Search results for: pediatric intensive care unit
3189 Development of the Family Capacity of Management of Patients with Autism Spectrum Disorder Diagnosis
Authors: Marcio Emilio Dos Santos, Kelly C. F. Dos Santos
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Caregivers of patients diagnosed with ASD are subjected to high stress situations due to the complexity and multiple levels of daily activities that require the organization of events, behaviors and socioemotional situations, such as immediate decision making and in public spaces. The cognitive and emotional requirement needed to fulfill this caregiving role exceeds the regular cultural process that adults receive in their process of preparation for conjugal and parental life. Therefore, in many cases, caregivers present a high level of overload, poor capacity to organize and mediate the development process of the child or patient about their care. Aims: Improvement in the cognitive and emotional capacities related to the caregiver function, allowing the reduction of the overload, the feeling of incompetence and the characteristic level of stress, developing a more organized conduct and decision making more oriented towards the objectives and procedural gains necessary for the integral development of the patient with diagnosis of ASD. Method: The study was performed with 20 relatives, randomly selected from a total of 140 patients attended. The family members were submitted to the Wechsler Adult Intelligence Scale III intelligence test and the Family assessment Management Measure (FaMM) questionnaire as a previous evaluation. Therapeutic activity in a small group of family members or caregivers, with weekly frequency, with a minimum workload of two hours, using the Feuerstein Instrumental Enrichment Cognitive Development Program - Feuerstein Instrumental Enrichment for ten months. Reapplication of the previous tests to verify the gains obtained. Results and Discussion: There is a change in the level of caregiver overload, improvement in the results of the Family assessment Management Measure and highlight to the increase of performance in the cognitive aspects related to problem solving, planned behavior and management of behavioral crises. These results lead to the discussion of the need to invest in the integrated care of patients and their caregivers, mainly by enabling cognitively to deal with the complexity of Autism. This goes beyond the simple therapeutic orientation about adjustments in family and school routines. The study showed that when the caregiver improves his/her capacity of management, the results of the treatment are potentiated and there is a reduction of the level of the caregiver's overload. Importantly, the study was performed for only ten months and the number of family members attended in the study (n = 20) needs to be expanded to have statistical strength.Keywords: caregiver overload, cognitive development program ASD caregivers, feuerstein instrumental enrichment, family assessment management measure
Procedia PDF Downloads 1293188 Interaction Effects of Dietary Ginger, Zingiber Officinale, on Plasma Protein Fractions in Rainbow Trout, Oncorhynchus Mykiss
Authors: Ali Taheri Mirghaed, Sara Ahani, Ashkan Zargar, Seyyed Morteza Hoseini
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Diseases are the major challenges in intensive aquaculture that cause significant annual losses. Antibiotic-therapy is a common way to control bacterial disease in fish, and oxytetracycline (OTC) is the only oral antibiotic in aquaculture approved FDA. OTC has been found to have negative effects on fish, such as oxidative stress and immune-suppression, thus, it is necessary to mitigate such effects. Medicinal herbs have various benefits on fish, including antioxidant, immunostimulant, and anti-microbial effects. Therefore, we hypothesized if dietary ginger meal (GM) interacts with dietary OTC by monitoring plasma protein fractions in rainbow trout. The study was conducted as a 2 × 2 factorial design, including diets containing 0 and 1% GM and 0 and 1.66 % OTC (corresponding to 100 mg/kg fish biomass per day). After ten days treating the fish (60 g individual weight) with these feeds, blood samples were taken from al treatments (n =3). Plasma was separated by centrifugation, and protein fractions were determined by electrophoresis. The results showed that OTC and GM had interaction effects on total protein (P<0.001), albumin (P<0.001), alpha-1 fraction (P=0.010), alpha-2 fraction (P=0.001), beta-2 fraction (P=0.014), and gamma fraction (P<0.001). Beta-1 fraction was significantly (P=0.030) affected by dietary GM. GM decreased plasma total protein, albumin, and beta-2 but increased beta-1 fraction. OTC significantly decreased total protein (P<0.001), albumin (P=0.001), alpha-2 fraction (P<0.001), beta-2 fraction (P=0.004), and gamma fraction (P<0.001) but had no significant effects on alpha-1 and beta-1 fractions. Dietary GM inhibited/suppressed the effects of dietary OTC on the plasma total protein and protein fractions. In conclusion, adding 1% GM to diet can mitigate the negative effects of dietary OTC on plasma proteins. Thus, GM may boost health of rainbow trout during the period of medication with OTC.Keywords: ginger, plasma protein electrophoresis, dietary additive, rainbow trout
Procedia PDF Downloads 933187 Energy and Nutrient Intakes in Cystic Fibrosis: Do They Achieve Guidelines ?
