Search results for: hospital waste
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4970

Search results for: hospital waste

860 Water Quality, Risk, Management and Distribution in Abeokuta, Ogun State

Authors: Ayedun Hassan, Ayadi Odunayo Peter

Abstract:

The ancient city of Abeokuta has been supplied with pipe borne water since 1911, yet, a continuous increase in population and unplanned city expansion makes water a very precious and scarce commodity. The government reserved areas (GRA’s) are well planned, and public water supply is available; however, the sub-urban areas consist of scattered structures with individuals trying to source water by digging wells and boreholes. The geology of the city consists of basement rock which makes digging wells and boreholes very difficult. The present study was conducted to assess the risk arising from the consumption of toxic elements in the groundwater of Abeokuta, Ogun State, Nigeria. Forty-five groundwater samples were collected from nine different areas of Abeokuta and analyzed for physicochemical parameters and toxic elements. The physicochemical parameters were determined using standard methods, while the toxic elements were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP/MS). Ninety-six percent (96%) of the water sample has pH < 6.5, and 11% has conductivity > 250 µSCm⁻¹ limits in drinking water as recommended by WHO. Seven percent (7%) of the samples have Pb concentration >10 µgL⁻¹ while 75% have Al concentration >200 µgL⁻¹ recommended by WHO. The order for risk of cancer from different area of Abeokuta are Cd²⁺ > As³⁺ > Pb²⁺ > Cr⁶⁺ for Funaab, Camp and Obantoko; As³⁺ > Cd²⁺ > Pb²⁺ > Cr⁶⁺ for Ita Osin, Isale Igbein, Ake and Itoku; Cd²⁺ >As > Cr⁶⁺ > Pb²⁺ for Totoro; Pb²⁺ > Cd²⁺ > As³⁺ > Cr⁶⁺ for Idiaba. The order of non-cancer hazard index (HI) calculated for groundwater of Abeokuta City are Cd²⁺ > As³⁺ > Mn²⁺ > Pb²⁺ > Ni²⁺ and were all greater than one, which implies susceptibility to other illnesses. The sources of these elements are the rock and inappropriate waste disposal method, which leached the elements into the groundwater. A combination of sources from food will accumulate these elements in the human body system. Treatment to remove Al and Pb is necessary, while the method of water distribution should be reviewed to ensure access to potable water by the residents.

Keywords: Abeokuta, groundwater, Nigeria, risk

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859 A Comparative Study on Fish Raised with Feed Formulated with Various Organic Wastes and Commercial Feed

Authors: Charles Chijioke Dike, Hugh Clifford Chima Maduka, Chinwe A. Isibor

Abstract:

Fish is among the products consumed at a very high rate. In most countries of the world, fish are used as part of the daily meal. The high cost of commercial fish feeds in Africa has made it necessary the development of an alternative source of fish feed processing from organic waste. The objective of this research is to investigate the efficacy of fish feeds processed from various animal wastes in order to know whether those feeds shall be alternatives to commercial feeds. This work shall be carried out at the Research Laboratory Unit of the Department of Human Biochemistry, Faculty of Basic Medical Sciences, College of Health Sciences, Nnamdi Azikiwe University (NAU), Nnewi Campus, Anambra State. The fingerlings to be used shall be gotten from the Agricultural Department of NAU, Awka, Anambra State, and allowed to acclimatize for 14 d. Animal and food wastes shall be gotten from Nnewi. The fish shall be grouped into 1-13 (Chicken manure only, cow dung only, pig manure only, chicken manure + yeast, cow dung + yeast, pig manure + yeast, chicken manure + other wastes + yeast, cow dung + other wastes + yeast, and pig manure + other wastes + yeast. Feed assessment shall be carried out by determining bulk density, feed water absorption, feed hardness, feed oil absorption, and feed water stability. The nutritional analysis shall be carried out on the feeds processed. The risk assessment shall be done on the fish by determining methylmercury (MeHg), polycyclic aromatic hydrocarbons (PAHs), and dichloro-diphenyl-trichloroethane (DDT) in the fish. The results from this study shall be analyzed statistically using SPSS statistical software, version 25. The hypothesis is that fish feeds processed from animal wastes are efficient in raising catfish. The outcome of this study shall provide the basis for the formulation of fish feeds from organic wastes.

Keywords: assessment, feeds, health risk, wastes

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858 Delivery of Patient-Directed Wound Care Via Mobile Application-Based Qualitative Analysis

Authors: Amulya Srivatsa, Gayatri Prakash, Deeksha Sarda, Varshni Nandakumar, Duncan Salmon

Abstract:

Delivery of Patient-Directed Wound Care Via Mobile Application-Based Qualitative Analysis Chronic wounds are difficult for patients to manage at-home due to their unpredictable healing process. These wounds are associated with increased morbidity and negatively affect physical and mental health. The solution is a mobile application that will have an algorithm-based checklist to determine the state of the wound based on different factors that vary from person to person. Once this information is gathered, the application will recommend a plan of care to the user and subsequent steps to be taken. The mobile application will allow users to perform a digital scan of the wound to extract quantitative information regarding wound width, length, and depth, which will then be uploaded to the EHR to notify the patient’s provider. This scan utilizes a photo taken by the user, who is prompted appropriately. Furthermore, users will enter demographic information and answer multiple choice and drop-down menus describing the wound state. The proposed solution can save patients from unnecessary trips to the hospital for chronic wound care. The next iteration of the application can incorporate AI to allow users to perform a digital scan of the wound to extract quantitative information regarding wound width, length, and depth, which can be shared with the patient’s provider to allow for more efficient treatment. Ultimately, this product can provide immediate and economical medical advice for patients that suffer from chronic wounds. Research Objectives: The application should be capable of qualitative analysis of a wound and recommend a plan of care to the user. Additionally, the results of the wound analysis should automatically upload to the patient’s EMR. Research Methodologies: The app has two components: the first is a checklist with tabs for varying factors that assists users in the assessment of their skin. Subsequently, the algorithm will create an at-home regimen for patients to follow to manage their wounds. Research Contributions: The app aims to return autonomy back to the patient and reduce the number of visits to a physician for chronic wound care. The app also serves to educate the patient on how best to care for their wounds.

