Child labor in the Era of Sustainable Development: insights from Jhenaidah City of Bangladesh

The existence of child labor in developing countries like Bangladesh is undoubtedly a serious problem in the era of sustainable development. Undoubtedly to abolish child labor from all level is not so easy. The current study was intended to assess the livelihoods pattern and causes of being involved as child labor in Jhenaidah city-Bangladesh and to find out the ways in which child labor can be diminished gradually. This study was exploratory in nature where convenience sampling was adapted, seventy-five children aged less than 18 years were interviewed with an interview schedule. The extent and prevalence of child labour in a country are being considered as a significant indicator of how far-off that country stays away from the overall sustainable development. The results of this study demonstrate that the majority (17/22.67%) children engaged in performing work in shops or hotels. The X2 (p\u3c0.5) results elucidate that there exists gender difference in child abuse and harassment. The rate of physical and mental abuse and torture was higher in male children, in contrast, the prevalence of sexual harassment and abuse by slung was significantly higher in female children. The working hours as an average above 7 hours or more, and per day wage of children in Jhenaidah found just above 1.4$ (120 BDT). The principal component analysis indicates that lack of parental employment facilities which has directly related to poverty found as the foremost reasons for a child to make involvement as labour before completing age 18, this result is not only applicable for Jhenaidah but also possibly applicable for all developing countries. Besides, father’s education and death of mother were the important indicators of being child laborer. The ways of eliminating child labour are not so easy task because the problem has been indissolubly embedded in our society for long. Hence, it requires moral, political will and commitment from all people in the society for ending and eradicating child labour. Alongside all these, international organizations must make sure their robust participation in enhancing this process

Never events in UK general practice: a survey of the views of general practitioners on their frequency and acceptability as a safety improvement approach

Background: Never events (NEs) are serious preventable patient safety incidents and are a component of formal quality and safety improvement (Q&SI) policies in the United Kingdom and elsewhere. A preliminary list of NEs for UK general practice has been developed, but the frequency of these events, or their acceptability to general practitioner (GPs) as a Q&SI approach, is currently unknown. The study aims to estimate (1) the frequency of 10 NEs occurring within GPs' own practices and (2) the extent to which the NE approach is perceived as acceptable for use. Methods: General practitioners were surveyed, and mixed-effects logistic regression models examined the relationship between GP opinions of NE, estimates of NE frequency, and the characteristics of the GPs and their practices. Results: Responses from 556 GPs in 412 practices were analyzed. Most participants (70%-88%, depending on the NE) agreed that the described incident should be designated as a NE. Three NEs were estimated to have occurred in less than 4% of practices in the last year; however, two NEs were estimated to have occurred in 45% to 61% of the practices. General practitioners reporting that a NE had occurred in their practice in the last year were significantly less likely to agree with the designation as a NE compared with GPs not reporting a NE (odds ratio, 0.42; 95% CI = 0.36-0.49). Conclusions: The NE approach may have Q&SI potential for general practice, but further work to adapt the concept and content is required

Modelling and Simulation of Noise Effects in Power Line Communications

Power line communications refers to the concept of transmitting information using the mains power line as a communications channel. Power line communication systems can be simply described as the distribution of data and other signals via electric power distribution wires. There are some challenges for communications over power lines, such as impedance variation, attenuation, channel transfer function varying widely over time, different kind of interference and noise in the system. This Paper deals with the noise scenario modelling approach and modulation schemes for the PLC system

Numerical models of solar distillation device: present and previous

In this paper, a detailed comparison of a few numerical models (with and without considering humid air properties) for the estimation of water production from a solar water distillation device is investigated. An extensive laboratory production experiments were executed under fifteen sets of external conditions to find the properties of evaporation and condensation coefficients to incorporate with the present evaporation and condensation models (two unique and independent theoretical models), respectively. The calculation accuracy of the evaporation flux computed by two evaporation models (present and previous), Dunkle's and Ueda's model, and of the hourly condensation flux estimated by two condensation models (present and previous) was examined using the field experimental results. It was found that the previous evaporation and condensation models using empirical relationships extremely overestimated and underestimated the observed production flux, respectively. The evaporation flux calculated by the conventional models of Dunkle and Ueda notably underestimated and overestimated the observed values, respectively. Finally, it is revealed that the present models have the smallest deviation between the calculated and the observed values among these six models and can predict the daily production flux

