. Social justice interests and expectations increase (and SDGs are more likely met) when a customer has high levels of satisfaction. The paper concludes with policy recommendations for Islamic financial institutions that enhance customer service experiences for better achieving the social justice aims of the Islamic economy and SDGs, including transparency in transactions, exemplary customer service and follow up, and attending to Islamic values in the aesthetics of bank.Keywords: customer satisfaction, Islamic economy, social justice, sustainable development goals
Procedia PDF Downloads 341879 Predictive Analytics Algorithms: Mitigating Elementary School Drop Out Rates
Authors: Bongs Lainjo
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Educational institutions and authorities that are mandated to run education systems in various countries need to implement a curriculum that considers the possibility and existence of elementary school dropouts. This research focuses on elementary school dropout rates and the ability to replicate various predictive models carried out globally on selected Elementary Schools. The study was carried out by comparing the classical case studies in Africa, North America, South America, Asia and Europe. Some of the reasons put forward for children dropping out include the notion of being successful in life without necessarily going through the education process. Such mentality is coupled with a tough curriculum that does not take care of all students. The system has completely led to poor school attendance - truancy which continuously leads to dropouts. In this study, the focus is on developing a model that can systematically be implemented by school administrations to prevent possible dropout scenarios. At the elementary level, especially the lower grades, a child's perception of education can be easily changed so that they focus on the better future that their parents desire. To deal effectively with the elementary school dropout problem, strategies that are put in place need to be studied and predictive models are installed in every educational system with a view to helping prevent an imminent school dropout just before it happens. In a competency-based curriculum that most advanced nations are trying to implement, the education systems have wholesome ideas of learning that reduce the rate of dropout.Keywords: elementary school, predictive models, machine learning, risk factors, data mining, classifiers, dropout rates, education system, competency-based curriculum
Procedia PDF Downloads 175878 Rotection of Old Grant Communal Properties of Minorities in Cantonment of Pakistan: Issues and Problems
Authors: Nayer Fardows, Zarash Nayer, Sarah Nayer Jaffar, Daud Nayer
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This paper analyses the issues related to communal properties of minorities in the cantonment area of Pakistan allotted in the mid-eighteenth centuries by the British Government to facilitate soldiers. These properties were old grants on which churches, institutes, hospitals, and residences were built. The ownership of these properties remained with British Government, but after the creation of Pakistan, changes by putting Government of Pakistan as the landlord of the property disturbed the inheritors as they remained as, holder of occupancy. The government of Pakistan issued a policy in 1997 to convert the status of old grant properties to regular lease. However, heavy taxes and high court’s decisions made it difficult to solve the issue. The study was conducted on six old grant properties of Edwardes College Peshawar cantonment situated in Khyber Pakhtunkhwa, Pakistan. The paper is descriptive research with a qualitative approach collecting data through government rules, acts, ordinance and decisions of the high courts. The result leads to three aspects; 1) holder of occupancy status of old grant properties in cantonment is similar as allotment of other properties by the government, 2) imposition of heavy taxes on conversion of property from old grant to regular lease restricted inheritors to further construct or transfer, 3) imposition of higher courts ban on conversion of communal properties contradict government policy of conversion. The paper recommends the Government of Pakistan a solution to maintain the status quo for communal properties that fall within the old grant.Keywords: British Government, communal properties, cantonment, old grant, institutions
Procedia PDF Downloads 145877 Efficient Fuzzy Classified Cryptographic Model for Intelligent Encryption Technique towards E-Banking XML Transactions
Authors: Maher Aburrous, Adel Khelifi, Manar Abu Talib
