Search results for: Greek public hospital sector
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10187

Search results for: Greek public hospital sector

7007 Private Decisions, Public Results: German Business Action in Response to the Refugee Crisis

Authors: O. M. van den Broek

Abstract:

This article examines how large German companies have responded to the 2014 refugee crisis. It challenges the assumption that the historical legacy of implicit CSR in Germany would lead to low levels of business response through CSR channels. Instead, and building on institutional CSR and the converging forces of globalization, this article argues that the urgency of a humanitarian crisis creates incentives, in the absence of formal institutional arrangement, for explicit CSR responses. This explorative research encompasses the 53 German companies presented on 2015 Forbes2000. A qualitative content analysis of corporate websites was supplemented with inquiry e-mails. Results indicate considerable evidence for the main hypothesis, showing a vast majority of companies responding to the refugee crisis. Levels of engagement varied, depending on the phase of the crisis, from core-business activities to non-integrated action. The high level of partnerships with the state and other non-state actors indicates a quest for enhanced legitimacy in the face of an absent democratic mandate.

Keywords: corporate social responsibility (CSR), implicit versus explicit CSR, public-private partnerships, European refugee crisis

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7006 Impact of Import Restriction on Rice Production in Nigeria

Authors: C. O. Igberi, M. U. Amadi

Abstract:

This research paper on the impact of import restriction on rice production in Nigeria is aimed at finding/proffering valid solutions to the age long problem of rice self-sufficiency, through a better understanding of policy measures used in the past, in this case, the effectiveness of rice import restriction of the early 90’s. It tries to answer the questions of; import restriction boosting domestic rice production and the macroeconomic determining factors of Gross Domestic Rice Product (GDRP). The research probe is investigated through literature and analytical frameworks, such that time series data on the GDRP, Gross Fixed Capital Formation (GFCF), average foreign rice producers’ prices(PPF), domestic producers’ prices (PPN) and the labour force (LABF) are collated for analysis (with an import restriction dummy variable, POL1). The research objectives/hypothesis are analysed using; Cointegration, Vector Error Correction Model (VECM), Impulse Response Function (IRF) and Granger Causality Test(GCT) methodologies. Results show that in the short-run error correction specification for GDRP, a percentage (1%) deviation away from the long-run equilibrium in a current quarter is only corrected by 0.14% in the subsequent quarter. Also, the rice import restriction policy had no significant effect on the GDRP at this time. Other findings show that the policy period has, in fact, had effects on the PPN and LABF. The choice variables used are valid macroeconomic factors that explain the GDRP of Nigeria, as adduced from the IRF and GCT, and in the long-run. Policy recommendations suggest that the import restriction is not disqualified as a veritable tool for improving domestic rice production, rather better enforcement procedures and strict adherence to the policy dictates is needed. Furthermore, accompanying policies which drive public and private capital investment and accumulation must be introduced. Also, employment rate and labour substitution in the agricultural sector should not be drastically changed, rather its welfare and efficiency be improved.

Keywords: import restriction, gross domestic rice production, cointegration, VECM, Granger causality, impulse response function

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7005 Adequate Dietary Intake to Improve Outcome of Urine: Urea Nitrogen with Balance Nitrogen and Total Lymphocyte Count

Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

Abstract:

The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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7004 Clinical Risk Score for Mortality and Predictors of Severe Disease in Adult Patients with Dengue

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

Abstract:

Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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7003 Sustainability as a Criterion in the Reconstruction of Libya’s Public Transport Infrastructure

Authors: Haitam Emhemad, Brian Agnew, David Greenwood

Abstract:

Amongst the many priorities facing Libya following the 2011 uprising is the provision of a transport infrastructure that will meet the nation’s needs and not undermine its prospects for economic prosperity as with many developing economies non-technical issues such as management, planning and financing are the major barriers to the efficient and effective provision of transport infrastructure. This is particularly true in the case of the effective incorporation of sustainability criteria, and the research upon which this paper is based involves the examination of alternative ways of approaching this problem. It is probably fair to say that criteria that relate to sustainability have not, historically, featured strongly in Libya’s approach to the development of its transport infrastructure. However, the current reappraisal of how best to redevelop the country’s transport infrastructure that has been afforded by recent events may offer the opportunity to alter this. The research examines recent case studies from a number of countries to explore ways in which sustainability has been included as a criterion for planning and procurement decisions. There will also be an in-depth investigation into the Libyan planning and legislative context to examine the feasibility of the introduction of such sustainability criteria into the process of planning and procurement of Libya’s transport infrastructure.

Keywords: Libya reconstruction, sustainability criteria, transport infrastructure, public transport

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7002 Using GIS and AHP Model to Explore the Parking Problem in Khomeinishahr

Authors: Davood Vatankhah, Reza Mokhtari Malekabadi, Mohsen Saghaei

Abstract:

