Search results for: recommended summary plan for emergency care and treatment

Authors: Rajib Husain, Mezbah Uddin, Mohammad Shamsal Islam, Rabeya Siddiquee

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Purpose: To determine the improvement of visual acuity in patients undergoing occlusion therapy. Methods: This was a prospective hospital-based study of newly diagnosed of amblyopia seen at the pediatric clinic of Chittagong Eye Infirmary & Training Complex. There were 32 refractive amblyopia subjects were examined & questionnaire was piloted. Included were all patients diagnosed with refractive amblyopia between 5 to 8 years, without previous amblyopia treatment, and whose parents were interested to participate in the study. Patients diagnosed with strabismic amblyopia were excluded. Patients were first corrected with the best correction for a month. When the VA in the amblyopic eye did not improve over a month, then occlusion treatment was started. Occlusion was done daily for 6-8 h together with vision therapy. The occlusion was carried out for three months. Results: Out of study 32 children, 31 of them have a good compliance of amblyopic treatment whereas one child has poor compliance. About 6% Children have amblyopia from Myopia, 7% Hyperopia, 32% from myopic astigmatism, 42% from hyperopic astigmatism and 13% have mixed astigmatism. The mean and Standard deviation of present average VA was 0.452±0.275 Log MAR and after an intervention of amblyopia therapy with vision therapy mean and Standard deviation VA was 0.155±0.157 Log MAR. Out of total respondent 21.85% have BCVA in range from (0-.2) log MAR, 37.5% have BCVA in range from (0.22-0.5) log MAR, 35.95% have in range from (0.52-0.8) log MAR, 4.7% have in range from (0.82-1) log MAR and after intervention of occlusion therapy with vision therapy 76.6% have VA in range from (0-.2) log MAR, 21.85% have VA in range from (0.22-0.5) log MAR, 1.5% have in range from (0.52-0.8) log MAR. Conclusion: Amblyopia is a most important factor in pediatric age group because it can lead to visual impairment. Thus, this study concludes that occlusion therapy with vision therapy is probably one of the best treatment methods for amblyopic patients (age 5-8 years), and compliance and age were the most critical factor predicting a successful outcome.

Keywords: amblyopia, occlusion therapy, vision therapy, eccentric fixation, visuoscopy

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Authors: Briony Gray, Glenn Simpson, Hajira Dambha-Miller, Andrew Farmer

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Multimorbidity may be strongly affected by a variety of conditions, factors, and variables requiring higher demands on health and social care services, infrastructure, and expenses. Holding one or more conditions increases one’s risk for development of future conditions; with patients over 65 years old at highest risk. Psychosocial factors such as anxiety and depression are rising exponentially globally, which has been amplified by the COVID19 pandemic. These are highly correlated and predict poorer outcomes when held in coexistence and increase the likelihood of comorbid physical health conditions. While possible future reform of social and healthcare systems may help to alleviate some of these mounting pressures, there remains an urgent need to better understand the potential role health behaviours and psychosocial conditions - such as anxiety and depression – may have on aging populations. Using the UK healthcare scene as a lens for analysis, this study uses big data collected in the UK Longitudinal Study of Aging (ELSA) to examine the role of anxiety and depression in ageing populations (65yrs+). Using logistic regression modelling, results identify the 10 most significant variables correlated with both anxiety and depression from data categorised into the areas of health behaviour, psychosocial, socioeconomic, and life satisfaction (each demonstrated through literature review to be of significance). These are compared with wider global research findings with the aim of better understanding the areas in which social and healthcare reform can support multimorbidity interventions, making suggestions for improved patient-centred care. Scope of future research is outlined, which includes analysis of 59 total multimorbidity variables from the ELSA dataset, going beyond anxiety and depression.

Keywords: multimorbidity, health behaviours, patient centred care, psychosocial factors

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Authors: Onur Ercan, Buket Askin, Erdogan Kucukoner

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Blueberry (Vaccinium corymbosum, bluegold) has become popular beverage due to their nutritional values such as vitamins, minerals, and antioxidants. In the study, the effects of pressing, mashing, enzymatic treatment, and pasteurization on anthocyanins, colour, and polyphenolics of blueberry juice (BJ) were studied. The blueberry juice (BJ) was produced with two different methods that direct juice extraction (DJE) and mash treatment process (MTP) were applied. After crude blueberry juice (CBJ) production, the samples were first treated with commercial enzymes [Novoferm-61 (Novozymes A/S) (2–10 mL/L)], to break down the hydrocolloid polysaccharides, mainly pectin and starch. The enzymes were added at various concentrations. The highest transmittance (%) was obtained for Novoferm-61 at a concentration of 2 mL/L was 66.53%. After enzymatic treatment, clarification trials were applied to the enzymatically treated BJs with adding various amounts of bentonite (10%, w/v), gelatin (1%, w/v) and kiselsol (15%, v/v). The turbidities of the clarified samples were then determined. However, there was no significant differences between transmittances (%) for samples. For that, only enzymatic treatment was applied to the blueberry juice processing (DDBJ, depectinized direct blueberry juice). Based on initial pressing process made to evaluate press function, it was determined that pressing fresh blueberries with no other processing did not render adequate juice due to lack of liquefaction. Therefore, the blueberries were mash into small pieces (3 mm) and then enzymatic treatments and clarification trials were performed. Finally, both BJ samples were pasteurized. Compositional analyses, colour properties, polyphenols and antioxidant properties were compared. Enzymatic treatment caused significant reductions in ACN content (30%) in Direct Blueberry Juice Processing (DBJ), while there was a significant increasing in Mash Treatment Processing (MTP). Overall anthocyanin levels were higher intreated samples after each processing step in MTP samples, but polyphenolic levels were slightly higher for both processes (DBJ and MTP). There was a reduction for ACNs and polyphenolics only after pasteurization. It has a result that the methods for tried to blueberry juice is suitable into obtain fresh juice. In addition, we examined fruit juice during processing stages; anthocyanin, phenolic substance content and antioxidant activity are higher, and yield is higher in fruit juice compared to DBJ method in MTP method, the MTP method should be preferred in processing juice of blueberry into fruit juice.