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Transactions performed by financial institutions on daily basis require XML encryption on large scale. Encrypting large volume of message fully will result both performance and resource issues. In this paper a novel approach is presented for securing financial XML transactions using classification data mining (DM) algorithms. Our strategy defines the complete process of classifying XML transactions by using set of classification algorithms, classified XML documents processed at later stage using element-wise encryption. Classification algorithms were used to identify the XML transaction rules and factors in order to classify the message content fetching important elements within. We have implemented four classification algorithms to fetch the importance level value within each XML document. Classified content is processed using element-wise encryption for selected parts with "High", "Medium" or “Low” importance level values. Element-wise encryption is performed using AES symmetric encryption algorithm and proposed modified algorithm for AES to overcome the problem of computational overhead, in which substitute byte, shift row will remain as in the original AES while mix column operation is replaced by 128 permutation operation followed by add round key operation. An implementation has been conducted using data set fetched from e-banking service to present system functionality and efficiency. Results from our implementation showed a clear improvement in processing time encrypting XML documents.Keywords: XML transaction, encryption, Advanced Encryption Standard (AES), XML classification, e-banking security, fuzzy classification, cryptography, intelligent encryption
Procedia PDF Downloads 411876 Variations in Breast Aesthetic Reconstruction Rates between Asian and Caucasian Patients Post Mastectomy in a UK Tertiary Breast Referral Centre: A Five-Year Institutional Review
Authors: Wisam Ismail, Chole Wright, Elizabeth Baker, Cathy Tait, Mohamed Salhab, Richard Linforth
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Background: Post-mastectomy breast reconstruction is an important treatment option for women with breast cancer with psychosocial, emotional and quality of life benefits. Despite this, Asian patients are one-fifth as likely as Caucasian patients to undergo reconstruction after mastectomy. Aim: This study aimed to assess the difference in breast reconstruction rates between Asian and Caucasian patients treated at Bradford Teaching Hospitals between May 2011 – December 2015.The long-term goal is to equip healthcare professionals to improve breast cancer treatment outcome by increasing breast reconstruction rates in this sub-population. Methods: All patients undergoing mastectomy were identified using a prospectively collected departmental database. Further data was obtained via retrospective electronic case note review. Bradford city population is about 530.000 by the end of 2015, with 67.44% of the city's population was White ethnic groups and 26.83% Asian Ethnic Groups (UK population consensus). The majority of Asian population speaks Urdu, hence an Urdu speaking breast care nurse was appointed to facilitate communications and deliver a better understanding of the reconstruction options and pathways. Statistical analysis was undertaken using the SAS program. Patients were stratified by age, self-reported ethnicity, axillary surgery and reconstruction. Relative odds were calculated using univariate and multivariate logistic regression analyses with adjustment for known confounders. An Urdu speaking breast care nurse was employed throughout this period to facilitate communication and patient decision making. Results: 506 patients underwent Mastectomy over 5 years. 72 (14%) Asian v. 434 (85%) Caucasian. Overall median age is 64 years (SD1.1). Asian median age is 62 (SD0.9), versus Caucasian 65 (SD1.2). Total axillary clearance rate was 30% (42% Asian v.30% Caucasian). Overall reconstruction rate was 126 patients (28.9%).Only 6 of 72 Asian patients (<1%) underwent breast reconstruction versus 121of 434 Caucasian (28%) (p < 0.04), Odds ratio 0.68, (95% confidence interval 0.57-0.79). Conclusions: There is a significant difference in post-mastectomy reconstruction rates between Asian and Caucasian patients. This difference is likely to be multi-factorial. Higher rates of axillary clearance in Asian patients might suggest later disease presentation and/or higher rates of subsequent adjuvant therapy, both of which, can impact on the suitability of breast reconstruction. Strategies aimed at reducing racial disparities in breast reconstruction should include symptom awareness to enable earlier presentation and facilitated communication to ensure informed decision-making.Keywords: aesthetic, Asian, breast, reconstruction
Procedia PDF Downloads 276875 Interrogating Economic Growth and Development in Nigeria: The Challenges
Authors: Enojo Kennie Enojo
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The paper focuses on the contradictions of economic growth and development in Nigeria with specific reference to the plethora issues and challenges associated with the sordid situation. The broad objective is to investigate the major causes of agitation for restructuring the entire political spectrum that promote and guarantee economic growth and development with empirical intellectual standpoint. The specific aim is to surgically examine the organic linkage between weaker institutions, lack of vibrant civil society, poor governance and the agitation for restructuring. The paper adopts the secondary source of data collection as its methodological strategy. Our findings reveals that most urban and rural dwellers where goods and services are either extracted, produced, or manufactured lack infrastructural facilities, preventing economic growth and development, which has been the consequence of poverty, inequality and unemployment. There is equally the issue of disconnection of the political class from the electorate, this is evident in lack of political power base not located in the society but rather with either the elites or godfathers this and many factors are responsible for flawed electoral system from 1999 to 2023 general elections. These egregious factors and others have resulted in the subscription of religion and ethnicity thereby the devaluation of national norms, identities and values. We adopt the combination of structural-functional approach, relative deprivation; rising expectation, frustration and aggression model to enable us critically interrogate these contradictions as subterfuge with both the centrifugal and centripetal forces constantly in fatality. We recommend among others that, there should be development across the federating units without prejudice.Keywords: restructuring, infrastructure, economic development, governance
