Search results for: emergency department admission
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2649

Search results for: emergency department admission

489 An Ethnographic Inquiry: Exploring the Saudi Students’ Motivation to Learn English Language

Authors: Musa Alghamdi

Abstract:

Although Saudi students’ motivation to learn English language as a foreign language in Saudi Arabia have been investigated by a number of studies; these have appeared almost completely as using the quantitative research paradigm. There is a significant lack of research that explores the Saudi students’ motivation using qualitative methods. It was essential, as an investigator, to be immersed in the community to understand the individuals under study via their actions and words, their thoughts, views and beliefs, and how those individuals credited to activities. Thus, the study aims to explore the Saudi students’ motivation to learn English language as a foreign language in Saudi Arabia employing qualitative methodology via applying ethnography. The study will be carried out in Saudi Arabia. Ethnography qualitative approach will be used in the current study by employing formal and informal interview instruments. Gardner’s motivation theory is used as frameworks for this study to aid the understanding of the research findings. The author, an English language lecturer, will undertake participant observations for 4 months. He will work as teaching-assistant (on an unpaid basis) with EFL lecturers in different discipline department at a Saudi university where students study English language as a minor course. The researcher will start with informal ethnographical interview with students during his existence with the informants in their natural context. Then the researcher will utilize the semi-structural interview. The informal interview will be with 14-16 students, then, he will carry out semi-structural interview with the same informants to go deep in their natural context to find out to what extent the Saudi university students are motivated to learn English as a foreign language. As well as, to find out the reasons that played roles in that. The findings of this study will add new knowledge about what factors motivate universities’ Saudi students to learn English language in Saudi Arabia. Very few chances have given to students to express themselves and to speak about their feelings in a more comfortable way in order to gain a clear image of those factors. The working author as an EFL teacher and lecturer will provide him secure access into EFL teaching and learning setting. It will help him attain richer insights into the nature EFL context in universities what will provide him with richer insights into the reasons behind the weakness of EFL level among Saudi students.

Keywords: motivation, ethnography, Saudi, language

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488 Mentor and Peer Feed-Back on Micro-Teaching: As a Tool for Enhancing of Pre-Service Teachers' Teaching Practices

Authors: Ayhan Cinici, Mustafa Ozden, Umit Duruk, Gulden Akdag

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The purpose of this study was to investigate how feedbacks left from two different sources (mentors and peers) during microteaching sessions effecting preservice teachers’ teaching skills and views on science teaching. Sampling process is twofold in the study. As part of qualitative research, among other counterparts, case study method was chosen and respectively, constructed six working groups in which there were six preservice teachers, totally from thirty six preservice teachers enrolled in the third grade of Elementary Education Department by random assignment. Subsequently, one preservice teacher from all groups was appointed as the moderator of those groups (totally six moderators). Rest of them taking part remained as audience in all groups. At the beginning of the instructional process, all participants were asked to watch some videos by which someone already recorded. After watching these videos, they were also given a chance to discuss their ideas and impressions regarding microteaching in the classroom atmosphere. Both academic staff as mentors and participants as preservice teachers took role in the process of determining which teaching skills would be taken into consideration as part of microteaching sessions. Each group were gathered at regular intervals throughout twelve weeks together with their mentor who guided them and performed their microteaching. Data was collected using reflective diaries by which researchers constructed for both preservice teachers playing role as teacher of the group and preservice teachers playing role as audience during these microteaching sessions. Semi structured interviews were also carried out with only preservice teachers playing role as teachers of the groups. Findings from these reflective diaries and semi structured interviews were analysed by descriptive statistics and content analysis method. With regard to these findings, explanatory themes and subthemes were categorized and supported by direct citations. The results reveal that preservice teachers playing role as the teachers of the each group consider “content knowledge” as the most important aspect among other teaching skills. Furthermore, preservice teachers also point out that the more they get feedback on any teaching skill, the more they get motivated to develop it.

Keywords: teacher education, microteaching, mentor, peer feedback

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487 Perceptions and Expectations by Participants of Monitoring and Evaluation Short Course Training Programmes in Africa

Authors: Mokgophana Ramasobana

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Background: At the core of the demand to utilize evidence-based approaches in the policy-making cycle, prioritization of limited financial resources and results driven initiatives is the urgency to develop a cohort of competent Monitoring and Evaluation (M&E) practitioners and public servants. The ongoing strides in the evaluation capacity building (ECB) initiatives are a direct response to produce the highly-sought after M&E skills. Notwithstanding the rapid growth of M&E short courses, participants perceived value and expectation of M&E short courses as a panacea for ECB have not been empirically quantified or measured. The objective of this article is to explicitly illustrate the importance of measuring ECB interventions and understanding what works in ECB and why it works. Objectives: This article illustrates the importance of establishing empirical ECB measurement tools to evaluate ECB interventions in order to ascertain its contribution to the broader evaluation practice. Method: The study was primarily a desktop review of existing literature, juxtaposed by a survey of the participants across the African continent based on the 43 M&E short courses hosted by the Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) in collaboration with the Department of Planning Monitoring and Evaluation (DPME) Results: The article established that participants perceive short course training as a panacea to improve their M&E practical skill critical to executing their organizational duties. In tandem, participants are likely to demand customized training as opposed to general topics in Evaluation. However, the organizational environments constrain the application of the newly acquired skills. Conclusion: This article aims to contribute to the 'how to' measure ECB interventions discourse and contribute towards the improvement to evaluate ECB interventions. The study finds that participants prefer training courses with longer duration to cover more topics. At the same time, whilst organizations call for customization of programmes, the study found that individual participants demand knowledge of generic and popular evaluation topics.

