Search results for: clinical assessment tools

Authors: F. O’Dowd, G. Murphy, M. Roche, E. Shudell, F. Keane, M. O’Kane

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Intoduction: Apremilast (Otezla®) is an oral phosphodiesterase-4 (PDE4) inhibitor indicated for treatment of adult patients with moderate to severe plaque psoriasis who have contraindications to have failed or intolerant of standard systemic therapy and/or phototherapy; and adult patients with active psoriatic arthritis. Apremilast influences intracellular regulation of inflammatory mediators. Two randomized, placebo-controlled trials evaluating apremilast in 1426 patients with moderate to severe plague psoriasis (ESTEEM 1 and 2) demonstrated that the commonest adverse reactions (AE’s) leading to discontinuation were nausea (1.6%), diarrhoea (1.0%), and headaches (0.8%). The overall proportion of subjects discontinuing due to adverse reactions was 6.1%. At week 16 these trials demonstrated significant more apremilast-treated patients (33.1%) achieved the primary end point PASI-75 than placebo (5.3%). We began prescribing apremilast in July 2015. Aim: To evaluate efficacy and tolerability of apremilast in an Irish teaching hospital psoriasis population. Methods: A proforma documenting clinical evaluation parameters, prior treatment experience and AE’s; was completed prospectively on all patients commenced on apremilast since July 2015 – July 2017. Data was collected at week 0,6,12,24,36 and week 52 with 20/71 patients having passed week 52. Efficacy was assessed using Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI). AE’s documented included GI effects, infections, changes in weight and mood. Retrospective chart review and telephone review was utilised for missing data. Results: A total of 71 adult subjects (38 male, 33 female; age range 23-57), with moderate to severe psoriasis, were evaluated. Prior treatment: 37/71 (52%) were systemic/biologic/phototherapy naïve; 14/71 (20%) has prior phototherapy alone;20/71 (28%) had previous systemic/biologic exposure; 12/71 (17%) had both psoriasis and psoriatic arthritis. PASI responses: mean baseline PASI was 10.1 and DLQI was 15.Week 6: N=71, n=15 (21%) achieved PASI 75. Week 12: N= 48, n=6 (13%) achieved a PASI 100%; n=16 (34.5%) achieved a PASI 75. Week 24: N=40, n=10 (25%) achieved a PASI 100; n=15 (37.5%) achieved a PASI 75. Week 52: N= 20, n=4 (20%) achieved a PASI 100; n= 16 (80%) achieved a PASI 75. (N= number of pts having passed the time point indicated, n= number of pts (out of N) achieving PASI or DLQI responses at that time). DLQI responses: week 24: N= 40, n=30 (75%) achieved a DLQI score of 0; n=5 (12.5%) achieved a DLQI score of 1; n=1 (2.5%) achieved a DLQI score of 10 (due to lack of efficacy). Adverse Events: The proportion of patients that discontinued treatment due to AE’s was n=7 (9.8%). One patient experienced nausea alleviated by dose reduction; another developed significant dysgeusia for certain foods, both continued therapy. Two patients lost 2-3 kg. Conclusion: Initial Irish patient experience of Apremilast appears comparable to that observed in trials with good efficacy and tolerability.

Keywords: Apremilast, introduction, Ireland, clinical audit

Procedia PDF Downloads 149

Authors: Leila Asadollahi

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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.

Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery

Procedia PDF Downloads 70

Authors: Boitumelo Ditshwane, Zelda Janse van Rensburg, Wanda Jacobs,

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Health literacy is defined as competencies and skills that individuals need to find, comprehend, evaluate, and use to make knowledgeable choices to improve their health and well-being. Low health literacy has been found to affect people’s ability to take care of their own health. Incomprehension of health education and health care instructions due to low health literacy is often due to information given at a level that is above the patient’s level of understanding. The study aimed to test the health literacy levels of South African PHC patients using a previously developed health literacy assessment tool. Determining health literacy levels may assist PHC nurses in providing health education and health care instructions to the patient on the patient’s level of understanding and, therefore, ensuring positive health outcomes for the patient. A health literacy assessment tool, translated into ten official South African languages, was used to quantitatively determine the health literacy levels of 400 PHC patients in five clinics in Gauteng, South Africa. Patients’ health literacy levels were tested in English, and nine other official languages spoken in South Africa and were compared. The results revealed that patients understand information better when given in their preferred language. Giving health education in a language and level that is better understood by the patient may lead to better health outcomes and prevent adverse health. Patients may better understand instructions provided, be more likely to follow the correct route of medication, honor appointments, comply with medication, and thus have better treatment outcomes.

Keywords: health literacy, primary health care, South Africa, patients

Procedia PDF Downloads 80

Authors: Bernice Lottering, Yi-Wen Lin

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Chronic pain and depression have an estimated 80% rate of comorbidity with unsatisfactory treatment interventions signifying the importance of developing effective therapeutic interventions for a serious chronic condition affecting a large majority of the global population. Chronic pain is defined as persistent pain presenting for over 3 months. This disease state increases the risk of developing depression in comparison to healthy individuals. In the current study, complete Freund’s adjuvant (CFA) was used to induce cell-mediated chronic inflammatory pain in a murine model. Significant mechanical and thermal hyperalgesia was induced, alongside observable depression-like behaviors. These conditions were attenuated through the use of electroacupuncture (EA). Similarly, these effects were also investigated with respect to the transient receptor potential vanilloid 1 (TRPV1), by analyzing the effects of TRPV1 gene deletion on the comorbidity of chronic pain and depression. The expression of the TRPV1 inflammatory response, and related downstream molecules, including protein kinases (PKs), mitogen-activated protein kinase (MAPKs), and transcriptional factors, were significantly reduced in the thalamus, prefrontal cortex (PFC), hippocampus, and periaqueductal gray (PAG) of CFA-treated mice. In addition, phosphorylated N-methyl-D-aspartate (NMDA) receptor 1 was also found to be reduced in the aforementioned areas, suggesting potential application and validity in a clinical setting. Our study determined the prospective therapeutic effects of EA in the treatment of chronic inflammatory pain and depression comorbidity and provides a novel and detailed mechanism underlying EA-mediated analgesia. These findings may be relevant in the utilization of clinical intervention approaches related to chronic pain and depression comorbidity.

