Search results for: binary outcomes

Authors: Jagannath Prasad Tegar, Zeeshan Ahmad

Abstract:

The Ordinary Portland Cement (OPC) is a major constituent of concrete, which is being used extensively since last half century. The production of cement is impacting not only environment alone, but depleting natural materials. During the past 3 decades, the scholars have carried out studies and researches to explore the supplementary cementatious materials such as Ground granulated Blast furnace slag (GGBFS), silica fumes (SF), metakaolin or fly ash (FA). This has contributed towards improved cementatious materials which are being used in construction, but not the way it is supposed to be. The alkali activated slag concrete is another innovation which has constituents of cementatious materials like Ground Granuled Blast Furnace Slag (GGBFS), Fly Ash (FA), Silica Fumes (SF) or Metakaolin. Alkaline activators like Sodium Silicate (Na₂SiO₃) and Sodium Hydroxide (NaOH) is utilized. In view of evaluating properties of alkali activated slag concrete blended with polypropylene shredding and accelerator, research study is being carried out. This research study is proposed to evaluate the effect of polypropylene shredding and accelerating admixture on mechanical properties of alkali-activated slag concrete. The mechanical properties include the compressive strength, splitting tensile strength and workability. The outcomes of this research are matched with the hypothesis and it is found that 27% of cement can be replaced with the ground granulated blast furnace slag (GGBFS) and for split tensile strength 20% replacement is achieved. Overall it is found that 20% of cement can be replaced with ground granulated blast furnace slag. The tests conducted in the laboratory for evaluating properties such as compressive strength test, split tensile strength test, and slump cone test. On the aspect of cost, it is substantially benefitted.

Keywords: ordinary Portland cement, activated slag concrete, ground granule blast furnace slag, fly ash, silica fumes

Procedia PDF Downloads 176

Authors: Yvonne A. Unrau

Abstract:

Social work education is a competency-based curriculum that relies mostly on cognitive frameworks and problem-solving models. Absent from the curriculum is knowledge and skills that draw from an embodiment perspective, especially somatic practice methods. Embodiment broadly encompasses the understanding that biological, political, historical, and social factors impact human development via changes to the nervous system. In the past 20 years, research has well-established that unresolved traumatic events, especially during childhood, negatively impacts long-term health and well-being. Furthermore, traumatic stress compromises cognitive processing and activates reflexive action such as ‘fight’ or ‘flight,’ which are the focus of somatic methods. The main objective of this paper is to show how embodiment perspectives and somatic methods can enhance social work practice overall. Using an exploratory approach, the author shares a decade-long journey that involved creating an education-support program for college students who exited the state foster care system. Personal experience, program outcomes and case study narratives revealed that ‘classical’ social work methods were insufficient to fully address the complex needs of college students who were living with complex traumatic stressors. The paper chronicles select case study scenarios and key program development milestones over a 10-year period to show the benefit of incorporating embodiment perspectives in social work practice. The lessons reveal that there is an immediate need for social work curriculum to include embodiment perspectives so that social workers may be equipped to respond competently to their many clients who live with unresolved trauma.

Keywords: social work practice, social work curriculum, embodiment, traumatic stress

Procedia PDF Downloads 124

Authors: Richard Grünwald, Wenling Wang, Yan Feng

Abstract:

The presented paper explores the changing dynamics of regional water security in the Mekong River Basin and examines the contemporary water-related challenges from a critical hydropolitical perspective. By drawing on the Lancang-Mekong Cooperation and Conflict Database (LMCCD) recording more than 3000 water-related events within the basin in the last 30 years, we identified several trends changing the dynamics of the regional water security in the Mekong River Basin. Firstly, there is growing politicization of water that is no longer interpreted as abundant. While some scientists blame the rapid basin development, particularly in upstream countries, other researchers consider climate change and cumulative environmental impacts of various water projects as the main culprit for changing the water flow. Secondly, there is an increasing securitization of large-scale hydropower dams with questionable outcomes. Despite hydropower dams raise many controversies, many riparian states push the development at all cost. Such water security dilemma can be especially traced to Laos and Cambodia, which highly invest in the hydropower sector even at the expense of the local environment and good relations with neighbouring countries situated lower on the river. Thirdly, there is a lack of accountable transboundary water governance that will effectively face a looming water crisis. To date, most of the existing cooperation mechanisms are undermined by the geopolitical interests of foreign donors and increasing mistrust to scientific approaches dealing with water insecurity. Our findings are beneficial for the policy-makers and other water experts who want to grasp the broader hydropolitical context in the Mekong River Basin and better understand the new water security threats, including misinterpretation of the hydrological data and legitimization of the pro-development narratives.

Keywords: critical hydropolitics, mekong river, politicization of science, water governance, water security

Procedia PDF Downloads 213

Authors: Farhad Fakoursevom

Abstract:

Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

Procedia PDF Downloads 99

Authors: Abisuga Oluwayemisi Adebola, Kerri Akiwowo, Deon de Beer, Kobus Van Der Walt

Abstract:

The convergence of additive manufacturing (AM) and traditional textile dyeing techniques has initiated innovative possibilities for improving the visual application and customization potential of 3D-printed polymer objects. Textile dyeing techniques have progressed to transform fabrics with vibrant colours and complex patterns over centuries. The layer-by-layer deposition characteristic of AM necessitates adaptations in dye application methods to ensure even colour penetration across complex surfaces. Compatibility between dye formulations and polymer matrices influences colour uptake and stability, demanding careful selection and testing of dyes for optimal results. This study investigates the development interaction between these areas, revealing the challenges and opportunities of applying textile dyeing methods to colour 3D-printed polymer materials. The method explores three innovative approaches to colour the 3D-printed polymer object: (a) Additive Manufacturing of a Prototype, (b) the traditional dyebath method, and (c) the contemporary digital sublimation technique. The results show that the layer lines inherent to AM interact with dyes differently and affect the visual outcome compared to traditional textile fibers. Skillful manipulation of textile dyeing methods and dye type used for this research reduced the appearance of these lines to achieve consistency and desirable colour outcomes. In conclusion, integrating textile dyeing techniques into colouring 3D-printed polymer materials connects historical craftsmanship with innovative manufacturing. Overcoming challenges of colour distribution, compatibility, and layer line management requires a holistic approach that blends the technical consistency of AM with the artistic sensitivity of textile dyeing. Hence, applying textile dyeing methods to 3D-printed polymers opens new dimensions of aesthetic and functional possibilities.

