Search results for: consultation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 244

Search results for: consultation

184 Management of the Asthma Crisis in the Unit of Intensive Care of the General Hospital of Reference of Kinshasa

Authors: Eddy K. Mukadi

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The aim of this study was to provide contributing elements to improve the management of the asthma crisis in the intensive care unit of the General Reference Hospital of Kinshasa. This was a descriptive study of all patients in the intensive care unit presenting with the asthma attack during the period from February 5, 2013 to February 5, 2014. The main data were obtained from consultation registry and medical records. A total of 35 patients, 21 of whom were male (majority) compared to 14 female. Average age of patients was 46.48 plus or minus 16.98 with extremes ranging from 21-75 years. The clinic was dominated by dyspnea in 100% of cases, followed by rales with 91.4% of cases. In spite of the control of the crisis obtained after the treatment with B2 mimetic by inhalation was introduced A 91.5%; 88% corticosteroids; 80% oxygen, the therapeutic principle recommended for the management of asthma attacks was not respected in the majority of cases. This is why we suggest that improving the quality of care to be administered to patients will yield more adequate results.

Keywords: asthma crisis, intensive care, general hospital, Kinshasa

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183 Proof of Concept Design and Development of a Computer-Aided Medical Evaluation of Symptoms Web App: An Expert System for Medical Diagnosis in General Practice

Authors: Ananda Perera

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Computer-Assisted Medical Evaluation of Symptoms (CAMEOS) is a medical expert system designed to help General Practices (GPs) make an accurate diagnosis. CAMEOS comprises a knowledge base, user input, inference engine, reasoning module, and output statement. The knowledge base was developed by the author. User input is an Html file. The physician user collects data in the consultation. Data is sent to the inference engine at servers. CAMEOS uses set theory to simulate diagnostic reasoning. The program output is a list of differential diagnoses, the most probable diagnosis, and the diagnostic reasoning.

Keywords: CDSS, computerized decision support systems, expert systems, general practice, diagnosis, diagnostic systems, primary care diagnostic system, artificial intelligence in medicine

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182 Development of an Systematic Design in Evaluating Force-On-Force Security Exercise at Nuclear Power Plants

Authors: Seungsik Yu, Minho Kang

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As the threat of terrorism to nuclear facilities is increasing globally after the attacks of September 11, we are striving to recognize the physical protection system and strengthen the emergency response system. Since 2015, Korea has implemented physical protection security exercise for nuclear facilities. The exercise should be carried out with full cooperation between the operator and response forces. Performance testing of the physical protection system should include appropriate exercises, for example, force-on-force exercises, to determine if the response forces can provide an effective and timely response to prevent sabotage. Significant deficiencies and actions taken should be reported as stipulated by the competent authority. The IAEA(International Atomic Energy Agency) is also preparing force-on-force exercise program documents to support exercise of member states. Currently, ROK(Republic of Korea) is implementing exercise on the force-on-force exercise evaluation system which is developed by itself for the nuclear power plant, and it is necessary to establish the exercise procedure considering the use of the force-on-force exercise evaluation system. The purpose of this study is to establish the work procedures of the three major organizations related to the force-on-force exercise of nuclear power plants in ROK, which conduct exercise using force-on-force exercise evaluation system. The three major organizations are composed of licensee, KINAC (Korea Institute of Nuclear Nonproliferation and Control), and the NSSC(Nuclear Safety and Security Commission). Major activities are as follows. First, the licensee establishes and conducts an exercise plan, and when recommendations are derived from the result of the exercise, it prepares and carries out a force-on-force result report including a plan for implementation of the recommendations. Other detailed tasks include consultation with surrounding units for adversary, interviews with exercise participants, support for document evaluation, and self-training to improve the familiarity of the MILES (Multiple Integrated Laser Engagement System). Second, KINAC establishes a force-on-force exercise plan review report and reviews the force-on-force exercise plan report established by licensee. KINAC evaluate force-on-force exercise using exercise evaluation system and prepare training evaluation report. Other detailed tasks include MILES training, adversary consultation, management of exercise evaluation systems, and analysis of exercise evaluation results. Finally, the NSSC decides whether or not to approve the force-on-force exercise and makes a correction request to the nuclear facility based on the exercise results. The most important part of ROK's force-on-force exercise system is the analysis through the exercise evaluation system implemented by KINAC after the exercise. The analytical method proceeds in the order of collecting data from the exercise evaluation system and analyzing the collected data. The exercise application process of the exercise evaluation system introduced in ROK in 2016 will be concretely set up, and a system will be established to provide objective and consistent conclusions between exercise sessions. Based on the conclusions drawn up, the ultimate goal is to complement the physical protection system of licensee so that the system makes licensee respond effectively and timely against sabotage or unauthorized removal of nuclear materials.

Keywords: Force-on-Force exercise, nuclear power plant, physical protection, sabotage, unauthorized removal

Procedia PDF Downloads 114
181 A Scoping Study and Stakeholder Consultation on Mental Health Determinants among Arab Immigrants and Refugees in North America

Authors: Sarah Elshahat, Tina Moffat

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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.

