Search results for: safety plan
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4989

Search results for: safety plan

789 Representations of Race and Social Movement Strategies in the US

Authors: Lee Artz

Abstract:

Based on content analyses of major US media, immediately following the George Floyd killing in May 2020, some mayors and local, state, and national officials offered favorable representations of protests against police violence. As the protest movement grew to historic proportions with 26 million joining actions in large cities and small towns, dominant representations of racism by elected officials and leading media shifted—replacing both the voices and demands of protestors with representations by elected officials. Major media quoted Black mayors and Congressional representatives who emphasized concerns about looting and the disruption of public safety. Media coverage privileged elected officials who criticized movement demands for defunding police and deplored isolated instances of property damaged by protestors. Subsequently, public opinion polls saw an increase in concern for law and order tropes and a decrease in support for protests against police violence. Black Lives Matter and local organizations had no coordinated response and no effective means of communication to counter dominant representations voiced by politicians and globally disseminated by major media. Politician and media-instigated public opinion shifts indicate that social movements need their own means of communication and collective decision-making--both of which were largely missing from Black Lives Matter leaders, leading to disaffection and a political split by more than 20 local affiliates. By itself, social media by myriad individuals and groups had limited purchase as a means for social movement communication and organization. Lacking a collaborative, coordinated strategy, organization, and independent media, the loose network of Black Lives Matter groups was unable to offer more accurate, democratic, and favorable representations of protests and their demands for more justice and equality. The fight for equality was diverted by the fight for representation.

Keywords: black lives matter, public opinion, racism, representations, social movements

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788 Photoelectrical Stimulation for Cancer Therapy

Authors: Mohammad M. Aria, Fatma Öz, Yashar Esmaeilian, Marco Carofiglio, Valentina Cauda, Özlem Yalçın

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Photoelectrical stimulation of cells with semiconductor organic polymers have been shown promising applications in neuroprosthetics such as retinal prosthesis. Photoelectrical stimulation of the cell membranes can be induced through a photo-electric charge separation mechanism in the semiconductor materials, and it can alter intracellular calcium level through both stimulation of voltage-gated ion channels and increase of intracellular reactive oxygen species (ROS) level. On the other hand, targeting voltage-gated ion channels in cancer cells to induce cell apoptosis through calcium signaling alternation is an effective mechanism which has been explained before. In this regard, remote control of the voltage-gated ion channels aimed to alter intracellular calcium by using photo-active organic polymers can be novel technology in cancer therapy. In this study, we used P (ITO/Indium thin oxide)/P3HT(poly(3-hexylthiophene-2,5-diyl)) and PN (ITO/ZnO/P3HT) photovoltaic junctions to stimulate MDA-MB-231 breast cancer cells. We showed that the photo-stimulation of breast cancer cells through photo capacitive current generated by the photovoltaic junctions are able to excite the cells and alternate intracellular calcium based on the calcium imaging (at 8mW/cm² green light intensity and 10-50 ms light durations), which has been reported already to safety stimulate neurons. The control group did not undergo light treatment and was cultured in T-75 flasks. We detected 20-30% cell death for ITO/P3HT and 51-60% cell death for ITO/ZnO/P3HT samples in the light treated MDA-MB-231 cell group. Western blot analysis demonstrated poly(ADP-ribose) polymerase (PARP) activated cell death in the light treated group. Furthermore, Annexin V and PI fluorescent staining indicated both apoptosis and necrosis in treated cells. In conclusion, our findings revealed that the photoelectrical stimulation of cells (through long time overstimulation) can induce cell death in cancer cells.

Keywords: Ca²⁺ signaling, cancer therapy, electrically excitable cells, photoelectrical stimulation, voltage-gated ion channels

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787 Ophthalmic Self-Medication Practices and Associated Factors among Adult Ophthalmic Patients

Authors: Sarah Saad Alamer, Shujon Mohammed Alazzam, Amjad Khater Alanazi, Mohamed Ahmed Sankari, Jana Sameer Sendy, Saleh Al-Khaldi, Khaled Allam, Amani Badawi

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Background: Self-medication is defined as the selection of medicines by individuals to treat self-diagnosed. There are a lot of concerns about the safety of long-term use of nonprescription ophthalmic drugs, which may lead to a variety of serious ocular complications. Topical steroids can produce severe eye-threatening complications, including the elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage. In recent times, many OTC ophthalmic preparations have been possible without a prescription. Objective: In our study, we aimed to determine the prevalence of self-medication ocular topical steroid practice and associated factors among adult ophthalmic patients attending King Saud medical city. Methods: This study was conducted as a cross-sectional study, targeting participants aged 18 years old or above who had used topical steroids eye drops to determine the prevalence of self-medication ocular topical steroid practice and associated factors among adult patients attending ophthalmology clinic in King Saud Medical City (KSMC) in the central region. Results: A total of 308 responses, 92(29.8%) were using ocular topical, 58(18.8%) with prescription, 5(1.6%) without prescription, 29(9.4%) with and without prescription while 216(70.1%) did not use it. The frequency of using ocular topical steroids without a prescription among participants was 11(12%) once and 33 (35%) many times. 26(28.3%) were having complication, mostly 11(12.4%) eye infection, 8(9%) Glaucoma, 6 (6.7%) Cataracts. Reasons for self-medication ocular topical steroid practice among participants were 14 (15.2%) repeated symptoms, 11(15.2%) had heard an advice from a friend, 11 (15.2%) thought they had enough knowledge. Conclusion: Our study reveals that, even though detecting a high level of knowledge and acceptable practices and attitudes among participants, the incidence of self-medication with steroid eye drops was observed. This practice is mainly due to participants having repeated symptoms and thinking they have enough knowledge. Increasing the education level of patients on self-medication steroid eye drops practice and it is associated complications would help reduce the incidence of self-medication steroid eye drops practice.

Keywords: self-medication, ophthalmic medicine, steroid eye drop, over the counter

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786 Fluoride Immobilization in Plaster Board Waste: A Safety Measure to Prevent Soil and Water Pollution

Authors: Venkataraman Sivasankar, Kiyoshi Omine, Hideaki Sano

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The leaching of fluoride from Plaster Board Waste (PBW) is quite feasible in soil and water environments. The Ministry of Environment, Japan recommended the standard limit of 0.8 mgL⁻¹ or less for fluoride. Although the utilization of PBW as a substitute for cement is rather meritorious, its fluoride leaching behavior deteriorates the quality of soil and water and therefore envisaged as a demerit. In view of this fluoride leaching problem, the present research is focused on immobilizing fluoride in PBW. The immobilization experiments were conducted with four chemical systems operated by DAHP (diammonium hydrogen phosphate) and phosphoric acid carbonization of bamboo mass coupled with certain inorganic reactions using reagents such as calcium hydroxide, sodium hydroxide, and aqueous ammonia. The fluoride immobilization was determined after shaking the reactor contents including the plaster board waste for 24 h at 25˚C. In the DAHP system, the immobilization of fluoride was evident from the leaching of fluoride in the range 0.071-0.12 mgL⁻¹, 0.026-0.14 mgL⁻¹ and 0.068-0.12 mgL⁻¹ for the reaction temperatures at 30˚C, 50˚C, and 90˚C, respectively, with final pH of 6.8. The other chemical systems designated as PACCa, PACAm, and PACNa could immobilize fluoride in PBW, and the resulting solution was analyzed with the fluoride less than the Japanese environmental standard of 0.8 mgL⁻¹. In the case of PACAm and PACCa systems, the calcium concentration was found undetectable and witnessed the formation of phosphate compounds. The immobilization of fluoride was found inversely proportional to the increase in the volume of leaching solvent and dose of PBW. Characterization studies of PBW and the solid after fluoride immobilization was done using FTIR (Fourier transform infrared spectroscopy), Raman spectroscopy, FE-SEM ( Field Emission Scanning Electron Microscopy) with EDAX (Energy Dispersive Spectroscopy), XRD (X-ray diffraction), and XPS (X-ray photoelectron spectroscopy). The results revealed the formation of new calcium phosphate compounds such as apatite, monetite, and hydroxylapatite. The participation of such new compounds in fluoride immobilization seems indispensable through the exchange mechanism of hydroxyl and fluoride groups. Acknowledgment: First author thanks to Japanese Society for the Promotion of Science (JSPS) for the award of the fellowship (ID No. 16544).