Keywords: chronic pain, depression, NMDA, prefrontal cortex, TRPV1

Procedia PDF Downloads 133

Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra

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Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.

Keywords: abscess packing, subcutaneous, perianal, pilonidal

Procedia PDF Downloads 73

Authors: Roman Kulikov, Svetlana Kolesnikova

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Last decade Cloud Computing technologies have been rapidly becoming ubiquitous. Each year more and more organizations, corporations, internet services and social networks trust their business sensitive information to Public Cloud. The data storage in Public Cloud is protected by security mechanisms such as firewalls, cryptography algorithms, backups, etc.. In this way, however, only outsider attacks can be prevented, whereas virtualization tools can be easily compromised by insider. The protection of Public Cloud’s critical elements from internal intruder remains extremely challenging. A hypervisor, also called a virtual machine manager, is a program that allows multiple operating systems (OS) to share a single hardware processor in Cloud Computing. One of the hypervisor's functions is to enforce access control policies. Furthermore, it prevents guest OS from disrupting each other and from accessing each other's memory or disk space. Hypervisor is the one of the most critical and vulnerable elements in Cloud Computing infrastructure. Nevertheless, it has been poorly protected from being compromised by insider. By exploiting certain vulnerabilities, privilege escalation can be easily achieved in insider attacks on hypervisor. In this way, an internal intruder, who has compromised one process, is able to gain control of the entire virtual machine. Thereafter, the consequences of insider attacks in Public Cloud might be more catastrophic and significant to virtual tools and sensitive data than of outsider attacks. So far, almost no preventive security countermeasures have been developed. There has been little attention paid for developing models to assist risks mitigation strategies. In this paper formal model of insider attacks on hypervisor is designed. Our analysis identifies critical hypervisor`s vulnerabilities that can be easily compromised by internal intruder. Consequently, possible conditions for successful attacks implementation are uncovered. Hence, development of preventive security countermeasures can be improved on the basis of the proposed model.

Keywords: insider attack, public cloud, cloud computing, hypervisor

Procedia PDF Downloads 361

Authors: Enoch Ocran

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Film Pertinence maintains consistency in storytelling by sustaining the natural flow of action while evoking a particular feeling or emotion from the viewers with selected motion pictures. This study presents a thorough investigation of "Film Pertinence" in videography that examines its influence in Africa and around the world. This research delves into the dynamic realm of visual storytelling through film, with a specific focus on the concept of Film Pertinence (FP). The study’s primary objectives are to conduct a comparative analysis of videography tools and techniques employed in both African and international contexts, examining how they contribute to the achievement of organizational goals and the enhancement of cultural awareness. The research methodology includes a comprehensive literature review, interviews with videographers from diverse backgrounds in Africa and the international arena, and the examination of pertinent case studies. The investigation aims to elucidate the multifaceted nature of videographic practices, with particular attention to equipment choices, visual storytelling techniques, cultural sensitivity, and adaptability. This study explores the impact of cultural differences on videography choices, aiming to promote understanding between African and foreign filmmakers and create more culturally sensitive films. It also explores the role of technology in advancing videography practices, resource allocation, and the influence of globalization on local filmmaking practices. The research also contributes to film studies by analyzing videography's impact on storytelling, guiding filmmakers to create more compelling narratives. The findings can inform film education, tailoring curricula to regional needs and opportunities. The study also encourages cross-cultural collaboration in the film industry by highlighting convergence and divergence in videography practices. At its core, this study seeks to explore the implications of film pertinence as a framework for videographic practice. It scrutinizes how cultural expression, education, and storytelling transcend geographical boundaries on a global scale. By analyzing the interplay between tools, techniques, and context, the research illuminates the ways in which videographers in Africa and worldwide apply film Pertinence principles to achieve cross-cultural communication and effectively capture the objectives of their clients. One notable focus of this paper is on the techniques employed by videographers in West Africa to emphasize storytelling and participant engagement, showcasing the relevance of FP in highlighting cultural awareness in visual storytelling. Additionally, the study highlights the prevalence of film pertinence in African agricultural documentaries produced for esteemed organizations such as the Roundtable on Sustainable Palm Oil (RSPO), Proforest, World Food Program, Fidelity Bank Ghana, Instituto BVRio, Aflatoun International, and the Solidaridad Network. These documentaries serve to promote prosperity, resilience, human rights, sustainable farming practices, community respect, and environmental preservation, underlining the vital role of film in conveying these critical messages. In summary, this research offers valuable insights into the evolving landscape of videography in different contexts, emphasizing the significance of film pertinence as a unifying principle in the pursuit of effective visual storytelling and cross-cultural communication.

