Search results for: NODAL analysis production system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 42720

Search results for: NODAL analysis production system

900 An Integrated Theoretical Framework on Mobile-Assisted Language Learning: User’s Acceptance Behavior

Authors: Gyoomi Kim, Jiyoung Bae

Abstract:

In the field of language education research, there are not many tries to empirically examine learners’ acceptance behavior and related factors of mobile-assisted language learning (MALL). This study is one of the few attempts to propose an integrated theoretical framework that explains MALL users’ acceptance behavior and potential factors. Constructs from technology acceptance model (TAM) and MALL research are tested in the integrated framework. Based on previous studies, a hypothetical model was developed. Four external variables related to the MALL user’s acceptance behavior were selected: subjective norm, content reliability, interactivity, self-regulation. The model was also composed of four other constructs: two latent variables, perceived ease of use and perceived usefulness, were considered as cognitive constructs; attitude toward MALL as an affective construct; behavioral intention to use MALL as a behavioral construct. The participants were 438 undergraduate students who enrolled in an intensive English program at one university in Korea. This particular program was held in January 2018 using the vacation period. The students were given eight hours of English classes each day from Monday to Friday for four weeks and asked to complete MALL courses for practice outside the classroom. Therefore, all participants experienced blended MALL environment. The instrument was a self-response questionnaire, and each construct was measured by five questions. Once the questionnaire was developed, it was distributed to the participants at the final ceremony of the intensive program in order to collect the data from a large number of the participants at a time. The data showed significant evidence to support the hypothetical model. The results confirmed through structural equation modeling analysis are as follows: First, four external variables such as subjective norm, content reliability, interactivity, and self-regulation significantly affected perceived ease of use. Second, subjective norm, content reliability, self-regulation, perceived ease of use significantly affected perceived usefulness. Third, perceived usefulness and perceived ease of use significantly affected attitude toward MALL. Fourth, attitude toward MALL and perceived usefulness significantly affected behavioral intention to use MALL. These results implied that the integrated framework from TAM and MALL could be useful when adopting MALL environment to university students or adult English learners. Key constructs except interactivity showed significant relationships with one another and had direct and indirect impacts on MALL user’s acceptance behavior. Therefore, the constructs and validated metrics is valuable for language researchers and educators who are interested in MALL.

Keywords: blended MALL, learner factors/variables, mobile-assisted language learning, MALL, technology acceptance model, TAM, theoretical framework

Procedia PDF Downloads 216
899 Revolutionizing Healthcare Communication: The Transformative Role of Natural Language Processing and Artificial Intelligence

Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

Abstract:

Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

Procedia PDF Downloads 54
898 The Effect of Mindfulness Meditation on Pain, Sleep Quality, and Self-Esteem in Patients Receiving Hemodialysis in Jordan

Authors: Hossam N. Alhawatmeh, Areen I. Albustanji

Abstract:

Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.

Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness

Procedia PDF Downloads 68
897 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

Abstract:

Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

Procedia PDF Downloads 250
896 Secure Optimized Ingress Filtering in Future Internet Communication

Authors: Bander Alzahrani, Mohammed Alreshoodi

Abstract:

Information-centric networking (ICN) using architectures such as the Publish-Subscribe Internet Technology (PURSUIT) has been proposed as a new networking model that aims at replacing the current used end-centric networking model of the Internet. This emerged model focuses on what is being exchanged rather than which network entities are exchanging information, which gives the control plane functions such as routing and host location the ability to be specified according to the content items. The forwarding plane of the PURSUIT ICN architecture uses a simple and light mechanism based on Bloom filter technologies to forward the packets. Although this forwarding scheme solve many problems of the today’s Internet such as the growth of the routing table and the scalability issues, it is vulnerable to brute force attacks which are starting point to distributed- denial-of-service (DDoS) attacks. In this work, we design and analyze a novel source-routing and information delivery technique that keeps the simplicity of using Bloom filter-based forwarding while being able to deter different attacks such as denial of service attacks at the ingress of the network. To achieve this, special forwarding nodes called Edge-FW are directly attached to end user nodes and used to perform a security test for malicious injected random packets at the ingress of the path to prevent any possible attack brute force attacks at early stage. In this technique, a core entity of the PURSUIT ICN architecture called topology manager, that is responsible for finding shortest path and creating a forwarding identifiers (FId), uses a cryptographically secure hash function to create a 64-bit hash, h, over the formed FId for authentication purpose to be included in the packet. Our proposal restricts the attacker from injecting packets carrying random FIds with a high amount of filling factor ρ, by optimizing and reducing the maximum allowed filling factor ρm in the network. We optimize the FId to the minimum possible filling factor where ρ ≤ ρm, while it supports longer delivery trees, so the network scalability is not affected by the chosen ρm. With this scheme, the filling factor of any legitimate FId never exceeds the ρm while the filling factor of illegitimate FIds cannot exceed the chosen small value of ρm. Therefore, injecting a packet containing an FId with a large value of filling factor, to achieve higher attack probability, is not possible anymore. The preliminary analysis of this proposal indicates that with the designed scheme, the forwarding function can detect and prevent malicious activities such DDoS attacks at early stage and with very high probability.

Keywords: forwarding identifier, filling factor, information centric network, topology manager

Procedia PDF Downloads 134
895 The Gut Microbiome in Cirrhosis and Hepatocellular Carcinoma: Characterization of Disease-Related Microbial Signature and the Possible Impact of Life Style and Nutrition

Authors: Lena Lapidot, Amir Amnon, Rita Nosenko, Veitsman Ella, Cohen-Ezra Oranit, Davidov Yana, Segev Shlomo, Koren Omry, Safran Michal, Ben-Ari Ziv

Abstract:

Introduction: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer related mortality worldwide. Liver Cirrhosis is the main predisposing risk factor for the development of HCC. The factor(s) influencing disease progression from Cirrhosis to HCC remain unknown. Gut microbiota has recently emerged as a major player in different liver diseases, however its association with HCC is still a mystery. Moreover, there might be an important association between the gut microbiota, nutrition, life style and the progression of Cirrhosis and HCC. The aim of our study was to characterize the gut microbial signature in association with life style and nutrition of patients with Cirrhosis, HCC-Cirrhosis and healthy controls. Design: Stool samples were collected from 95 individuals (30 patients with HCC, 38 patients with Cirrhosis and 27 age, gender and BMI-matched healthy volunteers). All participants answered lifestyle and Food Frequency Questionnaires. 16S rRNA sequencing of fecal DNA was performed (MiSeq Illumina). Results: There was a significant decrease in alpha diversity in patients with Cirrhosis (qvalue=0.033) and in patients with HCC-Cirrhosis (qvalue=0.032) compared to healthy controls. The microbiota of patients with HCC-cirrhosis compared to patients with Cirrhosis, was characterized by a significant overrepresentation of Clostridium (pvalue=0.024) and CF231 (pvalue=0.010) and lower expression of Alphaproteobacteria (pvalue=0.039) and Verrucomicrobia (pvalue=0.036) in several taxonomic levels: Verrucomicrobiae, Verrucomicrobiales, Verrucomicrobiaceae and the genus Akkermansia (pvalue=0.039). Furthermore, we performed an analysis of predicted metabolic pathways (Kegg level 2) that resulted in a significant decrease in the diversity of metabolic pathways in patients with HCC-Cirrhosis (qvalue=0.015) compared to controls, one of which was amino acid metabolism. Furthermore, investigating the life style and nutrition habits of patients with HCC-Cirrhosis, we found significant correlations between intake of artificial sweeteners and Verrucomicrobia (qvalue=0.12), High sugar intake and Synergistetes (qvalue=0.021) and High BMI and the pathogen Campylobacter (qvalue=0.066). Furthermore, overweight in patients with HCC-Cirrhosis modified bacterial diversity (qvalue=0.023) and composition (qvalue=0.033). Conclusions: To the best of the our knowledge, we present the first report of the gut microbial composition in patients with HCC-Cirrhosis, compared with Cirrhotic patients and healthy controls. We have demonstrated in our study that there are significant differences in the gut microbiome of patients with HCC-cirrhosis compared to Cirrhotic patients and healthy controls. Our findings are even more pronounced because the significantly increased bacteria Clostridium and CF231 in HCC-Cirrhosis weren't influenced by diet and lifestyle, implying this change is due to the development of HCC. Further studies are needed to confirm these findings and assess causality.

