Search results for: continuous care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5695

Search results for: continuous care

1975 Black-Hole Dimension: A Distinct Methodology of Understanding Time, Space and Data in Architecture

Authors: Alp Arda

Abstract:

Inspired by Nolan's ‘Interstellar’, this paper delves into speculative architecture, asking, ‘What if an architect could traverse time to study a city?’ It unveils the ‘Black-Hole Dimension,’ a groundbreaking concept that redefines urban identities beyond traditional boundaries. Moving past linear time narratives, this approach draws from the gravitational dynamics of black holes to enrich our understanding of urban and architectural progress. By envisioning cities and structures as influenced by black hole-like forces, it enables an in-depth examination of their evolution through time and space. The Black-Hole Dimension promotes a temporal exploration of architecture, treating spaces as narratives of their current state interwoven with historical layers. It advocates for viewing architectural development as a continuous, interconnected journey molded by cultural, economic, and technological shifts. This approach not only deepens our understanding of urban evolution but also empowers architects and urban planners to create designs that are both adaptable and resilient. Echoing themes from popular culture and science fiction, this methodology integrates the captivating dynamics of time and space into architectural analysis, challenging established design conventions. The Black-Hole Dimension champions a philosophy that welcomes unpredictability and complexity, thereby fostering innovation in design. In essence, the Black-Hole Dimension revolutionizes architectural thought by emphasizing space-time as a fundamental dimension. It reimagines our built environments as vibrant, evolving entities shaped by the relentless forces of time, space, and data. This groundbreaking approach heralds a future in architecture where the complexity of reality is acknowledged and embraced, leading to the creation of spaces that are both responsive to their temporal context and resilient against the unfolding tapestry of time.

Keywords: black-hole, timeline, urbanism, space and time, speculative architecture

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1974 Learning the C-A-Bs: Resuscitation Training at Rwanda Military Hospital

Authors: Kathryn Norgang, Sarah Howrath, Auni Idi Muhire, Pacifique Umubyeyi

Abstract:

Description : A group of nurses address the shortage of trained staff to respond to critical patients at Rwanda Military Hospital (RMH) by developing a training program and a resuscitation response team. Members of the group who received the training when it first launched are now trainer of trainers; all components of the training program are organized and delivered by RMH staff-the clinical mentor only provides adjunct support. This two day training is held quarterly at RMH; basic life support and exposure to interventions for advanced care are included in the test and skills sign off. Seventy staff members have received the training this year alone. An increased number of admission/transfer to ICU due to successful resuscitation attempts is noted. Lessons learned: -Number of staff trained 2012-2014 (to be verified). -Staff who train together practice with greater collaboration during actual resuscitation events. -Staff more likely to initiate BLS if peer support is present-more staff trained equals more support. -More access to Advanced Cardiac Life Support training is necessary now that the cadre of BLS trained staff is growing. Conclusions: Increased access to training, peer support, and collaborative practice are effective strategies to strengthening resuscitation capacity within a hospital.

Keywords: resuscitation, basic life support, capacity building, resuscitation response teams, nurse trainer of trainers

Procedia PDF Downloads 288
1973 Eat Right Campaign Initiative to Prevent Hypertension Amongst the Corporates in Uganda

Authors: Katanku Denis Musoga

Abstract:

Eat Right Campaign is an initiative that was started by the Nutrition Unit of Uganda Heart Institute with the objective of informing corporate workers in both the Government and Private sectors about how to eat to prevent Hypertension. In Uganda, according to the recent research undertaken by the Ministry of Health, 1 out of 4 adults is hypertensive and yet over 80% of those are not aware. This is attributed largely to poor eating habits influenced by a lack of knowledge. The major objective of the campaign was to demonstrate the need for effective strategic communication among the corporates by organizing workshops that involved dietary education, food demonstrations, and food preparation in an effort to prevent Hypertension. Permission from various Organizations was sought to carry out sensitization and health education while highlighting the significance of reducing financial losses to health care. The Campaign provided strategies for how to influence positive dietary changes. It involved screening for risk factors. A Pretest was given to the staff to ascertain their knowledge of how to eat right to prevent hypertension, and thereafter the campaign, a post-test was given to the same staff. This was done in all the 10 Organizations that we carried out the campaign. Over 80% of the staff had learned significantly and promised to practice what they had learned; also, the majority who had a higher Blood pressure measurement prior to the campaign returned with significantly lower blood pressure. Food demonstrations, preparations, and regular dietary education should be woven into the entire clinical and Public Health practice.

Keywords: eat right campaign initiative, corporates, prevent hypertension, dietary education

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1972 Micromechanical Modelling of Ductile Damage with a Cohesive-Volumetric Approach

Authors: Noe Brice Nkoumbou Kaptchouang, Pierre-Guy Vincent, Yann Monerie

Abstract:

The present work addresses the modelling and the simulation of crack initiation and propagation in ductile materials which failed by void nucleation, growth, and coalescence. One of the current research frameworks on crack propagation is the use of cohesive-volumetric approach where the crack growth is modelled as a decohesion of two surfaces in a continuum material. In this framework, the material behavior is characterized by two constitutive relations, the volumetric constitutive law relating stress and strain, and a traction-separation law across a two-dimensional surface embedded in the three-dimensional continuum. Several cohesive models have been proposed for the simulation of crack growth in brittle materials. On the other hand, the application of cohesive models in modelling crack growth in ductile material is still a relatively open field. One idea developed in the literature is to identify the traction separation for ductile material based on the behavior of a continuously-deforming unit cell failing by void growth and coalescence. Following this method, the present study proposed a semi-analytical cohesive model for ductile material based on a micromechanical approach. The strain localization band prior to ductile failure is modelled as a cohesive band, and the Gurson-Tvergaard-Needleman plasticity model (GTN) is used to model the behavior of the cohesive band and derived a corresponding traction separation law. The numerical implementation of the model is realized using the non-smooth contact method (NSCD) where cohesive models are introduced as mixed boundary conditions between each volumetric finite element. The present approach is applied to the simulation of crack growth in nuclear ferritic steel. The model provides an alternative way to simulate crack propagation using the numerical efficiency of cohesive model with a traction separation law directly derived from porous continuous model.

