Search results for: receiving converter
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1059

Search results for: receiving converter

249 The Capacity of Bolted and Screw Connections in Cold-Formed Steel Truss Structure through Analytical and Experimental Method

Authors: Slamet Setioboro, Rahutami Kusumaningsih, Prabowo Setiyawan, Danna Darmayadi

Abstract:

Designing of cold-formed steel capacity connections often based on the formula used for hot rolled steel. It makes the result of the actual capacity connection doesn’t accurate anymore. When the hot rolled steel receives the axial load pull, it will have different characteristics. As the result, there will be failure result when designing Truss structure made of hot rolled steel. This research aims to determine the capacity of actual cold-formed steel connections section which is loaded by the axial tensile force. It will test the appeal of the connection using bolt grafting tool and screw grafting tool. The variations of the test will be on the type of connection (single and double slap), the number of the connection tools and connection configuration. Bold and screw connections failure mode observed in this research are different each other. Failure mode of bolted connections includes sliding pivot plate, tearing at the plate and cutting of the bolt head. While the failure mode of screw connections includes tilting, hole-bearing, pull over and cutting the screw body out. This research was conducted using a laboratory test of HW2-600S Universal Testing Machine model with ASTM E8. It has done in the materials testing laboratory of Mechanical Engineering Department, Faculty of Engineering UNNES. The results obtained through the laboratory diversification towards theoretical calculations using the standards specified in ISO 7971-2013 Cold-Rolled Steel Structures. Based on the research, it can be concluded that the effective connection in receiving force strength is bolted connections neither single nor double plate. The method used is by applying 4 bolts through 2 parallel lines configuration. Furthermore, this connection deals with the consequences of holding the highest Pmaks, lowest failure risk and getting a little kind of mode of failure.

Keywords: axial load, cold-formed steel, capacity connections, bolted connections, screw connections

Procedia PDF Downloads 262
248 Postpartum Depression Screening and Referrals for Lower-Income Women in North Carolina, USA

Authors: Maren J. Coffman, Victoria C. Scott, J. Claire Schuch, Ashley N. Kelley, Jeri L. Ryan

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Postpartum Depression (PPD) is a leading cause of postpartum morbidity. PPD affects 7.1% of postpartum women and 19.2% of postpartum women when including minor depression. Lower-income women and ethnic minorities are more at risk for developing PPD and face multiple attitudinal and institutional barriers to receiving care. This study aims to identify PPD among low-income women and connect them to appropriate services in order to reduce the illness burden and enhance access to care. Screenings were conducted in two Women, Infants, and Children (WIC) clinics in the city of Charlotte, North Carolina, USA, from April 2017 to April 2018. WIC is a supplemental nutrition program that provides healthcare and nutrition to low-income pregnant women, breastfeeding women, and children under the age of 5. Additionally, a qualitative study was conducted to better understand the PPD continuum of care in order to identify opportunities for improvement. Mothers with infants were screened for depression risk using the PHQ-2. Mothers who scored ≥ 2 completed two additional standardized screening tools (PHQ-7, to complete the PHQ-9, and the Edinburgh) to assess depressive symptomatology. If indicated they may be suffering from depression, women were referred for case management services. Open-ended questions were used to understand treatment barriers. Four weeks after the initial survey, a follow-up telephone call was made to see if women had received care. Seven focus groups with WIC staff and managers, referral agency staff, local behavioral health professionals, and students examining the screenings, are being conducted March - April, 2018 to gather information related to current screening practices, referrals, follow up and treatment. Mothers (n = 231 as of February, 2018) were screened in English (65%) or Spanish (35%). According to preliminary results, 29% of mothers screened were at risk for postpartum depression (PHQ-2 ≥ 2). There were significant differences in preliminary screening results based on survey language (

Keywords: health disparities, maternal health, mental health, postpartum depression

Procedia PDF Downloads 152
247 Hypolipidemic and Antioxidant Effects of Mycelial Polysaccharides from Calocybe indica in Hyperlipidemic Rats Induced by High-Fat Diet

Authors: Govindan Sudha, Mathumitha Subramaniam, Alamelu Govindasamy, Sasikala Gunasekaran

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The aim of this study was to investigate the protective effect of Hypsizygus ulmarius polysaccharides (HUP) on reducing oxidative stress, cognitive impairment and neurotoxicity in D-galactose induced aging mice. Mice were subcutaneously injected with D-galactose (150 mg/kg per day) for 6 weeks and were administered HUP simultaneously. Aged mice receiving vitamin E (100 mg/kg) served as positive control. Chronic administration of D-galactose significantly impaired cognitive performance oxidative defence and mitochondrial enzymes activities as compared to control group. The results showed that HUP (200 and 400 mg/kg) treatment significantly improved the learning and memory ability in Morris water maze test. Biochemical examination revealed that HUP significantly increased the decreased activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST), mitochondrial enzymes-NADH dehydrogenase, malate dehydrogenase (MDH), isocitrate dehydrogenase (ICDH), Na+K+, Ca2+, Mg2+ATPase activities, elevated the lowered total anti-oxidation capability (TAOC), glutathione (GSH), vitamin C and decreased the raised acetylcholinesterase (AChE) activities, malondialdehyde (MDA), hydroperoxide (HPO), protein carbonyls (PCO), advanced oxidation protein products (AOPP) levels in brain of aging mice induced by D-gal in a dose-dependent manner. In conclusion, present study highlights the potential role of HUP against D-galactose induced cognitive impairment, biochemical and mitochondrial dysfunction in mice. In vitro studies on the effect of HUP on scavenging DPPH, ABTS, DMPD, OH radicals, reducing power, B-carotene bleaching and lipid peroxidation inhibition confirmed the free radical scavenging and antioxidant activity of HUP. The results suggest that HUP possesses anti-aging efficacy and may have potential in treatment of neurodegenerative diseases.