Keywords: characterization, fluoride, immobilization, plaster board waste

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785 Effect of Lowering the Proportion of Chlorella vulgaris in Fish Feed on Tilapia's Immune System

Authors: Hamza A. Pantami, Khozizah Shaari, Intan S. Ismail, Chong C. Min

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Introduction: Tilapia is the second-highest harvested freshwater fish species in Malaysia, available in almost all fish farms and markets. Unfortunately, tilapia culture in Malaysia is highly affected by Aeromonas hydrophila and Streptococcus agalactiae, which affect the production rate and consequently pose a direct negative economic impact. Reliance on drugs to control or reduce bacterial infections has been led to contamination of water bodies and development of drug resistance, as well as gave rise to toxicity issues in downstream fish products. Resorting to vaccines have helped curb the problem to a certain extent, but a more effective solution is still required. Using microalgae-based feed to enhance the fish immunity against bacterial infection offers a promising alternative. Objectives: This study aims to evaluate the efficacy of Chlorella vulgaris at lower percentage incorporation in feeds for an immune boost of tilapia in a shorter time. Methods: The study was in two phases. The safety concentration studies at 500 mg/kg-1 and the administration of cultured C. vulgaris biomass via incorporation into fish feed for five different groups in three weeks. Group 1 was the control (0% incorporation), whereas group 2, 3, 4 and 5 received 0.625%, 1.25%, 2.5% and 5% incorporation respectively. The parameters evaluated were the blood profile, serum lysozyme activity (SLA), serum bactericidal activity (SBA), phagocytosis activity (PA), respiratory burst activity (RBA), and lymphoproliferation activity (LPA). The data were analyzed via ANOVA using SPSS (version 16). Further testing was done using Tukey’s test. All tests were performed at the 95% confidence interval (p < 0.05). Results: There were no toxic signs in tilapia fish at 500 mg/kg-1. Treated groups showed significantly better immune parameters compared to the control group (p < 0.05). Conclusions: C. vulgaris crude biomass in a fish meal at a lower incorporation level of 5% can increase specific and non-specific immunity in tilapia fish in a shorter time duration.

Keywords: Chlorella vulgaris, hematology profile, immune boost, lymphoproliferation

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784 Transvaginal Repair of Anterior Vaginal Wall Prolapse with Polyvinylidene Fluoride (PVDF) Mesh: An Alternative for Previously Restricted Materials

Authors: Mohammad-Javad Eslami, Mahtab Zargham, Farshad Gholipour, Mohammadreza Hajian, Katayoun Bakhtiari, Sakineh Hajebrahimi, Melina Eghbal, Ziba Farajzadegan

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Introduction: To study the mid-term safety and functional outcomes of transvaginal anterior vaginal wall prolapse repair using polyvinylidene fluoride (PVDF) mesh (DynaMesh®-PR4) by the double trans-obturator technique (TOT). Methods: Between 2015 and 2020, we prospectively included women with symptomatic high-stage anterior vaginal wall prolapse with or without uterine prolapse or stress urinary incontinence (SUI) in the study. The patients underwent transvaginal repair of the prolapse using PVDF mesh in two medical centers. We followed all patients for at least 12 months. We recorded the characteristics of vaginal and sexual symptoms, urinary incontinence, and prolapse stage pre- and postoperatively using International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS), International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF), and Pelvic Organ Prolapse Quantification (POP-Q) system, respectively. Results: One hundred eight women were included in the final analysis with a mean follow-up time of 34.5 ± 18.6 months. The anatomical success was achieved in 103 (95.4%) patients. There was a significant improvement in patients’ vaginal symptoms, urinary incontinence, and quality of life scores postoperatively (p < 0.0001). Only six patients (5.5%) had mesh extrusion, five of whom were managed successfully. The total rates of complications and de novo urinary symptoms were 21.3% and 7.4%, respectively. Significant pain was reported in 17 cases (15.7%). Conclusion: Our findings show that using PVDF mesh in the double TOT technique for anterior vaginal wall prolapse repair is a safe procedure with high anatomic and functional success rates and acceptable complication rates in mid-term follow-up.

Keywords: stress urinary incontinence (SU, incontinence questionnaire-vaginal symptoms (ICIQ-VS), polyvinylidene fluoride (PVDF) mes, double trans-obturator technique (TOT)

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783 Finite Element Analysis of the Anaconda Device: Efficiently Predicting the Location and Shape of a Deployed Stent

Authors: Faidon Kyriakou, William Dempster, David Nash

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Abdominal Aortic Aneurysm (AAA) is a major life-threatening pathology for which modern approaches reduce the need for open surgery through the use of stenting. The success of stenting though is sometimes jeopardized by the final position of the stent graft inside the human artery which may result in migration, endoleaks or blood flow occlusion. Herein, a finite element (FE) model of the commercial medical device AnacondaTM (Vascutek, Terumo) has been developed and validated in order to create a numerical tool able to provide useful clinical insight before the surgical procedure takes place. The AnacondaTM device consists of a series of NiTi rings sewn onto woven polyester fabric, a structure that despite its column stiffness is flexible enough to be used in very tortuous geometries. For the purposes of this study, a FE model of the device was built in Abaqus® (version 6.13-2) with the combination of beam, shell and surface elements; the choice of these building blocks was made to keep the computational cost to a minimum. The validation of the numerical model was performed by comparing the deployed position of a full stent graft device inside a constructed AAA with a duplicate set-up in Abaqus®. Specifically, an AAA geometry was built in CAD software and included regions of both high and low tortuosity. Subsequently, the CAD model was 3D printed into a transparent aneurysm, and a stent was deployed in the lab following the steps of the clinical procedure. Images on the frontal and sagittal planes of the experiment allowed the comparison with the results of the numerical model. By overlapping the experimental and computational images, the mean and maximum distances between the rings of the two models were measured in the longitudinal, and the transverse direction and, a 5mm upper bound was set as a limit commonly used by clinicians when working with simulations. The two models showed very good agreement of their spatial positioning, especially in the less tortuous regions. As a result, and despite the inherent uncertainties of a surgical procedure, the FE model allows confidence that the final position of the stent graft, when deployed in vivo, can also be predicted with significant accuracy. Moreover, the numerical model run in just a few hours, an encouraging result for applications in the clinical routine. In conclusion, the efficient modelling of a complicated structure which combines thin scaffolding and fabric has been demonstrated to be feasible. Furthermore, the prediction capabilities of the location of each stent ring, as well as the global shape of the graft, has been shown. This can allow surgeons to better plan their procedures and medical device manufacturers to optimize their designs. The current model can further be used as a starting point for patient specific CFD analysis.

