Search results for: severe acute respiratory distress syndrome

Authors: Asma Naim, Warda Mushtaq

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Staphylococcus species are the most versatile and adaptive organism. They are widespread and naturally found on the skin, mucosa and nose in humans. Among these, Staphylococcus aureus is the most important species. These organisms act as opportunistic pathogens and can infect various organs of the host, causing minor skin infection to severe toxin mediated diseases, and life threatening nosocomial infections. Staphylococcus aureus has acquired resistance against β-lactam antibiotics by the production of β-lactamase, and Methicillin-Resistant Staphylococcus aureus (MRSA) strains have also been reported with increasing frequency. MRSA strains have been associated with nosocomial as well as community acquired infections. Medicinal plants have enormous potential as antimicrobial substances and have been used in traditional medicine. Search for medicinally valuable plants with antimicrobial activity is being emphasized due to increasing antibiotic resistance in bacteria. In the present study, the antibacterial potential of Rosmarinus officinalis (Rosemary) and Murraya koenigii (curry leaves) was evaluated. These are common household herbs used in food as enhancer of flavor and aroma. The crude aqueous infusion, decoction and ethanolic extracts of curry leaves and rosemary and essential oil of rosemary were investigated in the present study for antibacterial activity against multi-drug resistant Staphylococcus strains using well diffusion method. In the present study, 60 Multi-drug resistant clinical isolates of S. aureus (43) and Coagulase Negative Staphylococci (CoNS) (17) were screened against different concentrations of crude extracts of Rosmarinus officinalis and Murraya koenigii. Out of these 60 isolates, 43 were sensitive to the aqueous infusion of rosemary; 23 to aqueous decoction and 58 to ethanolic extract whereas, 24 isolates were sensitive to the essential oil. In the case of the curry leaves, no antibacterial activity was observed in aqueous infusion and decoction while only 14 isolates were sensitive to the ethanolic extract. The aqueous infusion of rosemary (50% concentration) exhibited a zone of inhibition of 21(±5.69) mm. against CoNS and 17(±4.77) mm. against S. aureus, the zone of inhibition of 50% concentration of aqueous decoction of rosemary was also larger against CoNS 17(±5.78) mm. then S. aureus 13(±6.91) mm. and the 50% concentrated ethanolic extract showed almost similar zone of inhibition in S. aureus 22(±3.61) mm. and CoNS 21(±7.64) mm. whereas, the essential oil of rosemary showed greater zone of inhibition against S. aureus i.e., 16(±4.67) mm. while CoNS showed 15(±6.94) mm. These results show that ethanolic extract of rosemary has significant antibacterial activity. Aqueous infusion and decoction of curry leaves revealed no significant antibacterial potential against all Staphylococcal species and ethanolic extract also showed only a weak response. Staphylococcus strains were susceptible to crude extracts and essential oil of rosemary in a dose depend manner, where the aqueous infusion showed highest zone of inhibition and ethanolic extract also demonstrated antistaphylococcal activity. These results demonstrate that rosemary possesses antistaphylococcal activity.

Keywords: antibacterial activity, curry leaves, multidrug resistant, rosemary, S. aureus

Procedia PDF Downloads 248

Authors: Caroline M. B. De Araujo, Helenise A. Do Nascimento, Claudia J. Da S. Cavalcanti, Mauricio A. Da Motta Sobrinho, Maria F. Pimentel

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Oil production is often followed by the joint production of water and gas. During the journey up to the surface, due to severe conditions of temperature and pressure, the mixing between these three components normally occurs. Thus, the three phases separation process must be one of the first steps to be performed after crude oil extraction, where the water-oil separation is the most complex and important step, since the presence of water into the process line can increase corrosion and hydrates formation. A wide range of methods can be applied in order to proceed with oil-water separation, being more commonly used: flotation, hydrocyclones, as well as the three phase separator vessels. Facing what has been presented so far, it is the aim of this paper to study a system consisting of a three-phase separator, evaluating the influence of three variables: temperature, working pressure and separator type, for two types of oil (light and heavy), by performing two factorial design plans 23, in order to find the best operating condition. In this case, the purpose is to obtain the greatest oil flow rate in the product stream (m3/h) as well as the lowest percentage of water in the oil stream. The simulation of the three-phase separator was performed using Aspen Hysys®2006 simulation software in stationary mode, and the evaluation of the factorial experimental designs was performed using the software Statistica®. From the general analysis of the four normal probability plots of effects obtained, it was observed that interaction effects of two and three factors did not show statistical significance at 95% confidence, since all the values were very close to zero. Similarly, the main effect "separator type" did not show significant statistical influence in any situation. As in this case, it has been assumed that the volumetric flow of water, oil and gas were equal in the inlet stream, the effect separator type, in fact, may not be significant for the proposed system. Nevertheless, the main effect “temperature” was significant for both responses (oil flow rate and mass fraction of water in the oil stream), considering both light and heavy oil, so that the best operation condition occurs with the temperature at its lowest level (30oC), since the higher the temperature, the liquid oil components pass into the vapor phase, going to the gas stream. Furthermore, the higher the temperature, the higher the formation water vapor, so that ends up going into the lighter stream (oil stream), making the separation process more difficult. Regarding the “working pressure”, this effect showed to be significant only for the oil flow rate, so that the best operation condition occurs with the pressure at its highest level (9bar), since a higher operating pressure, in this case, indicated a lower pressure drop inside the vessel, generating lower level of turbulence inside the separator. In conclusion, the best-operating condition obtained for the proposed system, at the studied range, occurs for temperature is at its lowest level and the working pressure is at its highest level.

Keywords: factorial experimental design, oil production, simulation, three-phase separator

Procedia PDF Downloads 286

Authors: Chris Thurlbourne

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Due to the continual demand for material to build, and a limit of good environmental material credentials of 'normal' building materials, there is a need to look at new and reconditioned material types - both biogenic and non-biogenic - and a field of research that accompanies this. This research development focuses on biogenic and non-biogenic material engineering and the impact of our environment on new and reconditioned material types. In our building industry and all the industries involved in constructing our built environment, building material types can be broadly categorized into two types, biogenic and non-biogenic material properties. Both play significant roles in shaping our built environment. Regardless of their properties, all material types originate from our earth, whereas many are modified through processing to provide resistance to 'forces of nature', be it rain, wind, sun, gravity, or whatever the local environmental conditions throw at us. Modifications are succumbed to offer benefits in endurance, resistance, malleability in handling (building with), and ergonomic values - in all types of building material. We assume control of all building materials through rigorous quality control specifications and regulations to ensure materials perform under specific constraints. Yet materials confront an external environment that is not controlled with live forces undetermined, and of which materials naturally act and react through weathering, patination and discoloring, promoting natural chemical reactions such as rusting. The purpose of the paper is to present recent research that explores the after-life of specific new and reconditioned biogenic and non-biogenic material types and how the understanding of materials' natural processes of transformation when exposed to the external climate, can inform initial design decisions. With qualities to receive in a transient and contingent manner, ecological relationships between material, the colonizing organisms and resulting performances invite opportunities for new design explorations for the benefit of both the needs of human society and the needs of our natural environment. The research follows designing for the benefit of both and engaging in both biogenic and non-biogenic material engineering whilst embracing the continual demand for colonization - human and environment, and the aptitude of a material to be colonized by one or several groups of living organisms without necessarily undergoing any severe deterioration, but embracing weathering, patination and discoloring, and at the same time establishing new habitat. The research follows iterative prototyping processes where knowledge has been accumulated via explorations of specific material performances, from laboratory to construction mock-ups focusing on the architectural qualities embedded in control of production techniques and facilitating longer-term patinas of material surfaces to extend the aesthetic beyond common judgments. Experiments are therefore focused on how the inherent material qualities drive a design brief toward specific investigations to explore aesthetics induced through production, patinas and colonization obtained over time while exposed and interactions with external climate conditions.

