Search results for: post release support services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14490

Search results for: post release support services

14130 Establishing an Evidence-Based Trauma Informed Care Pathway for Survivors of Modern Slavery

Authors: I. Brezeanu, J. Mackrill, A. Cajo, C. Mogollon

Abstract:

Modern Slavery is a serious crime, where often the victims are unable to leave their situation of exploitation, being controlled by threats, punishment, violence, coercion, and deception. In the UK, this term encompasses both Slavery and Human Trafficking. The number of potential victims who were referred to the National Referral Mechanism (NRM) increased exponentially in the past decade, passing from fewer than 700 potential victims referred in 2010 to more than 12.000 in 2021. Our study aims to explore how the concept of Trauma-Informed Care (TIC) approach can be adopted by services working with survivors of Modern Slavery and Trafficking (MST). Notably, in this paper, we will elaborate on how the complex needs of survivors are related to their traumatic experiences and what are the necessary steps and resources for implementing a Modern Slavery Trauma-Informed model. While there are relatively few services in the UK that have a deep understanding of the survivors’ and practitioners’ views of how trauma impacts their daily life, there is a strong need for developing services that are organised and delivered in ways that prevent retraumatisation and enable trauma survivors to engage safely with the right professionals at the right time, promoting healing through positive relationships. Such models, known as Trauma-Informed Approaches (TIAs), are seen as crucial to the empowerment of survivors, yet they remain a marginal implementation model by governments, law enforcement, judiciary, or care providers, who are frequently survivors’ first point of contact in the recovery process. In order to understand better how to provide best practice and to adopt the concept, this study is based on a multi-disciplinary approach, encompassing both theoretical perspectives and co-production. By combining qualitative and quantitative research and comparing different analysis of applied examples of TIC in the US and the UK, we gained important insights about the prevention and impact of trauma on survivors’ life. The articulation between more general expertise on Trauma-Informed Care developed by other institutions operating in the field, and the SJOG delivery, based on the Salvation Army’s Modern Slavery Victim Care and Coordination Contract (MSVCC) and the Care Quality Commission regulations, allowed to identify on one side what are the complex needs of survivors derived from their traumatic experiences, and on the other side, how could MST services prevent retraumatisation. Additional, two in-depth interviews with survivors, who receive support from one of our services at Olallo House in London, and a survey shared among all colleagues working with MST services completed the findings of the research with their personal experience and knowledge. Ultimately, we developed an evidence-based Trauma-Informed Care Pathway that aims to improve the wellbeing of survivors and to support them to live a meaningful life. The establishedpathway delivers three main outcomes belonging to the social determinants of health criteria – health and wellbeing, purpose and relationship, and covers key themes of the context of trauma, needs of individuals, and service support.

Keywords: trauma-informed care, modern slavery, human trafficking, trauma, retraumatisation

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14129 Computer Anxiety and the Use of Computerized System by University Librarians in Delta State University Library, Nigeria

Authors: L. Arumuru

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The paper investigates computer anxiety and the use of computerized library system by university librarians in Delta State University library, Abraka, Nigeria. Some of the root causes of computer anxiety among university librarians such as lack of exposure to computers at early age, inadequate computer skills, inadequate computer training, fear at the sight of a computer, lack of understanding of how computers work, etc. were pin-pointed in the study. Also, the different services rendered in the university libraries with the aid of computers such as reference services, circulation services, acquisition services, cataloguing and classification services, etc. were identified. The study employed the descriptive survey research design through the expo-facto method, with a population of 56 librarians, while the simple percentage and frequency counts were used to analyze the data generated from the administered copies of the questionnaire. Based on the aforementioned root causes of computer anxiety and the resultant effect on computerized library system, recommendations were proffered in the study.

Keywords: computer anxiety, computerized library system, library services, university librarians

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14128 Formal Specification of Web Services Applications for Digital Reference Services of Library Information System

Authors: Magaji Zainab Musa, Nordin M. A. Rahman, Julaily Aida Jusoh

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This paper discusses the formal specification of web services applications for digital reference services (WSDRS). Digital reference service involves a user requesting for help from a reference librarian and a reference librarian responding to the request of a user all by electronic means. In most cases users do not get satisfied while using digital reference service due to delay of response of the librarians. Another may be due to no response or due to librarian giving an irrelevant solution to the problem submitted by the user. WDSRS is an informal model that claims to reduce the problems of digital reference services in libraries. It uses web services technology to provide efficient way of satisfying users’ need in the reference section of libraries. But informal model is in natural language which is inconsistent and ambiguous that may cause difficulties to the developers of the system. In order to solve this problem we decided to convert the informal specifications into formal specifications. This is supposed to reduce the overall development time and cost. Formal specification can be used to provide an unambiguous and precise supplement to natural language descriptions. It can be rigorously validated and verified leading to the early detection of specification errors. We use Z language to develop the formal model and verify it with Z/EVES theorem prover tool.

Keywords: formal, specifications, web services, digital reference services

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14127 Influence of Cobalt Incorporation on the Structure and Properties of SOL-Gel Derived Mesoporous Bioglass Nanoparticles