Keywords: AAA, efficiency, finite element analysis, stent deployment

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782 A Computational Approach to Screen Antagonist’s Molecule against Mycobacterium tuberculosis Lipoprotein LprG (Rv1411c)

Authors: Syed Asif Hassan, Tabrej Khan

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Tuberculosis (TB) caused by bacillus Mycobacterium tuberculosis (Mtb) continues to take a disturbing toll on human life and healthcare facility worldwide. The global burden of TB remains enormous. The alarming rise of multi-drug resistant strains of Mycobacterium tuberculosis calls for an increase in research efforts towards the development of new target specific therapeutics against diverse strains of M. tuberculosis. Therefore, the discovery of new molecular scaffolds targeting new drug sites should be a priority for a workable plan for fighting resistance in Mycobacterium tuberculosis (Mtb). Mtb non-acylated lipoprotein LprG (Rv1411c) has a Toll-like receptor 2 (TLR2) agonist actions that depend on its association with triacylated glycolipids binding specifically with the hydrophobic pocket of Mtb LprG lipoprotein. The detection of a glycolipid carrier function has important implications for the role of LprG in Mycobacterial physiology and virulence. Therefore, considering the pivotal role of glycolipids in mycobacterial physiology and host-pathogen interactions, designing competitive antagonist (chemotherapeutics) ligands that competitively bind to glycolipid binding domain in LprG lipoprotein, will lead to inhibition of tuberculosis infection in humans. In this study, a unified approach involving ligand-based virtual screening protocol USRCAT (Ultra Shape Recognition) software and molecular docking studies using Auto Dock Vina 1.1.2 using the X-ray crystal structure of Mtb LprG protein was implemented. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the Ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has the higher hypothetical affinity, also has greater negative value. Based on the USRCAT, Lipinski’s values and molecular docking results, [(2R)-2,3-di(hexadecanoyl oxy)propyl][(2S,3S,5S,6R)-3,4,5-trihydroxy-2,6-bis[[(2R,3S,4S,5R,6S)-3,4,5-trihydroxy-6 (hydroxymethyl)tetrahydropyran-2-yl]oxy]cyclohexyl] phosphate (XPX) was confirmed as a promising drug-like lead compound (antagonist) binding specifically to the hydrophobic domain of LprG protein with affinity greater than that of PIM2 (agonist of LprG protein) with a free binding energy of -9.98e+006 Kcal/mol and binding affinity of -132 Kcal/mol, respectively. A further, in vitro assay of this compound is required to establish its potency in inhibiting molecular evasion mechanism of MTB within the infected host macrophages. These results will certainly be helpful in future anti-TB drug discovery efforts against Multidrug-Resistance Tuberculosis (MDR-TB).

Keywords: antagonist, agonist, binding affinity, chemotherapeutics, drug-like, multi drug resistance tuberculosis (MDR-TB), RV1411c protein, toll-like receptor (TLR2)

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781 ‘Green Gait’ – The Growing Relevance of Podiatric Medicine amid Climate Change

Authors: Angela Evans, Gabriel Gijon-Nogueron, Alfonso Martinez-Nova

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Background The health sector, whose mission is protecting health, also contributes to the climate crisis, the greatest health threat of the 21st century. The carbon footprint from healthcare exceeds 5% of emissions globally, surpassing 7% in the USA and Australia. Global recognition has led to the Paris Agreement, the United Nations Sustainable Development Goals, and the World Health Organization's Climate Change Action Plan. It is agreed that the majority of health impacts stem from energy and resource consumption, as well as the production of greenhouse gases in the environment and deforestation. Many professional medical associations and healthcare providers advocate for their members to take the lead in environmental sustainability. Objectives To avail and expand ‘Green Podiatry’ via the three pillars of: Exercise ; Evidence ; Everyday changes; to highlight the benefits of physical activity and exercise for both human health and planet health. Walking and running are beneficial for health, provide low carbon transport, and have evidence-based health benefits. Podiatrists are key healthcare professionals in the physical activity space and can influence and guide their patients to increase physical activity and avert the many non-communicable diseases that are decimating public health, eg diabetes, arthritis, depression, cancer, obesity. Methods Publications, conference presentations, and pilot projects pertinent to ‘Green Podiatry’ have been activated since 2021, and a survey of podiatrist’s knowledge and awareness has been undertaken.The survey assessed attitudes towards environmental sustainability in work environment. The questions addressed commuting habits, hours of physical exercise per week, and attitudes in the clinic, such as prescribing unnecessary treatments or emphasizing sports as primary treatment. Results Teaching and Learning modules have been developed for podiatric medicine students and graduates globally. These will be availed. A pilot foot orthoses recycling project has been undertaken and will be reported, in addition to established footwear recycling. The preliminary survey found almost 90% of respondents had no knowledge of green podiatry or footwear recycling. Only 30% prescribe sports/exercise as the primary treatment for patients, and 45% do not to prescribe unnecessary treatments. Conclusions Podiatrists are in a good position to lead in the crucial area of healthcare and climate change implications. Sufficient education of podiatrists is essential for the profession to beneficially promote health and physical activity, which is beneficial for the health of all peoples and all communities.

Keywords: climate change, gait, green, healthcare, sustainability

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780 Carbon Footprint of Educational Establishments: The Case of the University of Alicante

Authors: Maria R. Mula-Molina, Juan A. Ferriz-Papi

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Environmental concerns are increasingly obtaining higher priority in sustainability agenda of educational establishments. This is important not only for its environmental performance in its own right as an organization, but also to present a model for its students. On the other hand, universities play an important role on research and innovative solutions for measuring, analyzing and reducing environmental impacts for different activities. The assessment and decision-making process during the activity of educational establishments is linked to the application of robust indicators. In this way, the carbon footprint is a developing indicator for sustainability that helps understand the direct impact on climate change. But it is not easy to implement. There is a large amount of considering factors involved that increases its complexity, such as different uses at the same time (research, lecturing, administration), different users (students, staff) or different levels of activity (lecturing, exam or holidays periods). The aim of this research is to develop a simplified methodology for calculating and comparing carbon emissions per user at university campus considering two main aspects for carbon accountings: Building operations and transport. Different methodologies applied in other Spanish university campuses are analyzed and compared to obtain a final proposal to be developed in this type of establishments. First, building operation calculation considers the different uses and energy sources consumed. Second, for transport calculation, the different users and working hours are calculated separately, as well as their origin and traveling preferences. For every transport, a different conversion factor is used depending on carbon emissions produced. The final result is obtained as an average of carbon emissions produced per user. A case study is applied to the University of Alicante campus in San Vicente del Raspeig (Spain), where the carbon footprint is calculated. While the building operation consumptions are known per building and month, it does not happen with transport. Only one survey about the habit of transport for users was developed in 2009/2010, so no evolution of results can be shown in this case. Besides, building operations are not split per use, as building services are not monitored separately. These results are analyzed in depth considering all factors and limitations. Besides, they are compared to other estimations in other campuses. Finally, the application of the presented methodology is also studied. The recommendations concluded in this study try to enhance carbon emission monitoring and control. A Carbon Action Plan is then a primary solution to be developed. On the other hand, the application developed in the University of Alicante campus cannot only further enhance the methodology itself, but also render the adoption by other educational establishments more readily possible and yet with a considerable degree of flexibility to cater for their specific requirements.