Keywords: aging, antioxidants, mushroom, neurotoxicity

Procedia PDF Downloads 498
246 Antecedents and Impacts of Human Capital Flight in the Sub-Saharan Africa with Specific Reference to the Higher Education Sector: Conceptual Model

Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink

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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.

Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development

Procedia PDF Downloads 224
245 The Need of Sustainable Mining: Communities, Government and Legal Mining in Central Andes of Peru

Authors: Melissa R. Quispe-Zuniga, Daniel Callo-Concha, Christian Borgemeister, Klaus Greve

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The Peruvian Andes have a high potential for mining, but many of the mining areas overlay with campesino community lands, being these key actors for agriculture and livestock production. Lead by economic incentives, some communities are renting their lands to mining companies for exploration or exploitation. However, a growing number of campesino communities, usually social and economically marginalized, have developed resistance, alluding consequences, such as water pollution, land-use change, insufficient economic compensation, etc. what eventually end up in Socio-Environmental Conflicts (SEC). It is hypothesized that disclosing the information on environmental pollution and enhance the involvement of communities in the decision-making process may contribute to prevent SEC. To assess whether such complains are grounded on the environmental impact of mining activities, we measured the heavy metals concentration in 24 indicative samples from rivers that run across mining exploitations and farming community lands. Samples were taken during the 2016 dry season and analyzed by inductively-coupled-plasma-atomic-emission-spectroscopy. The results were contrasted against the standards of monitoring government institutions (i.e., OEFA). Furthermore, we investigated the water/environmental complains related to mining in the neighboring 14 communities. We explored the relationship between communities and mining companies, via open-ended interviews with community authorities and non-participatory observations of community assemblies. We found that the concentrations of cadmium (0.023 mg/L), arsenic (0.562 mg/L) and copper (0.07 mg/L), surpass the national water quality standards for Andean rivers (0.00025 mg/L of cadmium, 0.15 mg/L of arsenic and 0.01 mg/L of copper). 57% of communities have posed environmental complains, but 21% of the total number of communities were receiving an annual economic benefit from mining projects. However, 87.5% of the communities who had posed complains have high concentration of heavy metals in their water streams. The evidence shows that mining activities tend to relate to the affectation and vulnerability of campesino community water streams, what justify the environmental complains and eventually the occurrence of a SEC.

Keywords: mining companies, campesino community, water, socio-environmental conflict

Procedia PDF Downloads 173
244 Responsive Integrative Therapeutic Method: Paradigm for Addressing Core Deficits in Autism by Balkibekova

Authors: Balkibekova Venera Serikpaevna

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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

Procedia PDF Downloads 39
243 Design and Modeling of Human Middle Ear for Harmonic Response Analysis

Authors: Shende Suraj Balu, A. B. Deoghare, K. M. Pandey

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The human middle ear (ME) is a delicate and vital organ. It has a complex structure that performs various functions such as receiving sound pressure and producing vibrations of eardrum and propagating it to inner ear. It consists of Tympanic Membrane (TM), three auditory ossicles, various ligament structures and muscles. Incidents such as traumata, infections, ossification of ossicular structures and other pathologies may damage the ME organs. The conditions can be surgically treated by employing prosthesis. However, the suitability of the prosthesis needs to be examined in advance prior to the surgery. Few decades ago, this issue was addressed and analyzed by developing an equivalent representation either in the form of spring mass system, electrical system using R-L-C circuit or developing an approximated CAD model. But, nowadays a three-dimensional ME model can be constructed using micro X-Ray Computed Tomography (μCT) scan data. Moreover, the concern about patient specific integrity pertaining to the disease can be examined well in advance. The current research work emphasizes to develop the ME model from the stacks of μCT images which are used as input file to MIMICS Research 19.0 (Materialise Interactive Medical Image Control System) software. A stack of CT images is converted into geometrical surface model to build accurate morphology of ME. The work is further extended to understand the dynamic behaviour of Harmonic response of the stapes footplate and umbo for different sound pressure levels applied at lateral side of eardrum using finite element approach. The pathological condition Cholesteatoma of ME is investigated to obtain peak to peak displacement of stapes footplate and umbo. Apart from this condition, other pathologies, mainly, changes in the stiffness of stapedial ligament, TM thickness and ossicular chain separation and fixation are also explored. The developed model of ME for pathologies is validated by comparing the results available in the literatures and also with the results of a normal ME to calculate the percentage loss in hearing capability.

