Search results for: continuous care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5695

Search results for: continuous care

3535 The Role and Challenges of Social Workers in Child Protection: The Case of Indonesia

Authors: B. Rusyidi

Abstract:

Since 2009, the Indonesian Ministry of Social Affairs has been implementing Program Kesejahteraan Sosial Anak (PKSA) (Child Welfare Program) a conditional cash transfer program that targets neglected children, children with disabilities, street children, children in conflict with the law, and children in need of special protection, all from poor households. PKSA integrates three elements: Transfer of cash, care and social services through social workers, and institutional childcare assistance. This qualitative study analyzed the roles and the challenges of social workers in implementing PKSA and lays out recommendations to inform policy changes. Data were collected in late 2014 from national and local government and non-government child welfare agencies, social workers, and childcare institution representatives through interviews and Focused Group Discussions (FGDs). Field work took place in six districts in the provinces of Jakarta, Central Java and South Sulawesi. The study found that the social workers’ role was significant in facilitating cash transfer, providing education and guidance, and linking children and families to basic social services. This improved utilization of basic social services enhanced children and families’ behaviors and contributed to the well being of the children. However, only a small number of childcare institutions have social workers, leaving many children and families without care and social service linkages, depriving them of rehabilitative components to help them regain their social functions. Some social workers reported their struggles with heavy workloads, lack of professional competencies and training, limited job security, and inadequate professional acknowledgment from other professions. Parts of those challenges were due to the centralized nature of the program and the lack of shared vision and commitment about the child protection system among related government agencies both at the national and local levels. The study highlights the necessity to implement an integrated child protection system, decentralize the PKSA program, and increase the number, competence, case management, and management and monitoring of social workers. The most recent progress of the program and its impacts on social workers are also discussed.

Keywords: child protection, conditional cash transfer, program decentralization, social worker, working conditions

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3534 Mapping Context, Roles, and Relations for Adjudicating Robot Ethics

Authors: Adam J. Bowen

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Abstract— Should robots have rights or legal protections. Often debates concerning whether robots and AI should be afforded rights focus on conditions of personhood and the possibility of future advanced forms of AI satisfying particular intrinsic cognitive and moral attributes of rights-holding persons. Such discussions raise compelling questions about machine consciousness, autonomy, and value alignment with human interests. Although these are important theoretical concerns, especially from a future design perspective, they provide limited guidance for addressing the moral and legal standing of current and near-term AI that operate well below the cognitive and moral agency of human persons. Robots and AI are already being pressed into service in a wide range of roles, especially in healthcare and biomedical contexts. The design and large-scale implementation of robots in the context of core societal institutions like healthcare systems continues to rapidly develop. For example, we bring them into our homes, hospitals, and other care facilities to assist in care for the sick, disabled, elderly, children, or otherwise vulnerable persons. We enlist surgical robotic systems in precision tasks, albeit still human-in-the-loop technology controlled by surgeons. We also entrust them with social roles involving companionship and even assisting in intimate caregiving tasks (e.g., bathing, feeding, turning, medicine administration, monitoring, transporting). There have been advances to enable severely disabled persons to use robots to feed themselves or pilot robot avatars to work in service industries. As the applications for near-term AI increase and the roles of robots in restructuring our biomedical practices expand, we face pressing questions about the normative implications of human-robot interactions and collaborations in our collective worldmaking, as well as the moral and legal status of robots. This paper argues that robots operating in public and private spaces be afforded some protections as either moral patients or legal agents to establish prohibitions on robot abuse, misuse, and mistreatment. We already implement robots and embed them in our practices and institutions, which generates a host of human-to-machine and machine-to-machine relationships. As we interact with machines, whether in service contexts, medical assistance, or home health companions, these robots are first encountered in relationship to us and our respective roles in the encounter (e.g., surgeon, physical or occupational therapist, recipient of care, patient’s family, healthcare professional, stakeholder). This proposal aims to outline a framework for establishing limiting factors and determining the extent of moral or legal protections for robots. In doing so, it advocates for a relational approach that emphasizes the priority of mapping the complex contextually sensitive roles played and the relations in which humans and robots stand to guide policy determinations by relevant institutions and authorities. The relational approach must also be technically informed by the intended uses of the biomedical technologies in question, Design History Files, extensive risk assessments and hazard analyses, as well as use case social impact assessments.

Keywords: biomedical robots, robot ethics, robot laws, human-robot interaction

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3533 Colour and Curcuminoids Removal from Turmeric Wastewater Using Activated Carbon Adsorption

Authors: Nattawat Thongpraphai, Anusorn Boonpoke

Abstract:

This study aimed to determine the removal of colour and curcuminoids from turmeric wastewater using granular activated carbon (GAC) adsorption. The adsorption isotherm and kinetic behavior of colour and curcuminoids was invested using batch and fixed bed columns tests. The results indicated that the removal efficiency of colour and curcuminoids were 80.13 and 78.64%, respectively at 8 hr of equilibrium time. The adsorption isotherm of colour and curcuminoids were well fitted with the Freundlich adsorption model. The maximum adsorption capacity of colour and curcuminoids were 130 Pt-Co/g and 17 mg/g, respectively. The continuous experiment data showed that the exhaustion concentration of colour and curcuminoids occurred at 39 hr of operation time. The adsorption characteristic of colour and curcuminoids from turmeric wastewater by GAC can be described by the Thomas model. The maximum adsorption capacity obtained from kinetic approach were 39954 Pt-Co/g and 0.0516 mg/kg for colour and curcuminoids, respectively. Moreover, the decrease of colour and curcuminoids concentration during the service time showed a similar trend.