Keywords: depression, post-traumatic stress disorder, psychological distress, resilience

Procedia PDF Downloads 104
180 Methodology of Islamic Economics: Scope and Prospects

Authors: Ahmad Abdulkadir Ibrahim

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Observation of the methodology of Islamic economics laid down for the methods and instruments of analysis and even some of its basic assumptions in the modern world; is a matter that is of paramount importance. There is a need to examine the implications of different suggested definitions of Islamic economics, exploring its scope and attempting to outline its methodology. This paper attempts to deal with the definition of Islamic economics, its methodology, and its scope. It will outline the main methodological problem by addressing the question of whether Islamic economics calls for a methodology of its own or as an expanded economics. It also aims at drawing the attention of economists in the modern world to the obligation and consideration of the methodology of Islamic economics. The methodology adopted in this research is library research through the consultation of relevant literature, which focuses on the thematic study of the subject matter. This is followed by an analysis and discussion of the contents of the materials used. It is concluded that there is a certain degree of inconsistency in the way assumptions are incorporated that perhaps are alien to Islamic economics. The paper also observed that there is a difference between Islamic economists and other (conventional) economists in the profession. An important conclusion is that Islamic economists need to rethink what economics is all about and whether we really have to create an alternative to economics in the form of Islamic economics or simply have an Islamic perspective of the same discipline.

Keywords: methodology, Islamic economics, conventional economics, Muslim economists, framework, knowledge

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179 Assessing Bus Service Quality in Dhaka City from the Perspective of Female Passengers

Authors: S. K. Subah, R. Tasnim, M. I. Jahan, M. R. Islam

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While talking about how comfortable and convenient Dhaka's bus service is, the minimum emphasis is placed on the female commuters of the Dhaka city. Recognizing the contemporary situation, the supreme focus is to develop experimental model based on statistical methods. SEM has been adopted to quantify passenger satisfaction, which is affected by the perceived service quality. The study deals with 16 observed variables and three latent variables, which were correlated to identify their significance on the regulation of perceived SQ (Service Quality). To calibrate the model, a dataset of 250 responses from female users of local buses has been utilized through survey. A questionnaire structured with SQ variables was prepared in consultation with prevailing literature, practitioners, academicians, and users. The result concludes that the attributes of safe and secured environment have the most significant impact on the overall bus service quality according to the insight of female respondents. The study outcome might be a great help for the policymakers, women's organizations, and NGOs to formulate transport policy that will ensure a women-friendly public bus service.

Keywords: bus service quality, female perception, structural equation modelling, safety-security, women friendly bus

Procedia PDF Downloads 119
178 Developing Primary Care Datasets for a National Asthma Audit

Authors: Rachael Andrews, Viktoria McMillan, Shuaib Nasser, Christopher M. Roberts

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Background and objective: The National Review of Asthma Deaths (NRAD) found that asthma management and care was inadequate in 26% of cases reviewed. Major shortfalls identified were adherence to national guidelines and standards and, particularly, the organisation of care, including supervision and monitoring in primary care, with 70% of cases reviewed having at least one avoidable factor in this area. 5.4 million people in the UK are diagnosed with and actively treated for asthma, and approximately 60,000 are admitted to hospital with acute exacerbations each year. The majority of people with asthma receive management and treatment solely in primary care. This has therefore created concern that many people within the UK are receiving sub-optimal asthma care resulting in unnecessary morbidity and risk of adverse outcome. NRAD concluded that a national asthma audit programme should be established to measure and improve processes, organisation, and outcomes of asthma care. Objective: To develop a primary care dataset enabling extraction of information from GP practices in Wales and providing robust data by which results and lessons could be drawn and drive service development and improvement. Methods: A multidisciplinary group of experts, including general practitioners, primary care organisation representatives, and asthma patients was formed and used as a source of governance and guidance. A review of asthma literature, guidance, and standards took place and was used to identify areas of asthma care which, if improved, would lead to better patient outcomes. Modified Delphi methodology was used to gain consensus from the expert group on which of the areas identified were to be prioritised, and an asthma patient and carer focus group held to seek views and feedback on areas of asthma care that were important to them. Areas of asthma care identified by both groups were mapped to asthma guidelines and standards to inform and develop primary and secondary care datasets covering both adult and pediatric care. Dataset development consisted of expert review and a targeted consultation process in order to seek broad stakeholder views and feedback. Results: Areas of asthma care identified as requiring prioritisation by the National Asthma Audit were: (i) Prescribing, (ii) Asthma diagnosis (iii) Asthma Reviews (iv) Personalised Asthma Action Plans (PAAPs) (v) Primary care follow-up after discharge from hospital (vi) Methodologies and primary care queries were developed to cover each of the areas of poor and variable asthma care identified and the queries designed to extract information directly from electronic patients’ records. Conclusion: This paper describes the methodological approach followed to develop primary care datasets for a National Asthma Audit. It sets out the principles behind the establishment of a National Asthma Audit programme in response to a national asthma mortality review and describes the development activities undertaken. Key process elements included: (i) mapping identified areas of poor and variable asthma care to national guidelines and standards, (ii) early engagement of experts, including clinicians and patients in the process, and (iii) targeted consultation of the queries to provide further insight into measures that were collectable, reproducible and relevant.

