Search results for: Christian M. Oliveira
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 557

Search results for: Christian M. Oliveira

257 Controlling Images and Survival Strategies for Muslim Women in Pakistan

Authors: Ayesha Murtza

Abstract:

Controlling images develop misinformed behaviors about impoverished Muslim Pakistani women that add to the oppression these Pakistani women endure their whole lives. Meanwhile, patriarchal and stereotypical societies provide an ideological justification for gender, class, and racial oppression, especially for women. Cojoining the concepts of controlling images by Patricia Hill Collins (1990) and binary thinking by Barbara Christian (1987), this paper discusses the ways in which various controlling images of urban and rural women are being presented in Pakistani dramas. These images reinforce an interlocking system of oppression for women in Pakistan. This paper further explores how these controlling images of intersecting components like class, gender, religion, ethnicity, physical appearance, color, and caste normalize hegemonic gendered oppression in society and how men have the same attitude towards women of their family whether they belong to the rural or urban class since they are the product of the same society. It further sheds light on how these matrixes of domination are an inevitable part of Pakistani women’s everyday lives and how these women reinforce survival strategies for coping with all these forms of oppression. By employing the feminist interactional framework, this paper elucidates the role of masculinity, femininity, feminist activism, and traditional knowledge against a monolithic image of Pakistani women. By highlighting these, this paper complicates the role of descriptive and visual images, religion, women’s rights, and the stereotypical role of women in Pakistani dramas.

Keywords: controlling images, oppression, women, Pakistan

Procedia PDF Downloads 56
256 Toxicological Interactions of Silver Nanoparticles and Non-Essential Metals in Human Hepatocarcinoma Cell Line

Authors: Renata Rank Miranda, Arandi Ginane Bezerra, Ciro Alberto Oliveira Ribeiro, Marco AntôNio Ferreira Randi, Carmen Lúcia Voigt, Lilian Skytte, Kaare Lund Rasmussen, Francisco Filipak Neto, Frank Kjeldsen

Abstract:

Synergetic and antagonistic effects of drugs are well-known concerns in pharmacological assessments of dose and toxicity. Similar approach should be used in assessing cellular uptake and cytotoxicity of nanoparticles. Since nanoparticles are released into the aquatic environment they may interact with existing xenobiotics. Here we used biochemical assays and quantitative proteomics to assess the cytotoxicity of silver nanoparticles (AgNP) when human hepatoma HepG2 cells were co-exposed to 2 nm AgNP together with either Cd2+ or Hg2+ ions. Time-course experiments (2h, 4h, and 24h) were conducted to assess the first response to the exposure studies. The general trend was that a synergetic toxicological response was observed in cells exposed to both AgNP and Cd2+ or Hg2+, with AgNP and Cd2+ being more toxic. This was observed by a significant increase in the ROS and superoxide level of >35% in the case of AgNP+Cd2+ compared to the sum of responses of AgNP and Cd2+, individually. Metabolic activity and viability also dropped more for AgNP+Cd2+ (>10%) than for AgNP and Cd2+ combined. We used inductively coupled plasma mass spectrometry to investigate if AgNP facilitates larger influx of toxic metal ions into HepG2 cells. Only Hg2+ ions was found to be more efficiently engulfed as the concentration of Hg2+ was found 2.8 times larger compared to exposure experiments with only Hg2+. This effect was not observed for Cd2+. We now continue with deep proteomics studies to obtain wider details on the mechanism of the toxicity related to AgNP, Cd2+, and AgNP+Cd2+, respectively.

Keywords: nanotoxicology, silver nanoparticles, proteomics, human cell line

Procedia PDF Downloads 326
255 Adsorptive Performance of Surface Modified Montmorillonite in Vanadium Removal from Real Mine Water

Authors: Opeyemi Atiba-Oyewo, Taile Y. Leswfi, Maurice S. Onyango, Christian Wolkersdorfer

Abstract:

This paper describes the preparation of surface modified montmorillonite using hexadecyltrimethylammonium bromide (HDTMA-Br) for the removal of vanadium from mine water. The adsorbent before and after adsorption was characterised by Fourier transform infra-red (FT-IR), X-ray diffraction (XRD) and scanning electron microscopy (SEM), while the amount of vanadium adsorbed was determined by ICP-OES. The batch adsorption method was employed using vanadium concentrations in solution ranging from 50 to 320 mg/L and vanadium tailings seepage water from a South African mine. Also, solution pH, temperature and sorbent mass were varied. Results show that the adsorption capacity was affected by solution pH, temperature, sorbent mass and the initial concentration. Electrical conductivity of the mine water before and after adsorption was measured to estimate the total dissolved solids in the mine water. Equilibrium isotherm results revealed that vanadium sorption follows the Freundlich isotherm, indicating that the surface of the sorbent was heterogeneous. The pseudo-second order kinetic model gave the best fit to the kinetic experimental data compared to the first order and Elovich models. The results of this study may be used to predict the uptake efficiency of South Africa montmorillonite in view of its application for the removal of vanadium from mine water. However, the choice of this adsorbent for the uptake of vanadium or other contaminants will depend on the composition of the effluent to be treated.

