Search results for: life cycle based analysis
29253 Evaluation of the Role of Advocacy and the Quality of Care in Reducing Health Inequalities for People with Autism, Intellectual and Developmental Disabilities at Sheffield Teaching Hospitals
Authors: Jonathan Sahu, Jill Aylott
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Individuals with Autism, Intellectual and Developmental disabilities (AIDD) are one of the most vulnerable groups in society, hampered not only by their own limitations to understand and interact with the wider society, but also societal limitations in perception and understanding. Communication to express their needs and wishes is fundamental to enable such individuals to live and prosper in society. This research project was designed as an organisational case study, in a large secondary health care hospital within the National Health Service (NHS), to assess the quality of care provided to people with AIDD and to review the role of advocacy to reduce health inequalities in these individuals. Methods: The research methodology adopted was as an “insider researcher”. Data collection included both quantitative and qualitative data i.e. a mixed method approach. A semi-structured interview schedule was designed and used to obtain qualitative and quantitative primary data from a wide range of interdisciplinary frontline health care workers to assess their understanding and awareness of systems, processes and evidence based practice to offer a quality service to people with AIDD. Secondary data were obtained from sources within the organisation, in keeping with “Case Study” as a primary method, and organisational performance data were then compared against national benchmarking standards. Further data sources were accessed to help evaluate the effectiveness of different types of advocacy that were present in the organisation. This was gauged by measures of user and carer experience in the form of retrospective survey analysis, incidents and complaints. Results: Secondary data demonstrate near compliance of the Organisation with the current national benchmarking standard (Monitor Compliance Framework). However, primary data demonstrate poor knowledge of the Mental Capacity Act 2005, poor knowledge of organisational systems, processes and evidence based practice applied for people with AIDD. In addition there was poor knowledge and awareness of frontline health care workers of advocacy and advocacy schemes for this group. Conclusions: A significant amount of work needs to be undertaken to improve the quality of care delivered to individuals with AIDD. An operational strategy promoting the widespread dissemination of information may not be the best approach to deliver quality care and optimal patient experience and patient advocacy. In addition, a more robust set of standards, with appropriate metrics, needs to be developed to assess organisational performance which will stand the test of professional and public scrutiny.Keywords: advocacy, autism, health inequalities, intellectual developmental disabilities, quality of care
Procedia PDF Downloads 21429252 Automation of Embodied Energy Calculations for Buildings through Building Information Modelling
Authors: Ahmad Odeh
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Researchers are currently more concerned about the calculations of energy at the operational stage, mainly due to its larger environmental impact, but the fact remains, embodied energies represent a substantial contributor unaccounted for in the overall energy computation method. The calculation of materials’ embodied energy during the construction stage is complicated. This is due to the various factors involved. The equipment used, fuel needed, and electricity required for each type of materials varies with location and thus the embodied energy will differ for each project. Moreover, the method used in manufacturing, transporting and putting in place will have significant influence on the materials’ embodied energy. This anomaly has made it difficult to calculate or even bench mark the usage of such energies. This paper presents a model aimed at calculating embodied energies based on such variabilities. It presents a systematic approach that uses an efficient method of calculation to provide a new insight for the selection of construction materials. The model is developed in a BIM environment. The quantification of materials’ energy is determined over the three main stages of their lifecycle: manufacturing, transporting and placing. The model uses three major databases each of which contains set of the construction materials that are most commonly used in building projects. The first dataset holds information about the energy required to manufacture any type of materials, the second includes information about the energy required for transporting the materials while the third stores information about the energy required by machinery to place the materials in their intended locations. Through geospatial data analysis, the model automatically calculates the distances between the suppliers and construction sites and then uses dataset information for energy computations. The computational sum of all the energies is automatically calculated and then the model provides designers with a list of usable equipment along with the associated embodied energies.Keywords: BIM, lifecycle energy assessment, building automation, energy conservation
Procedia PDF Downloads 18429251 Design and Validation of Different Steering Geometries for an All-Terrain Vehicle
Authors: Prabhsharan Singh, Rahul Sindhu, Piyush Sikka
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The steering system is an integral part and medium through which the driver communicates with the vehicle and terrain, hence the most suitable steering geometry as per requirements must be chosen. The function of the chosen steering geometry of an All-Terrain Vehicle (ATV) is to provide the desired understeer gradient, minimum tire slippage, expected weight transfer during turning as these are requirements for a good steering geometry of a BAJA ATV. This research paper focuses on choosing the best suitable steering geometry for BAJA ATV tracks by reasoning the working principle and using fundamental trigonometric functions for obtaining these geometries on the same vehicle itself, namely Ackermann, Anti- Ackermann, Parallel Ackermann. Full vehicle analysis was carried out on Adams Car Analysis software, and graphical results were obtained for various parameters. Steering geometries were achieved by using a single versatile knuckle for frontward and rearward tie-rod placement and were practically tested with the help of data acquisition systems set up on the ATV. Each was having certain characteristics, setup, and parameters were observed for the BAJA ATV, and correlations were created between analytical and practical values.Keywords: all-terrain vehicle, Ackermann, Adams car, Baja Sae, steering geometry, steering system, tire slip, traction, understeer gradient
Procedia PDF Downloads 14629250 The Nature of Origin of New Criminal Occurrences in Gjakova Region: Cultural and Criminological “Intersection” in 1999-2009
Authors: Bekim Avdiaj