Keywords: film pertinence, Africa, cultural awareness, videography tools

Procedia PDF Downloads 67

Authors: Memory Ranga, Phillip Pretorious

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The South African Government has invested a lot of money in Information Technology Governance (ITG) within the Government departments. The ITG framework was spearheaded by the Department of Public Service and Administration (DPSA). This led to the development of a governing ITG DPSA framework and later the Government Wide Enterprise Architecture (GWEA) Framework for assisting the departments to implement ITG. In addition to this, the government departments have adopted the Information Systems Audit and Control Association (ISACA) Control Objectives for Information and Related Technology (COBIT) for ITG processes. Despite all these available frameworks, departments fail to fully capitalise and improve the ITG processes mainly as these are too generic and difficult to apply for specific governance needs. There has been less research done to evaluate the progress on ITG initiatives within the government departments. This paper aims to evaluate the existing ITG frameworks within selected government departments in South Africa. A quantitative research approach was used in this study. Data was collected through an online questionnaire targeting ICT Managers and Directors from government departments. The study is undertaken within a case study and only the Eastern Cape Province was selected for the research. Document review mainly on ITG framework and best practices was also used. Data was analysed using the Google Analytic tools and SPSS. A one–sample Chi-Squared Test was used to verity the evaluation findings. Findings show that there is evidence that the current guiding National governance framework (DPSA) is out dated and does not accommodate the new changes in other governance frameworks. The Eastern Cape Government Departments have spent huge amount of money on ITG but not yet able to identify the benefits of the ITG initiatives. The guiding framework is rigid and does to address some of the departmental needs making it difficult to be flexible and apply the DPSA framework. Furthermore, despite the large budget on ITG, the departments still find themselves with many challenges and unable to improve some of the processes and services. All the engaged Eastern Cape departments have adopted the COBIT framework, but none has been conducting COBIT maturity Assessment which is a functionality of COBIT. There is evidence of too many the ITG frameworks and underutilisation of these frameworks. The study provides a comprehensive evaluation of the ITG frameworks that have been adopted by the South African Government Departments in the Eastern Cape Province. The evaluation guides and recommends the government departments to rethink and adopt ITG frameworks that could be customised to accommodate their needs. The adoption and application of ITG by government departments should assist in better governance and service delivery to the citizens.

Keywords: information technology governance, COBIT, evaluate, framework, governance, DPSA framework

Procedia PDF Downloads 123

Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

Procedia PDF Downloads 428

Authors: Ana L. Martins, Luis Orfão

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Healthcare systems have been subject to various research efforts aiming at process improvement under a lean approach. Another perspective, agility, has also been used, though in a lower scale, in order to analyse the ability of different hospital services to adapt to demand uncertainties. Both perspectives have a common denominator, the improvement of effectiveness and efficiency of the services in a healthcare setting context. Mixing the two approached allows, on one hand, to streamline the processes, and on the other hand the required flexibility to deal with demand uncertainty in terms of both volume and variety. The present research aims to analyse the impacts of the combination of both perspectives in the effectiveness and efficiency of an hospital service. The adopted methodology is based on a case study approach applied to the process of the ambulatory surgery service of Hospital de Lamego. Data was collected from direct observations, formal interviews and informal conversations. The analyzed process was selected according to three criteria: relevance of the process to the hospital, presence of human resources, and presence of waste. The customer of the process was identified as well as his perception of value. The process was mapped using flow chart, on a process modeling perspective, as well as through the use of Value Stream Mapping (VSM) and Process Activity Mapping. The Spaghetti Diagram was also used to assess flow intensity. The use of the lean tools enabled the identification of three main types of waste: movement, resource inefficiencies and process inefficiencies. From the use of the lean tools improvement suggestions were produced. The results point out that leagility cannot be applied to the process, but the application of lean and agility in specific areas of the process would bring benefits in both efficiency and effectiveness, and contribute to value creation if improvements are introduced in hospital’s human resources and facilities management.

Keywords: case study, healthcare systems, leagility, lean management

Procedia PDF Downloads 200

Authors: Antonella Poce, Deborah Seid Howes, Maria Rosaria Re, Mara Valente

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The Creative Industries education contexts, Museum Education in particular, generally presents a low emphasis on the use of new digital technologies, digital abilities and transversal skills development. The spread of the Covid-19 pandemic has underlined the importance of these abilities and skills in cultural heritage education contexts: gaining digital skills, museum professionals will improve their career opportunities with access to new distribution markets through internet access and e-commerce, new entrepreneurial tools, or adding new forms of digital expression to their work. However, the use of web, mobile, social, and analytical tools is becoming more and more essential in the Heritage field, and museums, in particular, to face the challenges posed by the current worldwide health emergency. Recent studies highlight the need for stronger partnerships between the cultural and creative sectors, social partners and education and training providers in order to provide these sectors with the combination of skills needed for creative entrepreneurship in a rapidly changing environment. Considering the above conditions, the paper presents different examples of digital learning experiences carried out in Italian and USA contexts with the aim of promoting digital skills in museum professionals. In particular, a quali-quantitative research study has been conducted on two international Postgraduate courses, “Advanced Studies in Museum Education” (2 years) and “Museum Education” (1 year), in order to identify the educational effectiveness of the online learning strategies used (e.g., OBL, Digital Storytelling, peer evaluation) for the development of digital skills and the acquisition of specific content. More than 50 museum professionals participating in the mentioned educational pathways took part in the learning activity, providing evaluation data useful for research purposes.

Keywords: digital skills, museum professionals, technology, education

Procedia PDF Downloads 177

Authors: Theresa Bacon-Baguley, Martina Reinhold

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Introduction: Evaluation and analysis are the cornerstones of any successful program in higher education. When developing a program at a distant campus, it is essential that the process of evaluation and analysis be orchestrated in a timely manner with tools that can identify both the positive and negative components of distant education. We describe the utilization of a newly developed tool used to evaluate and analyze the successful expansion to a distant campus using Telepresence Technology. Like interactive television, Telepresence allows live interactive delivery but utilizes broadband cable. The tool developed is adaptable to any distant campus as the framework for the tool was derived from a systematic review of the literature. Methodology: Because Telepresence is a relatively new delivery system, the evaluation tool was developed based on a systematic review of literature in the area of distant education and ITV. The literature review identified four potential areas of concern: 1) technology, 2) confidence in the system, 3) faculty delivery of the content and, 4) resources at each site. Each of the four areas included multiple sub-components. Benchmark values were determined to be 80% or greater positive responses to each of the four areas and the individual sub-components. The tool was administered each semester during the didactic phase of the curriculum. Results: Data obtained identified site-specific issues (i.e., technology access, student engagement, laboratory access, and resources), as well as issues common at both sites (i.e., projection screen size). More specifically, students at the parent location did not have adequate access to printers or laboratory space, and students at the distant campus did not have adequate access to library resources. The evaluation tool identified that both sites requested larger screens for visualization of the faculty. The deficiencies were addressed by replacing printers, including additional orientation for students on library resources and increasing the screen size of the Telepresence system. When analyzed over time, the issues identified in the tool as deficiencies were resolved. Conclusions: Utilizing the tool allowed adjustments of the Telepresence delivery system in a timely manner resulting in successful implementation of an entire curriculum at a distant campus.