Keywords: computed tomography (μCT), human middle ear (ME), harmonic response, pathologies, tympanic membrane (TM)

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242 Predictors of Lost to Follow-Up among HIV Patients Attending Anti-Retroviral Therapy Treatment Centers in Nigeria

Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

Procedia PDF Downloads 283
241 Application of Bundle Care to Reduce Invasive Catheter-Associated Infection in High Risk Units at a Medical Center

Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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240 Impact of CYP3A5 Polymorphism on Tacrolimus to Predict the Optimal Initial Dose Requirements in South Indian Renal Transplant Recipients

Authors: S. Sreeja, Radhakrishnan R. Nair, Noble Gracious, Sreeja S. Nair, M. Radhakrishna Pillai

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Background: Tacrolimus is a potent immunosuppressant clinically used for the long term treatment of antirejection of transplanted organs in liver and kidney transplant recipients though dose optimization is poorly managed. However, So far no study has been carried out on the South Indian kidney transplant patients. The objective of this study is to evaluate the potential influence of a functional polymorphism in CYP3A5*3 gene on tacrolimus physiological availability/dose ratio in South Indian renal transplant patients. Materials and Methods: Twenty five renal transplant recipients receiving tacrolimus were enrolled in this study. Their body weight, drug dosage, and therapeutic concentration of Tacrolimus were observed. All patients were on standard immunosuppressive regime of Tacrolimus-Mycophenolate mofetil along with steroids on a starting dose of Tac 0.1 mg/kg/day. CYP3A5 genotyping was performed by PCR followed with RFLP. Conformation of RFLP analysis and variation in the nucleotide sequence of CYP3A5*3 gene were determined by direct sequencing using a validated automated generic analyzer. Results: A significant association was found between tacrolimus per dose/kg/d and CYP3A5 gene (A6986G) polymorphism in the study population. The CYP3A5 *1/*1, *1/*3 and *3/*3 genotypes were detected in 5 (20 %), 5 (20 %) and 15 (60 %) of the 25 graft recipients, respectively. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus Concentration/Dose ratio in kidney transplant recipients. Significantly higher L/D was observed among non-expressors 9.483 ng/mL(4.5- 14.1) as compared with the expressors 5.154 ng/mL (4.42-6.5 ) of CYP3A5. Acute rejection episodes were significantly higher for CYP3A5*1 homozygotes compared to patients with CYP3A5*1/*3 and CYP3A5*3/*3 genotypes (40 % versus 20 % and 13 %, respectively ). The dose normalized TAC concentration (ng/ml/mg/kg) was significantly lower in patients having CYP3A5*1/*3 polymorphism. Conclusion: This is the first study to extensively determine the effect of CYP3A5*3 genetic polymorphism on tacrolimus pharmacokinetics in South Indian renal transplant recipients and also shows that majority of our patients carry mutant allele A6986G in CYP3A5*3 gene. Identification of CYP3A5 polymorphism prior to transplantation could contribute to evaluate the appropriate initial dosage of tacrolimus for each patient.

Keywords: kidney transplant patients, CYP3A5 genotype, tacrolimus, RFLP

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239 Compliance Of Dialysis patients With Nutrition Guidelines: Insights From A Questionnaire

Authors: Zeiler M., Stadler D., Schmaderer C.

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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.

Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake

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238 Peer-Assisted Learning of Ebm in, a UK Medical School: Evaluation of the NICE Evidence Search Student Champion Scheme

Authors: Emily Jin, Harry Sharples, Anne Weist

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Introduction: NICE Evidence Search Student Champion Scheme is a peer-assisted learning scheme that aims to improve the routine use of evidence-based information by future health and social care staff. The focus is on the NICE evidence search portal that provides selected information from more than 800 reliable health, social care, and medicines sources, including up-to-date guidelines and information for the public. This paper aims to evaluate the effectiveness of the scheme when implemented in Liverpool School of Medicine and to understand the experiences of those attending. Methods: Twelve student champions were recruited and trained in February 2020 as peer tutors during a workshop facilitated by NICE. Cascade sessions were then organised and delivered on an optional basis for students, in small groups of < 10 to approximately 70 attendees. Surveys were acquired immediately before and 8-12 weeks after cascade sessions (n=47 and 45 respectively). Data from these surveys facilitated the analysis of the scheme. Results: Surveys demonstrated 74% of all attendees frequently searched for health and social care information online as a part of their studies. However, only 15% of attendees reported having prior formal training on searching for health information, despite receiving such training earlier on in the curriculum. After attending cascade sessions, students reported a 58% increase in confidence when searching for information using evidence search, from a pre-session a baseline of 36%. Conclusion: NICE Evidence Search Student Champion Scheme provided clear benefits for attending students, increasing confidence in searching for peer-reviewed, mainly secondary sources of health information. The lack of reported training represents the unmet need that the champion scheme satisfies, and this likely benefits student champions as well as attendees. Increasing confidence in searching for healthcare information online may support future evidence-based decision-making.