Keywords: wound, app, qualitative, analysis, home, chronic

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857 Foot Self-Monitoring Knowledge, Attitude, Practice, and Related Factors among Diabetic Patients: A Descriptive and Correlational Study in a Taiwan Teaching Hospital

Authors: Li-Ching Lin, Yu-Tzu Dai

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Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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856 Vitamin D Levels in Relation to Thyroid Disorders

Authors: Binaya Tamang, Buddhhi Raj Pokhrel, Narayan Gautam

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Background: There may be a connection between thyroid function and vitamin D status since both bind to similar nuclear hormone receptors and have similar response regions on gene promoters. The purpose of the current study was to investigate the relationship between thyroid hormones and vitamin D levels in females who were attending a tertiary care center in western Nepal and were either hypothyroid or euthyroid. Methods: This hospital-based cross-sectional study was carried out between March 2020 and March 2021 by the Biochemistry department of the Universal College of Medical Sciences (UCMS), Bhairahawa, Province No. 5, Nepal, in cooperation with Internal medicine. Prior to the study, institutional review committee approval (UCMS/IRC/008/20) was acquired from UCMS. Women who visited the Internal Medicine OPD of UCMS and were advised to get a thyroid function test (TFT) were included in the study population. Only those who were willing to participate in the study were enrolled after the goals and advantages of the study had been explained to them. Participants who had recently used vitamin D supplements and medications that affected thyroid hormones were excluded. The participants gave their consent verbally and in writing. After getting the consent, a convenient sample technique was applied. Serum was isolated after drawing 3 ml of blood in a plain vial. Chemiluminescence assay was used to analyze vitamin D and thyroid hormones (MAGLUMI 2000). SPSS version 16.0 for Windows was used to conduct the statistical analysis. Statistical significance was defined as a P-value < 0.05. Results: Majority of the study population (n=214, 71%) had insufficient serum vitamin D levels. Among the thyroid groups, the median Vitamin D levels were significantly lower in hypothyroid (16.88 ng/ml) as compared to the euthyroid groups (25.01 ng/ml) (P<0.001). Similarly, serum Vitamin D levels were considerably lower in the obese population (16.86 ng/ml) as compared to the normal BMI group (24.90 ng/ml) (P<0.001) as well as in the vegetarian (15.43 ng.ml) than mixed diet consumer (24.89 ng/ml) (P<0.01). Even after the adjustment for these variables, the Vitamin D levels were significantly lower in the hypothyroid population than in the euthyroid group (P<0.001). Conclusion: Comparing the hypothyroid population to the euthyroid, the median serum vitamin D levels were considerably lower. We were alarmed to see that the majority of euthyroid participants also had low levels of vitamin D. Therefore if left untreated, low vitamin D levels in hypothyroid patients could worsen their health further.

Keywords: vitamin D, thyroid hormones, euthyroid, hypothyroid, Nepal

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855 The Structure and Function Investigation and Analysis of the Automatic Spin Regulator (ASR) in the Powertrain System of Construction and Mining Machines with the Focus on Dump Trucks

Authors: Amir Mirzaei

Abstract:

The powertrain system is one of the most basic and essential components in a machine. The occurrence of motion is practically impossible without the presence of this system. When power is generated by the engine, it is transmitted by the powertrain system to the wheels, which are the last parts of the system. Powertrain system has different components according to the type of use and design. When the force generated by the engine reaches to the wheels, the amount of frictional force between the tire and the ground determines the amount of traction and non-slip or the amount of slip. At various levels, such as icy, muddy, and snow-covered ground, the amount of friction coefficient between the tire and the ground decreases dramatically and considerably, which in turn increases the amount of force loss and the vehicle traction decreases drastically. This condition is caused by the phenomenon of slipping, which, in addition to the waste of energy produced, causes the premature wear of driving tires. It also causes the temperature of the transmission oil to rise too much, as a result, causes a reduction in the quality and become dirty to oil and also reduces the useful life of the clutches disk and plates inside the transmission. this issue is much more important in road construction and mining machinery than passenger vehicles and is always one of the most important and significant issues in the design discussion, in order to overcome. One of these methods is the automatic spin regulator system which is abbreviated as ASR. The importance of this method and its structure and function have solved one of the biggest challenges of the powertrain system in the field of construction and mining machinery. That this research is examined.

Keywords: automatic spin regulator, ASR, methods of reducing slipping, methods of preventing the reduction of the useful life of clutches disk and plate, methods of preventing the premature dirtiness of transmission oil, method of preventing the reduction of the useful life of tires

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854 Physical Activity, Mental Health, and Body Composition in College Students after COVID-19 Lockdown

Authors: Manuela Caciula, Luis Torres, Simion Tomoiaga

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Introduction: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), more commonly referred to as COVID-19, has wreaked havoc on all facets of higher education since its inception in late 2019. College students, in particular, significantly reduced their daily energy expenditure and increased the time spent sitting to listen to online classes and complete their studies from home. This change, in combination with the associated COVID-19 lockdown, presumably decreased physical activity levels, increased mental health symptoms, and led to the promotion of unhealthy eating habits. Objectives: The main objective of this study was to determine the current self-reported physical activity levels, mental health symptoms, and body composition of college students after the COVID-19 lockdown in order to develop future interventions for the overall improvement of health. Methods: All participants completed pre-existing, well-validated surveys for both physical activity (International Physical Activity Questionnaire - long form) and mental health (Hospital Anxiety and Depression Scale). Body composition was assessed in person with the use of an Inbody 570 device. Results: Of the 90 American college students (M age = 22.52 ± 4.54, 50 females) who participated in this study, depressive and anxious symptom scores consistent with 58% (N = 52) heightened symptomatology, 17% (N = 15) moderate borderline symptomatology, and 25% (N = 23) asymptomatology were reported. In regard to physical activity, 79% (N = 71) of the students were highly physically active, 18% (N = 16) were moderately active, and 3% (N = 3) reported low levels of physical activity. Additionally, 46% (N = 41) of the students maintained an unhealthy body fat percentage based on World Health Organization recommendations. Strong, significant relationships were found between anxiety and depression symptomatology and body fat percentage (P = .003) and skeletal muscle mass (P = .015), with said symptomatology increasing with added body fat and decreasing with added skeletal muscle mass. Conclusions: Future health interventions for American college students should be focused on strategies to reduce stress, anxiety, and depressive characteristics, as well as nutritional information on healthy eating, regardless of self-reported physical activity levels.