Keywords: physician assistant, telepresence technology, distant education, assessment

Procedia PDF Downloads 124

Authors: E. Lacasa, J. L. Santolaya, I. Millán

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The progress toward sustainability implies maintaining and preferably improving both, human and ecosystem well-being, according to a triple bottom line that includes the environmental, economic and social dimensions. The life cycle assessment (LCA) is a method applicable to all production sectors that aims to quantify the environmental pressures and the benefits related to goods and services, as well as the trade-offs and the scope for improving areas of the production process. While using LCA to measure the environmental dimension of sustainability is widespread, similar approaches for the economic and the social dimensions still have limited application worldwide and there is a need for consistent and robust methods and indicators. This paper focuses on the milk production process and presents the analysis of the flows exchanged by an industrial installation through accounting all the energy and material inputs and the associated emissions and waste outputs at this stage of its life cycle. The functional unit is one litre of milk produced. Different metrics and indicators are used to assess the three dimensions of sustainability. Metrics considered useful to assess the production activities are the total water and energy consumptions and the milk production volume of each cow. The global warming, the value added and the working hours are indicators used to measure each sustainability dimension. The study is performed with two types of feeding of the cows, which includes a change in percentages of components as well. Nutritional composition of the milk obtained is almost kept. It is observed that environmental and social improvements involve high economic costs.

Keywords: milk production, sustainability, indicators, life cycle assessment

Procedia PDF Downloads 435

Authors: Dawang D. N., Dasat G. S., Nden D.

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Endophyte means “in the plant” are referred to all microorganisms that live in the internal tissues of stems, petioles, roots and leaves of plants causing no apparent symptoms of disease. Secondary metabolites from fungal endophytes have an enormous potential applications as antioxidant, antimicrobial, anticancer and antidiabeties. Thus, this study aimed to determine the antimicrobial activity of these metabolites against some clinical isolates. The fungi were subjected to fermentation medium and the metabolites were extracted using ethyl acetate. The fungal extracts showed both antibacterial and antifungal activities with maximum zone of inhibition diameter of 10.5mm against Aspergillus fumigatus. Staphylococcus aureus was inhibited by all the five crude extracts with inhibition zone diameter of 4mm. Endophytic fungal crude extract2 (EDF2) exhibited antimicrobial effect against all the test organisms used, EDF4 was active against all test organisms except on Penicillium chrysogenum and Klebsiella pneumoniae. Antibacterial standard of ciprofloxacin which is 15mm is comparable to the effect of endophytic extract of EDF1 and EDF2. Klebsiella pneumoniae was resistant to EDF4 and EDF5. EDF3 showed a wide range of antimicrobial activity against all the test organisms used. The highest inhibition zone diameter of 10.50mm recorded against Aspergillus fumigatus is comparable to antifungal standard of fluconazole (15.5mm). The result of this study suggests that endophytic fungi associated with the roots of Irish potato could be a promising source of novel bioactive compounds of pharmaceutical and industrial importance.

Keywords: endophyte, fungal extract, antimicrobial, potato

Procedia PDF Downloads 123

Authors: Maria Kazantzaki, Evangelos Tsakalos, Eleni Filippaki, Yannis Bassiakos

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Mediterranean areas are characterized by intense seismic and volcanic activity as well as eustatic changes, the result of which is the creation of particularly vulnerable coastal zones. The most vulnerable are low-lying coastal areas, the geomorphological evolution of which are highly affected by natural processes and anthropogenic interventions. Therefore, assessing changes that take place along coastal zones is of great importance in order to enable the development of integrated coastal management plans. A characteristic case is the gulf of Mirabello in N.E Crete, where intense coastal erosion, in combination with the tectonic subsidence of the area, threatens a large part of the coastal zone, resulting in direct socio-economic impacts. The present study assesses the temporal geomorphological changes that have taken place in the coastal zone of Mirabello gulf to provide a clear frame of the coastal zone evolution over time and performs a vulnerability assessment based on the coastal vulnerability index (CVI) methodology by Thieler and Hammar-Klose, considering geological features, coastal slope, relative sea-level change, shoreline erosion/accretion rates and mean significant wave height as well as mean tide range in the area. In light of this, an impact assessment, based on three different sea level rise scenarios, is also performed and presented.

Keywords: coastal vulnerability index, coastal erosion, GIS, sea level rise

Procedia PDF Downloads 171

Authors: Chih-Wei Chao, Jiashing Yu

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Microfluidic devices have recently emerged as promising tools for the fabrication of scaffolds for cell culture. To mimic the natural circumstances of organism for cells to grow, here we present three-dimensional (3D) scaffolds fabricated by microfluidics for cells cultivation. This work aims at investigating the behavior in terms of the viability and the proliferation capability of rat H9c2 cardiomyocytes in the gelatin 3D scaffolds by fluorescent images.