Keywords: evaluation capacity building, effectiveness and training, monitoring and evaluation (M&E) short course training, perceptions and expectations

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486 Advances in the Studies on Evaluation of Diversity and Habitat Preferences of Amphibians of Nigeria

Authors: Md Mizanur Rahman, Lotanna Micah Nneji, Adeola C. Adeniyi, Edem Archibong Eniang, Abiodun B. Onadeko, Felista Kasyoka Kilunda, Babatunde E. Adedeji, Ifeanyi C. Nneji, Adiaha A. A. Ugwumba, Jie-Qiong Jin, Min-Sheng Peng, Caroline Olory, Nsikan Eninekit, Jing Che

Abstract:

Nigeria contains a number of forest habitats that believed to host highly rich amphibian diversity. However, a dearth of herpetological studies has restricted information on the amphibian diversity in Nigeria. To cover the gap of knowledge, this study focused field surveys on relatively less studied forests–Afi Forest Reserve and Ikpan forest ecosystem. The goal of this study is to make a checklist and to investigate the habitat preferences of amphibians in these two forests. The study areas were surveyed between August 2018 and July 2019 following visual and acoustic methods. Individuals were identified using the morphological and molecular (16S ribosomal RNA) approach. Literature searches were conducted to document additional species that were not encountered during the current field surveys. Using the observational records and arrays of diversity indices, the patterns of species richness and abundance across habitat types were evaluated. Voucher specimens and tissue samples were deposited in the museums of the Department of Zoology, University of Ibadan Nigeria, and the remainder at the Kunming Institute of Zoology (KIZ), Chinese Academy of Sciences, Kunming, China. The result of this study revealed the presence of 30 and 31 amphibian species from the Afi Forest Reserve and the Ikpan Forest Ecosystem, respectively. There were two unidentified species from AFR and one from IFE. In total, 324 individuals of amphibian species were observed from the two study areas. Forest and swamps showed high species diversity and richness than the agricultural field and savannah. Savannah and agricultural fields had the highest similarity in the species composition. Given the increased human disturbances and consequent threats to these forests, this study offers recommendations for the initiation of conservation plans immediately.

Keywords: biodiversity, conservation, cryptic species, ecology, integrated taxonomy, species inventory

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485 Relevance for Traditional Medicine in South Africa: Experiences of Urban Traditional Healers, Izinyanga

Authors: Ntokozo Mthembu

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Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners- izinyanga. However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.

Keywords: indigenous healing practice, inyanga, COVID-19, therapeutic, urban, experience

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484 A Comparative Study to Evaluate Changes in Intraocular Pressure with Thiopentone Sodium and Etomidate in Patients Undergoing Surgery for Traumatic Brain Injury

Authors: Vasudha Govil, Prashant Kumar, Ishwar Singh, Kiranpreet Kaur

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Traumatic brain injury leads to elevated intracranial pressure. Intraocular pressure (IOP) may also be affected by intracranial pressure. Increased venous pressure in the cavernous sinus is transmitted to the episcleral veins, resulting in an increase in IOP. All drugs used in anesthesia induction can change IOP. Irritation of the gag reflex after usage of the endotracheal tube can also increase IOP; therefore, the administration of anesthetic drugs, which make the lowest change in IOP, is important, while cardiovascular depression must also be avoided. Thiopentone decreases IOP by 40%, whereas etomidate decreases IOP by 30-60% for up to 5 minutes. Hundred patients (age 18-55 years) who underwent emergency craniotomy for TBI are selected for the study. Patients are randomly assigned to two groups of 50 patients each accord¬ing to the drugs used for induction: group T was given thiopentone sodium (5mg kg-1) and group E was given etomi¬date (0.3mg kg-1). Preanaesthesia intraocular pressure (IOP) was measured using Schiotz tonometer. Induction of anesthesia was achieved with etomidate (0.3mg kg-1) or thiopentone (5mg kg-1) along with fentanyl (2 mcg kg-1). Intravenous rocuronium (0.9mg kg-1) was given to facilitate intubation. Intraocular pressure was measured after 1 minute of induction agent administration and 5 minutes after intubation. Maintainance of anesthesia was done with isoflurane in 50% nitrous oxide with fresh gas flow of 5 litres. At the end of the surgery, the residual neuromuscular block was reversed and the patient was shifted to ward/ICU. Patients in both groups were comparable in terms of demographic profile. There was no significant difference between the groups for the hemody¬namic and respiratory variables prior to thiopentone or etomidate administration. Intraocular pressure in thiopentone group in left eye and right eye before induction was 14.97±3.94 mmHg and 14.72±3.75 mmHg respectively and for etomidate group was 15.28±3.69 mmHg and 15.54±4.46 mmHg respectively. After induction IOP decreased significantly in both the eyes (p<0.001) in both the groups. After 5 min of intubation IOP was significantly less than the baseline in both the eyes but it was more than the IOP after induction with the drug. It was found that there was no statistically significant difference in IOP between the two groups at any point of time. Both the drugs caused a significant decrease in IOP after induction and after 5 minutes of endotracheal intubation. The mechanism of decrease in IOP by intravenous induction agents is debatable. Systemic hypotension after the induction of anaesthesia has been shown to cause a decrease in intra-ocular pressure. A decrease in the tone of the extra-ocular muscles can also result in a decrease in intra-ocular pressure. We observed that it is appropriate to use etomidate as an induction agent when elevation of intra-ocular pressure is undesirable owing to the cardiovascular stability it confers in the patients.

Keywords: etomidate, intraocular pressure, thiopentone, traumatic

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483 Single Mothers by Choice at Corona Time - The Perception of Social Support, Happiness and Work-Family Conflict and their Effect on State Anxiety

Authors: Orit Shamir Balderman, Shamir Michal

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Israel often deals with crisis situations, but most have been characterized as security crises (e.g., war). This is the first time that the Israel has dealt with a health and social emergency as part of a global crisis. The crisis began in January 2020 with the emergence of the novel coronavirus (Covid-19), which was defined as a pandemic (World Health Organization, 2020) and arrived in Israel in early March 2020. This study examined how single mothers by choice (SMBC) experience state anxiety (SA), social support, work–family conflict (WFC), and happiness. This group has not been studied in the context of crises in general or a global crisis. Using a snowball sample, 386 SMBCanswered an online questionnaire. The findings show a negative relationship between income and level of state anxiety. State anxiety was also negatively associated with social support, level of happiness, and WFC. Finally, a stepwise regression analysis indicated that happiness explained 34% of the variance in SA. We also found that most of the women did not turn to formal support agencies such as social workers, other Government Ministries, or municipal welfare. A positive and strong correlations was also found between SA and WFC. The findings of the study reinforce the understanding that although these women made a conscious and informed decision regarding the choice of their family cell, their situation is more complex in the absence of a spouse support. Therefore, this study, as other future studies in the field of SMBC, may contribute to the improvement of their social status and the understanding that they are a unique group. Although SMBC are a growing sector of society in the past few years, there are still special needs and special attention that is needed from the formal and informal supports systems. A comparative study of these two groups and in different countries would shed light on SA among mothers in general, regardless of their relationship status and location.Researchers should expand this study by comparing mothers in relationships and exploring how SMBC coped in other countries. In summary, the findings of the study contribute knowledge on three levels: (a) knowledge about SMBC in general and during crisis situations; (b) examination of social support using tools assessing receipt of assistance and support, some of which were developed for the present study; and (c) insights regarding counseling, accompaniment, and guidance of welfare mechanisms.