Keywords: physical activity, mental health, body composition, COVID-19

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853 In-Cylinder Exhaust Heat Recovery of an I. C. Engine Using Water Injection

Authors: Jayakrishnan U.

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A concept of adding two strokes to a four stroke Otto or Diesel engine cycle presented here for the waste heat recovery in a four stroke internal combustion engine. Four stroke Diesel cycle and Otto cycle engines have very low thermal efficiency due to high amount of energy loss in exhaust and also on the cooling of the engine. It is estimated about 35 percent of fuel energy is lost in exhaust of engine and 30 percent in cooling of engine. So by modifying a four-stroke Otto or Diesel engine by adding two-stroke heat recovery steam cycle is presented here. Water injection is used to get an additional power stroke by partial compression of the exhaust gases at the end of third stroke in a four stroke I.C.Engine. It is the conversion of a four-stroke cycle to a six-stroke cycle. By taking a four stroke petrol engine of known dimensions, an ideal thermodynamic model is used to analyse and calculate the events of exhaust gas compression and following two strokes of water injection. By changing the exhaust valve closing timing during exhaust stroke and analysing it on various points, an optimum amount of exhaust gas re-compression and amount of water injection can be found for maximizing efficiency and fuel economy. It is achieved by changing the exhaust valve timing and finding an optimum amount of exhaust re-compression, maximizing the net mean effective pressure of the steam expansion stroke (MEPsteam). Specific fuel consumption of the engine also decreases increasing the fuel economy. The valve closing timings for maximum MEPsteam is limited by either 1 bar or dew point temperature of expansion gas or moisture mixture to avoid moisture formation. By modifying the four-stroke Otto or Diesel cycle by adding two water injection stroke has the potential to significantly increase the engine efficiency and fuel economy.

Keywords: internal combustion engine, engine efficiency, six-stroke cycle, water injection, specific fuel consumption

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852 Effective Use of X-Box Kinect in Rehabilitation Centers of Riyadh

Authors: Reem Alshiha, Tanzila Saba

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Physical rehabilitation is the process of helping people to recover and be able to go back to their former activities that have been delayed due to external factors such as car accidents, old age and victims of strokes (chronic diseases and accidents, and those related to sport activities).The cost of hiring a personal nurse or driving the patient to and from the hospital could be costly and time-consuming. Also, there are other factors to take into account such as forgetfulness, boredom and lack of motivation. In order to solve this dilemma, some experts came up with rehabilitation software to be used with Microsoft Kinect to help the patients and their families for in-home rehabilitation. In home rehabilitation software is becoming more and more popular, since it is more convenient for all parties affiliated with the patient. In contrast to the other costly market-based systems that have no portability, Microsoft’s Kinect is a portable motion sensor that reads body movements and interprets it. New software development has made rehabilitation games available to be used at home for the convenience of the patient. The game will benefit its users (rehabilitation patients) in saving time and money. There are many software's that are used with the Kinect for rehabilitation, but the software that is chosen in this research is Kinectotherapy. Kinectotherapy software is used for rehabilitation patients in Riyadh clinics to test its acceptance by patients and their physicians. In this study, we used Kinect because it was affordable, portable and easy to access in contrast to expensive market-based motion sensors. This paper explores the importance of in-home rehabilitation by using Kinect with Kinectotherapy software. The software targets both upper and lower limbs, but in this research, the main focus is on upper-limb functionality. However, the in-home rehabilitation is applicable to be used by all patients with motor disability, since the patient must have some self-reliance. The targeted subjects are patients with minor motor impairment that are somewhat independent in their mobility. The presented work is the first to consider the implementation of in-home rehabilitation with real-time feedback to the patient and physician. This research proposes the implementation of in-home rehabilitation in Riyadh, Saudi Arabia. The findings show that most of the patients are interested and motivated in using the in-home rehabilitation system in the future. The main value of the software application is due to these factors: improve patient engagement through stimulating rehabilitation, be a low cost rehabilitation tool and reduce the need for expensive one-to-one clinical contact. Rehabilitation is a crucial treatment that can improve the quality of life and confidence of the patient as well as their self-esteem.

Keywords: x-box, rehabilitation, physical therapy, rehabilitation software, kinect

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851 Nano-Enhanced In-Situ and Field Up-Gradation of Heavy Oil

Authors: Devesh Motwani, Ranjana S. Baruah

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The prime incentive behind up gradation of heavy oil is to increase its API gravity for ease of transportation to refineries, thus expanding the market access of bitumen-based crude to the refineries. There has always been a demand for an integrated approach that aims at simplifying the upgrading scheme, making it adaptable to the production site in terms of economics, environment, and personnel safety. Recent advances in nanotechnology have facilitated the development of two lines of heavy oil upgrading processes that make use of nano-catalysts for producing upgraded oil: In Situ Upgrading and Field Upgrading. The In-Situ upgrading scheme makes use of Hot Fluid Injection (HFI) technique where heavy fractions separated from produced oil are injected into the formations to reintroduce heat into the reservoir along with suspended nano-catalysts and hydrogen. In the presence of hydrogen, catalytic exothermic hydro-processing reactions occur that produce light gases and volatile hydrocarbons which contribute to increased oil detachment from the rock resulting in enhanced recovery. In this way the process is a combination of enhanced heavy oil recovery along with up gradation that effectively handles the heat load within the reservoirs, reduces hydrocarbon waste generation and minimizes the need for diluents. By eliminating most of the residual oil, the Synthetic Crude Oil (SCO) is much easier to transport and more amenable for processing in refineries. For heavy oil reservoirs seriously impacted by the presence of aquifers, the nano-catalytic technology can still be implemented on field though with some additional investments and reduced synergies; however still significantly serving the purpose of production of transportable oil with substantial benefits with respect to both large scale upgrading, and known commercial field upgrading technologies currently on the market. The paper aims to delve deeper into the technology discussed, and the future compatibility.