Keywords: microfluidic device, H9c2, tissue engineering, 3D scaffolds

Procedia PDF Downloads 422

Authors: Nebojsa Stefanovic, Sasa Milijic, Natasa Danilovic Hristic

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Spatial plan of the special purpose area constitutes a basic tool in the planning of infrastructure corridor of a highway. The aim of the plan is to define the planning basis and provision of spatial conditions for the construction and operation of the highway, as well as for developing other infrastructure systems in the corridor. This paper presents a methodology and approach to the preparation of the Spatial Plan for the special purpose area for the infrastructure corridor of the highway E-80, Section Niš-Merdare in Serbia. The applied methodological approach is based on the combined application of the integrative and participatory method in the decision-making process on the sustainable development of the highway corridor. It was found that, for the planning and management of the infrastructure corridor, a key problem is coordination of spatial and urban planning, strategic environmental assessment and sectoral traffic planning and designing. Through the development of the plan, special attention is focused on increasing the accessibility of the local and regional surrounding, reducing the adverse impacts on the development of settlements and the economy, protection of natural resources, natural and cultural heritage, and the development of other infrastructure systems in the corridor of the highway. As a result of the applied methodology, this paper analyzes the basic features such as coverage, the concept, protected zones, service facilities and objects, the rules of development and construction, etc. Special emphasis is placed to methodology and results of the Strategic Environmental Assessment of the Spatial Plan, and to the importance of protection measures, with the special significance of air and noise protection measures. For evaluation in the Strategic Environmental Assessment, a multicriteria expert evaluation (semi-quantitative method) of planned solutions was used in relation to the set of goals and relevant indicators, based on the basic set of indicators of sustainable development. Evaluation of planned solutions encompassed the significance and size, spatial conditions and probability of the impact of planned solutions on the environment, and the defined goals of strategic assessment. The framework of the implementation of the Spatial Plan is presented, which is determined for the simultaneous elaboration of planning solutions at two levels: the strategic level of the spatial plan and detailed urban plan level. It is also analyzed the relationship of the Spatial Plan to other applicable planning documents for the planning area. The effects of this methodological approach relate to enabling integrated planning of the sustainable development of the infrastructure corridor of the highway and its surrounding area, through coordination of spatial, urban and sectoral traffic planning and design, as well as the participation of all key actors in the adoption and implementation of planned decisions. By the conclusions of the paper, it is pointed to the direction for further research, particularly in terms of harmonizing methodology of planning documentation and preparation of technical-design documentation.

Keywords: corridor, environment, highway, impact, methodology, spatial plan, urban

Procedia PDF Downloads 212

Authors: Aline Giardin, Ana Fontoura, Thomas Anderson

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Transsexuality is a condition that requires the work of professionals from various fields for diagnosis and treatment. The correct diagnosis is very important because the surgery is irreversible. Diagnostic elements are essentially clinical and an observation period of two years prior to surgery is recommended. In this review article, we discuss the importance of psychiatric nursing for the care of transgender patients, as well as their mental health. Transsexuality is a phenomenon that contrasts our common understandings of sexuality, but it is not a sexual issue. Also called gender dysphoria is a mismatch between the anatomical sex of an individual and their gender identity. In relation to mental health, among transsexuals, we find variations ranging from psychoses to total normality. As the etiology is still controversial, there is no biological marker and only the clinical criteria can be used. Portaria nº 2803, of November 19, 2013, Brazil, regulates the surgical reassignment of sex by the SUS and the nurse started to work also in operational groups (transsexuals who wish to perform surgery and other procedures of reassignment of sex). Health and education, establishes links and guides the care that female and male transsexual patients will have to have before and after surgery. It is also important to say that the work of health education is not only concerned with aspects related to the sexual reassignment surgery, but also with the mental health of its patients and with the family. One of the main complaints of patients is the impression that professionals seem to find them strange and feel extremely uncomfortable when they talk about their desire to undergo sex-change surgery: Investigate the role of nursing in the process of change sexual. Our methodology was a review of articles produced between 1994 and 2015. It was concluded that nursing should specialize for this new demand, which is growing more and more in our health services. We believe that nursing is specializing to enter this context and the expectations are good for the professionals and for the reception of the transsexual patient.

Keywords: transex, nursing, importance, patient

Procedia PDF Downloads 269

Authors: Emad A. S. Abu-Ayyash

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Cohesive devices, the linguistic tools that are usually employed to hold the different parts of the text together, have been the focus of a significant number of discourse analysis studies. These linguistic tools have grabbed the attention of researchers since the inception of the first and most comprehensive model of cohesion in 1976. However, it was noticed that some cohesive devices (e.g., endophoric reference, conjunctions, ellipsis, substitution, and lexical ties) – being thought of as more popular than others (e.g., exophoric reference) – were over-researched. The present paper explores the usage of two cohesive devices that have been evidently almost absent from discourse analysis studies. These cohesive devices are exophoric and homophoric references, the linguistic items that can be interpreted in terms of the physical and cultural contexts of discourse. The significance of the current paper, therefore, stems from the fact that it attempts to fill a gap in the research conducted so far on cohesive devices. This study provides an explanation of the concepts of the cohesive devices that have been employed in a plethora of research on cohesion and elucidates the relevant context-related concepts. The paper also identifies the gap in cohesive devices research. Exophora and homophora, the least visited cohesive devices in previous studies, were qualitatively and quantitatively explored in six opinion articles, four produced by eight postgraduate English as a Foreign Language (EFL) students in a university in the United Arab Emirates and two by professional NS writers in the Independent and the Guardian. The six pieces were about the United Kingdom Independent Party (UKIP) leader’s call to ban the burqa in the UK and were analysed vis-a-vis the employment and function of homophora and exophora. The study found that both EFL students and native speakers employed exophora and homophora considerably in their writing to serve a variety of functions, including building assumptions, supporting main ideas, and involving the readers among others.

Keywords: cohesive devices, context, culture, exophoric reference, homophoric reference