Keywords: building operations, built environment, carbon footprint, climate change, transport

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779 Statistical Characteristics of Code Formula for Design of Concrete Structures

Authors: Inyeol Paik, Ah-Ryang Kim

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In this research, a statistical analysis is carried out to examine the statistical properties of the formula given in the design code for concrete structures. The design formulas of the Korea highway bridge design code - the limit state design method (KHBDC) which is the current national bridge design code and the design code for concrete structures by Korea Concrete Institute (KCI) are applied for the analysis. The safety levels provided by the strength formulas of the design codes are defined based on the probabilistic and statistical theory.KHBDC is a reliability-based design code. The load and resistance factors of this code were calibrated to attain the target reliability index. It is essential to define the statistical properties for the design formulas in this calibration process. In general, the statistical characteristics of a member strength are due to the following three factors. The first is due to the difference between the material strength of the actual construction and that used in the design calculation. The second is the difference between the actual dimensions of the constructed sections and those used in design calculation. The third is the difference between the strength of the actual member and the formula simplified for the design calculation. In this paper, the statistical study is focused on the third difference. The formulas for calculating the shear strength of concrete members are presented in different ways in KHBDC and KCI. In this study, the statistical properties of design formulas were obtained through comparison with the database which comprises the experimental results from the reference publications. The test specimen was either reinforced with the shear stirrup or not. For an applied database, the bias factor was about 1.12 and the coefficient of variation was about 0.18. By applying the statistical properties of the design formula to the reliability analysis, it is shown that the resistance factors of the current design codes satisfy the target reliability indexes of both codes. Also, the minimum resistance factors of the KHBDC which is written in the material resistance factor format and KCE which is in the member resistance format are obtained and the results are presented. A further research is underway to calibrate the resistance factors of the high strength and high-performance concrete design guide.

Keywords: concrete design code, reliability analysis, resistance factor, shear strength, statistical property

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778 Omalizumab Therapy Experience for Asthma, at Zayed Military Hospital (ZMH) in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Ashraf Alzaabi, Jassim Abdou

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Introduction: 300 million people worldwide are affected by asthma .In UAE, prevalence is around 10% (900,000 people).Patients with persistent symptoms despite using high dose ICS plus a second controller +/- OCS are considered to have severe asthma. Omalizumab (Xolaire) an IgE monoclonal antibody is approved as add on therapy for severe allergic asthma. Objective: To determine the efficacy of omalizumab based on clinical outcomes in our cohort of patient pre and post 52 weeks of treatment to assess safety and tolerability of treatment. Methods: Medical records of patients receiving omalizumab therapy for asthma at ZMH ,Abu Dhabi were retrospectively analyzed.Patients fulfilling the criteria of severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months prior to and 12 months after commencement of omalizumab therapy was analysed by taking into account the number of exacerbations and hospitalizations in addition to maintenance of medication dosages, need for rescue reliever therapy and pulmonary function testing. Results: Total cohort of 21 patient (5 females), average age 41 years and av length of therapy 22 months were included. Seven patients (total 11/52%) managed to stop steroids on treatment while four were able to decrease the dosage. Mean exacerbation rate decreased from five/ year pre treatment to 1.36 while on treatment. Number of hospitalizations decreased from mean of two per year to 0.9 per year. Rescue reliever inhaler usage decreased from mean of 40 puffs to 15 puffs per week. 2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects including local irritation, severe limb and joint pains after 6 months. Conclusion: Treatment with omalizumab showed effect in terms of reduced number of exacerbations, maintenance therapy and reliever medications. However, no improvement was seen in PFTs.There is room for improved documentation in terms of symptom recording and use of rescue medicationas as well as for better patient education and counselling in order to improve compliance.

Keywords: asthma, omalizumab, severe allergic asthma, UAE

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777 The Effect of Interpersonal Relationships on Eating Patterns and Physical Activity among Asian-American and European-American Adolescents

Authors: Jamil Lane, Jason Freeman

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Background: The role of interpersonal relationships is vital predictors of adolescents’ eating habits, exercise activity, and health problems including obesity. The effect of interpersonal relationships (i.e. family, friends, and intimate partners) on individual health behaviors and development have gained considerable attention during the past 10 years. Teenagers eating habits and exercise activities are established through a dynamic course involving internal and external factors such as food preferences, body weight perception, and parental and peer influence. When conceptualizing one’s interpersonal relationships, it is important to understand that how one relates to others is shaped by their culture. East-Asian culture has been characterized as collectivistic, which describes the significant role intergroup relationships play in their construction of the self. Cultures found in North America, on the other hand, can be characterized as individualistic, meaning that these cultures encourage individuals to prioritize their interest over the needs and want of their compatriots. Individuals from collectivistic cultures typically have stronger boundaries between in-group and out-group membership, whereas those from individualistic cultures see themselves as distinct and separate from strangers as well as family or friends. Objective: The purpose of this study is to examine the effect of collectivism and individualism on interpersonal relationships that shapes eating patterns and physical activity among Asian-American and European-American adolescents. Design/Methods: Analyses were based on data from the National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in the United States who were surveyed from 1994 through 2008. This data will be used to examine interpersonal relationship factors that shape dietary intake and physical activity patterns within the Asian-American and European-American population in the United States. Factors relating to relationship strength, eating, and exercise behaviors were reported by participants in this first wave of data collection (1995). We plan to analyze our data using intragroup comparisons among those who identified as 'Asian-American' (n = 270) and 'White or European American' (n = 4,294) among the domains of positivity of peer influence and level of physical activity / healthy eating. Further, intergroup comparisons of these relationships will be made to extricate how the role positive peer influence in maintaining healthy eating and exercise habits differs with cultural variation. Results: We hypothesize that East-Asian participants with a higher degree of positivity in their peer and family relationships will experience a significantly greater rise in healthy eating and exercise behaviors than European-American participants with similar degrees of relationship positivity.

Keywords: interpersonal relationships, eating patterns, physical activity, adolescent health

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776 Disabilities in Railways: Proposed Changes to the Design of Railway Compartments for the Inclusion of Differently Abled Persons

Authors: Bathmajaa Muralisankar

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As much as railway station infrastructure designs and ticket-booking norms have been changed to facilitate use by differently abled persons, the railway train compartments themselves have not been made user-friendly for differently abled persons. Owing to safety concerns, dependency on others for their travel, and fear of isolation, differently abled people do not prefer travelling by train. Rather than including a dedicated compartment open only to the differently abled, including the latter with others in the normal compartment (with the proposed modifications discussed here) will make them feel secure and make for an enhanced travel experience for them. This approach also represents the most practical way to include a particular category of people in the mainstream society. Lowering the height of the compartment doors and providing a wider entrance with a ramp will provide easy entry for those using wheelchairs. As well, removing the first two alternate rows and the first two side seats will not only widen the passage and increase seating space but also improve wheelchair turning radius. This will help them travel without having to depend on others. Seating arrangements may be done to accommodate their family members near them instead of isolating the differently abled in a separate compartment. According to present ticket-booking regulations of the Indian Railways, three to four disabled persons may travel without their family or one to two along with their family, and the numbers may be added or reduced. To help visually challenged and hearing-impaired persons, in addition to the provision of special instruments, railings, and textured footpaths and flooring, the seat numbers above the seats may be set in metal or plastic as an outward projection so the visually impaired can touch and feel the numbers. Braille boards may be included at the entrance to the compartment along with seat numbers in the aforementioned projected manner. These seat numbers may be designed as buttons, which when pressed results in an announcement of the seat number in the applicable local language as well as English. Emergency buttons, rather than emergency chains, within the easy reach of disabled passengers will also help them.