Keywords: anthocyanins, blueberry, depectinization, polyphenols

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Authors: Sajjad Jafari, Reza Akbari

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Background and Aim: Chrysin, a flavonoid compound found in medicinal plants, honey, and propolis, has potential biological activities that make it an important perspective in the treatment of infectious and cancer diseases. The aim of this review study is to evaluate the biological activities of chrysin in the treatment of infectious and cancer diseases. Material and Methods: The present study is a review study that searched reputable scientific databases such as PubMed, Google Scholar, Scopus, and Web of Science from 2000 to 2023 using keywords such as antimicrobial, antifungal, chrysin, anticancer, antioxidants, and infectious diseases. The researchers examined 25 articles to determine the biological activities of chrysin. Results: Chrysin has high inhibitory or lethal activities on gram-positive and gram-negative bacteria, including Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, and Enterococcus faeces. It also has anti-biofilm effects and antifungal effects on strains such as Aspergillus niger and Candida albicans. Chrysin also has anticancer effects on various cancers, including colorectal cancer, pancreatic cancer, breast cancer, and MCF-7 cancer, which have been confirmed in vitro and in vivo. Conclusion: Chrysin has the potential as an important therapeutic option in the treatment of infectious and cancer diseases. Its high antimicrobial and anticancer activities, combined with its low toxicity in nanoparticle form, make it a promising candidate for further clinical trials. The production of anti-microbial and anti-cancer drugs from natural substances, such as chrysin, is a valuable contribution to the field of medicine.

Keywords: chrysin, antimicrobial, anticancer, infectious diseases

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Authors: Tongpong Sriboon, Prapita Thanarak, Chaitawatch Khunrangabsang

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Nowadays, the usage of power generated from photovoltaic system has been promoted significantly in Thailand. The targeted result which is to increase the Solar Power Generation in 2036 to 6000 megawatts (MW) was planned by Alternative Energy Development Plan (AEDP 2015) and Power Development Plan (PDP 2015). The solar rooftop 200 MW was promoted and supported under the Feed-in Tariff scheme (FiT) in two phases; phase I in 2012 and phase II in 2015. However, the number of people interested in supporting the projects reduced due to many reasons which range from the first process to the last that is to sell electricity back to Electricity Authority. This paper will review this situation especially in total electricity generated from solar rooftop system during the day that has been sold back to the grid utility in different capacity FiT rates. With many stakeholders involved, the regulations and criteria were established to maintain the standard of the system. Besides, lots of problems have occurred during the processes including reliability and quality. These problems were shortly followed by other irrevocably issues concerning politics, social, economic etc. In order to effectively develop solar PV power system in Thailand, the problems and solutions were compared to those from six countries including Japan, Australia. America, China, German and Malaysia. This paper particularly focuses on policies and measurement implemented to encourage the rising in solar PV system interest. This review enables one to gain insight into the nature of the changes that have taken place in each and every country mentioned above as well as the underlying reasons behind them. Brief analysis is carried out on identify key challenges and opportunities for solar PV application. This could help create a development path that is suitable with situations to enhance the overall performance of solar PV power generating system in Thailand.

Keywords: solar PV rooftop, PV policy, self-consumption, solar PV power generation

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Authors: S. Chuenchooklin, S. Taweepong, U. Pangnakorn

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This research was conducted in the Mae Sot Watershed whereas located in the Moei River Basin at the Upper Salween River Basin in Tak Province, Thailand. The Mae Sot Municipality is the largest urbanized in Tak Province and situated in the midstream of the Mae Sot Watershed. It usually faces flash flood problem after heavy rain due to poor flood management has been reported since economic rapidly bloom up in recently years. Its catchment can be classified as ungauged basin with lack of rainfall data and no any stream gaging station was reported. It was attached by most severely flood event in 2013 as the worst studied case for those all communities in this municipality. Moreover, other problems are also faced in this watershed such shortage water supply for domestic consumption and agriculture utilizations including deterioration of water quality and landslide as well. The research aimed to increase capability building and strengthening the participation of those local community leaders and related agencies to conduct better water management in urban area was started by mean of the data collection and illustration of appropriated application of some short period rainfall forecasting model as the aim for better flood relief plan and management through the hydrologic model system and river analysis system programs. The authors intended to apply the global rainfall data via the integrated data viewer (IDV) program from the Unidata with the aim for rainfall forecasting in short period of 7 - 10 days in advance during rainy season instead of real time record. The IDV product can be present in advance period of rainfall with time step of 3 - 6 hours was introduced to the communities. The result can be used to input to either the hydrologic modeling system model (HEC-HMS) or the soil water assessment tool model (SWAT) for synthesizing flood hydrographs and use for flood forecasting as well. The authors applied the river analysis system model (HEC-RAS) to present flood flow behaviors in the reach of the Mae Sot stream via the downtown of the Mae Sot City as flood extents as water surface level at every cross-sectional profiles of the stream. Both models of HMS and RAS were tested in 2013 with observed rainfall and inflow-outflow data from the Mae Sot Dam. The result of HMS showed fit to the observed data at dam and applied at upstream boundary discharge to RAS in order to simulate flood extents and tested in the field, and the result found satisfied. The result of IDV’s rainfall forecast data was compared to observed data and found fair. However, it is an appropriate tool to use in the ungauged catchment to use with flood hydrograph and river analysis models for future efficient flood relief plan and management.