Procedia PDF Downloads 39874 Evaluating the Teaching and Learning Value of Tablets
Authors: Willem J. A. Louw
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The wave of new advanced computing technology that has been developed during the recent past has significantly changed the way we communicate, collaborate and collect information. It has created a new technology environment and paradigm in which our children and students grow-up and this impacts on their learning. Research confirmed that Generation Y students have a preference for learning in the new technology environment. The challenge or question is: How do we adjust our teaching and learning to make the most of these changes. The complexity of effective and efficient teaching and learning must not be underestimated and changes must be preceded by proper objective research to prevent any haphazard developments that could do more harm than benefit. A blended learning approach has been used in the Forestry department for a few numbers of years including the use of electronic-peer assisted learning (e-pal) in a fixed-computer set-up within a learning management system environment. It was decided to extend the investigation and do some exploratory research by using a range of different Tablet devices. For this purpose, learning activities or assignments were designed to cover aspects of communication, collaboration and collection of information. The Moodle learning management system was used to present normal module information, to communicate with students and for feedback and data collection. Student feedback was collected by using an online questionnaire and informal discussions. The research project was implemented in 2013, 2014 and 2015 amongst first and third-year students doing a forestry three-year technical tertiary qualification in commercial plantation management. In general, more than 80% of the students alluded to that the device was very useful in their learning environment while the rest indicated that the devices were not very useful. More than ninety percent of the students acknowledged that they would like to continue using the devices for all of their modules whilst the rest alluded to functioning efficiently without the devices. Results indicated that information collection (access to resources) was rated the highest advantageous factor followed by communication and collaboration. The main general advantages of using Tablets were listed by the students as being mobility (portability), 24/7 access to learning material and information of any kind on a user friendly device in a Wi-Fi environment, fast computing process speeds, saving time, effort and airtime through skyping and e-mail, and use of various applications. Ownership of the device is a critical factor while the risk was identified as a major potential constraint. Significant differences were reported between the different types and quality of Tablets. The preferred types are those with a bigger screen and the ones with overall better functionality and quality features. Tablets significantly increase the collaboration, communication and information collection needs of the students. It does, however, not replace the need of a computer/laptop because of limited storage and computation capacity, small screen size and inefficient typing.Keywords: tablets, teaching, blended learning, tablet quality
Procedia PDF Downloads 248873 A Critical Appraisal of Adekunle Ajasin University Policy on Internet Resource Centre in Service Delivery Adekunle Ajasin University, Akungba-Akoko, Ondo State
Authors: Abimbola Olaotan Akinsete
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Government all over the world has intensified efforts in making internet and resource centres readily available in public institutions and centres for the advancement of humanity and working processes. Information and communication resource centre will not only help in the reduction of task that are presumed to be herculean. This centres influenced the working rate and productivity of both staffs and students and its benefit. The utilization of the internet and information resource centre will not only speed up service delivery, working time and efficiency of the system. Information and Communication Technology plays significant roles in presenting equalization strategy for developing university community and improving educational service delivery. This equalization will not only advance, accelerate and ensure results are accessed electronically, ensuring the transfer and confirmation of students’ academic records and their results in the world without physically available to request for these services. This study seeks to make Critical Appraisal of Adekunle Ajasin University Policy on Internet Resource Centre in Service Delivery Adekunle Ajasin University, Akungba-Akoko, Ondo State. The study employ descriptive survey design method in identifying hindrances of the non-utilization of technology in the service delivery in the university. Findings revealed that the adoption of internet and resource centre in the Exams and Records unit of the University shall help in delivering more in students’ records/results processing.Keywords: internet, resource, centre, policy and service delivery