Keywords: Cirrhosis, Hepatocellular carcinoma, life style, liver disease, microbiome, nutrition

Procedia PDF Downloads 103
894 Development of an Automatic Computational Machine Learning Pipeline to Process Confocal Fluorescence Images for Virtual Cell Generation

Authors: Miguel Contreras, David Long, Will Bachman

Abstract:

Background: Microscopy plays a central role in cell and developmental biology. In particular, fluorescence microscopy can be used to visualize specific cellular components and subsequently quantify their morphology through development of virtual-cell models for study of effects of mechanical forces on cells. However, there are challenges with these imaging experiments, which can make it difficult to quantify cell morphology: inconsistent results, time-consuming and potentially costly protocols, and limitation on number of labels due to spectral overlap. To address these challenges, the objective of this project is to develop an automatic computational machine learning pipeline to predict cellular components morphology for virtual-cell generation based on fluorescence cell membrane confocal z-stacks. Methods: Registered confocal z-stacks of nuclei and cell membrane of endothelial cells, consisting of 20 images each, were obtained from fluorescence confocal microscopy and normalized through software pipeline for each image to have a mean pixel intensity value of 0.5. An open source machine learning algorithm, originally developed to predict fluorescence labels on unlabeled transmitted light microscopy cell images, was trained using this set of normalized z-stacks on a single CPU machine. Through transfer learning, the algorithm used knowledge acquired from its previous training sessions to learn the new task. Once trained, the algorithm was used to predict morphology of nuclei using normalized cell membrane fluorescence images as input. Predictions were compared to the ground truth fluorescence nuclei images. Results: After one week of training, using one cell membrane z-stack (20 images) and corresponding nuclei label, results showed qualitatively good predictions on training set. The algorithm was able to accurately predict nuclei locations as well as shape when fed only fluorescence membrane images. Similar training sessions with improved membrane image quality, including clear lining and shape of the membrane, clearly showing the boundaries of each cell, proportionally improved nuclei predictions, reducing errors relative to ground truth. Discussion: These results show the potential of pre-trained machine learning algorithms to predict cell morphology using relatively small amounts of data and training time, eliminating the need of using multiple labels in immunofluorescence experiments. With further training, the algorithm is expected to predict different labels (e.g., focal-adhesion sites, cytoskeleton), which can be added to the automatic machine learning pipeline for direct input into Principal Component Analysis (PCA) for generation of virtual-cell mechanical models.

Keywords: cell morphology prediction, computational machine learning, fluorescence microscopy, virtual-cell models

Procedia PDF Downloads 185
893 Convective Boiling of CO₂/R744 in Macro and Micro-Channels

Authors: Adonis Menezes, J. C. Passos

Abstract:

The current panorama of technology in heat transfer and the scarcity of information about the convective boiling of CO₂ and hydrocarbon in small diameter channels motivated the development of this work. Among non-halogenated refrigerants, CO₂/ R744 has distinct thermodynamic properties compared to other fluids. The R744 presents significant differences in operating pressures and temperatures, operating at higher values compared to other refrigerants, and this represents a challenge for the design of new evaporators, as the original systems must normally be resized to meet the specific characteristics of the R744, which creates the need for a new design and optimization criteria. To carry out the convective boiling tests of CO₂, an experimental apparatus capable of storing (m= 10kg) of saturated CO₂ at (T = -30 ° C) in an accumulator tank was used, later this fluid was pumped using a positive displacement pump with three pistons, and the outlet pressure was controlled and could reach up to (P = 110bar). This high-pressure saturated fluid passed through a Coriolis type flow meter, and the mass velocities varied between (G = 20 kg/m².s) up to (G = 1000 kg/m².s). After that, the fluid was sent to the first test section of circular cross-section in diameter (D = 4.57mm), where the inlet and outlet temperatures and pressures, were controlled and the heating was promoted by the Joule effect using a source of direct current with a maximum heat flow of (q = 100 kW/m²). The second test section used a cross-section with multi-channels (seven parallel channels) with a square cross-section of (D = 2mm) each; this second test section has also control of temperature and pressure at the inlet and outlet as well as for heating a direct current source was used, with a maximum heat flow of (q = 20 kW/m²). The fluid in a biphasic situation was directed to a parallel plate heat exchanger so that it returns to the liquid state, thus being able to return to the accumulator tank, continuing the cycle. The multi-channel test section has a viewing section; a high-speed CMOS camera was used for image acquisition, where it was possible to view the flow patterns. The experiments carried out and presented in this report were conducted in a rigorous manner, enabling the development of a database on the convective boiling of the R744 in macro and micro channels. The analysis prioritized the processes from the beginning of the convective boiling until the drying of the wall in a subcritical regime. The R744 resurfaces as an excellent alternative to chlorofluorocarbon refrigerants due to its negligible ODP (Ozone Depletion Potential) and GWP (Global Warming Potential) rates, among other advantages. The results found in the experimental tests were very promising for the use of CO₂ in micro-channels in convective boiling and served as a basis for determining the flow pattern map and correlation for determining the heat transfer coefficient in the convective boiling of CO₂.

Keywords: convective boiling, CO₂/R744, macro-channels, micro-channels

Procedia PDF Downloads 126
892 Experimental Investigation on Tensile Durability of Glass Fiber Reinforced Polymer (GFRP) Rebar Embedded in High Performance Concrete

Authors: Yuan Yue, Wen-Wei Wang

Abstract:

The objective of this research is to comprehensively evaluate the impact of alkaline environments on the durability of Glass Fiber Reinforced Polymer (GFRP) reinforcements in concrete structures and further explore their potential value within the construction industry. Specifically, we investigate the effects of two widely used high-performance concrete (HPC) materials on the durability of GFRP bars when embedded within them under varying temperature conditions. A total of 279 GFRP bar specimens were manufactured for microcosmic and mechanical performance tests. Among them, 270 specimens were used to test the residual tensile strength after 120 days of immersion, while 9 specimens were utilized for microscopic testing to analyze degradation damage. SEM techniques were employed to examine the microstructure of GFRP and cover concrete. Unidirectional tensile strength experiments were conducted to determine the remaining tensile strength after corrosion. The experimental variables consisted of four types of concrete (engineering cementitious composite (ECC), ultra-high-performance concrete (UHPC), and two types of ordinary concrete with different compressive strengths) as well as three acceleration temperatures (20, 40, and 60℃). The experimental results demonstrate that high-performance concrete (HPC) offers superior protection for GFRP bars compared to ordinary concrete. Two types of HPC enhance durability through different mechanisms: one by reducing the pH of the concrete pore fluid and the other by decreasing permeability. For instance, ECC improves embedded GFRP's durability by lowering the pH of the pore fluid. After 120 days of immersion at 60°C under accelerated conditions, ECC (pH=11.5) retained 68.99% of its strength, while PC1 (pH=13.5) retained 54.88%. On the other hand, UHPC enhances FRP steel's durability by increasing porosity and compactness in its protective layer to reinforce FRP reinforcement's longevity. Due to fillers present in UHPC, it typically exhibits lower porosity, higher densities, and greater resistance to permeation compared to PC2 with similar pore fluid pH levels, resulting in varying degrees of durability for GFRP bars embedded in UHPC and PC2 after 120 days of immersion at a temperature of 60°C - with residual strengths being 66.32% and 60.89%, respectively. Furthermore, SEM analysis revealed no noticeable evidence indicating fiber deterioration in any examined specimens, thus suggesting that uneven stress distribution resulting from interface segregation and matrix damage emerges as a primary causative factor for tensile strength reduction in GFRP rather than fiber corrosion. Moreover, long-term prediction models were utilized to calculate residual strength values over time for reinforcement embedded in HPC under high temperature and high humidity conditions - demonstrating that approximately 75% of its initial strength was retained by reinforcement embedded in HPC after 100 years of service.