Authors: Ahmed El-Fiqi, Hae-Won Kim

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Incorporation of therapeutic elements such as Sr, Cu and Co into bioglass structure and their release as ions is considered as one of the promising approaches to enhance cellular responses, e.g., osteogenesis and angiogenesis. Here, cobalt as angiogenesis promoter has been incorporated (at 0, 1 and 4 mol%) into sol-gel derived calcium silicate mesoporous bioglass nanoparticles. The composition and structure of cobalt-free (CFN) and cobalt-doped (CDN) mesoporous bioglass nanoparticles have been analyzed by X-ray fluorescence (XRF), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS) and Fourier-Transform Infra-red spectroscopy (FT-IR). The physicochemical properties of CFN and CDN have been investigated using high-resolution transmission electron microscopy (HR-TEM), Selected area electron diffraction (SAED), and Energy-dispersive X-ray (EDX). Furthermore, the textural properties, including specific surface area, pore-volume, and pore size, have been analyzed from N²⁻sorption analyses. Surface charges of CFN and CDN were also determined from surface zeta potential measurements. The release of ions, including Co²⁺, Ca²⁺, and SiO₄⁴⁻ has been analyzed using inductively coupled plasma atomic emission spectrometry (ICP-AES). Loading and release of diclofenac as an anti-inflammatory drug model were explored in vitro using Ultraviolet-visible spectroscopy (UV-Vis). XRD results ensured the amorphous state of CFN and CDN whereas, XRF further confirmed that their chemical compositions are very close to the designed compositions. HR-TEM analyses unveiled nanoparticles with spherical morphologies, highly mesoporous textures, and sizes in the range of 90 - 100 nm. Moreover, N²⁻ sorption analyses revealed that the nanoparticles have pores with sizes of 3.2 - 2.6 nm, pore volumes of 0.41 - 0.35 cc/g and highly surface areas in the range of 716 - 830 m²/g. High-resolution XPS analysis of Co 2p core level provided structural information about Co atomic environment and it confirmed the electronic state of Co in the glass matrix. ICP-AES analysis showed the release of therapeutic doses of Co²⁺ ions from 4% CDN up to 100 ppm within 14 days. Finally, diclofenac loading and release have ensured the drug/ion co-delivery capability of 4% CDN.

Keywords: mesoporous bioactive glass, nanoparticles, cobalt ions, release

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14126 Continuity Through Best Practice. A Case Series of Complex Wounds Manage by Dedicated Orthopedic Nursing Team

Authors: Siti Rahayu, Khairulniza Mohd Puat, Kesavan R., Mohammad Harris A., Jalila, Kunalan G., Fazir Mohamad

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The greatest challenge has been in establishing and maintaining the dedicated nursing team. Continuity is served when nurses are assigned exclusively for managing wound, where they can continue to build expertise and skills. In addition, there is a growing incidence of chronic wounds and recognition of the complexity involved in caring for these patients. We would like to share 4 cases with different techniques of wound management. 1st case, 39 years old gentleman with underlying rheumatoid arthritis with chronic periprosthetic joint infection of right total knee replacement presented with persistent drainage over right knee. Patient was consulted for two stage revision total knee replacement. However, patient only agreed for debridement and retention of implant. After debridement, large medial and lateral wound was treated with Instillation Negative Pressure Wound Therapy Dressings. After several cycle, the wound size reduced, and conventional dressing was applied. 2nd case, 58 years old gentleman with underlying diabetes presented with right foot necrotizing fasciitis with gangrene of 5th toe. He underwent extensive debridement of foot with rays’ amputation of 5th toe. Post debridement patient was started on Instillation Negative Pressure Wound Therapy Dressings. After several cycle of VAC, the wound bed was prepared, and he underwent split skin graft over right foot. 3 rd case, 60 years old gentleman with underlying diabetes mellitus presented with right foot necrotizing soft tissue infection. He underwent rays’ amputation and extensive wound debridement. Upon stabilization of general condition, patient was discharge with regular wound dressing by same nurse and doctor during each visit to clinic follow up. After 6 months of follow up, the wound healed well. 4th case, 38-year-old gentleman had alleged motor vehicle accident and sustained closed fracture right tibial plateau. Open reduction and proximal tibial locking plate were done. At 2 weeks post-surgery, the patient presented with warm, erythematous leg and pus discharge from the surgical site. Empirical antibiotic was started, and wound debridement was done. Intraoperatively, 50cc pus was evacuated, unhealthy muscle and tissue debrided. No loosening of the implant. Patient underwent multiple wound debridement. At 2 weeks post debridement wound healed well, but the proximal aspect was unable to close immediately. This left the proximal part of the implant to be exposed. Patient was then put on VAC dressing for 3 weeks until healthy granulation tissue closes the implant. Meanwhile, antibiotic was change according to culture and sensitivity. At 6 weeks post the first debridement, the wound was completely close, and patient was discharge home well. At 3 months post operatively, patient wound and fracture healed uneventfully and able to ambulate independently. Complex wounds are too serious to be dealt with. Team managing complex wound need continuous support through the provision of educational tools to support their professional development, engagement with local and international expert, as well as highquality products that increase efficiencies in services

Keywords: VAC (Vacuum Assisted Closure), empirical- initial antibiotics, NPWT- negative pressure wound therapy, NF- necrotizing fasciitis, gangrene- blackish discoloration due to poor blood supply

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14125 Resin-coated Controlled Release Fertilizer (CRF) for Oil Palm: Laboratory and Main Nursery Evaluation

Authors: Umar Adli Amran, Tan Choon Chek, Mohd Shahkhirat Norizan, Then Kek Hoe

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Controlled release fertilizer (CRF) enables a regulated nutrients release for more efficient plant uptake compared to the normal granular fertilizer. It reduces nutrients loss via surface run-off and leaching, hence promotes sustainable agriculture. Although the performance of CRF in providing consistent and timely nutrients supply is well known, its expensive price limits it usage in a large scale plantation. This study is conducted to evaluate the properties and performance of bio-based polyurethane (PU)-coated CRF via laboratory and oil palm main nursery trial. The CRF is produced by coating of a normal commercial compound granular fertilizer from FGV Fertiliser Sdn. Bhd., namely Felda 10 (10.5-8-20-3+0.5B), and designated as CRF FGV10. Based on laboratory evaluation, the CRF FGV10 can sustain nutrients release for more than 6 months. Vegetative growth parameters such as girth size, palm height, third frond length, and the total number of fronds produced were recorded. Besides that, dry biomass of the oil palm seedlings was also determined. From the evaluation, it is proved that at 50% reduction of nutrients application rate and for only two times application (T3), CRF FGV10 enabled the oil palm seedlings to achieve similar vegetative growth with the control samples (T1). It is also proven that only PU-coated CRF FGV10 had allowed the reduction of fertilizer rate and application rounds.