Keywords: evidence-based medicine, NICE, medical education, medical school, peer-assisted learning

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237 Cost Effectiveness Analysis of a Community Intervention for Anti-Retroviral Therapy Delivery in Cambodia

Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

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236 Relationship-Centred Care in Cross-Linguistic Medical Encounters

Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: health care, Japanese-English medical encounters, language barriers, trust

Procedia PDF Downloads 233
235 The Effectiveness and the Factors Affect Farmer’s Adoption of Technological Innovation Citrus Gerga Lebong in Bengkulu Indonesia

Authors: Umi Pudji Astuti, Dedi Sugandi

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The effectiveness of agricultural extension is determined by the component in the agricultural extension system among others are agricultural extension methods. Effective methods should be selected and defined based on the characteristics of the target, the resources, the materials, and the objectives to be achieved. Citrus agribusiness development in Lebong is certainly supported by the role of stakeholders and citrus farmers, as well as the proper dissemination methods. Adoption in the extension process substantially can be interpreted as the changes of behavior process such as knowledge (cognitive), attitudes (affective), and skill (psycho-motoric) in a person after receiving "innovation" from extension submitted by target communities. Knowledge and perception are needed as a first step in adopting a innovation, especially of citrus agribusiness development in Lebong. The process of Specific technology adoption is influenced by internal factors and farmer perceptions of technological innovation. Internal factors such as formal education, experience trying to farm, owned land, production farm goods. The output of this study: 1) to analyze the effectiveness of field trial methods in improving cognitive and affective farmers; 2) Knowing the relationship of adoption level and knowledge of farmers; 3) to analyze the factors that influence farmers' adoption of citrus technology innovation. The method of this study is through the survey to 40 respondents in Rimbo Pengadang Sub District, Lebong District in 2014. Analyzing data is done by descriptive and statistical parametric (multiple linear functions). The results showed that: 1) Field trip method is effective to improve the farmer knowledge (23,17% ) and positively affect the farmer attitude; 2) the knowledge level of PTKJS innovation farmers "positively and very closely related".; 3) the factors that influence the level of farmers' adoption are internal factors (education, knowledge, and the intensity of training), and external factors respondents (distance from the house to the garden and from the house to production facilities shop).

Keywords: affect, adoption technology, citrus gerga, effectiveness dissemination

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234 Electret: A Solution of Partial Discharge in High Voltage Applications

Authors: Farhina Haque, Chanyeop Park

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The high efficiency, high field, and high power density provided by wide bandgap (WBG) semiconductors and advanced power electronic converter (PEC) topologies enabled the dynamic control of power in medium to high voltage systems. Although WBG semiconductors outperform the conventional Silicon based devices in terms of voltage rating, switching speed, and efficiency, the increased voltage handling properties, high dv/dt, and compact device packaging increase local electric fields, which are the main causes of partial discharge (PD) in the advanced medium and high voltage applications. PD, which occurs actively in voids, triple points, and airgaps, is an inevitable dielectric challenge that causes insulation and device aging. The aging process accelerates over time and eventually leads to the complete failure of the applications. Hence, it is critical to mitigating PD. Sharp edges, airgaps, triple points, and bubbles are common defects that exist in any medium to high voltage device. The defects are created during the manufacturing processes of the devices and are prone to high-electric-field-induced PD due to the low permittivity and low breakdown strength of the gaseous medium filling the defects. A contemporary approach of mitigating PD by neutralizing electric fields in high power density applications is introduced in this study. To neutralize the locally enhanced electric fields that occur around the triple points, airgaps, sharp edges, and bubbles, electrets are developed and incorporated into high voltage applications. Electrets are electric fields emitting dielectric materials that are embedded with electrical charges on the surface and in bulk. In this study, electrets are fabricated by electrically charging polyvinylidene difluoride (PVDF) films based on the widely used triode corona discharge method. To investigate the PD mitigation performance of the fabricated electret films, a series of PD experiments are conducted on both the charged and uncharged PVDF films under square voltage stimuli that represent PWM waveform. In addition to the use of single layer electrets, multiple layers of electrets are also experimented with to mitigate PD caused by higher system voltages. The electret-based approach shows great promise in mitigating PD by neutralizing the local electric field. The results of the PD measurements suggest that the development of an ultimate solution to the decades-long dielectric challenge would be possible with further developments in the fabrication process of electrets.

Keywords: electrets, high power density, partial discharge, triode corona discharge

Procedia PDF Downloads 181
233 Comparative Efficacy of Angiotensin Converting Enzymes Inhibitors and Angiotensin Receptor Blockers in Patients with Heart Failure in Tanzania: A Prospective Cohort Study

Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

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Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

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232 An Unexpected Helping Hand: Consequences of Redistribution on Personal Ideology

Authors: Simon B.A. Egli, Katja Rost

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Literature on redistributive preferences has proliferated in past decades. A core assumption behind it is that variation in redistributive preferences can explain different levels of redistribution. In contrast, this paper considers the reverse. What if it is redistribution that changes redistributive preferences? The core assumption behind the argument is that if self-interest - which we label concrete preferences - and ideology - which we label abstract preferences - come into conflict, the former will prevail and lead to an adjustment of the latter. To test the hypothesis, data from a survey conducted in Switzerland during the first wave of the COVID-19 crisis is used. A significant portion of the workforce at the time unexpectedly received state money through the short-time working program. Short-time work was used as a proxy for self-interest and was tested (1) on the support given to hypothetical, ailing firms during the crisis and (2) on the prioritization of justice principles guiding state action. In a first step, several models using OLS-regressions on political orientation were estimated to test our hypothesis as well as to check for non-linear effects. We expected support for ailing firms to be the same regardless of ideology but only for people on short-time work. The results both confirm our hypothesis and suggest a non-linear effect. Far-right individuals on short-time work were disproportionally supportive compared to moderate ones. In a second step, ordered logit models were estimated to test the impact of short-time work and political orientation on the rankings of the distributive justice principles need, performance, entitlement, and equality. The results show that being on short-time work significantly alters the prioritization of justice principles. Right-wing individuals are much more likely to prioritize need and equality over performance and entitlement when they receive government assistance. No such effect is found among left-wing individuals. In conclusion, we provide moderate to strong evidence that unexpectedly finding oneself at the receiving end changes redistributive preferences if personal ideology is antithetical to redistribution. The implications of our findings on the study of populism, personal ideologies, and political change are discussed.