Keywords: adsorption, vanadium, modified montmorillonite, equilibrium, kinetics, mine water

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254 Mechanical, Physical and Durability Properties of Cement Mortars Added with Recycled PP/PE-Based Food Packaging Waste Material

Authors: Livia Guerini, Christian Paglia

Abstract:

In Switzerland, only a fraction of plastic waste from food packaging is collected and recycled for further use in the food industry. Therefore, reusing these waste plastics for building applications can be an attractive alternative to disposal in order to reduce the problem of waste management and to make up for the depletion of raw materials needed for construction. In this study, experiments were conducted on the mechanical properties (compressive and flexural strength, elastic modulus), physical properties (density, workability, porosity, and water permeability) and durability (freeze/thaw resistance) of cementitious mortars with additions of recycled low-/high-density polyethylene (LDPE/HDPE)/ polypropylene (PP) regrind (addition of 5% and 10% by weight) and LDPE sheets (addition of 0.5% and 1.5% by weight) coming from food packaging. The results show that as the addition of plastic material increases, the density and mechanical properties of the mortars decrease compared to conventional ones. Porosity is similar in all the mixtures made, while the workability and the permeability are affected not only by the amount added but also by the shape of the plastic aggregate. Freeze/thaw resistance, on the other hand, is significantly higher in mortars with plastic aggregates than in traditional mortar. This feature may be interesting for the realization of outdoor mortars in cold environments.

Keywords: food packaging waste, durability properties, mechanical properties, mortar, recycled PE, recycled PP

Procedia PDF Downloads 113
253 Physician and Theologian: An Analysis of Ibn Rabban’s Approach on Sīra Nabawiyya

Authors: Ahmad Sanusi Azmi, Amiruddin Mohd Sobali, Zulhilmi Mohamed Nor, Mohd Yusuf Ismail, Amran Abdul Halim

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The non-Muslim communities’ reactions to the denials of the prophethood of Muḥammad in the ninth century created an impact on the development of Islamic prophetology. Vigorous refutations from non-Muslim community, specifically the Jews, Christians and Brahmins urged Muslims to develop a solid mechanism in defense of the status of their beloved prophet. One of the works that has been recognized as an apparatus to defend the Prophet Muḥammad veracity is al-Dīn wa al-Dawla composed by Ibn Rabban, a physician of the Caliph’s court. This study analyses the novelty of his approaches in exploring Sīra Nabawiyya and defending the prophethood of Muḥammad. The study employed a descriptive, comparative and critical approach where it analyses and extracts the author original approach in explaining the legitimacy of Muḥammad’s prophethood and enlightening the Prophet’s biography. The study in its finding argues that most of Ibn Rabban arguments in this work are actually developed from the foundations of Biblical scripture. His style of interpreting Biblical passages indicates a possible dependence on Ibn al-Layth’s letter. However, the way in which he presents Qur’ānic references seems not to be in accordance with Ibn al-Layth’s perspective. This is where the novelty of his approach is distinguished. As a result, the study also affirms that Ibn Rabban imposes his own standards of selection and interpretation of Qur’ānic verses when he applies it as reference to the Prophet life.

Keywords: Sīra Nabawiyya, Ibn Rabban, al-Dīn wa al-Dawla, Christian, Dalāil Nubuwwa

Procedia PDF Downloads 307
252 Further Evidence for the Existence of Broiler Chicken PFN (Pale, Firm and Non-Exudative Meat) and PSE (Pale, Soft and Exudative) in Brazilian Commercial Flocks

Authors: Leila M. Carvalho, Maria Erica S. Oliveira, Arnoud C. Neto, Elza I. Ida, Massami Shimokomaki, Marta S. Madruga

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The quality of broiler breast meat is changing as a result of the continuing emphasis on genetic selection for a more efficient meat production. Breast meat has been classified as PSE (pale, soft, exudative), DFD (dark, firm, dry) and normal color meat, and recently a third group has emerged: the so-called PFN (pale, firm, non-exudative) meat. This classification was based on pH, color and functional properties. The aim of this work was to confirm the existence of PFN and PSE meat by biochemical characterization and functional properties. Twenty four hours of refrigerated fillet, Pectoralis major, m. samples (n= 838) were taken from Cobb flocks 42-48 days old, obtained in Northeastern Brazil tropical region, the Northeastern, considered to have only dry and wet seasons. Color (L*), pH, water holding capacity (WHC), values were evaluated and compared with PSE group samples. These samples were classified as Normal (465.8), PSE meat (L*≥53; pH<5.8) and PFN (L*≥53; pH>5.8). The occurrence of control meat, PSE and PFN was 69.09%, 11.10% and 19.81%, respectively. Samples from PFN presented 4.0-5.0% higher WHC in relation to PSE meat and similar to control group. These results are explained by the fact that PSE meat syndrome occurs because of higher protein denaturation as the consequence of a simultaneous lower pH values under warm carcass sooner after slaughtering impairing the myofibril proteins functional properties. Conversely, PFN samples follow normal glycolysis rate maintaining the normal proteins activities. In conclusion, the results reported herein confirm the existence of this emerging broiler meat group with similar properties as control group and it should be considered as normal breast meat group.

Keywords: broiler breast meat, funcional properties, PFN, PSE

Procedia PDF Downloads 222
251 Geometrical Analysis of Tiling Patterns in Azari Style: The Case of Tabriz Kaboud Mosque

Authors: Seyyedeh Faezeh Miralami, Sahar Sayyadchapari, Mona Laleh, Zahra Poursafar

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Tiling patterns are magnificent display of decoration in Islamic period. They transform the dusty and dreary facades to splendid and ornate ones. Due to ideological factors and elements of Azari style decorations, geometrical patterns and vegetative designs became prevalent and pervasive in religious sites like mosques. Objectives: The objective of this research is a study of tiling patterns in Tabriz Kaboud mosque, as a splendid work of architecture in Azari style. In this study, the geometrical designs and tiling patterns employed in the mosque decorations are examined and analyzed. Method: The research is based on a descriptive analysis method. Data and information are collected based on documents library and field study. Then, polished and brushed, the study resulted in an illustrative conclusion. Findings: In religious sites such as mosques, geometry represents ‘divination’ in Christian theology and ‘Unity with God’ or ‘Tawhid’ in Islamic terminology. In other words, science, literature, architecture, and all forms of human expression and representation are pointed towards one cause, unity or divination. Tiling patterns of Kaboud Mosque, mostly hexagonal, circular, square and triangle, form outstanding architectonic features which recount a story, a narration of divination or unification with the One.