Keywords: nutrition, oil palm seedlings, polyurethane, sustainable manuring, vegetative growth

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14124 Touch Interaction through Tagging Context

Authors: Gabriel Chavira, Jorge Orozco, Salvador Nava, Eduardo Álvarez, Julio Rolón, Roberto Pichardo

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Ambient Intelligence promotes a shift in computing which involves fitting-out the environments with devices to support context-aware applications. One of main objectives is the reduction to a minimum of the user’s interactive effort, the diversity and quantity of devices with which people are surrounded with, in existing environments; increase the level of difficulty to achieve this goal. The mobile phones and their amazing global penetration, makes it an excellent device for delivering new services to the user, without requiring a learning effort. The environment will have to be able to perceive all of the interaction techniques. In this paper, we present the PICTAC model (Perceiving touch Interaction through TAgging Context), which similarly delivers service to members of a research group.

Keywords: ambient intelligence, tagging context, touch interaction, touching services

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14123 Linking Sustainable Public Procurement and the Sustainable Development Goals Targets in Zambia: A Preliminary Investigation

Authors: Charles P. Mukumba, Kahilu K. Shakantu

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Achieving the Sustainable Development Goals [SDGs] is a key to achieving transformational results that support Zambia’s development. Public procurement is an integral to the government’s mission to deliver goods and services, in a timely and economic manner beyond the value of money spent. This study explores the link between sustainable public procurement and the SDG targets in Zambia. And to validate the established links with the public sector procurement in Zambia. The study employed qualitative research using semi-structured interviews with 18 public procurement officials. The collected data was analysed using thematic analysis. The findings indicate that public procurement plays a fundamental role in achieving the sustainable development goals [SDGs] by helping to deliver core public services that support SDGs and also by systematising and co-delivering added value along the way. The study further established the importance of sustainable public procurement within the context of development. The interviews were limited to mainstream public sector procurement entities in Lusaka, Zambia. Sustainable public procurement actions have the potential to impact SDG goals. Promoting sustainable public procurement will enhance sustainable development and significantly improve supply chain that would benefit the economy, society and environment. Findings will inform policy-makers how to strategically design sustainable public procurement policy by attuning it to procuring entities objectives and priorities in order to contribute to the attainment of SDGs.

Keywords: sustainable public procurement, sustainable development goals, target, Zambia

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14122 Perception of Authorities in Social Support by Students under the Conditions of Inclusive Education

Authors: Jarmila Zolnova, Lucia Hrebenarova, Veronika Palkova

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The interconnections between supportive sources of authorities at school and students have been proved. Lacking research in this field in Slovakia translates into absenting perception of social support by students with special educational needs. The aim of this paper (presented by the poster) is to reveal and interpret the perception of frequency and importance of authorities at school from students' perspective. The sample included 718 students aged 10 years and 1 month on average. Eighty nine students of this count were students with special educational needs. Data were obtained from the Child and Adolescent Social Support Scale (CASSS) for students. Mutual relations between teachers acting as the source of support and students were not significant. Neither was significant the support of other school employees. Both groups of students assessed the frequency and importance of social support from teachers more positively than the support from other school employees.

Keywords: intact student, pedagogue, pupil with special education needs, school employee, social support

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14121 Everolimus Loaded Polyvinyl Alcohol Microspheres for Sustained Drug Delivery in the Treatment of Subependymal Giant Cell Astrocytoma

Authors: Lynn Louis, Bor Shin Chee, Marion McAfee, Michael Nugent

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This article aims to develop a sustained release formulation of microspheres containing the mTOR inhibitor Everolimus (EVR) using Polyvinyl alcohol (PVA) to enhance the bioavailability of the drug and to overcome poor solubility characteristics of Everolimus. This paper builds on recent work in the manufacture of microspheres using the sessile droplet technique by freezing the polymer-drug solution by suspending the droplets into pre-cooled ethanol vials immersed in liquid nitrogen. The spheres were subjected to 6 freezing cycles and 3 freezing cycles with thawing to obtain proper geometry, prevent aggregation, and achieve physical cross-linking. The prepared microspheres were characterised for surface morphology by SEM, where a 3-D porous structure was observed. The in vitro release studies showed a 62.17% release over 12.5 days, indicating a sustained release due to good encapsulation. This result is comparatively much more than the 49.06% release achieved within 4 hours from the solvent cast Everolimus film as a control with no freeze-thaw cycles performed. The solvent cast films were made in this work for comparison. A prolonged release of Everolimus using a polymer-based drug delivery system is essential to reach optimal therapeutic concentrations in treating SEGA tumours without systemic exposure. These results suggest that the combination of PVA and Everolimus via a rheological synergism enhanced the bioavailability of the hydrophobic drug Everolimus. Physical-chemical characterisation using DSC and FTIR analysis showed compatibility of the drug with the polymer, and the stability of the drug was maintained owing to the high molecular weight of the PVA. The obtained results indicate that the developed PVA/EVR microsphere is highly suitable as a potential drug delivery system with improved bioavailability in treating Subependymal Giant cell astrocytoma (SEGA).

Keywords: drug delivery system, everolimus, freeze-thaw cycles, polyvinyl alcohol

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14120 A Study on the Synthetic Resin of Fire Risk Using the Room Corner Test

Authors: Ji Hun Choi, Seung Un Chae, Kyeong Suk Cho

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Synthetic resins are widely used in various fields including electricity, engineering, construction and agriculture. Many of interior and exterior finishing materials for buildings are synthetic resin products. In this study, full-scale fire tests were conducted on polyvinyl chloride, polypropylene and urethane in accordance with the “ISO 9705: Fire test - Full-scale room test for surface products” to measure heat release rate, toxic gas emission and smoke production rate. Based on the tests, fire growth pattern and fire risk were analyzed. Findings from the tests conducted on polyvinyl chloride and urethane are as follows. The total heat release rate and total smoke production rate of polyvinyl chloride were 98.89MW and 5284.41m2, respectively and its highest CO2 concentration was 0.149%. The values obtained from the test with urethane were 469.94 MW, 3396.28 m2 and 1.549%. While heat release rate and CO2 concentration were higher in urethane implying its high combustibility, smoke production rate was 1.5 times higher in polyvinyl chloride. Follow-up tests are planned to be conducted to accumulate data for the evaluation of heat emission and fire risk associated with synthetic resins.