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The transition period of Kosovo society brought fundamental changes in all the spheres of organizing life. This was the period when also in the cultural tradition the biggest movement and an emerging from ‘isolation’ or from the ‘shell’ occurred. Transformation of the traditional and embracing of the modern began here. The same was experienced and is currently being experienced also by Gjakova and its surrounding which is historically renowned for its great tradition and culture. The population of this region is actually facing a transition from the traditional system into the modern one and quite often with huge leaps. These ‘movements’ or ‘evolutions’ of the society of this region, besides the numerous positive things it ‘harvested’, also brought things that do not at all correspond with their tradition as well as new criminal occurrences which in the past were not present in this area. Furthermore, some of the ‘new’ behaviours that are embraced from other ‘cultures’ and ‘civilizations’, and which are often exceeded, are quite perturbing. The security situation is also worrying, particularly following the appearance of some new criminal occurrences. Therefore, with this research paper we will strive to analyse the new cultural “intersections” as well as the nature of the origin of some new very worrying criminal occurrences. We will present there also some factors inciting into these occurrences, which were confessed by the persons involved in these criminal occurrences and who come from this very region.Keywords: crime, occurrence, culture, Gjakova Region
Procedia PDF Downloads 34529249 An Assumption to Philippine Air Transportation Sustainability in Global Pandemic: Way Forward
Authors: Marwin M. Dela Cruz
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Aviation as a transport sector is supportive of the seventeen (17) Sustainable Goals espoused by the United Nations. Air Transport Action Group (ATAG) states that over 18.1 million indirect jobs globally were sustained through the purchase of goods and services by companies in the aviation industry. This supply chain activity contributed approximately $816.4 billion to global GDP. This was achieved through numerous actions to lessen economic uncertainty and challenges. Its impact is not just a by-product of economic activity but of the facilities it generates. As the aviation industry is unifying its efforts, education and training should also come with it. The need for aviation education and training and a well-crafted regulatory policy initiated by lawmakers can provide a better aviation education. The Philippine State College of Aeronautics (PhilSCA), being the only government Higher Education Institution (HEI) in the Philippines, is given a very distinct congressional mandate to offer aviation-related courses to afford those in the aviation industry the opportunity to pursue studies. Having this, the industry has become the precursor and venue of present-day communities. In addition, it becomes an essential measure of a better life.Keywords: Philippine state college of aeronautics, aviation industry, sustainable goals, aviation education
Procedia PDF Downloads 6529248 Fused Deposition Modelling as the Manufacturing Method of Fully Bio-Based Water Purification Filters
Authors: Natalia Fijol, Aji P. Mathew
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We present the processing and characterisation of three-dimensional (3D) monolith filters based on polylactic acid (PLA) reinforced with various nature-derived nanospecies such as hydroxyapatite, modified cellulose fibers and chitin fibers. The nanospecies of choice were dispersed in PLA through Thermally Induced Phase Separation (TIPS) method. The biocomposites were developed via solvent-assisted blending and the obtained pellets were further single-screw extruded into 3D-printing filaments and processed into various geometries using Fused Deposition Modelling (FDM) technique. The printed prototypes included cubic, cylindrical and hour-glass shapes with diverse patterns of printing infill as well as varying pore structure including uniform and multiple level gradual pore structure. The pores and channel structure as well as overall shape of the prototypes were designed in attempt to optimize the flux and maximize the adsorption-active time. FDM is a cost and energy-efficient method, which does not require expensive tools and elaborated post-processing maintenance. Therefore, FDM offers the possibility to produce customized, highly functional water purification filters with tuned porous structures suitable for removal of wide range of common water pollutants. Moreover, as 3D printing becomes more and more available worldwide, it allows producing portable filters at the place and time where they are most needed. The study demonstrates preparation route for the PLA-based, fully biobased composite and their processing via FDM technique into water purification filters, addressing water treatment challenges on an industrial scale.Keywords: fused deposition modelling, water treatment, biomaterials, 3D printing, nanocellulose, nanochitin, polylactic acid
Procedia PDF Downloads 11129247 Subjectivity in Miracle Aesthetic Clinic Ambient Media Advertisement
Authors: Wegig Muwonugroho
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Subjectivity in advertisement is a ‘power’ possessed by advertisements to construct trend, concept, truth, and ideology through subconscious mind. Advertisements, in performing their functions as message conveyors, use such visual representation to inspire what’s ideal to the people. Ambient media is advertising medium making the best use of the environment where the advertisement is located. Miracle Aesthetic Clinic (Miracle) popularizes the visual representation of its ambient media advertisement through the omission of face-image of both female mannequins that function as its ambient media models. Usually, the face of a model in advertisement is an image commodity having selling values; however, the faces of ambient media models in Miracle advertisement campaign are suppressed over the table and wall. This face concealing aspect creates not only a paradox of subjectivity but also plurality of meaning. This research applies critical discourse analysis method to analyze subjectivity in obtaining the insight of ambient media’s meaning. First, in the stage of textual analysis, the embedding attributes upon female mannequins imply that the models are denoted as the representation of modern women, which are identical with the identities of their social milieus. The communication signs aimed to be constructed are the women who lose their subjectivities and ‘feel embarrassed’ to flaunt their faces to the public because of pimples on their faces. Second, in the stage of analysis of discourse practice, it points out that ambient media as communication media has been comprehensively responded by the targeted audiences. Ambient media has a role as an actor because of its eyes-catching setting, and taking space over the area where the public are wandering around. Indeed, when the public realize that the ambient media models are motionless -unlike human- stronger relation then appears, marked by several responses from targeted audiences. Third, in the stage of analysis of social practice, soap operas and celebrity gossip shows on the television become a dominant discourse influencing advertisement meaning. The subjectivity of Miracle Advertisement corners women by the absence of women participation in public space, the representation of women in isolation, and the portrayal of women as an anxious person in the social rank when their faces suffered from pimples. The Ambient media as the advertisement campaign of Miracle is quite success in constructing a new trend discourse of face beauty that is not limited on benchmarks of common beauty virtues, but the idea of beauty can be presented by ‘when woman doesn’t look good’ visualization.Keywords: ambient media, advertisement, subjectivity, power
Procedia PDF Downloads 31529246 The Response of Soil Biodiversity to Agriculture Practice in Rhizosphere
Authors: Yan Wang, Guowei Chen, Gang Wang
