Search results for: proper medication

Authors: Sitira Williams, Georgina Cherry, Andrea Wright, Kevin Wells, Taran Rai, Richard Brown, Travis Street, Alasdair Cook

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Social media sources (50) were identified, keywords defined by veterinarians and organised into 6 topics known to be indicative of feline pruritus: body areas, behaviors, symptoms, diagnosis, and treatments. These were augmented using academic literature, a cat owner survey, synonyms, and Google Trends. The content was collected using a social intelligence solution, with keywords tagged and filtered. Data were aggregated and de-duplicated. SL content matching body areas, behaviors and symptoms were reviewed manually, and posts were marked relevant if: posted by a pet owner, identifying an itchy cat and not duplicated. A sub-set of 493 posts published from 2009-2022 was used for reflexive thematic analysis in NVIVO (Burlington, MA) to identify themes. Five themes were identified: allergy, pruritus, additional behaviors, unusual or undesirable behaviors, diagnosis, and treatment. Most (258) posts reported the cat was excessively licking, itching, and scratching. The majority were indoor cats and were less playful and friendly when itchy. Half of these posts did not indicate a known cause of pruritus. Bald spots and scabs (123) were reported, often causing swelling and fur loss, and 56 reported bumps, lumps, and dry patches. Other impacts on the cat’s quality of life were ear mites, cat self-trauma and stress. Seven posts reported their cats’ symptoms caused them ongoing anxiety and depression. Cats with food allergies to poultry (often chicken and beef) causing bald spots featured in 23 posts. Veterinarians advised switching to a raw food diet and/or changing their bowls. Some cats got worse after switching, leaving owners’ needs unmet. Allergic reactions to flea bites causing excessive itching, red spots, scabs, and fur loss were reported in 13 posts. Some (3) posts indicated allergic reactions to medication. Cats with seasonal and skin allergies, causing sneezing, scratching, headshaking, watery eyes, and nasal discharge, were reported 17 times. Eighty-five posts identified additional behaviors. Of these, 13 reported their cat’s burst pimple or insect bite. Common behaviors were headshaking, rubbing, pawing at their ears, and aggressively chewing. In some cases, bites or pimples triggered previously unseen itchiness, making the cat irritable. Twenty-four reported their cat had anxiety: overgrooming, itching, losing fur, hiding, freaking out, breathing quickly, sleeplessness, hissing and vocalising. Most reported these cats as having itchy skin, fleas, and bumps. Cats were commonly diagnosed with an ear infection, ringworm, acne, or kidney disease. Acne was diagnosed in cats with an allergy flare-up or overgrooming. Ear infections were diagnosed in itchy cats with mites or other parasites. Of the treatments mentioned, steroids were most frequently used, then anti-parasitics, including flea treatments and oral medication (steroids, antibiotics). Forty-six posts reported distress following poor outcomes after medication or additional vet consultations. SL provides veterinarians with unique insights. Verbatim comments highlight the detrimental effects of pruritus on pets and owner quality of life. This study demonstrates the need for veterinarians to communicate management and treatment options more effectively to relieve owner frustrations. Data analysis could be scaled up using machine learning for topic modeling.

Keywords: content analysis, feline, itch, pruritus, social media, thematic analysis, veterinary dermatology

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Authors: Ponghyung Lee

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This study seeks to investigate the variations occurring to Korean consonantal variations center around laryngeal features of the concerned sounds, to the exclusion of others. Our fundamental premise is that the weak contrast associated with concerned segments might be held accountable for the oscillation of the status quo of the concerned consonants. What is more, we assume that an array of notions as a measure of communicative efficiency of linguistic units would be significantly influential on triggering those variations. To this end, we have tried to compute the surprisal, entropic contribution, and relative contrastiveness associated with Korean obstruent consonants. What we found therein is that the Information-theoretic perspective is compelling enough to lend support our approach to a considerable extent. That is, the variant realizations, chronologically and stylistically, prove to be profoundly affected by a set of Information-theoretic factors enumerated above. When it comes to the biblical proper names, we use Georgetown University CQP Web-Bible corpora. From the 8 texts (4 from Old Testament and 4 from New Testament) among the total 64 texts, we extracted 199 samples. We address the issue of laryngeal feature variations associated with Korean obstruent consonants under the presumption that the variations stem from the weak contrast among the triad manifestations of laryngeal features. The variants emerge from diverse sources in chronological and stylistic senses: Christianity biblical texts, ordinary casual speech, the shift of loanword adaptation over time, and ideophones. For the purpose of discussing what they are really like from the perspective of Information Theory, it is necessary to closely look at the data. Among them, the massive changes occurring to loanword adaptation of proper nouns during the centennial history of Korean Christianity draw our special attention. We searched 199 types of initially capitalized words among 45,528-word tokens, which account for around 5% of total 901,701-word tokens (12,786-word types) from Georgetown University CQP Web-Bible corpora. We focus on the shift of the laryngeal features incorporated into word-initial consonants, which are available through the two distinct versions of Korean Bible: one came out in the 1960s for the Protestants, and the other was published in the 1990s for the Catholic Church. Of these proper names, we have closely traced the adaptation of plain obstruents, e. g. /b, d, g, s, ʤ/ in the sources. The results show that as much as 41% of the extracted proper names show variations; 37% in terms of aspiration, and 4% in terms of tensing. This study set out in an effort to shed light on the question: to what extent can we attribute the variations occurring to the laryngeal features associated with Korean obstruent consonants to the communicative aspects of linguistic activities? In this vein, the concerted effects of the triad, of surprisal, entropic contribution, and relative contrastiveness can be credited with the ups and downs in the feature specification, despite being contentiousness on the role of surprisal to some extent.