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Authors: Cassey Younghans

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Background: Current health care trends demonstrate that there is an increasing number of patients being hospitalized with complex comorbidities. These complex needs require advanced therapies, and treatment goals often focus on doing everything possible to prolong life rather than focusing on the individual patient’s quality of life which is the goal of palliative care efforts. Patients benefit from palliative care in the early stages of the illness rather than after the disease progressed or the state of acuity has advanced. The clinical problem identified was that palliative care was not being implemented early enough in the disease process with patients who had complex medical conditions and who would benefit from the philosophy and skills of palliative care professionals. Purpose: The purpose of this quality improvement study was to increase the number of palliative care screenings and consults completed on adults after being admitted to one Non-ICU and Non-COVID hospital unit. Methods: A retrospective chart review assessing for possible missed opportunities to introduce palliation was performed for patients with six primary diagnoses, including heart failure, liver failure, end stage renal disease, chronic obstructive pulmonary disease, cerebrovascular accident, and cancer in a population of adults over the ago of 19 on one medical-surgical unit over a three-month period prior to the intervention. An educational session with the nurses on the benefits of palliative care was conducted by the researcher, and a screening tool was implemented. The expected outcome was to have an increase in early palliative care consultation with patients with complex comorbid conditions and a decrease in missed opportunities for the implementation of palliative care. Another retrospective chart review was completed following completion of the three month piloting of the tool. Results: During the retrospective chart review, 46 patients were admitted to the medical-surgical floor with the primary diagnoses identified in the inclusion criteria. Six patients had palliative care consults completed during that time. Twenty-two palliative care screening tools were completed during the intervention period. Of those, 15 of the patients scored a 7 or higher, suggesting that a palliative care consultation was warranted. The final retrospective chart review identified that 4 palliative consults were implemented during that time of the 31 patients who were admitted over the three month time frame. Conclusion: Educating nurses and implementing a palliative care screening upon admission can be of great value in providing early identification of patients who might benefit from palliative care. Recommendations – It is recommended that this screening tool should be used to help identify the patents of whom would benefit from a palliative care consult, and nurses would be able to initiated a palliative care consultation themselves.

Keywords: palliative care, screening, early, palliative care consult

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Authors: Citlali Aguilera Lira, David Lynch Steinicke, Andrea León García

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One of the challenges that higher education faces is to find how to approach the sustainability in an inclusive way to the student within all the different academic areas, how to move the sustainable development from the abstract field to the operational field. This research comes from the ecoliteracy and the pedagogical praxis as tools for rebuilding the teaching processes inside of universities. The purpose is to determine and describe which are the factors involved in the process of learning particularly in the Greenhouse-School Siembra UV. In the Greenhouse-School Siembra UV, of the University of Veracruz, are cultivated vegetables, medicinal plants and small cornfields under the usage of eco-technologies such as hydroponics, Wickingbed and Hugelkultur, which main purpose is the saving of space, labor and natural resources, as well as function as agricultural production alternatives in the urban and periurban zones. The sample was formed with students from different academic areas and who are actively involved in the greenhouse, as well as institutes from the University of Veracruz and governmental and non-governmental departments. This project comes from a pedagogic praxis approach, from filling the needs that the different professional profiles of the university students have. All this with the purpose of generate a pragmatic dialogue with the sustainability. It also comes from the necessity to understand the factors that intervene in the students’ praxis. In this manner is how the students are the fundamental unit in the sphere of sustainability. As a result, it is observed that those University of Veracruz students who are involved in the Greenhouse-school, Siembra UV, have enriched in different levels the sense of urban and periurban agriculture because of the diverse academic approaches they have and the interaction between them. It is concluded that the eco-technologies act as fundamental tools for ecoliteracy in society, where it is strengthen the nutritional and food security from a sustainable development approach.

Keywords: farming eco-technologies, food security, multidisciplinary, pedagogical praxis

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Authors: Said Ahmed Zohairy

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Significant shifts in the theory and practice of teaching vocabulary affect teachers’ decisions about learning materials’ design. Relevant literature supports teaching specialised, authentic, and multi-word lexical items rather than focusing on single-word vocabulary lists. Corpora, collections of texts stored in a database, presents a reliable source of teaching and learning materials. Although corpus-informed studies provided guidance for teachers to identify useful language chunks and phraseological units, there is a scarcity in the literature discussing the use of corpora in teaching English for academic and specific purposes (EASP). The aim of this study is to improve teaching practices and provide a description of the pedagogical choices and procedures of an EASP tutor in an attempt to offer guidance for novice corpus users. It draws on the researcher’s experience of utilising corpus linguistic tools to design vocabulary learning activities without focusing on students’ learning outcomes. Hence, it adopts a self-study research methodology which is based on five methodological components suggested by other self-study researchers. The findings of the study noted that designing specialised and corpus-informed vocabulary learning activities could be challenging for teachers, as they require technical knowledge of how to navigate corpora and utilise corpus analysis tools. Findings also include a description of the researcher’s approach to building and analysing a specialised corpus for the benefit of novice corpus users; they should be able to start their own journey of designing corpus-based activities.

Keywords: corpora, corpus linguistics, corpus-informed, English for academic and specific purposes, agribusiness, vocabulary, phraseological units, materials design

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Authors: Svetlana Cojocaru, Mircea Petic, Inga Titchiev

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Humanity faces more and more often with different social disasters, which in turn can generate new accidents and catastrophes. To mitigate their consequences, it is important to obtain early possible signals about the events which are or can occur and to prepare the corresponding scenarios that could be applied. Our research is focused on solving two problems in this domain: identifying signals related that an accident occurred or may occur and mitigation of some consequences of disasters. To solve the first problem, methods of selecting and processing texts from global network Internet are developed. Information in Romanian is of special interest for us. In order to obtain the mentioned tools, we should follow several steps, divided into preparatory stage and processing stage. Throughout the first stage, we manually collected over 724 news articles and classified them into 10 categories of social disasters. It constitutes more than 150 thousand words. Using this information, a controlled vocabulary of more than 300 keywords was elaborated, that will help in the process of classification and identification of the texts related to the field of social disasters. To solve the second problem, the formalism of Petri net has been used. We deal with the problem of inhabitants’ evacuation in useful time. The analysis methods such as reachability or coverability tree and invariants technique to determine dynamic properties of the modeled systems will be used. To perform a case study of properties of extended evacuation system by adding time, the analysis modules of PIPE such as Generalized Stochastic Petri Nets (GSPN) Analysis, Simulation, State Space Analysis, and Invariant Analysis have been used. These modules helped us to obtain the average number of persons situated in the rooms and the other quantitative properties and characteristics related to its dynamics.