Keywords: polymer, 3D-printing, sublimation, textile, dyeing, additive manufacturing

Procedia PDF Downloads 67

Authors: Milan N. A. Van Der Kuil, Anne M. A. Visser-Meily, Andrea W. M. Evers, Ineke J. M. Van Der Ham

Abstract:

Navigation ability is essential for autonomy and mobility in daily life. In patients with acquired brain injury, navigation impairment is frequently impaired; however, in this study, we tested the effectiveness of a serious gaming training protocol as a tool for cognitive rehabilitation to reduce navigation impairment. In total, 38 patients with acquired brain injury and subjective navigation complaints completed the experiment, with a partially blind, randomized control trial design. An objective navigation test was used to construct a strengths and weaknesses profile for each patient. Subsequently, patients received personalized compensation training that matched their strengths and weaknesses by addressing an egocentric or allocentric strategy or a strategy aimed at minimizing the use of landmarks. Participants in the experimental condition received psychoeducation and a home-based rehabilitation game with a series of exercises (e.g., map reading, place finding, and turn memorization). The exercises were developed to stimulate the adoption of more beneficial strategies, according to the compensatory approach. Self-reported navigation ability (wayfinding questionnaire), participation level, and objective navigation performance were measured before and after 1 and 4 weeks after completing the six-week training program. Results indicate that the experimental group significantly improved in subjective navigation ability both 1 and 4 weeks after completion of the training, in comparison to the score before training and the scores of the control group. Similarly, goal attainment showed a significant increase after the first and fourth week after training. Objective navigation performance was not affected by the training. This navigation training protocol provides an effective solution to address navigation impairment after acquired brain injury, with clear improvements in subjective performance and goal attainment of the participants. The outcomes of the training should be re-examined after implementation in a clinical setting.

Keywords: spatial navigation, cognitive rehabilitation, serious gaming, acquired brain injury

Procedia PDF Downloads 176

Authors: Rym Saidi, Pape Alioune Ndiaye, Ibnyasser Ammar, Zineb Rchiad, Khalid Daoui, Issam Kadmiri Meftahi, Adnane Bargaz

Abstract:

Chickpea (Cicer arietinum L.) is an important leguminous crop grown worldwide and plays a significant role in humans’ dietary consumption. Alongside nitrogen (N), low phosphorus (P) availability within agricultural soils is one of the major factors limiting chickpea growth and productivity. The combined application of beneficial bacterial inoculants and Rock P-fertilizer could boost chickpea performance and productivity, increasing P-utilization efficiency and minimizing nutrient losses under P-deficiency conditions. A greenhouse experiment was conducted to evaluate the response of chickpeas to two P-fertilizer forms (RP and TSP) under N2-fixer and P-solubilizer consortium inoculation to improve biological N fixation and P nutrition under P-deficient conditions. Under inoculation, chickpea chlorophyll content and chlorophyll fluorescence (RP+I and TSP+I) were increased compared to uninoculated treatments. The RP+I treatment increased both shoot and root dry weights by 48,80% and 72,68%, respectively, compared to the uninoculated RP fertilized control. Indeed, the bacterial consortium contributed to enhancing root morphological traits (e.g., root volume, surface area, and diameter) of all inoculated treatments versus the uninoculated treatments. Furthermore, soil available P and root inorganic P were significantly improved in RP+I by 162,84% and 73,24%, respectively, compared to uninoculated RP control. Our research outcomes suggest that the co-inoculation of chickpeas with N2-fixing, and P-solubilizing bacteria improves biomass yield and nutrient uptake. Eventually, enhancing chickpea agrophysiological performance, especially in restricted P-availability conditions.

Keywords: chickpea, consortium, beneficial bacterial inoculants, phosphorus deficiency, rock p-fertilizer, nutrient uptake

Procedia PDF Downloads 65

Authors: Farida Ibrahim

Abstract:

Right to information is the public's right to know through having access to public information held by state bodies. Recognized as a cornerstone in transparent, participatory and open democracies, the right to information is increasingly perceived today as an emerging human right on the international level. While this right is conceptualized in a range of different contexts, the paper focuses on its conceptualization as a force for socio-economic change for disadvantaged groups. The paper's goal is study the instrumental capacity of this right in empowering the public to access state-held information pertinent to their socio-economic rights. In this regard, the paper views the right to information as an inclusionary tool that is capable of spurring inclusion for individuals excluded from the ambits of both: public participation and social justice. For exploring this, the paper examines the advocacy role played by civil society groups in furthering this instrumental capacity. In particular, the paper presents a focused account on the Egyptian case. While Egypt has recently adopted its constitutional provision on access to information, doubts arise on Egyptian citizens' genuine ability to access information held by state bodies. The politico-economic environment, long term culture of bureaucratic secrecy, and legal framework do not provide promising outcomes on access to public information. Within the particular context of the Egyptian case, this paper questions the extent to which civil society in Egypt is capable of instrumentally employing the political opportunity offered by the constitutional entitlement to information access for pressuring public authorities to disclose information. Through four lawsuits brought by civil society groups in Egypt, the paper argues that the right to information has instrumentally provided civil society actors with new domains of mobilization for furthering the realization of social and economic rights, and ultimately, for renegotiating a new social order lining the relationship between the Egyptian state and its citizens marginalized by socio-economic imbalances.