Keywords: entropic contribution, laryngeal feature variation, relative contrastiveness, surprisal

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Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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Authors: Muhammad Qamar Masood, Syed Abbas Raza, Umar Yousaf Raja, Imran Hassan, Bilal Afzal, Muhammad Aleem Zahir, Atika Shaheer

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Background: Cardiovascular disease (CVD) is a major burden among people with type 2 diabetes (T2D) with 1 in 3 reported to have CVD. Therefore, understanding real-world clinical characteristics and prescribing patterns could help in better care. Objective: The CONVERGE (Cardiovascular Outcomes and Value in the Real world with GLP-1RAs) study characterized demographics and medication usage patterns in T2D intensified (add-on to metformin) overall population. The data were further divided into subgroups {dipeptidyl peptidase-4 inhibitors (DPP-4is), sulfonylureas (SUs), insulins, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT-2is)}, according to the latest prescribed antidiabetic agent (ADA) in India/Pakistan/Thailand. Here, we report findings from Pakistan. Methods: A multi-center retrospective study utilized data from medical records between 13-Sep-2008 (post-market approval of GLP-1RAs) and 31-Dec-2017 in adults (≥18-year-old). The data for this study were collected from 05 centers / institutes located in major cities of Pakistan, including Karachi, Lahore, Islamabad, and Multan. These centers included National Hospital, Aga Khan University Hospital, Diabetes Endocrine Clinic Lahore, Shifa International Hospital, Mukhtar A Sheikh Hospital Multan. Data were collected at start of medical record and at 6 or 12-months prior to baseline based on variable type; analyzed descriptively. Results: Overall, 1,010 patients were eligible. At baseline, overall mean age (SD) was 51.6 (11.3) years, T2D duration was 2.4 (2.6) years, HbA1c was 8.3% (1.9) and 35% received ≥1CVD medications in the past 1-year (before baseline). Most frequently prescribed ADAs post-metformin were DPP-4is and SUs (~63%). Only 6.5% received GLP-1RAs and SGLT-2is were not available in Pakistan during the study period. Overall, it took a mean of 4.4 years and 5 years to initiate GLP-1RAs and SGLT-2is, respectively. In comparison to other subgroups, more patients from GLP-1RAs received ≥3 types of ADA (58%), ≥1 CVD medication (64%) and had higher body mass index (37kg/m2). Conclusions: Utilization of GLP-1RAs and SGLT-2is was low, took longer time to initiate and not before trying multiple ADAs. This may be due to lack of evidence for CV benefits for these agents during the study period. The planned phase 2 of the CONVERGE study can provide more insights into utilization and barriers to prescribe GLP-1RAs and SGLT-2is post 2018 in Pakistan.

Keywords: type 2 diabetes, GLP-1RA, treatment intensification, cardiovascular disease

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Authors: Priyanka Sharma, Manoj Jais, Poonam Gupta, Suraiya K. Ansari, Ravinder Kaur

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Introduction: As much as the Health Care is necessary for the population, so is the management of the Biomedical waste produced. Biomedical waste is a wide terminology used for the waste material produced during the diagnosis, treatment or immunization of human beings and animals, in research or in the production or testing of biological products. Biomedical waste management is a chain of processes from the point of generation of Biomedical waste to its final disposal in the correct and proper way, assigned for that particular type of waste. Any deviation from the said processes leads to improper disposal of Biomedical waste which itself is a major health hazard. Proper segregation of Biomedical waste is the key for Biomedical Waste management. Improper disposal of BMW can cause sharp injuries which may lead to HIV, Hepatitis-B virus, Hepatitis-C virus infections. Therefore, proper disposal of BMW is of upmost importance. Health care establishments segregate the Biomedical waste and dispose it as per the Biomedical waste management rules in India. Objectives: This study was done to observe the current trends of Biomedical waste generated in a tertiary care Hospital in Delhi. Methodology: Biomedical waste management rounds were conducted in the hospital wards. Relevant details were collected and analysed and sites with maximum Biomedical waste generation were identified. All the data was cross checked with the commons collection site. Results: The total amount of waste generated in the hospital during January 2014 till December 2014 was 6,39,547 kg, of which 70.5% was General (non-hazardous) waste and the rest 29.5% was BMW which consisted highly infectious waste (12.2%), disposable plastic waste (16.3%) and sharps (1%). The maximum quantity of Biomedical waste producing sites were Obstetrics and Gynaecology wards with a total Biomedical waste production of 45.8%, followed by Paediatrics, Surgery and Medicine wards with 21.2 %, 4.6% and 4.3% respectively. The maximum average Biomedical waste generated was by Obstetrics and Gynaecology ward with 0.7 kg/bed/day, followed by Paediatrics, Surgery and Medicine wards with 0.29, 0.28 and 0.18 kg/bed/day respectively. Conclusions: Hospitals should pay attention to the sites which produce a large amount of BMW to avoid improper segregation of Biomedical waste. Also, induction and refresher training Program of Biomedical waste management should be conducted to avoid improper management of Biomedical waste. Healthcare workers should be made aware of risks of poor Biomedical waste management.