Keywords: tiling, Azari style, Tabriz Kaboud Mosque, Islamic architecture

Procedia PDF Downloads 294
250 UV-Vis Spectroscopy as a Tool for Online Tar Measurements in Wood Gasification Processes

Authors: Philip Edinger, Christian Ludwig

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The formation and control of tars remain one of the major challenges in the implementation of biomass gasification technologies. Robust, on-line analytical methods are needed to investigate the fate of tar compounds when different measures for their reduction are applied. This work establishes an on-line UV-Vis method, based on a liquid quench sampling system, to monitor tar compounds in biomass gasification processes. Recorded spectra from the liquid phase were analyzed for their tar composition by means of a classical least squares (CLS) and partial least squares (PLS) approach. This allowed for the detection of UV-Vis active tar compounds with detection limits in the low part per million by volume (ppmV) region. The developed method was then applied to two case studies. The first involved a lab-scale reactor, intended to investigate the decomposition of a limited number of tar compounds across a catalyst. The second study involved a gas scrubber as part of a pilot scale wood gasification plant. Tar compound quantification results showed good agreement with off-line based reference methods (GC-FID) when the complexity of tar composition was limited. The two case studies show that the developed method can provide rapid, qualitative information on the tar composition for the purpose of process monitoring. In cases with a limited number of tar species, quantitative information about the individual tar compound concentrations provides an additional benefit of the analytical method.

Keywords: biomass gasification, on-line, tar, UV-Vis

Procedia PDF Downloads 235
249 Development of an Aerosol Protection Capsule for Patients with COVID-19

Authors: Isomar Lima da Silva, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Biological isolation capsules are equipment commonly used in the control and prevention of infectious diseases in the hospital environment. This type of equipment, combined with pre-established medical protocols, contributes significantly to the containment of highly transmissible pathogens such as COVID-19. Due to its hermetic isolation, it allows more excellent patient safety, protecting companions and the health team. In this context, this work presents the development, testing, and validation of a medical capsule to treat patients affected by COVID-19. To this end, requirements such as low cost and easy handling were considered to meet the demand of people infected with the virus in remote locations in the Amazon region and/or where there are no ICU beds and mechanical ventilators for orotracheal intubation. Conceived and developed in a partnership between SAMEL Planos de Saúde and Instituto Conecthus, the device entitled "Vanessa Capsule" was designed to be used together with the NIV protocol (non-invasive ventilation), has an automatic exhaust system and filters performing the CO2 exchange, in addition to having BiPaps ventilatory support equipment (mechanical fans) in the Cabin Kit. The results show that the degree of effectiveness in protecting against infection by aerosols, with the protection cabin, is satisfactory, implying the consideration of the Vanessa capsule as an auxiliary method to be evaluated by the health team. It should also be noted that the medical observation of the evaluated patients found that the treatment against the COVID-19 virus started earlier with non-invasive mechanical ventilation reduces the patient's suffering and contributes positively to their recovery, in association with isolation through the Vanessa capsule.

Keywords: COVID-19, mechanical ventilators, medical capsule, non-invasive ventilation

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248 Using the Yield-SAFE Model to Assess the Impacts of Climate Change on Yield of Coffee (Coffea arabica L.) Under Agroforestry and Monoculture Systems

Authors: Tesfay Gidey Bezabeh, Tânia Sofia Oliveira, Josep Crous-Duran, João H. N. Palma

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Ethiopia's economy depends strongly on Coffea arabica production. Coffee, like many other crops, is sensitive to climate change. An urgent development and application of strategies against the negative impacts of climate change on coffee production is important. Agroforestry-based system is one of the strategies that may ensure sustainable coffee production amidst the likelihood of future impacts of climate change. This system involves the combination of trees in buffer extremes, thereby modifying microclimate conditions. This paper assessed coffee production under 1) coffee monoculture and 2) coffee grown using an agroforestry system, under a) current climate and b) two different future climate change scenarios. The study focused on two representative coffee-growing regions of Ethiopia under different soil, climate, and elevation conditions. A process-based growth model (Yield-SAFE) was used to simulate coffee production for a time horizon of 40 years. Climate change scenarios considered were representative concentration pathways (RCP) 4.5 and 8.5. The results revealed that in monoculture systems, the current coffee yields are between 1200-1250 kg ha⁻¹ yr⁻¹, with an expected decrease between 4-38% and 20-60% in scenarios RCP 4.5 and 8.5, respectively. However, in agroforestry systems, the current yields are between 1600-2200 kg ha⁻¹ yr⁻¹; the decrease was lower, ranging between 4-13% and 16-25% in RCP 4.5 and 8.5 scenarios, respectively. From the results, it can be concluded that coffee production under agroforestry systems has a higher level of resilience when facing future climate change and reinforces the idea of using this type of management in the near future for adapting climate change's negative impacts on coffee production.