Keywords: ductile failure, cohesive model, GTN model, numerical simulation

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1971 Direct and Moderating Effect of Religious Activities, Sustainability and Peer Support on Job Performance

Authors: Fahad Alam

Abstract:

Work stress directly affects job performance, specifically in a worse environment. Consequently, a social provision plays a crucial part for enhancement. Therefore, the current research investigates the direct and moderating effect between religious activities, sustainability and peer support on job performance at hospitals in Khyber PakhtunKhwa (KPK), Pakistan. Both primary and secondary data are collected through 261 questionnaires of medical employees from four district hospitals in Khyber PakhtunKhwa, Pakistan, in 2018. The analysis was carried out by SPSS16 and SMART PLS3, to test the direct effect of religious activities, sustainability and social support on job performance and the effect of moderating variable 'work environment' on job performance. The finding confirmed that direct and moderating variables play a significant positive effect among religious activities, sustainability and peer support on job performance, the variables help to diminish the strain level or the stress level, consequently helps in the job completed. Affirmative social approaches produce desirable effects on job performance. The research revealed that social provisions are significant triggers for superior practices. Moreover, the results are stimulating because some of the past literature revealed an insignificant correlation between social provision and performance. This study found that there is a significant relationship which persuades health care organizations.

Keywords: job performance, peer’s support, religious activities, sustainability, work environment

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1970 Prolonging Late Career Phase - a Sustainable Career Perspective

Authors: Hanna Salminen

Abstract:

Due to the large societal changes in working life, such as retirement reforms, globalization and technological changes, careers are becoming longer, more varied and unpredictable than before. Similar to other new career concepts, such as protean and boundaryless career, a sustainable career concept emphasizes an individual’s active role and agency in managing his/her own career in changing working life. However, the sustainable career concept also underlines the importance of safeguarding and developing human capital over time and thereby fostering continuity. Especially, the theoretical discussion around sustainable careers stresses flexible career choices that meet an individual’s own personal needs, allow work-family balance and promotes continuous learning. Although sustainable careers concern employees at all ages, this study focuses on older employees (aged 50+). So far, the changing nature of careers has been mainly investigated among younger generations, and the changing and prolonging late career phase has received less attention among career scholars. In other words, there is lack of knowledge regarding what constitutes a sustainable career in the late career phase and how the individual, organizational, and societal levels of sustainable career ecosystem are interconnected. The theoretical discussion around sustainable careers is closely linked to the sustainable management of human resources in organizations. In the field of human resource management (HRM), sustainable HRM has received more attention in recent years and it has been seen as a step forward from strategic HRM approach. As a concept, sustainable HRM stresses the long-term focus on organizations’ social, economic, and ecological resources, and the benefits of HRM practices for employees, organizations, and the society at large. However, some HRM scholars argue that the ecological and financial matters have overshadowed the social aspect of sustainability. In this study, the sustainable career and sustainable HRM literature are combined. As a result of an integrative literature review, this study provides new insight, how sustainable late career phase has been understood and conceptualized in sustainable career and sustainable HRM literature.

Keywords: sustainability, career, human resource management, ageing

Procedia PDF Downloads 118
1969 Optimal Tamping for Railway Tracks, Reducing Railway Maintenance Expenditures by the Use of Integer Programming

Authors: Rui Li, Min Wen, Kim Bang Salling

Abstract:

For the modern railways, maintenance is critical for ensuring safety, train punctuality and overall capacity utilization. The cost of railway maintenance in Europe is high, on average between 30,000 – 100,000 Euros per kilometer per year. In order to reduce such maintenance expenditures, this paper presents a mixed 0-1 linear mathematical model designed to optimize the predictive railway tamping activities for ballast track in the planning horizon of three to four years. The objective function is to minimize the tamping machine actual costs. The approach of the research is using the simple dynamic model for modelling condition-based tamping process and the solution method for finding optimal condition-based tamping schedule. Seven technical and practical aspects are taken into account to schedule tamping: (1) track degradation of the standard deviation of the longitudinal level over time; (2) track geometrical alignment; (3) track quality thresholds based on the train speed limits; (4) the dependency of the track quality recovery on the track quality after tamping operation; (5) Tamping machine operation practices (6) tamping budgets and (7) differentiating the open track from the station sections. A Danish railway track between Odense and Fredericia with 42.6 km of length is applied for a time period of three and four years in the proposed maintenance model. The generated tamping schedule is reasonable and robust. Based on the result from the Danish railway corridor, the total costs can be reduced significantly (50%) than the previous model which is based on optimizing the number of tamping. The different maintenance strategies have been discussed in the paper. The analysis from the results obtained from the model also shows a longer period of predictive tamping planning has more optimal scheduling of maintenance actions than continuous short term preventive maintenance, namely yearly condition-based planning.

Keywords: integer programming, railway tamping, predictive maintenance model, preventive condition-based maintenance

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1968 Effect of Different Thermomechanical Cycles on Microstructure of AISI 4140 Steel

Authors: L.L. Costa, A. M. G. Brito, S. Khan, L. Schaeffer

Abstract:

Microstructure resulting from the forging process is studied as a function of variables such as temperature, deformation, austenite grain size and cooling rate. The purpose of this work is to study the thermomechanical behavior of DIN 42CrMo4 (AISI 4140) steel maintained at the temperatures of 900°, 1000°, 1100° and 1200°C for the austenization times of 22, 66 and 200 minutes each and subsequently forged. These samples were quenched in water in order to study the austenite grain and to investigate the microstructure instead of quenching the annealed samples after forging they were cooled down naturally in the air. The morphologies and properties of the materials such as hardness; prepared by these two different routes have been compared. In addition to the forging experiments, the numerical simulation using the finite element model (FEM), microhardness profiles and metallography images have been presented. Forging force vs position curves has been compared with metallographic results for each annealing condition. The microstructural phenomena resulting from the hot conformation proved that longer austenization time and higher temperature decrease the forging force in the curves. The complete recrystallization phenomenon (static, dynamic and meta dynamic) was observed at the highest temperature and longest time i.e., the samples austenized for 200 minutes at 1200ºC. However, higher hardness of the quenched samples was obtained when the temperature was 900ºC for 66 minutes. The phases observed in naturally cooled samples were exclusively ferrite and perlite, but the continuous cooling diagram indicates the presence of austenite and bainite. The morphology of the phases of naturally cooled samples has shown that the phase arrangement and the previous austenitic grain size are the reasons to high hardness in obtained samples when temperature were 900ºC and 1100ºC austenization times of 22 and 66 minutes, respectively.