Keywords: GFRP bars, HPC, degeneration, durability, residual tensile strength.

Procedia PDF Downloads 36
891 Light, Restorativeness and Performance in the Workplace: A Pilot Study

Authors: D. Scarpanti, M. Brondino, M. Pasini

Abstract:

Background: the present study explores the role of light and restorativeness on work. According with the Attention Restoration Theory (ART) and a Model of Work Environment, the main idea is that some features of environment, i.e., lighting, influences the direct attention, and so, the performance. Restorativeness refers to the presence/absence level of all the characteristics of physical environment that help to regenerate direct attention. Specifically, lighting can affect level of fascination and attention in one hand; and in other hand promotes several biological functions via pineal gland. Different reviews on this topic show controversial results. In order to bring light on this topic, the hypotheses of this study are that lighting can affect the construct of restorativeness and, in the second time, the restorativeness can affect the performance. Method: the participants are 30 workers of a mechatronic company in the North Italy. Every subject answered to a questionnaire valuing their subjective perceptions of environment in a different way: some objective features of environment, like lighting, temperature and air quality; some subjective perceptions of this environment; finally, the participants answered about their perceived performance. The main attention is on the features of light and his components: visual comfort, general preferences and pleasantness; and the dimensions of the construct of restorativeness; fascination, coherence and being away. The construct of performance per se is conceptualized in three level: individual, team membership and organizational membership; and in three different components: proficiency, adaptability, and proactivity, for a total of 9 subcomponents. Findings: path analysis showed that some characteristics of lighting respectively affected the dimension of fascination; and, as expected, the dimension of fascination affected work performance. Conclusions: The present study is a first pilot step of a wide research. These first results can be summarized with the statement that lighting and restorativeness contribute to explain work performance variability: in details perceptions of visual comfort, satisfaction and pleasantness, and fascination respectively. Results related to fascination are particularly interesting because fascination is conceptualized as the opposite of the construct of direct attention. The main idea is, in order to regenerate attentional capacity, it’s necessary to provide a lacking of attention (fascination). The sample size did not permit to test simultaneously the role of the perceived characteristics of light to see how they differently contribute to predict fascination of the work environment. However, the results highlighted the important role that light could have in predicting restorativeness dimensions and probably with a larger sample we could find larger effects also on work performance. Furthermore, longitudinal data will contribute to better analyze the causal model along time. Applicative implications: the present pilot study highlights the relevant role of lighting and perceived restorativeness in the work environment and the importance to focus attention on light features and the restorative characteristics in the design of work environments.

Keywords: lighting, performance, restorativeness, workplace

Procedia PDF Downloads 137
890 Optimizing the Pair Carbon Xerogels-Electrolyte for High Performance Supercapacitors

Authors: Boriana Karamanova, Svetlana Veleva, Luybomir Soserov, Ana Arenillas, Francesco Lufrano, Antonia Stoyanova

Abstract:

Supercapacitors have received a lot of research attention and are promising energy storage devices due to their high power and long cycle life. In order to developed an advanced device with significant capacity for storing charge and cheap carbon materials, efforts must focus not only on improving synthesis by controlling the morphology and pore size but also on improving electrode-electrolyte compatibility of the resulting systems. The present study examines the relationship between the surface chemistry of two activated carbon xerogels, the electrolyte type, and the electrochemical properties of supercapacitors. Activated carbon xerogels were prepared by varying the initial pH of the resorcinol-formaldehyde aqueous solution. The materials produced are physicochemical characterized by DTA/TGA, porous characterization, and SEM analysis. The carbon xerogel based electrodes were prepared by spreading over glass plate a slurry containing the carbon gel, graphite, and poly vinylidene difluoride (PVDF) binder. The layer formed was dried consecutively at different temperatures and then detached by water. After, the layer was dried again to improve its mechanical stability. The developed electrode materials and the Aquivion® E87-05S membrane (Solvay Specialty Polymers), socked in Na2SO4 as a polymer electrolyte, were used to assembly the solid-state supercapacitor. Symmetric supercapacitor cells composed by same electrodes and 1 M KOH electrolytes are also assembled and tested for comparison. The supercapacitor performances are verified by different electrochemical methods - cyclic voltammetry, galvanostatic charge/discharge measurements, electrochemical impedance spectroscopy, and long-term durability tests in neutral and alkaline electrolytes. Specific capacitances, energy, and power density, energy efficiencies, and durability were compared into studied supercapacitors. Ex-situ physicochemical analyses on the synthesized materials have also been performed, which provide information about chemical and structural changes in the electrode morphology during charge / discharge durability tests. They are discussed on the basis of electrode-electrolyte interaction. The obtained correlations could be of significance in order to design sustainable solid-state supercapacitors with high power and energy density. Acknowledgement: This research is funded by the Ministry of Education and Science of Bulgaria under the National Program "European Scientific Networks" (Agreement D01-286 / 07.10.2020, D01-78/30.03.2021). Authors gratefully acknowledge.

Keywords: carbon xerogel, electrochemical tests, neutral and alkaline electrolytes, supercapacitors

Procedia PDF Downloads 118
889 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

Abstract:

Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

Procedia PDF Downloads 351
888 Offshore Wind Assessment and Analysis for South Western Mediterranean Sea

Authors: Abdallah Touaibia, Nachida Kasbadji Merzouk, Mustapha Merzouk, Ryma Belarbi

Abstract:

accuracy assessment and a better understand of the wind resource distribution are the most important tasks for decision making before installing wind energy operating systems in a given region, there where our interest come to the Algerian coastline and its Mediterranean sea area. Despite its large coastline overlooking the border of Mediterranean Sea, there is still no strategy encouraging the development of offshore wind farms in Algerian waters. The present work aims to estimate the offshore wind fields for the Algerian Mediterranean Sea based on wind data measurements ranging from 1995 to 2018 provided of 24 years of measurement by seven observation stations focusing on three coastline cities in Algeria under a different measurement time step recorded from 30 min, 60 min, and 180 min variate from one to each other, two stations in Spain, two other ones in Italy and three in the coast of Algeria from the east Annaba, at the center Algiers, and to Oran taken place at the west of it. The idea behind consists to have multiple measurement points that helping to characterize this area in terms of wind potential by the use of interpolation method of their average wind speed values between these available data to achieve the approximate values of others locations where aren’t any available measurement because of the difficulties against the implementation of masts within the deep depth water. This study is organized as follow: first, a brief description of the studied area and its climatic characteristics were done. After that, the statistical properties of the recorded data were checked by evaluating wind histograms, direction roses, and average speeds using MatLab programs. Finally, ArcGIS and MapInfo soft-wares were used to establish offshore wind maps for better understanding the wind resource distribution, as well as to identify windy sites for wind farm installation and power management. The study pointed out that Cap Carbonara is the windiest site with an average wind speed of 7.26 m/s at 10 m, inducing a power density of 902 W/m², then the site of Cap Caccia with 4.88 m/s inducing a power density of 282 W/m². The average wind speed of 4.83 m/s is occurred for the site of Oran, inducing a power density of 230 W/m². The results indicated also that the dominant wind direction where the frequencies are highest for the site of Cap Carbonara is the West with 34%, an average wind speed of 9.49 m/s, and a power density of 1722 W/m². Then comes the site of Cap Caccia, where the prevailing wind direction is the North-west, about 20% and 5.82 m/s occurring a power density of 452 W/m². The site of Oran comes in third place with the North dominant direction with 32% inducing an average wind speed of 4.59 m/s and power density of 189 W/m². It also shown that the proposed method is either crucial in understanding wind resource distribution for revealing windy sites over a large area and more effective for wind turbines micro-siting.