Keywords: biomedical waste, biomedical waste management, hospital-tertiary care, New Delhi

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Authors: Twarakavi Venkata Suresh Kumar, Sailaja Kumar, B. Eswara Reddy

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In a world of tremendous technical developments, effective and efficient higher education has always been a major challenge. The rising number of educational institutions have made it mandatory for healthy competitions among the institutions. To evaluate the qualitative competence of these educations institutions in engineering and technology and related disciplines, an efficient assessment technique in internal and external quality has to be followed. To achieve this, the curriculum is to be developed into courses, and each course has to be presented in the form teaching lesson plan consisting of topics and session outcome known as Course Outcomes (COs), that easily map into different Programme Outcomes (POs). The major objective of these methodologies is to provide quality technical education to its students. Detailed clear weightage in CO-PO mapping helps in proper measurable COs and to devise the POs attainment is an important issue. This ensures in assisting the achievement of the POs with proper weightage to POs, and also improves the successive curriculum development. In this paper, we presented a methodology for mapping CO and PO considering the key elements supported by each PO. This approach is useful in evaluating the attainment of POs which is based on the attainment of COs using the existing data from students' marks taken from various test items. Such direct assessment tools are used to measure the degree to which each student has achieved each course learning outcome by the completion of the course. Hence, these results are also useful in measuring the PO attainment for improving the programme vision and mission.

Keywords: attainment, course outcomes, programme outcomes, educational institutions

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Authors: Izani Uzair Zubair, Mohd Ismail Ibrahim, Mohd Nazri Shafei, Hassan Merican Omar Naina Merican, Mohamad Sabri Othman, Mohd Izmi Ahmad Ibrahim, Rasilah Ramli, Rajpal Singh Karam Singh

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Nurses experience a higher prevalence of low back pain (LBP) and musculoskeletal complaints as compared to other hospital workers. Due to no proper policy related to LBP, the job has exposed them to the problem. Thus, the current study aims to look at the intensity of the problem and factors associated with development of LBP. Method and Tools: A cross sectional study was carried out among 1292 nurses from six public hospitals in Penang. They were randomly selected and those who were pregnant and have been diagnosed to have LBP were excluded. A Malay validated BACK Questionnaire was used. The associated factors were determined by using multiple logistic regression from SPSS version 20.0. Result: Most of the respondents were at mean age 30 years old and had mean working experience 86 months. The prevalence of LBP was identified as 76% (95% CI 74, 82). Factors that were associated with LBP among nurses include lifting a heavy object (OR2.626 (95% CI 1.978, 3.486) p =0.001 and the estimation weight of the lifted object (OR1.443 (95% CI 1.056, 1.970) p =0.021. Conclusion: Nurses who practice lifting heavy object and weight of the object lifted give a significant contribution to the development of LBP. The prevalence of the problem is significantly high. Thus, a proper no weight lifting policy should be considered.

Keywords: low back pain, nurses, Penang public hospital, Penang

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Authors: Chun-Chin Huang

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Individuals with prediabetes increase the risk of developing type 2 diabetes. Exercise is a potent stimulator of skeletal muscle glucose uptake and thus good for maintaining glucose homeostasis. That could be a conducive method to improve blood glucose regulation and prevent type 2 diabetes without medication intake. The aim of this study was to summarize mechanisms of insulin resistance and investigate the beneficial effects of acute and chronic aerobic exercise on glycemic control in prediabetes and type 2 diabetes. Aerobic exercise regulates glucose homeostasis and reduces blood glucose, insulin concentrations. Therefore, the type of aerobic exercise brings positive effects to prediabetes and type 2 diabetes.

Keywords: insulin resistance, glucose sensitivity, impaired fasting glucose, impaired glucose tolerance

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Authors: Abhijit Trailokya

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Background: Cardiovascular diseases (CVD’s) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient’s profile being treated, and factors that determine treatment success or failure in achieving desired goals. Purpose: The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India. Methods: This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed. Results: 3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician’s lack of awareness about recent treatment guidelines also might contribute to patients’ poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient’s life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients. Conclusion: As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70%. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.