Keywords: synthetic resins, fire test, full-scale test, heat release rate, smoke production rate, polyvinyl chloride, polypropylene, urethane

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14119 The Impact of Level and Consequence of Service Co-Recovery on Post-Recovery Satisfaction and Repurchase Intent

Authors: Chia-Ching Tsai

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In service delivery, interpersonal interaction is the key to customer satisfaction, and apparently, the factor of human is critical in service delivery. Besides, customers quite care about the consequences of co-recovery. Thus, this research focuses on service failure caused by other customers and uses a 2x2 factorial design to investigate the impact of consequence and level of service co-recovery on post-recovery satisfaction and repurchase intent. 150 undergraduates were recruited as participants, and assigned to one of the four cells randomly. Every participant was requested to read the scenario and then rated the post-recovery satisfaction and repurchase intent. The results show that under the condition of failed co-recovery, level of co-recovery has no effect on post-recovery satisfaction, while under the condition of successful co-recovery, high-level co-recovery causes significantly higher post-recovery satisfaction than low-level co-recovery. Moreover, post-recovery satisfaction has significantly positive impact on repurchase intent. In the system of service delivery, customers interact with other customers frequently. Therefore, comparing with the literature, this research focuses on the service failure caused by other customers. This research also supplies a better understanding of customers’ view on consequences of different levels of co-recovery, which is helpful for the practitioners to make use of co-recovery.

Keywords: service failure, service co-recovery, consequence of co-recovery, level of co-recovery, post-recovery satisfaction, repurchase intent

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14118 Application of Alumina-Aerogel in Post-Combustion CO₂ Capture: Optimization by Response Surface Methodology

Authors: S. Toufigh Bararpour, Davood Karami, Nader Mahinpey

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Dependence of global economics on fossil fuels has led to a large growth in the emission of greenhouse gases (GHGs). Among the various GHGs, carbon dioxide is the main contributor to the greenhouse effect due to its huge emission amount. To mitigate the threatening effect of CO₂, carbon capture and sequestration (CCS) technologies have been studied widely in recent years. For the combustion processes, three main CO₂ capture techniques have been proposed such as post-combustion, pre-combustion and oxyfuel combustion. Post-combustion is the most commonly used CO₂ capture process as it can be readily retrofit into the existing power plants. Multiple advantages have been reported for the post-combustion by solid sorbents such as high CO₂ selectivity, high adsorption capacity, and low required regeneration energy. Chemical adsorption of CO₂ over alkali-metal-based solid sorbents such as K₂CO₃ is a promising method for the selective capture of diluted CO₂ from the huge amount of nitrogen existing in the flue gas. To improve the CO₂ capture performance, K₂CO₃ is supported by a stable and porous material. Al₂O₃ has been employed commonly as the support and enhanced the cyclic CO₂ capture efficiency of K₂CO₃. Different phases of alumina can be obtained by setting the calcination temperature of boehmite at 300, 600 (γ-alumina), 950 (δ-alumina) and 1200 °C (α-alumina). By increasing the calcination temperature, the regeneration capacity of alumina increases, while the surface area reduces. However, sorbents with lower surface areas have lower CO₂ capture capacity as well (except for the sorbents prepared by hydrophilic support materials). To resolve this issue, a highly efficient alumina-aerogel support was synthesized with a BET surface area of over 2000 m²/g and then calcined at a high temperature. The synthesized alumina-aerogel was impregnated on K₂CO₃ based on 50 wt% support/K₂CO₃, which resulted in the preparation of a sorbent with remarkable CO₂ capture performance. The effect of synthesis conditions such as types of alcohols, solvent-to-co-solvent ratios, and aging times was investigated on the performance of the support. The best support was synthesized using methanol as the solvent, after five days of aging time, and at a solvent-to-co-solvent (methanol-to-toluene) ratio (v/v) of 1/5. Response surface methodology was used to investigate the effect of operating parameters such as carbonation temperature and H₂O-to-CO₂ flowrate ratio on the CO₂ capture capacity. The maximum CO₂ capture capacity, at the optimum amounts of operating parameters, was 7.2 mmol CO₂ per gram K₂CO₃. Cyclic behavior of the sorbent was examined over 20 carbonation and regenerations cycles. The alumina-aerogel-supported K₂CO₃ showed a great performance compared to unsupported K₂CO₃ and γ-alumina-supported K₂CO₃. Fundamental performance analyses and long-term thermal and chemical stability test will be performed on the sorbent in the future. The applicability of the sorbent for a bench-scale process will be evaluated, and a corresponding process model will be established. The fundamental material knowledge and respective process development will be delivered to industrial partners for the design of a pilot-scale testing unit, thereby facilitating the industrial application of alumina-aerogel.

Keywords: alumina-aerogel, CO₂ capture, K₂CO₃, optimization

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14117 Antibacterial Hydrogels for Wound Care

Authors: Saba Atefyekta

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Aim: Control of bacterial bioburden in wounds is an important step for minimizing the risk of wound infection. An antimicrobial hydrogel wound dressing is developed out of soft polymeric hydrogels that contain antimicrobial peptides (AMPs). Such wound dressings can bind and kill all types of bacteria, even the resistance types at the wound site. Methods: AMPs are permanently bonded onto a soft nanostructured polymer via covalent attachment and physical entanglement. This improves stability, rapid antibacterial activity, and, most importantly, prevents the leaching of AMPs. Major Findings: Antimicrobial analysis of antimicrobial hydrogels using in-vitro wound models confirmed >99% killing efficiency against multiple bacterial trains, including MRSA, MDR, E. Coli. Furthermore, the hydrogel retained its antibacterial activity for up to 4 days when exposed to human serum. Tests confirmed no release of AMPs, and it was proven non-toxic to mammalian cells. An in-vivo study on human intact skin showed a significant reduction of bacteria for part of the subject’s skin treated with antibacterial hydrogels. A similar result was detected through a qualitative study in veterinary trials on different types of surgery wounds in cats, dogs, and horses. Conclusions: Antimicrobial hydrogels wound dressings developed by permanent attachment of AMPs can effectively and rapidly kill bacteria in contact. Such antibacterial hydrogel wound dressings are non-toxic and do not release any substances into the wound.