Keywords: wind ressources, mediterranean sea, offshore, arcGIS, mapInfo, wind maps, wind farms

Procedia PDF Downloads 130
887 Efficacy and Safety of Combination Therapy in Androgenetic Alopecia: Randomized Uncontrolled Evaluator, Blind Study

Authors: Shivani Dhande, Sanjiv Choudhary, Adarshlata Singh

Abstract:

Introduction: Early age of onset of baldness has marked psychological impact on personality. Combination therapies have better efficacy than monotherapy in androgenetic alopecia. Although medical, surgical treatment and cosmetic aids are available for treatment of pattern baldness, medical is first preferred the line of treatment. Although only 5% topical minoxidil is USFDA approved, 10% is available in India since 2007. Efficacy of tablet finasteride is well established in male pattern baldness. 5% topical minoxidil is effective and safe in female pattern baldness. There is a role of saw palmetto in regrowth of scalp hair. With this background research was undertaken to study efficacy and safety of topical minoxidil 10% + tab. Finesteride (1mg) + dermaroller in male pattern baldness and topical minoxidil 5% + cap. Saw palmetto (320 mg) + dermaroller in female pattern baldness. Methods and Materials: It was a randomized uncontrolled evaluator blind study consisting of total 21 patients, 15 of male pattern baldness and 6 of female pattern baldness within 20-35 yrs of age were enrolled. Male patients had Hamilton grade 2-4 MPB and females had Ludwig grade 2 FPB. Male patients were treated with Tab Finesteride 1mg once daily + 10% topical Minoxidil 1ml twice daily for 6 months. Female patients were treated with Cap. Saw palmetto 320 mg once daily + 5% topical Minoxidil twice daily for 6 months. In both male & female patients dermaroller therapy was used once in 10 days for 4 sittings followed by once in 15 days for next 5 months. Blood pressure and possible side effects were monitored in every follow up visits. Pre and post treatment photographs were taken. Assessment of hair growth was done at baseline and at the end of 6 months. Patients satisfactory grading scale and Physician assessment of hair growth scale were used to assessing the results. Trichoscan was done for assessment of hair-shaft diameter and density. Pre and post treatment photographs and Trichoscan hair growth analysis (by diameter and density) was done by physician (dermatologist) not directly involved in this study (evaluator blind). Result: This combination therapy showed moderate response in female pattern alopecia and good to excellent results in male pattern alopecia at the end of 6 months. During therapy none of the patients showed side effects like hypotension, headache and loss of libido, hirsuitism. Mild irritation due to crystal deposition was noted by 3 patients. Conclusion: Effective and early treatment using combination therapy with higher percent of Minoxidil for rapid hair growth is necessary in initial period since it will boost up the self-confidence in patients leading to better treatment compliance. Subsequent maintenance of hair growth can be done with lower concentration. No significant side effects with treatment are observed in both group of patients.

Keywords: androgenetic alopecia, dermaroller, finasteride, minoxidil, saw palmetto

Procedia PDF Downloads 231
886 Adaptation and Validation of Voice Handicap Index in Telugu Language

Authors: B. S. Premalatha, Kausalya Sahani

Abstract:

Background: Voice is multidimensional which convey emotion, feelings, and communication. Voice disorders have an adverse effect on the physical, emotional and functional domains of an individual. Self-rating by clients about their voice problem helps the clinicians to plan intervention strategies. Voice handicap index is one such self-rating scale contains 30 questions that quantify the functional, physical and emotional impacts of a voice disorder on a patient’s quality of life. Each subsection has 10 questions. Though adapted and validated versions of VHI are available in other Indian languages but not in Telugu, which is a Dravidian language native to India. It is mainly spoken in Andhra Pradesh and neighbouring states in southern India. Objectives: To adapt and validate the English version of Voice Handicap Index (VHI) into Telugu language and evaluate its internal consistency and clinical validate in Telugu speaking population. Materials: The study carried out in three stages. First stage was a forward translation of English version of VHI, was given to ten experts, who were well proficient in writing and reading Telugu and five speech-language pathologists to translate into Telugu. Second Stage was backward translation where translated version of Telugu was given to a different group of ten experts (who were well proficient in writing and reading Telugu) and five speech-language pathologists who were native Telugu speakers and had good proficiency in Telugu and English. The third stage was an administration of translated version on Telugu to the targeted population. Totally 40 clinical subjects and 40 normal controls served as participants, and each group had 26 males and 14 females’ age range of 20 to 60 years. Clinical group comprised of individuals with laryngectomee with the Tracheoesophageal puncture (n=18), laryngitis (n=11), vocal nodules (n=7) and vocal fold palsy (n=4). Participants were asked to mark of their each experience on a 5 point equal appearing scale (0=never, 1=almost never, 2=sometimes, 3=almost always, 4=always) with a maximum total score of 120. Results: Statistical analysis was made by using SPSS software (22.0.0 Version). Mean, standard deviation and percentage (%) were calculated all the participants for both the groups. Internal consistency of VHI in Telugu was found to be excellent with the consistency scores for all the domains such as physical, emotional and functional are 0.742, 0.934and 0.938. The validity of scores showed a significant difference between clinical population and control group for domains like physical, emotional and functional and total scores. P value found to be less than 0.001( < 0.001). Negative correlation found in age and gender among self-domains such as physical, emotional and functional total scores in dysphonic and control group. Conclusion: The present study indicated that VHI in Telugu is able to discriminate participants having voice pathology from normal populations, which make this as a valid tool to collect information about their voice from the participants.

Keywords: adaptation, Telugu Version, translation, Voice Handicap Index (VHI)

Procedia PDF Downloads 263
885 Metamorphosis of Caste: An Examination of the Transformation of Caste from a Material to Ideological Phenomenon in Sri Lanka

Authors: Pradeep Peiris, Hasini Lecamwasam

Abstract:

The fluid, ambiguous, and often elusive existence of caste among the Sinhalese in Sri Lanka has inspired many scholarly endeavours. Originally, Sinhalese caste was organized according to the occupational functions assigned to various groups in society. Hence cultivators came to be known as Goyigama, washers Dobi, drummers Berava, smiths Navandanna and so on. During pre-colonial times the specialized services of various groups were deployed to build water reservoirs, cultivate the land, and/or sustain the Buddhist order by material means. However, as to how and why caste prevails today in Sinhalese society when labour is in ideal terms free to move where it wants, or in other words, occupation is no longer strictly determined or restricted by birth, is a question worth exploring. Hence this paper explores how, and perhaps more interestingly why, when the nexus between traditional occupations and caste status is fast disappearing, caste itself has managed to survive and continues to be salient in politics in Sri Lanka. In answer to this larger question, the paper looks at caste from three perspectives: 1) Buddhism, whose ethical project provides a justification of social stratifications that transcends economic bases 2) Capitalism that has reactivated and reproduced archaic relations in a process of 'accumulation by subordination', not only by reinforcing the marginality of peripheral caste groups, but also by exploiting caste divisions to hinder any realization of class interests and 3) Democracy whose supposed equalizing effect expected through its ‘one man–one vote’ approach has been subverted precisely by itself, whereby the aggregate ultimately comes down to how many such votes each ‘group’ in society has. This study draws from field work carried out in Dedigama (in the District of Kegalle, Central Province) and Kelaniya (in the District of Colombo, Western Province) in Sri Lanka over three years. The choice of field locations was encouraged by the need to capture rural and urban dynamics related to caste since caste is more apparently manifest in rural areas whose material conditions partially warrant its prevalence, whereas in urban areas it exists mostly in the ideological terrain. In building its analysis, the study has employed a combination of objectivist and subjectivist approaches to capture the material and ideological existence of caste and caste politics in Sinhalese society. Therefore, methods such as in-depth interviews, observation, and collection of demographical and interpretive data from secondary sources were used for this study. The paper has been situated in a critical theoretical framework of social inquiry in an attempt to question dominant assumptions regarding such meta-labels as ‘Capitalism’ and ‘Democracy’, and also the supposed emancipatory function of religion (focusing on Buddhism).