Keywords: austenization time, thermomechanical effects, forging process, steel AISI 4140

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1967 Impact of Hepatitis C Virus Chronic Infection on Quality of Life in Egypt

Authors: Ammal M. Metwally, Ghada A. Abdel-Latif, Walaa A. Fouad, Thanaa M. Rabah, Amira Mohsen, Fatma A. Shaaban, Iman I. Salama

Abstract:

The study aimed at determining the impact of chronic hepatitis C virus (HCV) infection on patients’ Quality of Life (QoL) , its relation to geographical characteristics of patients, awareness of the disease, treatment regimen, co-morbid psychiatric or other diseases. 457 patients were randomly selected from ten National Treatment Reference Centers of Ministry of Health hospitals from four community locations representing Egypt. Health related QoL assessment questionnaire with the 36-item Short Form used for assessment of the enrolled patients. The study showed no significant difference between HCV patients in different governorates as regards total QoL. Females, illiterate patients and those had bilharziasis, diabetes mellitus, hypertension or were depressed had significantly the lowest QoL score. HCV patients who knew the danger of the disease had significant lower mean score of physical and mental health components. Optimal care of overall well-being of HCV patients requires adequate knowledge of their neurological and psychological status. It is important to know that any patient will need to take the time to know that his new physical limitations do not limit him as a person, as soul, no matter what other people are thinking as a positive hopeful attitude is essential for combating HCV.

Keywords: hepatitis C virus chronic infection - physical health component and mental health component of QoL– total quality of life

Procedia PDF Downloads 438
1966 Size Optimization of Microfluidic Polymerase Chain Reaction Devices Using COMSOL

Authors: Foteini Zagklavara, Peter Jimack, Nikil Kapur, Ozz Querin, Harvey Thompson

Abstract:

The invention and development of the Polymerase Chain Reaction (PCR) technology have revolutionised molecular biology and molecular diagnostics. There is an urgent need to optimise their performance of those devices while reducing the total construction and operation costs. The present study proposes a CFD-enabled optimisation methodology for continuous flow (CF) PCR devices with serpentine-channel structure, which enables the trade-offs between competing objectives of DNA amplification efficiency and pressure drop to be explored. This is achieved by using a surrogate-enabled optimisation approach accounting for the geometrical features of a CF μPCR device by performing a series of simulations at a relatively small number of Design of Experiments (DoE) points, with the use of COMSOL Multiphysics 5.4. The values of the objectives are extracted from the CFD solutions, and response surfaces created using the polyharmonic splines and neural networks. After creating the respective response surfaces, genetic algorithm, and a multi-level coordinate search optimisation function are used to locate the optimum design parameters. Both optimisation methods produced similar results for both the neural network and the polyharmonic spline response surfaces. The results indicate that there is the possibility of improving the DNA efficiency by ∼2% in one PCR cycle when doubling the width of the microchannel to 400 μm while maintaining the height at the value of the original design (50μm). Moreover, the increase in the width of the serpentine microchannel is combined with a decrease in its total length in order to obtain the same residence times in all the simulations, resulting in a smaller total substrate volume (32.94% decrease). A multi-objective optimisation is also performed with the use of a Pareto Front plot. Such knowledge will enable designers to maximise the amount of DNA amplified or to minimise the time taken throughout thermal cycling in such devices.

Keywords: PCR, optimisation, microfluidics, COMSOL

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1965 A Case Study on Performance of Isolated Bridges under Near-Fault Ground Motion

Authors: Daniele Losanno, H. A. Hadad, Giorgio Serino

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This paper presents a numerical investigation on the seismic performance of a benchmark bridge with different optimal isolation systems under near fault ground motion. Usually, very large displacements make seismic isolation an unfeasible solution due to boundary conditions, especially in case of existing bridges or high risk seismic regions. Hence, near-fault ground motions are most likely to affect either structures with long natural period range like isolated structures or structures sensitive to velocity content such as viscously damped structures. The work is aimed at analyzing the seismic performance of a three-span continuous bridge designed with different isolation systems having different levels of damping. The case study was analyzed in different configurations including: (a) simply supported, (b) isolated with lead rubber bearings (LRBs), (c) isolated with rubber isolators and 10% classical damping (HDLRBs), and (d) isolated with rubber isolators and 70% supplemental damping ratio. Case (d) represents an alternative control strategy that combines the effect of seismic isolation with additional supplemental damping trying to take advantages from both solutions. The bridge is modeled in SAP2000 and solved by time history direct-integration analyses under a set of six recorded near-fault ground motions. In addition to this, a set of analysis under Italian code provided seismic action is also conducted, in order to evaluate the effectiveness of the suggested optimal control strategies under far field seismic action. Results of the analysis demonstrated that an isolated bridge equipped with HDLRBs and a total equivalent damping ratio of 70% represents a very effective design solution for both mitigation of displacement demand at the isolation level and base shear reduction in the piers also in case of near fault ground motion.

Keywords: isolated bridges, near-fault motion, seismic response, supplemental damping, optimal design

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1964 Nursing and Allied Health Perception of Desirable Junior Doctor Attributes for Effective Collaboration and Teamwork

Authors: Maneka Marianne Britto, Hansraj Riteesh Bookun

Abstract:

The ability of a junior doctor to deliver complex multi-disciplinary care to patients in a paradigm of respect and collaboration requires a multitude of interpersonal skills and competencies. A short survey was used to explore the perspective of allied health staff on the desirable attributes of a junior doctor which are conducive to good teamwork. 23 allied health professionals (14 nurses, 4 physiotherapists, 2 dietitians, 1 occupational therapist, 1 speech therapist and 1 audiologist) responded to this 17-item survey. There were 17 females. The mean age of the respondents was 34.9 ± 10.1 years. The salient findings of our survey are that 95% of our respondents rated friendliness and non-clinical small talk with average importance or greater. 45% of them viewed these 2 items as very important or absolutely essential. A single respondent viewed these 2 items with little importance. The other criteria which were rated with high levels of importance were the acknowledgment of allied health suggestions and good ward organizational skills. Training these collaborative skills is challenging, and an enhanced understanding of interprofessional perspectives will help a junior doctor to achieve better clinical outcomes. It is hoped that this paper will further stimulate discussion in this area and will encourage junior doctors to engage in non-clinical conversations with allied health staff in the spirit of promoting effective teamwork.