Procedia PDF Downloads 102872 Relationship between Different Heart Rate Control Levels and Risk of Heart Failure Rehospitalization in Patients with Persistent Atrial Fibrillation: A Retrospective Cohort Study
Authors: Yongrong Liu, Xin Tang
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Background: Persistent atrial fibrillation is a common arrhythmia closely related to heart failure. Heart rate control is an essential strategy for treating persistent atrial fibrillation. Still, the understanding of the relationship between different heart rate control levels and the risk of heart failure rehospitalization is limited. Objective: The objective of the study is to determine the relationship between different levels of heart rate control in patients with persistent atrial fibrillation and the risk of readmission for heart failure. Methods: We conducted a retrospective dual-centre cohort study, collecting data from patients with persistent atrial fibrillation who received outpatient treatment at two tertiary hospitals in central and western China from March 2019 to March 2020. The collected data included age, gender, body mass index (BMI), medical history, and hospitalization frequency due to heart failure. Patients were divided into three groups based on their heart rate control levels: Group I with a resting heart rate of less than 80 beats per minute, Group II with a resting heart rate between 80 and 100 beats per minute, and Group III with a resting heart rate greater than 100 beats per minute. The readmission rates due to heart failure within one year after discharge were statistically analyzed using propensity score matching in a 1:1 ratio. Differences in readmission rates among the different groups were compared using one-way ANOVA. The impact of varying levels of heart rate control on the risk of readmission for heart failure was assessed using the Cox proportional hazards model. Binary logistic regression analysis was employed to control for potential confounding factors. Results: We enrolled a total of 1136 patients with persistent atrial fibrillation. The results of the one-way ANOVA showed that there were differences in readmission rates among groups exposed to different levels of heart rate control. The readmission rates due to heart failure for each group were as follows: Group I (n=432): 31 (7.17%); Group II (n=387): 11.11%; Group III (n=317): 90 (28.50%) (F=54.3, P<0.001). After performing 1:1 propensity score matching for the different groups, 223 pairs were obtained. Analysis using the Cox proportional hazards model showed that compared to Group I, the risk of readmission for Group II was 1.372 (95% CI: 1.125-1.682, P<0.001), and for Group III was 2.053 (95% CI: 1.006-5.437, P<0.001). Furthermore, binary logistic regression analysis, including variables such as digoxin, hypertension, smoking, coronary heart disease, and chronic obstructive pulmonary disease as independent variables, revealed that coronary heart disease and COPD also had a significant impact on readmission due to heart failure (p<0.001). Conclusion: The correlation between the heart rate control level of patients with persistent atrial fibrillation and the risk of heart failure rehospitalization is positive. Reasonable heart rate control may significantly reduce the risk of heart failure rehospitalization.Keywords: heart rate control levels, heart failure rehospitalization, persistent atrial fibrillation, retrospective cohort study
Procedia PDF Downloads 74871 Effective Student Engaging Strategies to Enhance Academic Learning in Middle Eastern Classrooms: An Action Research Approach
Authors: Anjum Afrooze
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The curriculum at General Sciences department in Prince Sultan University includes ‘Physical science’ for Computer Science, Information Technology and Business courses. Students are apathetic towards Physical Science and question, as to, ‘How this course is related to their majors?’ English is not a native language for the students and also for many instructors. More than sixty percent of the students come from institutions where English is not the medium of instruction, which makes student learning and academic achievement challenging. After observing the less enthusiastic student cohort for two consecutive semesters, the instructor was keen to find effective strategies to enhance learning and further encourage deep learning by engaging students in different tasks to empower them with necessary skills and motivate them. This study is participatory action research, in which instructor designs effective tasks to engage students in their learning. The study is conducted through two semesters with a total of 200 students. The effectiveness of this approach is studied using questionnaire at the end of each semester and teacher observation. Major outcomes of this study were overall improvement in students attitude towards science learning, enhancement of multiple skills like note taking, problem solving, language proficiency and also fortifying confidence. This process transformed instructor into engaging and reflecting practitioner. Also, these strategies were implemented by other instructors teaching the course and proved effective in opening a path to changes in related areas of the course curriculum. However, refinement in the strategies could be done based on student evaluation and instructors observation.Keywords: group activity, language proficiency, reasoning skills, science learning