Keywords: Buddhism, capitalism, caste, democracy, Sri Lanka

Procedia PDF Downloads 121
884 Analysis of Resistance and Virulence Genes of Gram-Positive Bacteria Detected in Calf Colostrums

Authors: C. Miranda, S. Cunha, R. Soares, M. Maia, G. Igrejas, F. Silva, P. Poeta

Abstract:

The worldwide inappropriate use of antibiotics has increased the emergence of antimicrobial-resistant microorganisms isolated from animals, humans, food, and the environment. To combat this complex and multifaceted problem is essential to know the prevalence in livestock animals and possible ways of transmission among animals and between these and humans. Enterococci species, in particular E. faecalis and E. faecium, are the most common nosocomial bacteria, causing infections in animals and humans. Thus, the aim of this study was to characterize resistance and virulence factors genes among two enterococci species isolated from calf colostrums in Portuguese dairy farms. The 55 enterococci isolates (44 E. faecalis and 11 E. faecium) were tested for the presence of the resistance genes for the following antibiotics: erythromicyn (ermA, ermB, and ermC), tetracycline (tetL, tetM, tetK, and tetO), quinupristin/dalfopristin (vatD and vatE) and vancomycin (vanB). Of which, 25 isolates (15 E. faecalis and 10 E. faecium) were tested until now for 8 virulence factors genes (esp, ace, gelE, agg, cpd, cylA, cylB, and cylLL). The resistance and virulence genes were performed by PCR, using specific primers and conditions. Negative and positive controls were used in all PCR assays. All enterococci isolates showed resistance to erythromicyn and tetracycline through the presence of the genes: ermB (n=29, 53%), ermC (n=10, 18%), tetL (n=49, 89%), tetM (n=39, 71%) and tetK (n=33, 60%). Only two (4%) E. faecalis isolates showed the presence of tetO gene. No resistance genes for vancomycin were found. The virulence genes detected in both species were cpd (n=17, 68%), agg (n=16, 64%), ace (n=15, 60%), esp (n=13, 52%), gelE (n=13, 52%) and cylLL (n=8, 32%). In general, each isolate showed at least three virulence genes. In three E. faecalis isolates was not found virulence genes and only E. faecalis isolates showed virulence genes for cylA (n=4, 16%) and cylB (n=6, 24%). In conclusion, these colostrum samples that were consumed by calves demonstrated the presence of antibiotic-resistant enterococci harbored virulence genes. This genotypic characterization is crucial to control the antibiotic-resistant bacteria through the implementation of restricts measures safeguarding public health. Acknowledgements: This work was funded by the R&D Project CAREBIO2 (Comparative assessment of antimicrobial resistance in environmental biofilms through proteomics - towards innovative theragnostic biomarkers), with reference NORTE-01-0145-FEDER-030101 and PTDC/SAU-INF/30101/2017, financed by the European Regional Development Fund (ERDF) through the Northern Regional Operational Program (NORTE 2020) and the Foundation for Science and Technology (FCT). This work was supported by the Associate Laboratory for Green Chemistry - LAQV which is financed by national funds from FCT/MCTES (UIDB/50006/2020 and UIDP/50006/2020).

Keywords: antimicrobial resistance, calf, colostrums, enterococci

Procedia PDF Downloads 178
883 Dietary Flaxseed Decreases Central Blood Pressure and the Concentrations of Plasma Oxylipins Associated with Hypertension in Patients with Peripheral Arterial Disease

Authors: Stephanie PB Caligiuri, Harold M Aukema, Delfin Rodriguez-Leyva, Amir Ravandi, Randy Guzman, Grant N. Pierce

Abstract:

Background: Hypertension leads to cardiac and cerebral events and therefore is the leading risk factor attributed to death in the world. Oxylipins may be mediators in these events as they can regulate vascular tone and inflammation. Oxylipins are derived from fatty acids. Dietary flaxseed is rich in the n3 fatty acid, alpha-linolenic acid, and, therefore, may have the ability to change the substrate profile of oxylipins. As a result, this could alter blood pressure. Methods: A randomized, double-blinded, controlled clinical trial, the Flax-PAD trial, was used to assess the impact of dietary flaxseed on blood pressure (BP), and to also assess the relationship of plasma oxylipins to BP in 81 patients with peripheral arterial disease (PAD). Patients with PAD were chosen for the clinical trial as they are at an increased risk for hypertension and cardiac and cerebral events. Thirty grams of ground flaxseed were added to food products to consume on a daily basis for 6 months. The control food products contained wheat germ, wheat bran, and mixed dietary oils instead of flaxseed. Central BP, which is more significantly associated to organ damage, cardiac, and cerebral events versus brachial BP, was measured by pulse wave analysis at baseline and 6 months. A plasma profile of 43 oxylipins was generated using solid phase extraction, HPLC-MS/MS, and stable isotope dilution quantitation. Results: At baseline, the central BP (systolic/diastolic) in the placebo and flaxseed group were, 131/73 ± 2.5/1.4 mmHg and 128/71 ± 2.6/1.4 mmHg, respectively. After 6 months of intervention, the flaxseed group exhibited a decrease in blood pressure of 4.0/1.0 mmHg. The 6 month central BP in the placebo and flaxseed groups were, 132/74 ± 2.9/1.8 mmHg and 124/70 ± 2.6/1.6 mmHg (P<0.05). Correlation and logistic regression analyses between central blood pressure and oxylipins were performed. Significant associations were observed between central blood pressure and 17 oxylipins, primarily produced from arachidonic acid. Every 1 nM increase in 16-hydroxyeicosatetraenoic acid (HETE) increased the odds of having high central systolic BP by 15-fold, of having high central diastolic BP by 6-fold and of having high central mean arterial pressure by 15-fold. In addition, every 1 nM increase in 5,6-dihydroxyeicosatrienoic acid (DHET) and 11,12-DHET increased the odds of having high central mean arterial pressure by 45- and 18-fold, respectively. Flaxseed induced a significant decrease in these as well as 4 other vasoconstrictive oxylipins. Conclusion: Dietary flaxseed significantly lowered blood pressure in patients with PAD and hypertension. Plasma oxylipins were strongly associated with central blood pressure and may have mediated the flaxseed-induced decrease in blood pressure.

Keywords: hypertension, flaxseed, oxylipins, peripheral arterial disease

Procedia PDF Downloads 451
882 An Overview on Micro Irrigation-Accelerating Growth of Indian Agriculture

Authors: Rohit Lall

Abstract:

The adoption of Micro Irrigation (MI) technologies in India has helped in achieving higher cropping and irrigation intensity with significant savings on resource savings such as labour, fertilizer and improved crop yields. These technologies have received considerable attention from policymakers, growers and researchers over the years for its perceived ability to contribute towards agricultural productivity and economic growth with the well-being of the growers of the country. Keeping the pace with untapped theoretical potential to cover government had launched flagship programs/centre sector schemes with earmarked budget to capture the potential under these waters saving techniques envisaged under these technologies by way of providing financial assistance to the beneficiaries for adopting these technologies. Micro Irrigation technologies have been in the special attention of the policymakers over the years. India being an agrarian economy having engaged 75% of the population directly or indirectly having skilled, semi-skilled and entrepreneurs in the sector with focused attention and financial allocations from the government under these technologies in covering the untapped potential under Pradhan Mantri Krishi Sinchayee Yojana (PMKSY) 'Per Drop More Crop component.' During the year 2004, a Taskforce on Micro Irrigation was constituted to estimate the potential of these technologies in India which was estimated 69.5 million hectares by the Task Force Report on MI however only 10.49 million hectares have been achieved so far. Technology collaborations by leading manufacturing companies in overseas have proved to a stepping stone in technology advancement and product up gradation with increased efficiencies. Joint ventures by the leading MI companies have added huge business volumes which have not only accelerated the momentum of achieving the desired goal but in terms of area coverage but had also generated opportunities for the polymer manufacturers in the country. To provide products matching the global standards Bureau of Indian Standards have constituted a sectional technical committee under the Food and Agriculture Department (FAD)-17 to formulated/devise and revise standards pertaining to MI technologies. The research lobby has also contributed at large by developing in-situ analysis proving MI technologies a boon for farming community of the country with resource conservation of which water is of paramount importance. Thus, Micro Irrigation technologies have proved to be the key tool for feeding the grueling demand of food basket of the growing population besides maintaining soil health and have been contributing towards doubling of farmers’ income.