Keywords: Albizia gummifera, CORDEX, Ethiopia, HADCM3 model, process-based model

Procedia PDF Downloads 82
247 Speech Enhancement Using Wavelet Coefficients Masking with Local Binary Patterns

Authors: Christian Arcos, Marley Vellasco, Abraham Alcaim

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In this paper, we present a wavelet coefficients masking based on Local Binary Patterns (WLBP) approach to enhance the temporal spectra of the wavelet coefficients for speech enhancement. This technique exploits the wavelet denoising scheme, which splits the degraded speech into pyramidal subband components and extracts frequency information without losing temporal information. Speech enhancement in each high-frequency subband is performed by binary labels through the local binary pattern masking that encodes the ratio between the original value of each coefficient and the values of the neighbour coefficients. This approach enhances the high-frequency spectra of the wavelet transform instead of eliminating them through a threshold. A comparative analysis is carried out with conventional speech enhancement algorithms, demonstrating that the proposed technique achieves significant improvements in terms of PESQ, an international recommendation of objective measure for estimating subjective speech quality. Informal listening tests also show that the proposed method in an acoustic context improves the quality of speech, avoiding the annoying musical noise present in other speech enhancement techniques. Experimental results obtained with a DNN based speech recognizer in noisy environments corroborate the superiority of the proposed scheme in the robust speech recognition scenario.

Keywords: binary labels, local binary patterns, mask, wavelet coefficients, speech enhancement, speech recognition

Procedia PDF Downloads 200
246 Solving a Micromouse Maze Using an Ant-Inspired Algorithm

Authors: Rolando Barradas, Salviano Soares, António Valente, José Alberto Lencastre, Paulo Oliveira

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This article reviews the Ant Colony Optimization, a nature-inspired algorithm, and its implementation in the Scratch/m-Block programming environment. The Ant Colony Optimization is a part of Swarm Intelligence-based algorithms and is a subset of biological-inspired algorithms. Starting with a problem in which one has a maze and needs to find its path to the center and return to the starting position. This is similar to an ant looking for a path to a food source and returning to its nest. Starting with the implementation of a simple wall follower simulator, the proposed solution uses a dynamic graphical interface that allows young students to observe the ants’ movement while the algorithm optimizes the routes to the maze’s center. Things like interface usability, Data structures, and the conversion of algorithmic language to Scratch syntax were some of the details addressed during this implementation. This gives young students an easier way to understand the computational concepts of sequences, loops, parallelism, data, events, and conditionals, as they are used through all the implemented algorithms. Future work includes the simulation results with real contest mazes and two different pheromone update methods and the comparison with the optimized results of the winners of each one of the editions of the contest. It will also include the creation of a Digital Twin relating the virtual simulator with a real micromouse in a full-size maze. The first test results show that the algorithm found the same optimized solutions that were found by the winners of each one of the editions of the Micromouse contest making this a good solution for maze pathfinding.

Keywords: nature inspired algorithms, scratch, micromouse, problem-solving, computational thinking

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245 The Use of Microbiological Methods to Reduce Aflatoxin M1 in Cheese

Authors: Bruna Goncalves, Jennifer Henck, Romulo Uliana, Eliana Kamimura, Carlos Oliveira, Carlos Corassin

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Studies have shown evidence of human exposure to aflatoxin M1 due to the consumption of contaminated milk and dairy products (mainly cheeses). This poses a great risk to public health, since milk and milk products are frequently consumed by a portion of the population considered immunosuppressed, children and the elderly. Knowledge of the negative impacts of aflatoxins on health and economics has led to investigations of strategies to prevent their formation in food, as well as to eliminate, inactivate or reduce the bioavailability of these toxins in contaminated products This study evaluated the effect of microbiological methods using lactic acid bacteria on aflatoxin M1 (AFM1) reduction in Minas Frescal cheese (typical Brazilian product, being among the most consumed cheeses in Brazil) spiked with 1 µg/L AFM1. Inactivated lactic acid bacteria (0,5%, v/v de L. rhamnosus e L. lactis) were added during the cheese production process. Nine cheeses were produced, divided into three treatments: negative controls (without AFM1 or lactic acid bacteria), positive controls (AFM1 only), and lactic acid bacteria + AFM1. Samples of cheese were collected on days 2, 10, 20 and 30 after the date of production and submitted to composition analyses and determination of AFM1 by high-performance liquid chromatography. The reductions of AFM1 in cheese by lactic acid bacteria at the end of the trial indicate a potential application of inactivated lactic acid bacteria in reducing the bioavailability of AFM1 in Minas frescal cheese without physical-chemical and microbiological modifications during the 30-day experimental period. The authors would like to thank São Paulo Research Foundation – FAPESP (grants #2017/20081-6 and #2017/19683-1).

Keywords: aflatoxin, milk, minas frescal cheese, decontamination

Procedia PDF Downloads 164
244 Characterization and Nanostructure Formation of Banana Peels Nanosorbent with Its Application

Authors: Opeyemi Atiba-Oyewo, Maurice S. Onyango, Christian Wolkersdorfer

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Characterization and nanostructure formation of banana peels as sorbent material are described in this paper. The transformation of this agricultural waste via mechanical milling to enhance its properties such as changed in microstructure and surface area for water pollution control and other applications were studied. Mechanical milling was employed using planetary continuous milling machine with ethanol as a milling solvent and the samples were taken at time intervals between 10 h to 30 h to examine the structural changes. The samples were characterised by X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infra-red (FTIR), Transmission electron microscopy (TEM) and Brunauer Emmett and teller (BET). Results revealed three typical structures with different deformation mechanisms and the grain-sizes within the range of (71-12 nm), nanostructure of the particles and fibres. The particle size decreased from 65µm to 15 nm as the milling progressed for a period of 30 h. The morphological properties of the materials indicated that the particle shapes becomes regular and uniform as the milling progresses. Furthermore, particles fracturing resulted in surface area increment from 1.0694-4.5547 m2/g. The functional groups responsible for the banana peels capacity to coordinate and remove metal ions, such as the carboxylic and amine groups were identified at absorption bands of 1730 and 889 cm-1, respectively. However, the choice of this sorbent material for the sorption or any application will depend on the composition of the pollutant to be eradicated.