Keywords: antibacterial wound dressing, antimicrobial peptides, post-surgical wounds, infection

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14116 Microbial Resource Research Infrastructure: A Large-Scale Research Infrastructure for Microbiological Services

Authors: R. Hurtado-Ortiz, D. Clermont, M. Schüngel, C. Bizet, D. Smith, E. Stackebrandt

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Microbiological resources and their derivatives are the essential raw material for the advancement of human health, agro-food, food security, biotechnology, research and development in all life sciences. Microbial resources, and their genetic and metabolic products, are utilised in many areas such as production of healthy and functional food, identification of new antimicrobials against emerging and resistant pathogens, fighting agricultural disease, identifying novel energy sources on the basis of microbial biomass and screening for new active molecules for the bio-industries. The complexity of public collections, distribution and use of living biological material (not only living but also DNA, services, training, consultation, etc.) and service offer, demands the coordination and sharing of policies, processes and procedures. The Microbial Resource Research Infrastructure (MIRRI) is an initiative within the European Strategy Forum Infrastructures (ESFRI), bring together 16 partners including 13 European public microbial culture collections and biological resource centres (BRCs), supported by several European and non-European associated partners. The objective of MIRRI is to support innovation in microbiology by provision of a one-stop shop for well-characterized microbial resources and high quality services on a not-for-profit basis for biotechnology in support of microbiological research. In addition, MIRRI contributes to the structuring of microbial resources capacity both at the national and European levels. This will facilitate access to microorganisms for biotechnology for the enhancement of the bio-economy in Europe. MIRRI will overcome the fragmentation of access to current resources and services, develop harmonised strategies for delivery of associated information, ensure bio-security and other regulatory conditions to bring access and promote the uptake of these resources into European research. Data mining of the landscape of current information is needed to discover potential and drive innovation, to ensure the uptake of high quality microbial resources into research. MIRRI is in its Preparatory Phase focusing on governance and structure including technical, legal governance and financial issues. MIRRI will help the Biological Resources Centres to work more closely with policy makers, stakeholders, funders and researchers, to deliver resources and services needed for innovation.

Keywords: culture collections, microbiology, infrastructure, microbial resources, biotechnology

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14115 Exploring Strategies Used by Victims of Intimate Partner Violence to Increase Sense of Safety: A Systematic Review and Quantitative Study

Authors: Thomas Nally, Jane Ireland, Roxanne Khan, Philip Birch

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Intimate Partner Violence (IPV), a significant societal problem, affects individuals worldwide. However, the strategies victims use to keep safe are under-researched. IPV is significantly under-reported, and services often are not able to be accessed by all victims. Thus they are likely to use their own strategies to manage their victimization before being able to seek support. Two studies were completed to understand these strategies. A systematic review of the literature and study completed with professionals who work with victims was undertaken to understand this area. In study one, a systematic review of the literature (n=61 papers), were analyzed using Thematic Analysis. The results indicated that victims use a large array of behaviors to increase their sense of safety and coping with emotions but also experience significant barriers to help-seeking. In study 2, sixty-nine professionals completed a measure exploring the likelihood and effectiveness of various victim strategies regarding increasing their sense of safety. Strategies included in the measure were obtained from those identified in study 1. Findings indicated that professionals perceived victims of IPV to be more likely to employ safety strategies and coping behaviors that may be ineffective but not help-seeking behaviors. Further, the responses were analyzed using Cluster Analysis. Safety strategies resulted in five clusters; perpetrator-directed strategies, prevention strategies, cognitive reappraisal, safety planning and avoidance strategies. Help-Seeking resulted in six clusters; information or practical support, abuse-related support, emotional support, secondary support and informal support. Finally, coping resulted in four clusters; emotional coping, self-directed coping, thought recording/change and cognitive coping. Both studies indicate that victims may use a variety of strategies to manage their safety besides seeking help. Professionals working with victims, using a strength-based approach, should understand what is used and is effective for victims who are unable to leave the relationships or access external support.

Keywords: intimate partner violence, help-seeking, professional support, victims, victim coping, victim safety

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14114 Management of Facial Nerve Palsy Following Physiotherapy

Authors: Bassam Band, Simon Freeman, Rohan Munir, Hisham Band

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Objective: To determine efficacy of facial physiotherapy provided for patients with facial nerve palsy. Design: Retrospective study Subjects: 54 patients diagnosed with Facial nerve palsy were included in the study after they met the selection criteria including unilateral facial paralysis and start of therapy twelve months after the onset of facial nerve palsy. Interventions: Patients received the treatment offered at a facial physiotherapy clinic consisting of: Trophic electrical stimulation, surface electromyography with biofeedback, neuromuscular re-education and myofascial release. Main measures: The Sunnybrook facial grading scale was used to evaluate the severity of facial paralysis. Results: This study demonstrated the positive impact of physiotherapy for patient with facial nerve palsy with improvement of 24.2% on the Sunnybrook facial grading score from a mean baseline of 34.2% to 58.2%. The greatest improvement looking at different causes was seen in patient who had reconstructive surgery post Acoustic Neuroma at 31.3%. Conclusion: The therapy shows significant improvement for patients with facial nerve palsy even when started 12 months post onset of paralysis across different causes. This highlights the benefit of this non-invasive technique in managing facial nerve paralysis and possibly preventing the need for surgery.