Keywords: biogenic and non-biogenic, natural processes of transformation, colonization, patina

Procedia PDF Downloads 87

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

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With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarms, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

Procedia PDF Downloads 42

Authors: Henry Lau, Dilupa Nakandala, Li Zhao

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In today’s business, it is well-recognized that risk is an important factor that needs to be taken into consideration before a decision is made. Studies indicate that both the number of risks faced by organizations and their potential consequences are growing. Supply chain risk management has become one of the major concerns for practitioners and researchers. Supply chain leaders and scholars are now focusing on the importance of managing supply chain risk. In order to meet the challenge of managing and mitigating supply chain risk (SCR), we must first identify the different dimensions of SCR and assess its relevant probability and severity. SCR has been classified in many different ways, and there are no consistently accepted dimensions of SCRs and several different classifications are reported in the literature. Basically, supply chain risks can be classified into two dimensions namely disruption risk and operational risk. Disruption risks are those caused by events such as bankruptcy, natural disasters and terrorist attack. Operational risks are related to supply and demand coordination and uncertainty, such as uncertain demand and uncertain supply. Disruption risks are rare but severe and hard to manage, while operational risk can be reduced through effective SCM activities. Other SCRs include supply risk, process risk, demand risk and technology risk. In fact, the disorganized classification of SCR has created confusion for SCR scholars. Moreover, practitioners need to identify and assess SCR. As such, it is important to have an overarching framework tying all these SCR dimensions together for two reasons. First, it helps researchers use these terms for communication of ideas based on the same concept. Second, a shared understanding of the SCR dimensions will support the researchers to focus on the more important research objective: operationalization of SCR, which is very important for assessing SCR. In general, fresh food supply chain is subject to certain level of risks, such as supply risk (low quality, delivery failure, hot weather etc.) and demand risk (season food imbalance, new competitors). Effective strategies to mitigate fresh food supply chain risk are required to enhance operations. Before implementing effective mitigation strategies, we need to identify the risk sources and evaluate the risk level. However, assessing the supply chain risk is not an easy matter, and existing research mainly use qualitative method, such as risk assessment matrix. To address the relevant issues, this paper aims to analyze the risk factor of the fresh food supply chain using an approach comprising both fuzzy logic and hierarchical holographic modeling techniques. This novel approach is able to take advantage the benefits of both of these well-known techniques and at the same time offset their drawbacks in certain aspects. In order to develop this integrated approach, substantial research work is needed to effectively combine these two techniques in a seamless way, To validate the proposed integrated approach, a case study in a fresh food supply chain company was conducted to verify the feasibility of its functionality in a real environment.

Keywords: fresh food supply chain, fuzzy logic, hierarchical holographic modelling, operationalization, supply chain risk

Procedia PDF Downloads 241

Authors: Hafid Smaili, Wilfred Rouwhorst, Paul Frost

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The trend of recent accident and incident cases worldwide show that the state-of-the-art automation and operations, for current and future demanding operational environments, does not provide the desired level of operational safety under crew peak workload conditions, specifically in complex situations such as loss-of-control in-flight (LOC-I). Today, the short term focus is on preparing crews to recognise and handle LOC-I situations through upset recovery training. This paper describes the cockpit integration aspects and piloted assessment of both a manually assisted and automatic upset detection and recovery system that has been developed and demonstrated within the European Advanced Cockpit for Reduction Of StreSs and workload (ACROSS) programme. The proposed system is a function that continuously monitors and intervenes when the aircraft enters an upset and provides either manually pilot-assisted guidance or takes over full control of the aircraft to recover from an upset. In order to mitigate the highly physical and psychological impact during aircraft upset events, the system provides new cockpit functionalities to support the pilot in recovering from any upset both manually assisted and automatically. A piloted simulator assessment was made in Oct-Nov 2015 using ten pilots in a representative civil large transport fly-by-wire aircraft in terms of the preference of the tested upset detection and recovery system configurations to reduce pilot workload, increase situational awareness and safe interaction with the manually assisted or automated modes. The piloted simulator evaluation of the upset detection and recovery system showed that the functionalities of the system are able to support pilots during an upset. The experiment showed that pilots are willing to rely on the guidance provided by the system during an upset. Thereby, it is important for pilots to see and understand what the aircraft is doing and trying to do especially in automatic modes. Comparing the manually assisted and the automatic recovery modes, the pilot’s opinion was that an automatic recovery reduces the workload so that they could perform a proper screening of the primary flight display. The results further show that the manually assisted recoveries, with recovery guidance cues on the cockpit primary flight display, reduced workload for severe upsets compared to today’s situation. The level of situation awareness was improved for automatic upset recoveries where the pilot could monitor what the system was trying to accomplish compared to automatic recovery modes without any guidance. An improvement in situation awareness was also noticeable with the manually assisted upset recovery functionalities as compared to the current non-assisted recovery procedures. This study shows that automatic upset detection and recovery functionalities are likely to positively impact the operational safety by means of reduced workload, improved situation awareness and crew stress reduction. It is thus believed that future developments for upset recovery guidance and loss-of-control prevention should focus on automatic recovery solutions.