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Soil microbial diversity is one of the important parameters to assess the soil fertility and soil health, even stability of the ecosystem. In this paper, we aim to reveal the soil microbial difference in rhizosphere and root zone, even to pick the special biomarkers influenced by the long term tillage practices, which included four treatments of no-tillage, ridge tillage, continuous cropping with corn and crop rotation with corn and soybean. Here, high-throughput sequencing was performed to investigate the difference of bacteria in rhizosphere and root zone. The results showed a very significant difference of species richness between rhizosphere and root zone soil at the same crop rotation system (p < 0.01), and also significant difference of species richness was found between continuous cropping with corn and corn-soybean rotation treatment in the rhizosphere statement, no-tillage and ridge tillage in root zone soils. Implied by further beta diversity analysis, both tillage methods and crop rotation systems influence the soil microbial diversity and community structure in varying degree. The composition and community structure of microbes in rhizosphere and root zone soils were clustered distinctly by the beta diversity (p < 0.05). Linear discriminant analysis coupled with effect size (LEfSe) analysis of total taxa in rhizosphere picked more than 100 bacterial taxa, which were significantly more abundant than that in root zone soils, whereas the number of biomarkers was lower between the continuous cropping with corn and crop rotation treatment, the same pattern was found at no-tillage and ridge tillage treatment. Bacterial communities were greatly influenced by main environmental factors in large scale, which is the result of biological adaptation and acclimation, hence it is beneficial for optimizing agricultural practices.Keywords: tillage methods, biomarker, biodiversity, rhizosphere
Procedia PDF Downloads 15529245 Developing a Product Circularity Index with an Emphasis on Longevity, Repairability, and Material Efficiency
Authors: Lina Psarra, Manogj Sundaresan, Purjeet Sutar
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In response to the global imperative for sustainable solutions, this article proposes the development of a comprehensive circularity index applicable to a wide range of products across various industries. The absence of a consensus on using a universal metric to assess circularity performance presents a significant challenge in prioritizing and effectively managing sustainable initiatives. This circularity index serves as a quantitative measure to evaluate the adherence of products, processes, and systems to the principles of a circular economy. Unlike traditional distinct metrics such as recycling rates or material efficiency, this index considers the entire lifecycle of a product in one single metric, also incorporating additional factors such as reusability, scarcity of materials, reparability, and recyclability. Through a systematic approach and by reviewing existing metrics and past methodologies, this work aims to address this gap by formulating a circularity index that can be applied to diverse product portfolio and assist in comparing the circularity of products on a scale of 0%-100%. Project objectives include developing a formula, designing and implementing a pilot tool based on the developed Product Circularity Index (PCI), evaluating the effectiveness of the formula and tool using real product data, and assessing the feasibility of integration into various sustainability initiatives. The research methodology involves an iterative process of comprehensive research, analysis, and refinement where key steps include defining circularity parameters, collecting relevant product data, applying the developed formula, and testing the tool in a pilot phase to gather insights and make necessary adjustments. Major findings of the study indicate that the PCI provides a robust framework for evaluating product circularity across various dimensions. The Excel-based pilot tool demonstrated high accuracy and reliability in measuring circularity, and the database proved instrumental in supporting comprehensive assessments. The PCI facilitated the identification of key areas for improvement, enabling more informed decision-making towards circularity and benchmarking across different products, essentially assisting towards better resource management. In conclusion, the development of the Product Circularity Index represents a significant advancement in global sustainability efforts. By providing a standardized metric, the PCI empowers companies and stakeholders to systematically assess product circularity, track progress, identify improvement areas, and make informed decisions about resource management. This project contributes to the broader discourse on sustainable development by offering a practical approach to enhance circularity within industrial systems, thus paving the way towards a more resilient and sustainable future.Keywords: circular economy, circular metrics, circularity assessment, circularity tool, sustainable product design, product circularity index
Procedia PDF Downloads 2229244 Qualitative and Quantitative Assessment of Sexual Dysfunction in Primary Obesity through an Observational Study
Authors: Aravind Bagade Shankaranarayana, Parampalli Geetha, Pallavi Gupta
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Objective: This study intends to evaluate sexual dysfunction qualitatively and quantitatively in males suffering from primary obesity through a single centered, observational study. Design and Methods: Sexual function of 33 obese males from the outpatient department of the hospital was assessed using IIEF questionnaire and semen analysis and the results were assessed for statistical significance. Results: A varying degree of sexual dysfunction was observed in four out of five areas of sexual functioning viz. erectile function (p<0.02), orgasmic function (p<0.02), sexual desire (p<0.08) and overall satisfaction (p<0.000) in obese individuals. Statistically significant dysfunction was not observed in intercourse satisfaction. Semen analysis was normal in 19 individuals (63.3%) and abnormal in 11 individuals (36.7%), with statistically insignificant p value 0.144, suggesting mild to moderate variation in semen parameters. Conclusions: Varying degree of sexual dysfunction is present in obese males, suggesting that obesity has a possible role in reducing the quality of sexual functioning in males as indicated in the classical Ayurvedic literature.Keywords: erectile dysfunction, krucchra vyavaya, obesity, sthoulya
Procedia PDF Downloads 32829243 A Spatial Point Pattern Analysis to Recognize Fail Bit Patterns in Semiconductor Manufacturing
Authors: Youngji Yoo, Seung Hwan Park, Daewoong An, Sung-Shick Kim, Jun-Geol Baek
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The yield management system is very important to produce high-quality semiconductor chips in the semiconductor manufacturing process. In order to improve quality of semiconductors, various tests are conducted in the post fabrication (FAB) process. During the test process, large amount of data are collected and the data includes a lot of information about defect. In general, the defect on the wafer is the main causes of yield loss. Therefore, analyzing the defect data is necessary to improve performance of yield prediction. The wafer bin map (WBM) is one of the data collected in the test process and includes defect information such as the fail bit patterns. The fail bit has characteristics of spatial point patterns. Therefore, this paper proposes the feature extraction method using the spatial point pattern analysis. Actual data obtained from the semiconductor process is used for experiments and the experimental result shows that the proposed method is more accurately recognize the fail bit patterns.Keywords: semiconductor, wafer bin map, feature extraction, spatial point patterns, contour map
Procedia PDF Downloads 37529242 Surveying Coastal Society Perception on Giant Sea Wall Jakarta Development Planning
Authors: Ammar Asfari, Faizah Finur Fithriah, Shighia Ajeng Savitri