Keywords: cardiovascular disease, diabetes mellitus, dyslipidemia, LDL-C, lipid lowering drug, statins

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Authors: Khalil Boukfoussa

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It is important to provide students with food that contains complete nutrients to provide them with mental and physical energy during the school day. Especially since the time students spend in school is equivalent to 50% of their time during the day, which increases the importance of proper nutrition in schools and makes it an ideal way to inculcate the foundations of a healthy lifestyle and healthy eating habits. Proper nutrition is one of the most important things that affect the health and process of growth and development in children, in addition to being a key factor in supporting the ability to focus, supporting mental abilities and developing the student’s academic achievement. In addition to the importance of a healthy diet for the development and growth of the child's body, proper nutrition can significantly contribute to protecting the body from catching viruses and helping it to pass the winter safely. Effective food control systems in different countries are essential to protect the health and safety of domestic consumers. These systems are also crucial in enabling countries to ensure the safety and quality of food entering international trade and to ensure that imported food conforms to national requirements. The current global food trade environment places significant obligations on both importing and exporting countries to strengthen their food control systems and to apply and implement risk-based food control strategiesConsumers are becoming more interested in the way food is produced, processed and marketed, and are increasingly demanding that governments assume greater responsibility for consumer protection and food safety. In many countries, food control is weak because of the abundance of legislation, the multiplicity of jurisdictions and weaknesses in control, monitoring and enforcement. The following guidelines seek to advise national authorities on strategies to strengthen food control systems to protect public health, prevent fraud and fraud, avoid food contamination and help facilitate trade. These Guidelines will assist authorities in selecting the most appropriate food control system options in terms of legislation, infrastructure and enforcement mechanisms. The document clarifies the broad principles that govern food control systems and provides examples of the infrastructure and methods by which national systems can operate

Keywords: food, nutrision, school, safty

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Authors: Prapin Nuchpiam

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The importance of social innovation has become increasingly significant as the process of developing effective solutions to social problems and being a force of change for people’s better quality of life. In order to promote social innovation, active collaboration between government, business organizations, and the civil society sector is needed. A proper legal framework also plays an important role in building the social innovation ecosystem. Currently, there is no specific law designed for social innovation or a so-called “social innovation law”. One of the legal frameworks for social innovation is the development of hybrid legal forms for social enterprises such as the UK’s Community Interest Company (CIC), the US’s Low-Profit Limited Liability Company (L3C) and the US’s Benefit Corporation (B-Corp), among others. This is because social enterprise is recognized as an organizational form of social innovation with its aim for social benefit goals and the achievement of financial sustainability. Nonetheless, there has been a debate over the differences and similarities between social innovation and social enterprise. Thus, social enterprise law might not fit well with social innovation, resulting in a search for a legal framework specially designed for social innovation. This paper aims to study the interrelationship between social innovation, social enterprise, and the role of law to see whether we need a specific law for social innovation. If so, what should such a legal framework look like? The paper will provide a critical analysis of innovative legal forms for social enterprise as a type of social innovation law. A proper legal framework for social innovation could help promote the sector, which could result in finding new solutions to social problems. It will also bring about a greater common understanding of the exciting development of legal scholarship in this way, which will, in turn, serve as a productive basis or direction for further research on this increasingly important topic.

Keywords: social innovation, social enterprise, legal framework, regulation

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Authors: Noraizah Abu Bakar, Norhayati Alais, Nurdiana Azizan, Fatimah Alwi, Muhammad Zaky Razaly

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This is a concise research module with the Islamic values concept proposed to a group of researches, potential researchers, PhD and Master Scholars to prepare themselves for their studies. The intention of designing this module is to help and guide Malaysian citizens to undergone their postgraduate’s studies. This is aligned with the 10th Malaysian plan- MyBrain 15. MyBrain 15 is a financial aid to Malaysian citizens to pursue PhD and Master programs. The program becomes one of Ministry of Education Strategic Plan to ensure by year 2013, there will be 60,000 PhD scholars in Malaysia. This module is suitable for the social science researchers; however it can be useful tool for science technology researchers such as Engineering and Information Technology disciplines too. The module consists of eight (8) series that provides a proper flow of information in doing research with the Islamic Value Application provided in each of the series. This module is designed to produce future researchers with a comprehensive knowledge of humankind and the hereafter. The uniqueness about this research module is designed based on Islamic values concept. Researchers were able to understand the proper research process and simultaneously be able to open their minds to understand Islam more closely. Application of Islamic values in each series could trigger a broader idea for researchers to examine in greater depth of knowledge related to humanities.

Keywords: Eight Series Research Module, Islamic Values concept, Teaching Methodology, Flow of Information, Epistemology of research

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Authors: Amir Reza Talaghat

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Since 2015, a new approach and policy regarding energy resources protection and using renewable energies has been started in Iran which was developing new projects. Investigating about the feasibility study of these new projects helped to figure out five steps to prepare an executive feasibility study of the concerned projects, which are proper site selections, authorizations, design and simulation, economic study and programming, respectively. The results were interesting and essential for decision makers and investors to start implementing of these projects in reliable condition. The research is obtained through collection and study of the project's documents as well as recalculation to review conformity of the results with GIS data and the technical information of the bidders. In this paper, it is attempted to describe the result of the performed research by describing the five steps as an executive methodology, for preparing a feasible study of installing a 10 MW – solar farm project. The corresponding results of the research also help decision makers to start similar projects is explained in this paper as follows: selecting the best location for the concerned PV plant, reliable and safe conditions for investment and the required authorizations to start implementing the solar farm project in the concerned region, selecting suitable component to achieve the best possible performance for the plant, economic profit of the investment, proper programming to implement the project on time.