Keywords: COVID-19, ideology, redistribution, redistributive preferences, self-interest

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231 Effects of Intracerebroventricular Injection of Ghrelin and Aerobic Exercise on Passive Avoidance Memory and Anxiety in Adult Male Wistar Rats

Authors: Mohaya Farzin, Parvin Babaei, Mohammad Rostampour

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Ghrelin plays a considerable role in important neurological effects related to food intake and energy homeostasis. As was found, regular physical activity may make available significant improvements to cognitive functions in various behavioral situations. Anxiety is one of the main concerns of the modern world, affecting millions of individuals’ health. There are contradictory results regarding ghrelin's effects on anxiety-like behavior, and the plasma level of this peptide is increased during physical activity. Here we aimed to evaluate the coincident effects of exogenous ghrelin and aerobic exercise on anxiety-like behavior and passive avoidance memory in Wistar rats. Forty-five male Wistar rats (250 ± 20 g) were divided into 9 groups (n=5) and received intra-hippocampal injections of 3.0 nmol ghrelin and performed aerobic exercise training for 8 weeks. Control groups received the same volume of saline and diazepam as negative and positive control groups, respectively. Learning and memory were estimated using a shuttle box apparatus, and anxiety-like behavior was recorded by an elevated plus-maze test (EPM). Data were analyzed by ANOVA test, and p<0.05 was considered significant. Our findings showed that the combined effect of ghrelin and aerobic exercise improves the acquisition, consolidation, and retrieval of passive avoidance memory in Wistar rats. Furthermore, it is supposed that the ghrelin receiving group spent less time in open arms and fewer open arms entries compared with the control group (p<0.05). However, exercising Wistar rats spent more time in the open arm zone in comparison with the control group (p<0.05). The exercise + Ghrelin administration established reduced anxiety (p<0.05). The results of this study demonstrate that aerobic exercise contributes to an increase in the endogenous production of ghrelin, and physical activity alleviates anxiety-related behaviors induced by intra-hippocampal injection of ghrelin. In general, exercise and ghrelin can reduce anxiety and improve memory.

Keywords: anxiety, ghrelin, aerobic exercise, learning, passive avoidance memory

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230 Status of Physical, Chemical and Biological Attributes of Isheri, Ogun River, in Relation to the Surrounding Anthropogenic Activities of Kara Abattoir, South West Nigeria

Authors: N. B. Ikenweiwe, A. A. Alimi, N. A. Bamidele, A. O. Ewumi, J. Dairo, I. A. Akinnubi, S. O. Otubusin

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A study on the physical, chemical and biological parameters of the lower course of Ogun River, Isheri-Olofin was carried out between January and December 2014 in order to determine the effects of the anthropogenic activities of the Kara abattoir and domestic waste depositions on the quality of the water. Water samples were taken twice each month at three selected stations A, B and C (based on characteristic features or activity levels) along the water course. Samples were analysed using standard methods for chemical and biological parameters the same day in the laboratory while physical parameters were determined in-situ with water parameters kit. Generally, results of Transparency, Dissolved Oxygen, Nitrates, TDS and Alkalinity fall below the permissible limits of WHO and FEPA standards for drinking and fish production. Results of phosphates, lead and cadmium were also low but still within the permissible limit. Only Temperature and pH were within limit. Low plankton community, (phytoplankton, zooplankton), which ranges from 3, 5 to 40, 23 were as a result of low levels of DO, transparency and phosphate. The presence of coliform bacteria of public health importance like Escherichia coli, Proteus vulgaris, Aeromonas sp., Shigella sp, Enterobacter aerogenes as well as gram negative bacteria Proteus morganii are mainly indicators of faecal pollution. Fish and other resources obtained from this water stand the risk of being contaminated with these organisms and man is at the receiving end. The results of the physical, chemical and some biological parameters of Isheri, Ogun River, according to this study showed that the live forms of aquatic and fisheries resources there are dwelling under stress as a result of deposition of bones, horns, faecal components, slurry of suspended solids, fat and blood into the water. Government should therefore establish good monitoring system against illegal waste depositions and create education programmes that will enlighten the community on the social, ecological and economic values of the river.