Function of urban transportation systems depends on the existence of the required infrastructures, appropriate placement of different components, and the cooperation of these components with each other. Establishing various neighboring parking spaces in city neighborhood in order to prevent long-term and inappropriate parking of cars in the allies is one of the most effective operations in reducing the crowding and density of the neighborhoods. Every place with a certain application attracts a number of daily travels which happen throughout the city. A large percentage of the people visiting these places go to these travels by their own cars; therefore, they need a space to park their cars. The amount of this need depends on the usage function and travel demand of the place. The study aims at investigating the spatial distribution of the public parking spaces, determining the effective factors in locating, and their combination in GIS environment in Khomeinishahr of Isfahan city. Ultimately, the study intends to create an appropriate pattern for locating parking spaces, determining the request for parking spaces of the traffic areas, choosing the proper places for providing the required public parking spaces, and also proposing new spots in order to promote quality and quantity aspects of the city in terms of enjoying public parking spaces. Regarding the method, the study is based on applied purpose and regarding nature, it is analytic-descriptive. The population of the study includes people of the center of Khomeinishahr which is located on Northwest of Isfahan having about 5000 hectares of geographic area and the population of 241318 people are in the center of Komeinishahr. In order to determine the sample size, Cochran formula was used and according to the population of 26483 people of the studied area, 231 questionnaires were used. Data analysis was carried out by usage of SPSS software and after estimating the required space for parking spaces, initially, the effective criteria in locating the public parking spaces are weighted by the usage of Analytic Hierarchical Process in the Arc GIS software. Then, appropriate places for establishing parking spaces were determined by fuzzy method of Order Weighted Average (OWA). The results indicated that locating of parking spaces in Khomeinishahr have not been carried out appropriately and per capita of the parking spaces is not desirable in relation to the population and request; therefore, in addition to the present parking lots, 1434 parking lots are needed in the area of the study for each day; therefore, there is not a logical proportion between parking request and the number of parking lots in Khomeinishahr.

Keywords: GIS, locating, parking, khomeinishahr

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7001 Design and Implementation of an Affordable Electronic Medical Records in a Rural Healthcare Setting: A Qualitative Intrinsic Phenomenon Case Study

Authors: Nitika Sharma, Yogesh Jain

Abstract:

Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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7000 Simulation of Wind Generator with Fixed Wind Turbine under Matlab-Simulink

Authors: Mahdi Motahari, Mojtaba Farzaneh, Armin Parsian Nejad

Abstract:

The rapidly growing wind industry is highly expressing the need for education and training worldwide, particularly on the system level. Modelling and simulating wind generator system using Matlab-Simulink provides expert help in understanding wind systems engineering and system design. Working under Matlab-Simulink we present the integration of the developed WECS model with public electrical grid. A test of the calculated power and Cp related to the experimental equivalent data, using statistical analysis is performed. The statistical indicators of accuracy show better results of the presented method with RMSE: 21%, 22%, MBE : 0.77%, 0.12 % and MAE :3%, 4%.On the other hand we study its behavior when integrated in whole power system. Three level of wind speeds have been chosen: low with 5m/s as the mean value, medium with 8m/s as the mean value and high speed with 12m/s as the mean value. These allowed predicting and supervising the active power produced by the system, characterized respectively by the middle powers of -150 kW, -250kW and -480 kW which will be injected directly into the public electrical grid and the reactive power, characterized respectively by the middle powers of 60 kW, 180 kW and 320 kW and will be consumed by the wind generator.

Keywords: modelling, simulation, wind generator, fixed speed wind turbine, Matlab-Simulink

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6999 Resolution of Artificial Intelligence Language Translation Technique Alongside Microsoft Office Presentation during Classroom Teaching: A Case of Kampala International University in Tanzania

Authors: Abigaba Sophia

Abstract:

Artificial intelligence (AI) has transformed the education sector by revolutionizing educational frameworks by providing new opportunities and innovative advanced platforms for language translation during the teaching and learning process. In today's education sector, the primary key to scholarly communication is language; therefore, translation between different languages becomes vital in the process of communication. KIU-T being an International University, admits students from different nations speaking different languages, and English is the official language; some students find it hard to grasp a word during teaching and learning. This paper explores the practical aspect of using artificial intelligence technologies in an advanced language translation manner during teaching and learning. The impact of this technology is reflected in the education strategies to equip students with the necessary knowledge and skills for professional activity in the best way they understand. The researcher evaluated the demand for this practice since students have to apply the knowledge they acquire in their native language to their countries in the best way they understand. The main objective is to improve student's language competence and lay a solid foundation for their future professional development. A descriptive-analytic approach was deemed best for the study to investigate the phenomena of language translation intelligence alongside Microsoft Office during the teaching and learning process. The study analysed the responses of 345 students from different academic programs. Based on the findings, the researcher recommends using the artificial intelligence language translation technique during teaching, and this requires the wisdom of human content designers and educational experts. Lecturers and students will be trained in the basic knowledge of this technique to improve the effectiveness of teaching and learning to meet the student’s needs.

Keywords: artificial intelligence, language translation technique, teaching and learning process, Microsoft Office

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6998 Effectiveness of Visual Auditory Kinesthetic Tactile Technique on Reading Level among Dyslexic Children in Helikx Open School and Learning Centre, Salem

Authors: J. Mano Ranjini

Abstract:

Each and every child is special, born with a unique talent to explore this world. The word Dyslexia is derived from the Greek language in which “dys” meaning poor or inadequate and “lexis” meaning words or language. Dyslexia describes about a different kind of mind, which is often gifted and productive, that learns the concept differently. The main aim of the study is to bring the positive outcome of the reading level by examining the effectiveness of Visual Auditory Kinesthetic Tactile technique on Reading Level among Dyslexic Children at Helikx Open School and Learning Centre. A Quasi experimental one group pretest post test design was adopted for this study. The Reading Level was assessed by using the Schonell Graded Word Reading Test. Thirty subjects were drawn by using purposive sampling technique and the intervention Visual Auditory Kinesthetic Tactile technique was implemented to the Dyslexic Children for 30 consecutive days followed by the post Reading Level assessment revealed the improvement in the mean score value of reading level by 12%. Multi-sensory (VAKT) teaching uses all learning pathways in the brain (visual, auditory, kinesthetic-tactile) in order to enhance memory and learning and the ability in uplifting emotional, physical and societal dimensions. VAKT is an effective method to improve the reading skill of the Dyslexic Children that ensures the enormous significance of learning thereby influencing the wholesome of the child’s life.