Keywords: characterization, nanostructure, nanosorbent, eco-friendly, banana peels, mechanical milling, water quality

Procedia PDF Downloads 251
243 The Management of Care by People with Type 2 Diabetes versus the Professional Care at Primary Health Care in Brazil

Authors: Nunila Ferreira de Oliveira, Silvana Martins Mishima

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Diabetes mellitus type 2 (DM2) prevalence, is increasing on the world, in Brazil is considered a public health problem. Treatment focuses on glycemic control depending primarily of lifestyle changes - not drug treatment (NDT), may involve drug therapy (DT) and requires continuous health monitoring. In Brazil this monitoring is performed by the Unified Health System (SUS) through Primary Health Care (PHC), which stimulate people with DM2 empowerment for care management. SUS was approved in 1988 and the PHC operationalization was strengthened with the creation of the Family Health Strategy (FHS) in 1994. Our aim was to analyze the people with DM2 participation in front of the care management health monitoring in the FHS. Qualitative research was carried out through non-participant observation of attendance of 25 people with DM2 in the FHS and interviewed at home. Ethical guidelines were followed. It was found that people with DM2 only follow professionals’ recommendations that make sense according to their own conceptions of health/disease; most of them emphasize the importance of (DT) with little emphasis on the NDT, was found great difficulty in the NDT and lack of knowledge about the disease and care. As regards monitoring the FHS, were observed therapeutic practices based on the bio medical model, although the APS search for another care perspective; NDT is not systematically accompanied by the health team and takes place a few educational activities on the DM2 in the FHS, with low user adoption. The work of the FHS is done by multidisciplinary teams, but we see the need for greater participation of nurses in clinical-care follow-up of this population and may also act in adapting to the NDT. Finally we emphasize the need for professional practices that consider the difficulties to care management by people with DM2, especially because of the NDT. It is noticed that the measures recommended by the FHS professionals are not always developed by people with DM2. We must seek the empowerment of people with DM2 to manage the form of care associated with the FHS team, seeking to reduce the incidence of complications and higher quality of life.

Keywords: diabetes mellitus, primary health care, nursing, management of care

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242 Antibiogram Profile of Antibacterial Multidrug Resistance in Democratic Republic of Congo: Situation in Bukavu City Hospitals

Authors: Justin Ntokamunda Kadima, Christian Ahadi Irenge, Patient Birindwa Mulashe, Félicien Mushagalusa Kasali, Patient Wimba

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Background: Bacterial strains carrying multidrug resistance traits are gaining ground worldwide, especially in countries with limited resources. This study aimed to evaluate the spreading of multidrug-resistant bacteria strains in Bukavu city hospitals in the Democratic Republic of Congo. Methods: We analyzed 758 antibiogram data recorded in files of patients consulted between January 2016 and December 2017 at three reference hospitals selected as sentinel sites, namely the Panzi General Reference Hospital (HGP), BIO -PHARM hospital (HBP), and Saint Luc Clinic (CSL). Results: Of 758 isolates tested, the laboratories identified 12 bacterial strains in 712 isolates, of which 223 (29.42%) presented MDR profile, including Escherichia coli (11.48%), Klebsiella pneumonia (6.07%), Enterobacter (5.8%), Staphylococcus aureus and coagulase-negative Staphylococci (1.58%), Proteus mirabilis (1.85%), Salmonella enterica (1.19%), Pseudomonas aeruginosa (0.53%), Streptococcus pneumonia (0.4%)), Citrobacter (0.13%), Neisseria gonorrhea (0.13%), Enterococcus faecalis (0.13%), and Morganella morganii (0.13%). Infected patients were significantly more adults (73.1% vs. 21.5%) compared to children and mainly women (63.7% vs. 30.9%; p = 0.001). Conclusion: The observed expansion requires that hospital therapeutic committees set up an effective clinical management system and define the right combinations of antibiotics.

Keywords: multidrug resistance, bacteria, antibiogram, Bukavu

Procedia PDF Downloads 54
241 Systematic Review of the Efficacy of Traditional Chinese Medicine in Parkinson Disease

Authors: Catarina Ramos Pereira, Jorge Rodrigues, Natália Oliveira, Jorge Machado, Maria Begoña Criado, Jorge Machado, Henri J. Greten

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Background: Parkinson's disease is a multi-system neurodegenerative disorder characterized by motor and non-motor symptoms. To slow disorder progression, different treatment options are now available, but in most cases, these therapeutic strategies also involve the presence of important side effects. This has led many patients to pursue complementary therapies, such as acupuncture, to alleviate PD symptoms. Therefore, an update on the efficacy of this treatment for patients of PD is of great value. This work presents a systematic review of the efficacy of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central), and Scielo databases were systematically searched from January 2011 through July 2021. Randomized controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles were conducted by two blinding authors through the Rayyan application. Results: 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Additional evidence should be supported by rigorous methodological strategies. Although firm conclusions cannot be drawn, acupuncture treatment, in the framework of an interdisciplinary care team, appears to have positive effects on PD symptoms.

Keywords: systematic review, Parkinson disease, acupuncture, traditional Chinese medicine

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240 Joint Optimal Pricing and Lot-Sizing Decisions for an Advance Sales System under Stochastic Conditions

Authors: Maryam Ghoreishi, Christian Larsen

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In this paper, we investigate the effect of stochastic inputs on problem of joint optimal pricing and lot-sizing decisions where the inventory cycle is divided into advance and spot sales periods. During the advance sales period, customer can make reservations while customer with reservations can cancel their order. However, during the spot sales period customers receive the order as soon as the order is placed, but they cannot make any reservation or cancellation during that period. We assume that the inter arrival times during the advance sales and spot sales period are exponentially distributed where the arrival rate is decreasing function of price. Moreover, we assume that the number of cancelled reservations is binomially distributed. In addition, we assume that deterioration process follows an exponential distribution. We investigate two cases. First, we consider two-state case where we find the optimal price during the spot sales period and the optimal price during the advance sales period. Next, we develop a generalized case where we extend two-state case also to allow dynamic prices during the spot sales period. We apply the Markov decision theory in order to find the optimal solutions. In addition, for the generalized case, we apply the policy iteration algorithm in order to find the optimal prices, the optimal lot-size and maximum advance sales amount.