Procedia PDF Downloads 145870 Gastronomy: The Preferred Digital Business Models and Impacts in Business Economics within Hospitality, Tourism, and Catering Sectors through Online Commerce
Authors: John Oupa Hlatshwayo
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Background: There seem to be preferred digital business models with varying impacts within hospitality, tourism and catering sub-sectors explored through online commerce, as all are ingrained in the business economics domain. Aim: A study aims to establish if such phenomena (Digital Business Models) exist and to what extent if any, within the hospitality, tourism and catering industries, respectively. Setting: This is a qualitative study conducted by exploring several (Four) institutions globally through Case Studies. Method: This research explored explanatory case studies to answer questions about ‘how’ or ’why’ with little control by a researcher over the occurrence of events. It is qualitative research, deductive, and inductive methods. Hence, a comprehensive approach to analyzing qualitative data was attainable through immersion by reading to understand the information. Findings: The results corroborated the notion that digital business models are applicable, by and large, in business economics. Thus, three sectors wherein enterprises operate in the business economics sphere have been narrowed down i.e. hospitality, tourism and catering, are also referred to as triangular polygons due to the atypical nature of being ‘stand-alone’, yet ‘sub-sectors’, but there are confounding factors to consider. Conclusion: The significance of digital business models and digital transformation shows an inevitable merger between business and technology within Hospitality, Tourism, and Catering. Contribution: Such symbiotic relationship of business and technology, persistent evolution of clients’ interface with end-products, forever changing market, current adaptation as well as adjustment to ‘new world order’ by enterprises must be embraced constantly without fail by Business Practitioners, Academics, Business Students, Organizations and Governments.Keywords: digital business models, hospitality, tourism, catering, business economics
Procedia PDF Downloads 17869 Bring Your Own Device Security Model in a Financial Institution of South Africa
Authors: Michael Nthabiseng Moeti, Makhulu Relebogile Langa, Joey Jansen van Vuuren
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This paper examines the utilization of personal electronic devices like laptops, tablets, and smartphones for professional duties within a financial organization. This phenomenon is known as bring your own device (BYOD). BYOD accords employees the freedom to use their personal devices to access corporate resources from anywhere in the world with Internet access. BYOD arrangements introduce significant security risks for both organizations and users. These setups change the threat landscape for enterprises and demand unique security strategies, as conventional tools tailored for safeguarding managed devices fall short in adequately protecting enterprise assets without active user cooperation. This paper applies protection motivation theory (PMT) to highlight behavioral risks from BYOD users that may impact the security of financial institutions. Thematic analysis was applied to gain a comprehensive understanding of how users perceive this phenomenon. These findings demonstrates that the existence of a security policy does not ensure that all employees will take measures to protect their personal devices. Active promotion of BYOD security policies is crucial for financial institution employees and management. This paper developed a BYOD security model which is useful for understanding compliant behaviors. Given that BYOD security is becoming a major concern across financial sector, it is important. The paper recommends that future research could expand the number of universities from which data is collected.Keywords: BYOD, information security, protection motivation theory, security risks, thematic analysis
Procedia PDF Downloads 31868 Cybersecurity Challenges and Solutions in ICT Management at the Federal Polytechnic, Ado-Ekiti: A Quantitative Study
Authors: Innocent Uzougbo Onwuegbuzie, Siene Elizabeth Eke