Keywords: aircraft accidents, automatic flight control, loss-of-control, upset recovery

Procedia PDF Downloads 210

Authors: Siba Soren, Purnendu Parhi

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Today, the world is facing a severe challenge due to depletion of traditional fossil fuels. Scientists across the globe are working for a solution that involves a dramatic shift to practical and environmentally sustainable energy sources. High-capacity energy systems, such as metal-air batteries, fuel cells, are highly desirable to meet the urgent requirement of sustainable energies. Among the fuel cells, Direct methanol fuel cells (DMFCs) are recognized as an ideal power source for mobile applications and have received considerable attention in recent past. In this advanced electrochemical energy conversion technologies, Oxygen Reduction Reaction (ORR) is of utmost importance. However, the poor kinetics of cathodic ORR in DMFCs significantly hampers their possibilities of commercialization. The oxygen is reduced in alkaline medium either through a 4-electron (equation i) or a 2-electron (equation ii) reduction pathway at the cathode ((i) O₂ + 2H₂O + 4e⁻ → 4OH⁻, (ii) O₂ + H₂O + 2e⁻ → OH⁻ + HO₂⁻ ). Due to sluggish ORR kinetics the ability to control the reduction of molecular oxygen electrocatalytically is still limited. The electrocatalytic ORR starts with adsorption of O₂ on the electrode surface followed by O–O bond activation/cleavage and oxide removal. The reaction further involves transfer of 4 electrons and 4 protons. The sluggish kinetics of ORR, on the one hand, demands high loading of precious metal-containing catalysts (e.g., Pt), which unfavorably increases the cost of these electrochemical energy conversion devices. Therefore, synthesis of active electrocatalyst with an increase in ORR performance is need of the hour. In the recent literature, there are many reports on transition metal oxide (TMO) based ORR catalysts for their high activity TMOs are also having drawbacks like low electrical conductivity, which seriously affects the electron transfer process during ORR. It was found that 2D graphene layer is having high electrical conductivity, large surface area, and excellent chemical stability, appeared to be an ultimate choice as support material to enhance the catalytic performance of bare metal oxide. g-C₃N₄ is also another candidate that has been used by the researcher for improving the ORR performance of metal oxides. This material provides more active reaction sites than other N containing carbon materials. Rare earth oxide like CeO₂ is also a good candidate for studying the ORR activity as the metal oxide not only possess unique electronic properties but also possess catalytically active sites. Here we will discuss the ORR performance (in alkaline medium) of N-rGO/C₃N₄ supported nano Cerium Oxides hybrid synthesized by microwave assisted Solvothermal method. These materials exhibit superior electrochemical stability and methanol tolerance capability to that of commercial Pt/C.

Keywords: oxygen reduction reaction, electrocatalyst, cerium oxide, graphene

Procedia PDF Downloads 194

Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

Procedia PDF Downloads 33

Authors: Beverly Wang

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Background: Rosai-Dorfman disease (RDD), aka sinus histiocytosis with massive lymphadenopathy, is a rare, idiopathic histiocytic proliferative disorder. Although RDD can be seen involving the head and neck lymph nodes, rarely it can affect other extranodal sites. It present 3 unique cases of RDD affecting the nasal cavity, paranasal sinuses, and ear canal. The initial clinical presentation on two cases mimicked a malignant neoplasm. The 3rd case of RDD co-existed with a cholesteatoma of the ear canal. The clinical presentation, histology and immunohistochemical stains, and radiographic findings are discussed. Design: An overview of 3 cases of RDD affected sinonasal cavity and ear canal from UCI Medical Center was conducted. Case 1: A 61 year old male complaining of breathing difficulty presented with bilateral polypoid sinonasal masses and severe nasal obstruction. The masses elevated the nasal floor, and involved the anterior nasal septum to lateral wall. It was endoscopically excised. At intraoperative consultation, frozen section reported a pleomorphic spindle cell neoplasm with scattered large atypical spindle cells, resembling a high grade sarcoma. Case 2: A 46 year old male presented with recurrent bilateral maxillary chronic sinusitis with mass formation, clinically suspicious for malignant lymphoma. Excisional tissue sample showed large irregular spindled histiocytes with abundant granular and vacuolated cytoplasm. Case 3: A 36 year old female with a history of asthma initially presented with left-sided chronic otalgia, occasional nausea, vertigo, and fluctuating pain exacerbated by head movement and temperature changes. CT scan revealed an external auditory canal mass extending to the middle ear, coexisting with a small cholesteatoma. Results: The morphology of all cases revealed large atypical spindled histiocytes resembling fibrohistiocytic or myofibroblastic proliferative neoplasms. Scattered emperipolesis was seen. All 3 cases were confirmed as extranodal sinus RDD, confirmed by immunohistochemistry. The large atypical cells were positive for S100, CD68, and CD163. No evidence for malignancy was identified. Case 3 showed concurrent RDD co-existing with a cholesteatoma. Conclusion: Due to its rarity and variable clinical presentations, the diagnosis of RDD is seldom clinically considered. Extranodal sinus RDD morphologically can be pitfall as mimicker of spindly neoplasm, especially at intraoperative consultation. It can create diagnostic and therapeutic challenges. Correlation of radiological findings with histologic features will help to reach the diagnosis.

Keywords: head and neck, extranodal, rosai-dorfman disease, mimicker, immunohistochemistry

Procedia PDF Downloads 79

Authors: Shailendra M. Pradhan, Upendra M. Pradhan

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Disasters are perennial features of human civilization. The recurring earthquakes, floods, cyclones, among others, that result in massive loss of lives and devastation, is a grim reminder of the fact that, despite all our success stories of development, and progress in science and technology, human society is perennially at risk to disasters. The apparent threat of climate change and global warming only severe our disaster risks. Darjeeling hills, situated along Eastern Himalayan region of India, and famous for its three Ts – tea, tourism and toy-train – is also equally notorious for its disasters. The recurring landslides and earthquakes, the cyclone Aila, and the Ambootia landslides, considered as the largest landslide in Asia, are strong evidence of the vulnerability of Darjeeling hills to natural disasters. Given its geographical location along the Hindu-Kush Himalayas, the region is marked by rugged topography, geo-physically unstable structure, high-seismicity, and fragile landscape, making it prone to disasters of different kinds and magnitudes. Most of the studies on disasters in Darjeeling hills are, however, scientific and geographical in orientation that focuses on the underlying geological and physical processes to the neglect of social and political conditions. This has created a tendency among the researchers and policy-makers to endorse and promote a particular type of discourse that does not consider the social and political aspects of disasters in Darjeeling hills. Disaster, this paper argues, is a complex phenomenon, and a result of diverse factors, both physical and human. The hazards caused by the physical and geological agents, and the vulnerabilities produced and rooted in political, economic, social and cultural structures of a society, together result in disasters. In this sense, disasters are as much a result of political and economic conditions as it is of physical environment. The human aspect of disasters, therefore, compels us to address intricating social and political challenges that ultimately determine our resilience and vulnerability to disasters. Set within the above milieu, the aims of the paper are twofold: a) to provide a political and sociological account of disasters in Darjeeling hills; and, b) to identify and address the root causes of its vulnerabilities to disasters. In situating disasters in Darjeeling Hills, the paper adopts the Pressure and Release Model (PAR) that provides a theoretical insight into the study of social and political aspects of disasters, and to examine myriads of other related issues therein. The PAR model conceptualises risk as a complex combination of vulnerabilities, on the one hand, and hazards, on the other. Disasters, within the PAR framework, occur when hazards interact with vulnerabilities. The root causes of vulnerability, in turn, could be traced to social and political structures such as legal definitions of rights, gender relations, and other ideological structures and processes. In this way, the PAR model helps the present study to identify and unpack the root causes of vulnerabilities and disasters in Darjeeling hills that have largely remained neglected in dominant discourses, thereby providing a more nuanced and sociologically sensitive understanding of disasters.