Keywords: asthma, primary care, general practice, dataset development

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177 Management of Coronary Heart Disease through Yoga

Authors: Subramaniam Iyer

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The most common disease that is pertaining to all human beings is heart-related. The reasons for coronary artery disease are due to lifestyle and eating habits. Due to this, many people mentally become sick, feeling that soon they will die due to their heart problems. This results in stress and anxiety, which has become common amongst all the Indians. Medicines are the commonest curative remedy in India, but it is proposed through this article some remedies through yoga. This article does not guarantee a 100% result, but it is a preventive remedy for coronary artery disease. Yoga is giving a new lease of life to many, so to tackle chronic diseases, it provides remedies that will be lifelong. It is brought to many people by Patanjali. Yoga will provide support to patients having coronary artery disease through its various relevant postures (asanas), which can be done very easily. Yoga does not send a message that if you do it regularly, you will be relieved from a particular disease. If it is performed every day, it will add vital energy for a smooth life, even if you are suffering from any chronic disease. In this article, we will be providing 6 postures (asanas), which can be performed at any time in the day, but the early morning will always be preferred (empty stomach) to get a good result. Secondly, these postures must be implemented after due consultation with your physician. If your physician disapproves, don’t do these postures as it will be harmful to your body.

Keywords: coronary artery, yoga, disease, remedy, medicine

Procedia PDF Downloads 117
176 Street Naming and Property Addressing Systems for New Development in Ghana: A Case Study of Nkawkaw in the Kwahu West Municipality

Authors: Jonathan Nii Laryea Ashong, Samuel Opare

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Current sustainable cities debate focuses on the formidable problems for the Ghana’s largest urban and rural agglomerations, the majority of all urban dwellers continue to reside in far smaller urban settlements. It is estimated that by year 2030, almost all the Ghana’s population growth will likely be intense in urban areas including Nkawkaw in the Kwahu West Municipality of Ghana. Nkawkaw is situated on the road and former railway between Accra and Kumasi, and lies about halfway between these cities. It is also connected by road to Koforidua and Konongo. According to the 2013 census, Nkawkaw has a settlement population of 61,785. Many international agencies, government and private architectures’ are been asked to adequately recognize the naming of streets and property addressing system among the 170 districts across Ghana. The naming of streets and numbering of properties is to assist Metropolitan, Municipal and District Assemblies to manage the processes for establishing coherent address system nationally. Street addressing in the Nkawkaw in the Kwahu West Municipality which makes it possible to identify the location of a parcel of land, public places or dwellings on the ground based on system of names and numbers, yet agreement on how to progress towards it remains elusive. Therefore, reliable and effective development control for proper street naming and property addressing systems are required. The Intelligent Addressing (IA) technology from the UK is being used to name streets and properties in Ghana. The intelligent addressing employs the technique of unique property Reference Number and the unique street reference number which would transform national security and other service providers’ ability to respond rapidly to distress calls. Where name change is warranted following the review of existing streets names, the Physical Planning Department (PPDs) shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the provisions of the policy and the processes outlined for street name change for new development. In the case of existing streets with no names, the respective PPDs shall, in consultation with the relevant traditional authorities and community leadership (or relevant major stakeholders), select a street name in accordance with the requirements set out in municipality. Naming of access ways proposed for new developments shall be done at the time of developing sector layouts (subdivision maps) for the designated areas. In the case of private gated developments, the developer shall submit the names of the access ways as part of the plan and other documentation forwarded to the Municipal District Assembly for approval. The names shall be reviewed first by the PPD to avoid duplication and to ensure conformity to the required standards before submission to the Assembly’s Statutory Planning Committee for approval. The Kwahu West Municipality is supposed to be self-sustaining, providing basic services to inhabitants as a result of proper planning layouts, street naming and property addressing system that prevail in the area. The implications of these future projections are discussed.

Keywords: Nkawkaw, Kwahu west municipality, street naming, property, addressing system

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175 Challenges in Promoting Software Usability and Applying Principles of Usage-Centred Design in Saudi Arabia

Authors: Kholod J. Alotaibi, Andrew M. Gravell

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A study was conducted in which 212 software developers in higher education institutions in Saudi Arabia were surveyed to gather an indication of their understanding of the concept of usability, their acceptance of its importance, and to see how well its principles are applied. Interviews were then held with 20 of these developers, and a demonstration of Usage-Centred Design was attempted, a highly usability focused software development methodology, at one select institution for its redesign of an e-learning exam system interface during the requirements gathering phase. The study confirms the need to raise awareness of usability and its importance, and for Usage-Centred Design to be applied in its entirety, also need to encourage greater consultation with potential end-users of software and collaborative practices. The demonstration of Usage-Centred Design confirmed its ability to capture usability requirements more completely and precisely than would otherwise be the case, and hence its usefulness for developers concerned with improving software usability. The concluding discussion delves on the challenges for promoting usability and Usage-Centred Design in light of the research results and findings and recommendations are made for the same.