Keywords: facial nerve palsy, treatment, physiotherapy, bells palsy, acoustic neuroma, ramsey-hunt syndrome

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14113 Analysing the Renewable Energy Integration Paradigm in the Post-COVID-19 Era: An Examination of the Upcoming Energy Law of China

Authors: Lan Wu

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The declared transformation towards a ‘new electricity system dominated by renewable energy’ by China requires a cleaner electricity consumption mix with high shares of renewable energy sourced-electricity (RES-E). Unfortunately, integration of RES-E into Chinese electricity markets remains a problem pending more robust legal support, evidenced by the curtailment of wind and solar power as a consequence of integration constraints. The upcoming energy law of the PRC (energy law) is expected to provide such long-awaiting support and coordinate the existing diverse sector-specific laws to deal with the weak implementation that dampening the delivery of their desired regulatory effects. However, in the shadow of the COVID-19 crisis, it remains uncertain how this new energy law brings synergies to RES-E integration, mindful of the significant impacts of the pandemic. Through the theoretical lens of the interplay between China’s electricity reform and legislative development, the present paper investigates whether there is a paradigm shift in energy law regarding renewable energy integration compared with the existing sector-specific energy laws. It examines the 2020 draft for comments on the energy law and analyses its relationship with sector-specific energy laws focusing on RES-E integration. The comparison is drawn upon five key aspects of the RES-E integration issue, including the status of renewables, marketisation, incentive schemes, consumption mechanisms, access to power grids, and dispatching. The analysis shows that it is reasonable to expect a more open and well-organized electricity market enabling absorption of high shares of RES-E. The present paper concludes that a period of prosperous development of RES-E in the post-COVID-19 era can be anticipated with the legal support by the upcoming energy law. It contributes to understanding the signals China is sending regarding the transition towards a cleaner energy future.

Keywords: energy law, energy transition, electricity market reform, renewable energy integration

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14112 An Activatable Prodrug for the Treatment of Metastatic Tumors

Authors: Eun-Joong Kim, Sankarprasad Bhuniya, Hyunseung Lee, Hyun Min Kim, Chaejoon Cheong, Su-khendu Maiti, Kwan Soo Hong, Jong Seung Kim

Abstract:

Metastatic cancers have historically been difficult to treat. However, metastatic tumors have been found to have high levels of reactive oxygen species such as hydrogen peroxide (H2O2), supporting the hypothesis that a prodrug could be activated by intracellular H2O2 and lead to a potential anti-metastatic therapy. In this study, prodrug 7 was designed to be activated by H2O2-mediated boronate oxidation, resulting in activation of the fluorophore for detection and release of the therapeutic agent, SN-38. Drug release from prodrug 7 was investigated by monitoring fluorescence after addition of H2O2 to the cancer cells. Prodrug 7 activated by H2O2 selectively inhibited tumor cell growth. Furthermore, intratracheally administered prodrug 7 showed effective anti-tumor activity in a mouse model of metastatic lung disease. Thus, this H2O2-responsive prodrug has therapeutic potential as a novel treatment for metastatic cancer via cellular imaging with fluorescence as well as selective release of the anti-cancer drug, SN-38.

Keywords: hydrogen peroxide, prodrug, metastatic tumors, fluorescence

Procedia PDF Downloads 437
14111 Improving Depression Symptoms and Antidepressant Medication Adherence Using Encrypted Short Message Service Text Message Reminders

Authors: Ogbonna Olelewe

Abstract:

This quality improvement project seeks to address the background and significance of promoting antidepressant (AD) medication adherence to reduce depression symptoms in patients diagnosed with major depression. This project aims to substantiate using daily encrypted short message service (SMS) text reminders to take prescribed antidepressant medications with the goal of increasing medication adherence to reduce depression scores in patients diagnosed with major depression, thereby preventing relapses and increasing remission rates. Depression symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9) scale. The PHQ-9 provides a total score of depression symptoms from mild to severe, ranging from 0 to 27. A -pretest/post-test design was used, with a convenience sample size of 35 adult patients aged 18 years old to 45 years old, diagnosed with MDD, and prescribed at least one antidepressant for one year or more. Pre- and post-test PHQ-9 scores were conducted to compare depression scores before and after the four-week intervention period. The results indicated improved post-intervention PHQ-9 scores, improved AD medication adherence, and a significant reduction in depression symptoms.

Keywords: major depressive disorder, antidepressants, short message services, text reminders, Medication adherence/non-adherence, Patient Health Questionnaire 9

Procedia PDF Downloads 132
14110 Identity-Based Encryption: A Comparison of Leading Classical and Post-Quantum Implementations in an Enterprise Setting

Authors: Emily Stamm, Neil Smyth, Elizabeth O'Sullivan

Abstract:

In Identity-Based Encryption (IBE), an identity, such as a username, email address, or domain name, acts as the public key. IBE consolidates the PKI by eliminating the repetitive process of requesting public keys for each message encryption. Two of the most popular schemes are Sakai-Kasahara (SAKKE), which is based on elliptic curve pairings, and the Ducas, Lyubashevsky, and Prest lattice scheme (DLP- Lattice), which is based on quantum-secure lattice cryptography. In or- der to embed the schemes in a standard enterprise setting, both schemes are implemented as shared system libraries and integrated into a REST service that functions at the enterprise level. The performance of both schemes as libraries and services is compared, and the practicalities of implementation and application are discussed. Our performance results indicate that although SAKKE has the smaller key and ciphertext sizes, DLP-Lattice is significantly faster overall and we recommend it for most enterprise use cases.

