Search results for: hospital capacity planning

Authors: Sonia Mastrangelo

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The Miller Umwelt Assessment Scale is a useful tool for obtaining information about the developmental capacities of children on the autism spectrum. The assessment, made up of 19 tasks in the areas of: body organization, contact with surroundings, expressive and receptive communication, representation, and social-emotional development, has been used with much success over the past 40 years. While many assessments are difficult to administer to children on the autism spectrum, the simplicity of the MUAS reveals key strengths and challenges for both low and high functioning children on the spectrum. The results guide parents and clinicians in providing a curriculum and/or home program that moves children up the developmental ladder.

Keywords: autism spectrum disorder, assessment, reading intervention, Miller method

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Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

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Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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Authors: Aaron Herve Mbwe Mbissik, Lotfi Khiari, Otmane Raji, Abdellatif Elghali, Abdelkarim Lajili, Muhammad Ouabid, Martin Jemo, Jean-Louis Bodinier

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Potassium (K) is an essential macronutrient for plant growth, helping to regulate several physiological and metabolic processes. Evaporite-related potash salts, mainly sylvite minerals (K chloride or KCl), are the principal source of K for the fertilizer industry. However, due to the high potash-supply risk associated with its considerable price fluctuations and uneven geographic distribution for most agriculture-based developing countries, the development of alternative sources of fertilizer K is imperative to maintain adequate crop yield, reduce yield gaps, and food security. Alkaline Igneous rocks containing significant K-rich silicate minerals such as K feldspar are increasingly seen as the best alternative available. However, these rocks may require to be hydrothermally treatment to enhance the release of potassium. In this study, we evaluate the fertilizing capacity of raw and hydrothermally treated K-bearing silicate rocks from different areas in Morocco. The effectiveness of rock powders was tested in a greenhouse experiment using ryegrass (Lolium multiflorum) by comparing them to a control (no K added) and to a conventional fertilizer (muriate of potash: MOP or KCl). The trial was conducted in a randomized complete block design with three replications, and plants were grown on K-depleted soils for three growing cycles. To achieve our objective, in addition to the analysis of the muriate response curve and the different biomasses, we also examined three necessary coefficients, namely: the K uptake, then apparent K recovery (AKR), and the relative K efficiency (RKE). The results showed that based on the optimum economic rate of MOP (230 kg.K.ha⁻¹) and the optimum yield (44 000 kg.K.ha⁻¹), the efficiency of K silicate rocks was as high as that of MOP. Although the plants took up only half of the K supplied by the powdered rock, the hydrothermal material was found to be satisfactory, with a biomass value reaching the optimum economic limit until the second crop cycle. In comparison, the AKR of the MOP (98.6%) and its RKE in the 1st cycle were higher than our materials: 39% and 38%, respectively. Therefore, the raw and hydrothermal materials mixture could be an appropriate solution for long-term agronomic use based on the obtained results.

Keywords: K-uptake, AKR, RKE, K-bearing silicate rock, MOP

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Authors: N. Azouaou, H. Mokaddem, D. Senadjki, K. Kedjit, Z. Sadaoui

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Introduction: Water contamination caused by dye industries, including food, leather, textile, plastic, cosmetics, paper-making, printing and dye synthesis, has caused more and more attention, since most dyes are harmful to human being and environments. Untreated coffee grounds were used as a high-efficiency adsorbent for the removal of a cationic dye (methylene blue, MB) from aqueous solution. Characterization of the adsorbent was performed using several techniques such as SEM, surface area (BET), FTIR and pH zero charge. The effects of contact time, adsorbent dose, initial solution pH and initial concentration were systematically investigated. Results showed the adsorption kinetics followed the pseudo-second-order kinetic model. Langmuir isotherm model is in good agreement with the experimental data as compared to Freundlich and D–R models. The maximum adsorption capacity was found equal to 52.63mg/g. In addition, the possible adsorption mechanism was also proposed based on the experimental results. Experimental: The adsorption experiments were carried out in batch at room temperature. A given mass of adsorbent was added to methylene blue (MB) solution and the entirety was agitated during a certain time. The samples were carried out at quite time intervals. The concentrations of MB left in supernatant solutions after different time intervals were determined using a UV–vis spectrophotometer. The amount of MB adsorbed per unit mass of coffee grounds (qt) and the dye removal efficiency (R %) were evaluated. Results and Discussion: Some chemical and physical characteristics of coffee grounds are presented and the morphological analysis of the adsorbent was also studied. Conclusions: The good capacity of untreated coffee grounds to remove MB from aqueous solution was demonstrated in this study, highlighting its potential for effluent treatment processes. The kinetic experiments show that the adsorption is rapid and maximum adsorption capacities qmax= 52.63mg/g achieved in 30min. The adsorption process is a function of the adsorbent concentration, pH and metal ion concentration. The optimal parameters found are adsorbent dose m=5g, pH=5 and ambient temperature. FTIR spectra showed that the principal functional sites taking part in the sorption process included carboxyl and hydroxyl groups.