Keywords: single mothers by choice, state anxiety, social support, happiness, work–family conflict

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482 An Econometric Analysis of the Flat Tax Revolution

Authors: Wayne Tarrant, Ethan Petersen

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The concept of a flat tax goes back to at least the Biblical tithe. A progressive income tax was first vociferously espoused in a small, but famous, pamphlet in 1848 (although England had an emergency progressive tax for war costs prior to this). Within a few years many countries had adopted the progressive structure. The flat tax was only reinstated in some small countries and British protectorates until Mart Laar was elected Prime Minister of Estonia in 1992. Since Estonia’s adoption of the flat tax in 1993, many other formerly Communist countries have likewise abandoned progressive income taxes. Economists had expectations of what would happen when a flat tax was enacted, but very little work has been done on actually measuring the effect. With a testbed of 21 countries in this region that currently have a flat tax, much comparison is possible. Several countries have retained progressive taxes, giving an opportunity for contrast. There are also the cases of Czech Republic and Slovakia, which have adopted and later abandoned the flat tax. Further, with over 20 years’ worth of economic history in some flat tax countries, we can begin to do some serious longitudinal study. In this paper we consider many economic variables to determine if there are statistically significant differences from before to after the adoption of a flat tax. We consider unemployment rates, tax receipts, GDP growth, Gini coefficients, and market data where the data are available. Comparisons are made through the use of event studies and time series methods. The results are mixed, but we draw statistically significant conclusions about some effects. We also look at the different implementations of the flat tax. In some countries there are equal income and corporate tax rates. In others the income tax has a lower rate, while in others the reverse is true. Each of these sends a clear message to individuals and corporations. The policy makers surely have a desired effect in mind. We group countries with similar policies, try to determine if the intended effect actually occurred, and then report the results. This is a work in progress, and we welcome the suggestion of variables to consider. Further, some of the data from before the fall of the Iron Curtain are suspect. Since there are new ruling regimes in these countries, the methods of computing different statistical measures has changed. Although we first look at the raw data as reported, we also attempt to account for these changes. We show which data seem to be fictional and suggest ways to infer the needed statistics from other data. These results are reported beside those on the reported data. Since there is debate about taxation structure, this paper can help inform policymakers of change the flat tax has caused in other countries. The work shows some strengths and weaknesses of a flat tax structure. Moreover, it provides beginnings of a scientific analysis of the flat tax in practice rather than having discussion based solely upon theory and conjecture.

Keywords: flat tax, financial markets, GDP, unemployment rate, Gini coefficient

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481 Economics of Sugandhakokila (Cinnamomum Glaucescens (Nees) Dury) in Dang District of Nepal: A Value Chain Perspective

Authors: Keshav Raj Acharya, Prabina Sharma

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Sugandhakokila (Cinnamomum glaucescens Nees. Dury) is a large evergreen native tree species; mostly confined naturally in mid-hills of Rapti Zone of Nepal. The species is identified as prioritized for agro-technology development as well as for research and development by a department of plant resources. This species is band for export outside the country without processing by the government of Nepal to encourage the value addition within the country. The present study was carried out in Chillikot village of Dang district to find out the economic contribution of C. glaucescens in the local economy and to document the major conservation threats for this species. Participatory Rural Appraisal (PRA) tools such as Household survey, key informants interviews and focus group discussions were carried out to collect the data. The present study reveals that about 1.7 million Nepalese rupees (NPR) have been contributed annually in the local economy of 29 households from the collection of C. glaucescens berries in the study area. The average annual income of each family was around NPR 67,165.38 (US$ 569.19) from the sale of the berries which contributes about 53% of the total household income. Six different value chain actors are involved in C. glaucescens business. Maximum profit margin was taken by collector followed by producer, exporter and processor. The profit margin was found minimum to regional and village traders. The total profit margin for producers was NPR 138.86/kg, and regional traders have gained NPR 17/kg. However, there is a possibility to increase the profit of producers by NPR 8.00 more for each kg of berries through the initiation of community forest user group and village cooperatives in the area. Open access resource, infestation by an insect to over matured trees and browsing by goats were identified as major conservation threats for this species. Handing over the national forest as a community forest, linking the producers with the processor through organized market channel and replacing the old tree through new plantation has been recommended for future.

Keywords: community forest, conservation threats, C. glaucescens, value chain analysis

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480 Molluscicidal Effect of Cassia occidentalis and Physalis angulata Leaf Extract in the Elimination of Water Snail

Authors: Haruna Karamba, Nafisa Muhammad Danyaro

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The study describe the action of natural latex (extract) of two sub-aquatic macrophytes plants i.e., Cassia occidentalis and Physalis angulata which were tested against two water snail species; Bulinus globusus and Lymnaea natalensis, the intermediate host of Bilharziasis (chistosomiasis) in the tropical countries. Bilherziasis is a disease prevalent and endermic to tropical Africa, seriously undermining health status of Nigerian youth. The easiest way to eradicate the disease is to eliminate the secondary host of the pathogen, chistosoma species. Therefore we carried out a research to investigate the molluscicidal effect of the leaf extract of C. occidentalis and P. angulata on mortality rate of B. globusus and L. natalensis water snails using pond water in the laboratory of science laboratory department of Kano State Polytechnic, Nigeria. One hundred and fifty juveniles’ snails were collected from Jakara Dam in the Northeastern part of Kano, Nigeria. The snails were put inside a plastic container and transported immediately to the laboratory where they were transferred into reservoir tank containing pond water and kept for 48 hours to get acclimatized with laboratory environment. Twelve water bathes 2/3 filled with pond water were prepared and kept in the laboratory. Leaf extract of the plants were obtained by blending and homogenizing the leaf tissue from which the extract were obtained and prepared in 10, 20, 30, 40 and 50 ppm, in addition to 0 ppm, which served as control. Ten snails were placed in each of the twelve water bathes. Six water bathes for the species of C. accidentalis extract and other six for P. angulata. The treatment combinations were maintained for 2 days after which the number of living snails present in each water bathes were counted and subsequently at 2 days intervals. The result indicated that extracts from both plants were lethal to the snails as concentration of the extract increases particularly mortality rate was highest at 40 and 50 ppm. Conclusively the toxicity of the extracts from these plants proven lethal to snails and hence can be used as molluscicides for cheap and easy method of eliminating water snails and therefore reducing the incidence of Bilharziasis.