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Jakarta as the capital city of Indonesia held an important role for the country, that is being the city where central government is located. But its topographic character which categorized as lowland area is causing an ultimate trouble. With average height of 7 meters above the sea level, flood keeps occurring in this city. On the other hand, water exploitation that caused land subsidence and sea-levels increasing by global warming make it even worse. Giant Sea Wall Development is a project created by Jakarta’s government to overcome flood, which is inspired by Saemangeum Dam in South Korea. For further planning, Giant Sea Wall is planned to be water reservoir for Jakarta’s inhabitants. This research’s aim is to fully understand the knowledge and opinion of people living in North Jakarta (Jakarta’s Coastal Area) on Giant Sea Wall development planning using qualitative method analysis with descriptive approach. The result of this research will be one of the determining factors in Giant Sea Wall Jakarta development planning continuance.Keywords: descriptive approach, Giant Sea Wall Jakarta, qualitative method analysis, society perception
Procedia PDF Downloads 27829241 Disaster Management Approach for Planning an Early Response to Earthquakes in Urban Areas
Authors: Luis Reynaldo Mota-Santiago, Angélica Lozano
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Determining appropriate measures to face earthquakesarea challenge for practitioners. In the literature, some analyses consider disaster scenarios, disregarding some important field characteristics. Sometimes, software that allows estimating the number of victims and infrastructure damages is used. Other times historical information of previous events is used, or the scenarios’informationis assumed to be available even if it isnot usual in practice. Humanitarian operations start immediately after an earthquake strikes, and the first hours in relief efforts are important; local efforts are critical to assess the situation and deliver relief supplies to the victims. A preparation action is prepositioning stockpiles, most of them at central warehouses placed away from damage-prone areas, which requires large size facilities and budget. Usually, decisions in the first 12 hours (standard relief time (SRT)) after the disaster are the location of temporary depots and the design of distribution paths. The motivation for this research was the delay in the reaction time of the early relief efforts generating the late arrival of aid to some areas after the Mexico City 7.1 magnitude earthquake in 2017. Hence, a preparation approach for planning the immediate response to earthquake disasters is proposed, intended for local governments, considering their capabilities for planning and for responding during the SRT, in order to reduce the start-up time of immediate response operations in urban areas. The first steps are the generation and analysis of disaster scenarios, which allow estimatethe relief demand before and in the early hours after an earthquake. The scenarios can be based on historical data and/or the seismic hazard analysis of an Atlas of Natural Hazards and Risk as a way to address the limited or null available information.The following steps include the decision processes for: a) locating local depots (places to prepositioning stockpiles)and aid-giving facilities at closer places as possible to risk areas; and b) designing the vehicle paths for aid distribution (from local depots to the aid-giving facilities), which can be used at the beginning of the response actions. This approach allows speeding up the delivery of aid in the early moments of the emergency, which could reduce the suffering of the victims allowing additional time to integrate a broader and more streamlined response (according to new information)from national and international organizations into these efforts. The proposed approachis applied to two case studies in Mexico City. These areas were affectedby the 2017’s earthquake, having limited aid response. The approach generates disaster scenarios in an easy way and plans a faster early response with a short quantity of stockpiles which can be managed in the early hours of the emergency by local governments. Considering long-term storage, the estimated quantities of stockpiles require a limited budget to maintain and a small storage space. These stockpiles are useful also to address a different kind of emergencies in the area.Keywords: disaster logistics, early response, generation of disaster scenarios, preparation phase
Procedia PDF Downloads 10829240 Government and Non-Government Policy Responses to Anti-Trafficking Initiatives: A Discursive Analysis of the Construction of the Problem of Human Trafficking in Australia and Thailand
Authors: Jessica J. Gillies
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Human trafficking is a gross violation of human rights and thus invokes a strong response particularly throughout the global academic community. A longstanding tension throughout academic debate remains the question of a relationship between anti-trafficking policy and sex industry policy. In Australia, over the previous decade, many human trafficking investigations have related to the sexual exploitation of female victims, and convictions in Australia to date have often been for trafficking women from Thailand. Sex industry policy in Australia varies between states, providing a rich contextual landscape in which to explore this relationship. The purpose of this study was to deconstruct how meaning is constructed surrounding human trafficking throughout these supposedly related political discourses in Australia. In order to analyse the discursive construction of the problem of human trafficking in relation to sex industry policy, a discursive analysis was conducted. The methodology of the study was informed by a feminist theoretical framework, and included academic sources and grey literature such as organisational reports and policy statements regarding anti-trafficking initiatives. The scope of grey literature was restricted to Australian and Thai government and non-government organisation texts. The chosen methodology facilitated a qualitative exploration of the influence of feminist discourses over political discourse in this arena. The discursive analysis exposed clusters of active feminist debates interacting with sex industry policy within individual states throughout Australia. Additionally, strongly opposed sex industry perspectives were uncovered within these competing feminist frameworks. While the influence these groups may exert over policy differs, the debate constructs a discursive relationship between human trafficking and sex industry policy. This is problematic because anti-trafficking policy is drawn to some extent from this discursive construction, therefore affecting support services for survivors of human trafficking. The discursive analysis further revealed misalignment between government and non-government priorities, Australian government anti-trafficking policy appears to favour criminal justice priorities; whereas non-government settings preference human rights protections. Criminal justice priorities invoke questions of legitimacy, leading to strict eligibility policy for survivors seeking support following exploitation in the Australian sex industry, undermining women’s agency and human rights. In practice, these two main findings demonstrate a construction of policy that has serious outcomes on typical survivors in Australia following a lived experience of human trafficking for the purpose of sexual exploitation. The discourses constructed by conflicting feminist arguments influence political discourses throughout Australia. The application of a feminist theoretical framework to the discursive analysis of the problem of human trafficking is unique to this study. The study has exposed a longstanding and unresolved feminist debate that has filtered throughout anti-trafficking political discourse. This study illuminates the problematic construction of anti-trafficking policy, and the implications in practice on survivor support services. Australia has received international criticism for the focus on criminal justice rather than human rights throughout anti-trafficking policy discourse. The outcome of this study has the potential to inform future language and constructive conversations contributing to knowledge around how policy effects survivors in the post trafficking experience.Keywords: Australia, discursive analysis, government, human trafficking, non-government, Thailand