Keywords: usability, usage-centred, applying principles of usage-centred, Saudi Arabia

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174 Prevalence of Lower Third Molar Impactions and Angulations Among Yemeni Population

Authors: Khawlah Al-Khalidi

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Prevalence of lower third molar impactions and angulations among Yemeni population The purpose of this study was to look into the prevalence of lower third molars in a sample of patients from Ibb University Affiliated Hospital, as well as to study and categorise their position by using Pell and Gregory classification, and to look into a possible correlation between their position and the indication for extraction. Materials and methods: This is a retrospective, observational study in which a sample of 200 patients from Ibb University Affiliated Hospital were studied, including patient record validation and orthopantomography performed in screening appointments in people aged 16 to 21. Results and discussion: Males make up 63% of the sample, while people aged 19 to 20 make up 41.2%. Lower third molars were found in 365 of the 365 instances examined, accounting for 91% of the sample under study. According to Pell and Gregory's categorisation, the most common position is IIB, with 37%, followed by IIA with 21%; less common classes are IIIA, IC, and IIIC, with 1%, 3%, and 3%, respectively. It was feasible to determine that 56% of the lower third molars in the sample were recommended for extraction during the screening consultation. Finally, there are differences in third molar location and angulation. There was, however, a link between the available space for third molar eruption and the need for tooth extraction.

Keywords: lower third molar, extraction, Pell and Gregory classification, lower third molar impaction

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173 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study

Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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172 Epidemiological, Clinical, Histopathological Profile and Management of Breast Cancer at Kinshasa University Clinics

Authors: Eddy K. Mukadi

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This work is a documentary and descriptive study devoted to the epidemiological, clinical, histopathological and therapeutic profile of breast cancer deals with the department of gynecology and obstetrics of the university clinics of Kinshasa during the period from 1 January 2014 to 31 December 2014. We have identified 56 cases of breast cancer. These cancers accounted for 45.2% of gynecological mammary cancers. The youngest in our series was 18 years old while the oldest was 74 years old; And the mean age of these patients was 43.4 years and mostly multiparous (35.7%). Brides (60.7%) and bachelors (26.8%) were the most affected by breast cancer. The reasons for consultation were dominated by nodules in the breast (48.2%) followed by pain (35.7%) and nipple discharge (14.3%). In 89.2% of the cases, it was the advanced clinical stage (stage 3 and 4) and the infiltrating ductal carcinoma was the most frequent histological type (75%) The malignant tumor was mainly in the left breast (55.3%), and chemotherapy with hormone therapy and patey was the most convenient treatment (42.8%), while patey mastectomy was performed in 12.5% of patients. Because of the high incidence of breast cancer identified in our study, some preventive measures must be taken into account to address this public health problem, including breast autopalpation once a month, Early detection system development of a national breast cancer policy and the implementation of a national breast cancer control program.

Keywords: breast cancer, histopathological profile, epidemiological profile, Kinshasa

Procedia PDF Downloads 179
171 Covid-19: Preparedness, Response, and Use of Video Technology in Managing Infection Rate at Lagos University Teaching Hospital, Lagos-Nigeria

Authors: Afolakemi Helen Olaleye, Ogunjobi A. O

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Since coronavirus disease 2019 (COVID-19) was first reported in Nigeria, the virus has spread to virtually all sub-Saharan Africa (SSA) countries. In Nigeria, government agencies came together to create a goal-driven taskforce in improving our response against the virus. As COVID-19 international spread has been curtailed, community spread became rampant locally, leading to many health authorities raising concerns over the scarcity of medical consumables and supplies. Here at Lagos university teaching Hospital (LUTH), we present data analysis of COVID-19 infections offered at our Hospital (LUTH) and the surrounding communities. In addition, the adopted innovative solution to control the spread of infection, methods used in filling shortages of consumables, personal protective equipment (PPE), and use of mobile video technology in patient’s consultation. The management style and strategy adopted has led to a decline in infection rates in our community and among our front line staff. The current COVID -19 crisis has created an opportunity to test and demonstrate our pandemic response and control of infectious disease along with the revealed unknown potential in our community.

Keywords: COVID-19, preparedness, response, Lagos university teaching hospital

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170 Etiologies of Megaloblastic Anemia in a Pediatric Hospital

Authors: Atitallah Sofien, Bouyahia Olfa, Mohsen S., Boussetta Khadija, Khemiri Monia, Fitouri Zohra, Boukthir Samir

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Introduction: Megaloblastic anemia (MA) is rare in children. The diversity of its etiologies can lead to misdiagnosis and may, therefore, delay the treatment. The aim of this study was to describe the epidemiological and etiological characteristics of children followed for MA at the Tunis children's hospital. Methodology: This is a retrospective study over a period of 25 years of all cases of MA in children in the Children's Hospital of Tunis. The diagnosis of MA was confirmed by myelogram in all patients. Results: We collected 29 observations, with an incidence of 1.2 cases/year and a sex ratio of 1. Sixty percent of the children were aged between 3 months and 2 years. The consultation time was between 15 and 30 days in a third of the patients. The clinical examination showed hypotrophy in 13% of cases, hepatosplenomegaly in 6% of cases, neurological or neurosensory damage in 23% of cases, and cardiac damage in 10% of children. MA was associated with thrombocytopenia in 65% of cases and leukoneutropenia in 24% of cases. One in 5 children had pancytopenia. The etiologies were mainly thiamine deficiency, Immerslund disease (20%), nutritional deficiency (13%), and Biermer anemia (13%). One of the patients presented an MA revealing visceral leishmaniasis. The outcome under vitamin B12, the dose of which was adapted to each etiology, was favorable for all patients. Conclusion: MA is rare in children with multiple etiologies that are mainly dominated by hereditary conditions and nutritional deficiencies, mainly in vitamin B12. The association with visceral leishmaniasis seems to be a particularity in our country not reported in the literature.