Keywords: solar farm, solar energy, execution of PV power plant PV power plant

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Authors: Muhammad Muhammad Suleiman

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The Nigerian political system has witnessed rising occurrences of election malpractice in the last decade. This has been due to election rigging and other forms of electoral fraud. In order to find a sustainable solution to this malpractice, the introduction of electronic voting (e-voting) has been suggested. This paper reviews the challenges, benefits, and issues associated with e-voting as a panacea for election malpractice in Nigeria. The review of existing literature revealed that e-voting can reduce the cost of conducting elections and reduce the opportunity for electoral fraud. The review suggests that the introduction of e-voting in the Nigerian political system would require adequate cybersecurity measures, trust-building initiatives, and proper legal frameworks to ensure its successful implementation. It is recommended that there should be an effective policy that would ensure the security of the system as well as the credibility of the results. Furthermore, a comprehensive awareness campaign needs to be conducted to ensure that voters understand the process and are comfortable using the system. In conclusion, e-voting has the potential to reduce the occurrence of election malpractice in the Nigerian political system. However, the successful implementation of e-voting will require effective policy interventions and trust-building initiatives. Additionally, the costs of acquiring the necessary infrastructure and equipment and implementing proper legal frameworks need to be considered.

Keywords: electronic voting, general election, candidate, INEC, cyberattack

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Authors: Awadh O. Al-Anazi

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As part of the organizational needs toward successful maintaining activities, a proper management system need to be put in place, ensuring the effectiveness of maintenance activities. The management system shall clearly describes the process of identifying, prioritizing, planning, scheduling, execution, and providing valuable feedback for all maintenance activities. Completion and accuracy of the system with proper implementation shall provide the organization with a strong platform for effective maintenance activities that are resulted in efficient outcomes toward business success. The purpose of this research was to introduce a practical tool for measuring the maintenance efficiency level within Saudi organizations. A comprehensive study was launched across many maintenance professionals throughout Saudi leading organizations. The study covered five main categories: work process, identification, planning and scheduling, execution, and performance monitoring. Each category was evaluated across many dimensions to determine its current effectiveness through a five-level scale from 'process is not there' to 'mature implementation'. Wide participation was received, responses were analyzed, and the study was concluded by highlighting major gaps and improvement opportunities within Saudi organizations. One effective implementation of the efficiency enhancement efforts was deployed in Saudi Kayan (one of Sabic affiliates). Below details describes the project outcomes: SK overall maintenance wrench time was measured at 20% (on average) from the total daily working time. The assessment indicates the appearance of several organizational gaps, such as a high amount of reactive work, poor coordination and teamwork, Unclear roles and responsibilities, as well as underutilization of resources. Multidiscipline team was assigned to design and implement an appropriate work process that is capable to govern the execution process, improve the maintenance workforce efficiency, and maximize wrench time (targeting > 50%). The enhanced work process was introduced through brainstorming and wide benchmarking, incorporated with a proper change management plan and leadership sponsorship. The project was completed in 2018. Achieved Results: SK WT was improved to 50%, which resulted in 1) reducing the Average Notification completion time. 2) reducing maintenance expenses on OT and manpower support (3.6 MSAR Actual Saving from Budget within 6 months).

Keywords: efficiency, enhancement, maintenance, work force, wrench time

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Authors: Manoj Malviya, Shubham Shinde

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The present study focuses on the determination of torsional stiffness of a space frame chassis and comparison of elements used in the Finite Element Analysis of frame. The study also discusses various concepts and design aspects of a space frame chassis with the emphasis on their applicability in BAJA SAE vehicles. Torsional stiffness is a very important factor that determines the chassis strength, vehicle control, and handling. Therefore, it is very important to determine the torsional stiffness of the vehicle before designing an optimum chassis so that it should not fail during extreme conditions. This study determines the torsional stiffness of frame with respect to suspension shocks, roll-stiffness and anti-roll bar rates. A spring model is developed to study the effects of suspension parameters. The engine greatly contributes to torsional stiffness, and therefore, its effects on torsional stiffness need to be considered. Deflections in the tire have not been considered in the present study. The proper element shape should be selected to analyze the effects of various loadings on chassis while implementing finite element methods. The study compares the accuracy of results and computational time for different element types. Shape functions of these elements are also discussed. Modelling methodology is discussed for the multibody analysis of chassis integrated with suspension arms and engine. Proper boundary conditions are presented so as to replicate the real life conditions.

Keywords: space frame chassis, torsional stiffness, multi-body analysis of chassis, element selection

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Authors: H. Ozbasaran

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Lateral torsional buckling is a global stability loss which should be considered in the design of slender structural members under flexure about their strong axis. It is possible to compute the load which causes lateral torsional buckling of a beam by finite element analysis, however, closed form equations are needed in engineering practice. Such equations can be obtained by using energy method. Unfortunately, this method has a vital drawback. In lateral torsional buckling applications of energy method, a proper function for the critical lateral torsional buckling mode should be chosen which can be thought as the variation of twisting angle along the buckled beam. The accuracy of the results depends on how close is the chosen function to the exact mode. Since critical lateral torsional buckling mode of the cantilever I-beams varies due to material properties, section properties, and loading case, the hardest step is to determine a proper mode function. This paper presents an approximate function for critical lateral torsional buckling mode of doubly symmetric cantilever I-beams. Coefficient matrices are calculated for the concentrated load at the free end, uniformly distributed load and constant moment along the beam cases. Critical lateral torsional buckling modes obtained by presented function and exact solutions are compared. It is found that the modes obtained by presented function coincide with differential equation solutions for considered loading cases.