Keywords: global rainfall, flood forecast, hydrologic modeling system, river analysis system

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Authors: Tahany W. Sadak

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Presented work discusses research results concerning the effect of the heat treatment process. Thermal fatigue which expresses repeated heating and cooling processes affect the ductility or the brittleness of the material. In this research, 70 specimens of copper (1.5 mm thickness, 85 mm length, 32 mm width) are subjected to thermal fatigue at different conditions. Heating temperatures T_h are 100, 300 and 500 °C. Number of repeated cycles N is from 1 to 100. Heating time t_h =600 Sec, and Cooling time; t_C= 900 Sec.  Results are evaluated and then compared to each other and to that of specimens without subjected to thermal fatigue.

Keywords: copper, thermal analysis, heat treatment, hardness, thermal fatigue

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Authors: Tsoaledi D. Thobejane, Barnabas C. Okere

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Gender mainstreaming has been adopted as a strategy for promoting gender equality in institutions of higher learning Worldwide, not least in Africa. This study investigated Gender Mainstreaming at the University of Venda, in Limpopo Province, South Africa. The study was based on the Feminist Theoretical Framework. Both qualitative and quantitative approaches were used. A case study research design was adopted. The study involved a population of 60 participants and a sample of 25 male and female workers selected using the purposive sampling technique. Data were presented in pie charts, tables, themes and in textual forms. Data were analysed through descriptive statistics and thematic analysis. The major findings and conclusions of the study were that the University of Venda faces enormous challenges in mainstreaming gender in the university functions. There are perceptions that most strategic higher positions in the institution are dominated by men while women are marginalized. Although the University has policies on gender, staff members do not know about them while management does not implement its policies. University of Venda makes use of the Employment Equity Act of 1998, but it is not clear whether line managers are aware of its implementation and how. In addition, favouritism, nepotism, patronage, and patriarchy played a role in gender mainstreaming. The study recommended that there should be more gender awareness activities, such as workshops, conferences, and symposia for workers and staff members in order to sensitize them about gender towards understanding. The study also recommended that deserving female staff members should be promoted, and all employees should be encouraged to read and understand gender policies. In addition, management should implement the institutions and national gender policies without fear or favour.

Keywords: gender mainstreaming, gender equality, institutions, representation

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Authors: Bengi Hakguder Taze, Sevcan Unluturk

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Şalak apricot (Prunus armeniaca L., cv. Şalak) is a specific variety grown in Igdir, Turkey. The fruit has distinctive properties distinguish it from other cultivars, such as its unique size, color, taste and higher water content. Drying is the widely used method for preservation of apricots. However, fresh consumption is preferred for Şalak apricot instead of drying due to its low dry matter content. Higher amounts of water in the structure and climacteric nature make the fruit sensitive against rapid quality loss during storage. Hence, alternative processing methods need to be introduced to extend the shelf life of the fresh produce. Mild heat (MH) treatment is of great interest as it can reduce the microbial load and inhibit enzymatic activities. Therefore, the aim of this study was to evaluate the impact of mild heat treatment on the natural microflora found on Şalak apricot surfaces and some physical quality parameters of the fruit, such as color and firmness. For this purpose, apricot samples were treated at different temperatures between 40 and 60 ℃ for different periods ranging between 10 to 60 min using a temperature controlled water bath. Natural flora on the fruit surfaces was examined using standard plating technique both before and after the treatment. Moreover, any changes in color and firmness of the fruit samples were also monitored. It was found that control samples were initially containing 7.5 ± 0.32 log CFU/g of total aerobic plate count (TAPC), 5.8±0.31 log CFU/g of yeast and mold count (YMC), and 5.17 ± 0.22 log CFU/g of coliforms. The highest log reductions in TAPC and YMC were observed as 3.87-log and 5.8-log after the treatments at 60 ℃ and 50 ℃, respectively. Nevertheless, the fruit lost its characteristic aroma at temperatures above 50 ℃. Furthermore, great color changes (ΔE ˃ 6) were observed and firmness of the apricot samples was reduced at these conditions. On the other hand, MH treatment at 41 ℃ for 10 min resulted in 1.6-log and 0.91-log reductions in TAPC and YMC, respectively, with slightly noticeable changes in color (ΔE ˂ 3). In conclusion, application of temperatures higher than 50 ℃ caused undesirable changes in physical quality of Şalak apricots. Although higher microbial reductions were achieved at those temperatures, temperatures between 40 and 50°C should be further investigated considering the fruit quality parameters. Another strategy may be the use of high temperatures for short time periods not exceeding 1-5 min. Besides all, MH treatment with UV-C light irradiation can be also considered as a hurdle strategy for better inactivation results.

Keywords: color, firmness, mild heat, natural flora, physical quality, şalak apricot

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Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli

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Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of the most important side effects of MTX. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone (PIO), is known to exert anti-inflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of PIO against MTX-induced nephropathy. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with PIO (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (1-30 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-PIO interaction was assessed. PIO treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with PIO. Collectively, PIO abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.