Keywords: adsorption, turmeric, colour, curcuminoids, activated carbon

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3532 Mixtures of Length-Biased Weibull Distributions for Loss Severity Modelling

Authors: Taehan Bae

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In this paper, a class of length-biased Weibull mixtures is presented to model loss severity data. The proposed model generalizes the Erlang mixtures with the common scale parameter, and it shares many important modelling features, such as flexibility to fit various data distribution shapes and weak-denseness in the class of positive continuous distributions, with the Erlang mixtures. We show that the asymptotic tail estimate of the length-biased Weibull mixture is Weibull-type, which makes the model effective to fit loss severity data with heavy-tailed observations. A method of statistical estimation is discussed with applications on real catastrophic loss data sets.

Keywords: Erlang mixture, length-biased distribution, transformed gamma distribution, asymptotic tail estimate, EM algorithm, expectation-maximization algorithm

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3531 Technological Development and Implementation of a Robotic Arm Motioned by Programmable Logic Controller

Authors: J. G. Batista, L. J. de Bessa Neto, M. A. F. B. Lima, J. R. Leite, J. I. de Andrade Nunes

Abstract:

The robot manipulator is an equipment that stands out for two reasons: Firstly because of its characteristics of movement and reprogramming, resembling the arm; secondly, by adding several areas of knowledge of science and engineering. The present work shows the development of the prototype of a robotic manipulator driven by a Programmable Logic Controller (PLC), having two degrees of freedom, which allows the movement and displacement of mechanical parts, tools, and objects in general of small size, through an electronic system. The aim is to study direct and inverse kinematics of the robotic manipulator to describe the translation and rotation between two adjacent links of the robot through the Denavit-Hartenberg parameters. Currently, due to the many resources that microcomputer systems offer us, robotics is going through a period of continuous growth that will allow, in a short time, the development of intelligent robots with the capacity to perform operations that require flexibility, speed and precision.

Keywords: Denavit-Hartenberg, direct and inverse kinematics, microcontrollers, robotic manipulator

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3530 Chronic Impact of Silver Nanoparticle on Aerobic Wastewater Biofilm

Authors: Sanaz Alizadeh, Yves Comeau, Arshath Abdul Rahim, Sunhasis Ghoshal

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The application of silver nanoparticles (AgNPs) in personal care products, various household and industrial products has resulted in an inevitable environmental exposure of such engineered nanoparticles (ENPs). Ag ENPs, released via household and industrial wastes, reach water resource recovery facilities (WRRFs), yet the fate and transport of ENPs in WRRFs and their potential risk in the biological wastewater processes are poorly understood. Accordingly, our main objective was to elucidate the impact of long-term continuous exposure to AgNPs on biological activity of aerobic wastewater biofilm. The fate, transport and toxicity of 10 μg.L-1and 100 μg.L-1 PVP-stabilized AgNPs (50 nm) were evaluated in an attached growth biological treatment process, using lab-scale moving bed bioreactors (MBBRs). Two MBBR systems for organic matter removal were fed with a synthetic influent and operated at a hydraulic retention time (HRT) of 180 min and 60% volumetric filling ratio of Anox-K5 carriers with specific surface area of 800 m2/m3. Both reactors were operated for 85 days after reaching steady state conditions to develop a mature biofilm. The impact of AgNPs on the biological performance of the MBBRs was characterized over a period of 64 days in terms of the filtered biodegradable COD (SCOD) removal efficiency, the biofilm viability and key enzymatic activities (α-glucosidase and protease). The AgNPs were quantitatively characterized using single-particle inductively coupled plasma mass spectroscopy (spICP-MS), determining simultaneously the particle size distribution, particle concentration and dissolved silver content in influent, bioreactor and effluent samples. The generation of reactive oxygen species and the oxidative stress were assessed as the proposed toxicity mechanism of AgNPs. Results indicated that a low concentration of AgNPs (10 μg.L-1) did not significantly affect the SCOD removal efficiency whereas a significant reduction in treatment efficiency (37%) was observed at 100 μg.L-1AgNPs. Neither the viability nor the enzymatic activities of biofilm were affected at 10 μg.L-1AgNPs but a higher concentration of AgNPs induced cell membrane integrity damage resulting in 31% loss of viability and reduced α-glucosidase and protease enzymatic activities by 31% and 29%, respectively, over the 64-day exposure period. The elevated intercellular ROS in biofilm at a higher AgNPs concentration over time was consistent with a reduced biological biofilm performance, confirming the occurrence of a nanoparticle-induced oxidative stress in the heterotrophic biofilm. The spICP-MS analysis demonstrated a decrease in the nanoparticles concentration over the first 25 days, indicating a significant partitioning of AgNPs into the biofilm matrix in both reactors. The concentration of nanoparticles increased in effluent of both reactors after 25 days, however, indicating a decreased retention capacity of AgNPs in biofilm. The observed significant detachment of biofilm also contributed to a higher release of nanoparticles due to cell-wall destabilizing properties of AgNPs as an antimicrobial agent. The removal efficiency of PVP-AgNPs and the biofilm biological responses were a function of nanoparticle concentration and exposure time. This study contributes to a better understanding of the fate and behavior of AgNPs in biological wastewater processes, providing key information that can be used to predict the environmental risks of ENPs in aquatic ecosystems.