Automatic segmentation of human ear in the wild

Ear biometrics has been a challenging and distinctive research area in recent times. The human ear possesses unique promising attributes that are being used by the researchers to carry out significant improvements in the field of human recognition using ear as a biometric. In order to achieve efficiency on any ear biometric system, the detection and segmentation of the human ear need to be performed precisely. Feeding accurately segmented images to the recognition system will result in higher recognition accuracy. In this paper, we present our work of segmentation of human ears from the images captured in unconstrained environment by employing the U-Net architecture on our own dataset and presented the results of ear segmentation. The U-Net model is also tested on the annotated web ears (AWE) segmentation dataset. We obtained 92.38% accuracy and 79.33% intersection over union (IoU) on the test data on our own dataset and 76.2% IoU on AWE segmentation dataset

An updated meta-analysis to assess the effectiveness of psychological interventions delivered by psychological specialists and generalist clinicians on glycaemic control and on psychological status

Objective: To update a meta-analysis and determine the effectiveness of psychological interventions on glycaemic control measured by HbA1c and psychological status in type 2 diabetes and to compare effects when interventions are delivered by generalist clinicians compared to psychological specialists. Methods: We used the original review protocol and searched the Cochrane central register of controlled trials, Medline, Embase, PsychLIT, and Google Scholar from February 2003 (end of previous review) to March 2007. We extracted data on the participants, interventions, delivery methods, comparison groups and outcome measures. Results: 35 trials were reviewed and meta-analysis of 19 trials (n = 1431), reporting HbA1c found a reduction in HbA1c by 0.54% (-0.32; 95% CI: -0.47 to -0.16). In nine trials (n = 832) interventions were delivered by diabetes or general clinicians reducing HbA1c by 0.51% (-0.27; 95% CI: -0.50 to 0.04). In nine trials, interventions (n = 561) were delivered by psychological specialists reducing HbA1c by 0.57% (-0.36; 95% CI: -0.61 to 0.12). Meta-analysis of 13 trials reporting psychological status found psychological status to be lower in the intervention groups -0.56 (95% CI: 1.00 to -0.13). Trial quality for the majority of studies remained poor. Conclusion: Our findings suggest that psychological and general clinicians are similarly effective in delivering psychological interventions, however, effect sizes for all clinicians have reduced since the earlier review. Practice implications: Psychological training opportunities for generalist clinicians could lead to wider availability of effective psychological care. © 2008 Elsevier Ireland Ltd. All rights reserved

Development and Validation of a Dynamic Operating Envelopes-enabled Demand Response Scheme in Low-voltage Distribution Networks

Dynamic operating envelopes (DOEs) offer an attractive solution for maintaining network integrity amidst increasing penetration of distributed energy resources (DERs) in low-voltage (LV) networks. Currently, the focus of DOEs primarily revolves around active power exports of rooftop photovoltaic (PV) generation, often neglecting the impact of demand response (DR). This paper presents a two-stage, coordinated approach for residential DR participation in electricity markets under the DOE framework. In the first stage, the distribution network service provider (DNSP) adopts a convex hull technique to establish DOEs at each customer point-of-connection (POC). In the second stage, the demand response aggregator (DRA) utilises DOEs assigned by the DNSP to develop a hierarchical control scheme for tracking a load set-point signal without jeopardising network statutory limits. To assess the effectiveness of the proposed control scheme in a practical setting, software-in-the-loop (SIL) tests are performed in a grid simulator, considering a real residential feeder with realistic household load and generation profiles. Simulation validations suggest that the DRA can provide precise DR while honouring network statutory limits and maintaining end-user thermal comfort. Furthermore, the overall approach is compliant with the market dispatch interval and preserves end-user data privacy.Comment: submitted to IEEE Transactions on Power Systems, 10 page

Patient access to healthcare services and optimisation of self-management for ethnic minority populations living with diabetes: A systematic review

A higher risk of diabetes mellitus in South Asian and Black African populations combined with lower reported access and self-management-related health outcomes informed the aims of this study. Our aims were to synthesise and evaluate evidence relating to patient self-management and access to healthcare services for ethnic minority groups living with diabetes. A comprehensive search strategy was developed capturing a full range of study types from 1995–2010, including relevant hand-searched literature pre-dating 1995. Systematic database searches of MEDLINE, Cochrane, DARE, HTA and NHSEED, the British Nursing Index, CAB abstracts, EMBASE, Global Health, Health Management Information Consortium and PsychInfo were conducted, yielding 21 288 abstracts. Following search strategy refinement and the application of review eligibility criteria; 11 randomised controlled trials (RCTs), 18 qualitative studies and 18 quantitative studies were evaluated and principal results extracted. Results suggest that self-management practices are in need of targeted intervention in terms of patients’ knowledge and understanding of their illness, inadequacy of information and language and communication difficulties arising from cultural differences. Access to health-care is similarly hindered by a lack of cultural sensitivity in service provision and under use of clinic-based interpreters and community-based services. Recommendations for practice and subsequent intervention primarily rest at the service level but key barriers at patient and provider levels are also identified

