Search results for: efficiency analysis and selection bias

Authors: Shaine Mehta, Neelam Parmar, Patrick White, Mark Ashworth

Abstract:

Patients with a history of substance have a high prevalence of comorbidities, including asthma and chronic obstructive pulmonary disease (COPD). Mortality rates are higher than that of the general population and the link to respiratory disease is reported. Randomised controlled trials (RCTs) support opioid substitution therapy as an effective means for harm reduction. However, whilst a high proportion of patients receiving opioid substitution therapy are smokers, to the author’s best knowledge there have been no studies of respiratory disease and smoking intensity in these patients. A cross sectional prevalence study was conducted using an anonymised patient-level database in primary care, Lambeth DataNet (LDN). We included patients aged 18 years and over who had records of ever having been prescribed methadone in primary care. Patients under 18 years old or prescribed buprenorphine (because of uncertainty about the prescribing indication) were excluded. Demographic, smoking, alcohol and asthma and COPD coding data were extracted. Differences between methadone and non-methadone users were explored with multivariable analysis. LDN contained data on 321, 395 patients ≥ 18 years; 676 (0.16%) had a record of methadone prescription. Patients prescribed methadone were more likely to be male (70.7% vs. 50.4%), older (48.9yrs vs. 41.5yrs) and less likely to be from an ethnic minority group (South Asian 2.1% vs. 7.8%; Black African 8.9% vs. 21.4%). Almost all those prescribed methadone were smokers or ex-smokers (97.3% vs. 40.9%); more were non-alcohol drinkers (41.3% vs. 24.3%). We found a high prevalence of COPD (12.4% vs 1.4%) and asthma (14.2% vs 4.4%). Smoking intensity data shows a high prevalence of ≥ 20 cigarettes per day (21.5% vs. 13.1%). Risk of COPD, adjusted for age, gender, ethnicity and deprivation, was raised in smokers: odds ratio 14.81 (95%CI 11.26, 19.47), and in the methadone group: OR 7.51 (95%CI: 5.78, 9.77). Furthermore, after adjustment for smoking intensity (number of cigarettes/day), the risk was raised in methadone group: OR 4.77 (95%CI: 3.13, 7.28). High burden of respiratory disease compounded by the high rates of smoking is a public health concern. This supports an integrated approach to health in patients treated for opiate dependence, with access to smoking cessation support. Further work may evaluate the current structure and commissioning of substance misuse services, including smoking cessation. Regression modelling highlights that methadone as a ‘risk factor’ was independently associated with COPD prevalence, even after adjustment for smoking intensity. This merits further exploration, as the association may be related to unexplored aspects of smoking (such as the number of years smoked) or may be related to other related exposures, such as smoking heroin or crack cocaine.

Keywords: methadone, respiratory disease, smoking cessation, substance misuse

Procedia PDF Downloads 147

Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

Abstract:

In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

Procedia PDF Downloads 102

Authors: Nothando Gwazani, K. R. Marembo

Abstract:

An increase in the atmospheric concentration of carbon dioxide (CO₂) from fossil fuel and land use change necessitates identification of strategies for mitigating threats associated with global warming. Oceans are insufficient to offset the accelerating rate of carbon emission. However, the challenges of oceans as a source of reducing carbon footprint can be effectively overcome by the storage of carbon in terrestrial carbon sinks. The gases with special optical properties that are responsible for climate warming include carbon dioxide (CO₂), water vapors, methane (CH₄), nitrous oxide (N₂O), nitrogen oxides (NOₓ), stratospheric ozone (O₃), carbon monoxide (CO) and chlorofluorocarbons (CFC’s). Amongst these, CO₂ plays a crucial role as it contributes to 50% of the total greenhouse effect and has been linked to climate change. Because plants act as carbon sinks, interest in terrestrial carbon sequestration has increased in an effort to explore opportunities for climate change mitigation. Removal of carbon from the atmosphere is a topical issue that addresses one important aspect of an overall strategy for carbon management namely to help mitigate the increasing emissions of CO₂. Thus, terrestrial ecosystems have gained importance for their potential to sequester carbon and reduce carbon sink in oceans, which have a substantial impact on the ocean species. Field data and electromagnetic spectrum bands were analyzed using ArcGIS 10.2, QGIS 2.8 and ERDAS IMAGINE 2015 to examine the vegetation distribution. Satellite remote sensing data coupled with Normalized Difference Vegetation Index (NDVI) was employed to assess future potential changes in vegetation distributions in Eastern Cape Province of South Africa. The observed 5-year interval analysis examines the amount of carbon absorbed using vegetation distribution. In 2015, the numerical results showed low vegetation distribution, therefore increased the acidity of the oceans and gravely affected fish species and corals. The outcomes suggest that the study area could be effectively utilized for carbon sequestration so as to mitigate ocean acidification. The vegetation changes measured through this investigation suggest an environmental shift and reduced vegetation carbon sink, and that threatens biodiversity and ecosystem. In order to sustain the amount of carbon in the terrestrial ecosystems, the identified ecological factors should be enhanced through the application of good land and forest management practices. This will increase the carbon stock of terrestrial ecosystems thereby reducing direct loss to the atmosphere.

Keywords: remote sensing, vegetation dynamics, carbon sequestration, terrestrial carbon sink

Procedia PDF Downloads 155

Authors: Steven Hidalgo, Patricio Neumann

Abstract:

The growth of societies has increased the consumption of raw materials and food obtained from nature. This has influenced the services offered by ecosystems to humans, mainly supply and regulation services. One of the indicators used to evaluate these services is Net Primary Productivity (NPP), which is understood as the energy stored in the form of biomass by primary organisms through the process of photosynthesis and respiration. The variation of NPP by defined area produces changes in the properties of terrestrial and aquatic ecosystems, which alter factors such as biodiversity, nutrient cycling, carbon storage and water quality. The analysis of NPP to evaluate variations in ecosystem services includes harvested NPP (understood as provisioning services), which is the raw material from agricultural systems used by humans as a source of energy and food, and the remaining NPP (expressed as a regulating service) or the amount of biomass that remains in ecosystems after the harvesting process, which is mainly related to factors such as biodiversity. Given that agriculture is a fundamental pillar of Chile's integral development, the purpose of this study is to evaluate provisioning and regulating ecosystem services in the agricultural sector, specifically in cereal production, in the communes of the central-southern regions of Chile through a conceptual framework based on the quantification of the fraction of Human Appropriation of Net Primary Productivity (HANPP) and the fraction remaining in the ecosystems (NPP remaining). A total of 161 communes were analyzed in the regions of O'Higgins, Maule, Ñuble, Bio-Bío, La Araucanía and Los Lagos, which are characterized by having the largest areas planted with cereals. It was observed that the region of La Araucanía produces the greatest amount of dry matter, understood as provisioning service, where Victoria is the commune with the highest cereal production in the country. In addition, the maximum value of HANPP was in the O'Higgins region, highlighting the communes of Coltauco, Quinta de Tilcoco, Placilla and Rengo. On the other hand, the communes of Futrono, Pinto, Lago Ranco and Pemuco, whose cereal production was important during the study, had the highest values of remaining NPP as a regulating service. Finally, an inverse correlation was observed between the provisioning and regulating ecosystem services, i.e., the higher the cereal or dry matter production in a defined area, the lower the net primary production remaining in the ecosystems. Based on this study, future research will focus on the evaluation of ecosystem services associated with other crops, such as forestry plantations, whose activity is an important part of the country's productive sector.