Keywords: buckling mode, cantilever, lateral-torsional buckling, I-beam

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Authors: Gianna Zou

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Propensity score matching (PSM), introduced by Paul R. Rosenbaum and Donald Rubin in 1983, is a popular statistical matching technique which tries to estimate the treatment effects by taking into account covariates that could impact the efficacy of study medication in clinical trials. PSM can be used to reduce the bias due to confounding variables. However, PSM assumes that the response values are normally distributed. In some cases, this assumption may not be held. In this paper, a machine learning method - Bayesian Additive Regression Tree (BART), is used as a more robust method of matching. BART can work well when models are misspecified since it can be used to model heterogeneous treatment effects. Moreover, it has the capability to handle non-linear main effects and multiway interactions. In this research, a BART Matching Method (BMM) is proposed to provide a more reliable matching method over PSM. By comparing the analysis results from PSM and BMM, BMM can perform well and has better prediction capability when the response values are not normally distributed.

Keywords: BART, Bayesian, matching, regression

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Authors: Osama Abaza, Tanay Datta Chowdhury

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As a driver's speed increases, so do the probability of an incident and likelihood of injury. The presence of equipment, personnel, and a changing landscape in construction zones create greater potential for incident. This is especially concerning in Alaska, where summer construction activity, coinciding with the peak annual traffic volumes, cannot be avoided. In order to reduce vehicular speeding in work zones, and therefore the probability of crash and incident occurrence, variable speed limit (VSL) systems can be implemented in the form of radar speed display trailers since the radar speed display trailers were shown to be effective at reducing vehicular speed in construction zones. Allocation of VSL not only help reduce the 85th percentile speed but also it will predominantly reduce mean speed as well. Total of 2147 incidents along with 385 crashes occurred only in one month around the construction zone in the Alaska which seriously requires proper attention. This research provided a thorough crash analysis to better understand the cause and provide proper countermeasures. Crashes were predominantly recoded as vehicle- object collision and sideswipe type and thus significant amount of crashes fall in the group of no injury to minor injury type in the severity class. But still, 35 major crashes with 7 fatal ones in a one month period require immediate action like the implementation of the VSL system as it proved to be a speed reducer in the construction zone on Alaskan roadways.

Keywords: speed, construction zone, crash, severity

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Authors: Saiyeed Jakaria Baksh Imran

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The earth is being endangered by many of the climate related issues today. The most serious issue for the world today is the global warming. Increase in Greenhouse gas (GHG) emissions post-industrial revolution period is the prime reason for global warming. Shipping is the fifth largest GHG emitting sector worldwide. The key reason for this is because, over 90% of the world trade is conducted through ocean as the ocean alone covers 70% of the earth surface. While the countries continue to develop, trade and commerce continue to increase between them simultaneously. However, there is no sign of reduction in GHG emission from shipping because of many concerned issues. Firstly, there is technological barrier for which ships cannot just become environment friendly immediately. Secondly, there is no alternative fuel available as well. Thirdly, there is no proper mechanism to measure how much ships emit as emission from ships vary according to the size, engine type and loading capacity of ships. The International Maritime Organization (IMO) being the governing body of the international shipping has implemented MARPOL Annex VI. However, the policy alone is not enough unless there is a proper data available regarding ship emissions, which the IMO is yet to figure out. This paper will present a critical analysis of existing IMO policies such as the Energy Efficiency Design Index (EEDI), Ship Energy Efficiency Management Plan (SEEMP), Data Collection System (SEEMP) and the IMO’s Initial Strategy on Reduction of Greenhouse Gas emissions from shipping. Also, the challenges exist in implementing such policies have been presented in the paper.

Keywords: GHG, IMO, EEDI, SEEMP, DCS, greenhouse gas, decarbonization, shipping

Procedia PDF Downloads 54

Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Aditya Manna

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Introduction: As in any developing countries state of West Bengal in India has a huge burden of cancer patients in advanced stage coming from rural area where awareness regarding the usefulness of palliative care in rather poor. Objective: Our goal is to give a pain free good quality of life in these advanced stage cancer patients. Objective of this study is to identify the main difficulties in achieving the above goal in a rural village setting in India. Method: Advanced cancer patients in need of palliative care in various villages in of rural India were selected for this study. Their symptoms and managements in that rural surroundings were evaluated by an NGO (under the guidance of a senior palliative care specialist) working in that area. An attempt was made to identify the main obstacles in getting proper palliative care in a rural setting. Results: Pain, fatigue are the main symptoms effecting these patients. In most patients pain and other symptoms control were grossly inadequate due to lack of properly trained manpower in the rural India. However regular homecare visits by a group of social workers were of immense help in the last few months of life. NGO team was well guided by a palliative care specialist. Conclusion: There is a wide gap of trained manpower in this filled in rural areas of India. Dedicated groups from rural area itself need encouragement and proper training, so that difficult symptoms can be managed locally along with necessary social and psychological support to these patients.