Keywords: biofilm, silver nanoparticle, single particle ICP-MS, toxicity, wastewater

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3529 Comparison of Cu Nanoparticle Formation and Properties with and without Surrounding Dielectric

Authors: P. Dubcek, B. Pivac, J. Dasovic, V. Janicki, S. Bernstorff

Abstract:

When grown only to nanometric sizes, metallic particles (e.g. Ag, Au and Cu) exhibit specific optical properties caused by the presence of plasmon band. The plasmon band represents collective oscillation of the conduction electrons, and causes a narrow band absorption of light in the visible range. When the nanoparticles are embedded in a dielectric, they also cause modifications of dielectrics optical properties. This can be fine-tuned by tuning the particle size. We investigated Cu nanoparticle growth with and without surrounding dielectric (SiO2 capping layer). The morphology and crystallinity were investigated by GISAXS and GIWAXS, respectively. Samples were produced by high vacuum thermal evaporation of Cu onto monocrystalline silicon substrate held at room temperature, 100°C or 180°C. One series was in situ capped by 10nm SiO2 layer. Additionally, samples were annealed at different temperatures up to 550°C, also in high vacuum. The room temperature deposited samples annealed at lower temperatures exhibit continuous film structure: strong oscillations in the GISAXS intensity are present especially in the capped samples. At higher temperatures enhanced surface dewetting and Cu nanoparticles (nanoislands) formation partially destroy the flatness of the interface. Therefore the particle type of scattering is enhanced, while the film fringes are depleted. However, capping layer hinders particle formation, and continuous film structure is preserved up to higher annealing temperatures (visible as strong and persistent fringes in GISAXS), compared to the non- capped samples. According to GISAXS, lateral particle sizes are reduced at higher temperatures, while particle height is increasing. This is ascribed to close packing of the formed particles at lower temperatures, and GISAXS deduced sizes are partially the result of the particle agglomerate dimensions. Lateral maxima in GISAXS are an indication of good positional correlation, and the particle to particle distance is increased as the particles grow with temperature elevation. This coordination is much stronger in the capped and lower temperature deposited samples. The dewetting is much more vigorous in the non-capped sample, and since nanoparticles are formed in a range of sizes, correlation is receding both with deposition and annealing temperature. Surface topology was checked by atomic force microscopy (AFM). Capped sample's surfaces were smoother and lateral size of the surface features were larger compared to the non-capped samples. Altogether, AFM results suggest somewhat larger particles and wider size distribution, and this can be attributed to the difference in probe size. Finally, the plasmonic effect was monitored by UV-Vis reflectance spectroscopy, and relative weak plasmonic effect could be explained by uncomplete dewetting or partial interconnection of the formed particles.

Keywords: coper, GISAXS, nanoparticles, plasmonics

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3528 A Qualitative Study to Explore the Social Perception and Stigma around Disability, and Its Impact on the Caring Experiences of Mothers of Children with Physical Disability in Bangladesh

Authors: Farjina Malek, Julie King, Niki Edwards

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Across the globe more than a billion people live with a disability and a further billion people, mostly carers, are indirectly impacted. While prevalence data is problematic, it is estimated that more than 15% of the population in Bangladesh live with a disability. Disability service infrastructure in Bangladesh is under-developed; and consequently, the onus of care falls on family, especially on mothers. Within the caring role, mothers encounter many challenging experiences which are not only due to the lack of support delivered through the Bangladeshi health care system but also related to the existence of stigma and perception around disability in the Bangladeshi society. Within this perception, the causes of disability are mostly associated with 'God’s will'; 'possession of ghosts on the disabled person'; and 'karma or the result of past sins of the family members especially the mothers'. These beliefs are likely to have a significant impact on the well-being of mothers and their caring experience of children with disability. This is an ongoing qualitative study which is conducting in-depth interviews with 30 mothers from five districts (Dhaka, Mymensingh, Manikganj, Tangail, and Gazipur) of Bangladesh with the aim to explore the impact of social perception and stigma around physical disability on the caring role of the mothers of children with physical disability. The major findings of this study show that the social perception around disability and the social expectation from a mother regarding her caring role have a huge impact on the well-being of mothers. Mothers are mostly expected to take their child on their lap to prove that they are ‘good mother’. These practices of lifting their children with physical disability and keeping them on the lap for a long time often cause chronic back pain of the mothers. Existing social beliefs consider disability as a ‘curse’ and punishment for the ‘sins’ of the family members, most often by the mother. Mothers are blamed if they give birth to ‘abnormal’ children. This social construction creates stigma, and thus, the caring responsibility of mothers become more challenging. It also encourages the family and mothers to hide their children from the society and to avoid seeking accessible disability services. The mothers also compromise their careers and social interaction as they have to stay with their children at home, and that has a significant impact on personal wellbeing, income, and empowerment of the mothers. The research is informed by intersectional theory and employed an interpretive phenomenological methodology to explore mothers’ experience of caring their children with physical disability, and the contribution and impact of key relationships within the family and the intersection with community and services.

Keywords: mother, family carer, physical disability, children, social stigma, key relationship

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3527 Local Religion 'Parmalim': Between Civilization and Faith

Authors: Sabrina Yulianti

Abstract:

This study aims to explain the identity struggles of local religious communities in Indonesia. Local religion in Indonesia is not recognized by the government and is not incorporated into the official religion in Indonesia. This makes the local religions in Indonesia experienced the challenges and obstacles in fulfilling their rights as citizens of Indonesia. Challenges and barriers they experience such as: difficulty in making of the birth certificate and marriage. It is as experienced by one of the local religions namely Parmalim which located in North Sumatra. Not only difficulty in taking care of the bureaucracy as a citizen, but the local religion is seen as a minority and sometimes regarded as follower of deviate religion.