Keywords: allied health, collaboration, doctor, medicine, surgery

Procedia PDF Downloads 117
1963 Formulation and in Vitro Characterization of Bioactives Loaded Polymeric Nanoparticle Incorporated into Multiphase Hydrogel System for the Treatment of Infected Burn Wound

Authors: Rajni Kant Panik, Deependra Singh, Manju Singh

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Despite significant advances in the treatment of severe burn injury, infection and sepsis persist as frequent causes of morbidity and mortality for burn victims due to extensive compromise of the skin and contiguous tissue that serve as a protective barrier against microbial invasion. In the setting of a burn wound infection, Staphylococcus aureus is the most commonly isolated pathogens from bloodstream infections in burn care hospitals. We aimed to develop a biocompatible system of Poly vinyl alcohol (PVA)-sodium alginate hydrogel carrying multiple drugs- catalase and mupirocin in controlled manner for effective and complete burn wound healing. PLGA nanoparticles of Catalase and mupirocin were prepared by homogenization method and optimized system was incorporated in PVA-sodium alginate slurry. PVA-sodium alginate hydrogels were prepared by freeze thaw method. The prepared dispersion was casted into films to prepare multiphase hydrogel system and characterized by in vitro and in vivo studies. The study clearly showed the beneficial effect of antioxidant enzyme and antibiotic in the treatment of infected burn wound, as evidenced by the reduced incidence of wound infection and the shortening of healing time.

Keywords: burn wound, catalase, mupirocin, wound healing

Procedia PDF Downloads 488
1962 Opportunities for Effective Communication Through the Delivery of an Autism Spectrum Disorder Diagnosis: A Scoping Review

Authors: M. D. Antoine

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When a child is diagnosed with an illness, condition, or developmental disorder, the process involved in understanding and accepting this diagnosis can be a very stressful and isolating experience for parents and families. The healthcare providers’ ability to effectively communicate in such situations represents a vital lifeline for parents. In this context, communication becomes a crucial element not only for getting through the period of grief but also for the future. We mobilized the five stages of grief model to summarize existing literature regarding the ways in which the experience ofan autism spectrum disorder diagnosis disclosurealigns with the experience of grief to explore how this can inform best practices for effective communication with parents through the diagnosis disclosure. Fifteen publications met inclusion criteria. Findings from the scoping review of empirical studies show that parents/families experience grief-like emotions during the diagnosis disclosure. However, grief is not an outcome of the encounter itself. In fact, the experience of the encounter can help mitigate the grief experience. The way parents/families receive and react to the ‘news’ depends on their preparedness, knowledge, and the support received through the experience. Individual communication skills, as well as policies and regulations, should be examined to alleviate adverse reactions in this context. These findings highlight the importance of further research into effective parent-provider communication strategies and their place in supporting quality autism care.

Keywords: autism spectrum disorder, autism spectrum disorder diagnosis, diagnosis disclosure, parent-provider communication, parental grief

Procedia PDF Downloads 161
1961 Study on the Factors Influencing the Built Environment of Residential Areas on the Lifestyle Walking Trips of the Elderly

Authors: Daming Xu, Yuanyuan Wang

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Abstract: Under the trend of rapid expansion of urbanization, the motorized urban characteristics become more and more obvious, and the walkability of urban space is seriously affected. The construction of walkability of space, as the main mode of travel for the elderly in their daily lives, has become more and more important in the current social context of serious aging. Settlement is the most basic living unit of residents, and daily shopping, medical care, and other daily trips are closely related to the daily life of the elderly. Therefore, it is of great practical significance to explore the impact of built environment on elderly people's daily walking trips at the settlement level for the construction of pedestrian-friendly settlements for the elderly. The study takes three typical settlements in Harbin Daoli District in three different periods as examples and obtains data on elderly people's walking trips and built environment characteristics through field research, questionnaire distribution, and internet data acquisition. Finally, correlation analysis and multinomial logistic regression model were applied to analyze the influence mechanism of built environment on elderly people's walkability based on the control of personal attribute variables in order to provide reference and guidance for the construction of walkability for elderly people in built environment in the future.

Keywords: built environment, elderly, walkability, multinomial logistic regression model

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1960 Viscoelastic Characterization of Gelatin/Cellulose Nanocrystals Aqueous Bionanocomposites

Authors: Liliane Samara Ferreira Leite, Francys Kley Vieira Moreira, Luiz Henrique Capparelli Mattoso

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The increasing environmental concern regarding the plastic pollution worldwide has stimulated the development of low-cost biodegradable materials. Proteins are renewable feedstocks that could be used to produce biodegradable plastics. Gelatin, for example, is a cheap film-forming protein extracted from animal skin and connective tissues of Brazilian Livestock residues; thus it has a good potential in low-cost biodegradable plastic production. However, gelatin plastics are limited in terms of mechanical and barrier properties. Cellulose nanocrystals (CNC) are efficient nanofillers that have been used to extend physical properties of polymers. This work was aimed at evaluating the reinforcing efficiency of CNC on gelatin films. Specifically, we have employed the continuous casting as the processing method for obtaining the gelatin/CNC bionanocomposites. This required a first rheological study for assessing the effect of gelatin-CNC and CNC-CNC interactions on the colloidal state of the aqueous bionanocomposite formulations. CNC were isolated from eucalyptus pulp by sulfuric acid hydrolysis (65 wt%) at 55 °C for 30 min. Gelatin was solubilized in ultra-pure water at 85°C for 20 min and then mixed with glycerol at 20 wt.% and CNC at 0.5 wt%, 1.0 wt% and 2.5 wt%. Rotational measurements were performed to determine linear viscosity (η) of bionanocomposite solutions, which increased with increasing CNC content. At 2.5 wt% CNC, η increased by 118% regarding the neat gelatin solution, which was ascribed to percolation CNC network formation. Storage modulus (G’) and loss modulus (G″) further determined by oscillatory tests revealed that a gel-like behavior was dominant in the bionanocomposite solutions (G’ > G’’) over a broad range of temperature (20 – 85 °C), particularly at 2.5 wt% CNC. These results confirm effective interactions in the aqueous gelatin-CNC bionanocomposites that could substantially increase the physical properties of the gelatin plastics. Tensile tests are underway to confirm this hypothesis. The authors would like to thank the Fapesp (process n 2016/03080-3) for support.