Keywords: water parameters, Isheri Ogun river, anthropogenic activities, Kara abattoir

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229 Women from the Margins: An Exploration of the African Women Marginalization in the South African Context from Postcolonial Feminist Perspective

Authors: Goodness Thandi Ntuli

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As one of the sub-Saharan African countries, South Africa has a majority of women living at the receiving end of all ferocious atrocities, afflictions and social ills such as utter poverty, unemployment, morbidity, sexual exploitation and abuse, gender-based and domestic violence. The response to these social ills that permeate the South African context like wildfire requires postcolonial feminism as a lens which needs to directly address this particular context. In the empirical study that was conducted among the Zulu people about Zulu young women in the South African context, it was found that a postcolonial young woman has a lot of social challenges that militate against her. In her struggle to liberate herself, there are layers of oppression that she has to deal with before attaining emancipation of any kind. These layers of oppression emanate from postcolonial effects on cultural norms that come with patriarchal issues, racial issues as the woman of colour and socio-economic issues as the poverty-stricken marginalised woman. Such layers also render marginalized women voiceless on many occasions, and hence the kind of feminism that needs to be applied in this context has to give them a voice, worth and human dignity that they deserve. From the postcolonial feminist perspective, this paper examines the condition of women from the margins and seeks the ways in which the layers of oppression could be disengaged. In the process of the severed layers of oppression, these women can be uplifted to becoming the women of worth, restored to life-giving dignity from the inferiority complex of racial discrimination and liberation from all forms of patriarchy and its upshots that keep them bound by gender inequality. This requires, in particular, postcolonial feminism that would find profound ways of reaching into the deep-seated socialization and internalization of every kind of prejudice against women. It is the kind of feminism that questions the status core even among those who consider themselves feminists. With the ruination of all postcolonial layers of oppression, women in the margins could find real emancipation that they have always longed for through feminism that will take into consideration their context. This calls for the rethinking of feminism in different contexts because the conditions of the oppressed woman of the South cannot be the same as the conditions of the woman who considers herself oppressed in the North.

Keywords: exploration, feminism, postcolonial, margins, South African, women

Procedia PDF Downloads 175
228 Multi-Criteria Selection and Improvement of Effective Design for Generating Power from Sea Waves

Authors: Khaled M. Khader, Mamdouh I. Elimy, Omayma A. Nada

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Sustainable development is the nominal goal of most countries at present. In general, fossil fuels are the development mainstay of most world countries. Regrettably, the fossil fuel consumption rate is very high, and the world is facing the problem of conventional fuels depletion soon. In addition, there are many problems of environmental pollution resulting from the emission of harmful gases and vapors during fuel burning. Thus, clean, renewable energy became the main concern of most countries for filling the gap between available energy resources and their growing needs. There are many renewable energy sources such as wind, solar and wave energy. Energy can be obtained from the motion of sea waves almost all the time. However, power generation from solar or wind energy is highly restricted to sunny periods or the availability of suitable wind speeds. Moreover, energy produced from sea wave motion is one of the cheapest types of clean energy. In addition, renewable energy usage of sea waves guarantees safe environmental conditions. Cheap electricity can be generated from wave energy using different systems such as oscillating bodies' system, pendulum gate system, ocean wave dragon system and oscillating water column device. In this paper, a multi-criteria model has been developed using Analytic Hierarchy Process (AHP) to support the decision of selecting the most effective system for generating power from sea waves. This paper provides a widespread overview of the different design alternatives for sea wave energy converter systems. The considered design alternatives have been evaluated using the developed AHP model. The multi-criteria assessment reveals that the off-shore Oscillating Water Column (OWC) system is the most appropriate system for generating power from sea waves. The OWC system consists of a suitable hollow chamber at the shore which is completely closed except at its base which has an open area for gathering moving sea waves. Sea wave's motion pushes the air up and down passing through a suitable well turbine for generating power. Improving the power generation capability of the OWC system is one of the main objectives of this research. After investigating the effect of some design modifications, it has been concluded that selecting the appropriate settings of some effective design parameters such as the number of layers of Wells turbine fans and the intermediate distance between the fans can result in significant improvements. Moreover, simple dynamic analysis of the Wells turbine is introduced. Furthermore, this paper strives for comparing the theoretical and experimental results of the built experimental prototype.

Keywords: renewable energy, oscillating water column, multi-criteria selection, Wells turbine

Procedia PDF Downloads 137
227 Anxiety and Self-Perceived L2 Proficiency: A Comparison of Which Can Better Predict L2 Pronunciation Performance