Procedia PDF Downloads 11729239 The Customization of 3D Last Form Design Based on Weighted Blending
Authors: Shih-Wen Hsiao, Chu-Hsuan Lee, Rong-Qi Chen
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When it comes to last, it is regarded as the critical foundation of shoe design and development. Not only the last relates to the comfort of shoes wearing but also it aids the production of shoe styling and manufacturing. In order to enhance the efficiency and application of last development, a computer aided methodology for customized last form designs is proposed in this study. The reverse engineering is mainly applied to the process of scanning for the last form. Then the minimum energy is used for the revision of surface continuity, the surface of the last is reconstructed with the feature curves of the scanned last. When the surface of a last is reconstructed, based on the foundation of the proposed last form reconstruction module, the weighted arithmetic mean method is applied to the calculation on the shape morphing which differs from the grading for the control mesh of last, and the algorithm of subdivision is used to create the surface of last mesh, thus the feet-fitting 3D last form of different sizes is generated from its original form feature with functions remained. Finally, the practicability of the proposed methodology is verified through later case studies.Keywords: 3D last design, customization, reverse engineering, weighted morphing, shape blending
Procedia PDF Downloads 33429238 Maternal Review: Challenges Experienced by Midwives in Malawi
Authors: Mercy D. Chirwa, Juliet Nyasulu, Lebisti Modiba, Makombo Ganga-Limando
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Maternal death review is an initiative that provides a deeper understanding of the causes and circumstances sorounding of maternal deaths in Malawi and globally. Midwives are frontline members of the healthcare team and have stories about what pregnant women go through as such they are better placed to contribute to these reviews. Despite midwives’ participation as members of the facility-based maternal death review team, maternal deaths continues to occur. A lot has been documented around processes involved in maternal review, however, not much has been written around challenges experienced by midwives in maternal death review. This study explored the challenges faced by midwives in the implementation of maternal death reviews in the context of the healthcare system in Malawi. Methodology: This was a qualitative exploratory study design. Focus group discussions and individual face-to-face interviews were used to collect data in the study. A total of 40 midwives, who met the inclusion criteria, participated in the study. Data was analysed manually using a thematic content procedure. Findings: The four major challenges identified were: knowledge and skill gaps; lack of leadership and accountability; lack of institutional political will and inconsistency in conducting FBMDR, impeding midwives’ effective contribution to the implementation of maternal death review. The practical solutions and recommendations that emerged were: need-based knowledge and skills updates, supportive leadership, effective and efficient interdisciplinary work ethics, and sustained availability of material and human resources. Conclusion: Midwives have the highest potential to contribute to the reduction of maternal deaths. Practice development strategies are required to improve their practice in all the areas they are challenged with.Keywords: facility-based maternal death review, maternal deaths, midwife, midwife challenges
Procedia PDF Downloads 6229237 Quantification of the Non-Registered Electrical and Electronic Equipment for Domestic Consumption and Enhancing E-Waste Estimation: A Case Study on TVs in Vietnam
Authors: Ha Phuong Tran, Feng Wang, Jo Dewulf, Hai Trung Huynh, Thomas Schaubroeck
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The fast increase and complex components have made waste of electrical and electronic equipment (or e-waste) one of the most problematic waste streams worldwide. Precise information on its size on national, regional and global level has therefore been highlighted as prerequisite to obtain a proper management system. However, this is a very challenging task, especially in developing countries where both formal e-waste management system and necessary statistical data for e-waste estimation, i.e. data on the production, sale and trade of electrical and electronic equipment (EEE), are often lacking. Moreover, there is an inflow of non-registered electronic and electric equipment, which ‘invisibly’ enters the EEE domestic market and then is used for domestic consumption. The non-registration/invisibility and (in most of the case) illicit nature of this flow make it difficult or even impossible to be captured in any statistical system. The e-waste generated from it is thus often uncounted in current e-waste estimation based on statistical market data. Therefore, this study focuses on enhancing e-waste estimation in developing countries and proposing a calculation pathway to quantify the magnitude of the non-registered EEE inflow. An advanced Input-Out Analysis model (i.e. the Sale–Stock–Lifespan model) has been integrated in the calculation procedure. In general, Sale-Stock-Lifespan model assists to improve the quality of input data for modeling (i.e. perform data consolidation to create more accurate lifespan profile, model dynamic lifespan to take into account its changes over time), via which the quality of e-waste estimation can be improved. To demonstrate the above objectives, a case study on televisions (TVs) in Vietnam has been employed. The results show that the amount of waste TVs in Vietnam has increased four times since 2000 till now. This upward trend is expected to continue in the future. In 2035, a total of 9.51 million TVs are predicted to be discarded. Moreover, estimation of non-registered TV inflow shows that it might on average contribute about 15% to the total TVs sold on the Vietnamese market during the whole period of 2002 to 2013. To tackle potential uncertainties associated with estimation models and input data, sensitivity analysis has been applied. The results show that both estimations of waste and non-registered inflow depend on two parameters i.e. number of TVs used in household and the lifespan. Particularly, with a 1% increase in the TV in-use rate, the average market share of non-register inflow in the period 2002-2013 increases 0.95%. However, it decreases from 27% to 15% when the constant unadjusted lifespan is replaced by the dynamic adjusted lifespan. The effect of these two parameters on the amount of waste TV generation for each year is more complex and non-linear over time. To conclude, despite of remaining uncertainty, this study is the first attempt to apply the Sale-Stock-Lifespan model to improve the e-waste estimation in developing countries and to quantify the non-registered EEE inflow to domestic consumption. It therefore can be further improved in future with more knowledge and data.Keywords: e-waste, non-registered electrical and electronic equipment, TVs, Vietnam
Procedia PDF Downloads 24129236 Anthocyanin Complex: Characterization and Cytotoxicity Studies