Keywords: provisioning services, regulating services, net primary productivity, agriculture

Procedia PDF Downloads 102

Authors: Mishadi Herath, Amin Talei, Andreas Hermawan, Clarina Chua

Abstract:

Green walls are vegetated structures on building’s wall that are considered as part of sustainable urban design. They are proved to have many micro-climate benefits such as reduction in indoor temperature, noise attenuation, and improvement in air quality. On the other hand, several studies have also been conducted on potential reuse of greywater in urban water management. Greywater is relatively clean when compared to blackwater; therefore, this study was aimed to assess the potential reuse of it for irrigating a green wall system. In this study, the campus of Monash University Malaysia located in Selangor state was considered as the study site where total 48 samples of greywater were collected from 7 toilets hand-wash and 5 pantries during 3 months period. The samples were tested to characterize the quality of greywater in the study site and compare it with local standard for irrigation water. PH and concentration of heavy metals, nutrients, Total Suspended Solids (TSS), Biochemical Oxygen Demand (BOD), Chemical Oxygen Demand (COD), total Coliform and E.coli were measured. Results showed that greywater could be directly used for irrigation with minimal treatment. Since the effluent of the system was supposed to be drained to stormwater drainage system, the effluent needed to meet certain quality requirement. Therefore, a biofiltration system was proposed to host the green wall plants and also treat the greywater (which is used as irrigation water) to the required level. To assess the performance of the proposed system, an experimental setup consisting of Polyvinyl Chloride (PVC) soil columns with sand-based filter media were prepared. Two different local creeper plants were chosen considering several factors including fast growth, low maintenance requirement, and aesthetic aspects. Three replicates of each plants were used to ensure the validity of the findings. The growth of creeping plants and their survivability was monitored for 6 months while monthly sampling and testing of effluent was conducted to evaluate effluent quality. An analysis was also conducted to estimate the potential cost and benefit of such system considering water and energy saving in the system. Results showed that the proposed system can work efficiently throughout a long period of time with minimal maintenance requirement. Moreover, the biofiltration-green wall system was found to be successful in reusing greywater as irrigating water while the effluent was meeting all the requirements for being drained to stormwater drainage system.

Keywords: biofiltration, green wall, greywater, sustainability

Procedia PDF Downloads 215

Authors: Jiayue Guo, Lili You

Abstract:

Background: Children and adolescent health are crucial for both personal well-being and the nation's future health landscape. Health Literacy (HL) is important in enabling adolescents to self-manage their health, a fundamental step towards health empowerment. However, there are limited tools for assessing HL among elementary and junior high school students. This study aims to construct and validate a test-based HL scale for Chinese students, offering a scientific reference for cross-cultural HL tool development. Methods: We conducted a cross-sectional online survey. Participants were recruited from a stratified cluster random sampling method, a total of 4189 Chinese in-school primary and secondary students. The development of the scale was completed by defining the concept of HL, establishing the item indicator system, screening items (7 health content dimensions), and evaluating reliability and validity. Delphi method expert consultation was used to screen items, the Rasch model was conducted for quality analysis, and Cronbach’s alpha coefficient was used to examine the internal consistency. Results: We developed four versions of the HL scale, each with a total score of 100, encompassing seven key health areas: hygiene, nutrition, physical activity, mental health, disease prevention, safety awareness, and digital health literacy. Each version measures four dimensions of health competencies: knowledge, skills, motivation, and behavior. After the second round of expert consultation, the average importance score of each item by experts is 4.5–5.0, and the coefficient of variation is 0.000–0.174. The knowledge and skills dimensions are judgment-based and multiple-choice questions, with the Rasch model confirming unidimensionality at a 5.7% residual variance. The behavioral and motivational dimensions, measured with scale-type items, demonstrated internal consistency via Cronbach's alpha and strong inter-item correlation with KMO values of 0.924 and 0.787, respectively. Bartlett's test of sphericity, with p-values <0.001, further substantiates the scale's reliability. Conclusions: The new test-based scale, designed to evaluate competencies within a multifaceted framework, aligns with current international adolescent literacy theories and China's health education policies, focusing not only on knowledge acquisition but also on the application of health-related thinking and behaviors. The scale can be used as a comprehensive tool for HL evaluation and a reference for other countries.

Keywords: adolescent health, Chinese, health literacy, rasch model, scale development

Procedia PDF Downloads 31

Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal

Abstract:

Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.

Keywords: migrants, migrant service delivery system, risk, vulnerability

Procedia PDF Downloads 272

Authors: Paolo Grasso, Sai Kalyan Yelike, Federico Benzi, Mathieu Le Cam

Abstract:

The cabin air quality (CAQ) in commercial aircraft is of prime interest, especially in the context of the COVID-19 pandemic. Current Environmental Control Systems (ECS) rely on a prescribed fresh airflow per passenger to dilute contaminants. An adaptive ECS strategy is proposed, leveraging air sensing and filtration technologies to ensure a better CAQ. This paper investigates the CAQ level achieved in commercial aircraft’s cabin during various flight scenarios. The modeling and simulation analysis is performed in a Modelica-based environment describing the dynamic behavior of the system. The model includes the following three main systems: cabin, recirculation loop and air-conditioning pack. The cabin model evaluates the thermo-hygrometric conditions and the air quality in the cabin depending on the number of passengers and crew members, the outdoor conditions and the conditions of the air supplied to the cabin. The recirculation loop includes models of the recirculation fan, ordinary and novel filtration technology, mixing chamber and outflow valve. The air-conditioning pack includes models of heat exchangers and turbomachinery needed to condition the hot pressurized air bled from the engine, as well as selected contaminants originated from the outside or bled from the engine. Different ventilation control strategies are modeled and simulated. Currently, a limited understanding of contaminant concentrations in the cabin and the lack of standardized and systematic methods to collect and record data constitute a challenge in establishing a causal relationship between CAQ and passengers' comfort. As a result, contaminants are neither measured nor filtered during flight, and the current sub-optimal way to avoid their accumulation is their dilution with the fresh air flow. However, the use of a prescribed amount of fresh air comes with a cost, making the ECS the most energy-demanding non-propulsive system within an aircraft. In such a context, this study shows that an ECS based on a reduced and adaptive fresh air flow, and relying on air sensing and filtration technologies, provides promising results in terms of CAQ control. The comparative simulation results demonstrate that the proposed adaptive ECS brings substantial improvements to the CAQ in terms of both controlling the asymptotic values of the concentration of the contaminant and in mitigating hazardous scenarios, such as fume events. Original architectures allowing for adaptive control of the inlet air flow rate based on monitored CAQ will change the requirements for filtration systems and redefine the ECS operation.