Keywords: palliative care, NGO, rural India, home care

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Authors: Mazin Alqhazo, Ayat Bani Rashaid

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This study examines the levels of dopamine and serotonin in blood samples of children who stutter compared with normal fluent speakers. Blood specimens from 50 children who stutter (6 females, 44 males) and 50 normal children matched age and gender were collected for the purpose of the current study. The concentrations of dopamine and serotonin were measured using the 1100 series high-performance liquid chromatography coupled with ultraviolet detector instrument (HPLC-UV). It was revealed that dopamine level in the blood samples of stuttering group and fluent group was not significant (P = 0.769), whereas the level of serotonin was significantly higher in the blood samples of stuttering group than the blood samples of fluent normal group (P = 0.015). It is concluded that serotonin blockers could be used in future studies to evaluate its role as a medication for the treatment of stuttering.

Keywords: dopamine, serotonin, stuttering, fluent speakers

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Sunday Moses Ojelabi

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Safety is the protection of the crew, passenger and equipment itself, as well as those living and working near bodies of water, from hazardous situations. To assure safety, watch keeping is paramount because neglecting your watchkeeping can lead to hazardous situations. Navigation is the assignment of a sailor to a specific route on a vessel to operate. Navigation is the process of planning, managing, and directing a vessel safely to the desired destination with the aid of intense and efficient watch keeping. Safety, i,e, all measures done to preserve the welfare of marine life, maritime infrastructure, facilities, ships, offshore installations, crew, and passengers, as well as the preservation of navigation and the ease of maritime trade, are referred to as safety measures;. When it comes to health, the absence of a proper first aid kit will affect injured sailors and passengers. Not using goggles while shipping, ear muffs, etc., in the course of maintenance can be hazardous. Watchkeeping: i.e the specific dutiies assigned to a personnel in a vessel to see to its continous smooth functionality. Your lookout or watch officer [officer on navigational duty] must be active at all times in the course of duty. Navigation refers to the technique of precisely determining a craft or vehicle's position and directing its motion along a particular course. The seafarers are not being put through regular seminars, training, and orientations. In parts of West Africa, sailors go to school without being able to secure jobs until their papers expire. For that, they won’t go for another Standard Trainning Certification and Watch keeping for Seafarers to upgrade their certificate. In light of this, they are not familiar with the new vessels in the country, and for this, they can`t meet the safety, watch keeping, and navigation standards. Also, shipping companies and ship owners are being selfish by not putting the proper things needed onboard regarding safety, watchkeeping, and navigational equipment. The questions raised in these presentations are the breakdown of the safety activities, watch keeping effectiveness, and navigational accuracy. All safety and watch keeping regulations should be applied efficiently. The problem identified includes a lack of safety instruments onboard vessels in African waters. Also, inadequate proper watchkeeping due to the excess workload on the seafarers can lead to an improper lookout, which gives room to collision, hijacking, and piracy. The impact of this research is to inform African seafarers, shipping companies, and ship owners of the necessary information concerning the safety of their lives and that of their passengers, cargo, and equipment.

Keywords: standard of training, certification, watch keeping for seafarers, navigation, safety, watchkeeping

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Authors: Reza Hadjiaghaie Vafaie, Sevda Givtaj

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Automation and control of biological samples and solutions at the microscale is a major advantage for biochemistry analysis and biological diagnostics. Despite the known potential of miniaturization in biochemistry and biomedical applications, comparatively little is known about fluid automation and control at the microscale. Here, we study the electric field effect inside a fluidic channel and proper electrode structures with different patterns proposed to form forward, reversal, and rotational flows inside the channel. The simulation results confirmed that the ac electro-thermal flow is efficient for the control and automation of high-conductive solutions. In this research, the fluid pumping and mixing effects were numerically studied by solving physic-coupled electric, temperature, hydrodynamic, and concentration fields inside a microchannel. From an experimental point of view, the electrode structures are deposited on a silicon substrate and bonded to a PDMS microchannel to form a microfluidic chip. The motions of fluorescent particles in pumping and mixing modes were captured by using a CCD camera. By measuring the frequency response of the fluid and exciting the electrodes with the proper voltage, the fluid motions (including pumping and mixing effects) are observed inside the channel through the CCD camera. Based on the results, there is good agreement between the experimental and simulation studies.