Authors: Sucharat Limsitthichaikoon, Kedsarin Saodaeng, Aroonsri Priprem, Teerasak Damrongrungruang
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Complexation of anthocyanins to mimic natural copigmentation process was investigated. Cyanidin-rich extracts from Zea mays L. CeritinaKulesh. anddelphinidin-rich extracts from ClitoriaternateaL. were used to form 4 anthocyanin complexes, AC1, AC2, AC3, and AC4, in the presence of several polyphenols and a trace metal. Characterizations of the ACs were conducted by UV, FTIR, DSC/TGA and morphological observations. Bathochromic shifts of the UV spectra of 4 formulas of ACs were observed at peak wavelengths of about 510-620 nm by 10 nm suggesting complex formation.FTIR spectra of the ACs indicate shifts of peaks from 1,733 cm-1 to 1,696 cm-1 indicating interactions and a decrease in the peak areas within the wavenumber of 3,400-3,500 cm-1 indicating changes in hydrogen bonding.Thermal analysis of all of the ACs suggests increases in melting temperature after complexation. AC with the highest melting temperature was morphologically observed by SEM and TEM to be crystal-like particles within a range of 50 to 200 nm. Particle size analysis of the AC by laser diffraction gave a range of 50-600 nm, indicating aggregation. This AC was shown to have no cytotoxic effect on cultured HGEPp0.5 and HGF (all p> 0.05) by MTT. Therefore, complexation of anthocyanins was simple and self-assembly process, potentially resulting in nanosized particles of anthocyanin complex.Keywords: anthocyanins, complexation, purple corn cops, butterfly pea, physicochemical characteristics, cytotoxicity
Procedia PDF Downloads 35829235 The Importance of Political Advice in Islam: Hadith Thematical Study
Authors: Nurzarimah Jamil, Mohd Nazaruddin Jamil
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This paper is a preliminary study about The Importance of Political Advice in Islam: Ḥadīth Thematical Study by showing the concept and proper ways to advice to politician based on hadith Prophet Muhammad (PBUH). The unique of political advice in Islam that Muslim already have the strong and fulfil example that can be apply in nowadays governance that is the way of political and leadership Prophet Muhammad show in his time. As a political leader, the Prophet Muhammad (PBUH) established a great state whose capital was Madinah. However, his real political leadership was in the realm of morality and spirituality in which he conducted himself perfectly in situations of weakness as well as strength. His way of dealing in Makkah and Madinah indicates his great political leadership. Based on fact nowadays some of the country not practicing the proper way to advice to rulers or governance that make a lot of madness around them. This paper also aims the concept and the proper way that can be following to all Muslim to advising by the politeness, justice and kindness.Keywords: Hadith, leadership, political advice, Prophet Muhammad
Procedia PDF Downloads 42529234 Modeling of Particle Reduction and Volatile Compounds Profile during Chocolate Conching by Electronic Nose and Genetic Programming (GP) Based System
Authors: Juzhong Tan, William Kerr
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Conching is one critical procedure in chocolate processing, where special flavors are developed, and smooth mouse feel the texture of the chocolate is developed due to particle size reduction of cocoa mass and other additives. Therefore, determination of the particle size and volatile compounds profile of cocoa bean is important for chocolate manufacturers to ensure the quality of chocolate products. Currently, precise particle size measurement is usually done by laser scattering which is expensive and inaccessible to small/medium size chocolate manufacturers. Also, some other alternatives, such as micrometer and microscopy, can’t provide good measurements and provide little information. Volatile compounds analysis of cocoa during conching, has similar problems due to its high cost and limited accessibility. In this study, a self-made electronic nose system consists of gas sensors (TGS 800 and 2000 series) was inserted to a conching machine and was used to monitoring the volatile compound profile of chocolate during the conching. A model correlated volatile compounds profiles along with factors including the content of cocoa, sugar, and the temperature during the conching to particle size of chocolate particles by genetic programming was established. The model was used to predict the particle size reduction of chocolates with different cocoa mass to sugar ratio (1:2, 1:1, 1.5:1, 2:1) at 8 conching time (15min, 30min, 1h, 1.5h, 2h, 4h, 8h, and 24h). And the predictions were compared to laser scattering measurements of the same chocolate samples. 91.3% of the predictions were within the range of later scatting measurement ± 5% deviation. 99.3% were within the range of later scatting measurement ± 10% deviation.Keywords: cocoa bean, conching, electronic nose, genetic programming
Procedia PDF Downloads 24529233 Material Handling Equipment Selection Using Fuzzy AHP Approach
Authors: Priyanka Verma, Vijaya Dixit, Rishabh Bajpai
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This research paper is aimed at selecting appropriate material handling equipment among the given choices so that the automation level in material handling can be enhanced. This work is a practical case scenario of material handling systems in consumer electronic appliances manufacturing organization. The choices of material handling equipment among which the decision has to be made are Automated Guided Vehicle’s (AGV), Autonomous Mobile Robots (AMR), Overhead Conveyer’s (OC) and Battery Operated Trucks/Vehicle’s (BOT). There is a need of attaining a certain level of automation in order to reduce human interventions in the organization. This requirement of achieving certain degree of automation can be attained by material handling equipment’s mentioned above. The main motive for selecting above equipment’s for study was solely based on corporate financial strategy of investment and return obtained through that investment made in stipulated time framework. Since the low cost automation with respect to material handling devices has to be achieved hence these equipment’s were selected. Investment to be done on each unit of this equipment is less than 20 lakh rupees (INR) and the recovery period is less than that of five years. Fuzzy analytic hierarchic process (FAHP) is applied here for selecting equipment where the four choices are evaluated on basis of four major criteria’s and 13 sub criteria’s, and are prioritized on the basis of weight obtained. The FAHP used here make use of triangular fuzzy numbers (TFN). The inability of the traditional AHP in order to deal with the subjectiveness and impreciseness in the pair-wise comparison process has been improved in the FAHP. The range of values for general rating purposes for all decision making parameters is kept between 0 and 1 on the basis of expert opinions captured on shop floor. These experts were familiar with operating environment and shop floor activity control. Instead of generating exact value the FAHP generates the ranges of values to accommodate the uncertainty in decision-making process. The four major criteria’s selected for the evaluation of choices of material handling equipment’s available are materials, technical capabilities, cost and other features. The thirteen sub criteria’s listed under these following four major criteria’s are weighing capacity, load per hour, material compatibility, capital cost, operating cost and maintenance cost, speed, distance moved, space required, frequency of trips, control required, safety and reliability issues. The key finding shows that among the four major criteria selected, cost is emerged as the most important criteria and is one of the key decision making aspect on the basis of which material equipment selection is based on. While further evaluating the choices of equipment available for each sub criteria it is found that AGV scores the highest weight in most of the sub-criteria’s. On carrying out complete analysis the research shows that AGV is the best material handling equipment suiting all decision criteria’s selected in FAHP and therefore it is beneficial for the organization to carry out automated material handling in the facility using AGV’s.Keywords: fuzzy analytic hierarchy process (FAHP), material handling equipment, subjectiveness, triangular fuzzy number (TFN)