Keywords: identity-based encryption, post-quantum cryptography, lattice-based cryptography, IBE

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14109 Synthesis and Characterization of Polycaprolactone for the Delivery of Rifampicin

Authors: Evelyn Osehontue Uroro, Richard Bright, Jing Yang Quek, Krasimir Vasilev

Abstract:

Bacterial infections have been a challenge both in the public and private sectors. The colonization of bacteria often occurs in medical devices such as catheters, heart valves, respirators, and orthopaedic implants. When biomedical devices are inserted into patients, the deposition of macromolecules such as fibrinogen and immunoglobin on their surfaces makes it easier for them to be prone to bacteria colonization leading to the formation of biofilms. The formation of biofilms on medical devices has led to a series of device-related infections which are usually difficult to eradicate and sometimes cause the death of patients. These infections require surgical replacements along with prolonged antibiotic therapy, which would incur additional health costs. It is, therefore, necessary to prevent device-related infections by inhibiting the formation of biofilms using intelligent technology. Antibiotic resistance of bacteria is also a major threat due to overuse. Different antimicrobial agents have been applied to microbial infections. They include conventional antibiotics like rifampicin. The use of conventional antibiotics like rifampicin has raised concerns as some have been found to have hepatic and nephrotoxic effects due to overuse. Hence, there is also a need for proper delivery of these antibiotics. Different techniques have been developed to encapsulate and slowly release antimicrobial agents, thus reducing host cytotoxicity. Examples of delivery systems are solid lipid nanoparticles, hydrogels, micelles, and polymeric nanoparticles. The different ways by which drugs are released from polymeric nanoparticles include diffusion-based release, elution-based release, and chemical/stimuli-responsive release. Polymeric nanoparticles have gained a lot of research interest as they are basically made from biodegradable polymers. An example of such a biodegradable polymer is polycaprolactone (PCL). PCL degrades slowly by hydrolysis but is often sensitive and responsive to stimuli like enzymes to release encapsulants for antimicrobial therapy. This study presents the synthesis of PCL nanoparticles loaded with rifampicin and the on-demand release of rifampicin for treating staphylococcus aureus infections.

Keywords: enzyme, Staphylococcus aureus, PCL, rifampicin

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14108 Barriers and Facilitators of Community Based Mental Health Intervention (CMHI) in Rural Bangladesh: Findings from a Descriptive Study

Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

Abstract:

Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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14107 Design of Saddle Support for Horizontal Pressure Vessel

Authors: Vinod Kumar, Navin Kumar, Surjit Angra, Prince Sharma

Abstract:

This paper presents the design analysis of saddle support of a horizontal pressure vessel. Since saddle have the vital role to support the pressure vessel and to maintain its stability, it should be designed in such a way that it can afford the vessel load and internal pressure of the vessel due to liquid contained in the vessel. A model of horizontal pressure vessel and saddle support is created in Ansys. Stresses are calculated using mathematical approach and Ansys software. The analysis reveals the zone of high localized stress at the junction part of the pressure vessel and saddle support due to operating conditions. The results obtained by both the methods are compared with allowable stress value for safe designing.

Keywords: ANSYS, pressure vessel, saddle, support

Procedia PDF Downloads 715
14106 Effectiveness of Simulation Resuscitation Training to Improve Self-Efficacy of Physicians and Nurses at Aga Khan University Hospital in Advanced Cardiac Life Support Courses Quasi-Experimental Study Design

Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

Abstract:

Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

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14105 Effective Service Provision and Multi-Agency Working in Service Providers for Children and Young People with Special Educational Needs and Disabilities: A Mixed Methods Systematic Review

Authors: Natalie Tyldesley-Marshall, Janette Parr, Anna Brown, Yen-Fu Chen, Amy Grove

Abstract:

It is widely recognised in policy and research that the provision of services for children and young people (CYP) with Special Educational Needs and Disabilities (SEND) is enhanced when health and social care, and education services collaborate and interact effectively. In the UK, there have been significant changes to policy and provisions which support and improve collaboration. However, professionals responsible for implementing these changes face multiple challenges, including a lack of specific implementation guidance or framework to illustrate how effective multi-agency working could or should work. This systematic review will identify the key components of effective multi-agency working in services for CYP with SEND; and the most effective forms of partnership working in this setting. The review highlights interventions that lead to service improvements; and the conditions in the local area that support and encourage success. A protocol was written and registered with PROSPERO registration: CRD42022352194. Searches were conducted on several health, care, education, and applied social science databases from the year 2012 onwards. Citation chaining has been undertaken, as well as broader grey literature searching to enrich the findings. Qualitative, quantitative, mixed methods studies and systematic reviews were included, assessed independently, and critically appraised or assessed for risk of bias using appropriate tools based on study design. Data were extracted in NVivo software and checked by a more experienced researcher. A convergent segregated approach to synthesis and integration was used in which the quantitative and qualitative data were synthesised independently and then integrated using a joint display integration matrix. Findings demonstrate the key ingredients for effective partnership working for services delivering SEND. Interventions deemed effective are described, and lessons learned across interventions are summarised. Results will be of interest to educators and health and social care professionals that provide services to those with SEND. These will also be used to develop policy recommendations for how UK healthcare, social care, and education services for CYP with SEND aged 0-25 can most effectively collaborate and achieve service improvement. The review will also identify any gaps in the literature to recommend areas for future research. Funding for this review was provided by the Department for Education.

Keywords: collaboration, joint commissioning, service delivery, service improvement

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14104 Present State of Local Public Transportation Service in Local Municipalities of Japan and Its Effects on Population

Authors: Akiko Kondo, Akio Kondo

Abstract:

We are facing regional problems to low birth rate and longevity in Japan. Under this situation, there are some local municipalities which lose their vitality. The aims of this study are to clarify the present state of local public transportation services in local municipalities and relation between local public transportation services and population quantitatively. We conducted a questionnaire survey concerning regional agenda in all local municipalities in Japan. We obtained responses concerning the present state of convenience in use of public transportation and local public transportation services. Based on the data gathered from the survey, it is apparent that we should some sort of measures concerning public transportation services. Convenience in use of public transportation becomes an object of public concern in many rural regions. It is also clarified that some local municipalities introduce a demand bus for the purpose of promotion of administrative and financial efficiency. They also introduce a demand taxi in order to secure transportation to weak people in transportation and eliminate of blank area related to public transportation services. In addition, we construct a population model which includes explanatory variables of present states of local public transportation services. From this result, we can clarify the relation between public transportation services and population quantitatively.