Authors: Jiexuan Lin, Huiyi Chen

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The development of L2 pronunciation competence remains understudied in the literature and it is not clear what may influence learners’ development of L2 pronunciation. The present study was an attempt to find out which of the two common factors in L2 acquisition, i.e., foreign language anxiety or self-perceived L2 proficiency, can better predict Chinese EFL learners’ pronunciation performance. 78 first-year English majors, who had received a three-month pronunciation training course, were asked to 1) fill out a questionnaire on foreign language classroom anxiety, 2) self-report their L2 proficiency in general, in speaking and in pronunciation, and 3) complete an oral and a written test on their L2 pronunciation (the score of the oral part indicates participants’ pronunciation proficiency in oral production, and the score of the written part indexes participants’ ability in applying pronunciation knowledge in comprehension.) Results showed that the pronunciation scores were negatively correlated with the anxiety scores, and were positively correlated with the self-perceived pronunciation proficiency. But only the written scores in the L2 pronunciation test, not the oral scores, were positively correlated with the L2 self-perceived general proficiency. Neither the oral nor the written scores in the L2 pronunciation test had a significant correlation with the self-perceived speaking proficiency. Given the fairly strong correlations, the anxiety scores and the self-perceived pronunciation proficiency were put in regression models to predict L2 pronunciation performance. The anxiety factor alone accounted for 13.9% of the variance and the self-perceived pronunciation proficiency alone explained 12.1% of the variance. But when both anxiety scores and self-perceived pronunciation proficiency were put in a stepwise regression model, only the anxiety scores had a significant and unique contribution to the L2 pronunciation performance (4.8%). Taken together, the results suggested that the learners’ anxiety level could better predict their L2 pronunciation performance, compared with the self-perceived proficiency levels. The obtained data have the following pedagogical implications. 1) Given the fairly strong correlation between anxiety and L2 pronunciation performance, the instructors who are interested in predicting learners’ L2 pronunciation proficiency may measure their anxiety level, instead of their proficiency, as the predicting variable. 2) The correlation of oral scores (in the pronunciation test) with pronunciation proficiency, rather than with speaking proficiency, indicates that a) learners after receiving some amounts of training are to some extent able to evaluate their own pronunciation ability, implying the feasibility of incorporating self-evaluation and peer comments in course instruction; b) the ‘proficiency’ measure used to predict pronunciation performance should be used with caution. The proficiency of specific skills seemingly highly related to pronunciation (i.e., speaking in this case) may not be taken for granted as an effective predictor for pronunciation performance. 3) The correlation between the written scores with general L2 proficiency is interesting.

Keywords: anxiety, Chinese EFL learners, L2 pronunciation, self-perceived L2 proficiency

Procedia PDF Downloads 334
226 Zinc Sorption by Six Agricultural Soils Amended with Municipal Biosolids

Authors: Antoine Karam, Lotfi Khiari, Bruno Breton, Alfred Jaouich

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Anthropogenic sources of zinc (Zn), including industrial emissions and effluents, Zn–rich fertilizer materials and pesticides containing Zn, can contribute to increasing the concentration of soluble Zn at levels toxic to plants in acid sandy soils. The application of municipal sewage sludge or biosolids (MBS) which contain metal immobilizing agents on coarse-textured soils could improve the metal sorption capacity of the low-CEC soils. The purpose of this experiment was to evaluate the sorption of Zn in surface samples (0-15 cm) of six Quebec (Canada) soils amended with MBS (pH 6.9) from Val d’Or (Quebec, Canada). Soil samples amended with increasing amounts (0 to 20%) of MBS were equilibrated with various amounts of Zn as ZnCl2 in 0.01 M CaCl2 for 48 hours at room temperature. Sorbed Zn was calculated from the difference between the initial and final Zn concentration in solution. Zn sorption data conformed to the linear form of Freundlich equation. The amount of sorbed Zn increased considerably with increasing MBS rate. Analysis of variance revealed a highly significant effect (p ≤ 0.001) of soil texture and MBS rate on the amount of sorbed Zn. The average values of the Zn-sorption capacity of MBS-amended coarse-textured soils were lower than those of MBS-amended fine textured soils. The two sandy soils (86-99% sand) amended with MBS retained 2- to 5-fold Zn than those without MBS (control). Significant Pearson correlation coefficients between the Zn sorption isotherm parameter, i.e. the Freundlich sorption isotherm (KF), and commonly measured physical and chemical entities were obtained. Among all the soil properties measured, soil pH gave the best significant correlation coefficients (p ≤ 0.001) for soils receiving 0, 5 and 10% MBS. Furthermore, KF values were positively correlated with soil clay content, exchangeable basic cations (Ca, Mg or K), CEC and clay content to CEC ratio. From these results, it can be concluded that (i) municipal biosolids provide sorption sites that have a strong affinity for Zn, (ii) both soil texture, especially clay content, and soil pH are the main factors controlling anthropogenic Zn sorption in the municipal biosolids-amended soils, and (iii) the effect of municipal biosolids on Zn sorption will be more pronounced for a sandy soil than for a clay soil.

Keywords: metal, recycling, sewage sludge, trace element

Procedia PDF Downloads 255
225 Pressures of a Pandemic on the Perinatal Women: Experiences of Welsh Women

Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

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The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

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224 An Investigation into the Views of Gifted Children on the Effects of Computer and Information Technologies on Their Lives and Education

Authors: Ahmet Kurnaz, Eyup Yurt, Ümit Çiftci

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In this study, too, an attempt was made to reveal the place and effects of information technologies on the lives and education of gifted children based on the views of gifted. To this end, the effects of information technologies on gifted are general skills, technology use, academic and social skills, and cooperative and personal skills were investigated. These skills were explored depending on whether or not gifted had their own computers, had internet connection at home, or how often they use the internet, average time period they spent at the computer, how often they played computer games and their use of social media. The study was conducted using the screening model with a quantitative approach. The sample of the study consisted of 129 gifted attending 5-12th classes in 12 provinces in different regions of Turkey. 64 of the participants were female while 65 were male. The research data were collected using the using computer of gifted and information technologies (UCIT) questionnaire which was developed by the researchers and given its final form after receiving expert view. As a result of the study, it was found that UCIT use improved foreign language speaking skills of gifted, enabled them to get to know and understand different cultures, and made use of computer and information technologies while they study. At the end of the study these result were obtained: Gifted have positive idea using computer and communication technology. There are differences whether using the internet about the ideas UCIT. But there are not differences whether having computer, inhabited city, grade level, having internet at home, daily and weekly internet usage durations, playing the computer and internet game, having Facebook and Twitter account about the UCIT. UCIT contribute to the development of gifted vocabulary, allows knowing and understand different cultures, developing foreign language speaking skills, gifted do not give up computer when they do their homework, improve their reading, listening, understanding and writing skills in a foreign language. Gifted children want to have transition to the use of tablets in education. They think UCIT facilitates doing their homework, contributes learning more information in a shorter time. They'd like to use computer-assisted instruction programs at courses. They think they will be more successful in the future if their computer skills are good. But gifted students prefer teacher instead of teaching with computers and they said that learning can be run from home without going to school.