Keywords: bionanocomposites, cellulose nanocrystals, gelatin, viscoelastic characterization

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1959 Uncloaking Priceless Pieces of Evidence: Psychotherapy with an Older New Zealand Man; Contributions to Understanding Hidden Historical Phenomena and the Trans-Generation Transmission of Silent and Un-Witnessed Trauma

Authors: Joanne M. Emmens

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This paper makes use of the case notes of a single psychoanalytically informed psychotherapy of a now 72-year-old man over a four-year period to explore the potential of qualitative data to be incorporated into a research methodology that can contribute theory and knowledge to the wider professional community involved in mental health care. The clinical material arising out of any psychoanalysis provides a potentially rich source of clinical data that could contribute valuably to our historical understanding of both individual and societal traumata. As psychoanalysis is primarily an investigation, it is argued that clinical case material is a rich source of qualitative data which has relevance for sociological and historical understandings and that it can potentially aluminate important ‘gaps’ and collective blind spots that manifest unconsciously and are a contributing factor in the transmission of trauma, silently across generations. By attending to this case material the hope is to illustrate the value of using a psychoanalytic centred methodology. It is argued that the study of individual defences and the manner in which they come into consciousness, allows an insight into group defences and the unconscious forces that contribute to the silencing or un-noticing of important sources (or originators) of mental suffering.

Keywords: dream furniture (Bion) and psychotic functioning, reverie, screen memories, selected fact

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1958 Passively Q-Switched 914 nm Microchip Laser for LIDAR Systems

Authors: Marco Naegele, Klaus Stoppel, Thomas Dekorsy

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Passively Q-switched microchip lasers enable the great potential for sophisticated LiDAR systems due to their compact overall system design, excellent beam quality, and scalable pulse energies. However, many near-infrared solid-state lasers show emitting wavelengths > 1000 nm, which are not compatible with state-of-the-art silicon detectors. Here we demonstrate a passively Q-switched microchip laser operating at 914 nm. The microchip laser consists of a 3 mm long Nd:YVO₄ crystal as a gain medium, while Cr⁴⁺:YAG with an initial transmission of 98% is used as a saturable absorber. Quasi-continuous pumping enables single pulse operation, and low duty cycles ensure low overall heat generation and power consumption. Thus, thermally induced instabilities are minimized, and operation without active cooling is possible while ambient temperature changes are compensated by adjustment of the pump laser current only. Single-emitter diode pumping at 808 nm leads to a compact overall system design and robust setup. Utilization of a microchip cavity approach ensures single-longitudinal mode operation with spectral bandwidths in the picometer regime and results in short laser pulses with pulse durations below 10 ns. Beam quality measurements reveal an almost diffraction-limited beam and enable conclusions concerning the thermal lens, which is essential to stabilize the plane-plane resonator. A 7% output coupler transmissivity is used to generate pulses with energies in the microjoule regime and peak powers of more than 600 W. Long-term pulse duration, pulse energy, central wavelength, and spectral bandwidth measurements emphasize the excellent system stability and facilitate the utilization of this laser in the context of a LiDAR system.

Keywords: diode-pumping, LiDAR system, microchip laser, Nd:YVO4 laser, passively Q-switched

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1957 Yields and Composition of the Gas, Liquid and Solid Fractions Obtained by Conventional Pyrolysis of Different Lignocellulosic Biomass Residues

Authors: María del Carmen Recio-Ruiz, Ramiro Ruiz-Rosas, Juana María Rosas, José Rodríguez-Mirasol, Tomás Cordero

Abstract:

Nowadays, fossil resources are main precursors for fuel production. Due to their contribution to the greenhouse effect and their future depletion, there is a constant search for environmentally friendly feedstock alternatives. Biomass residues constitute an interesting replacement for fossil resources because of their zero net CO₂ emissions. One of the main routes to convert biomass into energy and chemicals is pyrolysis. In this work, conventional pyrolysis of different biomass residues highly available such as almond shells, hemp hurds, olive stones, and Kraft lignin, was studied. In a typical experiment, the biomass was crushed and loaded into a fixed bed reactor under continuous nitrogen flow. The influence of temperature (400-800 ºC) and heating rate (10 and 20 ºC/min) on the pyrolysis yield and composition of the different fractions has been studied. In every case, the mass yields revealed that the solid fraction decreased with temperature, while liquid and gas fractions increased due to depolymerization and cracking reactions at high temperatures. The composition of every pyrolysis fraction was studied in detail. The results showed that the composition of the gas fraction was mainly CO, CO₂ when working at low temperatures, and mostly CH₄ and H₂at high temperatures. The solid fraction developed an incipient microporosity, with narrow micropore volume of 0.21 cm³/g. Regarding the liquid fraction, pyrolysis of almond shell, hemp hurds, and olive stones led mainly to a high content in aliphatic acids and furans, due to the high volatile matter content of these biomass (>74 %wt.), and phenols to a lesser degree, which were formed due to the degradation of lignin at higher temperatures. However, when Kraft lignin was used as bio-oil precursor, the presence of phenols was very prominent, and aliphatic compounds were also detected in a lesser extent.