Keywords: civil society, Egypt, right to information, socio-economic rights

Procedia PDF Downloads 281

Authors: Wade Ghribi, Abdelmoty M. Ahmed, Ahmed Said Badawy, Belgacem Bouallegue

Abstract:

In higher education institutions, the most pressing priority is to improve student performance and retention. Large volumes of student data are used in Educational Data Mining techniques to find new hidden information from students' learning behavior, particularly to uncover the early symptom of at-risk pupils. On the other hand, data with noise, outliers, and irrelevant information may provide incorrect conclusions. By identifying features of students' data that have the potential to improve performance prediction results, comparing and identifying the most appropriate ensemble learning technique after preprocessing the data, and optimizing the hyperparameters, this paper aims to develop a reliable students' performance prediction model for Higher Education Institutions. Data was gathered from two different systems: a student information system and an e-learning system for undergraduate students in the College of Computer Science of a Saudi Arabian State University. The cases of 4413 students were used in this article. The process includes data collection, data integration, data preprocessing (such as cleaning, normalization, and transformation), feature selection, pattern extraction, and, finally, model optimization and assessment. Random Forest, Bagging, Stacking, Majority Vote, and two types of Boosting techniques, AdaBoost and XGBoost, are ensemble learning approaches, whereas Decision Tree, Support Vector Machine, and Artificial Neural Network are supervised learning techniques. Hyperparameters for ensemble learning systems will be fine-tuned to provide enhanced performance and optimal output. The findings imply that combining features of students' behavior from e-learning and students' information systems using Majority Vote produced better outcomes than the other ensemble techniques.

Keywords: educational data mining, student performance prediction, e-learning, classification, ensemble learning, higher education

Procedia PDF Downloads 108

Authors: Musawira Iftikhar

Abstract:

The field of membrane materials is the most dynamic due to the constantly evolving requirements advancement of materials, to address challenges such as biocompatibility, protein-bound uremic toxins, blood coagulation, auto-immune responses, oxidative stress, and poor clearance of uremic toxins. Hemodialysis is a membrane filtration processes that is currently necessary for daily living of the patients with ESRD. Tens of millions of people with ESRD have benefited from hemodialysis over the past 60–70 years, both in terms of safeguarding life and a longer lifespan. Beyond challenges associated with the efficiency and separative properties of the membranes, ensuring hemocompatibility, or the safe circulation of blood outside the body for four hours every two days, remains a persistent challenge. This review explores the ongoing field of metal–Organic Frameworks (MOFs) and their applications in hemodialysis, offering a comprehensive examination of various MOFs employed to address challenges inherent in traditional hemodialysis methodologies. this This review included includes the experimental work done with various MOFs as a filler such as UiO-66, HKUST-1, MIL-101, and ZIF-8, which together lead to improved adsorption capacities for a range of uremic toxins and proteins. Furthermore, this review highlights how effectively MOF-based hemodialysis membranes remove a variety of uremic toxins, including p-cresol, urea, creatinine, and indoxyl sulfate and potential filler choices for the future. Future research efforts should focus on refining synthesis techniques, enhancing toxin selectivity, and investigating the long-term durability of MOF-based membranes. With these considerations, MOFs emerge as transformative materials in the quest to develop advanced and efficient hemodialysis technologies, holding the promise to significantly enhance patient outcomes and redefine the landscape of renal therapy.

Keywords: membrane, hemodailysis, metal organic frameworks, seperation, protein adsorbtion

Procedia PDF Downloads 56

Authors: Emile Niringiyimana, LI Ji Qing, Giovanni Dushimimana, Virginie Umwere

Abstract:

The development and utilization of renewable energy (RE) can not only effectively reduce carbon dioxide (CO2) emissions, but also became a solution to electricity shortage mitigation in rural areas. Hybrid RE systems are promising ways to provide consistent and continuous power for isolated areas. This work investigated the prospect and cost effectiveness of hybrid system complementarity between a 100kW solar PV system and a small-scale 200kW hydropower station in the South of Rwanda. In order to establish the optimal size of a RE system with adequate sizing of system components, electricity demand, solar radiation, hydrology, climate data are utilized as system input. The average daily solar radiation in Rukarara is 5.6 kWh/m2 and average wind speed is 3.5 m/s. The ideal integrated RE system, according to Homer optimization, consists of 91.21kW PV, 146kW hydropower, 12 x 24V li-ion batteries with a 20kW converter. The method of enhancing such hybrid systems control, sizing and choice of components is to reduce the Net present cost (NPC) of the system, unmet load, the cost of energy and reduction of CO2. The power consumption varies according to dominant source of energy in the system by controlling the energy compensation depending on the generation capacity of each power source. The initial investment of the RE system is $977,689.25, and its operation and maintenance expenses is $142,769.39 over a 25-year period. Although the investment is very high, the targeted profits in future are huge, taking into consideration of high investment in rural electrification structure implementations, tied with an increase of electricity cost and the 5 years payback period. The study outcomes suggest that the standalone hybrid PV-Hydropower system is feasible with zero pollution in Rukara community.