Authors: Hatice Akbıyık, Hülya Gökmen Özel, Nagehan Emiralioğlu, Elmas Ebru Güneş Yalçın, Deniz Doğru Ersöz, Hayriye Uğur Özçelik, Nural Kiper
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Background: Dietary recommendations in cystic fibrosis (CF) are based on the need to compensate for the increased energy needs of infection, the increased energy cost of breathing and the losses, incurred from malabsorption. Studies in CF indicate that dietary recommendations for CF patients can be difficult to achieve Aim: The aim of this study was to evaluate the energy and nutrient intakes and to compare in accordance with CF dietary guidelines in CF. Methods: One-hundred sixty patients with CF, aged between 2 to 20 years (mean±SD= 7.4±4.8 years) attending Hacettepe University, Faculty of Medicine, Department of Pediatric Pulmonary Diseases were included. Energy and nutrient intakes from foods and enteral products were calculated using a-24-hour dietary recall method with BEBIS 7.2 programme. Percentages of energy and nutrient intakes were compared in accordance with CF dietary guidelines. Patients or/and parents completed a questionnaire showing mealtime problems, usage of alternative therapies and type of nutrition. Statistical analyses were done using SPSS 16.0 programme. Results: It was obtained that 14.5% and 46.9% of the total energy intake were from proteins and carbohydrates, respectively. The actual contribution of total, saturated, monounsaturated and polyunsaturated fats to the total caloric intake was 37.5%, 14.3%, 14.9%, 9.9%, respectively. It was found that 87.7% of energy, 85% of protein 91.7% of carbohydrate, 81.1% of fat intakes were met, when compared CF recommended intakes of 120% RDA. Additionally 67%, 69.5%, 68.2% and 68.9% of the subjects did not achieve CF recommended intakes of 120% RDA for energy, protein, carbohydrate and fat, respectively. Patients with CF had low intakes for age for almost all vitamins and minerals, although supplementation was given. Especially most patients did not achieve the minimum recommended vitamin K intake of 120% RDA. The percentage meeting 120% RDA was 75.9% for vitamin K. It was shown that 41% of the patients had mealtime problems and they skipped the breakfast. Moreover 25.4% of the patients used alternative products outside the standard treatment (such as omega-3, ginger, turmeric, local honey). It was also showed that 60.8% of patients were using enteral products in addition to normal foods, the remaining patients were on only normal foods. Conclusion: The aims of improving nutritional status in children are to achieve normal weight gain and growth; optimize vitamin and mineral status; and slow the rate of clinical decline. In this study although enteral products were used in patients with CF, it was found that energy and nutrient requirements were unable to meet. Because dietary assessment is essential to identify the need for earlier nutritional intervention, in each visit patients need to be referred to CF specialist dietitian.Keywords: cystic fibrosis, energy and nutrient intakes, mealtime problems, malabsorbtion
Procedia PDF Downloads 4593186 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy
Authors: Itee Chowdhury, Shikha Modi
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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption
Procedia PDF Downloads 1273185 Optimal Sizes of Battery Energy Storage Systems for Economic Operation in Microgrid
Authors: Sirus Mohammadi, Sara Ansari, Darush dehghan, Habib Hoshyari
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Batteries for storage of electricity from solar and wind generation farms are a key element in the success of sustainability. In recent years, due to large integration of Renewable Energy Sources (RESs) like wind turbine and photovoltaic unit into the Micro-Grid (MG), the necessity of Battery Energy Storage (BES) has increased dramatically. The BES has several benefits and advantages in the MG-based applications such as short term power supply, power quality improvement, facilitating integration of RES, ancillary service and arbitrage. This paper presents the cost-based formulation to determine the optimal size of the BES in the operation management of MG. Also, some restrictions, i.e. power capacity of Distributed Generators (DGs), power and energy capacity of BES, charge/discharge efficiency of BES, operating reserve and load demand satisfaction should be considered as well. In this paper, a methodology is proposed for the optimal allocation and economic analysis of ESS in MGs on the basis of net present value (NPV). As the optimal operation of an MG strongly depends on the arrangement and allocation of its ESS, economic operation strategies and optimal allocation methods of the ESS devices are required for the MG.Keywords: microgrid, energy storage system, optimal sizing, net present value
Procedia PDF Downloads 4943184 Emotion Oriented Students' Opinioned Topic Detection for Course Reviews in Massive Open Online Course
Authors: Zhi Liu, Xian Peng, Monika Domanska, Lingyun Kang, Sannyuya Liu
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Massive Open education has become increasingly popular among worldwide learners. An increasing number of course reviews are being generated in Massive Open Online Course (MOOC) platform, which offers an interactive feedback channel for learners to express opinions and feelings in learning. These reviews typically contain subjective emotion and topic information towards the courses. However, it is time-consuming to artificially detect these opinions. In this paper, we propose an emotion-oriented topic detection model to automatically detect the students’ opinioned aspects in course reviews. The known overall emotion orientation and emotional words in each review are used to guide the joint probabilistic modeling of emotion and aspects in reviews. Through the experiment on real-life review data, it is verified that the distribution of course-emotion-aspect can be calculated to capture the most significant opinioned topics in each course unit. This proposed technique helps in conducting intelligent learning analytics for teachers to improve pedagogies and for developers to promote user experiences.Keywords: Massive Open Online Course (MOOC), course reviews, topic model, emotion recognition, topical aspects
Procedia PDF Downloads 2623183 Hydrodynamic Study of Laminar Flow in Agitated Vessel by a Curved Blade Agitator
Authors: A. Benmoussa, M. Bouanini, M. Rebhi