Keywords: Bio-oil, biomass, conventional pyrolysis, lignocellulosic

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1956 Workplace Development Programmes for Small and Medium-Sized Enterprises in Europe and Singapore: A Conceptual Study

Authors: Zhan Jie How

Abstract:

With the heightened awareness of workplace learning and its impact on improving organizational performance and developing employee competence, governments and corporations around the world are forced to intensify their cooperation to establish national workplace development programmes to guide these corporations in fostering engaging and collaborative workplace learning cultures. This conceptual paper aims to conduct a comparative study of existing workplace development programmes for small and medium-sized enterprises (SMEs) in Europe and Singapore, focusing primarily on the Swedish Production Leap, Finnish TEKES Liideri Programme, and Singapore SkillsFuture SME Mentors Programme. The study carries out a systematic review of the three workplace development programmes to examine the roles of external mentors or coaches in influencing the design and implementation of workplace learning strategies and practices in SMEs. Organizational, personal and external factors that promote or inhibit effective workplace mentorship are also scrutinized, culminating in a critical comparison and evaluation of the strengths and weaknesses of the aforementioned programmes. Based on the findings from the review and analyses, a heuristic conceptual framework is developed to illustrate the complex interrelationships among external workplace development programmes, internal learning and development initiatives instituted by the organization’s higher management, and employees' continuous learning activities at the workplace. The framework also includes a set of guiding principles that can be used as the basis for internal mediation between the competing perspectives of mentors and mentees (employers and employees of the organization) regarding workplace learning conditions, practices and their intended impact on the organization. The conceptual study provides a theoretical blueprint for future empirical research on organizational workplace learning and the impact of government-initiated workplace development programmes.

Keywords: employee competence, mentorship, organizational performance, workplace development programme, workplace learning culture

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1955 Combination of Diuretics and Selective Serotonin Reuptake Inhibitors Leading Severe Hyponatremia: A Case Report

Authors: Esra Bora, Alper Omeroglu, Zeynep Pelin Polat, Oguzhan Kara, Fatih Akdogan, Sema Ucak Basat

Abstract:

Hyponatremia is one of the most encountered electrolyte imbalance among all medical fields. It has a wide range of symptoms as well as complications from fatigue to loss of consciousness. Although a lot of factors can cause low sodium levels in serum, combining specific medications can lead to severe hyponatremia in a rapid onset which can cause high mortality and morbidity. The objective of this case report was to underline that prescribing specific medications disregarding their side effects can cause this common electrolyte imbalance but in a more severe manner. In this case report, we present a 46-year-old male patient with a serum sodium level of 104 mEq/L who consumed hydrochlorothiazide for hypertension and was under treatment with selective serotonin reuptake inhibitors (SSRIs) for major depression. The patient had tonic-clonic seizures at the second hour of the treatment and intubation was needed due to loss of consciousness and hypoxia. After proper replacement of sodium with hypertonic solutions in intensive care unit for nine days, extubation indicated. Even in healthy young males, hyponatremia due to two separately prescribed medications can lead life-threatening hyponatremia. Physicians should be aware of the side effects of diuretics, especially hydrochlorothiazides and SSRIs and their combinations.

Keywords: diuretics, hydrochlorothiazide, hyponatremia, SSRI

Procedia PDF Downloads 134
1954 Exercise Intensity Increasing Appetite, Energy, Intake Energy Expenditure, and Fat Oxidation in Sedentary Overweight Individuals

Authors: Ghalia Shamlan, M. Denise Robertson, Adam Collins

Abstract:

Appetite control (i.e. control of energy intake) is important for weight maintenance. Exercise contributes to the most variable component of energy expenditure (EE) but its impact is beyond the energy cost of exercise including physiological, behavioural, and appetite effects. Exercise is known to acutely influence effect appetite but evidence as to the independent effect of intensity is lacking. This study investigated the role of exercise intensity on appetite, energy intake (EI), appetite related hormone, fat utilisation and subjective measures of appetite. One hour after a standardised breakfast, 10 sedentary overweight volunteers. Subjects undertook either 8 repeated 60 second bouts of cycling at 95% VO2max (high intensity) or 30 minutes of continuous cycling, at a fixed cadence, equivalent to 50% of the participant’s VO2max (low intensity) in a randomised crossover design. Glucose, NEFA, glucagon-like peptide-1 (GLP-1) were measured fasted, postprandial, and pre and post-exercise. Satiety was assessed subjectively throughout the study using visual analogue scales (VAS). Ad libitum intake of a pasta meal was measured at the end (3-h post-breakfast). Interestingly, there was not significant difference in EE fat oxidation between HI and LI post-exercise. Also, no significant effect of high intensity (HI) was observed on the ad libitum meal, 24h and 48h EI post-exercise. However the mean 24h EI was 3000 KJ lower following HI than low intensity (LI). Despite, no significant differences in hunger score, glucose, NEFA and GLP-1 between both intensities were observed. However, NEFA and GLP-1 plasma level were higher until 30 min post LI. In conclusion, the similarity of EE and oxidation outcomes could give overweight individuals an option to choose between intensities. However, HI could help to reduce EI. There are mechanisms and consequences of exercise in short and long-term appetite control; however, these mechanisms warrant further explanation. These results support the need for future research in to the role of in regulation energy balance, especially for obese people.

Keywords: appetite, exercise, food intake, energy expenditure

Procedia PDF Downloads 489
1953 Telehealth Psychotherapy: A Comparison of Two Swedish Randomized Clinical Trials

Authors: Madeline Foster

Abstract:

Since the COVID-19 pandemic, telehealth usage for the delivery of psychotherapy has surged. The evidence base evaluating the success of telehealth interventions continues to grow, with both benefits as well as potential risks identified. This study compared two recent randomized clinical trials (RCTs) from Sweden that looked at the effectiveness of Cognitive Behavioral Therapy (CBT) delivered via telehealth (TH) versus face-to-face (FTF) for individuals with Obsessive Compulsive Disorder (OCD). The papers had mixed results. The first paper by Aspvall and colleagues compared the effect of a therapist-supported, internet-delivered stepped-care CBT program for children and adolescents aged 7 to 17 with face-to-face CBT (2021). In Aspvall’s study, the control scored a mean Y-BOCS of 10.57 and the TH intervention group scored a mean Y-BOCS of 11.57. The mean difference (0.91) met the criteria for noninferiority (p = 0.03). The second study by Lundström and colleagues also compared therapist-supported, internet-based CBT with FTF CBT for the treatment of those with DSM-5-diagnosed OCD. Conversely, while Lundström’s study reported improved symptoms across all groups, at follow up the difference in symptom severity between FTF and TH was clinically significant, with 77% of FTF participants responding to treatment compared to only 45% of TH participants. Due to the methodological limitations of Lundström’s study, it was concluded that Aspvall’s paper made a stronger scientific argument.