Keywords: gifted, using computer, communication technology, information technologies

Procedia PDF Downloads 371
223 Prenatal Can Reduce the Burden of Preterm Birth and Low Birthweight from Maternal Sexually Transmitted Infections: US National Data

Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

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We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

Procedia PDF Downloads 149
222 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia

Authors: Dinka Fikadu, Mulugeta Shegaze

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Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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221 Assessment of Indigenous People Living Condition in Coal Mining Region: An Evidence from Dhanbad, India

Authors: Arun Kumar Yadav

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Coal contributes a significant role in India’s developmental mission. But, ironically, on the other side it causes large scale population displacement and significant changes in indigenous people’s livelihood mechanism. Dhanbad which is regarded as one of the oldest and large mining area, as well as a “Coal Capital of India”. Here, mining exploration work started nearly a century ago. But with the passage of time, mining brings a lot of changes in the life of local people. In this context, study tries to do comparative situational analysis of the changes in the living condition of dwellers living in mines affected and non-mines affected villages based on livelihood approach. Since, this place has long history of mining so it is very difficult to conduct before and after comparison between mines and non-mines affected areas. Consequently, the present study is based on relative comparison approach to elucidate the actual scenario. By using primary survey data which was collected by the author during the month of September 2014 to March 2015 at Dhanbad, Jharkhand. The data were collected from eight villages, these were categorised broadly into mines and non-mines affected villages. Further at micro level, mines affected villages has been categorised into open cast and underground mines. This categorization will help us to capture the deeper understanding about the issues of mine affected villages group. Total of 400 household were surveyed. Result depicts that in every sphere mining affected villages are more vulnerable. Regarding financial capital, although mine affected villages are engaged in mining work and get higher mean income. But in contrast, non-mine affected villages are more occupationally diversified. They have an opportunity to earn money from diversified extents like agricultural land, working in mining area, selling coal informally as well as receiving remittances. Non-mines affected villages are in better physical capital which comprises of basic infrastructure to support livelihood. They have an access to secured shelter, adequate water supply & sanitation, and affordable information and transport. Mining affected villages are more prone to health risks. Regarding social capital, it shows that in comparison to last five years, law and order has been improved in mine affected villages.

Keywords: displacement, indigenous, livelihood, mining

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220 Critical Evaluation and Analysis of Effects of Different Queuing Disciplines on Packets Delivery and Delay for Different Applications

Authors: Omojokun Gabriel Aju

Abstract:

Communication network is a process of exchanging data between two or more devices via some forms of transmission medium using communication protocols. The data could be in form of text, images, audio, video or numbers which can be grouped into FTP, Email, HTTP, VOIP or Video applications. The effectiveness of such data exchange will be proved if they are accurately delivered within specified time. While some senders will not really mind when the data is actually received by the receiving device, inasmuch as it is acknowledged to have been received by the receiver. The time a data takes to get to a receiver could be very important to another sender, as any delay could cause serious problem or even in some cases rendered the data useless. The validity or invalidity of a data after delay will therefore definitely depend on the type of data (information). It is therefore imperative for the network device (such as router) to be able to differentiate among the packets which are time sensitive and those that are not, when they are passing through the same network. So, here is where the queuing disciplines comes to play, to handle network resources when such network is designed to service widely varying types of traffics and manage the available resources according to the configured policies. Therefore, as part of the resources allocation mechanisms, a router within the network must implement some queuing discipline that governs how packets (data) are buffered while waiting to be transmitted. The implementation of the queuing discipline will regulate how the packets are buffered while waiting to be transmitted. In achieving this, various queuing disciplines are being used to control the transmission of these packets, by determining which of the packets get the highest priority, less priority and which packets are dropped. The queuing discipline will therefore control the packets latency by determining how long a packet can wait to be transmitted or dropped. The common queuing disciplines are first-in-first-out queuing, Priority queuing and Weighted-fair queuing (FIFO, PQ and WFQ). This paper critically evaluates and analyse through the use of Optimized Network Evaluation Tool (OPNET) Modeller, Version 14.5 the effects of three queuing disciplines (FIFO, PQ and WFQ) on the performance of 5 different applications (FTP, HTTP, E-Mail, Voice and Video) within specified parameters using packets sent, packets received and transmission delay as performance metrics. The paper finally suggests some ways in which networks can be designed to provide better transmission performance while using these queuing disciplines.

Keywords: applications, first-in-first-out queuing (FIFO), optimised network evaluation tool (OPNET), packets, priority queuing (PQ), queuing discipline, weighted-fair queuing (WFQ)

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