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The mixing and agitation of fluid in stirred tank is one of the most important unit operations for many industries such as chemical, biotechnological, pharmaceutical, petrochemical, cosmetic, and food processing. Therefore, determining the level of mixing and overall behaviour and performance of the mixing tanks are crucial from the product quality and process economics point of views. The most fundamental needs for the analysis of these processes from both a theoretical and industrial perspective is the knowledge of the hydrodynamic behaviour and the flow structure in such tanks. Depending on the purpose of the operation carried out in mixer, the best choice for geometry of the tank and agitator type can vary widely. Initially, a local and global study namely the velocity and power number on a typical agitation system agitated by a mobile-type two-blade straight (d/D=0.5) allowed us to test the reliability of the CFD, the result were compared with those of experimental literature, a very good concordance was observed. The stream function, the velocity profile, the velocity fields and power number are analyzed. It was shown that the hydrodynamics is modified by the curvature of the mobile which plays a key role.Keywords: agitated tanks, curved blade agitator, laminar flow, CFD modelling
Procedia PDF Downloads 4163182 Digital System Design for Strategic Improvement Planning in Education: A Socio-Technical and Iterative Design Approach
Authors: Neeley Current, Fatih Demir, Kenneth Haggerty, Blake Naughton, Isa Jahnke
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Educational systems seek reform using data-intensive continuous improvement processes known as strategic improvement plans (SIPs). Schools turn to digital systems to monitor, analyze and report SIPs. One technical challenge of these digital systems focuses on integrating a highly diverse set of data sources. Another challenge is to create a learnable sociotechnical system to help administrators, principals and teachers add, manipulate and interpret data. This study explores to what extent one particular system is usable and useful for strategic planning activities and whether intended users see the benefit of the system achieve the goal of improving workflow related to strategic planning in schools. In a three-phase study, researchers used sociotechnical design methods to understand the current workflow, technology use, and processes of teachers and principals surrounding their strategic improvement planning. Additionally, design review and task analysis usability methods were used to evaluate task completion, usability, and user satisfaction of the system. The resulting socio-technical models illustrate the existing work processes and indicate how and at which places in the workflow the newly developed system could have an impact. The results point to the potential of the system but also indicate that it was initially too complicated for use. However, the diverse users see the potential benefits, especially to overcome the diverse set of data sources, and that the system could fill a gap for schools in planning and conducting strategic improvement plans.Keywords: continuous improvement process, education reform, strategic improvement planning, sociotechnical design, software development, usability
Procedia PDF Downloads 2973181 Distribution and Historical Trends of PAHs Deposition in Recent Sediment Cores of the Imo River, SE Nigeria
Authors: Miranda I. Dosunmu, Orok E. Oyo-Ita, Inyang O. Oyo-Ita
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Polycyclic aromatic hydrocarbons (PAHs) are a class of priority listed organic pollutants due to their carcinogenicity, mutagenity, acute toxicity and persistency in the environment. The distribution and historical changes of PAHs contamination in recent sediment cores from the Imo River were investigated using gas chromatography coupled with mass spectrometer. The concentrations of total PAHs (TPAHs) ranging from 402.37 ng/g dry weight (dw) at the surface layer of the Estuary zone (ESC6; 0-5 cm) to 92,388.59 ng/g dw at the near surface layer of the Afam zone (ASC5; 5-10 cm) indicate that PAHs contamination was localized not only between sample sites but also within the same cores. Sediment-depth profiles for the four (Afam, Mangrove, Estuary and illegal Petroleum refinery) cores revealed irregular distribution patterns in the TPAH concentrations except the fact that these levels became maximized at the near surface layers (5-10 cm) corresponding to a geological time-frame of about 1996-2004. This time scale coincided with the period of intensive bunkering and oil pipeline vandalization by the Niger Delta militant groups. Also a general slight decline was found in the TPAHs levels from near the surface layers (5-10 cm) to the most recent top layers (0-5 cm) of the cores, attributable to the recent effort by the Nigerian government in clamping down the illegal activity of the economic saboteurs. Therefore, the recent amnesty period granted to the militant groups should be extended. Although mechanism of perylene formation still remains enigmatic, examination of its distributions down cores indicates natural biogenic, pyrogenic and petrogenic origins for the compound at different zones. Thus, the characteristic features of the Imo River environment provide a means of tracing diverse origins for perylene.Keywords: perylene, historical trend, distribution, origin, Imo River
Procedia PDF Downloads 2513180 Stability Analysis of Endemic State of Modelling the Effect of Vaccination and Novel Quarantine-Adjusted Incidence on the Spread of Newcastle Disease Virus
Authors: Nurudeen Oluwasola Lasisi, Abdulkareem Afolabi Ibrahim
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Newcastle disease is an infection of domestic poultry and other bird species with virulent Newcastle disease virus (NDV). In this paper, we study the dynamics of modeling the Newcastle disease virus (NDV) using a novel quarantine-adjusted incidence. We do a comparison of Vaccination, linear incident rate, and novel quarantine adjusted incident rate in the models. The dynamics of the models yield disease free and endemic equilibrium states. The effective reproduction numbers of the models are computed in order to measure the relative impact for the individual bird or combined intervention for effective disease control. We showed the local and global stability of endemic equilibrium states of the models, and we found that stability of endemic equilibrium states of models are globally asymptotically stable if the effective reproduction numbers of the models equations are greater than a unit.Keywords: effective reproduction number, endemic state, mathematical model, Newcastle disease virus, novel quarantine-adjusted incidence, stability analysis