Keywords: task force on MI, standards, per drop more crop, doubling farmers’ income

Procedia PDF Downloads 107
881 A Multi-Perspective, Qualitative Study into Quality of Life for Elderly People Living at Home and the Challenges for Professional Services in the Netherlands

Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar

Abstract:

In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.

Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning

Procedia PDF Downloads 113
880 A Public Health Perspective on Deradicalisation: Re-Conceptualising Deradicalisation Approaches

Authors: Erin Lawlor

Abstract:

In 2008 Time magazine named terrorist rehabilitation as one of the best ideas of the year. The term deradicalisation has become synonymous with rehabilitation within security discourse. The allure for a “quick fix” when managing terrorist populations (particularly within prisons) has led to a focus on prescriptive programmes where there is a distinct lack of exploration into the drivers for a person to disengage or deradicalise from violence. It has been argued that to tackle a snowballing issue that interventions have moved too quickly for both theory development and methodological structure. This overly quick acceptance of a term that lacks rigorous testing, measuring, and monitoring means that there is distinct lack of evidence base for deradicalisation being a genuine process/phenomenon, leading to academics retrospectively attempting to design frameworks and interventions around a concept that is not truly understood. The UK Home Office has openly acknowledged the lack of empirical data on this subject. This lack of evidence has a direct impact on policy and intervention development. Extremism and deradicalisation are issues that affect public health outcomes on a global scale, to the point that terrorism has now been added to the list of causes of trauma, both in the direct form of being victim of an attack but also the indirect context of witnesses, children and ordinary citizens who live in daily fear. This study critiques current deradicalisation discourses to establish whether public health approaches offer opportunities for development. The research begins by exploring the theoretical constructs of both what deradicalisation, and public health issues are. Questioning: What does deradicalisation involve? Is there an evidential base on which deradicalisation theory has established itself? What theory are public health interventions devised from? What does success look like in both fields? From establishing this base, current deradicalisation practices will then be explored through examples of work already being carried out. Critiques can be broken into discussion points of: Language, the difficulties with conducting empirical studies and the issues around outcome measurements that deradicalisation interventions face. This study argues that a public health approach towards deradicalisation offers the opportunity to attempt to bring clarity to the definitions of radicalisation, identify what could be modified through intervention and offer insights into the evaluation of interventions. As opposed to simply focusing on an element of deradicalisation and analysing that in isolation, a public health approach allows for what the literature has pointed out is missing, a comprehensive analysis of current interventions and information on creating efficacy monitoring systems. Interventions, policies, guidance, and practices in both the UK and Australia will be compared and contrasted, due to the joint nature of this research between Sheffield Hallam University and La Trobe, Melbourne.

Keywords: radicalisation, deradicalisation, violent extremism, public health

Procedia PDF Downloads 54
879 Erasmus+ Program in Vocational Education: Effects of European International Mobility in Portuguese Vocational Schools

Authors: José Carlos Bronze, Carlinda Leite, Angélica Monteiro

Abstract:

The creation of the Erasmus Program in 1987 represented a milestone in promoting and funding international mobility in higher education in Europe. Its effects were so significant that they influenced the creation of the European Higher Education Area through the Bologna Process and ensured the program’s continuation and maintenance. Over the last decades, the escalating figures of participants and funds instigated significant scientific studies on the program's effects on higher education. More recently, in 2014, the program was renamed “Erasmus+” when it expanded into other fields of education, namely Vocational Education and Training (VET). Despite being now running in this field of education for a decade (2014-2024), its effects on VET remain less studied and less known, while the higher education field keeps attracting researchers’ attention. Given this gap, it becomes relevant to study the effects of E+ on VET, particularly in the priority domains of the Program: “Inclusion and Diversity,” “Participation in Democratic Life, Common Values and Civic Engagement,” “Environment and Fight Against Climate Change,” and “Digital Transformation.” This latter has been recently emphasized due to the COVID-19 pandemic that forced the so-called emergency remote teaching, leading schools to quickly transform and adapt to a new reality regardless of the preparedness levels of teachers and students. Together with the remaining E+ priorities, they directly relate to an emancipatory perspective of education sustained in soft skills such as critical thinking, intercultural awareness, autonomy, active citizenship, teamwork, and problem-solving, among others. Based on this situation, it is relevant to know the effects of E+ on the VET field, namely questioning how international mobility instigates digitalization processes and supports emancipatory queries therein. As an education field that more directly connects to hard skills and an instrumental approach oriented to the labor market’s needs, a study was conducted to determine the effects of international mobility on developing digital literacy and soft skills in the VET field. In methodological terms, the study used semi-structured interviews with teaching and non-teaching staff from three VET schools who are strongly active in the E+ Program. The interviewees were three headmasters, four mobility project managers, and eight teachers experienced in international mobility. The data was subjected to qualitative content analysis using the NVivo 14 application. The results show that E+ international mobility promotes and facilitates the use of digital technologies as a pedagogical resource at VET schools and enhances and generates students’ soft skills. In conclusion, E+ mobility in the VET field supports adopting the program’s priorities by increasing the teachers’ knowledge and use of digital resources and amplifying and generating participants’ soft skills.

Keywords: Erasmus international mobility, digital literacy, soft skills, vocational education and training

Procedia PDF Downloads 13
878 Young Adult Males’ Attitudes, Perceptions and Behaviours in Regards to Male Condoms in Cambodia: A Qualitative Study

Authors: Rebecca Johnson, Elizabeth Hoban

Abstract:

Condom use among young men in Cambodia has declined between 2005 and 2014 which has public health implications such as increased risks of sexually transmitted infections, including HIV, and unplanned pregnancies. Conversations about sexual and reproductive health issues, including condom use, are not socially sanctioned in Cambodian society leaving young adults with limited knowledge of, and poor access to sexual and reproductive health services. Additionally, men play a dominant role in decision making regarding condom use within sexual partnerships. This study sought to fill a gap in knowledge by exploring young adult males’ attitudes, perceptions and behaviours regarding condom use. In February and March 2018, twenty young adult males, aged 18 to 24 years, were recruited from urban, peri urban and rural areas in Cambodia. The young adult males participated in a face-to-face semi structured interview that used an interview guide and photo elicitation method. The interview explored participants’ knowledge of sexual and reproductive health issues and efficacy, sexual behaviours, and use of condoms. Inductive thematic analysis was conducted and the following major themes emerged: understanding of reproduction, understanding of sexually transmitted infections, knowledge about condoms, condom use, access to condoms, and sexual behaviour. Participants’ knowledge of condoms and specific reasons for their use varied; most participants understood that condoms provide protection from sexually transmitted infections and prevent pregnancy. Stigma associated with condom access was consistently referred to as a problem and the main reason cited by young men for not using condoms during sexual intercourse. The perceived importance of condom use altered with partner type and relationship status, dependent upon the need for protection from sexually transmitted infections or pregnancy. Condoms were used for infection control in the context of multiple relationships, or as a contraceptive method for unmarried and some married couples. The majority of young men engaged in premarital sexual intercourse, of those men the many used condoms. The inconsistent use of condoms by young men in Cambodia is of public health concern because of the increased risk of sexually transmitted infections (including HIV), and unplanned pregnancy. Public health action is required in order to minimize long term health issues for individuals and the community. Health education is required to increase knowledge of condom use, sexually transmitted infections and HIV, and reduce the stigma associated with this topic. Sustainable health promotion programs are needed to increase ease of access to condoms for young people. Public health policy in Cambodia needs to be reviewed to improve sexual and reproductive health outcomes for young adults.