DDX generators in UK primary medical care:a feasibility study using the Isabel diagnostic tool

Differential diagnosis generators in UK primary medical care: A feasibility study using the Isabel diagnostic toolThe problemAn estimated 12% of errors in primary medical care are thought to be a result of diagnostic errors, equating to between 3 to 60 diagnostic errors within NHS primary care per day. Diagnostic errors also account for 63% of medical malpractice claims against GPs. In addition to the huge financial cost, diagnostic errors endanger patient safety and can cause significant disability and death. Significantly it is recognised that many of these incidents are preventable. Addressing diagnostic error is complex and suggested interventions to reduce error are presently limited. The potential of Differential Diagnosis Generators (DDX) tools to address diagnostic error has been highlighted in the literature, however their feasibility for use in routine general medical practice remains unclear.The approachWe undertook a mixed-methods prospective feasibility study of one DDX tool, Isabel, in an inner-city general practice serving 18,000 patients from diverse backgrounds. The study comprised semi-structured qualitative interviews with 11 clinicians prior to the installation of Isabel and again after 6 months of Isabel being available for use.Training and access to Isabel was provided to all clinicians with diagnostic capabilities for 6 months during which a remote monitoring system also captured usage data including frequency of use and duration as well as the clinical impact such as the ordering of tests and referrals.FindingsDuring the pre-Isabel interviews, the majority of clinicians indicated perceived benefits of using other electronic systems e.g. GP Notebook which were occasionally used as diagnostic aides, particularly for difficult to diagnose conditions such as presentation of non-specific symptoms, mismatch between presenting symptoms and textbook diagnoses, rare diseases and infections as well as patients with multimorbidities. Although some concerns were raised regarding the number of differential diagnoses being generated by Isabel, increased time and impact on consultation, most clinicians indicated willingness to trial Isabel.Preliminary usage data, based on 4 months of usage demonstrates a peak in usage during the first month comprising of 133 queries which then tailed off in subsequent months with 53, 17 and 27 queries respectively. A total of 10 computer generated surveys were completed during this time where Isabel helped with confirming a diagnosis (n=2), broadened a differential list (n=7), impacted on ordering a diagnostic test (n=3), ordering medication (n=1) and helped refer more appropriately (n=3). Further results including post-Isabel interview data will be presented at the conference due to study completion.ConsequencesPreliminary evidence suggests that clinicians in primary care can use DDX tools such as Isabel to influence their decision making process in relation to diagnoses. However the relatively low usage of the tool in the context of the total number of consultations that GPs undertake suggests that opportunities where it can be used are limited

Managing diagnostic uncertainty in primary care: A systematic critical review

Abstract Background Diagnostic uncertainty is one of the largest contributory factors to the occurrence of diagnostic errors across most specialties in medicine and arguably uncertainty is greatest in primary care due to the undifferentiated symptoms primary care physicians are often presented with. Physicians can respond to diagnostic uncertainty in various ways through the interplay of a series of cognitive, emotional and ethical reactions. The consequences of such uncertainty however can impact negatively upon the primary care practitioner, their patients and the wider healthcare system. Understanding the nature of the existing empirical literature in relation to managing diagnostic uncertainty in primary medical care is a logical and necessary first step in order to understand what solutions are already available and/or to aid the development of any training or feedback aimed at better managing this uncertainty. This review is the first to characterize the existing empirical literature on managing diagnostic uncertainty in primary care. Methods Sixteen databases were systematically searched from inception to present with no restrictions. Hand searches of relevant websites and reference lists of included studies were also conducted. Two authors conducted abstract/article screening and data extraction. PRISMA guidelines were adhered to. Results Ten studies met the inclusion criteria. A narrative and conceptual synthesis was undertaken under the premises of critical reviews. Results suggest that studies have focused on internal factors (traits, skills and strategies) associated with managing diagnostic uncertainty with only one external intervention identified. Cognitive factors ranged from the influences of epistemological viewpoints to practical approaches such as greater knowledge of the patient, utilizing resources to hand and using appropriate safety netting techniques. Emotional aspects of uncertainty management included clinicians embracing uncertainty and working with provisional diagnoses. Ethical aspects of uncertainty management centered on communicating diagnostic uncertainties with patients. Personality traits and characteristics influenced each of the three domains. Conclusions There is little empirical evidence on how uncertainty is managed in general practice. However we highlight how the extant literature can be conceptualised into cognitive, emotional and ethical aspects of uncertainty which may help clinicians be more aware of their own biases as well as provide a platform for future research. Trial registration PROSPERO registration: CRD4201502755