Keywords: inventory control, pricing, Markov decision theory, advance sales system

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239 Systolic Blood Pressure and Its Determinants: Study in a Population Attending Pharmacies in a Portuguese Coastal City

Authors: M. J. Reis Lima, J. Oliveira, M. Brito, C. Lemos, A. Mascarenhas, E. Teixeira Lemos

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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic blood pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2. and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population, we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Our study even with some limitations might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

Keywords: hypertension, age, exercise, obesity and gender

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238 3D Dentofacial Surgery Full Planning Procedures

Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

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The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

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237 Single Atom Manipulation with 4 Scanning Tunneling Microscope Technique

Authors: Jianshu Yang, Delphine Sordes, Marek Kolmer, Christian Joachim

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Nanoelectronics, for example the calculating circuits integrating at molecule scale logic gates, atomic scale circuits, has been constructed and investigated recently. A major challenge is their functional properties characterization because of the connecting problem from atomic scale to micrometer scale. New experimental instruments and new processes have been proposed therefore. To satisfy a precisely measurement at atomic scale and then connecting micrometer scale electrical integration controller, the technique improvement is kept on going. Our new machine, a low temperature high vacuum four scanning tunneling microscope, as a customer required instrument constructed by Omicron GmbH, is expected to be scaling down to atomic scale characterization. Here, we will present our first testified results about the performance of this new instrument. The sample we selected is Au(111) surface. The measurements have been taken at 4.2 K. The atomic resolution surface structure was observed with each of four scanners with noise level better than 3 pm. With a tip-sample distance calibration by I-z spectra, the sample conductance has been derived from its atomic locally I-V spectra. Furthermore, the surface conductance measurement has been performed using two methods, (1) by landing two STM tips on the surface with sample floating; and (2) by sample floating and one of the landed tips turned to be grounding. In addition, single atom manipulation has been achieved with a modified tip design, which is comparable to a conventional LT-STM.

Keywords: low temperature ultra-high vacuum four scanning tunneling microscope, nanoelectronics, point contact, single atom manipulation, tunneling resistance

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236 Greenhouse Controlled with Graphical Plotting in Matlab

Authors: Bruno R. A. Oliveira, Italo V. V. Braga, Jonas P. Reges, Luiz P. O. Santos, Sidney C. Duarte, Emilson R. R. Melo, Auzuir R. Alexandria

Abstract:

This project aims to building a controlled greenhouse, or for better understanding, a structure where one can maintain a given range of temperature values (°C) coming from radiation emitted by an incandescent light, as previously defined, characterizing as a kind of on-off control and a differential, which is the plotting of temperature versus time graphs assisted by MATLAB software via serial communication. That way it is possible to connect the stove with a computer and monitor parameters. In the control, it was performed using a PIC 16F877A microprocessor which enabled convert analog signals to digital, perform serial communication with the IC MAX232 and enable signal transistors. The language used in the PIC's management is Basic. There are also a cooling system realized by two coolers 12V distributed in lateral structure, being used for venting and the other for exhaust air. To find out existing temperature inside is used LM35DZ sensor. Other mechanism used in the greenhouse construction was comprised of a reed switch and a magnet; their function is in recognition of the door position where a signal is sent to a buzzer when the door is open. Beyond it exist LEDs that help to identify the operation which the stove is located. To facilitate human-machine communication is employed an LCD display that tells real-time temperature and other information. The average range of design operating without any major problems, taking into account the limitations of the construction material and structure of electrical current conduction, is approximately 65 to 70 ° C. The project is efficient in these conditions, that is, when you wish to get information from a given material to be tested at temperatures not as high. With the implementation of the greenhouse automation, facilitating the temperature control and the development of a structure that encourages correct environment for the most diverse applications.

Keywords: greenhouse, microcontroller, temperature, control, MATLAB

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235 Influence of Layer-by-Layer Coating Parameters on the Properties of Hybrid Membrane for Water Treatment

Authors: Jenny Radeva, Anke-Gundula Roth, Christian Goebbert, Robert Niestroj-Pahl, Lars Daehne, Axel Wolfram, Juergen WIese

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The presented investigation studies the correlation between the process parameters of Layer-by-Layer (LbL) coatings and properties of the produced hybrid membranes for water treatment. The coating of alumina ceramic support membrane with polyelectrolyte multilayers on top results in hybrid membranes with increased fouling resistant behavior, high retention (up to 90%) of salt ions and various pharmaceuticals, selectivity to various organic molecules as known from LbL coated polyether sulfone membranes and the possibility of pH response control. Chosen polyelectrolytes were added to the support using the LbL-coating process. Parameters like the type of polyelectrolyte, ionic strength, and pH were varied in order to find the most suitable process conditions and to study how they influence the properties of the final product. The applied LbL-films was investigated in respect to its homogeneity and penetration depth. The analysis of the layer buildup was performed using fluorescence labeled polyelectrolyte molecules and Confocal Laser Scanning Microscopy as well as Scanning and Transmission Electron Microscopy. Furthermore, the influence of the coating parameters on the porosity, surface potential, retention, and permeability of the developed hybrid membranes were estimated. In conclusion, a comparison was drawn between the filtration performance of the uncoated alumina ceramic membrane and modified hybrid membranes.