Keywords: dependency, differently abled, inclusion, mainstream society

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775 Effect of Three Desensitizers on Dentinal Tubule Occlusion and Bond Strength of Dentin Adhesives

Authors: Zou Xuan, Liu Hongchen

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The ideal dentin desensitizing agent should not only have good biological safety, simple clinical operation mode, the superior treatment effect, but also should have a durable effect to resist the oral environmental temperature change and oral mechanical abrasion, so as to achieve a persistent desensitization effect. Also, when using desensitizing agent to prevent the post-operative hypersensitivity, we should not only prevent it from affecting crowns’ retention, but must understand its effects on bond strength of dentin adhesives. There are various of desensitizers and dentin adhesives in clinical treatment. They have different chemical or physical properties. Whether the use of desensitizing agent would affect the bond strength of dentin adhesives still need further research. In this in vitro study, we built the hypersensitive dentin model and post-operative dentin model, to evaluate the sealing effects and durability on exposed tubule by three different dentin desensitizers and to evaluate the sealing effects and the bond strength of dentin adhesives after using three different dentin desensitizers on post-operative dentin. The result of this study could provide some important references for clinical use of dentin desensitizing agent. 1. As to the three desensitizers, the hypersensitive dentin model was built to evaluate their sealing effects on exposed tubule by SEM observation and dentin permeability analysis. All of them could significantly reduce the dentin permeability. 2. Test specimens of three groups treated by desensitizers were subjected to aging treatment with 5000 times thermal cycling and toothbrush abrasion, and then dentin permeability was measured to evaluate the sealing durability of these three desensitizers on exposed tubule. The sealing durability of three groups were different. 3. The post-operative dentin model was built to evaluate the sealing effects of the three desensitizers on post-operative dentin by SEM and methylene blue. All of three desensitizers could reduce the dentin permeability significantly. 4. The influences of three desensitizers on the bonding efficiency of total-etch and self-etch adhesives were evaluated with the micro-tensile bond strength study and bond interface morphology observation. The dentin bond strength for Green or group was significantly lower than the other two groups (P<0.05).

Keywords: dentin, desensitizer, dentin permeability, thermal cycling, micro-tensile bond strength

Procedia PDF Downloads 383
774 Internet Health: A Cross-Sectional Survey Exploring Identified Risks and Online Safety Measures in Parent and Children with Neurodevelopmental Disorders

Authors: Abdirahim Mohamed, Sarita Rana Chhetri, Michael Sleath, Nadia Saleem

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Rationale: Internet usage has been very much integrated into our daily lives. Internet usage within a neurodevelopmental disorder population is also on the increase. Nevertheless, there is very little empirical research on how this population virtually protect themselves; along with how their parents can keep them safe online. This topic was an ever-growing concern to the parents within our services and in many cases would add to the stresses and mental health of parents. This ignited an idea within our team to conduct research to explore the perceived online risks within this population and how they keep themselves safe. In conjunction, we also explored how parents and caregivers monitor and safeguard their young people to the potential threats online. Our hypothesis was that the perceived risks will heavily outnumber the safeguarding measures implemented by this population. Method: Within the Coventry and Warwickshire NHS Partnership Trust Child and Adolescent Mental Health Service (CAMHS), we distributed qualitative questionnaires to all the clinical bases (N=80). Questions explored topics such as daily internet usage, safeguarding measures, and perceived threats. The researchers requested for all CAMHS clinicians to identify participants. Participants in this study were accessing CAMHS for neurodevelopmental specific interventions. Results: The data were analysed using both Excel and SPSS. Within SPSS, a MANOVA was conducted and found a significant difference between safeguarding measures and perceived online risks within responses (p ≤ 0.5). This supports our hypothesis that participants in this population are well versed in the safeguarding issues of the internet; however, struggle to implement appropriate preventative measures. Data were also screened using Excel and found that all parents and carers stated they 'monitored their child’s internet use'. Conclusion: Data suggest that parents/carers may require more specific intervention to equip them with preventative measures due to the clear discrepancy between perceived risks and safeguarding measures. More research may also need to be conducted around this area to determine appropriate methodology to explore this topic further.

Keywords: Internet, health , how safe are we , internet health check

Procedia PDF Downloads 255
773 Developing Sustainable Tourism Practices in Communities Adjacent to Mines: An Exploratory Study in South Africa

Authors: Felicite Ann Fairer-Wessels

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There has always been a disparity between mining and tourism mainly due to the socio-economic and environmental impacts of mines on both the adjacent resident communities and the areas taken up by the mining operation. Although heritage mining tourism has been actively and successfully pursued and developed in the UK, largely Wales, and Scandinavian countries, the debate whether active mining and tourism can have a mutually beneficial relationship remains imminent. This pilot study explores the relationship between the ‘to be developed’ future Nokeng Mine and its adjacent community, the rural community of Moloto, will be investigated in terms of whether sustainable tourism and livelihood activities can potentially be developed with the support of the mine. Concepts such as social entrepreneur, corporate social responsibility, sustainable development and triple bottom line are discussed. Within the South African context as a mineral rich developing country, the government has a statutory obligation to empower disenfranchised communities through social and labour plans and policies. All South African mines must preside over a Social and Labour Plan according to the Mineral and Petroleum Resources Development Act, No 28 of 2002. The ‘social’ component refers to the ‘social upliftment’ of communities within or adjacent to any mine; whereas the ‘labour’ component refers to the mine workers sourced from the specific community. A qualitative methodology is followed using the case study as research instrument for the Nokeng Mine and Moloto community with interviews and focus group discussions. The target population comprised of the Moloto Tribal Council members (8 in-depth interviews), the Moloto community members (17: focus groups); and the Nokeng Mine representatives (4 in-depth interviews). In this pilot study two disparate ‘worlds’ are potentially linked: on the one hand, the mine as social entrepreneur that is searching for feasible and sustainable ideas; and on the other hand, the community adjacent to the mine, with potentially sustainable tourism entrepreneurs that can tap into the resources of the mine should their ideas be feasible to build their businesses. Being an exploratory study the findings are limited but indicate that the possible success of tourism and sustainable livelihood activities lies in the fact that both the Mine and Community are keen to work together – the mine in terms of obtaining labour and profit; and the community in terms of improved and sustainable social and economic conditions; with both parties realizing the importance to mitigate negative environmental impacts. In conclusion, a relationship of trust is imperative between a mine and a community before a long term liaison is possible. However whether tourism is a viable solution for the community to engage in is debatable. The community could initially rather pursue the sustainable livelihoods approach and focus on life-supporting activities such as building, gardening, etc. that once established could feed into possible sustainable tourism activities.