Keywords: cabin air quality, commercial aircraft, environmental control system, ventilation

Procedia PDF Downloads 105

Authors: Sanjeeb Kumar Mishra, Aartee Jha, Madhu Thapa, Pragati Gautam

Abstract:

Introduction: High myopia has become a matter of global concern as it is a major risk factor for glaucoma. Various optic nerve head changes occur in high myopia over time. This might lead to difficulty in detecting pathologies associated with high myopia through conventional funduscopy examinations only. Bruch’s Membrane Opening (Area and Minimum Rim Width) is considered an anatomically more accurate and reliable landmark than the conventional clinical disc margin. Study Design: It was a hospital based cross-sectional and non-interventional type of study. Purpose: The purpose of our study was to measure Bruch’s Membrane Opening (area and Minimum Rim Width) in high myopic eyes and correlate it with axial length. Methods: A cross-sectional study was conducted at B.P Koirala Lions Center for Ophthalmic Studies, a tertiary-level eye center in Nepal. 80 eyes of 40 subjects (40% male and 60% female) aged 18-35 years with high myopia (Spherical Equivalent (SE) ≥ -6D) were taken as cases. Among them, RE of 39 and LE of 34 myopic subjects were included in the study. Spectral Domain-Optical Coherence Tomography of both the eyes of myopic patients was performed using Glaucoma Module Premiere Edition (GMPE) with Anatomic Positioning System (APS) to measure Bruch’s Membrane Opening (Area and Minimum Rim Width). Axial length in myopic patients was measured using Partial Coherence Interferometry (IOL Master). Results: Among 40 myopic subjects, 16 (40%) were males, whereas 24 (60%) were females. The mean age of myopic subjects was 24.64 ± 5.10 years, with minimum and maximum ages of 18 years and 35 years, respectively. The mean BMO area was 2.28 0.48 mm² in right eye and 2.15 0.59 mm² in left eye. BMO area in high myopic patient was significantly correlated with axial length. The correlation analysis of BMO area with axial length in RE and LE was found to be statistically significant at (r=0.465, p<0.003) and (r=0.374, p< 0.029), respectively. Likewise, the mean BMO-MRW was 325.69 ± 96µm in right eye and 339.20 ± 79.50µm in left eye. There was a significant correlation of BMO-MRW with axial length in both the eyes of myopic subjects. Moreover, a significant negative correlation of Inferior temporal, Nasal, and Inferior nasal quadrants (p<0.05) of BMO-MRW of right eye was found with axial length of right eye, whereas all the BMO-MRW quadrants of left eye were negatively correlated (p<0.05) with axial length in left eye. No significant differences were found between right eye and left eye on comparing means of refractive error, axial length, BMO area, and BMO-MRW. Conclusion: From this study, it can be concluded that BMO area enlarges in high myopia with an increase in axial length. Additionally, BMO-MRW thinning occurs along with the BMO enlargement and increases with axial length. There were no significant differences in refractive error, axial length, BMO area, and BMO-MRW between right eye and left eye.

Keywords: high myopia, Bruch’s membrane opening, Bruch’s membrane opening minimum rim width, spectral domain optical coherence tomography

Procedia PDF Downloads 23

Authors: Taru Hakanen, Mervi Murtonen

Abstract:

This study aims to increase understanding of the transition of business models in servitization. The significance of service in all business has increased dramatically during the past decades. Service-dominant logic (SDL) describes this change in the economy and questions the goods-dominant logic on which business has primarily been based in the past. A business model canvas is one of the most cited and used tools in defining end developing business models. The starting point of this paper lies in the notion that the traditional business model canvas is inherently goods-oriented and best suits for product-based business. However, the basic differences between goods and services necessitate changes in business model representations when proceeding in servitization. Therefore, new knowledge is needed on how the conception of business model and the business model canvas as its representation should be altered in servitized firms in order to better serve business developers and inter-firm co-creation. That is to say, compared to products, services are intangible and they are co-produced between the supplier and the customer. Value is always co-created in interaction between a supplier and a customer, and customer experience primarily depends on how well the interaction succeeds between the actors. The role of service experience is even stronger in service business compared to product business, as services are co-produced with the customer. This paper provides business model developers with a service business model canvas, which takes into account the intangible, interactive, and relational nature of service. The study employs a design science approach that contributes to theory development via design artifacts. This study utilizes qualitative data gathered in workshops with ten companies from various industries. In particular, key differences between Goods-dominant logic (GDL) and SDL-based business models are identified when an industrial firm proceeds in servitization. As the result of the study, an updated version of the business model canvas is provided based on service-dominant logic. The service business model canvas ensures a stronger customer focus and includes aspects salient for services, such as interaction between companies, service co-production, and customer experience. It can be used for the analysis and development of a current service business model of a company or for designing a new business model. It facilitates customer-focused new service design and service development. It aids in the identification of development needs, and facilitates the creation of a common view of the business model. Therefore, the service business model canvas can be regarded as a boundary object, which facilitates the creation of a common understanding of the business model between several actors involved. The study contributes to the business model and service business development disciplines by providing a managerial tool for practitioners in service development. It also provides research insight into how servitization challenges companies’ business models.

Keywords: boundary object, business model canvas, managerial tool, service-dominant logic

Procedia PDF Downloads 370

Authors: Edna T. Bernabe, Joshua Bilolo, Sheila Mae Artillero, Catlicia Joy Caseda, Liezel Once, Donne Ynah Grace Quirante

Abstract:

Internal communication is significant for an organization to function to its full extent. A strategic communication plan builds an organization’s structure and makes it more systematic. Information is a vital part of communication inside the organization as this lays every possible outcome—be it positive or negative. It is, therefore, imperative to assess the communication structure of a particular organization to secure a better and harmonious communication environment in any organization. Thus, this research was intended to identify the internal communication channels used in Polytechnic University of the Philippines-College of Communication (PUP-COC) as an organization, to identify the flow of information specifically in downward, upward, and horizontal communication, to assess the accuracy, consistency, and timeliness of its internal communication channels; and to come up with a proposed strategic communication plan of information dissemination to improve the existing communication flow in the college. The researchers formulated a framework from Input-Throughout-Output-Feedback-Goal of General System Theory and gathered data to assess the PUP-COC’s internal communication. The communication model links the objectives of the study to know the internal organization of the college. The qualitative approach and case study as the tradition of inquiry were used to gather deeper understanding of the internal organizational communication in PUP-COC, using Interview, as the primary methods for the study. This was supported with a quantitative data which were gathered through survey from the students of the college. The researchers interviewed 17 participants: the College dean, the 4 chairpersons of the college departments, the 11 faculty members and staff, and the acting Student Council president. An interview guide and a standardized questionnaire were formulated as instruments to generate the data. After a thorough analysis of the study, it was found out that two-way communication flow exists in PUP-COC. The type of communication channel the internal stakeholders use varies as to whom a particular person is communicating with. The members of the PUP-COC community also use different types of communication channels depending on the flow of communication being used. Moreover, the most common types of internal communication are the letters and memoranda for downward communication, while letters, text messages, and interpersonal communication are often used in upward communication. Various forms of social media have been found out to be of use in horizontal communication. Accuracy, consistency, and timeliness play a significant role in information dissemination within the college. However, some problems have also been found out in the communication system. The most common problem are the delay in the dissemination of memoranda and letters and the uneven distribution of information and instruction to faculty, staff, and students. This has led the researchers to formulate a strategic communication plan which aims to propose strategies that will solve the communication problems that are being experienced by the internal stakeholders.