Keywords: upgrading, synthetic crude oil, nano-catalytic technology, compatibility

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850 Sizing and Thermal Analysis of Mechanically Pumped Fluid Loop Thermal Control Technique for Small Satellite Scientific Applications

Authors: Shanmugasundaram Selvadurai, Amal Chandran

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Small satellites have become an alternative low-cost solution for several missions to accomplish specific missions such as Earth imaging, Technology demonstration, Education, and other commercial purposes. Small satellite missions focusing on Infrared imaging applications require lower temperature for scientific instruments and such low temperature can be achieved only using external cryocoolers but the disadvantage is that they generate a large amount of waste heat. Existing passive thermal control techniques are not capable to handle such large thermal loads and hence one of the traditional active Thermal Control System (TCS) is studied for a small satellite configuration. This work aims to downscale the existing Mechanically Pumped Fluid Loop (MPFL) TCS to a 27U CubeSat platform for an imaginary scientific instrument. The temperature-sensitive detector in the instrument considered to be maintained between 130K and 150K to reduce dark current noise and increase the data quality. A Single-Phase fluid based MPFL is chosen for this system-level study and this TCS consists of a microfluid pump, a micro-cryocooler, a fluid accumulator, external heaters, flow regulators, and sensors. This work also explains the thermal control system architecture with a conceptual design, arrangement of all the components, and thermal analysis for different low orbit conditions. Sizing and extensive trade studies for the components are conducted and the results have shown that the Single-phase MPFL system is able to handle the given thermal loads and maintain the satellite’s interface temperature within the desired limit.

Keywords: active thermal control system, satellite thermal, mechanically pumped fluid loop system, cryogenics, cryocooler

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849 Using Recycled Wastes (Glass Powder) as Partially Replacement for Cement

Authors: Passant Youssef, Ahmed El-Tair, Amr El-Nemr

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Lately, with the environmental changes, enthusiasts trigger to stop the contamination of environment. Thus, various efforts were exerted for innovating environmental friendly concrete to sustain as a ‘Green Building’ material. Green building materials consider the cement industry as one of the most sources of air pollutant with high rate of carbon dioxide (CO₂) emissions. Several methods were developed to extensively reduce the influence of cement industry on environment. These methods such as using supplementary cementitious material or improving the cement manufacturing process are still under investigation. However, with the presence of recycled wastes from construction and finishing materials, the use of supplementary cementitious materials seems to provide an economic solution. Furthermore, it improves the mechanical properties of cement paste, in addition to; it modulates the workability and durability of concrete. In this paper, the glass powder was considered to be used as partial replacement of cement. This study provided the mechanical influence for using the glass powder as partial replacement of cement. In addition, it examines the microstructure of cement mortar using scanning electron microscope and X-ray diffraction. The cement in concrete is replaced by waste glass powder in steps of 5%, 10%, 15%, 20% and 25% by weight of cement and its effects on compressive and flexure strength were determined after 7 and 28 days. It was found that the 5% glass powder replacement increased the 7 days compressive strength by 20.5%, however, there was no increase in compressive strength after 28 days; which means that the glass powder did not react in the cement mortar due to its amorphous nature on the long run, and it can act as fine aggregate better that cement replacement. As well as, the 5% and 10% glass powder replacement increased the 28 days flexural strength by 46.9%. SEM micrographs showed very dense matrix for the optimum specimen compared to control specimen as well; some glass particles were clearly observed. High counts of silica were optimized from XRD while amorphous materials such as calcium silicate cannot be directly detected.

Keywords: supplementary materials, glass powder, concrete, cementitious materials

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848 Impact of Preoperative Physiotherapy Care in Total Hip Arthroplasty in Slovakia and Austria

Authors: Peter Kutis, Vladimir Littva

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Nowadays, it is necessary to ensure that this reduction in costs is not at the expense of the quality of health care and future medical success. In general, physiotherapy for total hip joint arthroplasty is considered to be a routine matter that deals mainly with mobility training, increased muscular strength, and basic day-to-day activities such as bed-to-chair transition, standing, and walking. Within the KEGA project no. 003KU-4-2021, we decided to investigate preoperative physiotherapy care in Slovakia and Austria in total hip arthroplasty patients to shortened overall recovery. Research Sample and Methods: The sample comprised 498 respondents –patients who were indicated to total hip arthroplasty on the territory of Slovakia and Austria. There were 130 women in Slovakia and 135 women in Austria. The numbers of men were 120 in Slovakia and 113 men in Austria. The age of respondents was between 40 and 85 years of age. As a method of our research, we chose a non-standardized questionnaire, which consisted of three parts. The first part for the initial examination of the patient contained the identification of the patient according to the assigned number and subsequently 19 questions conditioned by the physical examination and evaluation of the patients. The second part of our questionnaire was completed after the patient's hospitalization and contained 10 questions that were conditioned by the patient's examination. The last third part for the overall assessment of the patient's state of health consisted of 12 questions conditioned by the patient's examination. This part was performed at the last meeting with the patient at the end of the treatment. All data were statistically processed by SPSS 25. Results: All data were evaluated at a significance level of p = 0.05. From the comparison of patients who underwent preoperative preparation, we can clearly state that the total duration of treatment is significantly shorter. A t-test of two mean values with uneven variance was used to verify the validity of the assumption. The total duration of treatment in patients with preoperative preparation was on average 92,635 days and without preoperative preparation was on average 135,884 days (t-Stat = 44,52784, t Critical one-tail = 1,648187415, t Critical two-tail = 1,965157). Conclusion: The results obtained during the research show the importance of adequate preoperative physiotherapeutic preparation of the patient. The results of total hip joint arthroplasty studies showed a significant reduction in a hospital stay as well as shortened total treatment time.

Keywords: THA, physiotherapy, recovery, preoperative physiotherapy care

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847 Optimization and Kinetic Analysis of the Enzymatic Hydrolysis of Oil Palm Empty Fruit Bunch To Xylose Using Crude Xylanase from Trichoderma Viride ITB CC L.67

Authors: Efri Mardawati, Ronny Purwadi, Made Tri Ari Penia Kresnowati, Tjandra Setiadi