Keywords: visual auditory kinesthetic tactile technique, reading level, dyslexic children, Helikx Open School

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6997 Media Coverage of Cervical Cancer in Malawi: A National Sample of Newspapers and a Radio Station

Authors: Elida Tafupenji Kamanga

Abstract:

Cancer of the cervix remains one of the high causes of death among Malawian women. Despite the government introduction of free screening services throughout the country, patronage still remains low and lack of knowledge high. Given the critical role mass media plays in relaying different information to the public including health and its influence on health behaviours, the study sought to analyse Malawi media coverage of the disease and its effectiveness. The findings of the study will help inform media advocacy directed at changing any coverage impeding the effective dissemination of cervical cancer message which consequently will help increase awareness and accessing of screening behaviours among women. A content analysis of 29 newspapers and promotional messages on cervical from a local radio station was conducted for the period from 2012 to 2015. Overall the results showed media coverage in terms of content and frequency increased for the four-year period. However, of concern was the quality of information both media presented to the public. The lapse in information provided means there is little education taking place through the media which could be contributing to the knowledge gap the women have thereby affecting their decision to screen. Also lack of adequate funding to media institutions and lack of collaboration between media institutions and stakeholders involved in the fight against the disease were noted as other contributing factors to low coverage of the disease. Designing messages that are not only informative and educative but also innovative may help increase awareness; improve the knowledge gap and potential adoption of preventive screening behaviour by Malawian women. Conversely, good communication between the media institutions and researchers involved in the fight against the disease through the channelling of new findings back to the public as well as increasing funding towards similar cause should be considered.

Keywords: cervical cancer, effectiveness, media coverage, screening

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6996 Thermodynamics Analysis of Transcritical HTHP Cycles Using Eco-Friendly Refrigerant and low-Grade Waste Heat Recovery: A Theoretical Evaluation

Authors: Adam Y. Sulaiman, Donal F. Cotter, Ming J. Huang, Neil J. Hewitt

Abstract:

Decarbonization of the industrial sector in developed countries has become indispensable for addressing climate change. Industrial processes including drying, distillation, and injection molding require a process heat exceeding 180°C, rendering the subcriticalHigh-Temperature heat pump(HTHP) technique unsuitable. A transcritical HTHP utilizing ecologically friendly working fluids is a highly recommended system that incorporates the features of high-energy efficiency, extended operational range, and decarbonizing the industrial sector. This paper delves into the possibility and feasibility of leveraging the HTTP system to provide up to 200°C of heat using R1233zd(E) as a working fluid. Using a steady-state model, various transcritical HTHP cycle configurations aretheoretically compared,analyzed, and evaluatedin this study. The heat transfer characteristics for the evaporator and gas cooler are investigated, as well as the cycle's energy, exergetic, and environmental performance. Using the LMTD method, the gas cooler's heat transfer coefficient, overall length, and heat transfer area were calculated. The findings indicate that the heat sink pressure level, as well as the waste heat temperature provided to the evaporator, have a significant impact on overall cycle performance. The investigation revealed the potential challenges and barriers, including the length of the gas cooler and the lubrication of the compression process. The basic transcritical HTTP cycle with additional IHX was demonstrated to be the most efficient cycle across a variety of heat source temperatures ranging from 70 to 90 °C based on theoretical energetic and exergetic performance.

Keywords: high-temperature heat pump, transcritical cycle, refrigerants, gas cooler, energy, exergy

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6995 An Empirical Diagnosis of the Maladies and Therapies of Budgeting in Nigeria

Authors: Ben-Caleb Egbide, Omolehinwa O. Eddy, Adeyemi S. Keyinde, Eriabie Sylvester, Ojeka Stephen

Abstract:

The national budget remains an integral part of the developmental plan of the economy of any country. The budget reflects the fundamental values underlying the government’s economic policies and objectives and whose execution is expected to realize national/public desires. In Nigeria, over three decades budget had failed to deliver the desired benefits, suggesting the existence of infractions, which are yet to be empirically ascertained. This paper attempts a diagnosis of the infractions peculiar to Nigeria budgetary system and their suggested panacea. Data were collected through the administration of questionnaire to a cross section of organizations/institutions representing government agencies and the general public. Mann-Whitney U test was employed to gauge the consistency in perception of the two groups. The result revealed that budget indiscipline, official corruption, allocative inefficiency and poor budget governance are the most influential infractions of budgeting in Nigeria. Consequently, it was suggested that budget transparency, target budgeting, zero tolerance on corruption and budget discipline are the most cogent therapies to the malfunctioning in Nigerian budgetary system.