Keywords: adsorption, methylene blue, coffee grounds, kinetic study

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: Diriba T. Balcha, Boris Kulig, Oliver Hensel, Eyassu Woldesenbet

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Enset fiber is agricultural waste and available in a surplus amount in Ethiopia. However, the hypothesized variation in properties of this fiber due to diversity of its plant source breed, fiber position within plant stem and chemical treatment duration had not proven that its application for the development of composite products is problematic. Currently, limited data are known on the functional properties of the fiber as a potential functional fiber. Thus, an effort is made in this study to narrow the knowledge gaps by characterizing it. The experimental design was conducted using Design-Expert software and the tensile test was conducted on Enset fiber from 10 breeds: Dego, Dirbo, Gishera, Itine, Siskela, Neciho, Yesherkinke, Tuzuma, Ankogena, and Kucharkia. The effects of 5% Na-OH surface treatment duration and fiber location along and across the plant pseudostem was also investigated. The test result shows that the rupture stress variation is not significant among the fibers from 10 Enset breeds. However, strain variation is significant among the fibers from 10 Enset breeds that breed Dego fiber has the highest strain before failure. Surface treated fibers showed improved rupture strength and elastic modulus per 24 hours of treatment duration. Also, the result showed that chemical treatment can deteriorate the load-bearing capacity of the fiber. The raw fiber has the higher load-bearing capacity than the treated fiber. And, it was noted that both the rupture stress and strain increase in the top to bottom gradient, whereas there is no significant variation across the stem. Elastic modulus variation both along and across the stem was insignificant. The rupture stress, elastic modulus, and strain result of Enset fiber are 360.11 ± 181.86 MPa, 12.80 ± 6.85 GPa and 0.04 ± 0.02 mm/mm, respectively. These results show that Enset fiber is comparable to other natural fibers such as abaca, banana, and sisal fibers and can be used as alternatives natural fiber for composites application. Besides, the insignificant variation of properties among breeds and across stem is essential for all breeds and all leaf sheath of the Enset fiber plant for fiber extraction. The use of short natural fiber over the long is preferable to reduce the significant variation of properties along the stem or fiber direction. In conclusion, Enset fiber application for composite product design and development is mechanically feasible.

Keywords: Agricultural waste, Chemical treatment, Fiber characteristics, Natural fiber

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Authors: Nick Toossi, Joseph Hartland

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Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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Authors: Balázs Kulcsár

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Today, there is no part of the world that does not bear the mark of man in some way. This process seems unstoppable. So perhaps the best thing we can do is to touch that handprint gently and with the utmost care. There are multiple uses for the same piece of land, the coordination of which requires careful and sustainable spatial planning. The case study of the Rétközlake in north-eastern Hungary illustrates a habitat rehabilitation project in which a number of human uses were coordinated with the conservation and restoration of the natural environment. Today, the good condition of the habitat can only be maintained artificially, but the project has paid particular attention to finding a sustainable solution. The rehabilitation of Lake Rétköz is considered good practice in resolving land-use conflicts.

Keywords: sustainability, ecosystem service, land use conflict, landscape utilization

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Authors: Rakesh Dogra, Arun Kumar, Arvind Kumar Sharma

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This paper reports the thermoluminescence as well as optical properties of rare earth doped lithium fluoride (LiF) nanophosphor, synthesized via chemical route. The rare earth impurities (Yb and Sm) have been observed to increase the deep trap center capacity, which, in turn, enhance the radiation resistance of the LiF. This suggests the viability of these materials to be used as high dose thermoluminescent detectors at high temperature. Further, optical absorption measurements revealed the formation of radiation induced stable color centers in LiF at room temperature, which are independent of the rare earth dopant.