Keywords: Darjeeling, disasters, PAR, vulnerabilities

Procedia PDF Downloads 273

Authors: Neritan Shkodrani

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On November 26, 2019, an earthquake hit the central western part of Albania. It was assessed as Mw 6.4. Its epicenter was located offshore north western Durrës, about 7 km north of the city. In this paper, the consequences of settlements of very soft soils have been discussed for the case of a residential building, mentioned as “K Building”, which was suffering a significant tilting after the earthquake. “KBuilding” is an RC framed building having 12+1 (basement) storiesand a floor area of 21000 m2. The construction of the building was completed in 2012. “KBuilding”, located in Durres city, suffered severe non-structural damage during November 26, 2019, Durrës Earthquake sequences. During the in-site inspections immediately after the earthquake, the general condition of the buildings, the presence of observable settlements on the ground, and the crack situation in the structure were determined, and damage inspection were performed. It was significant to note that the “K Building” presented tilting that might be attributed, as it was believed at the beginning, partially to the failure of the columns of the ground floor and partially to liquefaction phenomena, but it did not collapse. At the first moment was not clear if the foundation had a bearing capacity failure or the foundation failed because of the soil liquefaction. Geotechnical soil investigations by using CPTU test were executed, and their data are usedto evaluatebearing capacity, consolidation settlement of the mat foundation, and soil liquefaction since they were believed to be the main reasons of this building tilting.Geotechnical soil investigation consist in 5 (five) Static Cone Penetration tests with pore pressure measurement (piezocone test). They reached a penetration depth of 20.0 m to 30.0 mand, clearly shown the presence of very soft and organic soils in the soil profile of the site. Geotechnical CPT based analysis of bearing capacity, consolidation, and secondary settlement are applied, and results are reported for each test. These results shown very small values of allowable bearing capacity and very high values of consolidation and secondary settlements. Liquefaction analysis based on the data of CPTU tests and the characteristics of ground shaking of the mentioned earthquake has shown the possibility of liquefaction for some layers of the considered soil profile, but the estimated vertical settlements are at a small range and clearly shown that the main reason of the building tilting was not related to the consequences of liquefaction, but was an existing settlement caused from the applied bearing pressure of this building. All the CPTU tests were carried out on August 2021, almost two years after the November 26, 2019, Durrës Earthquake and when the building itself was demolished. After removing the mat foundation on September 2021, it was possible to carry out CPTU tests even on the footprint of the existing building, which made possible to observe the effects of long time applied of foundation bearing pressure to the consolidation on the considered soil profile.

Keywords: bearing capacity, cone penetration test, consolidation settlement, secondary settlement, soil liquefaction, etc

Procedia PDF Downloads 96

Authors: Getaneh Berie Tarekegn, Li-Chia Tai

Abstract:

With the rapid advancement of artificial intelligence, low-power built-in sensors on Internet of Things devices, and communication technologies, location-aware services have become increasingly popular and have permeated every aspect of people’s lives. Global navigation satellite systems (GNSSs) are the default method of providing continuous positioning services for ground and aerial vehicles, as well as consumer devices (smartphones, watches, notepads, etc.). However, the environment affects satellite positioning systems, particularly indoors, in dense urban and suburban cities enclosed by skyscrapers, or when deep shadows obscure satellite signals. This is because (1) indoor environments are more complicated due to the presence of many objects surrounding them; (2) reflection within the building is highly dependent on the surrounding environment, including the positions of objects and human activity; and (3) satellite signals cannot be reached in an indoor environment, and GNSS doesn't have enough power to penetrate building walls. GPS is also highly power-hungry, which poses a severe challenge for battery-powered IoT devices. Due to these challenges, IoT applications are limited. Consequently, precise, seamless, and ubiquitous Positioning, Navigation and Timing (PNT) systems are crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

Procedia PDF Downloads 47

Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

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Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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Authors: Partha Sarathi Nayek, Abhiparna Dasgupta, Maheshreddy Gade

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Earth retaining structure plays a vital role in stabilizing unstable road cuts and slopes in the mountainous region. The retaining structures located in seismically active regions like the Himalayas may experience moderate to severe earthquakes. An earthquake produces two kinds of ground motion: permanent quasi-static displacement (fault rapture) on the fault rupture plane and transient vibration, traveling a long distance. There has been extensive research work to understand the dynamic behavior of retaining structures subjected to transient ground motions. However, understanding the effect caused by fault rapture phenomena on retaining structures is limited. The presence of shallow crustal active faults and natural slopes in the Himalayan region further highlights the need to study the response of retaining structures subjected to fault rupture phenomena. In this paper, an attempt has been made to understand the dynamic response of the cantilever retaining wall subjected to surface fault rupture. For this purpose, a 2D finite element model consists of a retaining wall, backfill and foundation have been developed using Abaqus 6.14 software. The backfill and foundation material are modeled as per the Mohr-Coulomb failure criterion, and the wall is modeled as linear elastic. In this present study, the interaction between backfill and wall is modeled as ‘surface-surface contact.’ The entire simulation process is divided into three steps, i.e., the initial step, gravity load step, fault rupture step. The interaction property between wall and soil and fixed boundary condition to all the boundary elements are applied in the initial step. In the next step, gravity load is applied, and the boundary elements are allowed to move in the vertical direction to incorporate the settlement of soil due to the gravity load. In the final step, surface fault rupture has been applied to the wall-backfill system. For this purpose, the foundation is divided into two blocks, namely, the hanging wall block and the footwall block. A finite fault rupture displacement is applied to the hanging wall part while the footwall bottom boundary is kept as fixed. Initially, a numerical analysis is performed considering the reverse fault mechanism with a dip angle of 45°. The simulated result is presented in terms of contour maps of permanent displacements of the wall-backfill system. These maps highlighted that surface fault rupture can induce permanent displacement in both horizontal and vertical directions, which can significantly influence the dynamic behavior of the wall-backfill system. Further, the influence of fault mechanism, dip angle, and surface fault rupture position is also investigated in this work.

Keywords: surface fault rupture, retaining wall, dynamic response, finite element analysis

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Authors: Gift Udoh, Diane S. Rohlman, Benjamin Sindt