Keywords: local religion, faith, struggles, civilization, discrimination

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3526 The Imperative of Indigenous Entrepreneurship and Sustainable Development in the Globalized Economy

Authors: Innocent Felix Idoko

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The development of indigenous entrepreneurship is critical to the achievement of sustainable development in the internationalized economy. Sustainable development implies a continuous stimulus of growth and improvement of an economy in a fairly stable manner. The paradigms of a globalization are numerous to mention. However, to a great extent, these are trade-offs and dilemmas for indigenous entrepreneurship, particularly in the developing economies with infant industries that are essentially crucial to development. This paper analyses the pros and cons of globalization as relates to the complementary role of both foreign and indigenous entrepreneurs, the conflict of values between globalization and protectionism for local entrepreneurship. Using analytical and descriptive approach, the views of academicians, research fellows, literature reviews and both the theories of the mercantilists and those of free trade mainstream economists, and the G20, the paper concludes that there is a legitimate need for protectionism for domestic entrepreneurship in the developing economies as doing otherwise amount to stifling them.

Keywords: developing countries, entrepreneurship, globalization, infant-industries, protectionism, sustainable development

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3525 Influence of Different Asymmetric Rolling Processes on Shear Strain

Authors: Alexander Pesin, Denis Pustovoytov, Mikhail Sverdlik

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Materials with ultrafine-grained structure and unique physical and mechanical properties can be obtained by methods of severe plastic deformation, which include processes of asymmetric rolling (AR). Asymmetric rolling is a very effective way to create ultrafine-grained structures of metals and alloys. Since the asymmetric rolling is a continuous process, it has great potential for industrial production of ultrafine-grained structure sheets. Basic principles of asymmetric rolling are described in detail in scientific literature. In this work finite element modeling of asymmetric rolling and metal forming processes in multiroll gauge was performed. Parameters of the processes which allow achieving significant values of shear strain were defined. The results of the study will be useful for the research of the evolution of ultra-fine metal structure in asymmetric rolling.

Keywords: asymmetric rolling, equivalent strain, FEM, multiroll gauge, profile, severe plastic deformation, shear strain, sheet

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3524 Hydrodynamic Analysis with Heat Transfer in Solid Gas Fluidized Bed Reactor for Solar Thermal Applications

Authors: Sam Rasoulzadeh, Atefeh Mousavi

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Fluidized bed reactors are known as highly exothermic and endothermic according to uniformity in temperature as a safe and effective mean for catalytic reactors. In these reactors, a wide range of catalyst particles can be used and by using a continuous operation proceed to produce in succession. Providing optimal conditions for the operation of these types of reactors will prevent the exorbitant costs necessary to carry out laboratory work. In this regard, a hydrodynamic analysis was carried out with heat transfer in the solid-gas fluidized bed reactor for solar thermal applications. The results showed that in the fluid flow the input of the reactor has a lower temperature than the outlet, and when the fluid is passing from the reactor, the heat transfer happens between cylinder and solar panel and fluid. It increases the fluid temperature in the outlet pump and also the kinetic energy of the fluid has been raised in the outlet areas.

Keywords: heat transfer, solar reactor, fluidized bed reactor, CFD, computational fluid dynamics

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3523 Modeling the Transport of Charge Carriers in the Active Devices MESFET Based of GaInP by the Monte Carlo Method

Authors: N. Massoum, A. Guen. Bouazza, B. Bouazza, A. El Ouchdi

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The progress of industry integrated circuits in recent years has been pushed by continuous miniaturization of transistors. With the reduction of dimensions of components at 0.1 micron and below, new physical effects come into play as the standard simulators of two dimensions (2D) do not consider. In fact the third dimension comes into play because the transverse and longitudinal dimensions of the components are of the same order of magnitude. To describe the operation of such components with greater fidelity, we must refine simulation tools and adapted to take into account these phenomena. After an analytical study of the static characteristics of the component, according to the different operating modes, a numerical simulation is performed of field-effect transistor with submicron gate MESFET GaInP. The influence of the dimensions of the gate length is studied. The results are used to determine the optimal geometric and physical parameters of the component for their specific applications and uses.

Keywords: Monte Carlo simulation, transient electron transport, MESFET device, GaInP

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3522 Risk Assessment Tools Applied to Deep Vein Thrombosis Patients Treated with Warfarin

Authors: Kylie Mueller, Nijole Bernaitis, Shailendra Anoopkumar-Dukie

Abstract:

Background: Vitamin K antagonists particularly warfarin is the most frequently used oral medication for deep vein thrombosis (DVT) treatment and prophylaxis. Time in therapeutic range (TITR) of the international normalised ratio (INR) is widely accepted as a measure to assess the quality of warfarin therapy. Multiple factors can affect warfarin control and the subsequent adverse outcomes including thromboembolic and bleeding events. Predictor models have been developed to assess potential contributing factors and measure the individual risk of these adverse events. These predictive models have been validated in atrial fibrillation (AF) patients, however, there is a lack of literature on whether these can be successfully applied to other warfarin users including DVT patients. Therefore, the aim of the study was to assess the ability of these risk models (HAS BLED and CHADS2) to predict haemorrhagic and ischaemic incidences in DVT patients treated with warfarin. Methods: A retrospective analysis of DVT patients receiving warfarin management by a private pathology clinic was conducted. Data was collected from November 2007 to September 2014 and included demographics, medical and drug history, INR targets and test results. Patients receiving continuous warfarin therapy with an INR reference range between 2.0 and 3.0 were included in the study with mean TITR calculated using the Rosendaal method. Bleeding and thromboembolic events were recorded and reported as incidences per patient. The haemorrhagic risk model HAS BLED and ischaemic risk model CHADS2 were applied to the data. Patients were then stratified into either the low, moderate, or high-risk categories. The analysis was conducted to determine if a correlation existed between risk assessment tool and patient outcomes. Data was analysed using GraphPad Instat Version 3 with a p value of <0.05 considered to be statistically significant. Patient characteristics were reported as mean and standard deviation for continuous data and categorical data reported as number and percentage. Results: Of the 533 patients included in the study, there were 268 (50.2%) female and 265 (49.8%) male patients with a mean age of 62.5 years (±16.4). The overall mean TITR was 78.3% (±12.7) with an overall haemorrhagic incidence of 0.41 events per patient. For the HAS BLED model, there was a haemorrhagic incidence of 0.08, 0.53, and 0.54 per patient in the low, moderate and high-risk categories respectively showing a statistically significant increase in incidence with increasing risk category. The CHADS2 model showed an increase in ischaemic events according to risk category with no ischaemic events in the low category, and an ischaemic incidence of 0.03 in the moderate category and 0.47 high-risk categories. Conclusion: An increasing haemorrhagic incidence correlated to an increase in the HAS BLED risk score in DVT patients treated with warfarin. Furthermore, a greater incidence of ischaemic events occurred in patients with an increase in CHADS2 category. In an Australian population of DVT patients, the HAS BLED and CHADS2 accurately predicts incidences of haemorrhage and ischaemic events respectively.

Keywords: anticoagulant agent, deep vein thrombosis, risk assessment, warfarin

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3521 Factors Associated with Death during Tuberculosis Treatment of Patients Co-Infected with HIV at a Tertiary Care Setting in Cameroon: An 8-Year Hospital-Based Retrospective Cohort Study (2006-2013)

Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

Abstract:

Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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3520 Nutrient Removal and Microalgal Biomass Growth of Chlorella Vulgaris in Response to Centrate Wastewater Loadings

Authors: Lingfeng Wang, Zhipeng Chen, Shuang Qiu, Shijian Ge

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The effects of wastewater, with four different nutrient loadings, from synthetic centrate on biomass production of Chlorella vulgaris, nutrient removal, microalgal settling, and lipid production were investigated in photobioreactors under both batches and, subsequently, semi-continuous operations. At higher centrate concentration factors (17.2% and 36.2%), hydraulic retention time and pH adjustments could be employed to sustain acceptable microalgal growth rates and wastewater treatment. Similar nutrient removals efficiencies (>95%) and biomass production (0.42-0.51 g/L) were observed for the four centrate concentrations. Both the lipid productivity and lipid content decreased with increasing nutrient loading in the wastewater. The results also demonstrated that the mass ratio of carbohydrate to protein could provide a good indication of microalgal settling performance, rather than sole component composition or total extracellular polymeric substances.

Keywords: lipid production, microalgae, nutrient removal, wastewater

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3519 Correlation between Nutritional Status and Length of Stay and Hospital Costs in Critical Care and IPD Patients of Somdech Phra Debaratana Medical Center (SDMC), Faculty of Medicine, Ramathibodi Hospital

Authors: Nuttapimon Bhirommuang, Kulapong Jayanama

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Background: Prevalence of malnutrition in hospitalized patient is higher than general population. As a result of the unawareness of consequence and the more concerning in the other aspects of care, many patients with high risk of malnutrition are unrecognized. Even if malnutrition has been identified as affecting in many patient outcomes, the impact may differ in each population and group of patients. Objectives: The aims of this study were to examine the association between the nutritional status and the length of stay and hospital costs in hospitalized patients, to investigate the factors related these outcomes and to determine the frequency of malnutrition in hospitals. Method: This retrospective cohort study enrolled all patients aged 15 years old or older and admitted in SDMC, Ramathibodi Hospital between 1st January 2016 and 30th September 2016. The nutritional status assessment by Nutrition Alert Form (NAF) was performed by well-trained nurses in all patients at admission. Baseline characteristics were recorded. Length of stay and hospital costs were collected during their hospitalization. Univariate analysis, nonparametric rank test, Kruskal-Wallis test were used to compare means in the case of nonnormally and noncontinuously distributed data. Chi-square used to analyze categorical variables, the nutritional status and the length of stay and hospital costs and identify possible confounding factors (data were analyzed using SPSS version 18.0). Result: Of the 2,906 patients, 3.9% were severe malnutrition (NAF-C score > 10) and 11.4% were moderate malnutrition (NAF-B score 6 - 10). Both length of stay and hospital costs were found significantly higher in more severe malnutrition group (p < 0.001), NAF = A: 3.21 days, 95% CI 3.06-3.35 and 111,544.25 THB, 95% CI 106,994.41 – 116,094.1; NAF = B: 7.54 days, 95% CI 6.32 – 8.76 and 162,302.4 THB, 95% CI 129,557.88 – 195,046.92; NAF =C: 14.77 days, 95% CI 11.34 – 18.2 and 323,572.11 THB, 95% CI 226,958.1 – 420,096.13 (1 THB = 0.03019 USD). Age of each nutritional status group had also significant increase from NAF A to NAF C (p < 0.001): 55.07, 67.03 and 73.88 years old, respectively. Conclusion: The prevalence of malnutrition in Ramathibodi hospital is voluminous. Severe malnutrition screening by NAF is significantly correlated with worse clinical outcome, especially higher length of stay and hospital costs. Elderly is also a significant factor which correlates with malnutrition. The results of this study could change the awareness of health personnel and the practice protocol. Moreover, the further study concerning nutritional support in high-risk group of malnutrition is ongoing to confirm this hypothesis.