Keywords: lexicon of disasters, modelling, Petri nets, text annotation, social disasters

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Authors: Rihab Hamdi, Amel Hadri Hamida, Ouafae Bennis, Sakina Zerouali

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This paper features a performance analysis and robustness assessment of a digitally controlled DC-DC three-cell buck converter associated in parallel, operating in continuous conduction mode (CCM), facing feeding parameters variation and loads disturbance. The control strategy relies on the continuous-time with an averaged modeling technique for high-frequency switching converter. The methodology is to modulate the complete design procedure, in regard to the existence of an instantaneous current operating point for designing the digital closed-loop, to the same continuous-time domain. Moreover, the adopted approach is to include a digital voltage control (DVC) technique, taking an account for digital control delays and sampling effects, which aims at improving efficiency and dynamic response and preventing generally undesired phenomena. The results obtained under load change, input change, and reference change clearly demonstrates an excellent dynamic response of the proposed technique, also as provide stability in any operating conditions, the effectiveness is fast with a smooth tracking of the specified output voltage. Simulations studies in MATLAB/Simulink environment are performed to verify the concept.

Keywords: continuous conduction mode, digital control, parallel multi-cells converter, performance analysis, power electronics

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Authors: Nwafia Ifeyinwa Nkeiruka, Nwafia Walter Chukwuma

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Since the early 1980’s fungi have emerged as major causes of human diseases, especially among immunocompromised. The most commonly isolated yeast is Candida albicans and constitutes the 4th most common nosocomial BSI in humans. It is progressive and cumulative and become more complex over time.It can even lead to leaky gut syndrome that causes food and environmental allergies. It is worthy of note that all the available data on oral Candida risk factors in humans were documented essentially using data from studies conducted in other areas, hence there is need for comparative and complementary information from the South eastern part of Nigeria. Method: 200 subjects of all age groups of both sexes were randomly examined,by swabbing their palatine mucosa and dorsal tongue with sterile cotton wool,then cultured into Sabouraud dextrose agar plates supplemented with antibiotics and incubated aerobically at 37 degree for 48 hrs. Identification of Candida albicans was done by germ tubes tests, chlamydospores production on cornmeal agar supplemented with 1% Tween 80.Sugar and nitrogen assimilation test using API 20C Auxanogram and potassium nitrate agar. Results: Out of 30 samples that were positive for candida, 15 (50%) were candida albicans. Using the anova test (P < 0.05) this variation is significant (P = 0016). followed by C. dublinensis 3 (13%), C. tropicalis 3 (10%), C. pseudotropicalis 3 (10%), C, glabrata 2 (7%), C. parapsilosis 2 (7%) and lastly C. krusei 1 (3%).However, 53% of the patients were female while 47% were male. Among the HIV positive isolates.67% were HIV isolates not on drugs while 33% positives isolates were on drugs and the percentages of candida species in these patients were as follows C. albicans were 45% followed by C. glabrata and C.tropicalis which were 17% each, C.parapsilosis, C.dubliensis and C.pseudotropicalis were all 8% each. Conclusion: Oral Candidiasis is a marker of systemic diseases and in some cases, it may be the first clinical presentation. There is need for more intensive clinical and laboratory monitoring and possible early intervention to prevent the reoccurrence and resistance to treatment.

Keywords: oral cavity, Candida species, oral Candidiasis, risk factors

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Authors: Nathalie Bolding, Marta Montero, Joaquim Cevallos, Juan F. Martin-Lazaro

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Background: Inhaled epoprostenol (iEPO) have been shown to improve PaO2:FiO2 (PF) in combination with bronchodilators (BD). However, there is not an available device to deliver these two therapies concomitantly. We describe a new method to provide this therapy successfully. Objective: To evaluate the response to continuous nebulization of iEPO and intermittent nebulization of Salbutamol/Ipratropium bromide in adults with severe respiratory failure through a double mesh nebulisation in tandem. Methods: This observational study included two mechanical ventilated adults under hourly ventilatory, gasometrical and clinical measurements during 48h. Both had severe respiratory failure treated with continuous iEPO (50 – 200 micrograms/h) and BD (Salbutamol 2.5 mg and Ipratropium bromide 500 mcg every 6 hours) through double mesh nebulisation (Aerogen solo®) placed in tandem in the dry side of the humidificator. The primary endpoints were the variables associated with a positive response to this tandem nebulised therapy (PaFiO2 index, ROX index). Secondary endpoints were laboratory (ABG) clinical and ventilatory variables. Statistical analysis (SPSS v29) included linear regression and ANOVA. Results: The patients included (n=2) survived, both extubated, one after ECMO therapy. Severe acute respiratory failure had a positive response rate to continuous iEPO and intermittent BD: PaFiO2 increased (7.40 to 30.91; P75: 27%) as well as ROX index (2.91 to 11.43; P75: 33%). There was a linear correlation of improvement between iEPO with PaFiO2 (ANOVA, r=0.393, p<0.002) and ROX (r=0.419, p<0.001). iEPO+BD therapy did not show any complications. Conclusion: Continuous and intermittent mesh tandem nebulisation can be effectively delivered with this method with a positive effect in ventilatory parameters without observed complications. Randomised studies will be able to provide reassurance in this new therapy.

Keywords: tandem, mesh, nebulisers, pulmonary, vasoldilators, bronchodilators, respiratory, failure

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Authors: Demisash, Abate Getnet, Gudisa, Ababo Geleta, Daba, Berhane Olani

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As consumption trends of fish are rising in Ethiopia, assessment of the environmental performance of Fisheries becomes vital. Hence, Cleaner Production Assessment was conducted on Lake Tana No.1 Fish Supply Association. This paper focuses on determining the characteristics, quantity, and setting up cleaner production options for the site with the experimental investigation. The survey analysis showed that illegal waste dumping in Lake Tana is common practice in the area, and some of the main reasons raised were they have no option than doing this for dis-charging fish wastes. Quantifying a fish waste by examination of records at the point of generation resulted in a generation rate of 72,822.61 kg per year, which is a significant amount of waste and needs management system. The result of the proximate analysis showed high free fat content of about 12.33%, and this was a good candidate for the production of biodiesel that has been set as an option for fish waste utilization. Among the different waste management options, waste reduction by product optimization, which involves biodiesel production, was chosen as a potential method. Laboratory scale experiments were performed to produce a renewable energy source from the wastes. The resulting biodiesel was characterized and found to have a density of 0.756kg/L, viscosity 0.24p, and 153°C flashpoints, which shows the product has values in compliance with the American Society for Testing and Materials (ASTM) standards.