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This study investigates cybersecurity challenges and solutions in managing Information and Communication Technology (ICT) at the Federal Polytechnic, Ado-Ekiti, South-West Nigeria. The rapid evolution of ICT has revolutionized organizational operations and impacted various sectors, including education, healthcare, and finance. While ICT advancements facilitate seamless communication, complex data analytics, and strategic decision-making, they also introduce significant cybersecurity risks such as data breaches, ransomware, and other malicious attacks. These threats jeopardize the confidentiality, integrity, and availability of information systems, necessitating robust cybersecurity measures. The primary aim of this research is to identify prevalent cybersecurity challenges in ICT management, evaluate their impact on the institution's operations, and assess the effectiveness of current cybersecurity solutions. Adopting a quantitative research approach, data was collected through surveys and structured questionnaires from students, staff, and IT professionals at the Federal Polytechnic, Ado-Ekiti. The findings underscore the critical need for continuous investment in cybersecurity technologies, employee and student training, and regulatory compliance to mitigate evolving cyber threats. This research contributes to bridging the knowledge gap in cybersecurity management and provides valuable insights into effective strategies and technologies for safeguarding ICT systems in educational institutions. The study's objectives are to enhance the security posture of the Federal Polytechnic, Ado-Ekiti, in an increasingly digital world by identifying and addressing the cybersecurity challenges faced by its ICT management.Keywords: cybersecurity challenges, cyber threat mitigation, federal polytechnic Ado-Ekiti, ICT management
Procedia PDF Downloads 40867 Reconceptualising Faculty Teaching Competence: The Role of Agency during the Pandemic
Authors: Ida Fatimawati Adi Badiozaman, Augustus Raymond Segar
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The Covid-19 pandemic transformed teaching contexts at an unprecedented level. Although studies have focused mainly on its impact on students, little is known about how emergency online teaching affects faculty members in higher education. Given that the pandemic has robbed teachers of opportunities for adequate preparation, it is vital to understand how teaching competencies were perceived in the crisis-response transition to online teaching and learning (OTL). Therefore, the study explores how academics perceive their readiness for OTL and what competencies were perceived to be central. Therefore, through a mixed-methods design, the study first explores through a survey how academics perceive their readiness for OTL and what competencies were perceived to be central. Emerging trends from the quantitative data of 330 academics (three public and three private Higher learning institutions) led to the formulation of interview guides for the subsequent qualitative phase. The authors use critical sensemaking (CSM) to analyse interviews with twenty-two teachers (n = 22) (three public; three private HEs) toward understanding the interconnected layers of influences they draw from as they make sense of their teaching competence. The sensemaking process reframed competence and readiness in that agentic competency emerged as crucial in shaping resilience and adaptability during the transition to OTL. The findings also highlight professional learningcriticalto teacher competence: course design, communication, time management, technological competence, and identity (re)construction. The findings highlight opportunities for strategic orientation to change during crisis. Implications for pedagogy and policy are discussed.Keywords: online teaching, pedagogical competence, agentic competence, agency, technological competence
Procedia PDF Downloads 81866 Competence on Learning Delivery Modes and Performance of Physical Education Teachers in Senior High Schools in Davao
Authors: Juvanie C. Lapesigue
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Worldwide school closures result from a significant public health crisis that has affected the nation and the entire world. It has affected students, educators, educational organizations globally, and many other aspects of society. Academic institutions worldwide teach students using diverse approaches of various learning delivery modes. This paper investigates the competence and performance of physical education teachers using various learning delivery modes, including Distance learning, Blended Learning, and Homeschooling during online distance education. To identify the Gap between their age generation using various learning delivery that affects teachers' preparation for distance learning and evaluates how these modalities impact teachers’ competence and performance in the case of a pandemic. The respondents were the Senior High School teachers of the Department of Education who taught in Davao City before and during the pandemic. Purposive sampling was utilized on 61 Senior High School Teachers in Davao City Philippines. The result indicated that teaching performance based on pedagogy and assessment has significantly affected teaching performance in teaching physical education, particularly those Non-PE teachers teaching physical education subjects. It should be supplied with enhancement training workshops to help them be more successful in preparation in terms of teaching pedagogy and assessment in the following norm. Hence, a proposed unique training design for non-P.E. Teachers has been created to improve the teachers’ performance in terms of pedagogy and assessment in teaching P.E subjects in various learning delivery modes in the next normal.Keywords: distance learning, learning delivery modes, P.E teachers, senior high school, teaching competence, teaching performance
Procedia PDF Downloads 93865 A 20 Year Comparison of Australian Childhood Bicycle Injuries – Have We Made a Difference?
Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble
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Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.Keywords: paediatric, cycling, trauma, prevention, emergency
Procedia PDF Downloads 249864 Comparison of Sign Language Skill and Academic Achievement of Deaf Students in Special and Inclusive Primary Schools of South Nation Nationalities People Region, Ethiopia
Authors: Tesfaye Basha
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The purpose of this study was to examine the sign language and academic achievement of deaf students in special and inclusive primary schools of Southern Ethiopia. The study used a mixed-method to collect varied data. The study contained Signed Amharic and English skill tasks, questionnaire, 8th-grade Primary School Leaving Certificate Examination results, classroom observation, and interviews. For quantitative (n=70) deaf students and for qualitative data collection, 16 participants were involved. The finding revealed that the limitation of sign language is a problem in signing and academic achievements. This displays that schools are not linguistically rich to enable sign language achievement for deaf students. Moreover, the finding revealed that the contribution of Total Communication in the growth of natural sign language for deaf students was unsatisfactory. The results also indicated that special schools of deaf students performed better sign language skills and academic achievement than inclusive schools. In addition, the findings revealed that high signed skill group showed higher academic achievement than the low skill group. This displayed that sign language skill is highly associated with academic achievement. In addition, to qualify deaf students in sign language and academics, teacher institutions must produce competent teachers on how to teach deaf students with sign language and literacy skills.Keywords: academic achievement, inclusive school, sign language, signed Amharic, signed English, special school, total communication
Procedia PDF Downloads 133863 Evaluation of Machine Learning Algorithms and Ensemble Methods for Prediction of Students’ Graduation
Authors: Soha A. Bahanshal, Vaibhav Verdhan, Bayong Kim
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Graduation rates at six-year colleges are becoming a more essential indicator for incoming fresh students and for university rankings. Predicting student graduation is extremely beneficial to schools and has a huge potential for targeted intervention. It is important for educational institutions since it enables the development of strategic plans that will assist or improve students' performance in achieving their degrees on time (GOT). A first step and a helping hand in extracting useful information from these data and gaining insights into the prediction of students' progress and performance is offered by machine learning techniques. Data analysis and visualization techniques are applied to understand and interpret the data. The data used for the analysis contains students who have graduated in 6 years in the academic year 2017-2018 for science majors. This analysis can be used to predict the graduation of students in the next academic year. Different Predictive modelings such as logistic regression, decision trees, support vector machines, Random Forest, Naïve Bayes, and KNeighborsClassifier are applied to predict whether a student will graduate. These classifiers were evaluated with k folds of 5. The performance of these classifiers was compared based on accuracy measurement. The results indicated that Ensemble Classifier achieves better accuracy, about 91.12%. This GOT prediction model would hopefully be useful to university administration and academics in developing measures for assisting and boosting students' academic performance and ensuring they graduate on time.Keywords: prediction, decision trees, machine learning, support vector machine, ensemble model, student graduation, GOT graduate on time
Procedia PDF Downloads 72862 Agritourism Potentials in Oman: An Overview with Visionary for Adoption
Authors: A. Al Hinai, H. Jayasuriya, H. Kotagama
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Most Gulf Cooperation Council (GCC) countries with oil-based economy like Oman are looking for other potential revenue generation options as the crude oil price is regularly fluctuating due to changing geopolitical environment. Oman has advantage of possessing world-heritage nature tourism hotspots around the country and the government is making investments and strategies to uplift the tourism industry following Oman Vision 2040 strategies. Oman’s agriculture is not significantly contributing to the economy, but possesses specific and diversified arid cropping systems. Oman has modern farms; nevertheless some of the agricultural production activities are done with cultural practices and styles that would be attractive to tourists. The aim of this paper is to investigate the potentials for promoting agritourism industry in Oman; recognize potential sites, commodities and activities, and predict potential revenue generation as a projection from that of the tourism sector. Moreover, the study enables to foresee possible auxiliary advantages of agritourism such as, empowerment of women and youth, enhancement in the value-addition industry for agricultural produce through technology transfer and capacity building, and producing export quality products. Agritourism could increase employability, empowerment of women and youth, improve value-addition industry and export-oriented agribusiness. These efforts including provision of necessary technology-transfer and capacity-building should be rendered by the collaboration of academic institutions, relevant ministries and other public and private sector stakeholders.Keywords: agritourism, nature-based tourism, potentials, revenue generation, value addition