Keywords: schistosomiasis, bilharziasis, Bulinus globusus, Lymnea natalensis, Physalis angulata, Cassia occidentalis, Kano

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479 The Application of the Biopsychosocial-Spiritual Model to the Quality of Life of People Living with Sickle Cell Disease

Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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478 The Importance of Efficient and Sustainable Water Resources Management and the Role of Artificial Intelligence in Preventing Forced Migration

Authors: Fateme Aysin Anka, Farzad Kiani

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Forced migration is a situation in which people are forced to leave their homes against their will due to political conflicts, wars and conflicts, natural disasters, climate change, economic crises, or other emergencies. This type of migration takes place under conditions where people cannot lead a sustainable life due to reasons such as security, shelter and meeting their basic needs. This type of migration may occur in connection with different factors that affect people's living conditions. In addition to these general and widespread reasons, water security and resources will be one that is starting now and will be encountered more and more in the future. Forced migration may occur due to insufficient or depleted water resources in the areas where people live. In this case, people's living conditions become unsustainable, and they may have to go elsewhere, as they cannot obtain their basic needs, such as drinking water, water used for agriculture and industry. To cope with these situations, it is important to minimize the causes, as international organizations and societies must provide assistance (for example, humanitarian aid, shelter, medical support and education) and protection to address (or mitigate) this problem. From the international perspective, plans such as the Green New Deal (GND) and the European Green Deal (EGD) draw attention to the need for people to live equally in a cleaner and greener world. Especially recently, with the advancement of technology, science and methods have become more efficient. In this regard, in this article, a multidisciplinary case model is presented by reinforcing the water problem with an engineering approach within the framework of the social dimension. It is worth emphasizing that this problem is largely linked to climate change and the lack of a sustainable water management perspective. As a matter of fact, the United Nations Development Agency (UNDA) draws attention to this problem in its universally accepted sustainable development goals. Therefore, an artificial intelligence-based approach has been applied to solve this problem by focusing on the water management problem. The most general but also important aspect in the management of water resources is its correct consumption. In this context, the artificial intelligence-based system undertakes tasks such as water demand forecasting and distribution management, emergency and crisis management, water pollution detection and prevention, and maintenance and repair control and forecasting.

Keywords: water resource management, forced migration, multidisciplinary studies, artificial intelligence

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477 To Investigate a Discharge Planning Connect with Long Term Care 2.0 Program in a Medical Center in Taiwan

Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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476 Reading Literacy, Storytelling and Cognitive Learning: an Effective Connection in Sustainability Education

Authors: Rosa Tiziana Bruno

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The connection between education and sustainability has been posited to have benefit for realizing a social development compatible with environmental protection. However, an educational paradigm based on the passage of information or on the fear of a catastrophe might not favor the acquisition of eco-identity. To build a sustainable world, it is necessary to "become people" in harmony with other human beings, being aware of belonging to the same human community that is part of the natural world. This can only be achieved within an authentic educating community and the most effective tools for building educating communities are reading literacy and storytelling. This paper is the report of a research-action carried out in this direction, in agreement with the sociology department of the University of Salerno, which involved four hundred children and their teachers in a path based on the combination of reading literacy, storytelling, autobiographical writing and outdoor education. The goal of the research was to create an authentic educational community within the school, capable to encourage the acquisition of an eco-identity by the pupils, that is, personal and relational growth in the full realization of the Self, in harmony with the social and natural environment, with a view to an authentic education for sustainability. To ensure reasonable validity and reliability of findings, the inquiry started with participant observation and a process of triangulation has been used including: semi-structured interview, socio-semiotic analysis of the conversation and time budget. Basically, a multiple independent sources of data was used to answer the questions. Observing the phenomenon through multiple "windows" helped to comparing data through a variety of lenses. All teachers had the experience of implementing a socio-didactic strategy called "Fiabadiario" and they had the possibility to use it with approaches that fit their students. The data being collected come from the very students and teachers who are engaged with this strategy. The educational path tested during the research has produced sustainable relationships and conflict resolution within the school system and between school and families, creating an authentic and sustainable learning community.

Keywords: educating community, education for sustainability, literature in education, social relations

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475 Partnerships for Environmental Sustainability: An Effective Multistakeholder Governance Regime for Oil and Gas Producing Areas

Authors: Joy Debski

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Due to the varying degrees of the problem posed by global warming, environmental sustainability dominates international discourse. International initiatives' aims and expectations have proven particularly challenging to put into practice in developing nations. To reduce human exploitation of the environment, stricter measures are urgently needed. However, putting them into practice has proven more difficult. Relatively recent information from the Climate Accountability Institute and academic researchers shows that fossil fuel companies are major contributors to the climate crisis. Host communities in oil and gas-producing areas, particularly in developing nations, have grown hostile toward both oil and gas companies and government policies. It is now essential that the three main stakeholders—government, the oil and gas sector, and host communities—cooperate to achieve the shared objective of environmental sustainability. This research, therefore, advocates a governance system for Nigeria that facilitates the achieving the goal of environmental sustainability. This objective is achieved by the research's examination of the main institutional framework for environmental sustainability, evaluation of the strategies used by major oil companies to increase stakeholder engagement in environmental sustainability, and examination of the involvement of host communities in environmental sustainability. The study reveals that while environmental sustainability is important to the identified stakeholders, it's challenging to accomplish without an informed synergy. Hence the research advocates the centralisation of CSR through a CSR commission for environmental sustainability. The commission’s mandate is to facilitate, partner with, and endorse companies. The commission is strongly advised to incorporate host community liaison offices into the process of negotiating contracts with oil and gas firms, as well as to play a facilitative role in helping firms adhere to both domestic and international regulations. The recommendations can benefit Nigerian policymakers in enhancing their unsuccessful efforts to pass CSR legislation. Through the research-proposed CSR department, which has competent training and stakeholder engagement strategies, oil and gas companies can enhance and centralise their goals for environmental sustainability. Finally, the CSR Commission's expertise would give host communities more leverage when negotiating their memorandum of understanding with oil and gas companies.