Keywords: methotrexate, pioglitazone, endothelium, kidney

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Authors: Sotirios Longinos, Anna Loskutova, Assel Tolegenova, Assem Imanzhussip, Lei Wang

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Hot, dry rock (HDR) has substantial potential as a thermal energy source. It has been exploited by hydraulic fracturing to extract heat and generate electricity, which is a well-developed technique known for creating the enhanced geothermal systems (EGS). These days, LN2 is being tested as an environmental friendly fracturing fluid to generate densely interconnected crevices to augment heat exchange efficiency and production. This study examines experimentally the efficacy of LN2 cryogenic fracturing for granite samples in Kazakhstan with immersion method. A comparison of two different experimental models is carried out. The first mode is rock heating along with liquid nitrogen treatment (heating with freezing time), and the second mode is multiple times of heating along with liquid nitrogen treatment (heating with LN2 freezing-thawing cycles). The experimental results indicated that with multiple heating and LN2-treatment cycles, the permeability of granite first ameliorates with increasing number of cycles and later reaches a plateau after a certain number of cycles. On the other hand, density, P-wave velocity, uniaxial compressive strength, elastic modulus, and tensile strength indicate a downward trend with increasing heating and treatment cycles. The thermal treatment cycles do not seem to have an obvious effect on the Poisson’s ratio. The changing rate of granite rock properties decreases as the number of cycles increases. The deterioration of granite primarily happens within the early few cycles. The heating temperature during the cycles shows an important influence on the deterioration of granite. More specifically, mechanical deterioration and permeability amelioration become more remarkable as the heating temperature increases.LN2 fracturing generates many positives compared to conventional fracturing methods such as little water consumption, requirement of zero chemical additives, lessening of reservoir damage, and so forth. Based on the experimental observations, LN2 can work as a promising waterless fracturing fluid to stimulate hot, dry rock reservoirs.

Keywords: granite, hydraulic fracturing, liquid nitrogen, Kazakhstan

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Authors: Mehrdad Kamali-Sanzighi, Maziar Kamali-sanzighi

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Effect of waste date meal (WDM) addition to the diet on body chemical composition and fatty acids profile of fingerling cyprinus carpio were evaluated. Four treatments with 3 replication such as control treatment (no additional WDM; T1), 5% WDM (50 gr/kg; T2), 10% WDM (100 gr/kg; T3) and 15% WDM (150 gr/kg; T4) were done. 168 fish with initial weight of 2.48±0.06 gr were fed 3 times per day according to 5 % of fish body weight for 12 weeks. The body composition results showed that there is no significant differences between treatments (P>0.05). All of Fatty acids profile parameters show significant differences between different treatments (P<0.05). Although, the highest value of MUFA+PUFA, PUFA/SFA, MUFA+PUFA/SFA, W3, EPA+DHA parameters belong to control treatment (T1) and 5% WDM treatment (T2) had lowest value of MUFA, PUFA, MUFA+PUFA, PUFA/SFA, MUFA+PUFA/SFA, W3, W3/W6, DHA/EPA and EPA+DHA parameters except of SFA and W6/W3 that show highest value than other treatments. Atherogenic index (AI) had no significant differences between different treatments (P>0.05) but Thrombogenic index (TI) had significant differences between different experimental treatments (P<0.05). The 5% WDM and control treatment show highest and lowest values. Generally, treatments of 10 and 15% WDM (T3-T4) had moderate performance than the other experimental treatments. Finally, addition of WDM to common carp fingerlings diets help to insignificant improvement of chemical body composition and the saturated and unsaturated fatty acids profile of them were significant.

Keywords: waste, date, common carp, nutrition value

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Authors: Öznur Saribaş, Si̇bel Kahraman Çeti̇ntaş

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It is aimed to compare target volume and critical organ doses by using CyberKnife (CK) in accelerated partial breast irradiation (APBI) in patients with early stage breast cancer. Three different virtual plans were made for Iris, fixed and multi-leaf collimator (MLC) for 5 patients who received radiotherapy in the CyberKnife system. CyberKnife virtual plans were created, with 6 Gy per day totaling 30 Gy. Dosimetric parameters for the three collimators were analyzed according to the restrictions in the NSABP-39/RTOG 0413 protocol. The plans ensured critical organs were protected and GTV received 95 % of the prescribed dose. The prescribed dose was defined by the isodose curve of a minimum of 80. Homogeneity index (HI), conformity index (CI), treatment time (min), monitor unit (MU) and doses taken by critical organs were compared. As a result of the comparison of the plans, a significant difference was found for the duration of treatment, MU. However, no significant difference was found for HI, CI. V30 and V15 values of the ipsi-lateral breast were found in the lowest MLC. There was no significant difference between Dmax values for lung and heart. However, the mean MU and duration of treatment were found in the lowest MLC. As a result, the target volume received the desired dose in each collimator. The contralateral breast and contralateral lung doses were the lowest in the Iris. Fixed collimator was found to be more suitable for cardiac doses. But these values did not make a significant difference. The use of fixed collimators may cause difficulties in clinical applications due to the long treatment time. The choice of collimator in breast SBRT applications with CyberKnife may vary depending on tumor size, proximity to critical organs and tumor localization.

Keywords: APBI, CyberKnife, early stage breast cancer, radiotherapy.

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Authors: Alice Huffman, Joseph Hartland, Sam Gibbs

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Dermatology is often a neglected specialty in low-resource settings, despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV positive patients. African countries have the highest HIV infection rates and skin conditions are frequently misdiagnosed and mismanaged, because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV positive patients. A literature search within Embase, Medline and Google scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff a list of 15 skin conditions was included and a booklet created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff, alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.