Keywords: community development, mining tourism, sustainability, South Africa

Procedia PDF Downloads 283
772 Follicular Thyroid Carcinoma in a Developing Country: A Retrospective Study of 10 Years

Authors: Abdul Aziz, Muhammad Qamar Masood, Saadia Sattar, Saira Fatima, Najmul Islam

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Introduction: The most common endocrine tumor is thyroid cancer. Follicular Thyroid Carcinoma (FTC) accounts for 5%–10% of all thyroid cancers. Patients with FTC frequently present with more advanced stage diseases and a higher occurrence of distant metastases because of the propensity of vascular invasion. FTC is mainly treated with surgery, while radioactive iodine therapy is the main adjuvant therapy as per ATA guidelines. In many developing countries, surgical facilities and radioactive iodine are in short supply; therefore, understanding follicular thyroid cancer trends may help developing countries plan and use resources more effectively. Methodology: It was a retrospective observational study of FTC patients of age 18 years and above conducted at Aga Khan University Hospital, Karachi, from 1st January 2010 to 31st December 2019. Results: There were 404 patients with thyroid carcinoma, out of which forty (10.1%) were FTC. 50% of the patients were in the 41-60 years age group, and the female to male ratio was 1.5: 1. Twenty-four patients (60%) presented with complain of neck swelling followed by metastasis (20%) and compressive symptoms (20%). The most common site of metastasis was bone (87.5%), followed by lung (12.5%). The pre-operative thyroglobulin level was done in six out of eight metastatic patients (75%) in which it was elevated. This emphasizes the importance of checking thyroglobulin level in unusual presentation (bone pain, fractures) of a patient having neck swelling also to help in establishing the primary source of tumor. There was no complete documentation of ultrasound features of the thyroid gland in all the patients, which is an important investigation done in the initial evaluation of thyroid nodule. On FNAC, 50% (20 patients) had Bethesda category III-IV nodules, while 10% ( 4 patients ) had Bethesda category II. In sixteen patients, FNAC was not done as they presented with compressive symptoms or metastasis. Fifty percent had a total thyroidectomy and 50% had subtotal followed by completion thyroidectomy, plus ten patients had lymph node dissection, out of which seven had histopathological lymph node involvement. On histopathology, twenty-three patients (57.5%) had minimally invasive, while seventeen (42.5%) had widely invasive follicular thyroid carcinoma. The capsular invasion was present in thirty-three patients (82.5%); one patient had no capsular invasion, but there was a vascular invasion. Six patients' histopathology had no record of capsular invasion. In contrast, the lymphovascular invasion was present in twenty-six patients (65%). In this study, 65 % of the patients had clinical stage 1 disease, while 25% had stage 2 and 10% had clinical stage 4. Seventeen patients (42.5%) had received RAI 30-100 mCi, while ten patients (25%) received more than 100 mCi. Conclusion: FTC demographic and clinicopathological presentation are the same in Pakistan as compared to other countries. Surgery followed by RAI is the mainstay of treatment. Thus understanding the trend of FTC and proper planning and utilization of the resources will help the developing countries in effectively treating the FTC.

Keywords: thyroid carcinoma, follicular thyroid carcinoma, clinicopathological features, developing countries

Procedia PDF Downloads 176
771 Assessment of Attractency of Bactrocera Zonata and Bactrocera dorsalis (Diptera:Tephritidae) to Different Biolure Phagostimulant-Mixtures

Authors: Muhammad Dildar Gogi, Muhammad Jalal Arif, Muhammad Junaid Nisar, Mubashir Iqbal, Waleed Afzal Naveed, Muhammad Ahsan Khan, Ahmad Nawaz, Muhammad Sufian, Muhammad Arshad, Amna Jalal

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Fruit flies of Bactrocera genus cause heavy losses in fruits and vegetables globally and insecticide-application for their control creates issues of ecological backlash, environmental pollution, and food safety. There is need to explore alternatives and food-baits application is considered safe for the environment and effective for fruit fly management. Present experiment was carried out to assess the attractancy of five phagostimulant-Mixtures (PHS-Mix) prepared by mixing banana-squash, mulberry, protein-hydrolysate and molasses with some phagostimulant-lure sources including beef extract, fish extract, yeast, starch, rose oil, casein and cedar oil in five different ratios i.e., PHS-Mix-1 (1 part of all ingredients), PHS-Mix-2 (1 part of banana with 0.75 parts of all other ingredients), PHS-Mix-3 (1 part of banana with 0.5 parts of all other ingredients), PHS-Mix-4 (1 part of banana with 0.25 parts of all other ingredients) and PHS-Mix-5 (1 part of banana with 0.125 parts of all other ingredients). These were evaluated in comparison with a standard (GF-120). PHS-Mix-4 demonstrated 40.5±1.3-46.2±1.6% AI for satiated flies (class-II i.e., moderately attractive) and 59.5±2.0-68.6±3.0% AI for starved flies (class-III i.e., highly attractive) for both B. dorsalis and B. zonata in olfactometric study while the same exhibited 51.2±0.53% AI (class-III i.e., highly attractive) for B. zonata and 45.4±0.89% AI (class-II i.e., moderately attractive) for B. dorsalis in field study. PHS-Mix-1 proved non-attractive (class-I) and moderately attractive (class-II) phagostimulant in olfactometer and field studies, respectively. PHS-Mix-2 exhibited moderate attractiveness for starved lots in olfactometer and field-lot in field studies. PHS-Mix-5 proved non-attractive to starved and satiated lots of B. zonata and B. dorsalis females in olfactometer and field studies. Overall PHS-Mix-4 proved better phagostimulant-mixture followed by PHS-Mix-3 which was categorized as class-II (moderately attractive) phagostimulant for starved and satiated lots of female flies of both species in olfactometer and field studies; hence these can be exploited for fruit fly management.

Keywords: attractive index, field conditions, olfactometer, Tephritid flies

Procedia PDF Downloads 236
770 A Conceptual Framework of Integrated Evaluation Methodology for Aquaculture Lakes

Authors: Robby Y. Tallar, Nikodemus L., Yuri S., Jian P. Suen

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Research in the subject of ecological water resources management is full of trivial questions addressed and it seems, today to be one branch of science that can strongly contribute to the study of complexity (physical, biological, ecological, socio-economic, environmental, and other aspects). Existing literature available on different facets of these studies, much of it is technical and targeted for specific users. This study offered the combination all aspects in evaluation methodology for aquaculture lakes with its paradigm refer to hierarchical theory and to the effects of spatial specific arrangement of an object into a space or local area. Therefore, the process in developing a conceptual framework represents the more integrated and related applicable concept from the grounded theory. A design of integrated evaluation methodology for aquaculture lakes is presented. The method is based on the identification of a series of attributes which can be used to describe status of aquaculture lakes using certain indicators from aquaculture water quality index (AWQI), aesthetic aquaculture lake index (AALI) and rapid appraisal for fisheries index (RAPFISH). The preliminary preparation could be accomplished as follows: first, the characterization of study area was undertaken at different spatial scales. Second, an inventory data as a core resource such as city master plan, water quality reports from environmental agency, and related government regulations. Third, ground-checking survey should be completed to validate the on-site condition of study area. In order to design an integrated evaluation methodology for aquaculture lakes, finally we integrated and developed rating scores system which called Integrated Aquaculture Lake Index (IALI).The development of IALI are reflecting a compromise all aspects and it responds the needs of concise information about the current status of aquaculture lakes by the comprehensive approach. IALI was elaborated as a decision aid tool for stakeholders to evaluate the impact and contribution of anthropogenic activities on the aquaculture lake’s environment. The conclusion was while there is no denying the fact that the aquaculture lakes are under great threat from the pressure of the increasing human activities, one must realize that no evaluation methodology for aquaculture lakes can succeed by keeping the pristine condition. The IALI developed in this work can be used as an effective, low-cost evaluation methodology of aquaculture lakes for developing countries. Because IALI emphasizes the simplicity and understandability as it must communicate to decision makers and the experts. Moreover, stakeholders need to be helped to perceive their lakes so that sites can be accepted and valued by local people. For this site of lake development, accessibility and planning designation of the site is of decisive importance: the local people want to know whether the lake condition is safe or whether it can be used.