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EFB are mainly composed of cellulose (≈ 43%), hemicellulose (≈ 23%) and lignin (≈20%). The palm oil empty fruit bunches (EFB) is the lignosellulosic waste from crude palm oil industries mainly compose of (≈ 43%), hemicellulose (≈ 23%) and lignin (≈20%). Xylan, a polymer made of pentose sugar xylose and the most abundant component of hemicellulose in plant cell wall. Further xylose can be used as a raw material for production of a wide variety of chemicals such as xylitol, which is extensively used in food, pharmaceutical and thin coating applications. Currently, xylose is mostly produced from xylan via chemical hydrolysis processes. However, these processes are normally conducted at a high temperature and pressure, which is costly, and the required downstream processes are relatively complex. As an alternative method, enzymatic hydrolysis of xylan to xylose offers an environmentally friendly biotechnological process, which is performed at ambient temperature and pressure with high specificity and at low cost. This process is catalysed by xylanolytic enzymes that can be produced by some fungal species such as Aspergillus niger, Penicillium crysogenum, Tricoderma reseei, etc. Fungal that will be used to produce crude xylanase enzyme in this study is T. Viride ITB CC L.67. It is the purposes of this research to study the influence of pretreatment of EFB for the enzymatic hydrolysis process, optimation of temperature and pH of the hydrolysis process, the influence of substrate and enzyme concentration to the enzymatic hydrolysis process, the dynamics of hydrolysis process and followingly to study the kinetics of this process. Xylose as the product of enzymatic hydrolysis process analyzed by HPLC. The results show that the thermal pretreatment of EFB enhance the enzymatic hydrolysis process. The enzymatic hydrolysis can be well approached by the Michaelis Menten kinetic model, and kinetic parameters are obtained from experimental data.

Keywords: oil palm empty fruit bunches (EFB), xylose, enzymatic hydrolysis, kinetic modelling

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846 Influence of Digestate Fertilization on Soil Microbial Activity, Greenhouse Gas Emissions and Yield

Authors: M. Doyeni, S. Suproniene, V. Tilvikiene

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Agricultural wastes contribute significantly to global climate change through greenhouse gas emissions if not adequately recycled and sustainably managed. A recurring agricultural waste is livestock wastes that have consistently served as feedstock for biogas systems. The objective of this study was to access the influence of digestate fertilization on soil microbial activity and greenhouse gas emissions in agricultural fields. Wheat (Triticum spp. L.) was fertilized with different types of animal wastes digestates (organic fertilizers) and mineral nitrogen (inorganic fertilizer) for three years. The 170 kg N ha⁻¹ presented in digestates were split fertilized at an application rate of 90 and 80 kg N ha⁻¹. The soil microorganism activity could be predicted significantly using the dehydrogenase activity and soil microbial biomass carbon. By combining the two different monitoring approaches, the different methods applied in this study were sensitive to enzymatic activities and organic carbon in the living component of the soil organic matter. The emissions of greenhouse gasses (carbon dioxide (CO₂), methane (CH₄), and nitrous oxide (N₂O) were monitored directly by a static chamber system. The soil and environmental variables were measured to determine their influence on greenhouse gas emissions. Emission peaks was observed in N₂O and CO₂ after the first application of fertilizers with the emissions flattening out over the cultivating season while CH₄ emission was negligible with no apparent patterns observed. Microbial biomass carbon and dehydrogenase activity were affected by the fertilized organic digestates. A significant difference was recorded between the control and the digestate treated soils for the microbial biomass carbon and dehydrogenase. Results also showed individual and cumulative emissions of CO₂, CH₄ and N₂O from the digestates were relatively low suggesting the digestate fertilization can be an efficient method for improving soil quality and reducing greenhouse gases from agricultural sources in temperate climate conditions.

Keywords: greenhouse gas emission, manure digestate, soil microbial activity, yield

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845 The Impacts of Green Logistics Management Practices on Sustainability Performance in Nigeria

Authors: Ozoemelam Ikechukwu Lazarus, Nizamuddin B. Zainuddin, Abdul Kafi

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Numerous studies have been carried out on Green Logistics Management Practices (GLMPs) across the globe. The study on the practices and performance of green chain practices in Africa in particular has not gained enough scholarly attention. Again, the majority of supply chain sustainability research being conducted focus on environmental sustainability. Logistics has been a major cause of supply chain resource waste and environmental damage. Many sectors of the economy that engage in logistical operations significantly rely on vehicles, which emit pollutants into the environment. Due to urbanization and industrialization, the logistical operations of manufacturing companies represent a serious hazard to the society and human life, making the sector one of the fastest expanding in the world today. Logistics companies are faced with numerous difficulties when attempting to implement logistics practices along their supply chains. In Nigeria, manufacturing companies aspire to implement reverse logistics in response to stakeholders’ requirements to reduce negative environmental consequences. However, implementing this is impeded by a criteria framework, and necessitates the careful analysis of how such criteria interact with each other in the presence of uncertainty. This study integrates most of the green logistics management practices (GLMPs) into the Nigerian firms to improve generalizability, and credibility. It examines the effect of Green Logistics Management Practices on environmental performance, social performance, market performance, and financial performance in the logistics industries. It seeks to identify the critical success factors in order to develop a model that incorporates different factors from the perspectives of the technology, organization, human and environment to inform the adoption and use of technologies for logistics supply chain social sustainability in Nigeria. It uses exploratory research approach to collect and analyse the data.

Keywords: logistics, managemernt, suatainability, environment, operations

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844 Hydrodynamics of Periphyton Biofilters in Recirculating Aquaculture

Authors: Adam N. Bell, Sarina J. Ergas, Michael Nystrom, Nathan P. Brennan, Kevan L. Main

Abstract:

Integrated Multi-Trophic Aquaculture systems (IMTA) have the potential to improve the sustainability of seafood production, generate organic fertilizer and feed, remove waste discharges and reduce energy use. IMTA can include periphyton biofilters where algae and microbes grow on surfaces, along with caught detritus and amphipods. Periphyton biofilters provide many advantages: nitrification, denitrification, primary production and ecological diversity. The goal of this study was to determine how biofilter hydraulic residence time (τ) effects periphyton biomass production, dissolved oxygen (DO) and nutrient removal. A pilot scale recirculating aquaculture system (RAS) was designed, constructed and operated at different hydraulic residence times (τ= 1, 2, 4, 6, 8 hours per tank). For each τ, a conservative tracer study was conducted to investigate system hydrodynamics. Data on periphyton weights, pH, nitrogen species, phosphorus, temperature and DO were collected. The tracer study for τ =1 hour revealed that the normalized time < τ, indicating short-circuiting. Periphyton biomass production rate was relatively unaffected by τ (R_e<1 for all τ). Average ammonia nitrogen removal was > 75% for all trials. Nitrate and nitrite did not accumulate in the RAS for τ≥4 hours due to enhanced denitrification in anoxic zones. For τ≥4 hours DO concentration was at a maximum of 4 mg L-1 after 14:00, and decreased to 0 mg L-1 during nighttime. At τ=1 hour, the RAS stayed > 2 mg L-1 and DO was more evenly distributed. For the validation trial, the culture tank was stocked with Centropomus undecimalis (common snook) and the system was operated at τ= 1 hr. Preliminary results showed that a RAS with an integrated periphyton biofilter could support fish health with low nutrient concentrations DO > 6 mg L-1.