Keywords: HOMER optimization, hybrid power system, renewable energy, NPC and solar pv systems

Procedia PDF Downloads 61

Authors: Charles Horace Ampong

Abstract:

Non-linear models have been found to be useful in modeling the elasticity (measure of degree of responsiveness) of a dependent variable with respect to a set of independent variables ceteris paribus. This constant elasticity principle was applied to the dependent variable (Compressive Strength of Concrete in MPa) which was found to be non-linearly related to the independent variable (Water-Cement ratio in kg/m3) for given Ages of Concrete in days (3, 7, 28) at different levels of admixtures Superplasticizer (in kg/m3), Blast Furnace Slag (in kg/m3) and Fly Ash (in kg/m3). The levels of the admixtures were categorized as: S1=Some Plasticizer added & S0=No Plasticizer added; B1=some Blast Furnace Slag added & B0=No Blast Furnace Slag added; F1=Some Fly Ash added & F0=No Fly Ash added. The number of observations (samples) used for the research was one-hundred and thirty-two (132) in all. For Superplasticizer, it was found that Compressive Strength of Concrete was more elastic with regards to Water-Cement ratio at S1 level than at S0 level for the given ages of concrete 3, 7and 28 days. For Blast Furnace Slag, Compressive Strength with regards to Water-Cement ratio was more elastic at B0 level than at B1 level for concrete ages 3, 7 and 28 days. For Fly Ash, Compressive Strength with regards to Water-Cement ratio was more elastic at B0 level than at B1 level for Ages 3, 7 and 28 days. The research also tested for different combinations of the levels of Superplasticizer, Blast Furnace Slag and Fly Ash. It was found that Compressive Strength elasticity with regards to Water-Cement ratio was lowest (Elasticity=-1.746) with a combination of S0, B0 and F0 for concrete age of 3 days. This was followed by Elasticity of -1.611 with a combination of S0, B0 and F0 for a concrete of age 7 days. Next, the highest was an Elasticity of -1.414 with combination of S0, B0 and F0 for a concrete age of 28 days. Based on preceding outcomes, three (3) non-linear model equations for predicting the output elasticity of Compressive Strength of Concrete (in %) or the value of Compressive Strength of Concrete (in MPa) with regards to Water to Cement was formulated. The model equations were based on the three different ages of concrete namely 3, 7 and 28 days under investigation. The three models showed that higher elasticity translates into higher compressive strength. And the models revealed a trend of increasing concrete strength from 3 to 28 days for a given amount of water to cement ratio. Using the models, an increasing modulus of elasticity from 3 to 28 days was deduced.

Keywords: concrete, compressive strength, elasticity, water-cement

Procedia PDF Downloads 293

Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

Abstract:

Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

Procedia PDF Downloads 92

Authors: Amina Umulisa

Abstract:

Background: Despite efforts to enhance profitability and project planning, Rwanda has experienced a decline in project success rates, notably in housing projects managed by the Rwanda Social Security Board (RSSB). This study aims to assess the impact of investment strategies and project planning practices on the performance of pension funds projects in Rwanda, focusing on housing projects by RSSB. Methods: Using descriptive and correlational research designs, this study surveyed 109 randomly selected respondents from a pool of 148 workers. Data analysis was conducted using descriptive and inferential statistics in STATA version 18. Results: Findings revealed that 54% of respondents acknowledged the importance of personnel generation. Additionally, 61% agreed with the effectiveness of training programs, and 79% supported the cost of human resource utilization. In terms of project management practices, 65.7% could determine when a project needed adjustments, 65.7% agreed with the approved budget, and 73% supported forecasted expenses. Furthermore, 68% agreed with order placement, 76.0% with using the right materials, and 64.4% with defining project scope. The study found significant associations between order placement and project quality outcomes (r=0.711, P-value <0.001), as well as with time management (Pearson was 0.701 and sing was 0.00) and cost management (r=0.885, P-value <0.001). Moreover, project time targets were found to significantly affect quality management (Pearson was 0.798, sing was 0.000), time management, and cost management (r=0.740, P-value <0.001). Conclusion: The findings highlight the positive association between the project implementation stage and quality management, indicating effective project planning practices among senior staff. However, there is a need to enhance project team collaboration and coordination to improve the performance of constructed houses.

Keywords: project success rates, investment strategies, training programs, cost management

Procedia PDF Downloads 52

Authors: A. Barratt, M. H. Granat, S. Buttress, B. Roy

Abstract:

Introduction: Physiotherapy is an essential part of the treatment of patients with shoulder problems. The focus of treatment is usually centred on addressing specific physiotherapy goals, ultimately resulting in the improvement in pain and function. This study investigates if computerised physiotherapy using gamification principles are as effective as standard physiotherapy. Methods: Physiotherapy exergames were created using a combination of commercially available hardware, the Microsoft Kinect, and bespoke software. The exergames used were validated by mapping physiotherapy goals of physiotherapy which included; strength, range of movement, control, speed, and activation of the kinetic chain. A multicenter, randomised prospective controlled trial investigated the use of exergames on patients with Shoulder Impingement Syndrome who had undergone Arthroscopic Subacromial Decompression surgery. The intervention group was provided with the automated sensor-based technology, allowing them to perform exergames and track their rehabilitation progress. The control group was treated with standard physiotherapy protocols. Outcomes from different domains were used to compare the groups. An important metric was the assessment of shoulder range of movement pre- and post-operatively. The range of movement data included abduction, forward flexion and external rotation which were measured by the software, pre-operatively, 6 weeks and 12 weeks post-operatively. Results: Both groups show significant improvement from pre-operative to 12 weeks in elevation in forward flexion and abduction planes. Results for abduction showed an improvement for the interventional group (p < 0.015) as well as the test group (p < 0.003). Forward flexion improvement was interventional group (p < 0.0201) with the control group (p < 0.004). There was however no significant difference between the groups at 12 weeks for abduction (p < 0.118067) , forward flexion (p < 0.189755) or external rotation (p < 0.346967). Conclusion: Exergames may be used as an alternative to standard physiotherapy regimes; however, further analysis is required focusing on patient engagement.