Keywords: malnutrition, NAF, length of stay, hospital costs

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3518 Impact of Ethiopia's Productive Safety Net Program on Household Dietary Diversity and Child Nutrition in Rural Ethiopia

Authors: Tagel Gebrehiwot, Carolina Castilla

Abstract:

Food insecurity and child malnutrition are among the most critical issues in Ethiopia. Accordingly, different reform programs have been carried to improve household food security. The Food Security Program (FSP) (among others) was introduced to combat the persistent food insecurity problem in the country. The FSP combines a safety net component called the Productive Safety Net Program (PSNP) started in 2005. The goal of PSNP is to offer multi-annual transfers, such as food, cash or a combination of both to chronically food insecure households to break the cycle of food aid. Food or cash transfers are the main elements of PSNP. The case for cash transfers builds on the Sen’s analysis of ‘entitlement to food’, where he argues that restoring access to food by improving demand is a more effective and sustainable response to food insecurity than food aid. Cash-based schemes offer a greater choice of use of the transfer and can allow a greater diversity of food choice. It has been proven that dietary diversity is positively associated with the key pillars of food security. Thus, dietary diversity is considered as a measure of household’s capacity to access a variety of food groups. Studies of dietary diversity among Ethiopian rural households are somewhat rare and there is still a dearth of evidence on the impact of PSNP on household dietary diversity. In this paper, we examine the impact of the Ethiopia’s PSNP on household dietary diversity and child nutrition using panel household surveys. We employed different methodologies for identification. We exploit the exogenous increase in kebeles’ PSNP budget to identify the effect of the change in the amount of money households received in transfers between 2012 and 2014 on the change in dietary diversity. We use three different approaches to identify this effect: two-stage least squares, reduced form IV, and generalized propensity score matching using a continuous treatment. The results indicate the increase in PSNP transfers between 2012 and 2014 had no effect on household dietary diversity. Estimates for different household dietary indicators reveal that the effect of the change in the cash transfer received by the household is statistically and economically insignificant. This finding is robust to different identification strategies and the inclusion of control variables that determine eligibility to become a PSNP beneficiary. To identify the effect of PSNP participation on children height-for-age and stunting we use a difference-in-difference approach. We use children between 2 and 5 in 2012 as a baseline because by then they have achieved long-term failure to grow. The treatment group comprises children ages 2 to 5 in 2014 in PSNP participant households. While changes in height-for-age take time, two years of additional transfers among children who were not born or under the age of 2-3 in 2012 have the potential to make a considerable impact on reducing the prevalence of stunting. The results indicate that participation in PSNP had no effect on child nutrition measured as height-for-age or probability of beings stunted, suggesting that PSNP should be designed in a more nutrition-sensitive way.

Keywords: continuous treatment, dietary diversity, impact, nutrition security

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3517 A Patient Passport Application for Adults with Cystic Fibrosis

Authors: Tamara Vagg, Cathy Shortt, Claire Hickey, Joseph A. Eustace, Barry J. Plant, Sabin Tabirca

Abstract:

Introduction: Paper-based patient passports have been used advantageously for older patients, patients with diabetes, and patients with learning difficulties. However, these passports can experience issues with data security, patients forgetting to bring the passport, patients being over encumbered, and uncertainty with who is responsible for entering and managing data in this passport. These issues could be resolved by transferring the paper-based system to a convenient platform such as a smartphone application (app). Background: Life expectancy for some Cystic Fibrosis (CF) patients are rising and as such new complications and procedures are predicted. Subsequently, there is a need for education and management interventions that can benefit CF adults. This research proposes a CF patient passport to record basic medical information through a smartphone app which will allow CF adults access to their basic medical information. Aim: To provide CF patients with their basic medical information via mobile multimedia so that they can receive care when traveling abroad or between CF centres. Moreover, by recording their basic medical information, CF patients may become more aware of their own condition and more active in their health care. Methods: This app is designed by a CF multidisciplinary team to be a lightweight reflection of a hospital patient file. The passport app is created using PhoneGap so that it can be deployed for both Android and iOS devices. Data entered into the app is encrypted and stored locally only. The app is password protected and includes the ability to set reminders and a graph to visualise weight and lung function over time. The app is introduced to seven participants as part of a stress test. The participants are asked to test the performance and usability of the app and report any issues identified. Results: Feedback and suggestions received via this testing include the ability to reorder the list of clinical appointments via date, an open format of recording dates (in the event specifics are unknown), and a drop down menu for data which is difficult to enter (such as bugs found in mucus). The app is found to be usable and accessible and is now being prepared for a pilot study with adult CF patients. Conclusions: It is anticipated that such an app will be beneficial to CF adult patients when travelling abroad and between CF centres.

Keywords: Cystic Fibrosis, digital patient passport, mHealth, self management

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3516 A Review of Quantitative Psychology in Our Life

Authors: Shubham Tandon, Rajni Goel

Abstract:

The prime objective of our review paper is to study the quantitative psychology impact on our daily life. Quantitative techniques have been studied with the aim of discovering solutions in an advanced way. To get the unbiased and correct results, statistics and other useful mathematical aspects have been reviewed. So, many psychologists use quantitative techniques while working in the area of psychology with the aim of discovering solutions in an advanced way. This ensures their accurate outcomes as those will make use of precise criteria in knowing the minds and conditions of any person. Also, proper experimentation and observational tools are taken care of to avoid some possibilities of invalid data.