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BACKGROUND: There is concern regarding the widespread use of pesticides and impacts on public health. Farmers in Nigeria frequently apply pesticides, including organophosphate pesticides which are known neurotoxicants. They receive little guidance on how much to apply or information about safe handling practices. Pesticide poisoning is one of the major hazards that farmers face in Nigeria. Farmers continue to use highly neurotoxic pesticides for agricultural activities. Because farmers receive little or no information on safe handling and how much to apply, they continue to develop severe and mild illnesses caused by high exposures to pesticides. The project aimed to reduce pesticide exposure among rural farmers in Nigeria by identifying hazards associated with pesticide use and developing and pilot testing training to reduce exposures to pesticides utilizing the hierarchy of controls system. METHODS: Information on pesticide knowledge, behaviors, barriers to safety, and prevention methods was collected from farmers in Nigeria through workplace observations, questionnaires, and interviews. Pre and post-surveys were used to measure farmer’s knowledge before and after the delivery of pesticide safety training. Training topics included the benefits and risks of using pesticides, routes of exposure and health effects, pesticide label activity, use and selection of PPE, ways to prevent exposure and information on local resources. The training was evaluated among farmers and changes in knowledge, attitudes and behaviors were collected prior to and following the training. RESULTS: The training was administered to 60 farmers, a mean age of 35, with a range of farming experience (<1 year to > 50 years). There was an overall increase in knowledge after the training. In addition, farmers perceived a greater immediate risk from exposure to pesticides and their perception of their personal risk increased. For example, farmers believed that pesticide risk is greater to children than to adults, recognized that just because a pesticide is put on the market doesn’t mean it is safe, and they were more confident that they could get advice about handling pesticides. Also, there was greater awareness about behaviors that can increase their exposure (mixing pesticides with bare hands, eating food in the field, not washing hands before eating after applying pesticides, walking in fields recently sprayed, splashing pesticides on their clothes, pesticide storage). CONCLUSION: These results build on existing evidence from a 2022 article highlighting the need for pesticide safety training in Nigeria which suggested that pesticide safety educational programs should focus on community-based, grassroots-style, and involve a family-oriented approach. Educating farmers on agricultural safety while letting them share their experiences with their peers is an effective way of creating awareness on the dangers associated with handling pesticides. Also, for rural communities, especially in Nigeria, pesticide safety pieces of training may not be able to reach some locations, so intentional scouting of rural farming communities and delivering pesticide safety training will improve knowledge of pesticide hazards. There is a need for pesticide information centers to be situated in rural farming communities or agro supply stores, which gives rural farmers information.

Keywords: pesticide exposure, pesticide safety, nigeria, rural farming, pesticide education

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Authors: Dean Sinković, Tea Golja, Morena Paulišić

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Upon the end of the vicious war in former Yugoslavia in 1995, international development community widely promoted microfinance as the key development framework to eradicate poverty, create jobs, increase income. Widespread claims were made that microfinance institutions would play vital role in creating a bedrock for sustainable ‘bottom-up’ economic development trajectory, thus, helping newly formed states to find proper way from economic post-war depression. This uplifting neoliberal narrative has no empirical support in the Republic of Croatia. Firstly, the type of enterprises created via microfinance sector are small, unskilled, labor intensive, no technology and with huge debt burden. This results in extremely high failure rates of microenterprises and poor individuals plunging into even deeper poverty, acute indebtedness and social marginalization. Secondly, evidence shows that microcredit is exact reflection of dangerous and destructive sub-prime lending model with ‘boom-to-bust’ scenarios in which benefits are solely extracted by the tiny financial and political elite working around the microfinance sector. We argue that microcredit providers are not proper financial structures through which developing countries should look way out of underdevelopment and poverty. In order to achieve sustainable long-term growth goals, public policy needs to focus on creating, supporting and facilitating the small and mid-size enterprises development. These enterprises should be technically sophisticated, capable of creating new capabilities and innovations, with managerial expertise (skills formation) and inter-connected with other organizations (i.e. clusters, networks, supply chains, etc.). Evidence from South-East Europe suggest that such structures are not created via microfinance model but can be fostered through various forms of social enterprises. Various legal entities may operate as social enterprises: limited liability private company, limited liability public company, cooperative, associations, foundations, institutions, Mutual Insurances and Credit union. Our main hypothesis is that cooperatives are potential agents of social and economic transformation and community development in the region. Financial cooperatives are structures that can foster more efficient allocation of financial resources involving deeper democratic arrangements and more socially just outcomes. In Croatia, pioneers of the first social enterprises were civil society organizations whilst forming a separated legal entity. (i.e. cooperatives, associations, commercial companies working on the principles of returning the investment to the founder). Ever since 1995 cooperatives in Croatia have not grown by pursuing their own internal growth but mostly by relying on external financial support. The greater part of today’s registered cooperatives tend to be agricultural (39%), followed by war veterans cooperatives (38%) and others. There are no financial cooperatives in Croatia. Due to the above mentioned we look at the historical developments and the prevailing social enterprises forms and discuss their advantages and disadvantages as potential agents for social and economic transformation and community development in the region. There is an evident lack of understanding of this business model and of its potential for social and economic development followed by an unfavorable institutional environment. Thus, we discuss the role of governance and management in the formation of social enterprises in Croatia, stressing the challenges for the governance of the country’s social enterprise movement.

Keywords: financial cooperatives, governance and management models, microfinance institutions, social enterprises

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Authors: Adam Fheed

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Carbonate porosity can be deceptive in the aspect of hydrocarbon exploration due to pore geometry variations, which are to some extent controlled by fossils. Therefore, the main aim of this paper was to assess the dependence of pore geometry and reservoir quality on fossils. The Permian Zechstein Limestone (Ca1) carbonates from the Brońsko Reef, located on the Wolsztyn Ridge in West Poland, were examined. Seventy meters of drill cores were described along with well log examination and transmitted-light microscope research. The archival porosity-permeability data was utilized to calibrate the well logs and look for the potential petrophysical trends. Several organism assemblages were recognized in the reef. Its bottom was colonized by the branched bryozoans which were fragmented and dissolved leaving poorly connected molds. Subsequently, numerous bivalves and gastropods appeared and their shells were heavily dissolved to form huge, albeit poorly communicated caverns. Such pores were also typical for local brachiopod occurrences. Although the caverns were widespread, and probably linked to the meteoric dissolution or freshwater flushing, severe anhydrite cementation has destroyed the majority of pores. Close to the top of Ca1, near the center of the reef, the fossil-rich zone comprising fenestrate bryozoans, extremely abundant encrusting foraminifers, bivalves, brachiopods, gastropods and ostracods, was identified. The zone contained extremely frequent dissolution channels formed within former shells of foraminifers, which had previously encrusted the bryozoans. The deposition of Ca1 strata has ultimately terminated with a poorly porous and generally impermeable stromatolitic layer containing scarce fossils. In general, the permeability of the reef rocks studied turned out to be the highest under the presence of foraminifer-related channels. In such cases, it frequently approached 100 mD. The presence of channels and other pores gave the average effective porosity derived from shallow resistivity and helium porosimetry of around 16 and 18 %, respectively. The highest porosity (over 18 %), often co-occurring with relatively low permeability (chiefly below 20 mD) was noted for the bottommost zone of the reef, represented by branched bryozoans. This is probably owing to a large amount of unconnected bryozoan-related molds. It was concluded that fossils played a major role in porosity formation and controlled the pore geometry significantly. While the dissolution of bivalves and brachiopods resulted in cavernous porosity formation, numerous molds were typically related with the alteration of branched bryozoans, gastropods and ostracods. Importantly, the bendy dissolution channels after the encrusting foraminifers appeared to be decisive in improving reservoir quality – specifically when permeability is considered. Acknowledgment: The research was financed by the Polish National Science Centre’s project No. UMO-2016/23/N/ST10/00350.