Keywords: megaloblastic anemia, children, vitamin B12, anemia

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169 Multi Agent Based Pre-Hospital Emergency Management Architecture

Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

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Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

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168 The Fishery and Electricity Symbiosis Environment and Social Inspection in Taiwan: The Kaohsiung City Example

Authors: Bing-Shun Huang, Hung-Ju Chiu, Wen-Kai Hsieh, Hsiu-Chuan Lin, Ming-Lung Hung

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Taiwan's solar photovoltaic target in 2025 is 20 GW, of which the fish-electricity symbiosis target is 4 GW. In the future, many solar photovoltaic installations may cause local environmental or social impacts. Therefore, the Taiwan government inspects the fish-electricity symbiosis to reduce the impact of solar photovoltaics on the local environment or society. This stuy takes the symbiosis of fishery and electricity in Kaohsiung City as an example to explore Taiwan's environmental and social inspection practices. It mainly analyzes the two aspects of environmental ecology and social economy. The results show that the environmental inspection is mainly through site surveys, ecological information mapping, on-site interviews, and public consultation meetings. Social inspection mainly includes document analysis, on-site interviews, site surveys, expert discussions, and public consultations to identify possible local problems. Although the government had recognized the local issues, the future status may also change. It is recommended that future photoelectric companies should reconfirm the current situation of development sites when applying for the installation and propose countermeasures to solve the problem.

Keywords: taiwan, fish-electricity symbiosis, environment, society, inspection

Procedia PDF Downloads 165
167 Social Support and Self-Regulation on Changes in Exercise Behavior Among Infertile Women: A Cross-Sectional Study to Comparison of External and Internal Factors

Authors: Babak Nemat

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Background: Exercise behavior (EB) has a significant impact on infertility, but the magnitude of the effect is not easily determined. The aim of the present study was to assess the effect of social support and self-regulation, as external and internal factors, on changes in exercise behavior among infertile women. Methods: For a cross-sectional study conducted in Sanandaj (Iran) in 2023, we recruited infertile women (n=483) from 35 comprehensive healthcare centers by means of convenience sampling. Standardized face-to-face interviews were conducted using established and reliable instruments for the assessment of EB, social support, and self-regulation. Logistic regression models were applied to assess the association between EB, social support and self-regulation. Results: The majority of the participants (56.7%) had secondary infertility, while 70.8% of them did not perform any exercise. Self-regulation and social support were significantly higher in women with secondary infertility than in those with primary infertility (p < 0.01). Self-regulation was significantly lower in women whose height was below 160 centimeters (cm) (p<0.05). Social support was significantly higher among participants aged ≥ 35 years and weighing ≥ 60 kilograms (kg) (p < 0.01). The odds of EB adoption increased with self-regulation and social support (OR=1.05, 95% CI=1.02-1.09, p <0.01), (OR=1.06, 95% CI=1.02-1.11, p <0.01). Conclusion: Social support and self-regulation almost equally influenced EB in infertile women. Designing support and consultation programs can be considered in encouraging infertile women to exercise in future research.

Keywords: social support, regulation, infertility, women

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166 Effects of Social Support and Self-Regulation on Changes in Exercise Behavior Among Infertile Women: A Cross-Sectional Study to Comparison of External and Internal Factors

Authors: Arezoo Fallahi‎

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Background: Exercise behavior (EB) has a significant impact on infertility, but the magnitude of the effect is not easily determined. The aim of the present study was to assess the effect of social support and self-regulation, as external and internal factors, on changes in exercise behavior among infertile women. Methods: For a cross-sectional study conducted in Sanandaj (Iran) in 2020, we recruited infertile women (n=483) from 35 comprehensive healthcare centers by means of convenience sampling. Standardized face-to-face interviews were conducted using established and reliable instruments for the assessment of EB, social support, and self-regulation. Logistic regression models were applied to assess the association between EB, social support and self-regulation. Results: The majority of the participants (56.7%) had secondary infertility, while 70.8% of them did not perform any exercise. Self-regulation and social support were significantly higher in women with secondary infertility than in those with primary infertility (p < 0.01). Self-regulation was significantly lower in women whose height was below 160 centimeters (cm) (p<0.05). Social support was significantly higher among participants aged ≥ 35 years and weighing ≥ 60 kilograms (kg) (p < 0.01). The odds of EB adoption increased with self-regulation and social support (OR=1.05, 95% CI=1.02-1.09, p <0.01), (OR=1.06, 95% CI=1.02-1.11, p <0.01). Conclusion: Social support and self-regulation almost equally influenced EB in infertile women. Designing support and consultation programs can be considered in encouraging infertile women to do exercise in future research.