Keywords: dermatology, HIV, Malawi, skin disease

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Authors: Agne Jucyte Cicine, Vytautas Abromaitis, Zita Rasuole Gasiunaite, I. Vybernaite-Lubiene, D. Overlinge, K. Vilke

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Pharmaceutical pollution in aquatic environments has become a growing concern. Various active pharmaceutical ingredient (API) residues, hormones, antibiotics, or/and psychiatric drugs, have already been discovered in different environmental compartments. Due to existing ineffective wastewater treatment technologies to remove APIs, an underestimated amount can enter the ecosystem by discharged treated wastewater. Especially, psychiatric compounds, such as carbamazepine (CBZ) and venlafaxine (VNX), persist in effluent even post-treatment. Therefore, these pharmaceuticals usually exceed safe environmental levels and pose risks to the aquatic environment, particularly to sensitive ecosystems such as the Baltic Sea. CBZ, known for its chemical stability and long biodegradation time, accumulates in the environment, threatening aquatic life and human health through the food chain. As the use of medication rises, there is an urgent need for advanced wastewater treatment to reduce pharmaceutical contamination and meet future regulatory requirements. In this study, we tested advanced oxidation technology using ozone to remove two commonly used psychiatric drugs (carbamazepine and venlafaxine) from biologically treated wastewater effluent. Additionally, general water quality parameters (suspended matter (SPM), dissolved organic carbon (DOC), chemical oxygen demand (COD), and bacterial presence were analyzed. Three wastewater treatment plants (WWTPs) representing different anthropogenic pressures were selected: 1) resort, 2) resort and residential, and 3) residential, industrial, and resort. Wastewater samples for the experiment were collected during the summer season after mechanical and biological treatment and ozonated for 5, 10, and 15 minutes. The initial dissolved ozone concentration of 7,3±0,7 mg/L was held constant during all the experiments. Pharmaceutical levels in this study exceeded the predicted no-effect concentration (PNEC) of 500 and 90 ng L⁻¹ for CBZ and VNX, respectively, in all WWTPs, except CBZ in WWTP 1. Initial CBZ contamination was found to be lower in WWTP 1 (427.4 ng L⁻¹), compared with WWTP 2 (1266.5 ng L⁻¹) and 3 (119.2 ng L⁻¹). VNX followed a similar trend with concentrations of 341.2 ng L⁻¹, 361.4 ng L⁻¹, and 390.0 ng L⁻¹, respectively, for WWTPs 1, 2, and 3. It was determined that CBZ was not detected in the effluent after 5 minutes of ozonation in any of the WWTPs. Contrarily, VNX was still detected after 5, 10, and 15 minutes of treatment with ozone, however, under the limits of quantification (LOD) (<5ng L⁻¹). Additionally, general pollution of SPM, DOC, COD, and bacterial contamination was reduced notably after 5 minutes of treatment with ozone, while no bacterial growth was obtained. Although initial pharmaceutical levels exceeded PNECs, indicating ongoing environmental risks, ozonation demonstrated high efficiency in reducing pharmaceutical and general contamination in wastewater with different pollution matrices.

Keywords: Baltic Sea, ozonation, pharmaceuticals, wastewater treatment plants

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Authors: Tomasz Holecki, Hanna Dobrowolska

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In the Polish health care system, nurses and midwives are obliged to regularly update their professional knowledge. It is all regulated by the Law on the nurse and midwife’s profession and the code of ethics. The professional self-governing body (County Chamber of Nurses and Midwives) is obliged to organize ongoing training for them so that maintaining accessibility and availability to the high quality of educational services could be possible at all levels of post-graduate education. The aim of this study is an analysis of post-graduate education organized by the County Chamber of Nurses and Midwives in the city of Katowice, Poland, as a professional self-governing body operating in the area of Silesian province inhabited by almost 5 million citizens which bring together more than 30 thousand professionally active nurses and midwives. In the years 2000-2017, the self-government of nurses and midwives trained over 50,000 people. The education and supervision system over the labour of nurses and midwives establishes exercising control by a self-governing body. In practice, this means that conducting activities aimed at creating legal regulations and organizational conditions, as well as the practical implementation of courses, belongs to the professional self-government of nurses and midwives. The most of specialization courses that were provided from their own funds came from membership fees. The biggest group was participants of specializations in the fields of cardiac, anesthesia, and preventive nursing. The smallest group of people participated in such specializations as neonatal, emergency, and obstetrics nursing. The most popular specialist courses were in the fields of the electrocardiogram and cardiopulmonary resuscitation, whereas the least popular were the ones in the fields of protective vaccinations of neonates. So-called 'soft training-courses' in the fields of improvement of social skills and management were also provided. The research shows that a vast majority of nurses and midwives are interested in raising their professional qualifications. Specialist courses and selected fields of qualification courses received the most concrete attention. In light of conducted research, one can assert that cooperation inside the community of nurses and midwives provides access to high-quality education and training services regularly used by a wide circle of them. The presented results exemplify a level of real interest in specialist and qualification training-courses and also show sources of financing them.

Keywords: nurses and midwives, ongoing training, postgraduate education, specialist training-courses

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Authors: Angel Villabona-Ortíz, Candelaria Tejada-Tovar, Andrea Viera-Devoz