Procedia PDF Downloads 2443179 Environment Patterns and Mental Health of Older Adults in Long-Term Care Facilities: The Role of Activity Profiles
Authors: Shiau-Fang Chao, Yu-Chih Chen
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Owing to physical limitations and restrained lifestyle, older long-term care (LTC) residents are more likely to be affected by their environment than their community-dwelling counterparts. They also participate fewer activities and experience worse mental health than healthy older adults. This study adopts the ICF model to determine the extent to which the clustered patterns of LTC environment and activity participation are associated with older residents’ mental health. Method: Data were collected from a stratified equal probability sample of 634 older residents in 155 LTC institutions in Taiwan. Latent profile analysis (LPA) and latent class analysis (LCA) were conducted to explore the profiles for environment and activity participation. Multilevel modeling was performed to elucidate the relationships among environment profiles, activity profiles, and mental health. Results: LPA identified three mutually exclusive environment profiles (Low-, Moderate-, and High-Support Environment) based on the physical, social, and attitudinal environmental domains, consolidated from 12 environmental measures. LCA constructed two distinct activity profiles (Low- and High-Activity Participation) across seven activity domains (outdoor, volunteer-led leisure, spiritual, household chores, interpersonal exchange, social, and sedentary activity) that were factored from 20 activities. Compared to the Low-Support Environment class, older adults in the Moderate- and High-Support Environment classes had better mental health. Older residents in the Moderate- and High-Support Environment classes were more likely to be in the “High Activity” class, which in turn, exhibited better mental health. Conclusion: This study advances the current knowledge through rigorous methods and study design. The study findings lead to several conclusions. First, this study supports the use of ICF framework to institutionalized older individuals with functional limitations and demonstrates that both measures of environment and activity participation can be refined from multiple indicators. Second, environmental measures that encompass the physical, social, and attitudinal domains would provide a more comprehensive assessment on the place where an older individual embeds. Third, simply counting activities in which an older individual participates or considering a certain type of activity may not capture his or her way of life. Practitioners should not only focus on group or leisure activities within the institutions; rather, more efforts should be made to consider residents’ preferences for everyday life and support their remaining ability by encouraging continuous participation in activities they still willing and capable to perform. Fourth, environment and activity participation are modifiable factors which have greater potential to strengthen older LTC residents’ mental health, and activity participation should be considered in the link between environment and mental health. A combination of enhanced physical, social, and attitudinal environments, and continual engagement in various activities may optimize older LTC residents’ mental health.Keywords: activity, environment, mental health, older LTC residents
Procedia PDF Downloads 1973178 Social Processes and Organizational Structures for the Management of Exploration and Exploration within and across Organization Boundaries
Authors: Linda O. N. Nwabunike
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The role of internal and external efforts in the management of exploration and exploitation has been highlighted in literature. External ties support ambidexterity at different levels with, for instance: business unit ambidexterity, individual ambidexterity, organizational ambidexterity, and alliance ambidexterity. Recently studies have highlighted the combination of organization, alliance, and acquisition strategies for ambidexterity by conceptualizing ambidexterity across modes of operation. Literature still lacks detailed understanding of how these different processes are combined in the management of ambidexterity across modes of operation. This study plans to propose a conceptual model that illustrates the social processes involved in the management of ambidexterity across modes of operation. Main arguments are integrated from social structures, organizational design, and ambidexterity literature. The framework illustrates that how social capital is promoted by hierarchical relations within the organization and business relations across the boundaries of the organization. Whereby such social relations within and outside the organization are supported by the dual structures of the organization in the coordination of multiple efforts. This paper has potential to contribute to the understanding about how ambidexterity is attained.Keywords: ambidexterity, coordination, external-ties, social-capital
Procedia PDF Downloads 1683177 Review of Strategies for Hybrid Energy Storage Management System in Electric Vehicle Application
Authors: Kayode A. Olaniyi, Adeola A. Ogunleye, Tola M. Osifeko
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Electric Vehicles (EV) appear to be gaining increasing patronage as a feasible alternative to Internal Combustion Engine Vehicles (ICEVs) for having low emission and high operation efficiency. The EV energy storage systems are required to handle high energy and power density capacity constrained by limited space, operating temperature, weight and cost. The choice of strategies for energy storage evaluation, monitoring and control remains a challenging task. This paper presents review of various energy storage technologies and recent researches in battery evaluation techniques used in EV applications. It also underscores strategies for the hybrid energy storage management and control schemes for the improvement of EV stability and reliability. The study reveals that despite the advances recorded in battery technologies there is still no cell which possess both the optimum power and energy densities among other requirements, for EV application. However combination of two or more energy storages as hybrid and allowing the advantageous attributes from each device to be utilized is a promising solution. The review also reveals that State-of-Charge (SoC) is the most crucial method for battery estimation. The conventional method of SoC measurement is however questioned in the literature and adaptive algorithms that include all model of disturbances are being proposed. The review further suggests that heuristic-based approach is commonly adopted in the development of strategies for hybrid energy storage system management. The alternative approach which is optimization-based is found to be more accurate but is memory and computational intensive and as such not recommended in most real-time applications.Keywords: battery state estimation, hybrid electric vehicle, hybrid energy storage, state of charge, state of health