Keywords: social support, regulation, infertility, women, exercise

Procedia PDF Downloads 58
165 Recommendation of Semi Permanent Buildings for Tsunami Prone Areas

Authors: Fitri Nugraheni, Adwitya Bhaskara, N. Faried Hanafi

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Coastal is one area that can be a place to live. Various buildings can be built in the area around the beach. Many Indonesians use beaches as housing and work, but we know that coastal areas are identical to tsunami and wind. Costs incurred due to permanent damage caused by tsunamis and wind disasters in Indonesia can be minimized by replacing permanent buildings into semi-permanent buildings. Semi-permanent buildings can be realized by using cold-formed steel as a building. Thus, the purpose of this research is to provide efficient semi-permanent building recommendations for residents around the coast. The research is done by first designing the building model by using sketch-up software, then the validation phase is done in consultation with the expert consultant of cold form steel structure. Based on the results of the interview there are several revisions on several sides of the building by adding some bracing rods on the roof, walls and floor frame. The result of this research is recommendation of semi-permanent building model, where the nature of the building; easy to disassemble and install (knockdown), tsunami-friendly (continue the tsunami load), cost and time efficient (using cold-formed-steel and prefabricated GRC), zero waste, does not require many workers (less labor). The recommended building design concept also keeps the architecture side in mind thus it remains a comfortable occupancy for the residents.

Keywords: construction method, cold-formed steel, efficiency, semi-permanent building, tsunami

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164 The Occurrence of Depression with Chronic Liver Disease

Authors: Roop Kiran, Muhammad Shoaib Zafar, Nazish Idrees Chaudhary

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Depression is known to be the second most frequently occurring comorbid mental illness among patients suffering from chronic physical conditions. Around the world, depression is associated with chronic liver diseases as one of the dominant symptoms. This evidence brings attention to the research about various predictors for short life expectancy and poor quality of life in patients suffering from comorbid depression and CLD. Following are the objectives of this study i) measure the occurrence rate of comorbid depression among patients with CLD and ii) find the frequency of risk factors between patients with and without depression comorbid with CLD. This is a quantitative study with a cross-sectional design. The research data was collected through a measure called Hamilton Depression Rating Scale (HDRS) with a demographic Performa from 100 patients who visited the Department of Psychiatry for consultation at Mayo Hospital Lahore with a diagnosed CLD from the last four years. There were (42%) patients with CLD who had comorbid depression. Among depressed and non-depressed patients, significant differences were found (p<0.05) for unemployment in 25 (59.5%) males and 20 (34.5%) female patients, for co-morbidity in 25 (59.5%) males and 18 (31.0%) female patients, for illiteracy in 18 (42.9%) males and 13 (22.4%) female patients, for the history of CLD for more than the last 2years in 41 (97.6%) males and 47 (81.0%) female patients, for severity of CLD in 26 (61.9%) males and 20 (34.5%) female patients. This concludes that depression frequently occurs among patients with CLD. This study recommends considerable attention to plan preventative measures in the future and develop such intervention protocols that consider the management of risk factors that significantly influence comorbid depression with CLD.

Keywords: psychiatry, comorbid, health, quality of life

Procedia PDF Downloads 164
163 Problems concerning Legal Regulation of Electronic Governance in Georgia

Authors: Giga Phartenadze

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In the legal framework of regulation of electronic governance, those norms are considered which include measures for improvement of functions of public institutions and a complex of actions for raising their standard such as websites of public institutions, online services, some forms of internet interactions and higher level of internet services. An important legal basis for electronic governance in Georgia is Georgian Law about Electronic Communications which defines legal and economic basis for utilizing electronic communication systems in Georgia. As for single electronic basis for e-governance regulation, it can be said that it does not exist at all. The official websites of public institutions do not have standards for proactive spreading of information. At the same time, there is no common legal norm which would make all public institutions have an official website for public relations, accountability, publicity, and raising information quality. Electronic governance in Georgia needs comprehensive legal regulation. Public administration in electronic form is on the initial stage of development. Currently existing legal basis has a low quality for public institutions and officials as well as citizens and business. Services of e-involvement and e-consultation have also low quality. So far there is no established legal framework for e-governance. Therefore, a single legislative system of e-governance should be created which will help develop effective, comprehensive and multi component electronic systems in the country (central, regional, local levels). Such comprehensive legal framework will provide relevant technological, institutional, and informational conditions.

Keywords: law, e-government, public administration, Georgia

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162 Internalising Islamic Principles of Theocracy as a Pedestal for Good Governance in Nigeria

Authors: Busari Moshood Olanyi

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Good governance remains the expectation of every political party in power, especially in this democratic dispensation of the Nigerian Nation. The need to ensure that the citizenry enjoys the dividends of democracy as often promised during various electioneering campaigns is envisioned to be the motif for different agendas and political slogans by different administrations. Unfortunately, different political agendas towards the security of lives and properties, halting the pillage of the economy by corrupt public officials and creation of employment opportunities for the youths, have a record of setback in the history of political leadership and governance in Nigeria. Therefore, the paper examined the principles of Islamic theocracy in its advocacy for a paradigm shift in the Nigerian political system, with a view to engendering good governance. Islamic political terms such as Shūrā (mutual consultation), ‘Adālah (equality and justice), Khilāfah (succession and stewardship) Majlis ash-Shūrā (consultative forum) and Muḥāsabah (accountability) were espoused as sacrosanct to implementing Islamic theocracy as an alternative system of government in Nigeria. The paper concluded by being flexible on the nomenclature of the suggested political system, considering the multi-religious nature of the country as a political entity. Among other recommendations, infusion of politics into our moral/religious system and not the other way round was considered a good step in the direction of a political paradigm shift for ensuring good governance and guaranteeing its sustainability in Nigeria.