Keywords: shoulder, physiotherapy, exergames, gamification

Procedia PDF Downloads 194

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

Procedia PDF Downloads 107

Authors: Mingke Ma

Abstract:

The recent discovery of the High-Income Trap phenomena and the established Middle-Income Trap literature have identified the similarity of the structural challenges that both Mainland China and Taiwan have been facing since the simultaneous growth slowdown from the 2000s. Mainland China and Taiwan’s ineffectiveness in productivity growth weakened their overall competitiveness in Global Value Chains. With the subsequent decline of industrial profitability, social compression from late development persists and jeopardises the social cohesion. From Ma Ying-jeou’s ‘633’ promise and Tsai Ing-wen’s ‘5+2’ industrial framework to Mainland China’s 11th to 14th Five-Year Plans, leaderships across the Strait have been striving to constitute new models for inclusive and sustainable development through policy responses. This study argues that social consensuses that have been constructed by the domestic political processes define the feasibility of the reform strategies, which further construct the conditions for Cross-Strait interactions. Based on the existing literature of New Institutional Economics, Middle/High Income Trap, and Compressed Development, this study adopts a Historical Institutionalist analytical framework to identify how the historical path-dependency contributes to the contemporary growth constraints in both economies and the political difficulty on navigating the institutional and Organisational change. It continues by tracing the political process of economic reform to examine the sustainability and resilience of the manifested social consensus that had empowered the proposed policy frameworks. Afterwards, it examines how the political outcomes in such a simultaneous process shared by both Mainland China and Taiwan construct the social, economic, institutional, and political foundations of contemporary Cross-Strait engagement.

Keywords: historical institutionalism, political economy, cross-strait relations, high/middle income trap

Procedia PDF Downloads 195

Authors: Yusra Pintaningrum, Ilma Fahira Basyir, Sony Hilal Wicaksono, Vito A. Damay

Abstract:

Background: Coronary artery calcium (CAC) scores play an important role in improving prognostic accuracy and can be selectively used to guide the allocation of statin therapy for atherosclerotic cardiovascular disease outcomes and potentially associated with the occurrence of MACE (Major Adverse Cardiovascular Event) and MI (Myocardial Infarction). Objective: This systematic review and meta-analysis aim to analyze the findings of a study about CAC Score and statin treatment effect on MI and MACE risk. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “coronary artery calcium” AND “statin” AND “cardiovascular disease” Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on 11 studies included with a total of 1055 participants, we performed a meta-analysis and found that individuals with CAC score > 0 increased risk ratio of MI 8.48 (RR = 9.48: 95% CI: 6.22 – 14.45) times and MACE 2.48 (RR = 3.48: 95% CI: 2.98 – 4.05) times higher than CAC score 0 individual. Statin compared against non-statin treatment showed a statistically insignificant overall effect on the risk of MI (P = 0.81) and MACE (P = 0.89) in an individual with elevated CAC score 1 – 100 (P = 0.65) and > 100 (P = 0.11). Conclusions: This study found that an elevated CAC scores individual has a higher risk of MI and MACE than a non-elevated CAC score individual. There is no significant effect of statin compared against non-statin treatment to reduce MI and MACE in elevated CAC score individuals of 1 – 100 or > 100.

Keywords: coronary artery calcium, statin, cardiovascular disease, myocardial infarction, MACE

Procedia PDF Downloads 101

Authors: Wenzheng Fu, Yue Fu, Zhijiang Dong, Yujian Fu

Abstract:

The integration of artificial intelligence (AI) and machine learning (ML) into project management is transforming how engineering projects are executed, monitored, and controlled. This paper provides a comprehensive survey of AI and ML applications in project management, systematically categorizing their use in key areas such as project data analytics, monitoring, tracking, scheduling, and reporting. As project management becomes increasingly data-driven, AI and ML offer powerful tools for improving decision-making, optimizing resource allocation, and predicting risks, leading to enhanced project outcomes. The review highlights recent research that demonstrates the ability of AI and ML to automate routine tasks, provide predictive insights, and support dynamic decision-making, which in turn increases project efficiency and reduces the likelihood of costly delays. This paper also examines the emerging trends and future opportunities in AI-driven project management, such as the growing emphasis on transparency, ethical governance, and data privacy concerns. The research suggests that AI and ML will continue to shape the future of project management by driving further automation and offering intelligent solutions for real-time project control. Additionally, the review underscores the need for ongoing innovation and the development of governance frameworks to ensure responsible AI deployment in project management. The significance of this review lies in its comprehensive analysis of AI and ML’s current contributions to project management, providing valuable insights for both researchers and practitioners. By offering a structured overview of AI applications across various project phases, this paper serves as a guide for the adoption of intelligent systems, helping organizations achieve greater efficiency, adaptability, and resilience in an increasingly complex project management landscape.