Keywords: telehealth, Sweden, RCT, cognitive-behavioral therapy, obsessive-compulsive disorder

Procedia PDF Downloads 49
1952 Role of Adaptive Support Ventilation in Weaning of COPD Patients

Authors: A. Kamel Abd Elaziz Mohamed, B. Sameh Kamal el Maraghi

Abstract:

Introduction: Adaptive support ventilation (ASV) is an improved closed-loop ventilation mode that provides both pressure-controlled ventilation and PSV according to the patient’s needs. Aim of the work: To compare the short-term effects of Adaptive support ventilation (ASV), with conventional Pressure support ventilation (PSV) in weaning of intubated COPD patients. Patients and methods: Fifty patients admitted in the intensive care with acute exacerbation of COPD and needing intubation were included in the study. All patients were initially ventilated with control/assist control mode, in a stepwise manner and were receiving standard medical therapy. Patients were randomized into two groups to receive either ASV or PSV. Results: Out of fifty patients included in the study forty one patients in both studied groups were weaned successfully according to their ABG data and weaning indices. APACHE II score showed no significant difference in both groups. There were statistically significant differences between the groups in term of, duration of mechanical ventilation, weaning hours and length of ICU stay being shorter in (group 1) weaned by ASV. Re-intubation and mortality rate were higher in (group 11) weaned by conventional PSV, however the differences were not significant. Conclusion: ASV can provide automated weaning and achieve shorter weaning time for COPD patients hence leading to reduction in the total duration of MV, length of stay, and hospital costs.

Keywords: COPD patients, ASV, PSV, mechanical ventilation (MV)

Procedia PDF Downloads 382
1951 Effects of Moisture on Fatigue Behavior of Asphalt Concrete Mixtures Using Four-Point Bending Test

Authors: Mohit Chauhan, Atul Narayan

Abstract:

Moisture damage is the continuous deterioration of asphalt concrete mixtures by the loss of adhesive bond between the asphalt binder and aggregates, or loss of cohesive bonds within the asphalt binder in the presence of moisture. Moisture has been known to either cause or exacerbates distresses in asphalt concrete pavements. Since moisture would often retain for a relatively long duration at the bottom of asphalt concrete layer, the movement of traffic loading in this saturated condition would cause excess stresses or strains within the mixture. This would accelerate the degradation of the adhesion and cohesion within the mixture and likely to contribute the development of fatigue cracking in asphalt concrete pavements. In view of this, it is important to investigate the effect of moisture on the fatigue behavior of asphalt concrete mixtures. In this study, changes in fatigue characteristics after moisture conditioning were evaluated by conducting four-point beam fatigue tests on dry and moisture conditioned specimens. For this purpose, mixtures with two different types of binders were prepared and saturated with moisture using 700 mm Hg vacuum. Beam specimens, in this way, were taken to a saturation level of 65-75 percent. After preconditioning specimens in this degree of saturation and 60°C for a period of 24 hours, they were subjected to four point beam fatigue tests in strain-controlled mode with a strain amplitude of 400 microstrain. The results were then compared with the fatigue test results obtained with beam specimens that were not subjected to moisture conditioning. Test results show that the conditioning reduces both fatigue life and initial flexural stiffness of specimen significantly. The moisture conditioning was also found to increase the rate of reduction of flexural stiffness. Moreover, it was observed that the fatigue life ratio (FLR), the ratio of the fatigue life of the moisture conditioned sample to that of the dry sample, is significantly lower than the flexural stiffness ratio (FSR). The study indicates that four-point bending test is an appropriate tool with FLR and FSR as the potential parameters for moisture-sensitivity evaluation.

Keywords: asphalt concrete, fatigue cracking, moisture damage, preconditioning

Procedia PDF Downloads 127
1950 Bioecological Assessment of Cage Farming on the Soft Bottom Benthic Communities of the Vlora Gulf (Albania)

Authors: Ina Nasto, Denada Sota, Pudrila Haskoçelaj, Mariola Ismailaj, Hajdar Kicaj

Abstract:

Most of the fishing areas of the Mediterranean Sea are considered to be overfished, consequently fishing has decreased or is static. Considering the continuous increase in demand for fish, the option of aquaculture production has had a growing development in recent decades. The environmental impact of aquaculture in the marine ecosystem has been a subject of study for several years in the Mediterranean. In the case of the Albanian waters, and in particular the Gulf of Vlora, have had a progressive growing of aquaculture activity in the last twenty years. Given the convenient and secluded location for tourist activities, the bay of Ragusa was considered as the most suitable area to install the aquaculture cage system for the breeding of sea bass and sea bream. The impact of aquaculture in on the soft bottom benthic communities has been assessed at the biggest commercial fish farm (Alb-Adriatico Sh.P.K) established in coastal waters of Ragusa bay 30–50 m deep, in the southern part of the Gulf of Vlora. In order to determine if there is a possible impact on the aquaculture cage in benthic communities, a comparative analysis was undertaken between transects and samples with differences in distances between them and with a gradient of distance from the fish cages. A total of 275 taxa were identified (1 Foraminifera, 1 Porifera, 3 Cnidaria, 2 Platyhelminthes, 2 Nemertea, 1 Bryozoa, 171 Mollusca, 39 Annelida, 35 Crustacea, 14 Echinodermata, 1 Hemichordata, and 5 Tunicata). The anaysis showed three main habitats in the area: biocoenosis of terrigenous mud, residual areas with Possidonia oceanica and also residual assemblages of algal coralligenous. Four benthic biotic indexes were calculated (Shannon H ’, BENTIX, Simpson's Diversity and Peilou’s J’) also benthic indicators as total abundance, number of taxa and species frequency to evaluate possible ecological impact of fish cages in Ragusa bay.