Procedia PDF Downloads 2423176 Cantilever Secant Pile Constructed in Sand: Capping Beam Analysis and Design - Part I
Authors: Khaled R. Khater
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The paper theme is soil retaining structures. Cantilever secant-pile wall is triggering scientific point of curiosity. Specially the capping beams structural analysis and its interaction with secant piles as one integrated matrix. It is believed that straining actions of this integrated matrix are most probably induced due to a combination of induced line load and non-uniform horizontal pile tips displacement. The strategy that followed throughout this study starts by converting the pile head horizontal displacements generated by Plaxis-2D model to a system of concentrated line load acting per meter run along the capping beam. Then, those line loads are the input data of Staad-Pro 3D-model. Those models tailored to allow the capping beam and the secant piles interacting as one matrix, i.e. a unit. It is believed that the suggested strategy presents close to real structural simulation. The above is the paper thought and methodology. Three sand densities, one pile rigidity and one excavation depth, “h = 4.0-m,” are completely sufficient to achieve the paper’s objective.Keywords: secant piles, capping beam, analysis, design, plaxis 2D, staad pro 3D
Procedia PDF Downloads 1073175 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi
Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal
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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis
Procedia PDF Downloads 2003174 Adopting Quality Assurance Cycles in Accreditation and Strategic Planning in Higher Education Institutions
Authors: Fouzia Shersad, Sabeena Salam
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Introduction: Quality assurance cycles like RADAR, PDCA, ADRI are cycles of planning, implementation, assessment and improvement. These cycles are required when institutions apply for reaccreditation to accreditation bodies and for adoption of holistic models of institutional quality. Method of Study: The adoption of these cycles at the higher education institutions under the Dubai Medical University is studied to explore the feasibility and the benefits in institutions outcomes. After adequate faculty training, these steps were incorporated in all new activities and embedded in every new initiative and approach undertaken at unit and institutional levels. Conclusions: Improvement in student satisfaction rates and performance levels has been achieved. Wherever weaknesses or deficits have been identified, improvement strategies are implemented in a timely manner. The feedback has become an incentive for faculty members to implement new ideas. Implementation of these cycles for core processes at micro and macro levels have ensured that a systematic mechanism for corrective actions existed. This has led to increasing adoption of innovative initiatives. Another outcome was the recognition through national level awards for the overall institutions which have been certified by external reviewers.Keywords: higher education, quality, accreditation, institutional improvement
Procedia PDF Downloads 3803173 Shark Resources in the Iranian Waters of the Persian Gulf
Authors: Nassir Niamaimandi, Mehrdad Hosaini Shabankareh
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This study was analyzed the annual catch and trawl survey data of sharks in the northern part of the Persian Gulf (26˚ 30΄ to 30˚ 00΄N and 49˚ 00΄ to 56˚ 00΄E) from 2004 to 2009. Trawl survey was conducted by research vessel Ferdous, equipped with bottom trawl nets in meshes 400mm and 80mm at the body, and cod-end, respectively. Ten stratums were selected in the study area and 199 stations were randomly trawled. The density (CPUA) of shark resources was estimated based on swept area method. The annual total catch was obtained from Iranian fisheries organization (Shilat). The results of catch per unit area showed 250.7 kg/nm2 in 2004 to 49.7 kg/nm2 in 2009. There was a high degree of variability of CPUA among different areas and the maximum was estimated 1870.8 kg/nm2 in Nayband and Mogham. In catch composition data, sharks have a decreasing trend from 4.2% in 2004 to 2.9% in 2009 that shows a decline with an annual average 1.3% during 2004-2009. This results suggesting that the shark resource is overexploited and the current effort is far higher than the effort required harvesting optimum yields.Keywords: shark resources, Iranian waters, Persian Gulf, Trawl survey
Procedia PDF Downloads 5603172 Environmentally Friendly KOH and NH4OH-KOH Pulping of Rice Straw
Authors: Omid Ghaffarzadeh Mollabashi, Sara Khorshidi, Hossein Kermanian Seyed, Majid Zabihzadeh