Keywords: communication plan, downward communication, internal communication, upward communication

Procedia PDF Downloads 521

Authors: Tannia Vindel, Angel Matute, Erik Elvir, Kelvin Santos

Abstract:

Currently in Honduras, is been incentivized the generation of energy using renewable fonts, such as: hydroelectricity, wind power, biomass and, more recently with the strongest growth, photovoltaic energy. In July 2015 were installed 455.2 MW of photovoltaic energy, increasing by 24% the installed capacity of the national interconnected system existing in 2014, according the National Energy Company (NEC), that made possible reduce the thermoelectric dependency of the system. Given the good results of those large-scale photovoltaic plants, arises the question: is it interesting for the distribution utility and for the consumers the integration of photovoltaic systems in micro-scale in the urban and rural areas? To answer that question has been researched the insertion of photovoltaic energy in the residential sector in Tegucigalpa and Comayagüela (Central District), Honduras to determine the technical and economic viability. Francisco Morazán department, according the National Statistics Institute (NSI), in 2001 had more than 180,000 houses with power service. Tegucigalpa, department and Honduras capital, and Comayagüela, both, have the highest population density in the region, with 1,300,000 habitants in 2014 (NSI). The residential sector in the south-central region of Honduras represents a high percentage being 49% of total consumption, according with NEC in 2014; where 90% of this sector consumes in a range of 0 to 300 kWh / month. All this, in addition to the high level of losses in the transmission and distribution systems, 31.3% in 2014, and the availability of an annual average solar radiation of 5.20 kWh/(m2∙day) according to the NASA, suggests the feasibility of the implementation of photovoltaic systems as a solution to give a level of independency to the households, and besides could be capable of injecting the non-used energy to the grid. The capability of exchange of energy with the grid could make the photovoltaic systems acquisition more affordable to the consumers, because of the compensation energy programs or other kinds of incentives that could be created. Technical viability of the photovoltaic systems insertion has been analyzed, considering the solar radiation monthly average to determine the monthly average of energy that would be generated with the technology accessible locally and the effects of the injection of the energy locally generated on the grid. In addition, the economic viability has been analyzed too, considering the photovoltaic systems high costs, costs of the utility, location and monthly energy consumption requirements of the families. It was found that the inclusion of photovoltaic systems in Tegucigalpa and Comayagüela could decrease in 6 MW the demand for the region if 100% of the households use photovoltaic systems, which acquisition may be more accessible with the help of government incentives and/or the application of energy exchange programs.

Keywords: grid connected, photovoltaic, residential, technical analysis

Procedia PDF Downloads 266

Authors: Chandragouda R. Patil, K. S. Jagadeesh, S. D. Kalolgi

Abstract:

Biofertilizers containing live microbial cells can mobilize one or more nutrients to plants when applied to either seed or rhizosphere. They form an integral part of nutrient management strategies for sustainable production of agricultural crops. Annually, about 22 tons of lignite-based biofertilizers are being produced and supplied to farmers at the Institute of Organic Farming, University of Agricultural Sciences, Dharwad, Karnataka state India. Although carrier based biofertilizers are common, they have shorter shelf life, poor quality, high contamination, unpredictable field performance and high cost of solid carriers. Hence, liquid formulations are being developed to increase their efficacy and broaden field applicability. An attempt was made to develop liquid formulation of strains of Rhizobium NC-92 (Groundnut), Azospirillum ACD15 both nitrogen-fixing biofertilizers and Pseudomonas striata an efficient P-solubilizing bacteria (PSB). Different concentration of amendments such as additives (glycerol and polyethylene glycol), adjuvants (carboxyl methyl cellulose), gum arabica (GA), surfactant (polysorbate) and trehalose specifically for Azospirillum were found essential. Combinations of formulations of Rhizobium and PSB for groundnut and Azospirillum and PSB for maize were evaluated under field conditions to determine the optimum level of inoculum required. Each biofertilizer strain was inoculated at the rate of 2, 4, 8 ml per kg of seeds and the efficacy of each formulation both individually and in combinations was evaluated against the lignite-based formulation at the rate of 20 g each per kg seeds and a un-inoculated set was included to compare the inoculation effect. The field experiment had 17 treatments in three replicates and the best level of inoculum was decided based on net returns and cost: benefit ratio. In peanut, the combination of 4 ml of Rhizobium and 2 ml of PSB resulted in the highest net returns and higher cost to benefit ratio of 1:2.98 followed by treatment with a combination of 2 ml per kg each of Rhizobium and PSB with a B;C ratio of 1:2.84. The benefits in terms of net returns were to the extent of 16 percent due to inoculation with lignite based formulations while it was up to 48 percent due to the best combination of liquid biofertilizers. In maize combination of liquid formulations consisting of 4 ml of Azospirillum and 2 ml of PSB resulted in the highest net returns; about 53 percent higher than the un-inoculated control and 20 percent higher than the treatment with lignite based formulation. In both the crops inoculation with lignite based formulations significantly increased the net returns over un-inoculated control while levels higher or lesser than 4 ml of Rhizobium and Azospirillum and higher or lesser than 2 ml of PSB were not economical and hence not optimal for these two crops.

Keywords: Rhizobium, Azospirillum, phosphate solubilizing bacteria, liquid formulation, benefit-cost ratio

Procedia PDF Downloads 493

Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba

Abstract:

Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.