Keywords: public transportation, local municipality, regional analysis, regional issue

Procedia PDF Downloads 374
14103 Social Factors That Contribute to Promoting and Supporting Resilience in Children and Youth following Environmental Disasters: A Mixed Methods Approach

Authors: Caroline McDonald-Harker, Julie Drolet

Abstract:

Abstract— In the last six years Canada In the last six years Canada has experienced two major and catastrophic environmental disasters– the 2013 Southern Alberta flood and the 2016 Fort McMurray, Alberta wildfire. These two disasters resulted in damages exceeding 12 billion dollars, the costliest disasters in Canadian history. In the aftermath of these disasters, many families faced the loss of homes, places of employment, schools, recreational facilities, and also experienced social, emotional, and psychological difficulties. Children and youth are among the most vulnerable to the devastating effects of disasters due to the physical, cognitive, and social factors related to their developmental life stage. Yet children and youth also have the capacity to be resilient and act as powerful catalyst for change in their own lives and wider communities following disaster. Little is known, particularly from a sociological perspective, about the specific factors that contribute to resilience in children and youth, and effective ways to support their overall health and well-being. This paper focuses on the voices and experiences of children and youth residing in these two disaster-affected communities in Alberta, Canada and specifically examines: 1) How children and youth’s lives are impacted by the tragedy, devastation, and upheaval of disaster; 2) Ways that children and youth demonstrate resilience when directly faced with the adversarial circumstances of disaster; and 3) The cumulative internal and external factors that contribute to bolstering and supporting resilience among children and youth post-disaster. This paper discusses the characteristics associated with high levels of resilience in 183 children and youth ages 5 to 17 based on quantitative and qualitative data obtained through a mix methods approach. Child and youth participants were administered the Children and Youth Resilience Measure (CYRM-28) in order to examine factors that influence resilience processes including: individual, caregiver, and context factors. The CYRM-28 was then supplemented with qualitative interviews with children and youth to contextualize the CYRM-28 resiliency factors and provide further insight into their overall disaster experience. Findings reveal that high levels of resilience among child and youth participants is associated with both individual factors and caregiver factors, specifically positive outlook, effective communication, peer support, and physical and psychological caregiving. Individual and caregiver factors helped mitigate the negative effects of disaster, thus bolstering resilience in children and youth. This paper discusses the implications that these findings have for understanding the specific mechanisms that support the resiliency processes and overall recovery of children and youth following disaster; the importance of bridging the gap between children and youth’s needs and the services and supports provided to them post-disaster; and the need to develop resiliency processes and practices that empower children and youth as active agents of change in their own lives following disaster. These findings contribute to furthering knowledge about pragmatic and representative changes to resources, programs, and policies surrounding disaster response, recovery, and mitigation.

Keywords: children and youth, disaster, environment, resilience

Procedia PDF Downloads 105
14102 Effect of Co-Parenting Support on Duration of Exclusive Breastfeeding in a Developing Nation: A Randomised Controlled Trial

Authors: Phomid Techi, L. N. Padmasini, Mohan Mathew

Abstract:

Objective: To evaluate the effectiveness of co-parent support on the duration of exclusive breastfeeding by a randomized control trial. Introduction: The current rates of exclusive breastfeeding for 6 months in India is 46% (NFHS3 2008.). The purpose of the study is to evaluate the effectiveness of co-parenting support on duration of exclusive breastfeeding in primi mothers. Design: RCT: Willing parents of healthy TAGA babies born in our hospital were explained about the study purpose and randomly assigned to either trial or control group. The control group was given the usual care. The intervention group received usual care and in addition the trial intervention. Follow-up data was collected at the end of 6 mon. Intervention: Face to face 30-minute discussion in post partum unit on breast feeding benefits, techniques, and problem-solving information followed up by phone calls to mother every 4 weeks to answer questions/concerns. Outcome measures: Duration of exclusive breastfeeding Baseline demographic variables were measured. Results: After obtaining IEC approval a total of 100 couples were recruited, 100 is each group. In the intervention group, the rate of exclusive breastfeeding was 97.2% while in the control group it was 64% (p-value 0.00). Conclusion: Co-parenting support has an important role in promoting exclusive breastfeeding.

Keywords: co-parenting, exclusive breastfeeding, developing nation, randomised control trial

Procedia PDF Downloads 219
14101 Audit of Post-Caesarean Section Analgesia

Authors: Rachel Ashwell, Sally Millett

Abstract:

Introduction: Adequate post-operative pain relief is a key priority in the delivery of caesarean sections. This improves patient experience, reduces morbidity and enables optimal mother-infant interaction. Recommendations outlined in the NICE guidelines for caesarean section (CS) include offering peri-operative intrathecal/epidural diamorphine and post-operative opioid analgesics; offering non-steroidal anti-inflammatory drugs (NSAIDs) unless contraindicated and taking hourly observations for 12 hours following intrathecal diamorphine. Method: This audit assessed the provision of post-CS analgesia in 29 women over a two-week period. Indicators used were the use of intrathecal/epidural opioids, use of post-operative opioids and NSAIDs, frequency of observations and patient satisfaction with pain management on post-operative days 1 and 2. Results: All women received intrathecal/epidural diamorphine, 97% were prescribed post-operative opioids and all were prescribed NSAIDs unless contraindicated. Hourly observations were not maintained for 12 hours following intrathecal diamorphine. 97% of women were satisfied with their pain management on post-operative day 1 whereas only 75% were satisfied on day 2. Discussion: This service meets the proposed standards for the provision of post-operative analgesia, achieving high levels of patient satisfaction 1 day after CS. However, patient satisfaction levels are significantly lower on post-operative day 2, which may be due to reduced frequency of observations. The lack of an official audit standard for patient satisfaction on postoperative day 2 may result in reduced incentive to prioritise pain management at this stage.

Keywords: Caesarean section, analgesia, postoperative care, patient satisfaction

Procedia PDF Downloads 368