Keywords: environmental sustainability, corporate social responsibility, CSR, oil and gas, nigeria

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474 Lessons Learned from Push-Plus Implementation in Northern Nigeria

Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

Procedia PDF Downloads 293
473 Evaluation of the Self-Organizing Map and the Adaptive Neuro-Fuzzy Inference System Machine Learning Techniques for the Estimation of Crop Water Stress Index of Wheat under Varying Application of Irrigation Water Levels for Efficient Irrigation Scheduling

Authors: Aschalew C. Workneh, K. S. Hari Prasad, C. S. P. Ojha

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The crop water stress index (CWSI) is a cost-effective, non-destructive, and simple technique for tracking the start of crop water stress. This study investigated the feasibility of CWSI derived from canopy temperature to detect the water status of wheat crops. Artificial intelligence (AI) techniques have become increasingly popular in recent years for determining CWSI. In this study, the performance of two AI techniques, adaptive neuro-fuzzy inference system (ANFIS) and self-organizing maps (SOM), are compared while determining the CWSI of paddy crops. Field experiments were conducted for varying irrigation water applications during two seasons in 2022 and 2023 at the irrigation field laboratory at the Civil Engineering Department, Indian Institute of Technology Roorkee, India. The ANFIS and SOM-simulated CWSI values were compared with the experimentally calculated CWSI (EP-CWSI). Multiple regression analysis was used to determine the upper and lower CWSI baselines. The upper CWSI baseline was found to be a function of crop height and wind speed, while the lower CWSI baseline was a function of crop height, air vapor pressure deficit, and wind speed. The performance of ANFIS and SOM were compared based on mean absolute error (MAE), mean bias error (MBE), root mean squared error (RMSE), index of agreement (d), Nash-Sutcliffe efficiency (NSE), and coefficient of correlation (R²). Both models successfully estimated the CWSI of the paddy crop with higher correlation coefficients and lower statistical errors. However, the ANFIS (R²=0.81, NSE=0.73, d=0.94, RMSE=0.04, MAE= 0.00-1.76 and MBE=-2.13-1.32) outperformed the SOM model (R²=0.77, NSE=0.68, d=0.90, RMSE=0.05, MAE= 0.00-2.13 and MBE=-2.29-1.45). Overall, the results suggest that ANFIS is a reliable tool for accurately determining CWSI in wheat crops compared to SOM.

Keywords: adaptive neuro-fuzzy inference system, canopy temperature, crop water stress index, self-organizing map, wheat

Procedia PDF Downloads 45
472 The Relationship Between Social Support, Happiness, Work-Family Conflict and State-Trait Anxiety Among Single Mothers by Choice at Time of Covid-19 Pandemic

Authors: Shamir Balderman Orit, Shamir Michal

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Israel often deals with crisis situations, but most have been characterized as security crises (e.g., war). This is the first time that the Israel has dealt with a health and social emergency as part of a global crisis. The crisis began in January 2020 with the emergence of the novel coronavirus (Covid-19), which was defined as a pandemic (World Health Organization, 2020) and arrived in Israel in early March 2020. This study examined how single mothers by choice (SMBC) experience state anxiety (SA), social support, work–family conflict (WFC), and happiness. This group has not been studied in the context of crises in general or a global crisis. Using a snowball sample, 386 SMBCanswered an online questionnaire. The findings show a negative relationship between income and level of state anxiety. State anxiety was also negatively associated with social support, level of happiness, and WFC. Finally, a stepwise regression analysis indicated that happiness explained 34% of the variance in SA. We also found that most of the women did not turn to formal support agencies such as social workers, other Government Ministries, or municipal welfare. A positive and strong correlations was also found between SA and WFC. The findings of the study reinforce the understanding that although these women made a conscious and informed decision regarding the choice of their family cell, their situation is more complex in the absence of a spouse support. Therefore, this study, as other future studies in the field of SMBC, may contribute to the improvement of their social status and the understanding that they are a unique group. Although SMBC are a growing sector of society in the past few years, there are still special needs and special attention that is needed from the formal and informal supports systems. A comparative study of these two groups and in different countries would shed light on SA among mothers in general, regardless of their relationship status and location. Researchers should expand this study by comparing mothers in relationships and exploring how SMBC coped in other countries. In summary, the findings of the study contribute knowledge on three levels: (a) knowledge about SMBC in general and during crisis situations; (b) examination of social support using tools assessing receipt of assistance and support, some of which were developed for the present study; and (c) insights regarding counseling, accompaniment, and guidance of welfare mechanisms.

Keywords: single mothers by choice, state anxiety, social support, happiness, work-family conflict

Procedia PDF Downloads 100
471 Formal Innovations vs. Informal Innovations: The Case of the Mining Sector in Nigeria

Authors: Jegede Oluseye Oladayo

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The study mapped innovation activities in the formal and informal mining sector in Nigeria. Data were collected through primary and secondary sources. Primary data were collected through guided questionnaire administration, guided interviews and personal observation. A purposive sampling method was adopted to select firms that are micro, small and medium enterprises. The study covered 100 (50 in the formal sector and 50 in the informal sector) purposively selected companies in south-western Nigeria. Secondary data were collected from different published sources. Data were analysed using descriptive and inferential statistics. Of the four types of technological innovations sampled, organisational innovation was found to be highest both in the formal (100%) and informal (100%) sectors, followed by process innovation: 60% in the formal sector and 28% in the informal sector, marketing innovation and diffusion based innovation were implemented by 64% and 4% respectively in the formal sector. There were no R&D activities (intramural or extramural) in both sectors, however, innovation activities occur at moderate levels in the formal sector. This is characterised by acquisition of machinery, equipment, hardware (100%), software (56), training (82%) and acquisition of external knowledge (60%) in the formal sector. In the informal sector, innovation activities were characterised by acquisition of external knowledge (100%), training/learning by experience (100%) and acquisition of tools (68%). The impact of innovation on firm’s performance in the formal sector was expressed mainly as increased capacity of production (100%), reduced production cost per unit of labour (88%), compliance with governmental regulatory requirements (72%) and entry on new markets (60%). In the informal sector, the impact of innovation was mainly expressed in improved flexibility of production (70%) and machinery/energy efficiency (70%). The important technological driver of process innovation in the mining sector was acquisition of machinery which accounts for the prevalence of 100% both in the formal and informal sectors. Next to this is training and re-training of technical staff, 74% in both the formal and the informal sector. Other factors influencing organisational innovation are skill of workforce with a prevalence of 80% in both the formal and informal sector. The important technological drivers include educational background of the manager/head of technical department (54%) for organisational innovation and (50%) for process innovation in the formal sector. The study concluded that innovation competence of the firms was mostly organisational changes.