Keywords: lithium flouride, thermoluminescence, UV-VIS spectroscopy, Gamma radiations

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Authors: Zouhair Issa Ahmed, Ahmed Abdulrasool Ahmed, Falah Hassan Abdulsada

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This paper presents a layout of a factory using Pro-Model simulation by choosing the best layout that gives the highest productivity and least work in process. The general problem is to find the best sequence in which jobs pass between the machines which are compatible with the technological constraints and optimal with respect to some performance criteria. The best simulation with Pro-Model program increased productivity and reduced work in process by balancing lines of production compared with the current layout of factory when productivity increased from 45 products to 180 products through 720 hours.

Keywords: scheduling, Pro-Model, simulation, balancing lines of production, layout planning, WIP

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Authors: Mohammad Hossain Validad, Maryam Nakhaei-Moghadam, Monire Mahjoob

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Introduction: The prevalence of type 1 diabetes is increasing worldwide, and given the role of ethnicity and race in complications of diabetes, this study was designed to evaluate the ocular complications of type 1 diabetes mellitus in Zahedan. Methods: This prospective cross-sectional study was conducted on Type 1 diabetic children that referred to Alzahra Eye Hospital. All patients had a dilated binocular indirect ophthalmoscopy using a +90 D condensing lens and slit-lamp biomicroscopy. Age, gender, onset, duration of diabetes, and HbA1c level were recorded. Results: 76 type 1 diabetes patients with an age of 11.93 ± 3.76 years participated in this study. Out of 76 patients with diabetes, 19 people (25%) had ocular complications. There was a significant difference in age (P=0.01) and disease duration (P=0.07) between the two groups with and without ocular complications. Odd ratios for ocular complications with age and duration of diabetes were 1.32 and 1.32, respectively. Conclusion: Cataract was the most common ocular complication in type 1 diabetes in Zahedan, a tropical region that was significantly related to the duration of the disease and the age of the patients.

Keywords: diabet mellitus type one, cataract, ocular complication, hemoglobin A1C

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Authors: Nur Azilina Abdul Aziz, Tuti Katrina Abdullah, Ahmad Azmin Mohamad

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Lithium-transition metals and some of their oxides, such as LiCoO2, LiMn2O2, LiFePO4, and LiNiO2 have been used as cathode materials in high performance lithium-ion rechargeable batteries. Among the cathode materials, LiCoO2 has potential to been widely used as a lithium-ion battery because of its layered crystalline structure, good capacity, high cell voltage, high specific energy density, high power rate, low self-discharge, and excellent cycle life. This cathode material has been widely used in commercial lithium-ion batteries due to its low irreversible capacity loss and good cycling performance. However, there are several problems that interfere with the production of material that has good electrochemical properties, including the crystallinity, the average particle size and particle size distribution. In recent years, synthesis of nanoparticles has been intensively investigated. Powders prepared by the traditional solid-state reaction have a large particle size and broad size distribution. On the other hand, solution method can reduce the particle size to nanometer range and control the particle size distribution. In this study, LiCoO2 was synthesized using the sol–gel preparation method, which Lithium acetate and Cobalt acetate were used as reactants. The stoichiometric amounts of the reactants were dissolved in deionized water. The solutions were stirred for 30 hours using magnetic stirrer, followed by heating at 80°C under vigorous stirring until a viscous gel was formed. The as-formed gel was calcined at 700°C for 7 h under a room atmosphere. The structural and morphological analysis of LiCoO2 was characterized using X-ray diffraction and Scanning electron microscopy. The diffraction pattern of material can be indexed based on the α-NaFeO2 structure. The clear splitting of the hexagonal doublet of (006)/(102) and (108)/(110) in this patterns indicates materials are formed in a well-ordered hexagonal structure. No impurity phase can be seen in this range probably due to the homogeneous mixing of the cations in the precursor. Furthermore, SEM micrograph of the LiCoO2 shows the particle size distribution is almost uniform while particle size is between 0.3-0.5 microns. In conclusion, LiCoO2 powder was successfully synthesized using the sol–gel method. LiCoO2 showed a hexagonal crystal structure. The sample has been prepared clearly indicate the pure phase of LiCoO2. Meanwhile, the morphology of the sample showed that the particle size and size distribution of particles is almost uniform.

Keywords: cathode material, LiCoO2, lithium-ion rechargeable batteries, Sol-Gel method

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Authors: Sandeep Nath

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There are good stresses and bad stresses. To tell the difference, recognize early signs of stress, and label stress conditions correctly, we need to understand stress triggers and the mechanism of stress as it arises. By understanding this through mindfulness of body, mind, and spirit, we can be prepared to prevent harmful stress from escalating and ruining health; physical, mental, and emotional. We can also prepare others/peers to be stress-free. The understanding of this is available in a form closest to our natural being, in ancient oriental wisdom, and is brought together as actionable habits in the movement called RENEWALism. The constructs of RENEWALism Habits are detailed in this paper, and case studies presented of how mindfulness has equipped individuals with both capability and capacity to handle their situations and environments despite the odds.

