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176 Revolutionary Wastewater Treatment Technology: An Affordable, Low-Maintenance Solution for Wastewater Recovery and Energy-Saving
Authors: Hady Hamidyan
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As the global population continues to grow, the demand for clean water and effective wastewater treatment becomes increasingly critical. By 2030, global water demand is projected to exceed supply by 40%, driven by population growth, increased water usage, and climate change. Currently, about 4.2 billion people lack access to safely managed sanitation services. The wastewater treatment sector faces numerous challenges, including the need for energy-efficient solutions, cost-effectiveness, ease of use, and low maintenance requirements. This abstract presents a groundbreaking wastewater treatment technology that addresses these challenges by offering an energy-saving approach, wastewater recovery capabilities, and a ready-made, affordable, and user-friendly package with minimal maintenance costs. The unique design of this ready-made package made it possible to eliminate the need for pumps, filters, airlift, and other common equipment. Consequently, it enables sustainable wastewater treatment management with exceptionally low energy and cost requirements, minimizing investment and maintenance expenses. The operation of these packages is based on continuous aeration, which involves injecting oxygen gas or air into the aeration chamber through a tubular diffuser with very small openings. This process supplies the necessary oxygen for aerobic bacteria. The recovered water, which amounts to almost 95% of the input, can be treated to meet specific quality standards, allowing safe reuse for irrigation, industrial processes, or even potable purposes. This not only reduces the strain on freshwater resources but also provides economic benefits by offsetting the costs associated with freshwater acquisition and wastewater discharge. The ready-made, affordable, and user-friendly nature of this technology makes it accessible to a wide range of users, including small communities, industries, and decentralized wastewater treatment systems. The system incorporates user-friendly interfaces, simplified operational procedures, and integrated automation, facilitating easy implementation and operation. Additionally, the use of durable materials, efficient equipment, and advanced monitoring systems significantly reduces maintenance requirements, resulting in low overall life-cycle costs and alleviating the burden on operators and maintenance personnel. In conclusion, the presented wastewater treatment technology offers a comprehensive solution to the challenges faced by the industry. Its energy-saving approach, combined with wastewater recovery capabilities, ensures sustainable resource management and enhances environmental stewardship. This affordable, ready-made, and low-maintenance package promotes broad adoption across various sectors and communities, contributing to a more sustainable future for water and wastewater management.Keywords: wastewater treatment, energy saving, wastewater recovery, affordable package, low maintenance costs, sustainable resource management, environmental stewardship
Procedia PDF Downloads 92175 The Walkway Project: An Exploration of Informal Public Space Upgrading in Gugulethu, Cape Town
Authors: Kathryn Ewing
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Safe and accessible public spaces are vital elements of our South African cities. Public spaces hold the potential to act as important, vibrant places for learning, exchange, and practice. Public walkways, however, are some of the most neglected and extremely dangerous public spaces experienced in the local neighborhood of Gugulethu in Cape Town. Walkways feel insignificant, being recognized as informal and undetermined or retain complex fragments of formal erven. They are generally out of sight connecting minor streets and informal settlements. Community residents refer to the walkways as unsafe and dirty spaces. Local authorities allocate minimal to no municipal budgets nor maintenance plans resulting in a lack of basic services, particularly lighting and green infrastructure. ‘The Walkway Project’ presents a series of urban stories collected from co-design workshops, emotional mapping exercises, and fieldwork, including urban walks and urban talks. The narrative interprets the socio-spatial practice and complexity of informal public space in Gugulethu, Cape Town. The Walkway Project research, interrelated to the Master of Urban Design teaching and design-research studio, has a strong focus on participatory and engaged learning and action research methodology within a deliberate pedagogy. A consolidated urban design implementation plan exposes the impact and challenges of waste and water, opening the debate on relevant local solutions for resilience and safety in Cape Town. A small and neglected passage connecting two streets, commonly referred to as iThemba Walkway, is presented as a case study to show-case strategic urban design intervention strategies for urban upgrading. The iThemba walkway is a community-driven project that demonstrates active and responsible co-design and participatory development opportunities. In March 2021, when visited on an urban walk, the public space was covered by rubble and solid waste. By April 2021, the community cleaned the walkway and created an accessible passage for the school children to pass. Numerous co-design workshops have taken place over the past year. The walkway has emerged as a public space upgrading project facilitated, motivated, and implemented by multiple local partners and residents. Social maps from urban walks and talks illustrate the transformation of iThemba Walkway into an inclusive, safe, resilient, and sustainable urban space, linked to Sustainable Development Goal number 11, sustainable cities and communities. The outcomes of the upgrading project facilitate a deeper understanding of co-design methods, urban upgrading processes, and monitoring of public space and informal urbanism.Keywords: informal, public space, resilience, safety, upgrade, walkways
Procedia PDF Downloads 93174 Physical Activity Based on Daily Step-Count in Inpatient Setting in Stroke and Traumatic Brain Injury Patients in Subacute Stage Follow Up: A Cross-Sectional Observational Study