Keywords: innovation prevalence, innovation activities, innovation performance, innovation drivers

Procedia PDF Downloads 371
470 Distinguishing between Bacterial and Viral Infections Based on Peripheral Human Blood Tests Using Infrared Microscopy and Multivariate Analysis

Authors: H. Agbaria, A. Salman, M. Huleihel, G. Beck, D. H. Rich, S. Mordechai, J. Kapelushnik

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Viral and bacterial infections are responsible for variety of diseases. These infections have similar symptoms like fever, sneezing, inflammation, vomiting, diarrhea and fatigue. Thus, physicians may encounter difficulties in distinguishing between viral and bacterial infections based on these symptoms. Bacterial infections differ from viral infections in many other important respects regarding the response to various medications and the structure of the organisms. In many cases, it is difficult to know the origin of the infection. The physician orders a blood, urine test, or 'culture test' of tissue to diagnose the infection type when it is necessary. Using these methods, the time that elapses between the receipt of patient material and the presentation of the test results to the clinician is typically too long ( > 24 hours). This time is crucial in many cases for saving the life of the patient and for planning the right medical treatment. Thus, rapid identification of bacterial and viral infections in the lab is of great importance for effective treatment especially in cases of emergency. Blood was collected from 50 patients with confirmed viral infection and 50 with confirmed bacterial infection. White blood cells (WBCs) and plasma were isolated and deposited on a zinc selenide slide, dried and measured under a Fourier transform infrared (FTIR) microscope to obtain their infrared absorption spectra. The acquired spectra of WBCs and plasma were analyzed in order to differentiate between the two types of infections. In this study, the potential of FTIR microscopy in tandem with multivariate analysis was evaluated for the identification of the agent that causes the human infection. The method was used to identify the infectious agent type as either bacterial or viral, based on an analysis of the blood components [i.e., white blood cells (WBC) and plasma] using their infrared vibrational spectra. The time required for the analysis and evaluation after obtaining the blood sample was less than one hour. In the analysis, minute spectral differences in several bands of the FTIR spectra of WBCs were observed between groups of samples with viral and bacterial infections. By employing the techniques of feature extraction with linear discriminant analysis (LDA), a sensitivity of ~92 % and a specificity of ~86 % for an infection type diagnosis was achieved. The present preliminary study suggests that FTIR spectroscopy of WBCs is a potentially feasible and efficient tool for the diagnosis of the infection type.

Keywords: viral infection, bacterial infection, linear discriminant analysis, plasma, white blood cells, infrared spectroscopy

Procedia PDF Downloads 219
469 Validation of the Arabic Version of the Positive and Negative Syndrome Scale (PANSS)

Authors: Arij Yehya, Suhaila Ghuloum, Abdlmoneim Abdulhakam, Azza Al-Mujalli, Mark Opler, Samer Hammoudeh, Yahya Hani, Sundus Mari, Reem Elsherbiny, Ziyad Mahfoud, Hassen Al-Amin

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Introduction: The Positive and Negative Syndrome Scale (PANSS) is a valid instrument developed by Kay and colleagues6 to assess symptoms of patients with schizophrenia. It consists of 30 items that factor the symptoms into three subscales: positive, negative and general psychopathology. This scale has been translated and validated in several languages. Objective: This study aims to determine the validity and psychometric properties of the Arabic version of the PANSS. Methods: A standardized translation and cultural adaptation method was adopted. Patients diagnosed with schizophrenia (n=98), according to psychiatrist’s diagnosis based on DSM-IV criteria, were recruited from the Psychiatry Department at Rumailah Hospital, Qatar. A first rater confirmed the diagnosis using the Arabic version of Mini International Neuropsychiatric Interview (MINI 6). A second and independent rater-administered the Arabic version of PANSS. Also, a control group (n=101), with no history of psychiatric disorder was recruited from the family and friends of the patients and from primary health care centers in Qatar. Results: There were more males than females in our sample of patients with schizophrenia (68.9% and 31.6%, respectively). On the other hand, in the control group the number of females outweighed that of males (58.4% and 41.6% respectively). The scale had a good internal consistency with Cronbach’s alpha 0.91. There was a significant difference between the scores on the three subscales of the PANSS. Patients with schizophrenia scored significantly higher (p<.0001) than the control subjects on subscales for positive symptoms 20.01(SD=7.21) and 7.30(SD=1.38), negative symptoms 18.89(SD=8.88) and 7.37(SD=2.38) and general psychopathology 34.41 (SD=11.56) and 16.93 (SD=3.93), respectively. Factor analysis and ROC curve were carried out to further test the psychometrics of the scale. Conclusions: The Arabic version of PANSS is a reliable and valid tool to assess both positive and negative symptoms of patients with schizophrenia in a balanced manner. In addition to providing the Arab population with a standardized tool to monitor symptoms of schizophrenia, this version provides a gateway to compare the prevalence of positive and negative symptoms in the Arab world which can be compared to others done elsewhere.

Keywords: Arabic version, assessment, diagnosis, schizophrenia, validation

Procedia PDF Downloads 632
468 Angiographic Evaluation of ETT (Treadmill) Positive Patients in a Tertiary Care Hospital of Bangladesh

Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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Objective: To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. Methods: This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute,Dhaka,Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Results: Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87 ± 7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032)difference in the two groups(sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statically significant (p<0.004) and diabetic, dyslipidaemic patients having true positive which were statically significant (p < 0.032 & 0.030).True positive patients had family history were 68 (83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant(p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138)and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90%), followed by LCX 42 (51.85%), RCA 36 (44.44%) and the LMCA was 9 (11.11%), .40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. Conclusion: It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients,resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetis, dyslipidaemic, family history and smoking are likely to have a true positive treadmill test result.

Keywords: exercise tolerance test, coronary artery disease, coronary angiography, true positive, false positive

Procedia PDF Downloads 267
467 Opinions and Perceptions of Clinical Staff towards Caring for Obese Patients: A Qualitative Research Study in a Cardiac Centre in Bahrain

Authors: Catherine Mary Abou-Zaid, Sandra Goodwin

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This study was conducted in a cardiac center in Bahrain. The rise in the amount of obese patients’ both men and women, being admitted for surgical procedures has become an issue to the nurses and doctors as these patients pose a high risk of major complications arising from their problem. The cessation of obesity in the country is very high and obesity-related diseases has been the cause of concern among men and women, also related individual diseases such as cardiovascular, diabetes and chronic respiratory diseases are rising dramatically within Bahrain in the last 10 years. Rationale for the Study: The ontological approach will help to understand and assess the true nature of the social world and how the world looks at obesity. Obesity has to be looked at as being a realistic ongoing issue. The epistemological approach will look at the theory of the origins of the nature of knowledge, set the rule of validating and learning in the social world of what can be done to curb this concept and how this can help prevent otherwise preventable diseases. Design Methodology: The qualitative design methodology took the form of an ontological/epistemological approach using phenomenology as a framework. The study was based on a social research issue, therefore, ontological ‘realism and idealism’ will feature as the nature of the world from a social and natural context. Epistemological positions of the study will be how we as researchers will find the actual social world and the limiting of that knowledge. The one-to-one interviews will be transcribed and the taped verbatim will be coded and charted giving the thematic analytic results. Recommendations: The significance of the research brought many recommendations. These recommendations were taken from the themes and sub-themes and were presented to the centers management and the necessary arrangements for updating knowledge and attitudes towards obesity in cardiac patients was then presented to the in-service education department. Workshops and training sessions on promoting health education were organized and put into the educational calendar for the next academic year. These sessions would look at patient autonomy, the patients’ rights, healthy eating for patients and families and the risks associated with obesity in cardiac disease processes.