Keywords: Cambodia, condom use, sexual and reproductive health, young adult males

Procedia PDF Downloads 114
877 Genetics of Pharmacokinetic Drug-Drug Interactions of Most Commonly Used Drug Combinations in the UK: Uncovering Unrecognised Associations

Authors: Mustafa Malki, Ewan R. Pearson

Abstract:

Tools utilized by health care practitioners to flag potential adverse drug reactions secondary to drug-drug interactions ignore individual genetic variation, which has the potential to markedly alter the severity of these interactions. To our best knowledge, there have been limited published studies on the impact of genetic variation on drug-drug interactions. Therefore, our aim in this project is the discovery of previously unrecognized, clinically important drug-drug-gene interactions (DDGIs) within the list of most commonly used drug combinations in the UK. The UKBB database was utilized to identify the top most frequently prescribed drug combinations in the UK with at least one route of interaction (over than 200 combinations were identified). We have recognised 37 common and unique interacting genes considering all of our drug combinations. Out of around 600 potential genetic variants found in these 37 genes, 100 variants have met the selection criteria (common variant with minor allele frequency ≥ 5%, independence, and has passed HWE test). The association between these variants and the use of each of our top drug combinations has been tested with a case-control analysis under the log-additive model. As the data is cross-sectional, drug intolerance has been identified from the genotype distribution as presented by the lower percentage of patients carrying the risky allele and on the drug combination compared to those free of these risk factors and vice versa with drug tolerance. In GoDARTs database, the same list of common drug combinations identified by the UKBB was utilized here with the same list of candidate genetic variants but with the addition of 14 new SNPs so that we have a total of 114 variants which have met the selection criteria in GoDARTs. From the list of the top 200 drug combinations, we have selected 28 combinations where the two drugs in each combination are known to be used chronically. For each of our 28 combinations, three drug response phenotypes have been identified (drug stop/switch, dose decrease, or dose increase of any of the two drugs during their interaction). The association between each of the three phenotypes belonging to each of our 28 drug combinations has been tested against our 114 candidate genetic variants. The results show replication of four findings between both databases : (1) Omeprazole +Amitriptyline +rs2246709 (A > G) variant in CYP3A4 gene (p-values and ORs with the UKBB and GoDARTs respectively = 0.048,0.037,0.92,and 0.52 (dose increase phenotype)) (2) Simvastatin + Ranitidine + rs9332197 (T > C) variant in CYP2C9 gene (0.024,0.032,0.81, and 5.75 (drug stop/switch phenotype)) (3) Atorvastatin + Doxazosin + rs9282564 (T > C) variant in ABCB1 gene (0.0015,0.0095,1.58,and 3.14 (drug stop/switch phenotype)) (4) Simvastatin + Nifedipine + rs2257401 (C > G) variant in CYP3A7 gene (0.025,0.019,0.77,and 0.30 (drug stop/switch phenotype)). In addition, some other non-replicated, but interesting, significant findings were detected. Our work also provides a great source of information for researchers interested in DD, DG, or DDG interactions studies as it has highlighted the top common drug combinations in the UK with recognizing 114 significant genetic variants related to drugs' pharmacokinetic.

Keywords: adverse drug reactions, common drug combinations, drug-drug-gene interactions, pharmacogenomics

Procedia PDF Downloads 144
876 Restructurasation of the Concept of Empire in the Social Consciousness of Modern Americans

Authors: Maxim Kravchenko

Abstract:

The paper looks into the structure and contents of the concept of empire in the social consciousness of modern Americans. To construct the model of this socially and politically relevant concept we have conducted an experiment with respondents born and living in the USA. Empire is seen as a historic notion describing such entities as the British empire, the Russian empire, the Ottoman empire and others. It seems that the democratic regime adopted by most countries worldwide is incompatible with imperial status of a country. Yet there are countries which tend to dominate in the contemporary world and though they are not routinely referred to as empires, in many respects they are reminiscent of historical empires. Thus, the central hypothesis of the study is that the concept of empire is cultivated in some states through the intermediary of the mass media though it undergoes a certain transformation to meet the expectations of a democratic society. The transformation implies that certain components which were historically embedded in its structure are drawn to the margins of the hierarchical structure of the concept whereas other components tend to become central to the concept. This process can be referred to as restructuration of the concept of empire. To verify this hypothesis we have conducted a study which falls into two stages. First we looked into the definition of empire featured in dictionaries, the dominant conceptual components of empire are: importance, territory/lands, recognition, independence, authority/power, supreme/absolute. However, the analysis of 100 articles from American newspapers chosen at random revealed that authors rarely use the word «empire» in its basic meaning (7%). More often «empire» is used when speaking about countries, which no longer exist or when speaking about some corporations (like Apple or Google). At the second stage of the study we conducted an associative experiment with the citizens of the USA aged 19 to 45. The purpose of the experiment was to find out the dominant components of the concept of empire and to construct the model of the transformed concept. The experiment stipulated that respondents should give the first association, which crosses their mind, on reading such stimulus phrases as “strong military”, “strong economy” and others. The list of stimuli features various words and phrases associated with empire including the words representing the dominant components of the concept of empire. Then the associations provided by the respondents were classified into thematic clusters. For instance, the associations to the stimulus “strong military” were compartmentalized into three groups: 1) a country with strong military forces (North Korea, the USA, Russia, China); 2) negative impression of strong military (war, anarchy, conflict); 3) positive impression of strong military (peace, safety, responsibility). The experiment findings suggest that the concept of empire is currently undergoing a transformation which brings about a number of changes. Among them predominance of positively assessed components of the concept; emergence of two poles in the structure of the concept, that is “hero” vs. “enemy”; marginalization of any negatively assessed components.

Keywords: associative experiment, conceptual components, empire, restructurasation of the concept

Procedia PDF Downloads 297
875 Factors Influencing the Uptake of Vaccinations amongst Pregnant Women Following the COVID-19 Pandemic

Authors: Jo Parsons, Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton

Abstract:

The problem: Vaccinations are routinely offered to pregnant women in the UK for influenza (flu), pertussis (whooping cough), and COVID-19, yet the uptake of these vaccinations in pregnancy remains low. Pregnant women are at increased risk of hospitalisation, morbidity, and mortality from these preventable illnesses, which can also expose their unborn babies to an increased risk of serious complications, including in utero death. This research aims to explore how pregnant women feel about vaccinations offered during pregnancy (flu, whooping cough, and COVID-19), particularly following the COVID-19 pandemic. It also aims to examine factors influencing women’s decisions about vaccinations during pregnancy and how they feel about their health and vulnerabilities to illness arising from the COVID-19 pandemic. The approach: This is a qualitative study involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Pregnant women were recruited via participating hospitals and community groups. Midwives were recruited via participating hospitals and midwife-specific social media groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented will focus on data from pregnant women. Pregnant women reported a wide range of views and vaccination behaviour, and identified several factors influencing their decision whether to accept vaccinations or not. These included internal factors (comprised of beliefs about susceptibility to illness, perceptions of immunity, fear, and feelings of responsibility), other influences (including visibility of illness and external influences such as healthcare professional recommendations), vaccination-related factors (comprised of beliefs about effectiveness and safety of vaccinations, availability and accessibility of vaccinations and preferences for alternative forms of protection to vaccination) and COVID-19 specific factors (including COVID-19 vaccinations and COVID-19 specific influences). Implications: Findings identified some of the factors that affect pregnant women’s decisions when deciding to have a vaccination or not and how these decisions have been influenced by COVID-19. Findings highlight areas where healthcare professional advice needs to focus, such as the provision of information about the increased vulnerability to illnesses during pregnancy and consideration of opportunistic vaccination at hospital appointments to maximise uptake of vaccinations during pregnancy. Findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, COVID-19

Procedia PDF Downloads 73
874 Sustainable Harvesting, Conservation and Analysis of Genetic Diversity in Polygonatum Verticillatum Linn.