Keywords: Nigerian nation, democracy, good governance, Islamic theocracy, paradigm shift

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161 Pragmatics of Socio-Linguistic Influence on Neurologist-Patient Interaction in Selected Hospitals in Nigeria

Authors: Ayodele James Akinola

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This study examines how social and linguistic variables influenced communication between neurologists and patients in selected university teaching hospitals (UTHs) in southwestern Nigeria. Jacob Mey’s Pragmatic Acts, complemented by Emanuel and Emanuel’s model of doctor-patient relationship, served as the theoretical framework. Data comprising 22 audio-recorded neurologist-patient interactions were collected from two UTHs in the southwestern region of Nigeria. Data revealed that educational attainment of patients has insignificant influence on the interaction where the linguistic prowess of the patient has been impaired for consultative communication. However, the status influenced the degree of attention paid to patients by neurologists and determines the amount of time 'trying to help patients to communicate'. Patients with lower educational status and who could not communicate in English spent more time narrating their ailment to neurologists. Patients with higher educational status and could communicate in English saves consultation time as they express themselves briefly unlike those who were of little or no education in the clinics. Through this, diagnoses and therapeutic processes took eight to 12 minutes. 20 minutes was the longest duration recorded. Neurologist-patient interaction in the observed hospitals is shaped by neurologists’ experience, patients’ social variables and language.

Keywords: medical pragmatics, neurologist-patient interaction, nigeria, socio-linguistic influence

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160 Pilot Program for the Promotion of Normal Childbirth in the North, Northeast and Midwest of Brazil

Authors: Natália Bruno Chaves, Richardes Caúla, Roosevelt do Vale, Daniela Toneti, Rafaela Carvalho, Renata Silva Lopes, Antônio Carlos Júnior, Adner Nobre, Viviane Santiago, Yara Alana Caldato, Estefania Rodriguez Urrego, André Buarque Lemos, Catarina Nucci Stetner, Marcos Mauro Barreto, Stefany Moreira Lima, Mara Cavalcante, Ticiane Ribeiro

Abstract:

The Well Born (Nascer Bem – in Portuguese) Program was created in the Hapvida health network with the aim of improving access to safe and quality prenatal care for users. In addition to offering a line of prenatal care, the inclusion of obstetric nursing and the decentralization of childbirth, bring security that professionals did not indicate the route of delivery for professional convenience. The introduction of the nursing consultation came to reinforce the care to our users, strengthening their bond and reception. In 2021, the program maintained an average of 40% of normal births in the north, northeast and central-west regions of Brazil, an average above that observed in the rest of the country's private health systems, around 20%. In addition, the neonatal hospitalization rate of this population remained around 5.1%, a figure below the national average. With these data, the “Nascer Bem” program is affirmed as a safe and effective strategy for the promotion of safe normal birth.

Keywords: quality, safe, prenatal, obstetric nursing

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159 Shia School of Thought and the Experience of Political Order in Contemporary Era

Authors: Abdulvahab Forati

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Religious intellectualism is the only stream of consciousness in Iran that its religious theories formed Democracy. The theory of Religious intellectualism was utilized in Constitutional Revolution and Islamic Revolution. To instate Democracy in Iran, in compare with West and sunnis, the theory of Religious Intellectualism is being used differently. Unlike Democracy in the west that has started with the concept of Individualism and Natural Rights or in Sunni world that has started with the concept of consultation, it has started in Iran with mima-la-nas-fih (what we don’t have any proof for)or mantaqa-alfiraq-altashri’ (area of vacuum from reason). Shia scholars first acquainted with the concept of Democracy through theories of Sheikh Mortiza Ansari, and later some of his followers, including Akhund-e-khorasani and Mirzaye naeini, regarding Sheikh Ansari’s thoughts, began to analyze its Constitutional system and Democratic elements. But Imam Khomeini, the great founder of Islamic Republic of Iran, with respect to RAKHS (religious permission for having a choice)could make connection between Islam and Democracy. Instead of focusing on Civil contracts, he relied on Sirah Ughala (Tradition) and accepted many of the current conducts, e.g. Democracy and Political Parties and acknowledged the authority (Hujiat) of them even in absence of Infallibles. These two are the most notable experiences of shia political thoughts about Democracy within the last 100 years. In this article, the author tries to explain the second experience in Imam Khomeini’s thoughts and Sirah.