Keywords: Bentix index, Benthic community, invertebrates, aquaculture, Raguza bay

Procedia PDF Downloads 86
1949 The Reason of Principles of Construction Engineering and Management Being Necessary for Contracting Firms and Their Projects Managers

Authors: Mamoon Mousa Atout

Abstract:

The industries of construction are in continuous growth not only in Middle East rejoin but almost all over the world. For the last fifteen years, big expansion and increase of different types of projects has been observed. Many infrastructural projects have been developed, high rise buildings, big shopping malls, power sub-stations, roads, bridges, schools, universities and developing many of new cities with full and complete facilities. The growth and enlargement of the mentioned developed projects has been accomplished through many international and local contracting organizations. Senior management of these organizations depend on their qualified and experienced team whom are aware of the implications of project management, construction management, engineering management and resource management during tendering till final completion of the project. This research aims to find out why reasons of principles of construction engineering and management are necessary for contracting firms and their managers. Principles of construction management help contracting organizations to accomplish and deliver projects without delay. This can be maintained by establishing guidelines’ details for updating the adopted system of construction management that they have through qualified and experienced project managers. The research focuses on benefits of other essential skills of projects planning, monitoring and control. Defining roles and responsibilities of contractor project managers during tendering and execution is a part of the investigated factors that will be analyzed. Other skills like optimizing and utilizing the obtainable project resources to deliver the project within time, cost and quality will be also investigated to find out how these factors are affecting the performance of contracting firms, projects managers and projects. The conclusion of the research will help senior management team and the contractors project managers about the benefits of implications and benefits construction management system and its effect upon the performance and knowledge of contract values that they have, and the optimal profit margin of the firm it.

Keywords: construction management, contracting firms, project managers, planning processes, roles and responsibilities

Procedia PDF Downloads 285
1948 Integrated Machine Learning Framework for At-Home Patients Personalized Risk Prediction Using Activities, Biometric, and Demographic Features

Authors: Claire Xu, Welton Wang, Manasvi Pinnaka, Anqi Pan, Michael Han

Abstract:

Hospitalizations account for one-third of the total health care spending in the US. Early risk detection and intervention can reduce this high cost and increase the satisfaction of both patients and physicians. Due to the lack of awareness of the potential arising risks in home environment, the opportunities for patients to seek early actions of clinical visits are dramatically reduced. This research aims to offer a highly personalized remote patients monitoring and risk assessment AI framework to identify the potentially preventable hospitalization for both acute as well as chronic diseases. A hybrid-AI framework is trained with data from clinical setting, patients surveys, as well as online databases. 20+ risk factors are analyzed ranging from activities, biometric info, demographic info, socio-economic info, hospitalization history, medication info, lifestyle info, etc. The AI model yields high performance of 87% accuracy and 88 sensitivity with 20+ features. This hybrid-AI framework is proven to be effective in identifying the potentially preventable hospitalization. Further, the high indicative features are identified by the models which guide us to a healthy lifestyle and early intervention suggestions.

Keywords: hospitalization prevention, machine learning, remote patient monitoring, risk prediction

Procedia PDF Downloads 205
1947 Experimental Study on Strength and Durability Properties of Bio-Self-Cured Fly Ash Based Concrete under Aggressive Environments

Authors: R. Malathy

Abstract:

High performance concrete is not only characterized by its high strength, workability, and durability but also by its smartness in performance without human care since the first day. If the concrete can cure on its own without external curing without compromising its strength and durability, then it is said to be high performance self-curing concrete. In this paper, an attempt is made on the performance study of internally cured concrete using biomaterials, namely Spinacea pleracea and Calatropis gigantea as self-curing agents, and it is compared with the performance of concrete with existing self-cure chemical, namely polyethylene glycol. The present paper focuses on workability, strength, and durability study on M20, M30, and M40 grade concretes replacing 30% of fly ash for cement. The optimum dosage of Spinacea pleracea, Calatropis gigantea, and polyethylene glycol was taken as 0.6%, 0.24%, and 0.3% by weight of cement from the earlier research studies. From the slump tests performed, it was found that there is a minimum variation between conventional concrete and self-cured concrete. The strength activity index is determined by keeping compressive strength of conventionally cured concrete for 28 days as unity and observed that, for self-cured concrete, it is more than 1 after 28 days and more than 1.15 after 56 days because of secondary reaction of fly ash. The performance study of concretes in aggressive environment like acid attack, sea water attack, and chloride attack was made, and the results are positive and encouraging in bio-self-cured concretes which are ecofriendly, cost effective, and high performance materials.

Keywords: bio materials, Calatropis gigantea, self curing concrete, Spinacea oleracea

Procedia PDF Downloads 337
1946 Information Security Dilemma: Employees' Behaviour on Three-Dimensions to Failure

Authors: Dyana Zainudin, Atta Ur-Rahman, Thaier Hamed

Abstract:

This paper explains about human nature concept as to understand the significance of information security in employees’ mentality including leaders in an organisation. By studying on a theory concept of the latest Von Solms fourth waves, information security governance basically refers to the concept of a set of methods, techniques and tools that responsible for protecting resources of a computer system to ensure service availability, confidentiality and integrity of information. However, today’s information security dilemma relates to the acceptance of employees mentality. The major causes are a lack of communication and commitment. These types of management in an organisation are labelled as immoral/amoral management which effects on information security compliance. A recovery action is taken based on ‘learn a lesson from incident events’ rather than prevention. Therefore, the paper critically analysed the Von Solms fourth waves’ theory with current human events and its correlation by studying secondary data and also from qualitative analysis among employees in public sectors. ‘Three-dimensions to failure’ of information security dilemma are explained as deny, don’t know and don’t care. These three-dimensions are the most common vulnerable behaviour owned by employees. Therefore, by avoiding the three-dimensions to failure may improve the vulnerable behaviour of employees which is often related to immoral/amoral management.

Keywords: information security management system, information security behaviour, information security governance, information security culture

Procedia PDF Downloads 191