Keywords: artificial intelligence, decision support systems, machine learning, project management, resource optimization, risk prediction

Procedia PDF Downloads 21

Authors: Saleh Nabiyev

Abstract:

Renewable energy is becoming increasingly important in today's world due to its significant impact on the green economy, ecology, environment, and climate change. Renewable energy sources, such as solar and wind, are clean and sustainable, making them an ideal solution to reduce carbon emissions and mitigate the effects of climate change. The Karabakh region is located in the South Caucasus and covers an area of approximately 11,500 km². The region has a mountainous terrain, which can affect the availability of wind and solar resources. The Karabakh region has significant wind power potential, particularly in its mountainous areas where wind speeds are typically higher. According to a study conducted by the European Commission Joint Research Centre, the average wind speed in the Karabakh region is between 4 and 6 meters per second (m/s) at a height of 50 meters above ground level (AGL). However, wind speeds can be higher in some areas, reaching up to 10 m/s in some mountainous areas. The region also has significant solar power potential, with an average of 2,000 to 2,200 hours of sunshine per year. The region's high altitude and clear skies make it particularly suitable for the development of solar power projects. In this research, the application of satellite images, solar radiation, wind speed and direction, as well as various other materials to determine suitable areas for alternative energy sources, is investigated. The methodology for selecting suitable locations for solar and wind energy consists of four main parts: identification of factors, evaluation of factors, data preparation, and application of suitability analysis. At the end of the research, the territory of the Kalbajar and Lachin districts is suitable for wind energy. The southern plain part of Karabakh is highly evaluated in terms of solar energy potential, especially Jabrayil district. Generally, outcomes taken from this research are essential data for increasing of rational using natural resources, as well as combating climate change.

Keywords: GIS, remote sensing, suitability analysis, solar energy, wind energy

Procedia PDF Downloads 31

Authors: Ayesha Ali, Emilia Lindquist, Arif Jalal, Hannah Yusuf, Kayan Cheung, Rowan Eastabrook

Abstract:

It is currently estimated that over a third of deaths in children under five in Tanzania are caused by acute respiratory infections (ARIs). However, despite being one of the leading causes of morbidity and mortality across the developing world, its risk factors are poorly understood. Therefore, a systematic review of the literature published between 2015 and 2020 was conducted, focusing on risk factors for ARI in Tanzanian children under the age of five. 2015 Demographic and Health Survey (DHS) for Tanzania was analysed to supplement these findings with national data. 2224 papers were retrieved from two databases and were analysed by three independent reviewers. Thirteen papers were eligible for inclusion, covering a wide range of risk factors among which comorbidities (n=6), malnutrition (n=5), lack of parental education (n=4), poor socio-economic status (n=3), and delay in seeking healthcare (n=3) were the most cited risk factors. The risk factors with the highest reported risk ratios/odds ratios were lack of parental education (RR=11.5-14.5), followed by enrolment in school (RR=4.4), delay in seeking healthcare (RR=3.8) and cooking indoors (aOR =1.8-RR=5.5). The DHS data provided local context to these risk factors. For instance, the number of children experiencing symptoms of ARI in both urban and rural areas ranged between 4.5-5% in the two weeks prior to the survey. However, 79% of symptomatic children in Zanzibar received antibiotics for treatment compared to just 34% of those in the Southern Highlands. As demonstrated by both the systematic review and the DHS analysis, risk factors for ARI are predominantly socially determined, with Tanzania’s poorer rural children possessing the highest risk for ARI and more adverse health outcomes. Therefore, the burden of ARIs in Tanzanian children may be alleviated through the provision of appropriate treatment and parental education in rural areas.

Keywords: acute respiratory infection, child, health education, morbidity, mortality, pneumonia, Tanzania

Procedia PDF Downloads 192

Authors: Efe Çukur

Abstract:

This study aims to discuss and compare i) widespread and generic design, particularly industrial design education in relation to the specific needs of the automotive/transportation industry, and ii) an automotive/transportation design education model within and under to provide the conditions of design education and automotive industry, especially in Turkey and T.R.N.C. The automotive industry is the 11th largest in the world ($1.51 trillion). One of the most important departments in this industry, along with sales, marketing and engineering, is the design department. The automotive industry is known as the locomotive industry, but there is a non-automotive design department on the academic side of Turkey. This suggestion; includes the presentation of a program proposal that meets the needs of the industry for Turkey and T.R.N.C., the second largest automobile manufacturing country in Europe. On the education side, industrial design education has become a generic title. Automotive design studios are divided into several subgroups. Even in the higher graduate education, the automotive design departments get their subgroups like exterior design and interior design. Transportation design, which is a subfield of industrial design, is offered as higher education in transportation design departments, particularly in America and Europe. In these departments, the curriculum is shaped to the needs of the sectors. Higher education transportation design programs began in the mid-20th century. Until those high education programs...Until these high education programs, the industry has adapted architectures and engineers for designer workloads. Still today transportation design graduates are not the majority of the design studios. The content of the study is an in-depth comparison of these institutions and how the requirements, demands of the industry are met in this regard and revealed. Some of the institutions are selected from Europe and US. To be analyzed under the headings of staff, courses, syllabus, University-Industry collaboration, and location selection. The study includes short, mid, and long term proposals and a hypothesis for discussion. In short, the study will not only provide a wide comparative scope of information on generic and specialized aspects of design education in different countries but also propose a higher education model for automotive / transportation design with solid data of requirements, methodology, and structure regarding learning outcomes, and especially industry cooperation.

Keywords: design education, automotive - transportation design programs, transportation design, automotive industry in Turkey /T.R.N.C., automotive design education in Turkey /T.R.N.C.