Keywords: habits, mindfulness, renewalism, stress

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Authors: Rhaed Khiati, Muhammad Hanif

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In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Introduction: Digital innovations have been useful in supporting a client’s contraceptive user journey from awareness to method initiation. The concept of contraceptive self-care is being promoted globally as a means for achieving universal access to quality contraceptive care; however, information about this approach is limited. An important determinant of the scale of awareness is the message construct, choice of information channel, and an understanding of the socio-epidemiological dynamics within the target audience. Significant gains have been made recently in expanding the awareness base of DMPA-SC -a relatively new entrant into the family planning method mix. The cornerstone of this success is a multichannel promotion campaign themed Discover your Power (DYP). The DYP campaign combines content marketing across select social media platforms, chatbots, Cyber-IPC, Interactive Voice Response (IVR), and radio campaigns. Methodology: During implementation, the project monitored predefined metrics of awareness and intent, such as the number of persons reached with the messages, the number of impressions, and meaningful engagement (link-clicks). Metrics/indicators are extracted through native insight/analytics tools across the various platforms. The project also enlists community mobilizers (CMs) who go door-to-door and engage WRA to advertise DISC’s online presence and support them to engage with IVR, digital companion (chatbot), Facebook page, and DiscoverYourPower website. Results: The result showed that the digital platforms recorded 242 million impressions and reached 82 million users with key DMPA-SC self-injection messaging in the three countries. As many as 3.4 million persons engaged (liked, clicked, shared, or reposted) digital posts -an indication of intention. Conclusion: Digital solutions and innovations are gradually becoming the archetype for the advancement of the self-care agenda. Digital innovations can also be used to increase awareness and normalize contraceptive self-care behavior amongst women of reproductive age if they are made an integral part of reproductive health programming.

Keywords: digital transformation, health systems, DMPA-SC, family planning, self-care

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Authors: Amália S. Botter Fabbri

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This paper proposes the analysis of the Strategic Environmental Assessment (SEA) in relation to the three pillars of the sustainable development, highlighting its particular importance to combat climate change. Theoretical and practical examples from Europe show how SEA has been implemented under the SEA Directive in the recent years, while the Brazilian case study shows a situation in which no regulation on SEA was implemented, despite the strong demand for it, as revealed by past experiences and future planning needs. In the end, some aspects to the formulation of a SEA Act are suggested, in an attempt to contribute to a better Brazilian environmental governance in relation to the future plans, programmes and policies required to the reduction of greenhouse gases emissions.

Keywords: Brazil, climate change, Europe, strategic environmental assessment

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Authors: Luca Lezzerini

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Albania is suffering a continuous shrinking of its population and demographic distribution that faces all the problems connected with age increase. The paper examines the case of Gjirokastër, a city in the south of Albania that, despite having a UNESCO label as a world heritage site, is experimenting with the same shrinking phenomenon. The paper analyses in detail the current situation and propose an interdisciplinary approach based on smart technologies and sunset tourism to restart Gjirokastër’s economy and invert bad demographic trends. The proposed approach needs to review the current urban planning, reshaping and connecting some areas. It also proposes a smart city architecture to support this process.

Keywords: smart city, sunset tourism, shrinking city, Gjirokastër

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Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

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After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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Authors: Ali Alahmari