Keywords: biodiesel, cleaner production, renewable energy, waste management

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Authors: Hiromi Kawasaki, Satoko Yamasaki, Mika Iwasa, Tomoko Iki, Akiko Takaki

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In basic nursing, the conditions necessary for maintaining human health -temperature, humidity, illumination, distance from others, noise, moisture, meals, and excretion- were explained. Nursing students often think of these conditions in the context of a hospital room. In order to make students think of these conditions in terms of an environment necessary for maintaining health and preventing illness for residents, in the third year of community health nursing, students learned how to assess and improve the environment -particularly via the case of shelters in the event of a disaster. The importance of environmental management has increased in 2020 as a preventive measure against COVID-19 infection. We verified the effect of the lessons, which was decided to be conducted through distance learning. Sixty third-year nursing college students consented to participate in this study. Environmental standard knowledge for conducting environmental assessment was examined before and after class, and the percentage of correct answers was compared. The χ² test was used for the test, with a 5% significance level employed. Measures were evaluated via a report submitted by the students after class. Student descriptions were analyzed both qualitatively and descriptively with respect to expected health problems and suggestions for improvement. Students have already learned about the environment in terms of basic nursing in their second year. The correct answers for external environmental values concerning interpersonal distance, illumination, noise, and room temperature (p < 0.001) increased significantly after taking the class. Humidity was registered 83.3% before class and 93.3% after class (p = 0.077). Regarding the body, the percentage of students who answered correctly was 70% or more, both before and after the class. The students’ reports included overcrowding, high humidity/high temperature, and the number of toilets as health hazards. Health disorders to be prevented were heat stroke, infectious diseases, and economy class syndrome; improvement methods were recommended for hyperventilation, stretching, hydration, and waiting at home. After the public health nursing class, the students were able to not only propose environmental management of a hospital room but also had an understanding of the environment in terms of the lives of individuals, environmental assessment, and solutions to health problems. The response rate for basic items learned in the second year was already high before and after class, and interpersonal distance and ventilation were described by students. Students were able to use what they learned in basic nursing about the standards of the human mind and body. In the external environment, the memory of specific numerical values was ambiguous. The environment of the hospital room is controlled, and interest in numerical values may decrease. Nursing staff needs to maintain and improve human health as well as hospital rooms. With COVID-19, it was thought that students would continue to not only consider this point in reference to hospital rooms but also in regard to places where people gather. Even in distance learning, students were able to learn the important issues and lessons.

Keywords: environmental assessment, evacuation center, nursing education, nursing students

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Authors: Racha El Kadiri, Mohamed Sultan, Henrique Momm, Zachary Blair, Rachel Schultz, Tamer Al-Bayoumi

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The Mediterranean Basin is a very diverse region of nationalities and climate zones, with a strong dependence on agricultural activities. Predicting long term (with a lead of 1 to 12 months) rainfall, and future droughts could contribute in a sustainable management of water resources and economical activities. In this study, an integrated approach was adopted to construct predictive tools with lead times of 0 to 12 months to forecast rainfall amounts over nine subzones of the Mediterranean Basin region. The following steps were conducted: (1) acquire, assess and intercorrelate temporal remote sensing-based rainfall products (e.g. The CPC Merged Analysis of Precipitation [CMAP]) throughout the investigation period (1979 to 2016), (2) acquire and assess monthly values for all of the climatic indices influencing the regional and global climatic patterns (e.g., Northern Atlantic Oscillation [NOI], Southern Oscillation Index [SOI], and Tropical North Atlantic Index [TNA]); (3) delineate homogenous climatic regions and select nine pilot study zones, (4) apply data mining methods (e.g. neural networks, principal component analyses) to extract relationships between the observed rainfall and the controlling factors (i.e. climatic indices with multiple lead-time periods) and (5) use the constructed predictive tools to forecast monthly rainfall and dry and wet periods. Preliminary results indicate that rainfall and dry/wet periods were successfully predicted with lead zones of 0 to 12 months using the adopted methodology, and that the approach is more accurately applicable in the southern Mediterranean region.

Keywords: rainfall, neural networks, climatic indices, Mediterranean

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Authors: Esha Banerji

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This paper attempts an assessment of India's behaviour as a foreign policy actor amidst the COVID 19 pandemic by briefly surveying the various introductions and alterations made to India's foreign policy. First, the paper attempts to establish the key strategic pillars of Indian foreign policy after reviewing the existing works. It then proceeds to assess the prominent part played by Health Diplomacy ("Vaccine Maitri") in India's bilateral and multilateral relations during the pandemic and the role of the Indian diaspora in shaping India's foreign policy. This is followed by examining "India's Neighbourhood First policy" and the way it's been employed by the Indian government to extend India’s strategic influence during the pandemic. An empirical assessment will be done to examine the changing dynamics of India's relation with different regional groupings like SAARC, ASEAN, BIMSTEC, etc. The paper also explores the new alliances formed post-pandemic and India's role in them. This paper analyses the contemporary challenges that the largest nation in South Asia faces with the onset of a global pandemic and how Ancient Indian values like "Vasudhaiva Kutumbakam" have influenced India's foreign policy, especially during the pandemic. It also attempts to grasp the changes within the negotiation style of the Indian government, and the role played by various stakeholders in shaping India's position in the present geopolitical landscape. The study has been conducted using data collected from government records, External Affairs Ministry database, and other available literature. The paper concludes with an attempt to predict the far-reaching strategic implications that the policy, as mentioned above, may have for India.

Keywords: Indian foreign policy, COVID19, diplomacy, post pandemic world

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