Procedia PDF Downloads 43029232 3D Numerical Simulation of Undoweled and Uncracked Joints in Short Paneled Concrete Pavements
Authors: K. Sridhar Reddy, M. Amaranatha Reddy, Nilanjan Mitra
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Short paneled concrete pavement (SPCP) with shorter panel size can be an alternative to the conventional jointed plain concrete pavements (JPCP) at the same cost as the asphalt pavements with all the advantages of concrete pavement with reduced thickness, less chance of mid-slab cracking and or dowel bar locking so common in JPCP. Cast-in-situ short concrete panels (short slabs) laid on a strong foundation consisting of a dry lean concrete base (DLC), and cement treated subbase (CTSB) will reduce the thickness of the concrete slab to the order of 180 mm to 220 mm, whereas JPCP was with 280 mm for the same traffic. During the construction of SPCP test sections on two Indian National Highways (NH), it was observed that the joints remain uncracked after a year of traffic. The undoweled and uncracked joints load transfer variability and joint behavior are of interest with anticipation on its long-term performance of the SPCP. To investigate the effects of undoweled and uncracked joints on short slabs, the present study was conducted. A multilayer linear elastic analysis using 3D finite element package for different panel sizes with different thicknesses resting on different types of solid elastic foundation with and without temperature gradient was developed. Surface deflections were obtained from 3D FE model and validated with measured field deflections from falling weight deflectometer (FWD) test. Stress analysis indicates that flexural stresses in short slabs are decreased with a decrease in panel size and increase in thickness. Detailed evaluation of stress analysis with the effects of curling behavior, the stiffness of the base layer and a variable degree of load transfer, is underway.Keywords: joint behavior, short slabs, uncracked joints, undoweled joints, 3D numerical simulation
Procedia PDF Downloads 17229231 The Relationships between Carbon Dioxide (CO2) Emissions, Energy Consumption and GDP for Israel: Time Series Analysis, 1980-2010
Authors: Jinhoa Lee
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The relationships between environmental quality, energy use and economic output have created growing attention over the past decades among researchers and policy makers. Focusing on the empirical aspects of the role of CO2 emissions and energy use in affecting the economic output, this paper is an effort to fulfill the gap in a comprehensive case study at a country level using modern econometric techniques. To achieve the goal, this country-specific study examines the short-run and long-run relationships among energy consumption (using disaggregated energy sources: crude oil, coal, natural gas, electricity), carbon dioxide (CO2) emissions and gross domestic product (GDP) for Israel using time series analysis from the year 1980-2010. To investigate the relationships between the variables, this paper employs the Phillips–Perron (PP) test for stationarity, Johansen maximum likelihood method for cointegration and a Vector Error Correction Model (VECM) for both short- and long-run causality among the research variables for the sample. The long-run equilibrium in the VECM suggests significant positive impacts of coal and natural gas consumptions on GDP in Israel. In the short run, GDP positively affects coal consumption. While there exists a positive unidirectional causality running from coal consumption to consumption of petroleum products and the direct combustion of crude oil, there exists a negative unidirectional causality running from natural gas consumption to consumption of petroleum products and the direct combustion of crude oil in the short run. Overall, the results support arguments that there are relationships among environmental quality, energy use and economic output but the associations can to be differed by the sources of energy in the case of Israel over of period 1980-2010.Keywords: CO2 emissions, energy consumption, GDP, Israel, time series analysis
Procedia PDF Downloads 64429230 Transcriptomic Analysis of Non-Alcoholic Fatty Liver Disease in Cafeteria Diet Induced Obese Rats
Authors: Mohammad Jamal
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Non-alcoholic fatty liver disease (NAFLD) has become one of the most chronic liver diseases, prevalent among people with morbid obesity. NAFLD does not develop clinically significant liver disease, however cirrhosis and liver cancer develop in subset and currently there are no approved therapies for the treatment of NAFLD. The study is aimed to understand the various key genes involved in the mechanism of NAFLD which can be valuable for developing diagnostic and predictive biomarkers based on their histologic stage of liver. The study was conducted on 16 male Sprague Dawley rats. The animals were divided in two groups: control group (n=8) fed on ad libitum normal chow and regular water and the cafeteria group (CAF)) (n=8) fed on high fatty/ carbohydrate diet. The animals received their respective diet from 4 weeks onwards from D.O.B until 25 weeks. Liver was extracted and RT² Profiler PCR Array was used to assess the NAFLD related genes. Histological evaluation was performed using H&E stain in liver tissue sections. Our PCR array results showed that genes involved in anti-inflammatory activity (Ifng, IL10), fatty acid uptake/oxidation (Fabp5), apoptosis (Fas), lipogenesis (Gck and Srebf1), Insulin signalling (Igfbp1) and metabolic pathway (pdk4) were upregulated in the liver of cafeteria fed obese rats. Bloated hepatocytes, displaced nucleus and higher lipid content were seen in the liver of cafeteria fed obese rats. Although Liver biopsies remain the gold standard in evaluating NAFLD, however an approach towards non-invasive markers could be used in understanding the physiology, therapeutic potential, and the targets to combat NAFLD.Keywords: biomarkers, cafeteria diet, obesity, NAFLD
Procedia PDF Downloads 13629229 Technology Optimization of Compressed Natural Gas Home Fast Refueling Units
Authors: Szymon Kuczynski, Krystian Liszka, Mariusz Laciak, Andrii Oliinyk, Robert Strods, Adam Szurlej