Keywords: aesthetic value, AHP, aquaculture lakes, integrated lakes, RAPFISH

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769 Ergonomic Adaptations in Visually Impaired Workers - A Literature Review

Authors: Kamila Troper, Pedro Mestre, Maria Lurdes Menano, Joana Mendonça, Maria João Costa, Sandra Demel

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Introduction: Visual impairment is a problem that has an influence on hundreds of thousands of people all over the world. Although it is possible for a Visually Impaired person to do most jobs, the right training, technological assistance, and emotional support are essential. Ergonomics be able to solve many of the problems/issues with the relative ease of positioning, lighting and design of the workplace. A little forethought can make a tremendous difference to the ease with which a person with an impairment function. Objectives: Review the main ergonomic adaptation measures reported in the literature in order to promote better working conditions and safety measures for the visually impaired. Methodology: This was an exploratory-descriptive, qualitative literature systematic review study. The main databases used were: PubMed, BIREME, LILACS, with articles and studies published between 2000 and 2021. Results: Based on the principles of the theoretical references of ergonomic analysis of work, the main restructuring of the physical space of the workstations were: Accessibility facilities and assistive technologies; A screen reader that captures information from a computer and sends it in real-time to a speech synthesizer or Braille terminal; Installations of software with voice recognition, Monitors with enlarged screens; Magnification software; Adequate lighting, magnifying lenses in addition to recommendations regarding signage and clearance of the places where the visually impaired pass through. Conclusions: Employability rates for people with visual impairments(both those who are blind and those who have low vision)are low and continue to be a concern to the world and for researchers as a topic of international interest. Although numerous authors have identified barriers to employment and proposed strategies to remediate or circumvent those barriers, people with visual impairments continue to experience high rates of unemployment.

Keywords: ergonomic adaptations, visual impairments, ergonomic analysis of work, systematic review

Procedia PDF Downloads 170
768 Fire Resilient Cities: The Impact of Fire Regulations, Technological and Community Resilience

Authors: Fanny Guay

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Building resilience, sustainable buildings, urbanization, climate change, resilient cities, are just a few examples of where the focus of research has been in the last few years. It is obvious that there is a need to rethink how we are building our cities and how we are renovating our existing buildings. However, the question remaining is how can we assure that we are building sustainable yet resilient cities? There are many aspects one can touch upon when discussing resilience in cities, but after the event of Grenfell in June 2017, it has become clear that fire resilience must be a priority. We define resilience as a holistic approach including communities, society and systems, focusing not only on resisting the effects of a disaster, but also how it will cope and recover from it. Cities are an example of such a system, where components such as buildings have an important role to play. A building on fire will have an impact on the community, the economy, the environment, and so the entire system. Therefore, we believe that fire and resilience go hand in hand when we discuss building resilient cities. This article aims at discussing the current state of the concept of fire resilience and suggests actions to support the built of more fire resilient buildings. Using the case of Grenfell and the fire safety regulations in the UK, we will briefly compare the fire regulations in other European countries, more precisely France, Germany and Denmark, to underline the difference and make some suggestions to increase fire resilience via regulation. For this research, we will also include other types of resilience such as technological resilience, discussing the structure of buildings itself, as well as community resilience, considering the role of communities in building resilience. Our findings demonstrate that to increase fire resilience, amending existing regulations might be necessary, for example, how we performed reaction to fire tests and how we classify building products. However, as we are looking at national regulations, we are only able to make general suggestions for improvement. Another finding of this research is that the capacity of the community to recover and adapt after a fire is also an essential factor. Fundamentally, fire resilience, technological resilience and community resilience are closely connected. Building resilient cities is not only about sustainable buildings or energy efficiency; it is about assuring that all the aspects of resilience are included when building or renovating buildings. We must ask ourselves questions as: Who are the users of this building? Where is the building located? What are the components of the building, how was it designed and which construction products have been used? If we want to have resilient cities, we must answer these basic questions and assure that basic factors such as fire resilience are included in our assessment.

Keywords: buildings, cities, fire, resilience

Procedia PDF Downloads 154
767 Identifying, Reporting and Preventing Medical Errors Among Nurses Working in Critical Care Units At Kenyatta National Hospital, Kenya: Closing the Gap Between Attitude and Practice

Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

Procedia PDF Downloads 231
766 Identifying the Barriers to Institutionalizing a One Health Concept in Responding to Zoonotic Diseases in South Asia

Authors: Rojan Dahal

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One Health refers to a collaborative effort between multiple disciplines - locally, nationally, and globally - to attain optimal health. Although there were unprecedented intersectoral alliances between the animal and human health sectors during the avian influenza outbreak, there are different views and perceptions concerning institutionalizing One Health in South Asia. It is likely a structural barrier between the relevant professionals working in different entities or ministries when it comes to collaborating on One Health actions regarding zoonotic diseases. Politicians and the public will likely need to invest large amounts of money, demonstrate political will, and understand how One Health works to overcome these barriers. One Health might be hard to invest in South Asian countries, where the benefits are based primarily on models and projections and where numerous issues related to development and health need urgent attention. The other potential barrier to enabling the One Health concept in responding to zoonotic diseases is a failure to represent One Health in zoonotic disease control and prevention measures in the national health policy, which is a critical component of institutionalizing the One Health concept. One Health cannot be institutionalized without acknowledging the linkages between animal, human, and environmental sectors in dealing with zoonotic diseases. Efforts have been made in the past to prepare a preparedness plan for One Health implementation, but little has been done to establish a policy environment to institutionalize One Health. It is often assumed that health policy refers specifically to medical care issues and health care services. When drafting, reviewing, and redrafting the policy, it is important to engage a wide range of stakeholders. One Health institutionalization may also be hindered by the interplay between One Health professionals and bureaucratic inertia in defining the priorities of diseases due to competing interests on limited budgets. There is a possibility that policymakers do not recognize the importance of veterinary professionals in preventing human diseases originating in animals. Compared to veterinary medicine, the human health sector has produced most of the investment and research outputs related to zoonotic diseases. The public health profession may consider itself superior to the veterinary profession. Zoonotic diseases might not be recognized as threats to human health, impeding integrated policies. The effort of One Health institutionalization remained only among the donor agencies and multi-sectoral organizations. There is a need for strong political will and state capacity to overcome the existing institutional, financial, and professional barriers for its effective implementation. There is a need to assess the structural challenges, policy challenges, and the attitude of the professional working in the multiple disciplines related to One Health. Limited research has been conducted to identify the reasons behind the barriers to institutionalizing the One Health concept in South Asia. Institutionalizing One Health in responding to zoonotic diseases breaks down silos and integrates animals, humans, and the environment.