Keywords: cardiac patients, diabetes, education & training, obesity cessation, qualitative

Procedia PDF Downloads 327
466 Epidemiological Analysis of the Patients Supplied with Foot Orthoses in Ortho-Prosthetic Center of Kosovo

Authors: Ardiana Murtezani, Ilirijana Dallku, Teuta Osmani Vllasolli, Sabit Sllamniku

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Background: The use of foot orthoses are always indicated when there are alterations of the optimal biomechanics' position of the foot. Orthotics are very effective and very suitable for the majority of patients with pain due to overload which can be related to biomechanical disorders. Aim: To assess the frequency of patients requiring foot orthoses, type of orthoses and analysis of their disease leading to the use of foot orthoses. Material and Methods: Our study included 128 patients with various foot pathologies, treated at the outpatient department of the Ortho-Prosthetic Center of Kosovo (OPCK) in Prishtina. Prospective-descriptive clinical method was used during this study. Functional status of patients was examined, and the following parameters are noted: range of motion measurements for the affected joints/lower extremities, manual test for muscular strength below the knee and foot of the affected extremity, perimeter measurements of the lower extremities, measurements of lower extremities, foot length measurement, foot width measurements and size. In order to complete the measurements the following instruments are used: plantogram, pedogram, meter and cork shoe lift appliances. Results: The majority of subjects in this study are male (60.2% vs. 39.8%), and the dominant age group was 0-9 (47.7%), 61 subjects respectively. Most frequent foot disorders were: congenital disease 60.1%, trauma cases 13.3%, consequences from rheumatologic disease 12.5%, neurologic dysfunctions 11.7%, and the less frequented are the infectious cases 1.6%. Congenital anomalies were the most frequent cases, and from this group majority of cases suffered from pes planovalgus (37.5%), eqinovarus (15.6%) and discrepancies between extremities (6.3%). Furthermore, traumatic amputations (2.3%) and arthritis (0.8%). As far as neurologic disease, subjects with cerebral palsy are represented with (3.1%), peroneal nerve palsy (2.3%) and hemiparesis (1.6%). Infectious disease osteomyelitis sequels are represented with (1.6%). Conclusion: Based on our study results, we have concluded that the use of foot orthoses for patients suffering from rheumatoid arthritis and nonspecific arthropaty was effective treatment choice, leading to decrease of pain, less deformities and improves the quality of life.

Keywords: orthoses, epidemiological analysis, rheumatoid arthritis, rehabilitation

Procedia PDF Downloads 225
465 Optimization of Bills Assignment to Different Skill-Levels of Data Entry Operators in a Business Process Outsourcing Industry

Authors: M. S. Maglasang, S. O. Palacio, L. P. Ogdoc

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Business Process Outsourcing has been one of the fastest growing and emerging industry in the Philippines today. Unlike most of the contact service centers, more popularly known as "call centers", The BPO Industry’s primary outsourced service is performing audits of the global clients' logistics. As a service industry, manpower is considered as the most important yet the most expensive resource in the company. Because of this, there is a need to maximize the human resources so people are effectively and efficiently utilized. The main purpose of the study is to optimize the current manpower resources through effective distribution and assignment of different types of bills to the different skill-level of data entry operators. The assignment model parameters include the average observed time matrix gathered from through time study, which incorporates the learning curve concept. Subsequently, a simulation model was made to duplicate the arrival rate of demand which includes the different batches and types of bill per day. Next, a mathematical linear programming model was formulated. Its objective is to minimize direct labor cost per bill by allocating the different types of bills to the different skill-levels of operators. Finally, a hypothesis test was done to validate the model, comparing the actual and simulated results. The analysis of results revealed that the there’s low utilization of effective capacity because of its failure to determine the product-mix, skill-mix, and simulated demand as model parameters. Moreover, failure to consider the effects of learning curve leads to overestimation of labor needs. From 107 current number of operators, the proposed model gives a result of 79 operators. This results to an increase of utilization of effective capacity to 14.94%. It is recommended that the excess 28 operators would be reallocated to the other areas of the department. Finally, a manpower capacity planning model is also recommended in support to management’s decisions on what to do when the current capacity would reach its limit with the expected increasing demand.

Keywords: optimization modelling, linear programming, simulation, time and motion study, capacity planning

Procedia PDF Downloads 511
464 The Characteristics of the Operating Parameters of the Vertical Axis Wind Turbine for the Selected Wind Speed

Authors: Zdzislaw Kaminski, Zbigniew Czyz

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The paper discusses the results of the research into a wind turbine with a vertical axis of rotation which was performed with the open return wind tunnel, Gunt HM 170, at the laboratory of the Department of Thermodynamics, Fluid Mechanics and Propulsion Aviation Systems of Lublin University of Technology. Wind tunnel experiments are a necessary step to construct any new type of wind turbine, to validate design assumptions and numerical results. This research focused on the rotor with the blades capable of modifying their working surfaces, i.e. absorbing wind kinetic energy. The operation of this rotor is based on adjusting angular aperture α of the top and bottom parts of the blades mounted on an axis. If this angle α increases, the working surface which absorbs wind kinetic energy also increases. The study was performed on scaled and geometrically similar models with the criteria of similarity relevant for the type of research preserved. The rotors with varied angular apertures of their blades were printed for the research with a powder 3D printer, ZPrinter® 450. This paper presents the research results for the selected flow speed of 6.5 m/s for the three angular apertures of the rotor blades, i.e. 30°, 60°, 90° at varied speeds. The test stand enables the turbine rotor to be braked to achieve the required speed and airflow speed and torque to be recorded. Accordingly, the torque and power as a function of airflow were plotted. The rotor with its adjustable blades enables turbine power to be adjusted within a wide range of wind speeds. A variable angular aperture of blade working surfaces α in a wind turbine enables us to control the speed of the turbine and consequently its output power. Reducing the angular aperture of working surfaces results in reduced speed, and if a special current generator applied, electrical output power is reduced, too. Speed adjusted by changing angle α enables the maximum load acting on rotor blades to be controlled. The solution under study is a kind of safety against a damage of a turbine due to possible high wind speed.