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Wastewater treatment is an issue of vital importance in these times where the impacts of human activities are most evident, which have become essential tasks for the normal functioning of society. However, they put entire ecosystems at risk by time destroying the possibility of sustainable development. Various conventional technologies are used to remove pollutants from water. Agroindustrial waste is the product with the potential to be used as a renewable raw material for the production of energy and chemical products, and their use is beneficial since products with added value are generated from materials that were not used before. Considering the benefits that the use of residual biomass brings, this project proposes the use of agro-industrial residues from corn crops for the production of natural adsorbents whose purpose is aimed at the remediation of contaminated water bodies with large loads of nutrients. The adsorption capacity of two biomaterials obtained from the processing of corn stalks was evaluated by batch system tests. Biochar impregnated with sulfuric acid and thermally activated was synthesized. On the other hand, the cellulose was extracted from the corn stalks and chemically modified with cetyltrimethylammonium chloride in order to quaternize the surface of the adsorbent. The adsorbents obtained were characterized by thermogravimetric analysis (TGA), scanning electron microscopy (SEM), infrared spectrometry with Fourier Transform (FTIR), analysis by Brunauer, Emmett and Teller method (BET) and X-ray Diffraction analysis ( XRD), which showed favorable characteristics for the cellulose extraction process. Higher adsorption capacities of the nutrients were obtained with the use of biochar, with phosphate being the anion with the best removal percentages. The effect of the initial adsorbate concentration was evaluated, with which it was shown that the Freundlich isotherm better describes the adsorption process in most systems. The adsorbent-phosphate / nitrate systems fit better to the Pseudo Primer Order kinetic model, while the adsorbent-sulfate systems showed a better fit to the Pseudo second-order model, which indicates that there are both physical and chemical interactions in the process. Multicomponent adsorption tests revealed that phosphate anions have a higher affinity for both adsorbents. On the other hand, the thermodynamic parameters standard enthalpy (ΔH °) and standard entropy (ΔS °) with negative results indicate the exothermic nature of the process, whereas the ascending values of standard Gibbs free energy (ΔG °). The adsorption process of anions with biocarbon and modified cellulose is spontaneous and exothermic. The use of the evaluated biomateriles is recommended for the treatment of industrial effluents contaminated with sulfate, nitrate and phosphate anions.

Keywords: adsorption, biochar, modified cellulose, corn stalks

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Authors: Najade Sheriff, Malaz Elsaddig, Kevin Jones

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Background: Death in the first month of life accounts for an increasing proportion of under-five mortality. Advancement to reduce this number is being made across the globe; however, progress is slowest in sub-Saharan Africa. Objectives: The study aims to identify differences between neonatal deaths of inpatient babies born in a hospital facility in rural Uganda to those of neonates admitted from the community and to explore whether they can be used to risk stratify neonatal admissions. Results: A retrospective chart review was conducted on records for neonates admitted to the Special Care Baby Unit (SCBU) Kitovu Hospital from 1st July 2016 to 21st July 2017. A total of 442 babies were admitted and the overall neonatal mortality was 24.8% (40% inpatient, 37% community, 23% hospital referrals). 40% of deaths occurred within 24 hours of admission and the majority were male (63%). 43% of babies were hypothermic upon admission, a significantly greater proportion of which were inpatient babies born in labour ward (P=0.0025). Intrapartum related death accounted for ½ of all inpatient babies whereas complications of prematurity were the predominant cause of death in the community group (37%). Severe infection does not seem like a significant factor of mortality for inpatients (2%) as it does for community admissions (29%). Furthermore, with 52.5% of community admissions weighing < 1500g, very low birth weight (VLBW) may be a significant risk factor for community neonatal death. Conclusion: The neonatal mortality rate in this study is high, and the leading causes of death are all largely preventable. A high rate of inpatient birth asphyxiation indicates the need for good quality facility-based perinatal care as well as a greater focus on the management of hypothermia, such as Kangaroo care. Moreover, a reduction in preterm deliveries is necessary to reduce associated comorbidities, and monitoring for signs of infection is especially important for community admissions.

Keywords: community, mortality, newborn, Uganda

Procedia PDF Downloads 187

Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Jiri Barta

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This paper deals with the prevention and management of emergencies. It focuses on the protection of assets of the critical infrastructure entities that are important to preventing, preparing for and management of emergencies and crisis situations. The paper defines assets and specifies their use and place in the process of crisis management and planning. Critical assets that are protected from the negative effects of emergency or crisis situation we can use in crisis management and response. This basic rule applies mainly to the substantial assets used in the protection of critical infrastructure processes.

Keywords: asset, continuity, critical infrastructure, crisis management process

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Authors: Sahar M. El-Gowilly, Mai M. Helmy, Hanan M. El-Gowelli

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Methotrexate (MTX) is widely used in treatment of cancers and autoimmune diseases. However, nephrotoxicity is one of its most important side effects. The peroxisome proliferator-activated receptor gamma agonist, pioglitazone, is known to exert antiinflammatory and reno-protective effects in various kidney injuries. The purpose of this study was to investigate the potential involvement of endothelial damage in MTX-induced renal injury and to elaborate the possible protective effect of pioglitazone against MTX-induced endothelial impairment. Compared with saline-treated rats, treatment with MTX (7 mg/kg for 3 day) caused significant elevations in serum levels of urea and creatinine, increased renal nitrate/nitrite level and impaired renovascular responsiveness of isolated perfused kidney to endothelium-dependent vasodilations induced by acetylcholine (0.01-2.43 nmol) and isoprenaline (1µmol). These effects were abolished by concurrent treatment with pioglitazone (2.5 mg/kg, for 5 days starting two days before MTX). Alternatively, MTX treatment did not affect endothelium-independent renovascular relaxation induced by sodium nitroprusside (0.001-10 μmole). The possibility that alterations in renal antioxidants, circulating cytokine and apoptotic factor (Fas) levels contributed to MTX-pioglitazone interaction was assessed. Pioglitazone treatment abrogated renal oxidative stress (decreased reduced glutathione and catalase activity and increased malondialdehyde), elevated serum cytokine (interleukin-6, interleukin-10, tumor necrosis factor-alpha and transforming growth factor-beta1) and Fas induced by MTX. Histologically, MTX caused defused tubular cells swelling and vacuolization associated with endothelial damage in renal arterioles. These effects disappeared upon co-treated with pioglitazone. Collectively, pioglitazone abolished MTX-induced endothelium dysfunction and nephrotoxicity via ameliorating oxidative stress and rectifying cytokines and Fas abnormalities caused by MTX.