Keywords: dissolution channels, fossils, Permian, porosity

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Authors: Basavaraj Yenagi, P. Nagaraju, C. R. Patil

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Groundnut (Arachis hypohaea L.) is called as “King of oilseeds” and one of the most important food and cash crops in Indian subcontinent. Yield and quality of oil are negatively correlated with poor or imbalanced nutrition and constant exposure to both biotic and abiotic stress factors. Variety of diseases affect groundnut plant, most of them are caused by fungi and lead to severe yield loss. Imbalanced nutrition increases the concerns of environmental deterioration which includes soil fertility. Among different microbial antagonists, Pseudomonas is common member of the plant growth promoting rhizobacteria microflora present in the rhizosphere of groundnut. These are known to produce a beneficial effect on groundnut due to their high metabolic activity leading to the production of enzymes, exopolysaccharides, secondary metabolites, and antibiotics. The ability of pseudomonas lies on their ability to produce antibiotic metabolites such as 2, 4-diacetylphloroglucinol (DAPG). DAPG can inhibit the growth of fungal pathogens namely collar rot and stem rot and also increase the availability of plant nutrients through increased solubilization and uptake of nutrients. Hence, the present study was conducted for three consecutive years (2014 to 2016) in vertisol during the rainy season to assess the efficacy of DAPG producing fluorescent pseudomonas for enhancing nutrient use efficacy, bio-control of soil-borne diseases and yield of groundnut at University of Agricultural Sciences, Dharwad farm. The experiment was laid out in an RCBD with three replications and seven treatments. The mean of three years data revealed that the effect of DAPG-producing producing fluorescent pseudomonas enhanced groundnut yield, uptake of nitrogen and phosphorus and nutrient use efficiency and also found to be effective in bio-control of collar rot and stem rot incidence leading to increase pod yield of groundnut. Higher dry pod yield of groundnut was obtained with DAPG 2(3535 kg ha-1) closely followed by DAPG 4(3492 kg ha-1), FP 98(3443 kg ha-1), DAPG 1(3414 kg ha-1), FP 86(3361 kg ha-1) and Trichoderma spp. (3380 kg ha-1) over control(3173 kg ha-1). A similar trend was obtained with other growth and yield attributing parameters. N uptake ranged from 8.21 percent to FP 86 to 17.91 percent with DAPG 2 and P uptake ranged between 5.56 percent with FP 86 to 16.67 percent with DAPG 2 over control. The first year, there was no incidence of collar rot. During the second year, the control plot recorded 2.51 percent incidence and it ranged from 0.82 percent to 1.43 percent in different DAPG-producing fluorescent pseudomonas treatments. The similar trend was noticed in the third year with lower incidence. The stem rot incidence was recorded during all the three years. Mean data indicated that the control plot recorded 2.65 percent incidence and it ranged from 0.71 percent to 1.23 percent in different DAPG-producing fluorescent pseudomonas treatments. The increase in net monetary benefits ranged from Rs.5975 ha-1 to Rs.11407 ha 1 in different treatments. Hence, as a low-cost technology, seed treatment with available DAPG-producing fluorescent pseudomonas has a beneficial effect on groundnut for enhancing groundnut yield, nutrient use efficiency and bio-control of soil-borne diseases.

Keywords: groundnut, DAPG, fluorescent pseudomonas, nutrient use efficiency, collar rot, stem rot

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Authors: Markandeya Kunchi

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Usability testing (UT) is one of the vital steps in the User-centred design (UCD) process when designing a product. In an e-commerce ecosystem, UT becomes primary as new products, features, and services are launched very frequently. And, there are losses attached to the company if an unusable and inefficient product is put out to market and is rejected by customers. This paper tries to answer why UT is important in the product life-cycle of an E-commerce ecosystem. Secondary user research was conducted to find out work patterns, development methods, type of stakeholders, and technology constraints, etc. of a typical E-commerce company. Qualitative user interviews were conducted with product managers and designers to find out the structure, project planning, product management method and role of the design team in a mid-level company. The paper tries to address the usual apprehensions of the company to inculcate UT within the team. As well, it stresses upon factors like monetary resources, lack of usability expert, narrow timelines, and lack of understanding of higher management as some primary reasons. Outsourcing UT to vendors is also very prevalent with mid-level e-commerce companies, but it has its own severe repercussions like very little team involvement, huge cost, misinterpretation of the findings, elongated timelines, and lack of empathy towards the customer, etc. The shortfalls of the unavailability of a UT process in place within the team and conducting UT through vendors are bad user experiences for customers while interacting with the product, badly designed products which are neither useful and nor utilitarian. As a result, companies see dipping conversions rates in apps and websites, huge bounce rates and increased uninstall rates. Thus, there was a need for a more lean UT system in place which could solve all these issues for the company. This paper highlights on optimizing the UT process with a collaborative method. The degree of optimization and structure of collaborative method is the highlight of this paper. Collaborative method of UT is one in which the centralised design team of the company takes for conducting and analysing the UT. The UT is usually a formative kind where designers take findings into account and uses in the ideation process. The success of collaborative method of UT is due to its ability to sync with the product management method employed by the company or team. The collaborative methods focus on engaging various teams (design, marketing, product, administration, IT, etc.) each with its own defined roles and responsibility in conducting a smooth UT with users In-house. The paper finally highlights the positive results of collaborative UT method after conducting more than 100 In-lab interviews with users across the different lines of businesses. Some of which are the improvement of interaction between stakeholders and the design team, empathy towards users, improved design iteration, better sanity check of design solutions, optimization of time and money, effective and efficient design solution. The future scope of collaborative UT is to make this method leaner, by reducing the number of days to complete the entire project starting from planning between teams to publishing the UT report.

Keywords: collaborative method, e-commerce, product management method, usability testing

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Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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Authors: Amunupura Kiriwandeiye Gedara, Asintha Saminda Gnanaratne

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The security forces can be described as a workforce that goes beyond the role of ensuring the national security and contributes to the development process of the country. Soldiers are following combatant training courses during their tenure, they are equipped with a variety of vocational training courses to satisfy the needs of the army, to equip them with vocational training capabilities to achieve the development and reconstruction goals of the country as well as for the betterment of society in the event of emergencies. But with retirement, their relationship with the military is severed, and they are responsible for the future of their lives. The main purpose of this study was to examine how such professional capabilities can contribute to the development of the country, the current socio-economic status of the retired soldiers, and the current application of the vocational training skills they have mastered in the army to develop and rebuild the country in an effective manner. After analyzing the available research literature related to this field, a conceptual framework was developed and according to qualitative research methodology, and data obtained from Case studies and interviews are analyzed by using thematic analysis. Factors influencing early retirement include a lack of understanding of benefits, delays in promotions, not being properly evaluated for work, getting married on hasty decisions, and not having enough time to spend on family and household chores. Most of the soldiers are not aware about various programs and benefits available to retirees. They do not have a satisfactory attitude towards the retirement guidance they receive from the army at the time of retirement. Also, due to the lack of understanding about how to use their vocational capabilities successfully pursue their retirement life, the majority of people are employed in temporary jobs, and some are successful in post-retirement life due to their successful use of training received. Some live on pensions without engaging in any income-generating activities, and those who retire after 12 years of service are facing severe economic hardships as they do not get pensions. Although they have received training in various fields, they do not use them for their benefit due to lack of proper guidance. Although the government implements programs, they are not clearly aware of them. Barriers to utilization of training include an absence of a system to identify the professional skills of retired soldiers, interest in civil society affairs, exploration of opportunities in the civil and private sectors, and politicization of services. If they are given the opportunity, they will be able to contribute to the development and reconstruction process. The findings of the study further show that it has many social, economic, political, and psychological benefits not only for individuals but also for a country. Entrepreneurship training for all retired soldiers, improving officers' understanding, streamlining existing mechanisms, creating new mechanisms, setting up a separate unit for retirees, and adapting them to civil society, private and non-governmental contributions, and training courses can be identified as potential means to improve the current situation.