Authors: Brigitte Mischler, Marget Hund, Hilfiker Roger, Clare Maguire
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Background: Brain injury is one of the main causes of permanent physical disability, and improving walking ability is one of the most important goals for patients. After inpatient rehabilitation, most do not receive long-term rehabilitation services. Physical activity is important for the health prevention of the musculoskeletal system, circulatory system and the psyche. Objective: This follow-up study measured physical activity in subacute patients after traumatic brain injury and stroke. The difference in the number of steps in the inpatient setting was compared to the number of steps 1 year after the event in the outpatient setting. Methods: This follow-up study is a cross-sectional observational study with 29 participants. The measurement of daily step count over a seven-day period one year after the event was evaluated with the StepWatch™ ankle sensor. The number of steps taken one year after the event in the outpatient setting was compared with the number of steps taken during the inpatient stay and evaluated if they reached the recommended target value. Correlations between steps-count and exit domain, FAC level, walking speed, light touch, joint position sense, cognition, and fear of falling were calculated. Results: The median (IQR) daily step count of all patients was 2512 (568.5, 4070.5). During follow-up, the number of steps improved to 3656(1710,5900). The average difference was 1159(-2825, 6840) steps per day. Participants who were unable to walk independently (FAC 1) improved from 336(5-705) to 1808(92, 5354) steps per day. Participants able to walk with assistance (FAC 2-3) walked 700(31-3080) and at follow-up 3528(243,6871). Independent walkers (FAC 4-5) walked 4093(2327-5868) and achieved 3878(777,7418) daily steps at follow-up. This value is significantly below the recommended guideline. Step-count at follow-up showed moderate to high and statistically significant correlations: positive for FAC score, positive for FIM total score, positive for walking speed, and negative for fear of falling. Conclusions: Only 17% of all participants achieved the recommended daily step count one year after the event. We need better inpatient and outpatient strategies to improve physical activity. In everyday clinical practice, pedometers and diaries with objectives should be used. A concrete weekly schedule should be drawn up together with the patient, relatives, or nursing staff after discharge. This should include daily self-training, which was instructed during the inpatient stay. A good connection to social life (professional connection or a daily task/activity) can be an important part of improving daily activity. Further research should evaluate strategies to increase daily step counts in inpatient settings as well as in outpatient settings.Keywords: neurorehabilitation, stroke, traumatic brain injury, steps, stepcount
Procedia PDF Downloads 14173 Preventative Programs for At-Risk Families of Child Maltreatment: Using Home Visiting and Intergenerational Relationships
Authors: Kristina Gordon
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One in three children in the United States is a victim of a maltreatment investigation, and about one in nine children has a substantiated investigation. Home visiting is one of several preventative strategies rooted in an early childhood approach that fosters maternal, infant, and early childhood health, protection, and growth. In the United States, 88% of states report administering home visiting programs or state-designed models. The purpose of this study was to conduct a systematic review on home visiting programs in the United States focused on the prevention of child abuse and neglect. This systematic review included 17 articles which found that most of the studies reported optimistic results. Common across studies was program content related to (1) typical child development, (2) parenting education, and (3) child physical health. Although several factors common to home visiting and parenting interventions have been identified, no research has examined the common components of manualized home visiting programs to prevent child maltreatment. Child maltreatment can be addressed with home visiting programs with evidence-based components and cultural adaptations that increase prevention by assisting families in tackling the risk factors they face. An innovative approach to child maltreatment prevention is bringing together at-risk families with the aging community. This innovative approach was prompted due to existing home visitation programs only focusing on improving skillsets and providing temporary relationships. This innovative approach can provide the opportunity for families to build a relationship with an aging individual who can share their wisdom, skills, compassion, love, and guidance, to support families in their well-being and decrease child maltreatment occurrence. Families would be identified if they experience any of the risk factors, including parental substance abuse, parental mental illness, domestic violence, and poverty. Families would also be identified as at risk if they lack supportive relationships such as grandparents or relatives. Families would be referred by local agencies such as medical clinics, hospitals, schools, etc., that have interactions with families regularly. The aging community would be recruited at local housing communities and community centers. An aging individual would be identified by the elderly community when there is a need or interest in a relationship by or for the individual. Cultural considerations would be made when assessing for compatibility between the families and aging individuals. The pilot program will consist of a small group of participants to allow manageable results to evaluate the efficacy of the program. The pilot will include pre-and post-surveys to evaluate the impact of the program. From the results, data would be created to determine the efficacy as well as the sufficiency of the details of the pilot. The pilot would also be evaluated on whether families were referred to Child Protective Services during the pilot as it relates to the goal of decreasing child maltreatment. The ideal findings will display a decrease in child maltreatment and an increase in family well-being for participants.Keywords: child maltreatment, home visiting, neglect, preventative, abuse