Procedia PDF Downloads 93

Authors: Swee Yang Low, Dong Eon Kim, Canh Tien Trinh Nguyen, Yixiong Cai, Shie-Yui Liong

Abstract:

Nee Soon swamp forest is one of the last vestiges of tropical wetland in Singapore. Understanding the hydrological regime of the swamp forest and implications for water quality is critical to guide stakeholders in implementing effective measures to preserve the wetland against anthropogenic impacts. In particular, although current field measurement data do not indicate a concern with organic pollution, reviewing the ways in which the wetland responds to elevated organic waste influx (and the corresponding impact on dissolved oxygen, DO) can help identify potential hotspots, and the impact on the outflow from the catchment which drains into downstream controlled watercourses. An integrated water quality model is therefore developed in this study to investigate spatial and temporal concentrations of DO levels and organic pollution (as quantified by biochemical oxygen demand, BOD) within the catchment’s river network under hypothetical, projected scenarios of spiked upstream inflow. The model was developed using MIKE HYDRO for modelling the study domain, as well as the MIKE ECO Lab numerical laboratory for characterising water quality processes. Model parameters are calibrated against time series of observed discharges at three measurement stations along the river network. Over a simulation period of April 2014 to December 2015, the calibrated model predicted that a continuous spiked inflow of 400 mg/l BOD will elevate downstream concentrations at the catchment outlet to an average of 12 mg/l, from an assumed nominal baseline BOD of 1 mg/l. Levels of DO were decreased from an initial 5 mg/l to 0.4 mg/l. Though a scenario of spiked organic influx at the swamp forest’s undeveloped upstream sub-catchments is currently unlikely to occur, the outcomes nevertheless will be beneficial for future planning studies in understanding how the water quality of the catchment will be impacted should urban redevelopment works be considered around the swamp forest.

Keywords: hydrology, modeling, water quality, wetland

Procedia PDF Downloads 140

Authors: Yasir Ali Soomro

Abstract:

Companies that demonstrate corporate social responsibilities (CSR) are more likely to withstand any downturn or crises because of the trust built with stakeholders. Many firms are utilizing CSR marketing to improve the interactions with their various stakeholders, mainly the consumers. Most previous research on CSR has focused on the impact of CSR on customer responses and behaviors toward a company. As online food ordering and grocery shopping remains inevitable. This study will investigate structural relationships among consumer positive emotions (CPE) and negative emotions (CNE), Corporate Reputation (CR), Customer Trust (CT), Brand Image (BI), and Brand attitude (BA) on behavioral outcomes such as Online purchase intention (OPI) and Word of mouth (WOM) in retail grocery and food restaurants setting. Hierarchy of Effects Model will be used as theoretical, conceptual framework. The model describes three stages of consumer behavior: (i) cognitive, (ii) affective, and (iii) conative. The study will apply a quantitative method to test the hypotheses; a self-developed questionnaire with non-probability sampling will be utilized to collect data from 500 consumers belonging to generation X, Y, and Z residing in KSA. The study will contribute by providing empirical evidence to support the link between CSR and customer affective and conative experiences in Saudi Arabia. The theoretical contribution of this study will be empirically tested comprehensive model where CPE, CNE, CR, CT, BI, and BA act as mediating variables between the perceived CSR & Online purchase intention (OPI) and Word of mouth (WOM). Further, the study will add more to how the emotional/ psychological process mediates in the CSR literature, especially in the Middle Eastern context. The proposed study will also explain the effect of perceived CSR marketing initiatives directly and indirectly on customer behavioral responses.

Keywords: corporate social responsibility, corporate reputation, consumer emotions, loyalty, online purchase intention, word-of-mouth, structural equation modeling

Procedia PDF Downloads 91

Authors: Nazaitul Idya Hamzah, Muhammad Syafiq Mazli, Maszatul Akmar Mustafa

Abstract:

The peak demand forecast is crucial to identify the future generation plant up needed in the long-term capacity planning analysis for Peninsular Malaysia as well as for the transmission and distribution network planning activities. Currently, peak demand forecast (in Mega Watt) is derived from the generation forecast by using load factor assumption. However, a forecast using this method has underperformed due to the structural changes in the economy, emerging trends and weather uncertainty. The dynamic changes of these drivers will result in many possible outcomes of peak demand for Peninsular Malaysia. This paper will look into the independent model of peak demand forecasting. The model begins with the selection of driver variables to capture long-term growth. This selection and construction of variables, which include econometric, emerging trend and energy variables, will have an impact on the peak forecast. The actual framework begins with the development of system energy and load shape forecast by using the system’s hourly data. The shape forecast represents the system shape assuming all embedded technology and use patterns to continue in the future. This is necessary to identify the movements in the peak hour or changes in the system load factor. The next step would be developing the peak forecast, which involves an iterative process to explore model structures and variables. The final step is combining the system energy, shape, and peak forecasts into the hourly system forecast then modifying it with the forecast adjustments. Forecast adjustments are among other sales forecasts for electric vehicles, solar and other adjustments. The framework will result in an hourly forecast that captures growth, peak usage and new technologies. The advantage of this approach as compared to the current methodology is that the peaks capture new technology impacts that change the load shape.

Keywords: hourly load profile, load forecasting, long term peak demand forecasting, peak demand

Procedia PDF Downloads 172

Authors: Dilek Dede

Abstract:

This study aims at scrutinized the dilemma between education place and working place with professional socialization dimension over the beginning teachers in Turkey is to be found the solution for the dilemma in Turkey. The research question is that how can be explained the gap between education place and working place for beginning teachers in Turkey. That expected to contribute to literature with the solutions for shorting the gap between working area and education area of the teaching profession in Turkey case. The study is constructed in two section. Firstly, socialization of the teaching profession and teaching modules have been discussed through the profession, education, working place indicators. In the second section, Secondly, two educational specialists from Turkey has been interviewed about their observation on trainee teachers compelling to participate the class for candidate teachers after university grade. Then, the dilemma between education area and working area of the teaching profession has been detected by of semi-structured and in-depth interviews, the literature on the relationality of institutions and regulation is discussed. The following outcomes have been accessed in accordance with the data set and literature linkage axis: Firstly, teachers coming from the distinctive programmes as an educational background. Hence, teachers who pertain to distinctive cultures work in the same environment. That cause cultural conflicts and complication of socialization of profession. Secondly, the insufficient partnership between schools and universities besides, the education classes lead to a struggle of culture among these two institutions. Thirdly, the education classes are designed as bureaucratic form instead of coalescence between head teachers and trainee teachers around a common culture. That become deep the dilemma. In conclusion, on condition that applied-oriented education that advocates in-service learning is promoted and this programme is supported with well-structured the in-service training through the partnership of universities and schools, the gap between the working-area and education-area might be shortened.