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Urban drainage in Saudi Arabia is an increasingly challenging issue due to factors such as climate change and rapid urban expansion. The existing infrastructure, based on traditional drainage systems, is not always able to cope with the increased precipitation, sometimes leading to rainwater runoff and floods causing disturbances and damage to property. Therefore, there is a need to find new ways of managing drainage, such as Sustainable Urban Drainage Systems (SUDS). The research has highlighted the main driving forces behind the need for change, revealed by the participants, to the need to adopt new ideas and approaches for urban drainage. However, while moving towards this, certain factors that may hinder the aim of using the experiences of other countries and taking advantage of innovative solutions. The research illustrates an initial conceptual model for these factors emerging from the analysis. It identifies some of the fundamental issues affecting the resistance to change towards the adoption of the concept of sustainability in Saudi Arabia, with Riyadh city as a case study. This was by using a qualitative approach, whereby, through two phases of fieldwork during 2013 and 2014, twenty-six semi-structured interviews were conducted with a number of representative officials and professionals from key government departments and organisations related to urban drainage management. Grounded Theory approach was followed to analyse the qualitative data obtained. Resistance to change was classified to: firstly: individual inertia (e.g. familiarity with the conventional solutions and approaches, lack of awareness, and considering sustainability as a marginal matter in urban planning). This resulted in not paying the desired attention, and impact on planning and setting priorities for development. Secondly: institutionalised inertia (e.g. lack of technical and design specifications for other unconventional drainage solutions, lack of consideration by decision makers in other disciplines such as contributions from environmental and geographical studies, and routine work and bureaucracy). This contributes to the weakness of decision-making, weakness in the role of research, and a lack of human resources. It seems that attitudes towards change may have reduced the ability to move forward towards sustainable development, in addition to contributing towards difficulties in some aspects of the decision-making process. Thus, the chapter provides insights into the current situation in Saudi Arabia and contributes to understanding the decisions that are made regarding change.

Keywords: climate change, new knowledge and approaches, resistance to change, Saudi Arabia, SUDS, urban drainage, urban expansion

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Authors: Coriolano Salvini, Ambra Giovannelli

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The use of renewable energy sources for electric power production leads to reduced CO2 emissions and contributes to improving the domestic energy security. On the other hand, the intermittency and unpredictability of their availability poses relevant problems in fulfilling safely and in a cost efficient way the load demand along the time. Significant benefits in terms of “grid system applications”, “end-use applications” and “renewable applications” can be achieved by introducing energy storage systems. Among the currently available solutions, CAES (Compressed Air Energy Storage) shows favorable features. Small-medium size plants equipped with artificial air reservoirs can constitute an interesting option to get efficient and cost-effective distributed energy storage systems. The present paper is addressed to the design and off-design analysis of the compression system of small size CAES plants suited to absorb electric power in the range of hundreds of kilowatt. The system of interest is constituted by an intercooled (in case aftercooled) multi-stage reciprocating compressor and a man-made reservoir obtained by connecting large diameter steel pipe sections. A specific methodology for the system preliminary sizing and off-design modeling has been developed. Since during the charging phase the electric power absorbed along the time has to change according to the peculiar CAES requirements and the pressure ratio increases continuously during the filling of the reservoir, the compressor has to work at variable mass flow rate. In order to ensure an appropriately wide range of operations, particular attention has been paid to the selection of the most suitable compressor capacity control device. Given the capacity regulation margin of the compressor and the actual level of charge of the reservoir, the proposed approach allows the instant-by-instant evaluation of minimum and maximum electric power absorbable from the grid. The developed tool gives useful information to appropriately size the compression system and to manage it in the most effective way. Various cases characterized by different system requirements are analysed. Results are given and widely discussed.

Keywords: artificial air storage reservoir, compressed air energy storage (CAES), compressor design, compression system management.

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Authors: F. Noto, G. Costa, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

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At Istituto Nazionale di Fisica Nucleare – Laboratorio Nazionale del Sud (INFN-LNS), a broad experience in the design, construction and commissioning of ECR and microwave ion sources is available. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations, which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadron therapy facility using heavy ions. In this paper, we analyzed the dimensional test and electrical test about an innovative solution for the containment chamber that allows us to solve our isolation and structural problems.

Keywords: FEM analysis, electron cyclotron resonance ion source, dielectrical measurement, hadron therapy

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Authors: Lauren Zammerilla Westcott, Ronald C. Jones, James W. Fleshman

Abstract:

The surgical treatment of breast cancer has rapidly evolved over the past 50 years, progressing from Halsted’s radical mastectomy to a public campaign of surgical options, aesthetic reconstruction, and patient empowerment. This article examines the happenings that led to the transition of breast surgery as a subset of general surgery to its own specialized field. Sparked by the research of Dr. Bernard Fisher and the first National Surgical Adjuvant Breast and Bowel Project trial in 1971, the field of breast surgery underwent significant growth over the next several decades, enabling general surgeons to limit their practices to the breast. High surgical volumes eventually led to the development of the first formal breast surgical oncology fellowship in a large community-based hospital at Baylor University Medical Center in 1982. The establishment of the American Society of Breast Surgeons, as well several landmark clinical trials and public campaign efforts, further contributed to the advancement of breast surgery, making it the specialized field of the current era.