Keywords: drive torque, renewable energy, power, wind turbine, wind tunnel

Procedia PDF Downloads 251
463 The Role of Glyceryl Trinitrate (GTN) in 99mTc-HIDA with Morphine Provocation Scan for the Investigation of Type III Sphincter of Oddi Dysfunction (SOD)

Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland

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Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.

Keywords: GTN, HIDA, MORPHINE, SOD

Procedia PDF Downloads 297
462 Psychological Factors of Readiness of Defectologists to Professional Development: On the Example of Choosing an Educational Environment

Authors: Inna V. Krotova

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The study pays special attention to the definition of the psychological potential of a specialist-defectologist, which determines his desire to increase the level of his or her professional competence. The group included participants of the educational environment – an additional professional program 'Technologies of psychological and pedagogical assistance for children with complex developmental disabilities' implemented by the department of defectology and clinical psychology of the KFU jointly with the Support Fund for the Deafblind people 'Co-Unity'. The purpose of our study was to identify the psychological aspects of the readiness of the specialist-defectologist to his or her professional development. The study assessed the indicators of psychological preparedness, and its four components were taken into account: motivational, cognitive, emotional and volitional. We used valid and standardized tests during the study. As a result of the factor analysis of data received (from Extraction Method: Principal Component Analysis, Rotation Method: Varimax with Kaiser Normalization, Rotation converged in 12 iterations), there were identified three factors with maximum factor load from 24 indices, and their correlation coefficients with other indicators were taken into account at the level of reliability p ≤ 0.001 and p ≤ 0.01. Thus the system making factor was determined – it’s a 'motivation to achieve success'; it formed a correlation galaxy with two other factors: 'general internality' and 'internality in the field of achievements', as well as with such psychological indicators as 'internality in the field of family relations', 'internality in the field of interpersonal relations 'and 'low self-control-high self-control' (the names of the scales used is the same as names in the analysis methods. In conclusion of the article, we present some proposals to take into account the psychological model of readiness of specialists-defectologists for their professional development, to stimulate the growth of their professional competence. The study has practical value for all providers of special education and organizations that have their own specialists-defectologists, teachers-defectologists, teachers for correctional and ergotherapeutic activities, specialists working in the field of correctional-pedagogical activity (speech therapists) to people with special needs who need true professional support.

Keywords: psychological readiness, defectologist, professional development, psychological factors, special education, professional competence, innovative educational environment

Procedia PDF Downloads 171
461 Sexually Transmitted Diseases Taboo: Time to Rethink

Authors: Kalpana Gupta

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Sexually transmitted infections (STIs) are infections that are spread primarily through sexual contact. In our daily practice, we see gonorrhea, chancroid, syphilis, and chlamydial infections that can be cured, as well as HIV, genital herpes, HPV, and hepatitis B infections that cannot be cured but can be managed with available treatments. Many people in India are infected with Sexually transmitted diseases (STDs), and the figures are quite high because of a lack of awareness and communication, as well as a taboo against these diseases. Numerous taboos and associated stigma shape patients’ lives and have a significant impact on health care policies, medical research, and current issues in medical ethics. Current statistics emphasize the importance of delivering sex education to this important demographic promptly. The long-standing tradition of girls marrying very young, especially in rural areas, and often too much older men, causes a slew of STIs. Stigma and HIV have a cyclical relationship; people who experience stigma and discrimination are marginalized and made more vulnerable to HIV/STDs, while those living with HIV are more vulnerable to stigma and discrimination. As urban pressures have grown, so have slums - and they have fast become ideal breeding grounds for STDs. In developed countries, strict laws have been enacted requiring people suffering from STDs to seek immediate treatment as well as contact the health department. Unfortunately, because of the stigma associated with the disease, patients in India are reluctant to reveal the source of infection. With various schemes, India is attempting to promote sex education and awareness. For example, the Ministry of Health and Family Welfare developed the National Adolescent Health Programme (also known as the Rashtriya Kishor Swasthya Karyakram) in partnership with the United Nations Population Fund (UNFPA). Whereas, National AIDS Control Organisation was set up so that every person living with HIV has access to quality care and is treated with dignity and breaking all taboos. It becomes clear that research and healthcare policies will not be effective in assisting patients with STDs unless these "nonscientific" elements are taken into account.

Keywords: sexually transmitted diseases, sexually transmitted infections, taboo, stigma, HIV/STDs, sex education and awareness, treatment, quality care, medications, healthcare policies

Procedia PDF Downloads 182
460 Climate Change and Migration in the Semi-arid Tropic and Eastern Regions of India: Exploring Alternative Adaptation Strategies

Authors: Gauri Sreekumar, Sabuj Kumar Mandal

Abstract:

Contributing about 18% to India’s Gross Domestic Product, the agricultural sector plays a significant role in the Indian rural economy. Despite being the primary source of livelihood for more than half of India’s population, most of them are marginal and small farmers facing several challenges due to agro-climatic shocks. Climate change is expected to increase the risk in the regions that are highly agriculture dependent. With systematic and scientific evidence of changes in rainfall, temperature and other extreme climate events, migration started to emerge as a survival strategy for the farm households. In this backdrop, our present study aims to combine the two strands of literature and attempts to explore whether migration is the only adaptation strategy for the farmers once they experience crop failures due adverse climatic condition. Combining the temperature and rainfall information from the weather data provided by the Indian Meteorological Department with the household level panel data on Indian states belonging to the Eastern and Semi-Arid Tropics regions from the Village Dynamics in South Asia (VDSA) collected by the International Crop Research Institute for the Semi-arid Tropics, we form a rich panel data for the years 2010-2014. A Recursive Econometric Model is used to establish the three-way nexus between climate change-yield-migration while addressing the role of irrigation and local non-farm income diversification. Using Three Stage Least Squares Estimation method, we find that climate change induced yield loss is a major driver of farmers’ migration. However, irrigation and local level non-farm income diversification are found to mitigate the adverse impact of climate change on migration. Based on our empirical results, we suggest for enhancing irrigation facilities and making local non-farm income diversification opportunities available to increase farm productivity and thereby reduce farmers’ migration.

Keywords: climate change, migration, adaptation, mitigation

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