Keywords: one health, institutionalization, South Asia, institutionalizations

Procedia PDF Downloads 82
765 A Unified Model for Predicting Particle Settling Velocity in Pipe, Annulus and Fracture

Authors: Zhaopeng Zhu, Xianzhi Song, Gensheng Li

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Transports of solid particles through the drill pipe, drill string-hole annulus and hydraulically generated fractures are important dynamic processes encountered in oil and gas well drilling and completion operations. Different from particle transport in infinite space, the transports of cuttings, proppants and formation sand are hindered by a finite boundary. Therefore, an accurate description of the particle transport behavior under the bounded wall conditions encountered in drilling and hydraulic fracturing operations is needed to improve drilling safety and efficiency. In this study, the particle settling experiments were carried out to investigate the particle settling behavior in the pipe, annulus and between the parallel plates filled with power-law fluids. Experimental conditions simulated the particle Reynolds number ranges of 0.01-123.87, the dimensionless diameter ranges of 0.20-0.80 and the fluid flow behavior index ranges of 0.48-0.69. Firstly, the wall effect of the annulus is revealed by analyzing the settling process of the particles in the annular geometry with variable inner pipe diameter. Then, the geometric continuity among the pipe, annulus and parallel plates was determined by introducing the ratio of inner diameter to an outer diameter of the annulus. Further, a unified dimensionless diameter was defined to confirm the relationship between the three different geometry in terms of the wall effect. In addition, a dimensionless term independent from the settling velocity was introduced to establish a unified explicit settling velocity model applicable to pipes, annulus and fractures with a mean relative error of 8.71%. An example case study was provided to demonstrate the application of the unified model for predicting particle settling velocity. This paper is the first study of annulus wall effects based on the geometric continuity concept and the unified model presented here will provide theoretical guidance for improved hydraulic design of cuttings transport, proppant placement and sand management operations.

Keywords: wall effect, particle settling velocity, cuttings transport, proppant transport in fracture

Procedia PDF Downloads 152
764 [Keynote Talk]: Mental Health Challenges among Women in Dubai, Mental Health Needs Assessment for Dubai (2015), Public Health and Safety Department - Dubai Health Authority (DHA)

Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

Procedia PDF Downloads 198
763 Development of a Tilt-Rotor Aircraft Model Using System Identification Technique

Authors: Ferdinando Montemari, Antonio Vitale, Nicola Genito, Giovanni Cuciniello

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The introduction of tilt-rotor aircraft into the existing civilian air transportation system will provide beneficial effects due to tilt-rotor capability to combine the characteristics of a helicopter and a fixed-wing aircraft into one vehicle. The disposability of reliable tilt-rotor simulation models supports the development of such vehicle. Indeed, simulation models are required to design automatic control systems that increase safety, reduce pilot's workload and stress, and ensure the optimal aircraft configuration with respect to flight envelope limits, especially during the most critical flight phases such as conversion from helicopter to aircraft mode and vice versa. This article presents a process to build a simplified tilt-rotor simulation model, derived from the analysis of flight data. The model aims to reproduce the complex dynamics of tilt-rotor during the in-flight conversion phase. It uses a set of scheduled linear transfer functions to relate the autopilot reference inputs to the most relevant rigid body state variables. The model also computes information about the rotor flapping dynamics, which are useful to evaluate the aircraft control margin in terms of rotor collective and cyclic commands. The rotor flapping model is derived through a mixed theoretical-empirical approach, which includes physical analytical equations (applicable to helicopter configuration) and parametric corrective functions. The latter are introduced to best fit the actual rotor behavior and balance the differences existing between helicopter and tilt-rotor during flight. Time-domain system identification from flight data is exploited to optimize the model structure and to estimate the model parameters. The presented model-building process was applied to simulated flight data of the ERICA Tilt-Rotor, generated by using a high fidelity simulation model implemented in FlightLab environment. The validation of the obtained model was very satisfying, confirming the validity of the proposed approach.

Keywords: flapping dynamics, flight dynamics, system identification, tilt-rotor modeling and simulation

Procedia PDF Downloads 185
762 Changes in the fecal Microbiome of Periparturient Dairy Cattle and Associations with the Onset of Salmonella Shedding

Authors: Lohendy Munoz-Vargas, Stephen O. Opiyo, Rose Digianantonio, Michele L. Williams, Asela Wijeratne, Gregory Habing

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Non-typhoidal Salmonella enterica is a zoonotic pathogen with critical importance in animal and public health. The persistence of Salmonella on farms affects animal productivity and health, and represents a risk for food safety. The intestinal microbiota plays a fundamental role in the colonization and invasion of this ubiquitous microorganism. To overcome the colonization resistance imparted by the gut microbiome, Salmonella uses invasion strategies and the host inflammatory response to survive, proliferate, and establish infections with diverse clinical manifestations. Cattle serve as reservoirs of Salmonella, and periparturient cows have high prevalence of Salmonella shedding; however, to author`s best knowledge, little is known about the association between the gut microbiome and the onset of Salmonella shedding during the periparturient period. Thus, the objective of this study was to assess the association between changes in bacterial communities and the onset of Salmonella shedding in cattle approaching parturition. In a prospective cohort study, fecal samples from 98 dairy cows originating from four different farms were collected at four time points relative to calving (-3 wks, -1 wk, +1 wk, +3 wks). All 392 samples were cultured for Salmonella. Sequencing of the V4 region of the 16S rRNA gene using the Illumina platform was completed to evaluate the fecal microbiome in a selected sample subset. Analyses of microbial composition, diversity, and structure were performed according to time points, farm, and Salmonella onset status. Individual cow fecal microbiomes, predominated by Bacteroidetes, Firmicutes, Spirochaetes, and Proteobacteria phyla, significantly changed before and after parturition. Microbial communities from different farms were distinguishable based on multivariate analysis. Although there were significant differences in some bacterial taxa between Salmonella positive and negative samples, our results did not identify differences in the fecal microbial diversity or structure for cows with and without the onset of Salmonella shedding. These data suggest that determinants other than the significant changes in the fecal microbiome influence the periparturient onset of Salmonella shedding in dairy cattle.

Keywords: dairy cattle, microbiome, periparturient, Salmonella

Procedia PDF Downloads 156
761 Automated Manual Handling Risk Assessments: Practitioner Experienced Determinants of Automated Risk Analysis and Reporting Being a Benefit or Distraction

Authors: S. Cowley, M. Lawrance, D. Bick, R. McCord

Abstract:

Technology that automates manual handling (musculoskeletal disorder or MSD) risk assessments is increasingly available to ergonomists, engineers, generalist health and safety practitioners alike. The risk assessment process is generally based on the use of wearable motion sensors that capture information about worker movements for real-time or for posthoc analysis. Traditionally, MSD risk assessment is undertaken with the assistance of a checklist such as that from the SafeWork Australia code of practice, the expert assessor observing the task and ideally engaging with the worker in a discussion about the detail. Automation enables the non-expert to complete assessments and does not always require the assessor to be there. This clearly has cost and time benefits for the practitioner but is it an improvement on the assessment by the human. Human risk assessments draw on the knowledge and expertise of the assessor but, like all risk assessments, are highly subjective. The complexity of the checklists and models used in the process can be off-putting and sometimes will lead to the assessment becoming the focus and the end rather than a means to an end; the focus on risk control is lost. Automated risk assessment handles the complexity of the assessment for the assessor and delivers a simple risk score that enables decision-making regarding risk control. Being machine-based, they are objective and will deliver the same each time they assess an identical task. However, the WHS professional needs to know that this emergent technology asks the right questions and delivers the right answers. Whether it improves the risk assessment process and results or simply distances the professional from the task and the worker. They need clarity as to whether automation of manual task risk analysis and reporting leads to risk control or to a focus on the worker. Critically, they need evidence as to whether automation in this area of hazard management leads to better risk control or just a bigger collection of assessments. Practitioner experienced determinants of this automated manual task risk analysis and reporting being a benefit or distraction will address an understanding of emergent risk assessment technology, its use and things to consider when making decisions about adopting and applying these technologies.

Keywords: automated, manual-handling, risk-assessment, machine-based

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760 Risk Management Approach for a Secure and Performant Integration of Automated Drug Dispensing Systems in Hospitals

Authors: Hind Bouami, Patrick Millot

Abstract:

Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

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