Procedia PDF Downloads 137861 Analysis of the Impact and Effectiveness of Government Funded Small-Scale Biogas Projects in Giyani Municipality, Limpopo
Authors: Lindiwe Ngcobo
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The aim of the study is to describe and understand the benefits and costs of having biogas digesters at both household and society level. On a household level, the purpose is to understand how rural households benefit from the biogas digesters, for example, by converting animal and human waste through biogas digesters, and at what costs the benefits are realized. At a societal level, the purpose is to understand the costs and benefits of biogas digesters relative to the situation of rural communities who do not have flush toilets and have no appropriate waste disposal services while they incur electricity costs. Multiple regression analysis was used to determine the effect of biogas digesters on electricity availability and waste management. The results showed that beneficiaries spent less on electricity using household waste, and also waste disposal costs were eliminated from household expenses. A move to biogas energy production can be beneficial to rural households. It is economically and environmentally friendly. Small-scale farmers need to be introduced to agricultural innovations that can assist them in producing nutritious crops at a low cost. This can be a good opportunity to start an agribusiness that focuses on organic crops. Extensions and training institutions have to play a part in supporting households to develop entrepreneurial skills. Cost-benefit analysis showed that the benefits of biogas exceed the costs of the biogas projects. This implies that this technology should be promoted in rural households. Government financial incentives must be put in place to motivate a generation of organic Agri-prenuers.Keywords: Agri-prenuers, biogas digester, biogas energy, disposal costs
Procedia PDF Downloads 136860 Incidence and Risk Factors of Traumatic Lumbar Puncture in Newborns in a Tertiary Care Hospital
Authors: Heena Dabas, Anju Paul, Suman Chaurasia, Ramesh Agarwal, M. Jeeva Sankar, Anurag Bajpai, Manju Saksena
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Background: Traumatic lumbar puncture (LP) is a common occurrence and causes substantial diagnostic ambiguity. There is paucity of data regarding its epidemiology. Objective: To assess the incidence and risk factors of traumatic LP in newborns. Design/Methods: In a prospective cohort study, all inborn neonates admitted in NICU and planned to undergo LP for a clinical indication of sepsis were included. Neonates with diagnosed intraventricular hemorrhage (IVH) of grade III and IV were excluded. The LP was done by operator - often a fellow or resident assisted by bedside nurse. The unit has policy of not routinely using any sedation/analgesia during the procedure. LP is done by 26 G and 0.5-inch-long hypodermic needle inserted in third or fourth lumbar space while the infant is in lateral position. The infants were monitored clinically and by continuous measurement of vital parameters using multipara monitor during the procedure. The occurrence of traumatic tap along with CSF parameters and other operator and assistant characteristics were recorded at the time of procedure. Traumatic tap was defined as presence of visible blood or more than 500 red blood cells on microscopic examination. Microscopic trauma was defined when CSF is not having visible blood but numerous RBCs. The institutional ethics committee approved the study protocol. A written informed consent from the parents and the health care providers involved was obtained. Neonates were followed up till discharge/death and final diagnosis was assigned along with treating team. Results: A total of 362 (21%) neonates out of 1726 born at the hospital were admitted during the study period (July 2016 to January, 2017). Among these neonates, 97 (26.7%) were suspected of sepsis. A total of 54 neonates were enrolled who met the eligibility criteria and parents consented to participate in the study. The mean (SD) birthweight was 1536 (732) grams and gestational age 32.0 (4.0) weeks. All LPs were indicated for late onset sepsis at the median (IQR) age of 12 (5-39) days. The traumatic LP occurred in 19 neonates (35.1%; 95% C.I 22.6% to 49.3%). Frank blood was observed in 7 (36.8%) and in the remaining, 12(63.1%) CSF was detected to have microscopic trauma. The preliminary risk factor analysis including birth weight, gestational age and operator/assistant and other characteristics did not demonstrate clinically relevant predictors. Conclusion: A significant number of neonates requiring lumbar puncture in our study had high incidence of traumatic tap. We were not able to identify modifiable risk factors. There is a need to understand the reasons and further reduce this issue for improving management in NICUs.Keywords: incidence, newborn, traumatic, lumbar puncture
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