Keywords: budgeting, budget maladies, budget therapies, Nigeria

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6994 An Exploration of Architecture Design Methods in Urban Fringe Belt Based on Typo-Morphological Research- A Case of Expansion Project of the Second Middle School in Xuancheng, China

Authors: Dong Yinan, Zhou Zijie

Abstract:

Urban fringe belt is an important part of urban morphology research. Different from the relatively fixed central district of city, the position of fringe belt is changing. In the process of urban expansion, the original fringe belt is likely to be merged by the new-built city, even become new city public center. During the change, we are facing the dialectic between restoring the organicity of old urban form and creating new urban image. There are lots of relevant research in urban scale, but when we focus on building scale, rare design method can be proposed, thus some new individual building cannot match the overall urban planning intent. The expansion project of the second middle school in Xuancheng is facing this situation. The existing campus is located in the south fringe belt of Xuancheng, Anhui province, China, adjacent to farmland and ponds. While based on the Xucheng urban planning, the farmland and ponds will be transformed into a big lake, around which new public center will be built; the expansion of the school becomes an important part of the boundary of the new public center. Therefore, the expansion project faces challenges from both urban and building scale. In urban scale, we analyze and summarize the fringe belt characters through the reading of existing and future urban organism, in order to determine the form of the expansion project. Meanwhile, in building scale, we study on different types of school buildings and select appropriate type which can satisfy to both urban form and school function. This research attempts to investigate design methods based on an under construction project in Xuancheng, a historic city in southeast China. It also aims to bridge the gap from urban design to individual building design through the typo-morphological research.

Keywords: design methods, urban fringe belt, typo-morphological research, middle school

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6993 Life Cycle Datasets for the Ornamental Stone Sector

Authors: Isabella Bianco, Gian Andrea Blengini

Abstract:

The environmental impact related to ornamental stones (such as marbles and granites) is largely debated. Starting from the industrial revolution, continuous improvements of machineries led to a higher exploitation of this natural resource and to a more international interaction between markets. As a consequence, the environmental impact of the extraction and processing of stones has increased. Nevertheless, if compared with other building materials, ornamental stones are generally more durable, natural, and recyclable. From the scientific point of view, studies on stone life cycle sustainability have been carried out, but these are often partial or not very significant because of the high percentage of approximations and assumptions in calculations. This is due to the lack, in life cycle databases (e.g. Ecoinvent, Thinkstep, and ELCD), of datasets about the specific technologies employed in the stone production chain. For example, databases do not contain information about diamond wires, chains or explosives, materials commonly used in quarries and transformation plants. The project presented in this paper aims to populate the life cycle databases with specific data of specific stone processes. To this goal, the methodology follows the standardized approach of Life Cycle Assessment (LCA), according to the requirements of UNI 14040-14044 and to the International Reference Life Cycle Data System (ILCD) Handbook guidelines of the European Commission. The study analyses the processes of the entire production chain (from-cradle-to-gate system boundaries), including the extraction of benches, the cutting of blocks into slabs/tiles and the surface finishing. Primary data have been collected in Italian quarries and transformation plants which use technologies representative of the current state-of-the-art. Since the technologies vary according to the hardness of the stone, the case studies comprehend both soft stones (marbles) and hard stones (gneiss). In particular, data about energy, materials and emissions were collected in marble basins of Carrara and in Beola and Serizzo basins located in the province of Verbano Cusio Ossola. Data were then elaborated through an appropriate software to build a life cycle model. The model was realized setting free parameters that allow an easy adaptation to specific productions. Through this model, the study aims to boost the direct participation of stone companies and encourage the use of LCA tool to assess and improve the stone sector environmental sustainability. At the same time, the realization of accurate Life Cycle Inventory data aims at making available, to researchers and stone experts, ILCD compliant datasets of the most significant processes and technologies related to the ornamental stone sector.

Keywords: life cycle assessment, LCA datasets, ornamental stone, stone environmental impact

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6992 Theoretical Analysis of the Existing Sheet Thickness in the Calendering of Pseudoplastic Material

Authors: Muhammad Zahid

Abstract:

The mechanical process of smoothing and compressing a molten material by passing it through a number of pairs of heated rolls in order to produce a sheet of desired thickness is called calendering. The rolls that are in combination are called calenders, a term derived from kylindros the Greek word for the cylinder. It infects the finishing process used on cloth, paper, textiles, leather cloth, or plastic film and so on. It is a mechanism which is used to strengthen surface properties, minimize sheet thickness, and yield special effects such as a glaze or polish. It has a wide variety of applications in industries in the manufacturing of textile fabrics, coated fabrics, and plastic sheeting to provide the desired surface finish and texture. An analysis has been presented for the calendering of Pseudoplastic material. The lubrication approximation theory (LAT) has been used to simplify the equations of motion. For the investigation of the nature of the steady solutions that exist, we make use of the combination of exact solution and numerical methods. The expressions for the velocity profile, rate of volumetric flow and pressure gradient are found in the form of exact solutions. Furthermore, the quantities of interest by engineering point of view, such as pressure distribution, roll-separating force, and power transmitted to the fluid by the rolls are also computed. Some results are shown graphically while others are given in the tabulated form. It is found that the non-Newtonian parameter and Reynolds number serve as the controlling parameters for the calendering process.

Keywords: calendering, exact solutions, lubrication approximation theory, numerical solutions, pseudoplastic material

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6991 Pooled Analysis of Three School-Based Obesity Interventions in a Metropolitan Area of Brazil

Authors: Rosely Sichieri, Bruna K. Hassan, Michele Sgambato, Barbara S. N. Souza, Rosangela A. Pereira, Edna M. Yokoo, Diana B. Cunha

Abstract:

Obesity is increasing at a fast rate in low and middle-income countries where few school-based obesity interventions have been conducted. Results of obesity prevention studies are still inconclusive mainly due to underestimation of sample size in cluster-randomized trials and overestimation of changes in body mass index (BMI). The pooled analysis in the present study overcomes these design problems by analyzing 4,448 students (mean age 11.7 years) from three randomized behavioral school-based interventions, conducted in public schools of the metropolitan area of Rio de Janeiro, Brazil. The three studies focused on encouraging students to change their drinking and eating habits over one school year, with monthly 1-h sessions in the classroom. Folders explaining the intervention program and suggesting the participation of the family, such as reducing the purchase of sodas were sent home. Classroom activities were delivered by research assistants in the first two interventions and by the regular teachers in the third one, except for culinary class aimed at developing cooking skills to increase healthy eating choices. The first intervention was conducted in 2005 with 1,140 fourth graders from 22 public schools; the second, with 644 fifth graders from 20 public schools in 2010; and the last one, with 2,743 fifth and sixth graders from 18 public schools in 2016. The result was a non-significant change in BMI after one school year of positive changes in dietary behaviors associated with obesity. Pooled intention-to-treat analysis using linear mixed models was used for the overall and subgroup analysis by BMI status, sex, and race. The estimated mean BMI changes were from 18.93 to 19.22 in the control group and from 18.89 to 19.19 in the intervention group; with a p-value of change over time of 0.94. Control and intervention groups were balanced at baseline. Subgroup analyses were statistically and clinically non-significant, except for the non-overweight/obese group with a 0.05 reduction of BMI comparing the intervention with control. In conclusion, this large pooled analysis showed a very small effect on BMI only in the normal weight students. The results are in line with many of the school-based initiatives that have been promising in relation to modifying behaviors associated with obesity but of no impact on excessive weight gain. Changes in BMI may require great changes in energy balance that are hard to achieve in primary prevention at school level.

Keywords: adolescents, obesity prevention, randomized controlled trials, school-based study

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6990 Impact of Radio on Rural Development: A Study of Ipokia Local Government Area, Nigeria

Authors: Haruna Shola Adeosun, Adeoye Odedeji

Abstract:

This paper examines the impact of radio on rural development. The researcher employed survey method to gather primary data. The objectives and questions were used from and hypotheses were formulated were raised from the statement of the problem. Cultivation theory was used as the theoretical study. The populations of the study were the inhabitant of Ipokia Local Government. Questionnaires were administered on the 400 respondents. Data gathered were analyzed, interpreted and hypotheses of the study were tested. The finding revealed that; radio has impacted on the rural dwellers and there is a significant relationship between radio and rural dwellers. Also, radio has brought socio-economic development on rural dwellers. The study recommended that radio messages should be designed in line with the pre-existing attitudes of the rural dwellers. It was also discovered that radio stations should endeavour to use local dialects especially when the radio programme is aimed at the rural dwellers that effective communication that can increase active participation of government and the public. Finally, the study recommends that radio stations should be well funded to produce programmes that would serve the purpose of educating and informing the public on issues relevant to them and there is need to establish community radio stations that will be closer to rural dwellers.

Keywords: impact, radio, rural, development

Procedia PDF Downloads 313
6989 Osteochondroma of Clivus: An Unusual Cause of Headache

Authors: Muhammad Faisal Khilji, Rana Shoaib Hamid, Asim Qureshi

Abstract:

A fifty years old female presented in the emergency department of a tertiary care hospital with complaints of migraine type headache for the last few months. Her last episode of headache was severe, increasing in intensity, associated with nausea but no fever, lasting more than 24 hours and not resolving with analgesics. On examination there was no neurological deficit. CT scan of brain showed a large Pedunculated, non-expansible, non-aggressive bony lesion in the clivus with its sharp fragment impinging into the pons. Findings were further confirmed with MRI brain. Trans-sphenoidal excision biopsy was done and histopathology proved the lesion to be osteochondroma of clivus.

Keywords: osteochondroma, clivus, headache, CT scan

Procedia PDF Downloads 417
6988 Angiographic Evaluation of ETT (Treadmill) Positive Patients in a Tertiary Care Hospital of Bangladesh

Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

Abstract:

Objective: To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. Methods: This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute,Dhaka,Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Results: Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87 ± 7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032)difference in the two groups(sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statically significant (p<0.004) and diabetic, dyslipidaemic patients having true positive which were statically significant (p < 0.032 & 0.030).True positive patients had family history were 68 (83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant(p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138)and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90%), followed by LCX 42 (51.85%), RCA 36 (44.44%) and the LMCA was 9 (11.11%), .40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. Conclusion: It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients,resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetis, dyslipidaemic, family history and smoking are likely to have a true positive treadmill test result.

Keywords: exercise tolerance test, coronary artery disease, coronary angiography, true positive, false positive

Procedia PDF Downloads 267
6987 Burnout Syndrome: A Study of Financial Professionals

Authors: Sara Santos, Maria João Santos

Abstract:

Thisarticleanalyzesthethemeofwork-family conflict and professional stress among financial workers and their relationships with burnout syndrome. This also studieshowthesocio demographicandworkingcharacteristicsoftheseprofessionalsinfluencetheirlevelsofburnout. Weadopted a mixedmethodbasedontheanalysisof 255 surveysand 24 interviewscarriedoutwith financial sector professionals. Thekeyresultsincludeverificationofhowtheseprofessionalsregister a positive relationshipbetweenwork-familyconflictandburnoutsyndrome as well as betweenprofessional stress andburnout. Thestudycontributes to a betterunderstandingoftheimpactsthatwork-familyconflictsandprofessional stress haveon financial professionalsandhowtheycontribute to thevariationsprevailingintheirrespectivelevelsofburnout.