Keywords: beginning teachers, construction of a common, social mobilization in the teaching profession, teacher training institution, the relationality of the regulations and institutions

Procedia PDF Downloads 165

Authors: Pinna Beatrice., Laini Alex, Negro Giovanni, Burgazzi Gemma, Viaroli Pierluigi, Vezza Paolo

Abstract:

Habitat models rarely consider macroinvertebrates as ecological targets in rivers. Available approaches mainly focus on single macroinvertebrate species, not addressing the ecological needs and functionality of the entire community. This research aimed to provide an approach to model the habitat of the macroinvertebrate community. The approach is based on the recently developed Flow-T index, together with a Random Forest (RF) regression, which is employed to apply the Flow-T index at the meso-habitat scale. Using different datasets gathered from both field data collection and 2D hydrodynamic simulations, the model has been calibrated in the Trebbia river (2019 campaign), and then validated in the Trebbia, Taro, and Enza rivers (2020 campaign). The three rivers are characterized by a braiding morphology, gravel riverbeds, and summer low flows. The RF model selected 12 mesohabitat descriptors as important for the macroinvertebrate community. These descriptors belong to different frequency classes of water depth, flow velocity, substrate grain size, and connectivity to the main river channel. The cross-validation R² coefficient (R²𝒸ᵥ) of the training dataset is 0.71 for the Trebbia River (2019), whereas the R² coefficient for the validation datasets (Trebbia, Taro, and Enza Rivers 2020) is 0.63. The agreement between the simulated results and the experimental data shows sufficient accuracy and reliability. The outcomes of the study reveal that the model can identify the ecological response of the macroinvertebrate community to possible flow regime alterations and to possible river morphological modifications. Lastly, the proposed approach allows extending the MesoHABSIM methodology, widely used for the fish habitat assessment, to a different ecological target community. Further applications of the approach can be related to flow design in both perennial and non-perennial rivers, including river reaches in which fish fauna is absent.

Keywords: ecological flows, macroinvertebrate community, mesohabitat, river habitat modeling

Procedia PDF Downloads 94

Authors: Pascal U. Onu, Doris A. Ogbang, Emmanuel Okechukwu.

Abstract:

Background: Plastics in their various forms have become ubiquitous in a very short space of time. This ubiquitous nature has plagued and daunted nations globally, overwhelming their ability to manage the environmental impact, especially its linkages to climate change. This has mobilized nations globally and triggered debates on the best approaches to ensure sustainability in terms of its production and utilization, as total elimination seems unrealistic. Objective: This study undertook to understand the pattern of plastic waste management, and its pollution awareness levels by the residents of the study area. Methods: Data were obtained through questionnaires designed specifically for plastic waste and qualitatively via journals and articles. Simple descriptive survey techniques with a survey population size of 300 respondents using kobo collect were employed. Results: Analysis based on disaggregated data indicated a proportionate distribution among male and female respondents (53% male and 47% female, respectively). Overall awareness levels on plastic waste's contribution to climate change, compared to its environmental impact, are reflective of a dire need for increased efforts in strengthening awareness creation, especially across gender populations and religious backgrounds. Drainage blockage topped the ranks among common problems caused by plastic waste within the area. Various plastic waste disposal methods were ranked, while pro-environmental measures for reducing the waste menace showed more willingness from males at 52%. Conclusion: These outcomes are instructive and suggest the need for renewed and increased awareness/education on the nexus of plastic pollution to climate change and also appropriate synergies/collaboration between government, private sector, and local communities, especially in the area of recycling to improve sustainability in plastic waste management.

Keywords: plastic waste, KAP, climate change, Nigeria

Procedia PDF Downloads 40

Authors: Rachida Benabbou, Sang Hun Park, Hee Chung Lee

Abstract:

The world’s population is increasing with unprecedented speed, leading to fast growing urbanization pace. Cities since the Industrial revolution had evolved to fit the growing demand on infrastructure, roads, transportation, and housing. Through this evolution, cities had grown into grey, polluted, and vehicle-oriented urban areas with a significant lack of green spaces. Consequently, we ended up with low quality of life for citizens. Therefore, many cities, nowadays, are revising the way we think urbanism and try to grow into more livable and citizen-friendly, by creating change from the inside out. Thus, cities are trying to bring back nature in its crowded grey centers and regenerate many urban areas as green public spaces not only as a way to give new breath to the city, but also as a way to create change either in the environmental, social and economic levels. The city of Seoul is one of the fast growing global cities. Its population is over 12 million and it is expected to continue to grow to a point where the quality of life may seriously deteriorate. As most green areas in Seoul are located in the suburbs in form of mountains, the city’s urban areas suffer from lack of accessible green spaces in a walking distance. Understanding the gravity and consequences of this issue, Seoul city is undergoing major changes. Many of its projects are oriented to be green public spaces where citizens can enjoy the public life in healthy outdoors. The aim of this paper is to explore the results of urban conversions into green public spaces. Starting with different locations, nature, size, and scale, these conversions can lead to significant change in the surrounding areas, thus can be used as an efficient tool of regeneration for urban areas. Through a comparative analysis of three different types of urban conversions projects in the city of Seoul, we try to show the positive urban influence of the outcomes, in order to encourage cities to use green spaces as a strategic tool for urban regeneration and redevelopment.

Keywords: urban conversion, green public space, change, urban regeneration

Procedia PDF Downloads 305

Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

Abstract:

Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

Procedia PDF Downloads 241