Keywords: breast cancer, breast fellowship, breast surgery, surgical history

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Authors: Renjith George Pallivathukal, Preethy Mary Donald

Abstract:

Asymptomatic oral lesions are often ignored by the patients and usually will be identified only in advanced stages. Early detection of precancerous lesions is important for better prognosis. It is also important for the oral health care person to be aware of the regional prevalence of oral lesions in order to provide early care for the same. We conducted a retrospective study to assess the prevalence of oral lesions based on the information available from patient records in a teaching dental school. Dental records of patients who attended the department of Oral medicine and diagnosis between September 2014 and September 2016 were retrieved and verified for oral lesions. Results: The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The lesions were classified as white (40.5%), red (23%), ulcerated (10.5%), pigmented (15.2%) and soft tissue enlargements (10.8%). 52% of the patients were unaware of the oral lesions before the dental visit. Overall, the prevalence of lesions in dental patients lower to national estimates, but the prevalence of some lesions showed variations.

Keywords: oral mucosal lesion, pre-cancer, prevalence, soft tissue lesion

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Authors: Shobha Rani R. Hiremath, Keerthana R., Madhuvan H. S.

Abstract:

1.BACKGROUND: Type 2 Diabetes is a chronic health condition where the body cannot effectively use the insulin it produces, leading to elevated blood sugar levels It is often associated with lifestyle factors and insulin resistance. Globally, diabetes is on the rise, with urban areas like Bangalore seeing a surge due to lifestyle changes, stress, and dietary habits. To manage diabetes effectively, over 50 medications are available, each serving to regulate blood sugar through different mechanisms. This reflects the complex and individualized nature of diabetes treatment. Given the increase in medications for Type 2 diabetes mellitus, it is important to evaluate their effectiveness and safety so that clinicians can make informed choices while treating their patients. 2.OBJECTIVES: To evaluate the effectiveness of various anti-diabetic medications used in the hospital in Type 2 diabetes patients by monitoring their HbA1c levels. To assess the safety of these medications by monitoring Adverse drug reactions if any. 3. METHODOLOGY: Design : Prospective Cohort study, Study period: 8 months, Sample Size: 100 patients. Inclusion Criteria: Patients above 18 years of both genders who were diagnosed with T2DM and who were prescribed oral hypoglycaemic agents. Exclusion Criteria: Diabetic patients with hepatic/renal failure, patients prescribed with insulin /not prescribed with OHAs and patients who were terminally ill, pregnant and lactating patients. Source of Data: Prescriptions, lab reports, ECG reports. Data collection forms were used to collect data which consisted of patient demographic details, drugs prescribed, laboratory investigations such as HbA1C, FBS, PPBS , ECG and any ADRs experienced. Data was collected at baseline, 3 months, and 6 months. It was statistically analyzed using SPSS (version 26) software. 4. RESULTS: Greater number of patients (46%) were in the age group of greater than 61 years. 43 patients had no co-morbidities whereas 51 patients had Hypertension as the co morbidity. Basically 5 Drug combinations were prescribed as follows. Combination 1: Tablet Metformin HCL + Glimepiride (500, 2 mg) : 1-0-1, Combination 2: Tablet Sitagliptin + Metformin HCL (50, 500 mg) : 1-0-1, Combination 3: Tablet Vildagliptin + Metformin HCL (50, 500 mg): 1-0-1, Combination 4: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2 ,2 ,500mg): : 1-0-1, Combination 5: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2, 2 ,500mg): : 1-0-1 and T. Sitagliptin +Metformin HCL (50, 500 mg): 0-1-0. Combination 5 (Voglibose, Glimepiride, Metformin, Sitagliptin) was most effective in reducing HbA1c levels, showing a significant decrease (-0.00682, p = 0.001), followed by Combinations 4 and 3. However, Combination 5 also had the highest incidence of gastrointestinal side effects (72.7%) and ECG abnormalities (27.3%). Combination 1 (Metformin + Glimepiride) had the highest occurrence of hypoglycemia due to Glimepiride's insulin-stimulating effects. Weight loss was most notable in Combination 5, affecting 36.36% of patients. 5.CONCLUSION: The enhanced effectiveness of Combinations 3, 4, and 5 suggests that a multi-drug approach that incorporates different mechanisms of action is more effective in managing HbA1c levels in patients with diabetes. Adverse effect profiles should be considered for personalized treatment strategies.