Procedia PDF Downloads 116172 The Effect of Online Analyzer Malfunction on the Performance of Sulfur Recovery Unit and Providing a Temporary Solution to Reduce the Emission Rate
Authors: Hamid Reza Mahdipoor, Mehdi Bahrami, Mohammad Bodaghi, Seyed Ali Akbar Mansoori
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Nowadays, with stricter limitations to reduce emissions, considerable penalties are imposed if pollution limits are exceeded. Therefore, refineries, along with focusing on improving the quality of their products, are also focused on producing products with the least environmental impact. The duty of the sulfur recovery unit (SRU) is to convert H₂S gas coming from the upstream units to elemental sulfur and minimize the burning of sulfur compounds to SO₂. The Claus process is a common process for converting H₂S to sulfur, including a reaction furnace followed by catalytic reactors and sulfur condensers. In addition to a Claus section, SRUs usually consist of a tail gas treatment (TGT) section to decrease the concentration of SO₂ in the flue gas below the emission limits. To operate an SRU properly, the flow rate of combustion air to the reaction furnace must be adjusted so that the Claus reaction is performed according to stoichiometry. Accurate control of the air demand leads to an optimum recovery of sulfur during the flow and composition fluctuations in the acid gas feed. Therefore, the major control system in the SRU is the air demand control loop, which includes a feed-forward control system based on predetermined feed flow rates and a feed-back control system based on the signal from the tail gas online analyzer. The use of online analyzers requires compliance with the installation and operation instructions. Unfortunately, most of these analyzers in Iran are out of service for different reasons, like the low importance of environmental issues and a lack of access to after-sales services due to sanctions. In this paper, an SRU in Iran was simulated and calibrated using industrial experimental data. Afterward, the effect of the malfunction of the online analyzer on the performance of SRU was investigated using the calibrated simulation. The results showed that an increase in the SO₂ concentration in the tail gas led to an increase in the temperature of the reduction reactor in the TGT section. This increase in temperature caused the failure of TGT and increased the concentration of SO₂ from 750 ppm to 35,000 ppm. In addition, the lack of a control system for the adjustment of the combustion air caused further increases in SO₂ emissions. In some processes, the major variable cannot be controlled directly due to difficulty in measurement or a long delay in the sampling system. In these cases, a secondary variable, which can be measured more easily, is considered to be controlled. With the correct selection of this variable, the main variable is also controlled along with the secondary variable. This strategy for controlling a process system is referred to as inferential control" and is considered in this paper. Therefore, a sensitivity analysis was performed to investigate the sensitivity of other measurable parameters to input disturbances. The results revealed that the output temperature of the first Claus reactor could be used for inferential control of the combustion air. Applying this method to the operation led to maximizing the sulfur recovery in the Claus section.Keywords: sulfur recovery, online analyzer, inferential control, SO₂ emission
Procedia PDF Downloads 75171 The Role of Supply Chain Agility in Improving Manufacturing Resilience
Authors: Maryam Ziaee
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This research proposes a new approach and provides an opportunity for manufacturing companies to produce large amounts of products that meet their prospective customers’ tastes, needs, and expectations and simultaneously enable manufacturers to increase their profit. Mass customization is the production of products or services to meet each individual customer’s desires to the greatest possible extent in high quantities and at reasonable prices. This process takes place at different levels such as the customization of goods’ design, assembly, sale, and delivery status, and classifies in several categories. The main focus of this study is on one class of mass customization, called optional customization, in which companies try to provide their customers with as many options as possible to customize their products. These options could range from the design phase to the manufacturing phase, or even methods of delivery. Mass customization values customers’ tastes, but it is only one side of clients’ satisfaction; on the other side is companies’ fast responsiveness delivery. It brings the concept of agility, which is the ability of a company to respond rapidly to changes in volatile markets in terms of volume and variety. Indeed, mass customization is not effectively feasible without integrating the concept of agility. To gain the customers’ satisfaction, the companies need to be quick in responding to their customers’ demands, thus highlighting the significance of agility. This research offers a different method that successfully integrates mass customization and fast production in manufacturing industries. This research is built upon the hypothesis that the success key to being agile in mass customization is to forecast demand, cooperate with suppliers, and control inventory. Therefore, the significance of the supply chain (SC) is more pertinent when it comes to this stage. Since SC behavior is dynamic and its behavior changes constantly, companies have to apply one of the predicting techniques to identify the changes associated with SC behavior to be able to respond properly to any unwelcome events. System dynamics utilized in this research is a simulation approach to provide a mathematical model among different variables to understand, control, and forecast SC behavior. The final stage is delayed differentiation, the production strategy considered in this research. In this approach, the main platform of products is produced and stocked and when the company receives an order from a customer, a specific customized feature is assigned to this platform and the customized products will be created. The main research question is to what extent applying system dynamics for the prediction of SC behavior improves the agility of mass customization. This research is built upon a qualitative approach to bring about richer, deeper, and more revealing results. The data is collected through interviews and is analyzed through NVivo software. This proposed model offers numerous benefits such as reduction in the number of product inventories and their storage costs, improvement in the resilience of companies’ responses to their clients’ needs and tastes, the increase of profits, and the optimization of productivity with the minimum level of lost sales.Keywords: agility, manufacturing, resilience, supply chain