Keywords: water treatment, membranes, ceramic membranes, hybrid membranes, layer-by-layer modification

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234 A Gamification Teaching Method for Software Measurement Process

Authors: Lennon Furtado, Sandro Oliveira

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The importance of an effective measurement program lies in the ability to control and predict what can be measured. Thus, the measurement program has the capacity to provide bases in decision-making to support the interests of an organization. Therefore, it is only possible to apply for an effective measurement program with a team of software engineers well trained in the measurement area. However, the literature indicates that are few computer science courses that have in their program the teaching of the software measurement process. And even these, generally present only basic theoretical concepts of said process and little or no measurement in practice, which results in the student's lack of motivation to learn the measurement process. In this context, according to some experts in software process improvements, one of the most used approaches to maintaining the motivation and commitment to software process improvements program is the use of the gamification. Therefore, this paper aims to present a proposal of teaching the measurement process by gamification. Which seeks to improve student motivation and performance in the assimilation of tasks related to software measurement, by incorporating elements of games into the practice of measurement process, making it more attractive for learning. And as a way of validating the proposal will be made a comparison between two distinct groups of 20 students of Software Quality class, a control group, and an experiment group. The control group will be the students that will not make use of the gamification proposal to learn software measurement process, while the experiment group, will be the students that will make use of the gamification proposal to learn software measurement process. Thus, this paper will analyze the objective and subjective results of each group. And as objective result will be analyzed the student grade reached at the end of the course, and as subjective results will be analyzed a post-course questionnaire with the opinion of each student about the teaching method. Finally, this paper aims to prove or refute the following hypothesis: If the gamification proposal to teach software measurement process does appropriate motivate the student, in order to attribute the necessary competence to the practical application of the measurement process.

Keywords: education, gamification, software measurement process, software engineering

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233 National Scope Study on Resilience of Nursing Teams During the COVID-19 Pandemic: Brazilian Experience

Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Pedro Henrique Tertuliano Leoni, Carla Aparecida Arena Ventura, Ana Cristina de Oliveira e Silva, Renata Karina Reis

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Context and significance: Resilience is a protective agent for the physical and mental well-being of nursing professionals. Team members are constantly subjected to high levels of work stress that can negatively impact care performance and users of health services. Stress levels have been exacerbated with the COVID-19 pandemic. Objective: The aim of this study was to analyze the resilience of nursing professionals in Brazil during the COVID-19 pandemic. Method: Cross-sectional study with a quantitative approach carried out with professionals from nursing teams from all regions of Brazil. Data collection took place in the first year of the pandemic between October and December 2020. Data were obtained through an online questionnaire posted on social networks. The information collected included the sociodemographic characterization of the nursing professionals and the Brief Resilient Coping Scale was applied. Student's t-test for independent samples and analysis of variance (ANOVA) were used to compare resilience scores with sociodemographic variables. Results: 8,792 nursing professionals participated in the study, 5,767 (65.6%) were nurses, 7,437 (84.6%) were female and 2,643 (30.1%) were from the Northeast region of Brazil, 5,124 (58.8% ) had low levels of resilience. The results showed a statistically significant difference between the resilience score and the variables: professional category (p<0.001); sex (p = 0.003); age range (p<0.001); region of Brazil (p<0.001); marital status (p=0.029) and providing assistance in a field hospital (p<0.001). Conclusion: Participants in this study had, in general, low levels of resilience. There is an urgent need for actions aimed at promoting the psychological health of nursing professionals inserted in pandemic contexts. Descriptors: Psychological Resilience; Nursing professionals; COVID-19; SARSCoV-2.

Keywords: psychological resilience, nursing professionals, COVID-19, SARS-CoV-2

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232 Selection of New Business in Brazilian Companies Incubators through Hierarchical Methodology

Authors: Izabel Cristina Zattar, Gilberto Passos Lima, Guilherme Schünemann de Oliveira

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In Brazil, there are several institutions committed to the development of new businesses based on product innovation. Among them are business incubators, universities and science institutes. Business incubators can be defined as nurseries for new companies, which may be in the technology segment, discussed in this article. Business incubators provide services related to infrastructure, such as physical space and meeting rooms. Besides these services, incubators also offer assistance in the form of information and communication, access to finance, relationship networks and business monitoring and mentoring processes. Business incubators support not all technology companies. One of the business incubators tasks is to assess the nature and feasibility of new business proposals. To assist this goal, this paper proposes a methodology for evaluating new business using the Analytic Hierarchy Process (AHP). This paper presents the concepts used in the assessing methodology application for new business, concepts that have been tested with positive results in practice. This study counts on three main steps: first, a hierarchy was built, based on new business manuals used by the business incubators. These books and manuals relate business selection requirements, such as the innovation status and other technological aspects. Then, a questionnaire was generated, in order to guide incubator experts in the parity comparisons at all hierarchy levels. The weights of each requirement are calculated from information obtained from the questionnaire responses. Finally, the proposed method was applied to evaluate five new business proposals, which were applying to be part of a company incubator. The main result is the classification of these new businesses, which helped the incubator experts to decide what companies were more eligible to work with. This classification may also be helpful to the decision-making process of business incubators in future selection processes.