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The main problem that hinders the intensive use of non-wood raw materials in papermaking industry is the environmental pollution caused by black liquor. As a matter of fact, black liquor of nonwood pulping is discharged to the environment due to the lack of recovery. Traditionally, NaOH pulping produces Na-based black liquor that may increase soil erosion and reduce soil permeability. With substitution of KOH/NH4OH with NaOH as the cooking liquor, K and N can act as a soil fertilizer while offering an environmentally acceptable disposal alternative. For this purpose, rice straw samples were pulped under the following conditions; Constant factors were: straw weight: 100 gram (based on oven dry), liquor to straw ratio 7:1 and maximum temperature, 170 and 180 ºC. Variable factors for KOH cooks were: KOH dosage of 14, 17 and %20 on oven dry of straw and times at maximum temperature of 60 and 90 minutes. For KOH-NH4OH cooks, KOH dosage of 5 and %10 and NH4OH dosage of 25 and %35, both based as oven dry of straw were applied. Besides, time at maximum temperature was 90 minutes. Yield ranges of KOH and KOH-NH4OH pulp samples were obtained from 37.28 to 48.62 and 45.63 to 48.08 percent, respectively. In addition, Kappa number ranged from 21.91 to 29.85 and 55.15 to 56.25, respectively. In comparison with soda, soda-AQ, cold soda, kraft, EDA (dissolving), De-Ethylene Glycol (dissolving), burst and tensile index for KOH pulp was more in similar cooking condition. With an exception of soda pulps, tear index of the mentioned pulp is more than all compared treatments. Therefore, it can be resulted that KOH pulping method is an appropriate choice for making paper of the rice straw. Also, compared to KOH-NH4OH, KOH pulping method is more appropriate choice because of better pulping results.Keywords: environmentally friendly process, rice straw, NH4OH-KOH pulping, pulp properties
Procedia PDF Downloads 2703171 Factors Influencing Intention to Engage in Long-term Care Services among Nursing Aide Trainees and the General Public
Authors: Ju-Chun Chien
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Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.Keywords: long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior
Procedia PDF Downloads 1573170 An Organocatalytic Construction of Vicinal Tetrasubstituted Stereocenters via Mannich Reaction of 2-Substituted Benzofuran-3-One with Isatin-Derived Ketimine
Authors: Koilpitchai Sivamuthuraman, Venkitasamy Kesavan
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3-substituted 3-amino-2-oxindole skeleton bearing adjacent tetrasubstituted stereogenic centers is of great importance because of these heterocyclic motifs possess a wide range of pharmacological activity. The catalytic asymmetric construction of multi functionalised heterocyclic compound with adjacent tetrasubstituted stereocenters is one of the most difficult tasks in organic synthesis. To date, the most straightforward methodologies have been developed for synthesis of chiral 3-substituted 3-amino-2-oxindoles through the addition of carbon nucleophiles to isatin-derived ketimines. However, only a few successful examples have been described for the assembly of vicinal tetrasubstituted stereocenters using isatin derived ketimines as electrophiles. On the other hand, 2,2-Disubstituted benzofuran-3(2H)-ones and related frameworks are characteristic of a quaternary stereogenic center at C2 position present in quite a number of natural products and bioactive Molecules.Despite the intensive efforts devoted for the construction of 2,2-Disubstituted Benzofuran-3[2H]-one, there are only a few asymmetric methods such as organocatalytic Michael addition and enantioselective halogenations were reported till now. Due to the biological importance of oxindole and benzofuran-3-one, it is proposed here with the synthesis of hybrid molecule containing tetrasubstituted stereo centers through asymmetric organocatalysis. The addition of 2-substituted Benzofuran-3-one(1a) to isatin-derived ketimines(2a) using a bifunctional organocatalyst(catalyst IV or V), leading to chiral heterocyclic compounds containing both 3-amino 2-oxindole and benzofurn-3-one bearing vicinal quaternary stereocenters with good yields and excellent enantioselectivity. The present study extends the scope of the catalytic asymmetric Mannich reaction with isatin-derived ketimines, providing a new class of amino oxindole derivatives having benzofuran-3-one.Keywords: asymmetric synthesis, benzofuran-3-one, isatin-derived ketimines, quaternary stereocenters
Procedia PDF Downloads 1913169 Reading High Rise Residential Development in Istanbul on the Theory of Globalization
Authors: Tuba Sari
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One of the major transformations caused by the industrial revolution, technological developments and globalization is undoubtedly acceleration of urbanization process. Globalization, in particular, is one of the major factors that trigger this transformation. In this context, as a result of the global metropolitan city system, multifunctional rising structure forms are becoming undeniable fact of the world’s leading metropolises as the manifestation of prestige and power with different life choices, easy accessibility to services related to the era of technology. The scope of research deals with five different urban centers in İstanbul where high-rise housing is increasing dramatically after 2000’s. Therefore, the research regards multi-centered urban residential pattern being created by high-rise housing structures in the city. The methodology of the research is based on two main issue, one of them is related to sampling method of high-rise housing projects in İstanbul, while the other method of the research is based on the model of Semantics. In the framework of research hypothesis, it is aimed to prove that the character of vertical intensive structuring in Istanbul is based on seeking of different forms and images in the expressive quality, considering the production of existing high-rise buildings in residential areas in recent years. In respect to rising discourse of 'World City' in the globalizing world, it is very important to state the place of Istanbul in other developing world metropolises. In the perspective of 'World City' discourse, Istanbul has different projects concerning with globalization, international finance companies, cultural activities, mega projects, etc. In brief, the aim of this research is examining transformation forms of high-rise housing development in Istanbul within the frame of developing world cities, searching and analyzing discourse and image related to these projects.Keywords: globalization, high-rise, housing, image
Procedia PDF Downloads 2853168 Establishing a Cause-Effect Relationship among the Key Success Factors of Healthcare Waste Management in India
Authors: Ankur Chauhan, Amol Singh