Keywords: burnout syndrome, financial area, conflict, stres

Procedia PDF Downloads 204
6986 The Strategic Gas Aggregator: A Key Legal Intervention in an Evolving Nigerian Natural Gas Sector

Authors: Olanrewaju Aladeitan, Obiageli Phina Anaghara-Uzor

Abstract:

Despite the abundance of natural gas deposits in Nigeria and the immense potential, this presents both for the domestic and export oriented revenue, there exists an imbalance in the preference for export as against the development and optimal utilization of natural gas for the domestic industry. Considerable amounts of gas are still being wasted by flaring in the country to this day. Although the government has set in place initiatives to harness gas at the flare and thereby reduce volumes flared, the gas producers would rather direct the gas produced to the export market whereas gas apportioned to the domestic market is often marred by the low domestic gas price which is often discouraging to the gas producers. The exported fraction of gas production no doubt yields healthy revenues for the government and an encouraging return on investment for the gas producers and for this reason export sales remain enticing and preferable to the domestic sale of gas. This export pull impacts negatively if left unchecked, on the domestic market which is in no position to match the price at the international markets. The issue of gas price remains critical to the optimal development of the domestic gas industry, in that it comprises the basis for investment decisions of the producers on the allocation of their scarce resources and to what project to channel their output in order to maximize profit. In order then to rebalance the domestic industry and streamline the market for gas, the Gas Aggregation Company of Nigeria, also known as the Strategic Aggregator was proposed under the Nigerian Gas Master Plan of 2008 and then established pursuant to the National Gas Supply and Pricing Regulations of 2008 to implement the domestic gas supply obligation which focuses on ramping-up gas volumes for domestic utilization by mandatorily requiring each gas producer to dedicate a portion of its gas production for domestic utilization before having recourse to the export market. The 2008 Regulations further stipulate penalties in the event of non-compliance. This study, in the main, assesses the adequacy of the legal framework for the Nigerian Gas Industry, given that the operational laws are structured more for oil than its gas counterpart; examine the legal basis for the Strategic Aggregator in the light of the Domestic Gas Supply and Pricing Policy 2008 and the National Domestic Gas Supply and Pricing Regulations 2008 and makes a case for a review of the pivotal role of the Aggregator in the Nigerian Gas market. In undertaking this assessment, the doctrinal research methodology was adopted. Findings from research conducted reveal the reawakening of the Federal Government to the immense potential of its gas industry as a critical sector of its economy and the need for a sustainable domestic natural gas market. A case for the review of the ownership structure of the Aggregator to comprise a balanced mix of the Federal Government, gas producers and other key stakeholders in order to ensure the effective implementation of the domestic supply obligations becomes all the more imperative.

Keywords: domestic supply obligations, natural gas, Nigerian gas sector, strategic gas aggregator

Procedia PDF Downloads 212
6985 Using Geographic Information Systems to Trace Conditions for Young Women's Experiences of Public Spaces in Disadvantaged Neighborhoods

Authors: Alazar G. Ejigu

Abstract:

Cities have traditionally been designed for and by men. Despite positive changes in this regard, contemporary cities appear to offer limited options and experiences to women in their everyday life. There are differences regarding the quality of space. Distressed or disadvantaged areas often have less access to urban qualities, such as services, parks, and public places, than more privileged ones. The most attractive meeting-places are located centrally, whereas many suburban areas lack these elements. By focusing on young women living in multi-ethnic working-class suburban areas in Stockholm - a group generally ignored and disadvantaged; the study aims to examine various forms of inequality or equality in three selected neighborhoods. Spatial data was collected through walk-along with the young girls, inventory of the places, and geodata made available by Statistics Sweden (SCB). The combined data was analyzed with the help of Geographic Information Systems (GIS). In line with Crenshaw - one of the forerunners of intersectional thinking – the project departs from the idea that if we address the needs of those who are disadvantaged and restructure urban space accordingly, then others will benefit too. Thus, working our way towards a more equal city.

Keywords: GIS, segregation, gender equality, urban planning

Procedia PDF Downloads 128
6984 A Sociological Investigation on the Population and Public Spaces of Nguyen Cong Tru, a Soviet-Style Collective Housing Complex in Hanoi in Regards to Its New Community-Focused Architectural Design

Authors: Duy Nguyen Do, Bart Julien Dewancker

Abstract:

Many Soviet-style collective housing complexes (also known as KTT) were built since the 1960s in Hanoi to support the post-war population growth. Those low-rise buildings have created well-knitted, robust communities, so much to the point that in most complexes, all families in one housing block would know each other, occasionally interact and provide supports in need. To understand how the community of collective housing complexes have developed and maintained in order to adapt their advantages into modern housing designs, the study is executed on the site of Nguyen Cong Tru KTT. This is one of the oldest KTT in Hanoi, completed in 1954. The complex also has an unique characteristic that is closely related to its community: the symbiotic relationship with Hom – a flea market that has been co-developing with Nguyen Cong Tru KTT since its beginning. The research consists of three phases: the first phase is a sociological investigation with Nguyen Cong Tru KTT’s current residents and a site survey on the complex’s economic and architectural characteristics. In the second phase, the collected data is analyzed to find out people’s opinions with the KTT’s concerning their satisfaction with the current housing status, floor plan organization, community, the relationship between the KTT’s dedicated public spaces with the flea market and their usage. Simultaneously, the master plan and gathered information regarding current architectural characteristics of the complex are also inspected. On the third phase, the analyses’ results will provide information regarding the issues, positive trends and significant historical features of the complex’s architecture in order to generate suitable proposals for the redesigning project of Nguyen Cong Tru KTT, a design focused on vitalizing modern apartments’ communities.

