Patient Satisfaction and Associated Factors with Services Provided at Outpatient Departments

Asking patients what they think how they feel about the health service they have received is an important step towards improving the quality of care and, ensuring that local health services are meeting clients needs and expectations. Facility- based cross-sectional study was conducted from April 1-7, 2019 in randomly selected primary hospitals found in Guraghe zone. There were 266 randomly selected patients who attended the primary hospitals were participated in the study. Data was collected using a interviewer-administered structured questionnaire and analyzed using SPSS version 21. Multiple logistic regression analysis used to identify predictors of patient satisfaction. The overall of patient satisfaction level with the health service provided at the outpatient departments of the primary hospitals was 66.5% (95% C.I. 60.8%-72.2%). waiting time (AOR 3.65), informing patients about cause of illness (AOR, 2.46) and waiting area cleanliness (AOR 2.33) were among the significant predictors of patients satisfaction. Acknowledging the limitation of the cross-sectional study design findings of this study indicate that waiting time, telling the cause of illness, cleanliness of the waiting area are important predictors of patient satisfaction

Assessment of Handling Practices, Utilization and Concentration of Iodine in Iodized Salt at Wondo Genet town, Southern Ethiopia: A Crossectional Study

Iodine deficiency is severe public health problem in Ethiopia. One out of every 1000 population is mentally handicapped due to a congenital thyroid deficiency, and about 50,000 prenatal deaths are occurring annually due to iodine deficiency disorders.nbsp Even though the problem is serious, there were no adequate researches conducted. Therefore, this study focuses on assessment of handling practices of iodized salt and the amount of iodine concentration retained in iodized salts at households and retailers level in Wondo Genet town. The objective of this study was to assess handling practices and concentration of iodine across iodized salt consumption in retailers and households level. Two hundred ninety four households and seventh six retailers were selected by systematic random sampling method for survey using questionnaire and rapid test kit method was used to measure iodine concentration of salt used by the households. The result of this study indicated that iodized salt coverage was found to be 100 % at households and retailers level. Iodine level in the salt examined by iodometric titration, in this study was 4.4 to 70.9 ppm. This indicates the need for further improvement of handling practices of iodized salt. Iodine level in the salt examined by iodometric titration in this study was 60.54% of households and 65.79% retailers salt samples had 15 ndash 40 ppm iodine concentration. This shows that in the iodized salt there is no adequate iodine content in accordance with the nbsprecommendation. Majority of the households 37.4% add iodized salt half way during boiling of the food/coffee. Although the coverage of iodized salt in the study area was high but availability of adequate iodized salt at household level was low as compared to the WHO recommendation.There for this shows that handling practice of iodized salt at the household and retailer level and utilization practice at the household level is poor

Expanding the Repertoire of Carbapenem-Hydrolyzing Metallo-ß-Lactamases by Functional Metagenomic Analysis of Soil Microbiota

Carbapenemases are bacterial enzymes that hydrolyze carbapenems, a group of last-resort β-lactam antibiotics used for treatment of severe bacterial infections. They belong to three β-lactamase classes based amino acid sequence (A, B, and D). The aim of this study was to elucidate occurrence, diversity and functionality of carbapenemase-encoding genes in soil microbiota by functional metagenomics. Ten plasmid libraries were generated by cloning metagenomic DNA from agricultural (n = 6) and grassland (n = 4) soil into Escherichia coli. The libraries were cultured on amoxicillin-containing agar and up to 100 colonies per library were screened for carbapenemase production by CarbaNP test. Presumptive carbapenemases were characterized with regard to DNA sequence, minimum inhibitory concentration (MIC) of β-lactams, and imipenem hydrolysis. Nine distinct class B carbapenemases, also known as metallo-beta-lactamases (MBLs), were identified in six soil samples, including two subclass B1 (GRD23-1 and SPN79-1) and seven subclass B3 (CRD3-1, PEDO-1, GRD33-1, ESP-2, ALG6-1, ALG11-1, and DHT2-1). Except PEDO-1 and ESP-2, these enzymes were distantly related to any previously described MBLs (33 to 59% identity). RAIphy analysis indicated that six enzymes (CRD3-1, GRD23-1, DHT2-1, SPN79-1, ALG6-1, and ALG11-1) originated from Proteobacteria, two (PEDO-1 and ESP-2) from Bacteroidetes and one (GRD33-1) from Gemmatimonadetes. All MBLs detected in soil microbiota were functional when expressed in E. coli, resulting in detectable imipenem-hydrolyzing activity and significantly increased MICs of clinically relevant β-lactams. Interestingly, the MBLs yielded by functional metagenomics generally differed from those detected in the same soil samples by antibiotic selective culture, showing that the two approaches targeted different subpopulations in soil microbiota. © 2016 Gudeta, Bortolaia, Pollini, Docquier, Rossolini, Amos, Wellington and Guardabassi.Grant HEALTH-F3-2011-282004(EvoTAR

Topology Optimization of Beam Structures with Various End andLoading Conditions

Topology optimization deals with optimum material (mass) distribution within a design domain to find optimal lay-out of a structure subjected to certain boundary and loading conditions. Topology optimization can be used to address conflicting requirements, such as light weight and high-strength/stiffness design. In this paper, a simulation program to analyze topology optimization of beam structures with seven different end conditions and three types of loads (single point load, two point loads and uniformly distributed load) is developed using MATLAB code adapted from Sigmund’s 99 line topology optimization code. Furthermore, the program has been enhanced with a graphical user interface for ease of use. Using the developed system, it is possible to analyze the effect of different parameters