Keywords: type 2 diabetes, safety, oral anti diabetic medications, effectiveness

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Authors: C. C. Alamanjo, A. O. Adepoju, H. Martin, R. N. Baines

Abstract:

Peri-urban agriculture in Jos Nigeria serves as a major means of livelihood for both urban and peri-urban poor, and constitutes huge commercial inclination with a target market that has spanned beyond Plateau State. Yet, the sustainability of this sector is threatened by intensive application of urban refuse ash contaminated with heavy metals, as a result of the highly heterogeneous materials used in ash production. Hence, this research aimed to understand the current fertilizer employed by farmers, their perception and acceptability in utilization of household sewage sludge for agricultural purposes and their capacity in mitigating risks associated with such practice. Mixed methods approach was adopted, and data collection tools used include survey questionnaire, focus group discussion with farmers, participants and field observation. The study identified that farmers maintain a complex mixture of organic and chemical fertilizers, with mixture composition that is dependent on fertilizer availability and affordability. Also, farmers have decreased the rate of utilization of urban refuse ash due to labor and increased logistic cost and are keen to utilize household sewage sludge for soil fertility improvement but are mainly constrained by accessibility of this waste product. Nevertheless, farmers near to sewage disposal points have commenced utilization of household sewage sludge for improving soil fertility. Farmers were knowledgeable on composting but find their strategic method of dewatering and sun drying more convenient. Irrigation farmers were not enthusiastic for treatment, as they desired both water and sludge. Secondly, household sewage sludge observed in the field is heterogeneous due to nearness between its disposal point and that of urban refuse, which raises concern for possible cross-contamination of pollutants and also portrays lack of extension guidance as regards to treatment and management of household sewage sludge for agricultural purposes. Hence, farmers concerns need to be addressed, particularly in providing extension advice and establishment of decentralized household sewage sludge collection centers, for continuous availability of liquid and concentrated sludge. Urgent need is also required for the Federal Government of Nigeria to increase commitment towards empowering her subsidiaries for efficient discharge of corporate responsibilities.

Keywords: ash, farmers, household, peri-urban, refuse, sewage, sludge, urban

Procedia PDF Downloads 135

Authors: Amjad Al Shammari, Ashraf Ibrahim, Laila Seada

Abstract:

Background and Objectives: Incidence of thyroid carcinoma has been increasing world-wide. In the present study, we evaluated diagnostic accuracy of Fine needle aspiration (FNA) and its efficiency in early detecting neoplastic lesions of thyroid gland over a 3-year period. Methods: Data have been retrieved from pathology files in King Khalid Hospital. For each patient, age, gender, FNA, site & size of nodule and final histopathologic diagnosis were recorded. Results: Study included 490 cases where 419 of them were female and 71 male. Male to female ratio was 1:6. Mean age was 43 years for males and 38 for females. Cases with confirmed histopathology were 131. In 101/131 (77.1%), concordance was found between FNA and histology. In 30/131 (22.9%), there was discrepancy in diagnosis. Total malignant cases were 43, out of which 14 (32.5%) were true positive and 29 (67.44%) were false negative. No false positive cases could be found in our series. Conclusion: FNA could diagnose benign nodules in all cases, however, in malignant cases, ultrasound findings have to be taken into consideration to avoid missing of a microcarcinoma in the contralateral lobe.

Keywords: FNA, hail, histopathology, thyroid

Procedia PDF Downloads 336

Authors: Marco Furinghetti, Alberto Pavese, Michele Rinaldi

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Concave Surface Slider devices have been more and more used in real applications for seismic protection of both bridge and building structures. Several research activities have been carried out, in order to investigate the lateral response of such a typology of devices, and a reasonably high level of knowledge has been reached. If radial analysis is performed, the frictional force is always aligned with respect to the restoring force, whereas under bidirectional seismic events, a bi-axial interaction of the directions of motion occurs, due to the step-wise projection of the main frictional force, which is assumed to be aligned to the trajectory of the isolator. Nonetheless, if non-linear time history analyses have to be performed, standard codes provide precise rules for the definition of an averagely spectrum-compatible set of accelerograms in radial conditions, whereas for bidirectional motions different combinations of the single components spectra can be found. Moreover, nowadays software for the adjustment of natural accelerograms are available, which lead to a higher quality of spectrum-compatibility and to a smaller dispersion of results for radial motions. In this endeavor a simplified design procedure is defined, for building structures, base-isolated by means of Concave Surface Slider devices. Different case study structures have been analyzed. In a first stage, the capacity curve has been computed, by means of non-linear static analyses on the fixed-base structures: inelastic fiber elements have been adopted and different direction angles of lateral forces have been studied. Thanks to these results, a linear elastic Finite Element Model has been defined, characterized by the same global stiffness of the linear elastic branch of the non-linear capacity curve. Then, non-linear time history analyses have been performed on the base-isolated structures, by applying seven bidirectional seismic events. The spectrum-compatibility of bidirectional earthquakes has been studied, by considering different combinations of single components and adjusting single records: thanks to the proposed procedure, results have shown a small dispersion and a good agreement in comparison to the assumed design values.