Keywords: CAUTI, male external catheter, reusable, skin adhesive

Procedia PDF Downloads 109

Authors: Tania Lisboa, Angela Voyajolu, Adam Ockelford

Abstract:

The positive impact of music on the development of children with autism is widely acknowledged: music offers a unique channel for communication, wellbeing and self-regulation, as well as access to culture and a means of creative engagement. Yet, no coherent program exists for parents, carers and teachers to follow with their children in the early years, when the need for interventions is often most acute. Hence, research and the development of resources is urgently required. Autism is a project with children on the autism spectrum. The project aims at promoting the participants’ engagement with music through involvement in specially-designed musical activities with parents and carers. The main goal of the research is to verify the effectiveness of newly designed resources and strategies, which are based on the Sounds of Intent in the Early Years (SoI-EY) framework of musical development. This is a pilot study, comprising case studies of five children with autism in the early years. The data comprises semi-structured interviews, observations of videos, and feedback from parents on resources. Interpretative Phenomenological Analysis was chosen to analyze the interviews. The video data was coded in relation to the SoI-EY framework. The feedback from parents was used to evaluate the resources (i.e. musical activity cards). The participants’ wider development was also assessed through selected elements of the Early Years Foundation Stage (EYFS), a national assessment framework used in England: specifically, communication, language and social-emotional development. Five families of children on the autism spectrum (aged between 4-8 years) participated in the pilot. The research team visited each family 4 times over a 3-month period, during which the children were observed, and musical activities were suggested based on the child’s assessed level of musical development. Parents then trialed the activities, providing feedback and gathering further video observations of their child’s musical engagement between visits. The results of one case study will be featured in this paper, in which the evidence suggests that specifically tailored musical activity may promote communication and social engagement for a child with language difficulties on the autism spectrum. The resources were appropriate for the children’s involvement in musical activities. Findings suggest that non-specialist musical engagement with family and carers can be a powerful means to foster communication. The case study featured in this paper illustrates this with a child of limited verbal ability. There is a need for further research and development of resources that can be made available to all those working with children on the autism spectrum.

Keywords: autism, development, music education, resources

Procedia PDF Downloads 104

Authors: Yunhan Zhang, Xiaopeng Li, Zhongxiao Peng

Abstract:

Additive manufacturing (AM) possesses several key characteristics, including high design freedom, energy-efficient manufacturing process, reduced material waste, high resolution of finished products, and excellent performance of finished products. These advantages have garnered widespread attention and fueled rapid development in recent decades. AM has significantly broadened the spectrum of available materials in the manufacturing industry and is gradually replacing some traditionally manufactured parts. Similar to components produced via traditional methods, products manufactured through AM are susceptible to degradation caused by wear during their service life. Given the prevalence of 316L stainless steel (SS) parts and the limited research on the tribological behavior of 316L SS samples or products fabricated using AM technology, this study aims to investigate the degradation process and wear mechanisms of 316L SS disks fabricated using AM technology. The wear mechanisms and tribological performance of these AM-manufactured samples are compared with commercial 316L SS samples made using conventional methods. Additionally, methods to enhance the tribological performance of additive-manufactured SS samples are explored. Four disk samples with a diameter of 75 mm and a thickness of 10 mm are prepared. Two of them (Group A) are prepared from a purchased SS bar using a milling method. The other two disks (Group B), with the same dimensions, are made of Gas Atomized 316L Stainless Steel (size range: 15-45 µm) purchased from Carpenter Additive and produced using Laser Powder Bed Fusion (LPBF). Pin-on-disk tests are conducted on these disks, which have similar surface roughness and hardness levels. Multiple tests are carried out under various operating conditions, including varying loads and/or speeds, and the friction coefficients are measured during these tests. In addition, the evolution of the surface degradation processes is monitored by creating moulds of the wear tracks and quantitatively analyzing the surface morphologies of the mould images. This analysis involves quantifying the depth and width of the wear tracks and analyzing the wear debris generated during the wear processes. The wear mechanisms and wear performance of these two groups of SS samples are compared. The effects of load and speed on the friction coefficient and wear rate are investigated. The ultimate goal is to gain a better understanding of the surface degradation of additive-manufactured SS samples. This knowledge is crucial for enhancing their anti-wear performance and extending their service life.

Keywords: degradation process, additive manufacturing, stainless steel, surface features

Procedia PDF Downloads 81

Authors: Tania Chalton

Abstract:

In June 2013, an independent review of the Liverpool Care Pathway (LCP) identified a number of problems with the implementation of the LCP in the UK and recommended that it be replaced by individual care plans for each patient. As a result of the UK findings, in November 2013 the Ministry of Health (MOH) commissioned the Palliative Care Council to initiate a programme of work to investigate an appropriate approach for the care of people in their last days of life in New Zealand (NZ). The Last Days of Life Working Group commenced a process to develop national consensus on the care of people in their last days of life in April 2014. In order to develop its advice for the future provision of care to people in their last days of life, the Working Group (WG) established a comprehensive work programme and as a result has developed a series of working papers. Specific areas of focus included: An analysis of the UK Independent Review findings and an assessment of these findings to the NZ context. A stocktake of services providing care to people in their last days of life, including aged residential care (ARC); hospices; hospitals; and primary care. International and NZ literature reviews of evidence and best practice. Survey of family to understand the consumer perspective on the care of people in their last days of life. Key aspects of care that required further considerations for NZ were: Terminology: clarify terminology used in the last days of life and in relation to death and dying. Evidenced based: including specific review of evidence regarding, spiritual, culturally appropriate care as well as dementia care. Diagnosis of dying: need for both guidance around the diagnosis of dying and communication with family. Workforce issues: access to an appropriate workforce after hours. Nutrition and hydration: guidance around appropriate approaches to nutrition and hydration. Symptom and pain management: guidance around symptom management. Documentation: documentation of the person’s care which is robust enough for data collection and auditing requirements, not ‘tick box’ approach to care. Education and training: improved consistency and access to appropriate education and training. Leadership: A dedicated team or person to support and coordinate the introduction and implementation of any last days of life model of care. Quality indicators and data collection: model of care to enable auditing and regular reviews to ensure on-going quality improvement. Cultural and spiritual: address and incorporate any cultural and spiritual aspects. A final document was developed incorporating all the evidence which provides guidance to the health sector on best practice for people at end of life: “Principles and guidance for the last days of life: Te Ara Whakapiri”.

Keywords: end of life, guidelines, New Zealand, palliative care

Procedia PDF Downloads 435

Authors: Roberta Martino, Viviana Ventre

Abstract:

From a theoretical point of view, the relationship between the risk associated with an investment and the expected value are directly proportional, in the sense that the market allows a greater result to those who are willing to take a greater risk. However, empirical evidence proves that this relationship is distorted in the minds of investors and is perceived exactly the opposite. To deepen and understand the discrepancy between the actual actions of the investor and the theoretical predictions, this paper analyzes the essential parameters used for the valuation of financial assets with greater attention to two elements: probability and the passage of time. Although these may seem at first glance to be two distinct elements, they are closely related. In particular, the error in the theoretical description of the relationship between risk and return lies in the failure to consider the impatience that is generated in the decision-maker when events that have not yet happened occur in the decision-making context. In this context, probability loses its objective meaning and in relation to the psychological aspects of the investor, it can only be understood as the degree of confidence that the investor has in the occurrence or non-occurrence of an event. Moreover, the concept of objective probability does not consider the inter-temporality that characterizes financial activities and does not consider the condition of limited cognitive capacity of the decision maker. Cognitive psychology has made it possible to understand that the mind acts with a compromise between quality and effort when faced with very complex choices. To evaluate an event that has not yet happened, it is necessary to imagine that it happens in your head. This projection into the future requires a cognitive effort and is what differentiates choices under conditions of risk and choices under conditions of uncertainty. In fact, since the receipt of the outcome in choices under risk conditions is imminent, the mechanism of self-projection into the future is not necessary to imagine the consequence of the choice and the decision makers dwell on the objective analysis of possibilities. Financial activities, on the other hand, develop over time and the objective probability is too static to consider the anticipatory emotions that the self-projection mechanism generates in the investor. Assuming that uncertainty is inherent in valuations of events that have not yet occurred, the focus must shift from risk management to uncertainty management. Only in this way the intertemporal dimension of the decision-making environment and the haste generated by the financial market can be cautioned and considered. The work considers an extension of the prospectus theory with the temporal component with the aim of providing a description of the attitude towards risk with respect to the passage of time.