Keywords: Analytic Hierarchy Process (AHP), Brazilian companies incubators, technology companies, incubator

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231 Development of LSM/YSZ Composite Anode Materials for Solid Oxide Electrolysis Cells

Authors: Christian C. Vaso, Rinlee Butch M. Cervera

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Solid oxide electrolysis cell (SOEC) is a promising technology for hydrogen production that will contribute to the sustainable energy of the future. An important component of this SOEC is the anode material and one of the promising anode material for such application is the Sr-doped LaMnO3 (LSM) and Yttrium-stabilized ZrO2 (YSZ) composite material. In this study, LSM/YSZ with different weight percent compositions of LSM and YSZ were synthesized using solid-state reaction method. The obtained samples, 60LSM/40YSZ, 50LSM/50YSZ, and 40LSM/60YSZ, were fully characterized for its microstructure using X-ray diffraction, FTIR, and SEM/EDS. EDS analysis confirmed the elemental composition and distribution of the synthesized samples. Surface morphology of the sample using SEM exhibited a well sintered and densified samples and revealed a beveled cube-like LSM morphology while the YSZ phase appeared to have a sphere-like microstructure. Density measurements using Archimedes principle showed relative densities greater than 90%. In addition, AC impedance measurement of the synthesized samples have been investigated at intermediate temperature range (400-700 °C) in an inert and oxygen gas flow environment. At pure states, LSM exhibited a high electronic conductivity while YSZ demonstrated an ionic conductivity of 3.25 x 10-4 S/cm at 700 °C under Oxygen gas environment with calculated activation energy of 0.85eV. The composite samples were also studied and revealed that as the YSZ content of the composite electrode increases, the total conductivity decreases.

Keywords: ceramic composites, fuel cells, strontium lanthanum manganite, yttria partially-stabilized zirconia

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230 Social Media Marketing in Indonesian Social Enterprise: The Effect of Members' Level of Participation on Brand Trust and Brand Commitment

Authors: Irsanti Hasyim, Christian Wibisono, Angela Teressia

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Social enterprises, as one of the way of doing business are on the rise and emerging from the innovations of decades of social initiatives. In simple way, social enterprises use the business platform to achieve social and/or environmental objectives whilst simultaneously seeking a financial return. In Indonesia, the number of social enterprises rapidly grows and most of them were using social media as their business platform. Social Media are perceived as tools for creating online communities of users who share interests, activities, and objectives. Many companies view the use of online communities in social media as a profitable marketing tool from which they can derive several benefits. Through social media, consumers share experiences with and suggest ideas to others while developing new relationships within their communities. Therefore, this study intends to identify the benefits that participants in online communities seek and examine the relationships between members’ levels of participation, brand trust, and brand commitment. Using convenience sampling method, 236 fully answered questioner was collected and used as a sample of this research. The sample of this research consisted of member or follower in several social media from selected social enterprise in Indonesia. Data collected in this research were process by using Partial Least Square and came up with the result that functional benefit and monetary benefit, are only two from five benefits that proposed were the only variable that has significant result even though from APC, ARS and AARS outcomes show that the model can be claimed to be significant.

Keywords: brand trust, brand commitment, social enterprise, social media

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229 The Chemical Composition and Larvicidal Activity of Essential Oils Derived from Piper Longepetiolatum and Piper Brachypetiolatum (Piperaceae) Against Aedes Aegypti Larvae (Culicidae) Were Investigated

Authors: Suelen C. Lima, André C. de Oliveira, Rosemary A. Roque

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Dengue is fatal arboviruses transmitted by the A. aegypti mosquito to more than 100 countries, for which the WHO estimates that 2.5 million people will be infected by these disease. The widespread of these diseases is due, among other factors, to the resistance that A. aegypti has to several commercial insecticides. On the other hand, natural products based on plants of the genus Piper (Piperaceae) are characterized by their insecticidal activities against mosquitoes. Piper longepetiolatum and Piper brachypetiolatum are species with wide distribution in the State of Amazonas. However, there is no investigation of phytochemical or biological of these plants against mosquitoes such as A. aegypti. The main of this study was to identify the chemical composition of the essential oil (EOs) from P. longepetiolatum and P. brachypetiolatum and to evaluate the biological activity against A. aegypti. The EOs were extracted by hydrodistillation from leaves (200 g) of P. longepetiolatum and P. brachypetiolatum and analyzed by GC-MS and GC-FID. The main compounds β-caryophyllene (99.9% of purity) and E-nerolidol (99.4% of purity) were purchased from Sigma-Aldrich® Brazil. The larvicidal activity of EOs (20 to 100 ppm), β-caryophyllene and E-nerolidol (10 to 50 ppm) was performed according to WHO protocol against A. aegypti larvae. The GC-MS and GC-FID analysis of EOs from P. longepetiolatum and P. brachypetiolatum indicated the majority presence of β-caryophyllene (35.42%) and E-nerolidol (49.79%), respectively. The results showed that all natural products presented larvicidal activity against A. aegypti. In this aspect, the OE from P. brachypetiolatum (LC50 of 15.51 ppm and LC90 of 22.79 ppm) was more active than the OE from P. longepetiolatum (LC50 of 47.17 ppm and LC90 of 69.60 ppm) (p < 0.05). Regarding of main compounds, E-nerolidol (LC50 of 9.50 ppm and LC90 of 23.89 ppm) showed higher larvicidal activity than the β-caryophyllene compound (LC50 of 79.00 ppm and LC90 of 230.91 ppm) (p < 0.05). The larvae treated with these natural products showed tremors and lethargic movements, suggesting that these natural products have neurotoxic action. These observations support studies to investigate the mechanism of action. This is the first record of the chemical composition and larvicidal activity of the EO from P. longepetiolatum and P. brachypetiolatum rich in β-caryophyllene and E-nerolidol against A. aegypti larvae.

Keywords: piperaceae, aedes, sesquiterpenes, biological control

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228 Translation of Self-Inject Contraception Training Objectives Into Service Performance Outcomes

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

Procedia PDF Downloads 54