Keywords: sustainable aquaculture, resource recovery, nitrogen, microalgae, hydrodynamics, integrated multi-trophic aquaculture

Procedia PDF Downloads 131
843 An Evaluation on the Effectiveness of a 3D Printed Composite Compression Mold

Authors: Peng Hao Wang, Garam Kim, Ronald Sterkenburg

Abstract:

The applications of composite materials within the aviation industry has been increasing at a rapid pace.  However, the growing applications of composite materials have also led to growing demand for more tooling to support its manufacturing processes. Tooling and tooling maintenance represents a large portion of the composite manufacturing process and cost. Therefore, the industry’s adaptability to new techniques for fabricating high quality tools quickly and inexpensively will play a crucial role in composite material’s growing popularity in the aviation industry. One popular tool fabrication technique currently being developed involves additive manufacturing such as 3D printing. Although additive manufacturing and 3D printing are not entirely new concepts, the technique has been gaining popularity due to its ability to quickly fabricate components, maintain low material waste, and low cost. In this study, a team of Purdue University School of Aviation and Transportation Technology (SATT) faculty and students investigated the effectiveness of a 3D printed composite compression mold. A 3D printed composite compression mold was fabricated by 3D scanning a steel valve cover of an aircraft reciprocating engine. The 3D printed composite compression mold was used to fabricate carbon fiber versions of the aircraft reciprocating engine valve cover. The 3D printed composite compression mold was evaluated for its performance, durability, and dimensional stability while the fabricated carbon fiber valve covers were evaluated for its accuracy and quality. The results and data gathered from this study will determine the effectiveness of the 3D printed composite compression mold in a mass production environment and provide valuable information for future understanding, improvements, and design considerations of 3D printed composite molds.

Keywords: additive manufacturing, carbon fiber, composite tooling, molds

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842 Valorisation of Mango Seed: Response Surface Methodology Based Optimization of Starch Extraction from Mango Seeds

Authors: Tamrat Tesfaye, Bruce Sithole

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Box-Behnken Response surface methodology was used to determine the optimum processing conditions that give maximum extraction yield and whiteness index from mango seed. The steeping time ranges from 2 to 12 hours and slurring of the steeped seed in sodium metabisulphite solution (0.1 to 0.5 w/v) was carried out. Experiments were designed according to Box-Behnken Design with these three factors and a total of 15 runs experimental variables of were analyzed. At linear level, the concentration of sodium metabisulphite had significant positive influence on percentage yield and whiteness index at p<0.05. At quadratic level, sodium metabisulphite concentration and sodium metabisulphite concentration2 had a significant negative influence on starch yield; sodium metabisulphite concentration and steeping time*temperature had significant (p<0.05) positive influence on whiteness index. The adjusted R2 above 0.8 for starch yield (0.906465) and whiteness index (0.909268) showed a good fit of the model with the experimental data. The optimum sodium metabisulphite concentration, steeping hours, and temperature for starch isolation with maximum starch yield (66.428%) and whiteness index (85%) as set goals for optimization with the desirability of 0.91939 was 0.255w/v concentration, 2hrs and 50 °C respectively. The determined experimental value of each response based on optimal condition was statistically in accordance with predicted levels at p<0.05. The Mango seeds are the by-products obtained during mango processing and possess disposal problem if not handled properly. The substitution of food based sizing agents with mango seed starch can contribute as pertinent resource deployment for value-added product manufacturing and waste utilization which might play significance role of food security in Ethiopia.

Keywords: mango, synthetic sizing agent, starch, extraction, textile, sizing

Procedia PDF Downloads 231
841 Vancomycin Resistance Enterococcus and Implications to Trauma and Orthopaedic Care

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

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Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

Procedia PDF Downloads 149
840 Health Psychology Intervention: Identifying Early Symptoms in Neurological Disorders

Authors: Simon B. N. Thompson

Abstract:

Early indicator of neurological disease has been proposed by the expanded Thompson Cortisol Hypothesis which suggests that yawning is linked to rises in cortisol levels. Cortisol is essential to the regulation of the immune system and pathological yawning is a symptom of multiple sclerosis (MS). Electromyography activity (EMG) in the jaw muscles typically rises when the muscles are moved – extended or flexed; and yawning has been shown to be highly correlated with cortisol levels in healthy people. It is likely that these elevated cortisol levels are also seen in people with MS. The possible link between EMG in the jaw muscles and rises in saliva cortisol levels during yawning were investigated in a randomized controlled trial of 60 volunteers aged 18-69 years who were exposed to conditions that were designed to elicit the yawning response. Saliva samples were collected at the start and after yawning, or at the end of the presentation of yawning-provoking stimuli, in the absence of a yawn, and EMG data was additionally collected during rest and yawning phases. Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, and health details were collected and the following exclusion criteria were adopted: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners, t (23) = -4.263, p = 0.000, as compared with the non-yawners between rest and post-stimuli, which was non-significant. There were also significant differences between yawners and non-yawners for the EMG potentials with the yawners having higher rest and post-yawning potentials. Significant evidence was found to support the Thompson Cortisol Hypothesis suggesting that rises in cortisol levels are associated with the yawning response. Further research is underway to explore the use of cortisol as a potential diagnostic tool as an assist to the early diagnosis of symptoms related to neurological disorders. Bournemouth University Research & Ethics approval granted: JC28/1/13-KA6/9/13. Professional code of conduct, confidentiality, and safety issues have been addressed and approved in the Ethics submission. Trials identification number: ISRCTN61942768. http://www.controlled-trials.com/isrctn/

Keywords: cortisol, electromyography, neurology, yawning

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839 Fastidious Enteric Pathogens in HIV

Authors: S. Pathak, R. Lazarus

Abstract:

A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

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838 Utility of Thromboelastography to Reduce Coagulation-Related Mortality and Blood Component Rate in Neurosurgery ICU

Authors: Renu Saini, Deepak Agrawal

Abstract:

Background: Patients with head and spinal cord injury frequently have deranged coagulation profiles and require blood products transfusion perioperatively. Thromboelastography (TEG) is a ‘bedside’ global test of coagulation which may have role in deciding the need of transfusion in such patients. Aim: To assess the usefulness of TEG in department of neurosurgery in decreasing transfusion rates and coagulation-related mortality in traumatic head and spinal cord injury. Method and Methodology: A retrospective comparative study was carried out in the department of neurosurgery over a period of 1 year. There are two groups in this study. ‘Control’ group constitutes the patients in whom data was collected over 6 months (1/6/2009-31/12/2009) prior to installation of TEG machine. ‘Test’ group includes patients in whom data was collected over 6months (1/1/2013-30/6/2013) post TEG installation. Total no. of platelet, FFP, and cryoprecipitate transfusions were noted in both groups along with in hospital mortality and length of stay. Result: Both groups were matched in age and sex of patients, number of head and spinal cord injury cases, number of patients with thrombocytopenia and number of patients who underwent operation. Total 178 patients (135 head injury and 43 spinal cord injury patents) were admitted in neurosurgery department during time period June 2009 to December 2009 i.e. prior to TEG installation and after TEG installation a total of 243 patients(197 head injury and 46 spinal cord injury patents) were admitted. After TEG introduction platelet transfusion significantly reduced (p=0.000) compare to control group (67 units to 34 units). Mortality rate was found significantly reduced after installation (77 patients to 57 patients, P=0.000). Length of stay was reduced significantly (Prior installation 1-211days and after installation 1-115days, p=0.02). Conclusion: Bedside TEG can dramatically reduce platelet transfusion components requirement in department of neurosurgery. TEG also lead to a drastic decrease in mortality rate and length of stay in patients with traumatic head and spinal cord injuries. We recommend its use as a standard of care in the patients with traumatic head and spinal cord injuries.

Keywords: blood component transfusion, mortality, neurosurgery ICU, thromboelastography

Procedia PDF Downloads 325
837 Bacteriological Quality and Physicochemical Water Beaches of the City of Annaba (Mediterranean Sea)

Authors: Wahiba Boudraa, Farah Chettibbi, Meriem Aberkane, Fatma Djamaa, Moussa Houhamdi

Abstract:

The intensity of human activities in regions surrounding the Mediterranean Sea always has a strong long-term environmental impact resulting in coastal and marine degradation, as well as an aggravated risk of more serious damage. The available data on water quality show that most water resources in Algeria are polluted by uncontrolled discharges from municipal sewage and untreated industrial effluents. Annaba is a coastal town in Algeria; The Gulf of Annaba, responds to these changes as it receives the continental inputs and urban waste, industrial without prior treatment of a highly industrialized and urbanized city, subject to the same environmental problems that know the rest of the Algerian coast. In later year, the beaches of bacterial enumeration process waters showed relatively high levels of bacterial indicators of fecal contamination (group D streptococci, total and fecal coliforms), which reflect the risks to people attending these beaches. During the twelve months of our study, we isolated from three beaches in the city of Annaba (St. Cloud, El-Kettara, and Djenane El Bey) a number of pathogenic microorganisms considered, namely: Salmonella, Aeromonas, Citrobacter, Yersinia, Enterococcus, and E.coli. The microbial count revealed elevated levels of coliform bacteria, fecal coliforms and fecal streptococci quite high especially in urban beaches (St. Cloud and El-Kettara). They are widely popular during the summer by many vacationers. For the physico-chemical parameters, there exist some weak values which increase during the pluvial period, hivernal and festival saison. These values remain, nevertheless, weak to be able to cause an organic or metallic pollution.

Keywords: quality microbiology, pollution of water, fecal contamination, physico-chemistry, beaches of Annaba city, Algeria.

Procedia PDF Downloads 345
836 Imaging Features of Hepatobiliary Histiocytosis

Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

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Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

Procedia PDF Downloads 282
835 Reducing the Incidence Rate of Pressure Sore in a Medical Center in Taiwan

Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

Procedia PDF Downloads 267
834 Hearing Threshold Levels among Steel Industry Workers in Samut Prakan Province, Thailand

Authors: Petcharat  Kerdonfag, Surasak Taneepanichskul, Winai Wadwongtham

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Industrial noise is usually considered as the main impact of the environmental health and safety because its exposure can cause permanently serious hearing damage. Despite providing strictly hearing protection standards and campaigning extensively encouraging public health awareness among industrial workers in Thailand, hazard noise-induced hearing loss has dramatically been massive obstacles for workers’ health. The aims of the study were to explore and specify the hearing threshold levels among steel industrial workers responsible in which higher noise levels of work zone and to examine the relationships of hearing loss and workers’ age and the length of employment in Samut Prakan province, Thailand. Cross-sectional study design was done. Ninety-three steel industrial workers in the designated zone of higher noise (> 85dBA) with more than 1 year of employment from two factories by simple random sampling and available to participate in were assessed by the audiometric screening at regional Samut Prakan hospital. Data of doing screening were collected from October to December, 2016 by the occupational medicine physician and a qualified occupational nurse. All participants were examined by the same examiners for the validity. An Audiometric testing was performed at least 14 hours after the last noise exposure from the workplace. Workers’ age and the length of employment were gathered by the developed occupational record form. Results: The range of workers’ age was from 23 to 59 years, (Mean = 41.67, SD = 9.69) and the length of employment was from 1 to 39 years, (Mean = 13.99, SD = 9.88). Fifty three (60.0%) out of all participants have been exposing to the hazard of noise in the workplace for more than 10 years. Twenty-three (24.7%) of them have been exposing to the hazard of noise less than or equal to 5 years. Seventeen (18.3%) of them have been exposing to the hazard of noise for 5 to 10 years. Using the cut point of less than or equal to 25 dBA of hearing thresholds, the average means of hearing thresholds for participants at 4, 6, and 8 kHz were 31.34, 29.62, and 25.64 dB, respectively for the right ear and 40.15, 32.20, and 25.48 dB for the left ear, respectively. The more developing age of workers in the work zone with hazard of noise, the more the hearing thresholds would be increasing at frequencies of 4, 6, and 8 kHz (p =.012, p =.026, p =.024) for the right ear, respectively and for the left ear only at the frequency 4 kHz (p =.009). Conclusion: The participants’ age in the hazard of noise work zone was significantly associated with the hearing loss in different levels while the length of participants’ employment was not significantly associated with the hearing loss. Thus hearing threshold levels among industrial workers would be regularly assessed and needed to be protected at the beginning of working.