Keywords: quantitative psychology, psychologists, statistics, person, results, minds

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3515 The Effect of Immobilization Conditions on Hydrogen Production from Palm Oil Mill Effluent

Authors: A. W. Zularisam, Lakhveer Singh, Mimi Sakinah Abdul Munaim

Abstract:

In this study, the optimization of hydrogen production using polyethylene glycol (PEG) immobilized sludge was investigated in batch tests. Palm oil mill effluent (POME) is used as a substrate that can act as a carbon source. Experiment focus on the effect of some important affecting factors on fermentative hydrogen production. Results showed that immobilized sludge demonstrated the maximum hydrogen production rate of 340 mL/L-POME/h under follow optimal condition: amount of biomass 10 mg VSS/ g bead, PEG concentration 10%, and cell age 24 h or 40 h. More importantly, immobilized sludge not only enhanced hydrogen production but can also tolerate the harsh environment and produce hydrogen at the wide ranges of pH. The present results indicate the potential of PEG-immobilized sludge for large-scale operations as well; these factors play an important role in stable and continuous hydrogen production.

Keywords: bioydrogen, immobilization, polyethylene glycol, palm oil mill effluent, dark fermentation

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3514 The Evaluation of Surface Integrity during Machining of Inconel 718 with Various Laser Assistance Strategies

Authors: Szymon Wojciechowski, Damian Przestacki, Tadeusz Chwalczuk

Abstract:

The paper is focused on the evaluation of surface integrity formed during turning of Inconel 718 with the application of various laser assistance strategies. The primary objective of the work was to determine the relations between the applied machining strategy and the obtained surface integrity, in order to select the effective cutting conditions allowing the obtainment of high surface quality. The carried out experiment included the machining of Inconel 718 in the conventional turning conditions, as well as during the continuous laser assisted machining and sequential laser assistance. The surface integrity was evaluated by the measurements of machined surface topographies, microstructures and the microhardness. Results revealed that surface integrity of Inconel 718 is strongly affected by the selected machining strategy. The significant improvement of the surface roughness formed during machining of Inconel 718, can be reached by the application of simultaneous laser heating and cutting (LAM).

Keywords: Inconel 718, laser assisted machining, surface integrity, turning

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3513 Effect of Leadership Style on Organizational Performance

Authors: Khadija Mushtaq, Mian Saqib Mehmood

Abstract:

This paper attempts to determine the impact of leadership style and learning orientation on organizational performance in Pakistan. A sample of 158 middle managers selected from sports and surgical factories from Sialkot. The empirical estimation is based on a multiple linear regression analysis of the relationship between leadership style, learning orientation and organizational performance. Leadership style is measure through transformational leadership and transactional leadership. The transformational leadership has insignificant impact on organizational performance. The transactional leadership has positive and significant relation with organizational performance. Learning orientation also has positive and significant relation with organizational performance. Linear regression used to estimate the relation between dependent and independent variables. This study suggests top manger should prefer continuous process for improvement for any change in system rather radical change.

Keywords: transformational leadership, transactional leadership, learning orientation, organizational performance, Pakistan

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3512 Environment Situation Analysis of Germany

Authors: K. Y. Chen, H. Chua, C. W. Kan

Abstract:

In this study, we will analyze Germany’s environmental situation such as water and air quality and review its environmental policy. In addition, we will collect the yearly environmental data as well as information concerning public environmental investment. Based on the data collect, we try to find out the relationship between public environmental investment and sustainable development in Germany. In addition, after comparing the trend of environmental quality and situation of environmental policy and investment, we may have some conclusions and learnable aspects to refer to. Based upon the data collected, it was revealed that Germany has established a well-developed institutionalization of environmental education. And the ecological culture at school is dynamic and continuous renewal. The booming of green markets in Germany is a very successful experience for learning. The green market not only creates a number of job opportunities, but also helps the government to improve and protect the environment. Acknowledgement: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: Germany, public environmental investment, environment quality, sustainable development

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3511 Exploring SSD Suitable Allocation Schemes Incompliance with Workload Patterns

Authors: Jae Young Park, Hwansu Jung, Jong Tae Kim

Abstract:

Whether the data has been well parallelized is an important factor in the Solid-State-Drive (SSD) performance. SSD parallelization is affected by allocation scheme and it is directly connected to SSD performance. There are dynamic allocation and static allocation in representative allocation schemes. Dynamic allocation is more adaptive in exploiting write operation parallelism, while static allocation is better in read operation parallelism. Therefore, it is hard to select the appropriate allocation scheme when the workload is mixed read and write operations. We simulated conditions on a few mixed data patterns and analyzed the results to help the right choice for better performance. As the results, if data arrival interval is long enough prior operations to be finished and continuous read intensive data environment static allocation is more suitable. Dynamic allocation performs the best on write performance and random data patterns.

Keywords: dynamic allocation, NAND flash based SSD, SSD parallelism, static allocation

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3510 Synthesis of Highly Valuable Fuel Fractions from Waste Date Seeds Oil

Authors: Farrukh Jamil, Ala'A H. Al-Muhtaseb, Lamya Al-Haj, Mohab A. Al-Hinai

Abstract:

Environmental problems and the security of energy supply have motivated the attention in the expansion of alternatives for fossil based fuels. Biomass has been recognized as a capable resource because it is plentifully available and in principle carbon dioxide neutral. Present study focuses on utilization date seeds oil for synthesizing high value fuels formulations such as green diesel and jet fuel. The hydrodeoxygenation of date seeds oil occurred to be highly efficient at following operating conditions temperature 300°C pressure 10bar with continuous stirring at 500 rpm. Products characterization revealed the efficiency of hydrodeoxygenation by formation of linear hydrocarbons (paraffin) in larger fraction. Based on the type of components in product oil it was calculated that maximum fraction lies within the range of green diesel 72.78 % then jet fuel 28.25 % by using Pt/C catalyst. It can be concluded that waste date seeds oil has potential to be used for obtaining high value products.