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The increasing human resource has led to the rapid increment in the generation of healthcare waste across the world. Since, this waste consists of the infectious and hazardous components emerged from the patient care activities in different healthcare facilities; therefore, its proper management becomes vital for mitigating its negative impact on society and environment. The present research work focuses on the identification of the key success factors for developing a successful healthcare waste management plan. In addition, the key success factors have been studied by developing a causal diagram with the help of a decision making trial and evaluation (DEMATEL) approach. The findings of the study would help in the filtration of dominant key success factors which would further help in making a comparative assessment of the waste management plan of different hospitals.Keywords: healthcare waste disposal, environment and society, multi-criteria decision making, DEMATEL
Procedia PDF Downloads 3883167 A Low-Cost Disposable PDMS Microfluidic Cartridge with Reagent Storage Silicone Blisters for Isothermal DNA Amplification
Authors: L. Ereku, R. E. Mackay, A. Naveenathayalan, K. Ajayi, W. Balachandran
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Over the past decade the increase of sexually transmitted infections (STIs) especially in the developing world due to high cost and lack of sufficient medical testing have given rise to the need for a rapid, low cost point of care medical diagnostic that is disposable and most significantly reproduces equivocal results achieved within centralised laboratories. This paper present the development of a disposable PDMS microfluidic cartridge incorporating blisters filled with reagents required for isothermal DNA amplification in clinical diagnostics and point-of-care testing. In view of circumventing the necessity for external complex microfluidic pumps, designing on-chip pressurised fluid reservoirs is embraced using finger actuation and blister storage. The fabrication of the blisters takes into consideration three proponents that include: material characteristics, fluid volume and structural design. Silicone rubber is the chosen material due to its good chemical stability, considerable tear resistance and moderate tension/compression strength. The case of fluid capacity and structural form go hand in hand as the reagent need for the experimental analysis determines the volume size of the blisters, whereas the structural form has to be designed to provide low compression stress when deformed for fluid expulsion. Furthermore, the top and bottom section of the blisters are embedded with miniature polar opposite magnets at a defined parallel distance. These magnets are needed to lock or restrain the blisters when fully compressed so as to prevent unneeded backflow as a result of elasticity. The integrated chip is bonded onto a large microscope glass slide (50mm x 75mm). Each part is manufactured using a 3D printed mould designed using Solidworks software. Die-casting is employed, using 3D printed moulds, to form the deformable blisters by forcing a proprietary liquid silicone rubber through the positive mould cavity. The set silicone rubber is removed from the cast and prefilled with liquid reagent and then sealed with a thin (0.3mm) burstable layer of recast silicone rubber. The main microfluidic cartridge is fabricated using classical soft lithographic techniques. The cartridge incorporates microchannel circuitry, mixing chamber, inlet port, outlet port, reaction chamber and waste chamber. Polydimethylsiloxane (PDMS, QSil 216) is mixed and degassed using a centrifuge (ratio 10:1) is then poured after the prefilled blisters are correctly positioned on the negative mould. Heat treatment of about 50C to 60C in the oven for about 3hours is needed to achieve curing. The latter chip production stage involves bonding the cured PDMS to the glass slide. A plasma coroner treater device BD20-AC (Electro-Technic Products Inc., US) is used to activate the PDMS and glass slide before they are both joined and adequately compressed together, then left in the oven over the night to ensure bonding. There are two blisters in total needed for experimentation; the first will be used as a wash buffer to remove any remaining cell debris and unbound DNA while the second will contain 100uL amplification reagents. This paper will present results of chemical cell lysis, extraction using a biopolymer paper membrane and isothermal amplification on a low-cost platform using the finger actuated blisters for reagent storage. The platform has been shown to detect 1x105 copies of Chlamydia trachomatis using Recombinase Polymerase Amplification (RPA).Keywords: finger actuation, point of care, reagent storage, silicone blisters
Procedia PDF Downloads 3703166 Heritage Tree Expert Assessment and Classification: Malaysian Perspective
Authors: B.-Y.-S. Lau, Y.-C.-T. Jonathan, M.-S. Alias
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Heritage trees are natural large, individual trees with exceptionally value due to association with age or event or distinguished people. In Malaysia, there is an abundance of tropical heritage trees throughout the country. It is essential to set up a repository of heritage trees to prevent valuable trees from being cut down. In this cross domain study, a web-based online expert system namely the Heritage Tree Expert Assessment and Classification (HTEAC) is developed and deployed for public to nominate potential heritage trees. Based on the nomination, tree care experts or arborists would evaluate and verify the nominated trees as heritage trees. The expert system automatically rates the approved heritage trees according to pre-defined grades via Delphi technique. Features and usability test of the expert system are presented. Preliminary result is promising for the system to be used as a full scale public system.Keywords: arboriculture, Delphi, expert system, heritage tree, urban forestry
Procedia PDF Downloads 3133165 The Major Challenge of the Health System Health Management Services in Kosovo and Impact on Satisfaction
Authors: Nevruz Zogu, Shpetim Rezniqi
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In the framework of transformational economic development social pluralism and the free, market health systems operating in the countries of our region are naturally involved in a process of profound change and reform. Health systems actually represent complex ensembles centers and public and private institutions (domestic and foreign), who administer substantial amounts of human, technological, material, financial, information and scientific facts • The goal of health systems is much more than medical care. It includes the promotion, protection, treatment and rehabilitation of health of the population. • Meeting the needs of increasingly diverse broader health services efficient, secure the quality and affordability of their increasing cost of unstoppable, requires the necessary reform of health systems and implementing policies and new management methods, to ensure effectiveness and health benefits as higher population.Keywords: health, management, economy, finance