Keywords: Shia school, Islamic revolution, democracy, political order

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158 Research Methods and Design Strategies to Improve Resilience in Coastal and Estuary Cities

Authors: Irene Perez Lopez

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Delta and estuary cities are spaces constantly evolving, incessantly altered by the ever-changing actions of water transformation. Strategies that incorporate comprehensive and integrated approaches to planning and design with water will play a powerful role in defining new types of flood defense. These strategies will encourage more resilient and active urban environments, allowing for new spatial and functional programs. This abstract presents the undergoing research in Newcastle, the first urbanized delta in New South Wales (Australia), and the region's second-biggest catchment and estuary. The research methodology is organized in three phases: 1) a projective cartography that analyses maps and data across the region's recorded history, identifying past and present constraints, and predicting future conditions. The cartography aids to identify worst-case scenarios, revealing the implications of land reclamation that have not considered the confronting evolution of climate change and its conflicts with inhabitation; 2) the cartographic studies identify the areas under threat and form the basis for further interdisciplinary research, complimented by community consultation, to reduce flood risk and increase urban resilience and livability; 3) a speculative or prospective phase of design with water to generate evidence-based guidelines that strengthen urban resilience of shorelines and flood prone areas.

Keywords: coastal defense, design, urban resilience, mapping

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157 Integrating GIS and Analytical Hierarchy Process-Multicriteria Decision Analysis for Identification of Suitable Areas for Artificial Recharge with Reclaimed Water

Authors: Mahmoudi Marwa, Bahim Nadhem, Aydi Abdelwaheb, Issaoui Wissal, S. Najet

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This work represents a coupling between the geographic information system (GIS) and the multicriteria analysis aiming at the selection of an artificial recharge site by the treated wastewater for the Ariana governorate. On regional characteristics, bibliography and available data on artificial recharge, 13 constraints and 5 factors were hierarchically structured for the adequacy of an artificial recharge. The factors are subdivided into two main groups: environmental factors and economic factors. The adopted methodology allows a preliminary assessment of a recharge site, the weighted linear combination (WLC) and the analytical hierarchy process (AHP) in a GIS. The standardization of the criteria is carried out by the application of the different membership functions. The form and control points of the latter are defined by the consultation of the experts. The weighting of the selected criteria is allocated according to relative importance using the AHP methodology. The weighted linear combination (WLC) integrates the different criteria and factors to delineate the most suitable areas for artificial recharge site selection by treated wastewater. The results of this study showed three potential candidate sites that appear when environmental factors are more important than economic factors. These sites are ranked in descending order using the ELECTRE III method. Nevertheless, decision making for the selection of an artificial recharge site will depend on the decision makers in force.

Keywords: artificial recharge site, treated wastewater, analytical hierarchy process, ELECTRE III

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156 Financial Management Skills of Supreme Student Government Officers in the Schools Division of Quezon: Basis for Project Financial Literacy Information Program

Authors: Edmond Jaro Malihan

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This study aimed to develop and propose Project Financial Literacy Information Program (FLIP) for the Schools Division of Quezon to improve the financial management skills of Supreme Student Government (SSG) officers across different school sizes. This employed a descriptive research design covering the participation of 424 selected SSG officers using purposive sampling procedures from the SDO-Quezon. The consultation was held with DepEd officials, budget officers, and financial advisors to validate the design of the self-made questionnaires in which the computed mean was verbally interpreted using the four-point Likert scale. The data gathered were presented and analyzed using weighted arithmetic mean and ANOVA test. Based on the findings, generally, SSG officers in the SDO-Quezon possess high financial management skills in terms of budget preparation, resource mobilization, and auditing and evaluation. The size of schools has no significant difference and does not contribute to the financial management skills of SSG officers, which they apply in implementing their mandated programs, projects, and activities (PPAs). The Project Financial Literacy Information Program (FLIP) was developed considering their general level of financial management skills and the launched PPAs by the organization. The project covered the suggested training program vital in conducting the Virtual Division Training on Financial Management Skills of the SSG officers.

Keywords: financial management skills, SSG officers, school size, financial literacy information program

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155 Research the Counseling of Taichung Taiwan's 10 Creative Zones

Authors: Feng Shih-Jen, Chiang Yi-Hua, Yang Min-Chih

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After going through mass production and contract manufacturing phases, under the global consumption trend, Taiwan’s traditional industry has turned to creative design, research and development to gain recognition in the consumer market, build competitiveness in the global market and further promote the products from Taiwan’s traditional industry. Taichung City is rich in cultural creative resources, outperforming other counties/cities in originality, creative talents, cultural taste, art/culture participation and global marketing. As the result this has created a diversified and vibrant cultural market in Taichung, giving Taichung the highest potential as a cultural creative city. This research, through the project by Taichung Cultural Creative Industry Promotion Office, has built an exchange platform for the cultural creative industry in central Taiwan. The platform will promote exchanges of creative ideas in the cultural creative industry in Taiwan as well as industrial transformation and brings more value for the industry. This study also proposes the idea of “Taichung Cultural Creative Exhibition” Therefore, this study was conducted in Taiwan, Taichung 10 Creative Zone Exhibition, which is divided into four stages counseling. Respectively, of the first order: the cultural creative Zone specialty shops offer; The second stage is the industrial settlement discussions and counseling workshops in the ground; The third stage of consultation for the recruitment of the cultural creative businesses separate estate; The fourth stage is the story of the build cultural and creative industry. Hope through periodic counseling, handling Taichung 10 Creative Zone Exhibition.

Keywords: cultural creative industry, counseling, Taichung, Taiwan's creative zones

Procedia PDF Downloads 463