Keywords: impatience, risk aversion, subjective probability, uncertainty

Procedia PDF Downloads 109

Authors: Merih Welay Welesilassie, Marianne Nikolov

Abstract:

Research into second and foreign language (L2) acquisitions has demonstrated that L2 anxiety, perceived proficiency, and L2 willingness to communicate (L2WTC) profoundly impact language learning outcomes. However, the complex interplay between these variables has yet to be fully explored, as these factors are dynamic and context-specific and can vary across different learners and learning environments. This study, therefore, utilized a cross-sectional quantitative survey research design to scrutinise the causal relationships between L2 anxiety, English proficiency, and L2WTC of 609 Ethiopian preparatory school students. The model for the L2WTC, both inside and outside the classroom, has been expanded to include an additional sub-scale known as the L2WTC in a digital setting. Moreover, in contrast to the commonly recognised debilitative-focused L2 anxiety, the construct of L2 anxiety has been divided into facilitative and debilitative anxiety. This method allows to measure not only the presence or absence of anxiety but also evaluate if anxiety helps or hinders the L2 learning experience. A self-assessment proficiency measure was also developed specifically for Ethiopian high school students. The study treated facilitative and debilitative anxiety as independent variables while considering self-assessed English proficiency and L2WTC in the classroom, outside the classroom, and in digital settings as dependent variables. Additionally, self-assessed English proficiency was used as an independent variable to predict L2WTC in these three settings. The proposed model, including these variables, was tested using structural equation modelling (SEM). According to the descriptive analysis, the mean scores of L2WTC in the three settings were generally low, ranging from 2.30 to 2.84. Debilitative anxiety casts a shadow on the positive aspects of anxiety. Self-assessed English proficiency was also too low. According to SEM, debilitative anxiety displayed a statistically significant negative impact on L2WTC inside the classroom, outside the classroom, in digital settings, and in self-assessed levels of English proficiency. In contrast, facilitative anxiety was found to positively contribute to L2WTC outside the classroom, in digital settings, and in self-assessed English proficiency. Self-assessed English proficiency made a statistically significant and positive contribution to L2WTC within the classroom, outside the classroom, and in digital contexts. L2WTC inside the classroom was found to positively contribute to L2WTC outside the classrooms and in digital contexts. The findings were systematically compared with existing studies, and the pedagogical implications, limitations, and potential avenues for future research were elucidated. The outcomes of the study have the potential to significantly contribute to the advancement of theoretical and empirical knowledge about improving English education, learning, and communication not only in Ethiopia but also in similar EFL contexts, thereby providing valuable insights for educators, researchers, and policymakers.

Keywords: debilitative anxiety, facilitative anxiety, L2 willingness to communicate, self-assessed English proficiency

Procedia PDF Downloads 18

Authors: Ekaterina G. Lipatova

Abstract:

The developing potential of a video task in teaching foreign languages involves the opportunities to improve four aspects of speech production process: listening, reading, speaking and writing. A video represents the sequence of actions, realized in the pictures logically connected and verbalized speech flow that simplifies and stimulates the process of perception. In this connection listening skills of students are developed effectively as well as their intellectual properties such as synthesizing, analyzing and generalizing the information. In terms of teaching capacity, a video task, in our opinion, is more stimulating than a traditional listening, since it involves the student into the plot of the communicative situation, emotional background and potentially makes them react to the gist in the cognitive and communicative ways. To be an effective method of teaching the video task should be structured in the way of psycho-linguistic characteristics of speech production process, in other words, should include three phases: before-watching, while-watching and after-watching. The system of tasks provided to each phase might involve the situations on reflecting to the video content in the forms of filling-the-gap tasks, multiple choice, True-or-False tasks (reading skills), exercises on expressing the opinion, project fulfilling (writing and speaking skills). In the before-watching phase we offer the students to adjust their perception mechanism to the topic and the problem of the chosen video by such task as “what do you know about such a problem?”, “is it new for you?”, “have you ever faced the situation of…?”. Then we proceed with the lexical and grammatical analysis of language units that form the body of a speech sample to lessen the perception and develop the student’s lexicon. The goal of while-watching phase is to build the student’s awareness about the problem presented in the video and challenge their inner attitude towards what they have seen by identifying the mistakes in the statements about the video content or making the summary, justifying their understanding. Finally, we move on to development of their speech skills within the communicative situation they observed and learnt by stimulating them to search the similar ideas in their backgrounds and represent them orally or in the written form or express their own opinion on the problem. It is compulsory to highlight, that a video task should contain the urgent, valid and interesting event related to the future profession of the student, since it will help to activate cognitive, emotional, verbal and ethic capacity of students. Also, logically structured video tasks are easily integrated into the system of e-learning and can provide the opportunity for the students to work with the foreign language on their own.

Keywords: communicative situation, perception mechanism, speech production process, speech skills

Procedia PDF Downloads 246

Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

Abstract:

Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

Procedia PDF Downloads 352

Authors: Orkide Donma, Mustafa M. Donma

Abstract:

Association between insulin resistance (IR) and hematological parameters has long been a matter of interest. Within this context, body mass index (BMI), red blood cells, white blood cells and platelets were involved in this discussion. Parameters related to platelets associated with IR may be useful indicators for the identification of IR. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) are being questioned for their possible association with IR. The aim of this study was to investigate the association between platelet (PLT) count as well as PLT indices and the surrogate indices used to determine IR in morbid obese (MO) children. A total of 167 children participated in the study. Three groups were constituted. The number of cases was 34, 97 and 36 children in the normal BMI, MO and metabolic syndrome (MetS) groups, respectively. Sex- and age-dependent BMI-based percentile tables prepared by World Health Organization were used for the definition of morbid obesity. MetS criteria were determined. BMI values, homeostatic model assessment for IR (HOMA-IR), alanine transaminase-to-aspartate transaminase ratio (ALT/AST) and diagnostic obesity notation model assessment laboratory (DONMA-lab) index values were computed. PLT count and indices were analyzed using automated hematology analyzer. Data were collected for statistical analysis using SPSS for Windows. Arithmetic mean and standard deviation were calculated. Mean values of PLT-related parameters in both control and study groups were compared by one-way ANOVA followed by Tukey post hoc tests to determine whether a significant difference exists among the groups. The correlation analyses between PLT as well as IR indices were performed. Statistically significant difference was accepted as p-value < 0.05. Increased values were detected for PLT (p < 0.01) and PCT (p > 0.05) in MO group compared to those observed in children with N-BMI. Significant increases for PLT (p < 0.01) and PCT (p < 0.05) were observed in MetS group in comparison with the values obtained in children with N-BMI (p < 0.01). Significantly lower MPV and PDW values were obtained in MO group compared to the control group (p < 0.01). HOMA-IR (p < 0.05), DONMA-lab index (p < 0.001) and ALT/AST (p < 0.001) values in MO and MetS groups were significantly increased compared to the N-BMI group. On the other hand, DONMA-lab index values also differed between MO and MetS groups (p < 0.001). In the MO group, PLT was negatively correlated with MPV and PDW values. These correlations were not observed in the N-BMI group. None of the IR indices exhibited a correlation with PLT and PLT indices in the N-BMI group. HOMA-IR showed significant correlations both with PLT and PCT in the MO group. All of the three IR indices were well-correlated with each other in all groups. These findings point out the missing link between IR and PLT activation. In conclusion, PLT and PCT may be related to IR in addition to their identities as hemostasis markers during morbid obesity. Our findings have suggested that DONMA-lab index appears as the best surrogate marker for IR due to its discriminative feature between morbid obesity and MetS.

Keywords: children, insulin resistance, metabolic syndrome, plateletcrit, platelet indices

Procedia PDF Downloads 108

Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

Abstract:

The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

Procedia PDF Downloads 186

Authors: Zeynep Guler

Abstract:

Argumentation and the production of scientific arguments are essential components that are necessary for helping students become scientifically literate through engaging them in constructing and critiquing ideas. Incorporating argumentation into science classrooms is challenging and can be a long-term process for both students and teachers. Students have difficulty in engaging tasks that require them to craft arguments, evaluate them to seek weaknesses, and revise them. Teachers also struggle with facilitating argumentation when they have underdeveloped science practices, underdeveloped pedagogical knowledge for argumentation science teaching, or underdeveloped teaching practice with argumentation (or a combination of all three). Thus, there is a need to support teachers in developing pedagogy for science teaching as argumentation, planning and implementing teaching practice for facilitating argumentation and also in becoming more agentic in this regards. Looking specifically at the experience of agency within education, it is arguable that agency is necessary for teachers’ renegotiation of professional purposes and practices in the light of changing educational practices. This study investigated how science teachers develop pedagogy for argumentation both individually and with their colleagues and also how teachers become more agentic (or not) through the active engagement of their contexts-for-action that refer to this as an ecological understanding of agency in order to positively influence or change their practice and their students' engagement with argumentation over two academic years. Through educational design study, this study conducted with three secondary science teachers (key stage 3-year 7 students aged 11-12) in the UK to find out if similar or different patterns of developing pedagogy for argumentation and of becoming more agentic emerge as they engage in planning and implementing a cycle of activities during the practice of teaching science with argumentation. Data from video and audio-recording of classroom practice and open-ended interviews with the science teachers were analysed using content analysis. The findings indicated that all the science teachers perceived strong agency in their opportunities to develop and apply pedagogical practices within the classroom. The teachers were pro-actively shaping their practices and classroom contexts in ways that were over and above the amendments to their pedagogy. They demonstrated some outcomes in developing pedagogy for argumentation and becoming more agentic in their teaching in this regards as a result of the collaboration with their colleagues and researcher; some appeared more agentic than others. The role of the collaboration between their colleagues was seen crucial for the teachers’ practice in the schools: close collaboration and support from other teachers in planning and implementing new educational innovations were seen as crucial for the development of pedagogy and becoming more agentic in practice. They needed to understand the importance of scientific argumentation but also understand how it can be planned and integrated into classroom practice. They also perceived constraint emerged from their lack of competence and knowledge in posing appropriate questions to help the students engage in argumentation, providing support for the students' construction of oral and written arguments.

Keywords: argumentation, teacher professional development, teacher agency, students' construction of argument

Procedia PDF Downloads 135

Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

Abstract:

Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

Procedia PDF Downloads 218

Authors: Sara R. Knigge, Sugat R. Tuladhar, Hans-Klaus HöFfler, Tobias Schilling, Tim Kaufeld, Axel Haverich

Abstract:

Tissue engineered (TE) heart valves based on degradable electrospun fiber scaffold represent a promising approach to overcome the known limitations of mechanical or biological prostheses. But the mechanical stress in the high-pressure system of the human circulation is a severe challenge for the delicate materials. Hence, the prediction of the scaffolds` in vivo degradation kinetics must be as accurate as possible to prevent fatal events in future animal or even clinical trials. Therefore, this study investigates whether long-term testing in full blood provides more meaningful results regarding the degradation behavior than conventional tests in simulated body fluids (SBF) or Phosphate Buffered Saline (PBS). Fiber mats were produced from a polycaprolactone (PCL)/tetrafluoroethylene solution by electrospinning. The morphology of the fiber mats was characterized via scanning electron microscopy (SEM). A maximum physiological degradation environment utilizing a test set-up with porcine full blood was established. The set-up consists of a reaction vessel, an oxygenator unit, and a roller pump. The blood parameters (pO2, pCO2, temperature, and pH) were monitored with an online test system. All tests were also carried out in the test circuit with SBF and PBS to compare conventional degradation media with the novel full blood setting. The polymer's degradation is quantified by SEM picture analysis, differential scanning calorimetry (DSC), and Raman spectroscopy. Tensile and cyclic loading tests were performed to evaluate the mechanical integrity of the scaffold. Preliminary results indicate that PCL degraded slower in full blood than in SBF and PBS. The uptake of water is more pronounced in the full blood group. Also, PCL preserved its mechanical integrity longer when degraded in full blood. Protein absorption increased during the degradation process. Red blood cells, platelets, and their aggregates adhered on the PCL. Presumably, the degradation led to a more hydrophilic polymeric surface which promoted the protein adsorption and the blood cell adhesion. Testing degradable implants in full blood allows for developing more reliable scaffold materials in the future. Material tests in small and large animal trials thereby can be focused on testing candidates that have proven to function well in an in-vivo-like setting.