Keywords: collective house community, collective house public space, community-focused, redesigning Nguyen Cong Tru KTT, sociological investigation

Procedia PDF Downloads 352
6983 Creating Smart and Healthy Cities by Exploring the Potentials of Emerging Technologies and Social Innovation for Urban Efficiency: Lessons from the Innovative City of Boston

Authors: Mohammed Agbali, Claudia Trillo, Yusuf Arayici, Terrence Fernando

Abstract:

The wide-spread adoption of the Smart City concept has introduced a new era of computing paradigm with opportunities for city administrators and stakeholders in various sectors to re-think the concept of urbanization and development of healthy cities. With the world population rapidly becoming urban-centric especially amongst the emerging economies, social innovation will assist greatly in deploying emerging technologies to address the development challenges in core sectors of the future cities. In this context, sustainable health-care delivery and improved quality of life of the people is considered at the heart of the healthy city agenda. This paper examines the Boston innovation landscape from the perspective of smart services and innovation ecosystem for sustainable development, especially in transportation and healthcare. It investigates the policy implementation process of the Healthy City agenda and eHealth economy innovation based on the experience of Massachusetts’s City of Boston initiatives. For this purpose, three emerging areas are emphasized, namely the eHealth concept, the innovation hubs, and the emerging technologies that drive innovation. This was carried out through empirical analysis on results of public sector and industry-wide interviews/survey about Boston’s current initiatives and the enabling environment. The paper highlights few potential research directions for service integration and social innovation for deploying emerging technologies in the healthy city agenda. The study therefore suggests the need to prioritize social innovation as an overarching strategy to build sustainable Smart Cities in order to avoid technology lock-in. Finally, it concludes that the Boston example of innovation economy is unique in view of the existing platforms for innovation and proper understanding of its dynamics, which is imperative in building smart and healthy cities where quality of life of the citizenry can be improved.

Keywords: computing paradigm, emerging technologies, equitable healthcare, healthy cities, open data, smart city, social innovation

Procedia PDF Downloads 329
6982 Rapid Detection of the Etiology of Infection as Bacterial or Viral Using Infrared Spectroscopy of White Blood Cells

Authors: Uraib Sharaha, Guy Beck, Joseph Kapelushnik, Adam H. Agbaria, Itshak Lapidot, Shaul Mordechai, Ahmad Salman, Mahmoud Huleihel

Abstract:

Infectious diseases cause a significant burden on the public health and the economic stability of societies all over the world for several centuries. A reliable detection of the causative agent of infection is not possible based on clinical features, since some of these infections have similar symptoms, including fever, sneezing, inflammation, vomiting, diarrhea, and fatigue. Moreover, physicians usually encounter difficulties in distinguishing between viral and bacterial infections based on symptoms. Therefore, there is an ongoing need for sensitive, specific, and rapid methods for identification of the etiology of the infection. This intricate issue perplex doctors and researchers since it has serious repercussions. In this study, we evaluated the potential of the mid-infrared spectroscopic method for rapid and reliable identification of bacterial and viral infections based on simple peripheral blood samples. Fourier transform infrared (FTIR) spectroscopy is considered a successful diagnostic method in the biological and medical fields. Many studies confirmed the great potential of the combination of FTIR spectroscopy and machine learning as a powerful diagnostic tool in medicine since it is a very sensitive method, which can detect and monitor the molecular and biochemical changes in biological samples. We believed that this method would play a major role in improving the health situation, raising the level of health in the community, and reducing the economic burdens in the health sector resulting from the indiscriminate use of antibiotics. We collected peripheral blood samples from young 364 patients, of which 93 were controls, 126 had bacterial infections, and 145 had viral infections, with ages lower than18 years old, limited to those who were diagnosed with fever-producing illness. Our preliminary results showed that it is possible to determine the infectious agent with high success rates of 82% for sensitivity and 80% for specificity, based on the WBC data.

Keywords: infectious diseases, (FTIR) spectroscopy, viral infections, bacterial infections.

Procedia PDF Downloads 127
6981 Occupational Health Services (OHS) in Hong Kong Hospitals and the Experience of Nurses: A Mixed Methods Study

Authors: Wong Yat Cheung Maggie

Abstract:

Occupational Safety and Health Ordinance (OS&HO) (Chap 509) was enacted in 1997, OHS in HK should be growing and maturing, with a holistic approach to occupational health and safety in the workplace including physical, mental, social and spiritual well-being. The question is “How effective are OHSPs in meeting the current needs of HK health workers?” This study was designed to explore the issue for the first time, to empirically analyse the views of those who work in the system. The study employed a mixed method approach to collect various data from Occupational Health Service Providers (OHSPs), Occupational Health Service Consumers (OHSC): Registered nurses working in the hospital setting. This study was designed in two phases and two stages. Phase I Stage I was a paper survey to collect the data on OHSP. Then Phase I Stage II was a follow-up interview. Phase II Stage I was a paper survey to collect the data on OHSC. Then Phase II Stage II was a follow-up focus group study on OHSC for further clarification of the Phase II and Stage I result. The Phase I result reflects HK OHSPs point of view and their experience in the existing OHS practice in the local hospitals. It reflects various styles of reporting systems, staff profiles background and resource in providing OHS in HK hospitals. However, the basic OHS concern is similar between hospitals. In general, the OHS policies and procedures are available on site even though they may have different foci. The Phase II result is reflecting the HKs OHSCs echoes the OHSP feedback at providing of OHS, OHS concern and related policies and procedure are available on site. However, the most significant feedback from the OHSC at Phase II Stage II shows, nurses experienced various OHS concern most commonly work stress, workplace harassment and back strain without formal or official report to the related parties. The lack of reporting was due to the management handling attitude, stakeholders’ compliance and term of definition still have room to be improved even the related policies and procedures are available on site.