Keywords: methotrexate, pioglitazone, endothelium, kidney

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Authors: Murray Anderson, Galina Freed, Karli Jahn

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Trauma is increasingly recognized as an important construct that has health implications for those who struggle with various mental health issues. For those individuals who meet the criteria for a diagnosis of hoarding disorder (HD), many have experienced some form of trauma. Further, some of the therapeutic interventions for those with HD can further perpetuate or magnify the experience of trauma. Therefore, the aim of this scoping review is to identify and document the nature and extent of research evidence related to trauma as it connects with HD. This review was guided by the questions, ‘How can our understanding of the trauma cycle help us to better appreciate the experiences of individuals who hoard, and how will a trauma informed lens inform the interventions for hoarding disorder? A comprehensive literature search was performed to identify original studies that contained the words “hoarding” and “trauma.” PsychINFO”,''EBSCO host,” “CINAHL” and “PubMed” were searched between January 2005 and April 2021. Articles were screened by three reviewers. Data extracted included publication date, demographics, study design, type of analysis, and noted connections between hoarding and trauma. Of the 329 articles, all duplicates, articles on hoardings of animals, articles not in English, and those without full-text availability were removed. Five categories were found in the remaining 45 articles, including (a) traumatic and stressful life events; (b) the link between posttraumatic stress disorder, trauma, and hoarding; (c) the relationships between different comorbidities, trauma, and hoarding; (d) the lack of early emotional expression and other forms of parental deprivation; and (e) the role of attachment. Lastly, the literature explains how the links between hoarding and trauma are difficult to study due to the highly stigmatized identities with this population. The review provided strong support for the connections between the experience of trauma and HD. What is missing from the literature is the use of a trauma-informed lens to better account for the ways in which hoarding disorder is understood. Other missing pieces in the literature are the potential uses of a trauma-informed lens to enhance the therapeutic process, to understand and reduce treatment attrition, and to improve treatment outcomes. The application of a trauma informed lens could improve our understanding of effective interactions among clients, families, and communities and improve the education around hoarding-related matters. Exploring the connections between trauma and HD can improve therapeutic delivery and destigmatize the experience of dealing with clutter and hoarding concerns. This awareness can also provide health care professionals with both the language and skills to liberate them from a reductionist view on HD.

Keywords: hoarding, attachment, parental deprivation, trauma

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Authors: S. Mamoucha, J. Rahul, N. Christodoulakis

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Introduction: Nature has been the source of medicinal agents since the dawn of the human existence on Earth. Currently, millions of people, in the developing world, rely on medicinal plants for primary health care, income generation and lifespan improvement. In Greece, more than 5500 plant taxa are reported while about 250 of them are considered to be of great pharmaceutical importance. Among the plants used for medical purposes, Vitex agnus-castus L. (Verbenaceae) is known since ancient times. It is a small tree or shrub, widely distributed in the Mediterranean basin up to the Central Asia. It is also known as chaste tree or monks pepper. Theophrastus mentioned the shrub several times, as ‘agnos’ in his ‘Enquiry into Plants’. Dioscorides mentioned the use of V. agnus-castus for the stimulation of lactation in nursing mothers and the treatment of several female disorders. The plant has important medicinal properties and a long tradition in folk medicine as an antimicrobial, diuretic, digestive and insecticidal agent. Materials and methods: Leaves were cleaned, detached, fixed, sectioned and investigated with light and Scanning Electron Microscopy (SEM). Histochemical tests were executed as well. Specific histochemical reagents (osmium tetroxide, H2SO4, vanillin/HCl, antimony trichloride, Wagner’ s reagent, Dittmar’ s reagent, potassium bichromate, nitroso reaction, ferric chloride and di methoxy benzaldehyde) were used for the sub cellular localization of secondary metabolites. Results: Light microscopical investigations of the elongated leaves of V. agnus-castus revealed three layers of palisade parenchyma, just below the single layered adaxial epidermis. The spongy parenchyma is rather loose. Adaxial epidermal cells are larger in magnitude, compared to those of the abaxial epidermis. Four different types of capitate, secreting trichomes, were localized among the abaxial epidermal cells. Stomata were observed at the abaxial epidermis as well. SEM revealed the interesting arrangement of trichomes. Histochemical treatment on fresh and plastic embedded tissue sections revealed the nature and the sites of secondary metabolites accumulation (flavonoids, steroids, terpenes). Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: Vitex agnus-castus, leaf anatomy, histochemical reagents, secondary metabolites

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Authors: Akanksha Dicholkar, Celin Jacob, Omkar More

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Work force instability, as demonstrated by high rates of staff turnover and lingering vacancy rates, continues to be a major challenge faced by health care organizations. The impact is manifested in workflow inefficiencies, delays in delivering patient care, and dissatisfaction among patients and staff, all of which can have significant negative effects on quality of care and patient safety. In addition, the staggering administrative costs created by a transient work force threaten health care organizations financial viability. One nurse retention strategy is to have newly hired nurses partake in Preceptorship. Precepting is a way to enculturate new employees into their role. Also good professional, collegial relationship between an experienced nurse and a newly hired nurse relations was evidenced. This study demonstrates impact of preceptor program on absconding rate, employee satisfaction & Patient satisfaction. Purpose of study: To decrease absconding rate. Objective: 1. To reduce the high absconding rate among nurses in Aster Medcity (AMC). 2. To facilitate the acclimatization of the newly hired nurse into their role, focusing on professional growth, inter-professional relationships and clinical skills required for the job. Methodology: Descriptive study by Convenience sampling method and collect data by direct observation, questionnaire, interviews. Sample size as per Sample size statistical table at 95 % CI. We conducted a pre and post intervention analysis to assess the impact of Preceptorship at AMC, with a daily occupancy of approx. 300 patients. Result: Preceptor program has had a significant improvement positive impact on all measured parameters. Absconding rate came down from 20% to 0% (P= 0.001). Patient satisfaction scores rose from 85% to 95%. Employee satisfaction rose form 65% to 85%. Conclusion: The project proved that Preceptor Development Programme and the steps taken in hand holding of the new joinees were effective in reducing the absconding rate among nurses and improved the overall satisfaction of new nurses. Preceptee satisfaction with the preceptorship experience was correlated with favorable evaluation of the relationship between the preceptee and preceptor. These findings indicate that when preceptors and preceptees have the benefit of formal preceptorship programs that are well supported, and when the preceptors’ efforts are rewarded, satisfaction is enhanced for both participants, preceptor commitment to the role is reinforced.