Keywords: Electrospun scaffold, full blood degradation test, long-term polymer degradation, tissue engineered aortic heart valve

Procedia PDF Downloads 153

Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

Abstract:

Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

Procedia PDF Downloads 122

Authors: Kanti Sapkota, Do Hyun Lee, Sung Soo Han

Abstract:

Nanocomposites have been widely used in various fields such as electronics, catalysis, and in chemical, biological, biomedical and optical fields. They display broad biomedical properties like antidiabetic, anticancer, antioxidant, antimicrobial and antibacterial activities. Moreover, nanomaterials have been used for wastewater treatment. Particularly, bimetallic hybrid nanocomposites exhibit unique features as compared to their monometallic components. Hybrid nanomaterials not only afford the multifunctionality endowed by their constituents but can also show synergistic properties. In addition, these hybrid nanomaterials have noteworthy catalytic and optical properties. Notably, Au−Ag based nanoparticles can be employed in sensor and catalysis due to their characteristic composition-tunable plasmonic properties. Due to their importance and usefulness, various efforts were developed for their preparation. Generally, chemical methods have been described to synthesize such bimetallic nanocomposites. In such chemical synthesis, harmful and hazardous chemicals cause environmental contamination and increase toxicity levels. Therefore, ecologically benevolent processes for the synthesis of nanomaterials are highly desirable to diminish such environmental and safety concerns. In this regard, here we disclose a simple, cost-effective, external additive free and eco-friendly method for the synthesis of Au-Ag@AgCl nanocomposites using Nephrolepis cordifolia root extract. Au-Ag@AgCl NCs were obtained by the simultaneous reduction of cationic Ag and Au into AgCl in the presence of plant extract. The particle size of 10 to 50 nm was observed with the average diameter of 30 nm. The synthesized nanocomposite was characterized by various modern characterization techniques. For example, UV−visible spectroscopy was used to determine the optical activity of the synthesized NCs, and Fourier transform infrared (FT-IR) spectroscopy was employed to investigate the functional groups present in the biomolecules that were responsible for both reducing and capping agents during the formation of nanocomposites. Similarly, powder X-ray diffraction (XRD), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), thermogravimetric analysis (TGA) and energy-dispersive X-ray (EDX) spectroscopy were used to determine crystallinity, size, oxidation states, thermal stability and weight loss of the synthesized nanocomposites. As a synthetic application, the synthesized nanocomposite exhibited excellent catalytic activity for the multicomponent synthesis of biologically interesting quinoline molecules via domino annulation-aromatization reaction of aniline, arylaldehyde, and phenyl acetylene derivatives. Interestingly, the nanocatalyst was efficiently recycled for five times without substantial loss of catalytic properties.

Keywords: nanoparticles, catalysis, multicomponent, quinoline

Procedia PDF Downloads 129

Authors: Elena Maria Scalisi, Roberta Pecoraro, Martina Contino, Sara Ignoto, Carmelo Iaria, Santi Concetto Pavone, Gino Sorbello, Loreto Di Donato, Maria Violetta Brundo

Abstract:

5G Technology is evolving to satisfy a variety of service requirements that may allow high data-rate connections (1Gbps) and lower latency times than current (<1ms). In order to support a high data transmission speed and a high traffic service for eMBB (enhanced mobile broadband) use cases, 5G systems have the characteristic of using different frequency bands of the radio wave spectrum (700 MHz, 3.6-3.8 GHz and 26.5-27.5 GHz), thus taking advantage of higher frequencies than previous mobile radio generations (1G-4G). However, waves at higher frequencies have a lower capacity to propagate in free space and therefore, in order to guarantee the capillary coverage of the territory for high reliability applications, it will be necessary to install a large number of repeaters. Following the introduction of this new technology, there has been growing concern over the past few months about possible harmful effects on human health. The aim of this preliminary study is to evaluate possible short term effects induced by 5G-millimeter waves on embryonic development and early life stages of Danio rerio by Z-FET. We exposed developing zebrafish at frequency of 27 GHz, with a standard pyramidal horn antenna placed at 15 cm far from the samples holder ensuring an incident power density of 10 mW/cm2. During the exposure cycle, from 6 h post fertilization (hpf) to 96 hpf, we measured a different morphological endpoints every 24 hours. Zebrafish embryo toxicity test (Z-FET) is a short term test, carried out on fertilized eggs of zebrafish and it represents an effective alternative to acute test with adult fish (OECD, 2013). We have observed that 5G did not reveal significant impacts on mortality nor on morphology because exposed larvae showed a normal detachment of the tail, presence of heartbeat, well-organized somites, therefore hatching rate was lower than untreated larvae even at 48 h of exposure. Moreover, the immunohistochemical analysis performed on larvae showed a negativity to the HSP-70 expression used as a biomarkers. This is a preliminary study on evaluation of potential toxicity induced by 5G and it seems appropriate to underline the importance that further studies would take, aimed at clarifying the probable real risk of exposure to electromagnetic fields.

Keywords: Biomarker of exposure, embryonic development, 5G waves, zebrafish embryo toxicity test

Procedia PDF Downloads 131

Authors: Zaima Umar, Anas S. Qureshi, Adeel Sarfraz, Saqib Umar, Talha Umar, Muhammad Usman

Abstract:

Ostrich has been a good source of food and income for people across the world. To get a better understanding of health and health-related problems, the knowledge of its digestive system is of utmost importance. The present study was conducted to determine the morphological and histometrical variations in the digestive system and associated glands of ostrich (Struthio camelus) as regard to the gender and progressive age. A total of 40 apparently healthy ostriches of both genders and two progressive age groups; young one (less than two year, group A); and adult (2-15 years, group B) in equal number were used in this study. Digestive organs including tongue, esophagus, proventriculus, gizzard, small and large intestines and associated glands like liver and pancreas were collected immediately after slaughtering the birds. The organs of the digestive system and associated glands of each group were studied grossly and histologically. Grossly colour, shape consistency, weight and various dimensions (length, width, and circumference) of organs of the digestive tract and associated glands were recorded. The mean (± SEM) of all gross anatomical parameters in group A were significantly (p ≤ 0.01) different from that of group B. For microscopic studies, 1-2 cm tissue samples of organs of the digestive system and associated glands were taken. The tissue was marked and fixed in the neutral buffer formaldehyde solution for histological studies. After fixation, the sections of 5-7 µm were cut and stained by haematoxylin and eosin stain. All the layers (epithelium, lamina propria, lamina muscularis, submucosa and tunica muscularis) were measured (µm) with the help of automated computer software Image J®. The results of this study provide valuable information on the gender and age-related histological and histometrical variations in the digestive organs of ostrich (Struthio camelus). The microscopic studies of different parts of the digestive system revealed highly significant differences (p ≤ 0.01) among the two groups. The esophagus was lined by non-keratinized stratified squamous epithelium. The duodenum, jejunum, and ileum showed similar histological structures. Statistical analysis revealed significant (p ≤ 0.05) increase in the thickness of different tunics of the gastrointestinal tract in adult birds (up to 15 years) as compared with young ones (less than two years). Therefore, it can be concluded that there is a gradual but consistent growth in the observed digestive organs mimicking that of other poultry species and may be helpful in determining the growth pattern in this bird. However, there is a need to record the changes at closer time intervals.

Keywords: ostrich, digestive system, histomorphometry, grossly

Procedia PDF Downloads 147