Keywords: development, reconstruction, retired soldiers, vocational capabilities

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Authors: Mariko Hara, Mari Aoki, Takako Ito, Masao Sugita

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Social distancing measures due to the COVID-19 crisis had a severe impact on music and art practices based in community settings. They had to re-think how to connect with their dispersed community using online tools. As the social distancing continues, there is an urgent need to investigate the possibilities of online community music and art practices. Are they sustainable actions that can have positive impacts on the community and the quality of lives of people over time? The Online Lindgren Café (hereafter ‘OLC’) is a monthly online literature event which started in June 2020. In the OLC, up to 14 members meet online to discuss the works of Astrid Lindgren and similar authors. Members come from various places in Japan and Norway, with a variety of expertise from music therapy, music education, psychotherapy, music sociology, storytelling, and theatre, and their family members join them. In these meetings, music and arts activities emerged in response to interests among the members. The resources and experiences of the members helped to develop these activities further. This paper first introduces one of the music and art activities in one specific event, a collaborative picture book-making with music, which was initiated and led by the second author. The third author chose the music, and the activity itself was recorded. This is followed by the description of a reflecting event, where the recording of the collaborative picture book-making activity was shared to facilitate further creations (drawings, haiku, and fabric weaving) as well as group reflections on the trajectories of the Online Lindgren Café. Finally, we will discuss the preliminary findings using the data collected at the reflecting event. Key findings suggest that the resource-driven approach of the OLC leveled the relationships among the intergenerational, multi-cultural, and interdisciplinary members. This enabled the members to set aside their professional and/or predominant identities, which allowed them to discover their own and others’ resources. The relaxed, unstructured, and liminal phenomenon at OLC can be regarded as a form of communitas, where members gain a sense of liberation and belonging in a different way from in-person communications. Participation from one’s home, as well as a video conferencing function that allowed the members to position themselves among the other participants in equal-sized windows, seems to have enabled members to feel safe to express themselves openly at the same time feel a sense of belonging. Furthermore, in the OLC, music and arts activities acted to inclusively connect and re-connect dispersed, intergenerational members with each other. For instance, in a music and drawing activity, music acted as a means for each member to engage in their own ‘drawing space’ while still feeling connected with the others. The positive experiences from these activities inspired the members to use similar approaches outside of the OLC. The finding suggests that, because of its resource-driven approach supported by the music and arts activities, the OLC could be developed further as a permeable and sustainable action even after any current social distancing measures are lifted.

Keywords: communitas, COVID-19, musical affordances, online community of practices, resource-driven approach

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Miranda Lin

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This project examined the impact of a globally focused service-learning project implemented in a multicultural education course in a Midwestern university. This project facilitated critical self-reflection and build cross-cultural competence while nurturing a partnership with two schools that serve students with disabilities in Vietnam. Through a service-learning project, pre-service teachers connected via Skype with the principals/teachers at schools in Vietnam to identify and subsequently develop needed instructional materials for students with mild, moderate, and severe disabilities. Qualitative data sources include students’ intercultural competence self-reflection survey (pre-test and post-test), reflections, discussions, service project, and lesson plans. Literature Review- Global service-learning is a teaching strategy that encompasses service experiences both in the local community and abroad. Drawing on elements of global learning and international service-learning, global service-learning experiences are guided by a framework that is designed to support global learning outcomes and involve direct engagement with difference. By engaging in real-world challenges, global service-learning experiences can support the achievement of learning outcomes such as civic. Knowledge and intercultural knowledge and competence. Intercultural competence development is considered essential for cooperative and reciprocal engagement with community partners.Method- Participants (n=27*) were mostly elementary and early childhood pre-service teachers who were enrolled in a multicultural education course. All but one was female. Among the pre-service teachers, one Asian American, two Latinas, and the rest were White. Two pre-service teachers identified themselves as from the low socioeconomic families and the rest were from the middle to upper middle class.The global service-learning project was implemented in the spring of 2018. Two Vietnamese schools that served students with disabilities agreed to be the global service-learning sites. Both schools were located in an urban city.Systematic collection of data coincided with the course schedule as follows: an initial intercultural competence self-reflection survey completed in week one, guided reflections submitted in week 1, 9, and 16, written lesson plans and supporting materials for the service project submitted in week 16, and a final intercultural competence self-reflection survey completed in week 16. Significance-This global service-learning project has helped participants meet Merryfield’s goals in various degrees. They 1) learned knowledge and skills in the basics of instructional planning, 2) used a variety of instructional methods that encourage active learning, meet the different learning styles of students, and are congruent with content and educational goals, 3) gained the awareness and support of their students as individuals and as learners, 4) developed questioning techniques that build higher-level thinking skills, and 5) made progress in critically reflecting on and improving their own teaching and learning as a professional educator as a result of this project.

Keywords: global service-learning, teacher education, intercultural competence, diversity

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Authors: V. Schmidt, L. Janovák, N. Wiegand, B. Patczai, K. Turzó

Abstract:

Large bone defects are not able to heal spontaneously. Bioactive glasses seem to be appropriate (bio)materials for bone reconstruction. Bioactive glasses are osteoconductive and osteoinductive, therefore, play a useful role in bony regeneration and repair. Because of their not optimal mechanical properties (e.g., brittleness, low bending strength, and fracture toughness), their applications are limited. Bioactive glass can be used as a coating material applied on metal surfaces. In this way -when using them as implants- the excellent mechanical properties of metals and the biocompatibility and bioactivity of glasses will be utilized. Furthermore, ion release effects of bioactive glasses regarding osteogenic and angiogenic responses have been shown. Silicate bioactive glasses (45S5 Bioglass) induce the release and exchange of soluble Si, Ca, P, and Na ions on the material surface. This will lead to special cellular responses inducing bone formation, which is favorable in the biointegration of the orthopedic prosthesis. The incorporation of other additional elements in the silicate network such as fluorine, magnesium, iron, silver, potassium, or zinc has been shown, as the local delivery of these ions is able to enhance specific cell functions. Although hip and knee prostheses present a high success rate, bacterial infections -mainly implant associated- are serious and frequent complications. Infection can also develop after implantation of hip prostheses, the elimination of which means more surgeries for the patient and additional costs for the clinic. Prosthesis-related infection is a severe complication of orthopedic surgery, which often causes prolonged illness, pain, and functional loss. While international efforts are made to reduce the risk of these infections, orthopedic surgical infections (SSIs) continue to occur in high numbers. It is currently estimated that up to 2.5% of primary hip and knee surgeries and up to 20% of revision arthroplasties are complicated by periprosthetic joint infection (PJIs). According to some authors, these numbers are underestimated, and they are also increasing. Staphylococcus aureus is the leading cause of both SSIs and PJIs, and the prevalence of methicillin-resistant S. aureus (MRSA) is on the rise, particularly in the United States. These deep infections lead to implant removal and consequently increase morbidity and mortality. The study targets this clinical problem using our experience so far with the Ag-doped polymer coatings on Titanium implants. Non-modified or modified (e.g., doped with antibacterial agents, like Ag) bioactive glasses could play a role in the prevention of infections or the therapy of infected tissues. Bioactive glasses have excellent biocompatibility, proved by in vitro cell culture studies of human osteoblast-like MG-63 cells. Ag-doped bioactive glass-scaffold has a good antibacterial ability against Escherichia coli and other bacteria. It may be concluded that these scaffolds have great potential in the prevention and therapy of implant-associated bone infection.

Keywords: antibacterial agents, bioactive glass, hip and knee prosthesis, medical implants

Procedia PDF Downloads 193

Authors: Ramalan Musa Yerima

Abstract:

The paper titled “loading by number” explained a strategy developed recently by Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably leads to the reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly, deliver goods on time or they pushed themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommend that if a strategy called loading by number is integrated with other multiple safety measures such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is design to ensure that the sequence of departure of drivers from motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively towards ensuring a safer commercial transportation system.

Keywords: commercial, safety, strategy, transportation

Procedia PDF Downloads 61

Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

Abstract:

Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

Procedia PDF Downloads 116

Authors: Ramalan Musa Yerima

Abstract:

The paper titled “Loading by number” explained a strategy developed recently by the Zonal Commanding Officer of the Federal Road Safety Corps of Nigeria, covering Sokoto, Kebbi and Zamfara States of Northern Nigeria. The strategy is aimed at reducing competition, which will invariably lead to a reduction in speed, reduction in dangerous driving, reduction in crash rate, reduction in injuries, reduction in property damages and reduction in death through road traffic crashes (RTC). This research paper presents a study focused on enhancing the safety of commercial vehicles. The background of this study highlights the alarming statistics related to commercial vehicle crashes in Nigeria with a focus on Sokoto, Kebbi and Zamfara States, which often result in significant damage to property, loss of lives, and economic costs. The significance and aims is to investigate and propose an effective strategy to enhance the safety of commercial vehicles. The study recognizes the pressing need for heightened safety measures in commercial transportation, as it impacts not only the well-being of drivers and passengers but also the overall public safety. To achieve the objectives, an examination of accident data, including causes and contributing factors, was performed to identify critical areas for improvement. The major finding of the study reveals that when competition comes into play within the realm of commercial driving, it has detrimental effects on road safety and resource management. Commercial drivers are pushed to complete their routes quickly and deliver goods on time, or they push themselves to arrive quickly for more passengers and new contracts. This competitive environment, fuelled by internal and external pressures such as tight deadlines, poverty and greed, often leads to sad endings. The study recommends that if a strategy called loading by number is integrated with other multiple safety measures, such as driver training programs, regulatory enforcement, and infrastructure improvements, commercial vehicle safety can be significantly enhanced. "Loading by Number” approach is designed to ensure that the sequence of departure of drivers from the motor park ‘A’ would be communicated to motor park officials of park ‘B’, which would be considered sequentially when giving them returning passengers, regardless of the first to arrive. In conclusion, this paper underscores the significance of improving the safety measures of commercial vehicles, as they are often larger and heavier than other vehicles on the road. Whenever they are involved in accidents, the consequences can be more severe. Commercial vehicles are also frequently involved in long-haul or interstate transportation, which means they cover longer distances and spend more time on the road. This increased exposure to driving conditions increases the probability of accidents occurring. By implementing the suggested measures, policymakers, transportation authorities, and industry stakeholders can work collectively toward ensuring a safer commercial transportation system.

Keywords: commercial, safety, strategy, transport

Procedia PDF Downloads 63

Authors: Mariam Anwaar, Kiran B. Ahmad

Abstract:

Borderline Personality Disorder (BPD) is an invasive presence of affect instability, disturbance in self-concept and attachment in relationships. The profound indicator is the dichotomous approach of the world in which the ego categorizes individuals, especially their significant others, into secure or threatful beings, leaving little room for a complex combination of characteristics in one person. This defense mechanism of splitting their world has been described through the explanatory model of unconscious conflict theorized by Sigmund Freud’s Electra Complex in the Phallic Stage. The central role is of the father with whom the daughter experiences penis envy, thus identifying with the mother’s characteristics to receive the father’s attention. However, Margret Mahler, an object relation theorist, elucidates the central role of the mother and that the split occurs during the pre-Electra complex stage. Amid the 14 and 24 months of the infant, it acknowledges the world away from the mother as they have developed milestones such as crawling. In such novelty, the infant crawls away from the mother creating a sense of independence (individuation). On the other hand, being distant causes anxiety, making them return to their original object of security (separation). In BPD, the separation-individuation stage is disrupted, due to contradictory actions of the caregiver, which results in splitting the object into negative and positive aspects, repressing the former and adhering to the latter for survival. Thus, with time, the ego distorts the reality into dichotomous categories, using the splitting defenses, and the mental representation of the self is distorted due to the internalization of the negative objects. The explanatory model was recognized in the case study of Fizza, at 21-year-old Pakistani female, residing in Karachi. Her marital status is single with an occupation being a dental student. Fizza lives in a nuclear family but is surrounded by her extended family as they all are in close vicinity. She came with the complaints of depressive symptoms for two-years along with self-harm due to severe family conflicts. Through the intervention of Dialectical Behavior Therapy (DBT), the self-harming actions were reduced, however, this libidinal energy transformed into claustrophobic symptoms and, along with this, Fizza has always experienced vivid dreams. A retrospective method of Jungian dream-analysis was applied to locate the origins of the splitting in the unconscious. The result was the revelation of a sexual harassment trauma at the age of six-years which was displaced in the form of self-harm. In addition to this, the presence of a conflict at the separation-individuation stage was detected during the dream-analysis, and it was the underlying explanation of the claustrophobic symptoms. This qualitative case study implicates the use of a patient’s subjective experiences, such as dreams, to journey through the spiral of the unconscious in order to not only detect repressed memories but to use them in psychotherapy as a means of healing the patient.

Keywords: borderline personality disorder, dream-analysis, Electra complex, separation-individuation, splitting, unconscious

Procedia PDF Downloads 153

Authors: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

Abstract:

Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

Procedia PDF Downloads 89