Authors: Anchal Rana

Abstract:

Indian Himalayas with their diverse climatic conditions are home to many rare and endangered medicinal flora. One such species is Polygonatum verticillatum Linn., popularly known as King Solomon’s Seal or Solomon’s Seal. Its mention as an incredible medicinal herb comes from 5000 years ago in Indian Materia Medica as a component of Ashtavarga, a poly-herbal formulation comprising of eight herbs illustrated as world’s first ever revitalizing and rejuvenating nutraceutical food, which is now commercialised in the name ‘Chaywanprash’. It is an erect tall (60 to 120 cm) perennial herb with sessile, linear leaves and white pendulous flowers. The species grows well in an altitude range of 1600 to 3600 m amsl, and propagates mostly through rhizomes. The rhizomes are potential source for significant phytochemicals like flavonoids, phenolics, lectins, terpenoids, allantoin, diosgenin, β-Sitosterol and quinine. The presence of such phytochemicals makes the species an asset for antioxidant, cardiotonic, demulcent, diuretic, energizer, emollient, aphrodisiac, appetizer, glactagogue, etc. properties. Having profound concentrations of macro and micronutrients, species has fine prospects of being used as a diet supplement. However, due to unscientific and gregarious uprooting, it has been assigned a status of ‘vulnerable’ and ‘endangered’ in the Conservation Assessment and Management Plan (CAMP) process conducted by Foundation for Revitalisation of Local Health Traditions (FRLHT) during 2010, according to IUCN Red-List Criteria. Further, destructive harvesting, land use disturbances, heavy livestock grazing, climatic changes and habitat fragmentation have substantially contributed towards anomaly of the species. It, therefore, became imperative to conserve the diversity of the species and make judicious use in future research and commercial programme and schemes. A Gene Bank was therefore established at High Altitude Herbal Garden of the Forest Research Institute, Dehradun, India situated at Chakarata (30042’52.99’’N, 77051’36.77’’E, 2205 m amsl) consisting 149 accessions collected from thirty-one geographical locations spread over three Himalayan States of Jammu and Kashmir, Himachal Pradesh, and Uttarakhand. The present investigations purport towards sampling and collection of divergent germplasm followed by planting and cultivation techniques. The ultimate aim is thereby focussed on analysing genetic diversity of the species and capturing promising genotypes for carrying out further genetic improvement programme so to contribute towards sustainable development and healthcare.

Keywords: Polygonatum verticillatum Linn., phytochemicals, genetic diversity, conservation, gene bank

Procedia PDF Downloads 145
873 Political Skills in Social Management and Responsibility of Media Studies

Authors: Musa Miah

Abstract:

Society and social activities are directly governed by political sociology. Political sociology has an impact on the whole of human society, the interrelationships of people in society, social responsibilities and duties, the nature of society, society and culture of different countries, conducting social activities, social change and social development. Through this, the correct knowledge and decision are made by analyzing the complexities of society in different ways. In modern civilized society, people need to get accurate knowledge about how they live, their behavior, customs and principles. The need for political sociology is undeniable, even if new plans are to be adopted for the development of society. The importance of practicing political sociology is immense if any country, nation, or society is to move forward on the path of sustainable development. Research has shown that political sociology is an essential aspect of the social impact of development, sociological analysis of poverty or underdevelopment, development of human values in individual life. The importance of political sociology for knowing the overall aspect of society is undeniable. Because, to know about social problems, to identify social problems, to find the cause of any social problem, one needs to know political sociology. Apart from knowing about the class structure of the society, people of different classes and professions live in the society. It is possible to gain knowledge about. He is also involved in various societies, communities and groups in the country and abroad. Therefore, research has shown that in order to successfully solve any task of the society, it is necessary to know the society in full. Media Studies: Media studies are directly related to socialization. Media strategy has had a positive impact on the management and direction of society. At present, Media Studies in Bangladesh is working towards providing opportunities for up-to-date and quality higher education. Introduced Department of Journalism, Communication and Media Studies in different universities of Bangladesh. The department has gained immense popularity since its inception. Here the top degree holders, as well as eminent editors, senior journalists, writers and researchers, are giving their opinions. Now there is ample scope for research in newspapers, magazines, radio, television and online media as well as outside of work as an advertising-documentary filmmaker or in domestic and foreign NGOs or other corporate organizations. According to the study, media studies have had a positive impact on the media in Bangladesh, especially television channels, the expansion and development of online media and the creation of clear ideas about communication, journalism and the media. Workshops, seminars and discussions are being held on contemporary national and international issues in addition to theoretical concepts. Journalism, communication and mass media are quite exceptional and challenging compared to the traditional subjects considering the present times. In this regard, there is a unique opportunity to build a modern society with taste and personality without mere employment.

Keywords: Bangladesh, Dhaka, social activities, political sociology

Procedia PDF Downloads 134
872 A Kunitz-Type Serine Protease Inhibitor from Rock Bream, Oplegnathus fasciatus Involved in Immune Responses

Authors: S. D. N. K. Bathige, G. I. Godahewa, Navaneethaiyer Umasuthan, Jehee Lee

Abstract:

Kunitz-type serine protease inhibitors (KTIs) are identified in various organisms including animals, plants and microbes. These proteins shared single or multiple Kunitz inhibitory domains link together or associated with other types of domains. Characteristic Kunitz type domain composed of around 60 amino acid residues with six conserved cysteine residues to stabilize by three disulfide bridges. KTIs are involved in various physiological processes, such as ion channel blocking, blood coagulation, fibrinolysis and inflammation. In this study, two Kunitz-type domain containing protein was identified from rock bream database and designated as RbKunitz. The coding sequence of RbKunitz encoded for 507 amino acids with 56.2 kDa theoretical molecular mass and 5.7 isoelectric point (pI). There are several functional domains including MANEC superfamily domain, PKD superfamily domain, and LDLa domain were predicted in addition to the two characteristic Kunitz domain. Moreover, trypsin interaction sites were also identified in Kunitz domain. Homology analysis revealed that RbKunitz shared highest identity (77.6%) with Takifugu rubripes. Completely conserved 28 cysteine residues were recognized, when comparison of RbKunitz with other orthologs from different taxonomical groups. These structural evidences indicate the rigidity of RbKunitz folding structure to achieve the proper function. The phylogenetic tree was constructed using neighbor-joining method and exhibited that the KTIs from fish and non-fish has been evolved in separately. Rock bream was clustered with Takifugu rubripes. The SYBR Green qPCR was performed to quantify the RbKunitz transcripts in different tissues and challenged tissues. The mRNA transcripts of RbKunitz were detected in all tissues (muscle, spleen, head kidney, blood, heart, skin, liver, intestine, kidney and gills) analyzed and highest transcripts level was detected in gill tissues. Temporal transcription profile of RbKunitz in rock bream blood tissues was analyzed upon LPS (lipopolysaccharide), Poly I:C (Polyinosinic:polycytidylic acid) and Edwardsiella tarda challenge to understand the immune responses of this gene. Compare to the unchallenged control RbKunitz exhibited strong up-regulation at 24 h post injection (p.i.) after LPS and E. tarda injection. Comparatively robust expression of RbKunits was observed at 3 h p.i. upon Poly I:C challenge. Taken together all these data indicate that RbKunitz may involve into to immune responses upon pathogenic stress, in order to protect the rock bream.

Keywords: Kunitz-type, rock bream, immune response, serine protease inhibitor

Procedia PDF Downloads 362
871 Improving Patient and Clinician Experience of Oral Surgery Telephone Clinics

Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

Abstract:

During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

Procedia PDF Downloads 48