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Despіte all glоbal ecоnоmіc shіfts and the fact that Natural Gas іs recоgnіzed wоrldwіde as the maіn and the leadіng alternatіve tо оіl prоducts іn transpоrtatіоn sectоr, there іs a huge barrіer tо swіtch passenger vehіcle segment tо Natural gas - the lack оf refuelіng іnfrastructure fоr Natural Gas Vehіcles. Whіle іnvestments іn publіc gas statіоns requіre establіshed NGV market іn оrder tо be cоst effectіve, the market іs nоt there due tо lack оf refuelіng statіоns. The key tо sоlvіng that prоblem and prоvіdіng barrіer breakіng refuelіng іnfrastructure sоlutіоn fоr Natural Gas Vehіcles (NGV) іs Hоme Fast Refuelіng Unіts. Іt оperates usіng Natural Gas (Methane), whіch іs beіng prоvіded thrоugh gas pіpelіnes at clіents hоme, and electrіcіty cоnnectіоn pоіnt. Іt enables an envіrоnmentally frіendly NGV’s hоme refuelіng just іn mіnutes. The underlyіng technоlоgy іs a patented technоlоgy оf оne stage hydraulіc cоmpressоr (іnstead оf multіstage mechanіcal cоmpressоr technоlоgy avaіlable оn the market nоw) whіch prоvіdes the pоssіbіlіty tо cоmpress lоw pressure gas frоm resіdentіal gas grіd tо 200 bar fоr іts further usage as a fuel fоr NGVs іn the mоst ecоnоmіcally effіcіent and cоnvenіent fоr custоmer way. Descrіptіоn оf wоrkіng algоrіthm: Twо hіgh pressure cylіnders wіth upper necks cоnnected tо lоw pressure gas sоurce are placed vertіcally. Іnіtіally оne оf them іs fіlled wіth lіquіd and anоther оne – wіth lоw pressure gas. Durіng the wоrkіng prоcess lіquіd іs transferred by means оf hydraulіc pump frоm оne cylіnder tо anоther and back. Wоrkіng lіquіd plays a rоle оf pіstоns іnsіde cylіnders. Mоvement оf wоrkіng lіquіd іnsіde cylіnders prоvіdes sіmultaneоus suctіоn оf a pоrtіоn оf lоw pressure gas іntо оne оf the cylіnder (where lіquіd mоves dоwn) and fоrcіng оut gas оf hіgher pressure frоm anоther cylіnder (where lіquіd mоves up) tо the fuel tank оf the vehіcle / stоrage tank. Each cycle оf fоrcіng the gas оut оf the cylіnder rіses up the pressure оf gas іn the fuel tank оf a vehіcle wіth 2 cylіnders. The prоcess іs repeated untіl the pressure оf gas іn the fuel tank reaches 200 bar. Mоbіlіty has becоme a necessіty іn peоple’s everyday lіfe, whіch led tо оіl dependence. CNG Hоme Fast Refuelіng Unіts can become a part fоr exіstіng natural gas pіpelіne іnfrastructure and becоme the largest vehіcle refuelіng іnfrastructure. Hоme Fast Refuelіng Unіts оwners wіll enjоy day-tо-day tіme savіngs and cоnvenіence - Hоme Car refuelіng іn mіnutes, mоnth-tо-mоnth fuel cоst ecоnоmy, year-tо-year іncentіves and tax deductіbles оn NG refuelіng systems as per cоuntry, reduce CО2 lоcal emіssіоns, savіng cоsts and mоney.Keywords: CNG (compressed natural gas), CNG stations, NGVs (natural gas vehicles), natural gas
Procedia PDF Downloads 20029228 A Study on the Ideal and Actual Coping Responses of Public and Private College School Teachers on Job-Related Stress
Authors: Zaralyn Bernardo, Dante Boac, Annabelle Del Rosario
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Professional individuals who are in a primary role to impart learning with the new generation are alarmingly tend to have a vast decrease in their workforce due to stress at work. Thus, the study used mixed method research design to explore the ideal and actual coping patterns of college school teachers, both private and public, using Coping Response Inventory-Adult (CRI-Adult). It was suggested that in order for coping to be effective there must be a congruence or good match between coping efforts and preferred coping style. Results basically provided the same information on sources of teacher stress. However, workload and low salary were more likely heightened, for public and private school, respectively. There is also a significant difference between the ideal and actual coping style of college school teachers. Though the public school teachers leaned towards problem-focused as their ideal way of coping, both public and private teachers are somewhat inclined to use emotion-focused coping in actual situation. Results of FGD identified the factors that contribute to the incongruence or mismatch in their preferred style of coping and actual efforts to cope. Identified factors based on thematic analysis (TA) are clustered into themes such as affectivity and rehearsal of the preferred coping responses, sensitivity to pressure impairs coping efficacy, seeking for social acceptance and approval, indefinite appraisal of perceived stress, emotional dysregulation, and impulsivity, immediate desire to terminate negative emotion and adversity. Most of the factors somewhat provide partial elucidation on the engagement of the respondents on emotion-focused coping.Keywords: coping responses subtypes, appraisal, teacher stress, ideal and actual coping
Procedia PDF Downloads 15729227 Modeling of Building a Conceptual Scheme for Multimodal Freight Transportation Information System
Authors: Gia Surguladze, Nino Topuria, Lily Petriashvili, Giorgi Surguladze
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Modeling of building processes of a multimodal freight transportation support information system is discussed based on modern CASE technologies. Functional efficiencies of ports in the eastern part of the Black Sea are analyzed taking into account their ecological, seasonal, resource usage parameters. By resources, we mean capacities of berths, cranes, automotive transport, as well as work crews and neighbouring airports. For the purpose of designing database of computer support system for Managerial (Logistics) function, using Object-Role Modeling (ORM) tool (NORMA – Natural ORM Architecture) is proposed, after which Entity Relationship Model (ERM) is generated in automated process. The software is developed based on Process-Oriented and Service-Oriented architecture, in Visual Studio.NET environment.Keywords: seaport resources, business-processes, multimodal transportation, CASE technology, object-role model, entity relationship model, SOA
Procedia PDF Downloads 42429226 Enhancing Rural Agricultural Value Chains through Electric Mobility Services in Ethiopia
Authors: Clemens Pizzinini, Philipp Rosner, David Ziegler, Markus Lienkamp
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Transportation is a constitutional part of most supply and value chains in modern economies. Smallholder farmers in rural Ethiopia face severe challenges along their supply and value chains. In particular, suitable, affordable, and available transport services are in high demand. To develop a context-specific technical solutions, a problem-to-solution methodology based on the interaction with technology is developed. With this approach, we fill the gap between proven transportation assessment frameworks and general user-centered techniques. Central to our approach is an electric test vehicle that is implemented in rural supply and value chains for research, development, and testing. Based on our objective and the derived methodological requirements, a set of existing methods is selected. Local partners are integrated into an organizational framework that executes major parts of this research endeavour in the Arsi Zone, Oromia Region, Ethiopia.Keywords: agricultural value chain, participatory methods, agile methods, sub-Saharan Africa, Ethiopia, electric vehicle, transport service
Procedia PDF Downloads 6429225 Optical Repeater Assisted Visible Light Device-to-Device Communications
Authors: Samrat Vikramaditya Tiwari, Atul Sewaiwar, Yeon-Ho Chung
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Device-to-device (D2D) communication is considered a promising technique to provide wireless peer-to-peer communication services. Due to increasing demand on mobile services, available spectrum for radio frequency (RF) based communications becomes scarce. Recently, visible light communications (VLC) has evolved as a high speed wireless data transmission technology for indoor environments with abundant available bandwidth. In this paper, a novel VLC based D2D communication that provides wireless peer-to-peer communication is proposed. Potential low operating power devices for an efficient D2D communication over increasing distance of separation between devices is analyzed. Optical repeaters (OR) are also proposed to enhance the performance in an environment where direct D2D communications yield degraded performance. Simulation results show that VLC plays an important role in providing efficient D2D communication up to a distance of 1 m between devices. It is also found that the OR significantly improves the coverage distance up to 3.5 m.Keywords: visible light communication, light emitting diode, device-to-device, optical repeater
Procedia PDF Downloads 47329224 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana
Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey
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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy
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