Methods and Costs for Pond-Catchment Rehabilitation on the Borana Plateau

The Borana Plateau is an important rangeland for Ethiopia. One key limitation for people and livestock is lack of drinking water. Hundreds of ponds are important water sources for most of the year. Pond catchments are poorly managed because livestock access is uncontrolled. Catchments are stripped bare of vegetation due to trampling and heavy grazing, and unprotected soil is prone to erosion. When the rains come the ponds quickly fill with sediment. Sedimentation reduces pond holding capacity and much labor is required to clean them out. As part of a pilot research project we rehabilitated four ponds and their immediate catchment using a combination of: (1) Perimeter bush-fencing to confine livestock access to a few narrow corridors leading to the water\u27s edge; (2) erosion control using dams and trenches to capture sediment prior to it entering the ponds; and (3) pond de-sedimentation using human labor. In tandem these methods have completely renovated the four sites in less than two years and could be adopted by the pastoralists. Here we report how we implemented each method as well as estimate the total cost of rehabilitation. Overall, the average cost to rehabilitate one seven-hectare pond catchment was 283, 045 Ethiopian Birr (or USD $14,152) including cash and in-kind sources. Costs were almost entirely labor. The largest outlay was for de-sedimentation at 87 percent of total costs on average, followed by erosion control (9 percent) and bush fencing (4 percent). If all 162 ponds in our study area were rehabilitated the cost would exceed 46 million Birr; this might be defrayed if communities can donate some of the labor. The high cost of rehabilitation illustrates that poor catchment management has major economic consequences that undermine system sustainability. Cost data also reveal that a small investment in preventing sedimentation via bush-fencing, grazing management, and erosion control would yield high returns in terms of reducing the need for regular, and expensive de-sedimentation via manual labor

Two-phase flow boiling in small to micro-diameter tubes

This thesis is dedicated to the experimental and theoretical study of flow boiling in small to micro diameter tubes using R 134a. Flow pattern, heat transfer and pressure drop studies were conducted in stainless steel cold drawn tubes with internal diameter 2.88,1.1, and 0.52 mm using an existing facility that was designed with a long term research objective of improving the fundamental understanding of flow boiling in small metallic tubes. The facility was moved to the present location from London South Bank University and re-commissioned before carrying out the experiments. The test sections were heated by a direct passage of alternating current and wall temperatures were measured at 15 axial locations by miniature thermocouples that were directly spotwelded at the tube outer wall. A digital high-speed camera was used to simultaneously observe the flow patterns (during the heat transfer tests) directly at a borosilicate glass tube located immediately downstream of the heat transfer test section. The purpose of the flow visualization study was to support understanding of the heat transfer characteristics and development of flow regime-specific models. The heat transfer and pressure drop data of X. Huo (2005) in the 4.26 and 2.01 mm tubes and the flow visualization results of Chen (2006) for the tubes of diameter 4.26,2.88,2.01, and 1.1 mm were included with the new data in an extensive analysis of flow boiling heat transfer and pressure drop in five vertical tubes with internal diameters 4.26, 2.88,2.01, 1.1 and 0.52 mm. The wide range of tube diameter was chosen to investigate the influence of tube size and possibly identify the threshold where the effect of small or micro diameter effects become significant. In the experiments, parameters were varied in the ranges: mass flux 100 to 700 kg/m2s; heat flux 1.6 to 150 kW/m; pressure 6 to 14 bar; quality up to 0.9 and the inlet temperature was controlled at a subcooling of 1-5K. There was no clear significant difference between the characteristics and magnitude of the heat transfer coefficients in the 4.26 mm and 2.88 mm tubes but the coefficients in the 2.01 and 1.1 mm tube were higher. The heat transfer results suggested that a tube size of about 2 mm might be considered as a critical diameter to distinguish small and conventional tubes. Further differences have now been observed in the 0.52 mm tube. These differences, both in flow patterns and heat transfer, indicate a possible second change from small to micro behaviour at diameters less than 1 mm for R 134a. Also, the results showed axial variations in heat transfer characteristics marking the importance of surface conditions on heat transfer. This calls for a further detail investigation to understand the underlying physics in the initiation of boiling, effect of surface condition on nucleation, and structure of newly emerging flow patterns, particularly in very small tubes. Existing correlations were examined using the results of the five tubes and indicated that these correlations do not predict the present small diameter data to a satisfactory degree. Therefore, two new correlations that take into account both magnitude and characteristic effect of tube diameter have been proposed covering the 4.26 mm-1.1 mm and the smallest 0.52 mm tube, respectively. A detailed comparison was also made with the state-of-the-art flow regime-specific model of Thome et al. (2004) and verified that the mechanistic modelling approach has a promising capability of predicting two phase heat transfer in small diameter tubes, although it still requires further development. Some improvements have been proposed and tested against the current data. Using a similar approach, a new two phase pressure drop model has been proposed and compared with the current data with encouraging results.EThOS - Electronic Theses Online ServiceGBUnited Kingdo