Keywords: absconding rate, preceptor, employee satisfaction index, satisfaction index

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Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu

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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.

Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana

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Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

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Authors: Rasha Ahmadi

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In December 2019, a coronavirus, currently identified as SARS-CoV-2, produced a series of acute atypical respiratory illnesses in Wuhan, Hubei Province, China. The sickness induced by this virus was named COVID-19. The virus is transmittable between humans and has caused pandemics worldwide. The number of death tolls continues to climb and a huge number of countries have been obliged to perform social isolation and lockdown. Lack of focused therapy continues to be a problem. Epidemiological research showed that senior patients were more susceptible to severe diseases, whereas children tend to have milder symptoms. In this study, we focus on other possible side effects of COVID-19 and more detailed treatment strategies. Using bioinformatics analysis, we first isolated the gene expression profile of patients with severe COVID-19 from the GEO database. Patients' blood samples were used in the GSE183071 dataset. We then categorized the genes with high and low expression. In the next step, we uploaded the genes separately to the Enrichr database and evaluated our data for signs and symptoms as well as related medication regimens. The results showed that 138 genes with high expression and 108 genes with low expression were observed differentially in the severe COVID-19 VS control group. Symptoms and diseases such as embolism and thrombosis of the abdominal aorta, ankylosing spondylitis, suicidal ideation or attempt, regional enteritis were observed in genes with high expression and in genes with low expression of acute and subacute forms of ischemic heart, CNS infection and poliomyelitis, synovitis and tenosynovitis. Following the detection of diseases and possible signs and symptoms, Carmustine, Bithionol, Leflunomide were evaluated more significantly for high-expression genes and Chlorambucil, Ifosfamide, Hydroxyurea, Bisphenol for low-expression genes. In general, examining the different and invisible aspects of COVID-19 and identifying possible treatments can help us significantly in the emergency and hospitalization of patients.

Keywords: phenotypes, drug regimens, gene expression profiles, bioinformatics analysis, severe COVID-19

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Authors: Hamidreza Sahaleh

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Because of the stringent prerequisite of low sulfur and heavier raw oil feedstock more hydrogen will be devoured in the refineries. Specifically if huge scale limits are the reaction to an expanded hydrogen request, certain configuration and building background are obliged with, which will be depicted in this paper with an illustration. Chosen procedure plan prerequisite will be recorded and portrayed in agreement to the flowsheet. Also, a determination of imaginative outline elements, similar to process condensate reuse, safe reformer start up and prerequisites will be highlighted.

Keywords: low sulfur, raw oil, refineries, flowsheet

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Authors: Farzaneh Yazdani, Nastaran Yazdani, Laya Nobakht

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The aim of this study was to explore the changes that may happen in students attitudes regarding disability after attending the module ‘Disability: theories, nature and experiences’ designed around reflective self-awareness exercises. Literature indicates enhanced knowledge does not automatically lead to changes in attitude. Health care professionals are the most significant people to instil hope in their clients to pursue a happy life. As an advocate for people with disability, health care professionals need to believe themselves in people with disability being able to pursue a happy life as an abled body does. Researchers aimed to explore the impact of the ‘Disability’ module using discussion and reflective exercises, on students’ way of thinking and possible changes in attitude towards disability. Students were asked to write stories from the beginning and after completing the module. A thematic analysis was applied to identify the students’ way of communicating their thoughts and feelings about disable-bodied /disability before and after the module. Three major themes were identified to represent the differences before and after attending the module as: problem /solution oriented approach towards perceived problems, separating/ integrating disable/able-bodied, passive/ active role of disable-bodied and society.

Keywords: qualitative study, reflection, rehabilitation, thematic analysis

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Authors: Ana Beatriz C. G. Silva, Luiz Carlos Wrobel, Fernando Luiz B. Ribeiro

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This paper presents a thermoregulation model using the finite element method to perform numerical analyses of brain cooling procedures as a contribution to the investigation on the use of therapeutic hypothermia after ischemia in adults. The use of computational methods can aid clinicians to observe body temperature using different cooling methods without the need of invasive techniques, and can thus be a valuable tool to assist clinical trials simulating different cooling options that can be used for treatment. In this work, we developed a FEM package applied to the solution of the continuum bioheat Pennes equation. Blood temperature changes were considered using a blood pool approach and a lumped analysis for intravascular catheter method of blood cooling. Some analyses are performed using a three-dimensional mesh based on a complex geometry obtained from computed tomography medical images, considering a cooling blanket and a intravascular catheter. A comparison is made between the results obtained and the effects of each case in brain temperature reduction in a required time, maintenance of body temperature at moderate hypothermia levels and gradual rewarming.

Keywords: brain cooling, finite element method, hypothermia treatment, thermoregulation

Procedia PDF Downloads 311