Keywords: concave surface slider, spectrum-compatibility, bidirectional earthquake, base isolation

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Authors: Anderson Rocha-Buelvas, Jaqueline Mena Huertas, Edith Burbano Rosero, Arsenio Hidalgo Troya, Mauricio Casas Cruz

Abstract:

COVID-19 is a disruptive pandemic for the public health and economic system of whole countries, including Colombia. Nariño Department is the southwest of the country and draws attention to being on the border with Ecuador, constantly facing demographic transition affecting infections between countries. In Nariño, the early routine diagnosis of SARS-CoV-2, which can be handled at BSL-2, has affected the transmission dynamics of COVID-19. However, new emerging and re-emerging viruses with biological flexibility classified as a Risk Group 3 agent can take advantage of epidemiological opportunities, generating the need to increase clinical diagnosis, mainly in border regions between countries. The overall objective of this project was to assure the quality of the analytical process in the diagnosis of high biological risk pathogens in Nariño by building a laboratory that includes biosafety level (BSL)-2 and (BSL)-3 containment zones. The delimitation of zones was carried out according to the Verification Tool of the National Health Institute of Colombia and following the standard requirements for the competence of testing and calibration laboratories of the International Organization for Standardization. This is achieved by harmonization of methods and equipment for effective and durable diagnostics of the large-scale spread of highly pathogenic microorganisms, employing negative-pressure containment systems and UV Systems in accordance with a finely controlled electrical system and PCR systems as new diagnostic tools. That increases laboratory capacity. Protection in BSL-3 zones will separate the handling of potentially infectious aerosols within the laboratory from the community and the environment. It will also allow the handling and inactivation of samples with suspected pathogens and the extraction of molecular material from them, allowing research with pathogens with high risks, such as SARS-CoV-2, Influenza, and syncytial virus, and malaria, among others. The diagnosis of these pathogens will be articulated across the spectrum of basic, applied, and translational research that could receive about 60 daily samples. It is expected that this project will be articulated with the health policies of neighboring countries to increase research capacity.

Keywords: medical laboratory science, SARS-CoV-2, public health surveillance, Colombia

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Authors: W. Mazari, K. Boucherit, Z. Boucherit-Otmani, M. N. Rahmoun, M. Benabdallah

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The hospital or any other establishment of care can be considered as an ecosystem where the patient comes into contact with a frightening microbial universe and a risk to contract infection that is referred to as nosocomial or health care-associated. In these last years, the incidence of these infections has risen sharply. Several microorganisms are the cause of these nosocomial infections and the emergence of resistance of the microbial strains against antibiotics creates a danger to public health. The search for new antimicrobial agents to overcome this problem has produced interesting compounds through chemical synthesis, which plays a very important role in the research and discovery of new drugs. It is in this framework that our study was conducted at our laboratory and it involves evaluating the antibacterial activity of thirteen 2-pyridone derivatives synthesized by two methods, the diffusion disc method and the dilution method against eight Gram negative bacterial strains. The results seem interesting especially for two products that have shown the best activities against Escherichia coli ATCC 25922 and Enterobacter cloacae ATCC 13047 with CMI of 512µg/ml.

Keywords: heterocyclic derivatives, chemical synthesis, antimicrobial activity, biotechnology

Procedia PDF Downloads 367

Authors: Xin-Yan Ji, Jing Wang, Chang Liu, Yan-Qiang Bi, Zhong-Xu Xu, Xi-Yuan Li

Abstract:

Thermal tests of electronic units are critically important for the reliability validation and performance demonstration of the spacecraft hard-wares. The tailoring equation in MIL-STD-1540 is based on fatigue of solder date. In the present paper, a new test condition tailoring expression is proposed to fit different thermo-mechanical fatigue and different subsystems, by introducing an integrated evaluating method for the fatigue acceleration exponent. The validate test has been accomplished and the data has been analyzed and compared with that from the MIL-STD-1540 tailoring equations. The results are encouraging and reasonable.

Keywords: thermal cycling test, thermal fatigue, tailoring equation, test condition planning

Procedia PDF Downloads 460