Keywords: occupational health service, registered nurse, Hong Kong hospital, mixed method

Procedia PDF Downloads 325
6980 Commodity Factory or Food Farms an Irrational Dilemma: Reflections on the Brazilian Scenario

Authors: Monica Dantas

Abstract:

At what socio-economic costs can the food industry offer products at low prices? This research seeks to understand and to explore how we attribute competence and meaning, what enables the outcomes of agriculture and what institutions provides validation regarding food production. This study objective is to explain and interpret conditions of the present state of agriculture in Brazil centring on two distinct segments, agribusiness and family farming, as the Brazilian, rapidly changing political environment unfolds. The approach is grounded in multidisciplinary literature drawing from the politics of development, the sociology of food, the sustainability framework and the conceptual differences between agribusiness and family farming regarding the innate purpose of the two segments. In addition, a quantitative portion of the research includes secondary data analysis from statistical measurements, economic indicators, federal budget information, and census data to compare the two segments, conveying a general snapshot of the conditions investigated. The results raised questions about the perceived image of the success of agribusiness, against some contradicting economic checks and balances. Analyzing how public funds are invested in agriculture shed light on what can enable or undermine the development of food systems in Brazil. It also revealed how politics, ideology, and corporations might influence the Brazilian Federal. In the 2000-2018 observed timeline of annual federal spending on agriculture in Brazil, there is variation in the amount invested in family farming that seems to 'coincide' with the ideological direction of the federal government in power. It was also observed that significant changes in the institutional framework and financial support either promoted or purposely undermined family farming importance using public institutions to validate support for agribusiness.

Keywords: food politics, sustainability, family farming, food system, public budget

Procedia PDF Downloads 122
6979 Exploring Menstrual Disposal and Myths in Mumbai’s Slums through Filmmaking

Authors: Annika Agarwal, Sara Baumann

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The urbanization of Mumbai has loosened restrictions placed on Indian women while menstruating, like not praying or entering the kitchen, but it has also introduced sanitary issues. On one hand, residents use community toilets that lack water, electricity, doors, or disposal, making menstruation a communal issue. On the other hand, menstrual taboos perpetuate a culture of a dirty and clandestine menstrual experience. This dichotomy makes India the ideal location for public health research given the complexities of purity and pollution concepts in the Hindu tradition. This study asks: What are the attitudes, practices, and sources of knowledge production around menstrual disposal among men and women of different age groups in Dharavi? Using collaborative filmmaking (CF), researchers cocreated films on menstrual disposal with 20-30 women from 3 slum sites: Dharavi, Kandivali, and Kalwa. Results demonstrate 1) fear and availability issues around sustainable product use, 2) the prominence of certain myths and traditions, 3) lack of disposal facilities and clean toilets, and 4) a lack of discussion around periods with males. These factors jeopardize the health and safety for menstruating women.

Keywords: menstruation, sustainability, sanitation, public health, global health

Procedia PDF Downloads 48
6978 Assessing the Prevalence of Accidental Iatrogenic Paracetamol Overdose in Adult Hospital Patients Weighing <50kg: A Quality Improvement Project

Authors: Elisavet Arsenaki

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Paracetamol overdose is associated with significant and possibly permanent consequences including hepatotoxicity, acute and chronic liver failure, and death. This quality improvement project explores the prevalence of accidental iatrogenic paracetamol overdose in hospital patients with a low body weight, defined as <50kg and assesses the impact of educational posters in trying to reduce it. The study included all adult inpatients on the admissions ward, a short stay ward for patients requiring 12-72 hour treatment, and consisted of three cycles. Each cycle consisted of 3 days of data collection in a given month (data collection for cycle 1 occurred in January 2022, February 2022 for cycle 2 and March 2022 for cycle 3). All patients given paracetamol had their prescribed dose checked against their charted weight to identify the percentage of adult inpatients <50kg who were prescribed 1g of paracetamol instead of 500mg. In the first cycle of the audit, data were collected from 83 patients who were prescribed paracetamol on the admissions ward. Subsequently, four A4 educational posters were displayed across the ward, on two separate occasions and with a one-month interval in between each poster display. The aim of this was to remind prescribing doctors of their responsibility to check patient body weight prior to prescribing paracetamol. Data were collected again one week after each round of poster display, from 72 and 70 patients respectively. Over the 3 cycles with a cumulative 225 patients, 15 weighed <50kg (6.67%) and of those, 5 were incorrectly prescribed 1g of paracetamol, yielding a 33.3% prevalence of accidental iatrogenic paracetamol overdose in adult inpatients. In cycle 1 of the project, 3 out of 6 adult patients weighing <50kg were overdosed on paracetamol, meaning that 50% of low weight patients were prescribed the wrong dose of paracetamol for their weight. In the second data collection cycle, 1 out of 5 <50kg patients were overdosed (20%) and in the third cycle, 1 out of 4 (25%). The use of educational posters resulted in a lower prevalence of accidental iatrogenic paracetamol overdose in low body weight adult inpatients. However, the differences observed were statistically insignificant (p value 0.993 and 0.995 respectively). Educational posters did not induce a significant decrease in the prevalence of accidental iatrogenic paracetamol overdose. More robust strategies need to be employed to further decrease paracetamol overdose in patients weighing <50kg.

Keywords: iatrogenic, overdose, paracetamol, patient, safety

Procedia PDF Downloads 109