Keywords: date seeds, hydrodeoxygenation, paraffin, deoxygenation

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3509 Hand Hygiene Habits of Ghanaian Youths in Accra

Authors: Cecilia Amponsem-Boateng, Timothy B. Oppong, Haiyan Yang, Guangcai Duan

Abstract:

The human palm has been identified as one of the richest habitats for human microbial accommodation making hand hygiene essential to primary prevention of infection. Since the hand is in constant contact with fomites which have been proven to be mostly contaminated, building hand hygiene habits is essential for the prevention of infection. This research was conducted to assess the hand hygiene habits of Ghanaian youths in Accra. This study used a survey as a quantitative method of research. The findings of the study revealed that out of the 254 participants who fully answered the questionnaire, 22% had the habit of washing their hands after outings while only 51.6% had the habit of washing their hands after using the bathroom. However, about 60% of the participants said they sometimes ate with their hands while 28.9% had the habit of eating with the hand very often, a situation that put them at risk of infection from their hands since some participants had poor handwashing habits; prompting the need for continuous education on hand hygiene.

Keywords: hand hygiene, hand hygiene habit, hand washing, hand sanitizer use

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3508 Analysis of Sickle Cell Disease and Maternal Mortality in United Kingdom

Authors: Basma Hassabo, Sarah Ahmed, Aisha Hameed

Abstract:

Aims and Objectives: To determine the incidence of maternal mortality amongst pregnant women with sickle cell disease (SCD) in the United Kingdom and to determine exact cause of death in these women. Background: SCD is caused by the ‘sickle’ gene and is characterized by episodes of severe bone pain and other complications like acute chest syndrome, chronic pulmonary hypertension, stroke, retinopathy, chronic renal failure, hepato-splenic crises, avascular bone necrosis, sepsis and leg ulcers. SCD is a continual cause of maternal mortality and fetal complications, and it comprises 1.5% of all Direct and Indirect deaths in the UK. Sepsis following premature rupture of membranes with ascending infection, post-partum infection and pre-labour overwhelming septic shock is one of its leading causes of death. Over the last fifty years of maternal mortality reports in UK, between 1 to 4 pregnant women died in each triennium. Material and Method: This is a retrospective study that involves pregnant women who died from SCD complications in the UK between 1952-2012. Data were collected from the UK Confidential Enquiries into Maternal Death and its causes between 1952–2012. Prior to 1985, exact cause of death in this cohort was not recorded. Results: 33 deaths reported between 1964 and 1984. 17 deaths were reported due to sickle cell disease between 1985 and 2012. Five women in this group died of sickle cell crisis, one woman had liver sequestration crisis, two women died of venous thromboembolism, two had myocardial fibrosis and three died of sepsis. Remaining women died of amniotic fluid embolism, SUDEP, myocardial ischemia and intracranial haemorrhage. Conclusion: The leading causes of death in sickle cell sick pregnant women are sickle cell crises, sepsis, venous thrombosis and thromboembolism. Prenatal care for women with SCD should be managed by a multidisciplinary team that includes an obstetrician, nutritionist, primary care physician, and haematologist. In every sick Sickle Cell woman Sickle Cell crises should be on the top of the list of differential diagnosis. Aggressive treatment of complications with low threshold to commence broad-spectrum antibiotics and LMWH contribute to better outcomes.

Keywords: incidence, maternal mortality, sickle cell disease (SCD), uk

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3507 A Supervised Goal Directed Algorithm in Economical Choice Behaviour: An Actor-Critic Approach

Authors: Keyvanl Yahya

Abstract:

This paper aims to find a algorithmic structure that affords to predict and explain economic choice behaviour particularly under uncertainty (random policies) by manipulating the prevalent Actor-Critic learning method that complies with the requirements we have been entrusted ever since the field of neuroeconomics dawned on us. Whilst skimming some basics of neuroeconomics that might be relevant to our discussion, we will try to outline some of the important works which have so far been done to simulate choice making processes. Concerning neurological findings that suggest the existence of two specific functions that are executed through Basal Ganglia all the way down to sub-cortical areas, namely 'rewards' and 'beliefs', we will offer a modified version of actor/critic algorithm to shed a light on the relation between these functions and most importantly resolve what is referred to as a challenge for actor-critic algorithms, that is lack of inheritance or hierarchy which avoids the system being evolved in continuous time tasks whence the convergence might not emerge.

Keywords: neuroeconomics, choice behaviour, decision making, reinforcement learning, actor-critic algorithm

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3506 Fatigue Evaluation of Link Slab for Continuous Girder-Type Precast Modular Bridges

Authors: Jae-Joon Song, Sang-Yoon Lee, Bong-Chul Joo

Abstract:

The girder-type precast modular bridge has been developed as a simply supported bridge. The girder-type precast modular bridge could be applied to the multi-span bridges through the continuity method. The continuity of the girder-type precast modular bridge is achieved by using the link slab which is easy to construction and appropriate to the rapid construction. In this study, the link slab with transition zone was used for the continuity of the precast modular bridges, and the construction detail of link slab was modified. In addition, the modified iterative design method of link slab was proposed in this study. To verify the proposed design method, the fatigue test using the mock-up specimen was conducted with cycle loading condition up to two million cycles.

Keywords: precast, modular bridge, link slab

Procedia PDF Downloads 427