Keywords: hearing threshold levels, hazard of noise, hearing loss, audiometric testing

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833 Recovery of Selenium from Scrubber Sludge in Copper Process

Authors: Lakshmikanth Reddy, Bhavin Desai, Chandrakala Kari, Sanjay Sarkar, Pradeep Binu

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The sulphur dioxide gases generated as a by-product of smelting and converting operations of copper concentrate contain selenium apart from zinc, lead, copper, cadmium, bismuth, antimony, and arsenic. The gaseous stream is treated in waste heat boiler, electrostatic precipitator and scrubbers to remove coarse particulate matter in order to produce commercial grade sulfuric acid. The gas cleaning section of the acid plant uses water to scrub the smelting gases. After scrubbing, the sludge settled at the bottom of the scrubber, was analyzed in present investigation. It was found to contain 30 to 40 wt% copper and selenium up to 40 wt% selenium. The sludge collected during blow-down is directly recycled to the smelter for copper recovery. However, the selenium is expected to again vaporize due to high oxidation potential during smelting and converting, causing accumulation of selenium in sludge. In present investigation, a roasting process has been developed to recover the selenium before the copper recovery from the sludge at smelter. Selenium is associated with copper in sludge as copper selenide, as determined by X-ray diffraction and electron microscopy. The thermodynamic and thermos-gravimetry study revealed that the copper selenide phase present in the sludge was amenable to oxidation at 600°C forming oxides of copper and selenium (Cu-Se-O). However, the dissociation of selenium from the copper oxide was made possible by sulfatation using sulfur dioxide between 450 to 600°C, resulting into the formation of CuSO₄ (s) and SeO₂ (g). Lab scale trials were carried out in vertical tubular furnace to determine the optimum roasting conditions with respect to roasting time, temperature and molar ratio of O₂:SO₂. Using these optimum conditions, selenium up to 90 wt% in the form of SeO₂ vapors could be recovered from the sludge in a large-scale commercial roaster. Roasted sludge free from the selenium and containing oxides and sulfates of copper could now be recycled in the smelter for copper recovery.

Keywords: copper, selenium, copper selenide, sludge, roasting, SeO₂

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832 A Cross-Sectional Study on Clinical Self-Efficacy of Final Year School of Nursing Students among Universities of Tigray Region, Northern Ethiopia

Authors: Awole Seid, Yosef Zenebe, Hadgu Gerensea, Kebede Haile Misgina

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Background: Clinical competence is one of the ultimate goals of nursing education. Clinical skills are more than successfully performing tasks; it incorporates client assessment, identification of deficits and the ability to critically think to provide solutions. Assessment of clinical competence, particularly identifying gaps that need improvement and determining the educational needs of nursing students have great importance in nursing education. Thus this study aims determining clinical self-efficacy of final year school of nursing students in three universities of Tigray Region. Methods: A cross-sectional study was conducted on 224 final year school of nursing students from department of nursing, psychiatric nursing, and midwifery on three universities of Tigray region. Anonymous self-administered questionnaire was administered to generate data collected on June, 2017. The data were analyzed using SPSS version 20. The result is described using tables and charts as required. Logistic regression was employed to test associations. Result: The mean age of students was 22.94 + 1.44. Generally, 21% of students have been graduated in the department in which they are not interested. The study demonstrated 28.6% had poor and 71.4% had good perceived clinical self-efficacy. Beside this, 43.8% of psychiatric nursing and 32.6% of comprehensive nursing students have poor clinical self-efficacy. Among the four domains, 39.3% and 37.9% have poor clinical self- efficacy with regard to ‘Professional development’ and ‘Management of care’. Place of the institution [AOR=3.480 (1.333 - 9.088), p=0.011], interest during department selection [AOR=2.202 (1.045 - 4.642), p=.038], and theory-practice gap [AOR=0.224 (0.110 - 0.457), p=0.000] were significantly associated with perceived clinical self-efficacy. Conclusion: The magnitude of students with poor clinically self efficacy was high. Place of institution, theory-practice gap, students interest to the discipline were the significant predictors of clinical self-efficacy. Students from youngest universities have good clinical self-efficacy. During department selection, student’s interest should be respected. The universities and other stakeholders should improve the capacity of surrounding affiliate teaching hospitals to set and improve care standards in order to narrow the theory-practice gap. School faculties should provide trainings to hospital staffs and monitor standards of clinical procedures.

Keywords: clinical self-efficacy, nursing students, Tigray, northern Ethiopia

Procedia PDF Downloads 171
831 Site Selection in Adaptive Reuse Architecture for Social Housing in Johannesburg, South Africa

Authors: Setapo Moloi, Jun-Ichiro Giorgos Tsutsumi

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South Africa’s need for the provision of housing within its major city centres, specifically Gauteng Province (GP), is a major concern. Initiatives for converting misused/ unused buildings to suitable housing for residents who work in the city as well as prospective citizens are currently underway, one aspect that is needed currently, is the re-possession of these buildings repurposing, into housing communities for quality low cost mixed density housing and for this process to have minimal strain on existing infrastructure like energy, emission reduction etc. Unfortunately, there are instances in Johannesburg, the country’s economic capital, with 2017 estimates claiming that 700 buildings lay unused or misused due to issues that will be discussed in this paper, these then become hubs for illegal activity and are an unacceptable form of shelter. It can be argued that the provision of inner-city social housing is lacking, but not due to the unavailability of funding or usable land and buildings, but that these assets are not being used appropriately nor to their full potential. Currently the GP government has mandated the re-purposing of all buildings that meet their criteria (structural stability, feasibility, adaptability, etc.) with the intention of inviting interested parties to propose conversions of the buildings into densified social housing. Going forward, the proposed focus is creation of social housing communities within existing buildings which may be retrofitted with sustainable technologies, green design strategies and principles, aiming for the finished buildings to achieve ‘Net-Zero/Positive’ status. A Net-Zero building, according to The Green Building Council of South Africa (GBCSA) is a building which manages to produce resources it needs to function, and reduces wastage, emissions and demand of these resources during its lifespan. The categories which GBCSA includes are carbon, water, waste and ecology, this may include material selection, construction methods, etc.

Keywords: adaptive reuse, conversion, net-zero, social housing, sustainable communities

Procedia PDF Downloads 138