Procedia PDF Downloads 4213164 Attraction and Retention of Newly Graduated Medical Doctors to Deprived Regions in Ghana: A Qualitative Case Study
Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah
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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.Keywords: attraction, retention, medical doctors, deprived regions, Ghana
Procedia PDF Downloads 1103163 Vegetation Integrated with Architecture: A Comparative Study in Vijayawada
Authors: Clince Rodrigues
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Due to high dense areas, there is a continuous increase in the global warming and urban pollution, thus integrating green with the built environment is vital. The paper deals with the understanding of vegetation in architecture and how a proper design strategy can aim at improving not only the performances of buildings but also the outdoor climate. In the present scenario of cities, one cannot inhale pure air. Vegetations combat global warming by absorbing the carbon emitted by vehicles, lowering carbon emissions from fossil fuel-burning plants, and reducing the energy used for climate control in buildings by the use of plants which can reduce the carbon emission and thus, making the environment less polluted. A comparative study of areas, neighborhood and dwelling unit has been used as a scope for understanding different scenarios and scale. By comparing a system (area; building) with and without vegetation, and then finding out the difference. Understanding the Vijayawada city by taking its past and present conditions, and how these changes have affected the environment and people at a macro and micro level. Built environment and climactic performance at the building level and surrounding spaces are the areas that are covered in the study.Keywords: climate, environment, neighborhood, pollution, vegetation, Vijayawada, urban
Procedia PDF Downloads 1573162 Ultrasensitive Hepatitis B Virus Detection in Blood Using Nano-Porous Silicon Oxide: Towards POC Diagnostics
Authors: N. Das, N. Samanta, L. Pandey, C. Roy Chaudhuri
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Early diagnosis of infection like Hep-B virus in blood is important for low cost medical treatment. For this purpose, it is desirable to develop a point of care device which should be able to detect trace quantities of the target molecule in blood. In this paper, we report a nanoporous silicon oxide sensor which is capable of detecting down to 1fM concentration of Hep-B surface antigen in blood without the requirement of any centrifuge or pre-concentration. This has been made possible by the presence of resonant peak in the sensitivity characteristics. This peak is observed to be dependent only on the concentration of the specific antigen and not on the interfering species in blood serum. The occurrence of opposite impedance change within the pores and at the bottom of the pore is responsible for this effect. An electronic interface has also been designed to provide a display of the virus concentration.Keywords: impedance spectroscopy, ultrasensitive detection in blood, peak frequency, electronic interface
Procedia PDF Downloads 4023161 Adsorptive Waste Heat Based Air-Conditioning Control Strategy for Automotives
Authors: Indrasen Raghupatruni, Michael Glora, Ralf Diekmann, Thomas Demmer
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As the trend in automotive technology is fast moving towards hybridization and electrification to curb emissions as well as to improve the fuel efficiency, air-conditioning systems in passenger cars have not caught up with this trend and still remain as the major energy consumers amongst others. Adsorption based air-conditioning systems, e.g. with silica-gel water pair, which are already in use for residential and commercial applications, are now being considered as a technology leap once proven feasible for the passenger cars. In this paper we discuss a methodology, challenges and feasibility of implementing an adsorption based air-conditioning system in a passenger car utilizing the exhaust waste heat. We also propose an optimized control strategy with interfaces to the engine control unit of the vehicle for operating this system with reasonable efficiency supported by our simulation and validation results in a prototype vehicle, additionally comparing to existing implementations, simulation based as well as experimental. Finally we discuss the influence of start-stop and hybrid systems on the operation strategy of the adsorption air-conditioning system.Keywords: adsorption air-conditioning, feasibility study, optimized control strategy, prototype vehicle
Procedia PDF Downloads 4353160 Performance of Derna Steam Power Plant at Varying Super-Heater Operating Conditions Based on Exergy
Authors: Idris Elfeituri
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In the current study, energy and exergy analysis of a 65 MW steam power plant was carried out. This study investigated the effect of variations of overall conductance of the super heater on the performance of an existing steam power plant located in Derna, Libya. The performance of the power plant was estimated by a mathematical modelling which considers the off-design operating conditions of each component. A fully interactive computer program based on the mass, energy and exergy balance equations has been developed. The maximum exergy destruction has been found in the steam generation unit. A 50% reduction in the design value of overall conductance of the super heater has been achieved, which accordingly decreases the amount of the net electrical power that would be generated by at least 13 MW, as well as the overall plant exergy efficiency by at least 6.4%, and at the same time that would cause an increase of the total exergy destruction by at least 14 MW. The achieved results showed that the super heater design and operating conditions play an important role on the thermodynamics performance and the fuel utilization of the power plant. Moreover, these considerations are very useful in the process of the decision that should be taken at the occasions of deciding whether to replace or renovate the super heater of the power plant.Keywords: Exergy, Super-heater, Fouling; Steam power plant; Off-design., Fouling;, Super-heater, Steam power plant
Procedia PDF Downloads 333