Keywords: microfluidic, nano/micro actuator, AC electrothermal, Reynolds number, micropump, micromixer, microfabrication, mass transfer, biomedical applications

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Authors: Enebe Christian Chukwudi

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Water bodies around the world notably underground water, ground water, rivers, streams, and seas, face degradation of their water quality as a result of activities associated with coal utilization including coal mining, coal processing, coal burning, waste storage and thermal pollution from coal plants which tend to contaminate these water bodies. This contamination results from heavy metals, presence of sulphate and iron, dissolved solids, mercury and other toxins contained in coal ash, sludge, and coal waste. These wastes sometimes find their way to sources of urban water supply and contaminate them. A major problem encountered in the supply of potable water to Enugu municipality is the contamination of Ajali River, the source of water supply to Enugu municipal by coal waste. Hydro geochemical analysis of Ajali water samples indicate high sulphate and iron content, high total dissolved solids(TDS), low pH (acidity values) and significant hardness in addition to presence of heavy metals, mercury, and other toxins. This is indicative of the following remedial measures: I. Proper disposal of mine wastes at designated disposal sites that are suitably prepared. II. Proper water treatment and III. Reduction of coal related contaminants taking advantage of clean coal technology.

Keywords: effects, coal, utilization, water quality, sources, waste, contamination, treatment

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Authors: Y. Y. Babanyara, B. A. Gana, T. Garba, M. A. Batari

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Proper management of dental waste is a crucial issue for maintaining human health and the environment. The waste generated in the dental clinics has the potential for spreading infections and causing diseases, so improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist, waste handlers, general public and the environment through production of toxins or as by-products of the destruction process. Staff that provide dental healthcare ought to be aware of the proper handling and the system of management of dental waste used by different dental hospitals. The method of investigation adopted in the paper involved a desk study in which documents and records relating to dental waste handling were studied to obtain background information on existing dental waste management in Nigeria other countries of the world are also mentioned as examples. Additionally, information on generation, handling, segregation, risk associated during handling and treatment of dental medical waste were sought in order to determine the best method for safe disposal. This article provides dentists with the information they need to properly dispose of mercury and amalgam waste, and provides suggestions for managing the other wastes that result from the day-to-day activities of a dental office such as: used X-ray fixers and developers; cleaners for X-ray developer systems; lead foils, shields and aprons; chemiclave/chemical sterilant solutions; disinfectants, cleaners, and other chemicals; and, general office waste. Additionally, this study may be beneficial for authorities and researchers of developing countries to work towards improving their present dental waste management system.

Keywords: clinic, dental, disposal, environment, waste management

Procedia PDF Downloads 294

Authors: Kangujam Monika, Kiranbala Devi Thokchom, Soibam Sandhyarani Devi

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Earthquake is a major natural hazard in India. Manipur, located in the North-Eastern Region of India, is one of the most affected location in the region prone to earthquakes since it lies in an area where Indian and Eurasian tectonic plates meet and is in seismic Zone V which is the most severe intensity zone, according to IS Code. Some recent earthquakes recorded in Manipur are M 6.7 epicenter at Tamenglong (January 4, 2016), M 5.2 epicenter at Churachandpur (February 24, 2017) and most recent M 4.4 epicenter at Thoubal (June 19, 2017). In these recent earthquakes, some houses and buildings were damaged, landslides were also occurred. A field study was carried out. An overview of the various causal factors involved in triggering of earthquake in Manipur has been discussed. It is found that improper planning, poor design, negligence, structural irregularities, poor quality materials, construction of foundation without proper site soil investigation and non-implementation of remedial measures, etc., are possibly the main causal factors for damage in Manipur during earthquake. The study also suggests, though the proper design of structure and foundation along with soil investigation, ground improvement methods, use of modern techniques of construction, counseling with engineer, mass awareness, etc., might be effective solution to control the hazard in many locations. An overview on the analysis pertaining to earthquake in Manipur together with on-going detailed site specific geotechnical investigation were presented.

Keywords: Manipur, earthquake, hazard, structure, soil

Procedia PDF Downloads 189

Authors: Nahed Al-Hajeri

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There are several reasons which lead to a delay in project completion, out of all, one main reason is the delay in deliverable processing, i.e. submission and review of documents. Most of the project cycles start with a list of deliverables but without a sequence of submission of the same, means without a direction to move, leading to overlapping of activities and more interdependencies. Hence Project Design Deliverables (PDD) is developed as a solution to Organize Transmittals (Documents/Drawings) received from contractors/consultants during different phases of an EPC (Engineering, Procurement, and Construction) projects, which gives proper direction to the stakeholders from the beginning, to reduce inter-discipline dependency, avoid overlapping of activities, provide a list of deliverables, sequence of activities, etc. PDD attempts to provide a list and sequencing of the engineering documents/drawings required during different phases of a Project which will benefit both client and Contractor in performing planned activities through timely submission and review of deliverables. This helps in ensuring improved quality and completion of Project in time. The successful implementation begins with a detailed understanding the specific challenges and requirements of the project. PDD will help to learn about vendor document submissions including general workflow, sequence and monitor the submission and review of the deliverables from the early stages of Project. This will provide an overview for the Submission of deliverables by the concerned during the projects in proper sequence. The goal of PDD is also to hold responsible and accountability of all stakeholders during complete project cycle. We believe that successful implementation of PDD with a detailed list of documents and their sequence will help organizations to achieve the project target.

Keywords: EPC (Engineering, Procurement, and Construction), project design deliverables (PDD), econometrics sciences, management sciences

Procedia PDF Downloads 374