Procedia PDF Downloads 89170 Convergence of Strategic Tasks of Business Tourism and Hotel Industry Development: The Case of Georgia
Authors: Nana Katsitadze, Tamar Atanelishvili, Mariam Kutateladze, Alexandre Tushishvili
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In the modern world, tourism has emerged as one of the most powerful economic sectors, and due to its high economic performance, it is attractive to the countries with various levels of economic development. The purpose of the present paper, dedicated to discussing the current problems of tourism development, is to find ways which will contribute to bringing more benefits to the country from the sector. Georgia has been successfully developing leisure tourism for the last ten years, and at the next stage of development business, tourism gains particular importance for Georgia as a means of mitigating the negative socio-economic effects caused by the seasonality of tourism and as a high-cost tourism market. Therefore, the object of the paper is to study the factors that contribute to the development of business tourism. The paper uses the research methods such as system analysis, synthesis, analogy, as well as historical, comparative, economic, and statistical methods of analysis. The information base for the research is made up of the statistics on the functioning of the tourism market of Georgia and foreign countries as well as official data provided by international organizations in the field of tourism. Based on the experience of business tourism around the world and identifying the successful start of business tourism development in Georgia and its causing factors, a business tourism development model for Georgia has been developed. The model might be useful as a methodological material for developing a business tourism development concept for the countries with limited financial resources but rich in tourism resources like Georgia. On the initial stage of development (in absence of conventional centers), the suggested concept of business tourism development involves organizing small and medium-sized meetings both in large cities and in regions by using high-class hotel infrastructure and event management services. Relocation of small meetings to the regions encourages inclusive development of the sector based on increasing the awareness of these regions as tourist sites as well as the increase in employment and sales of other tourism or consumer products. Business tourism increases the number of hotel visitors in the non-seasonal period and improves hotel performance indicators, which enhances the attractiveness of investing in the hotel business. According to the present concept of business tourism development, at the initial stage, development of business tourism is based on the existing markets, including internal market, neighboring markets and the markets of geographically relatively near countries and at the next stage, the concept involves generating tourists from other relatively distant target markets. As a result, by gaining experience in business tourism, enhancing professionalism, increasing awareness and stimulating infrastructure development, the country will prepare the basis to move to a higher stage of tourism development. In addition, the experience showed that for attracting large customers, peculiarities of the field require activation of state policy and active use of marketing mechanisms and tools of the state.Keywords: hotel industry development, MICE model, MICE strategy, MICE tourism in Georgia
Procedia PDF Downloads 154169 A Strategic Approach in Utilising Limited Resources to Achieve High Organisational Performance
Authors: Collen Tebogo Masilo, Erik Schmikl
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The demand for the DataMiner product by customers has presented a great challenge for the vendor in Skyline Communications in deploying its limited resources in the form of human resources, financial resources, and office space, to achieve high organisational performance in all its international operations. The rapid growth of the organisation has been unable to efficiently support its existing customers across the globe, and provide services to new customers, due to the limited number of approximately one hundred employees in its employ. The combined descriptive and explanatory case study research methods were selected as research design, making use of a survey questionnaire which was distributed to a sample of 100 respondents. A sample return of 89 respondents was achieved. The sampling method employed was non-probability sampling, using the convenient sampling method. Frequency analysis and correlation between the subscales (the four themes) were used for statistical analysis to interpret the data. The investigation was conducted into mechanisms that can be deployed to balance the high demand for products and the limited production capacity of the company’s Belgian operations across four aspects: demand management strategies, capacity management strategies, communication methods that can be used to align a sales management department, and reward systems in use to improve employee performance. The conclusions derived from the theme ‘demand management strategies’ are that the company is fully aware of the future market demand for its products. However, there seems to be no evidence that there is proper demand forecasting conducted within the organisation. The conclusions derived from the theme 'capacity management strategies' are that employees always have a lot of work to complete during office hours, and, also, employees seem to need help from colleagues with urgent tasks. This indicates that employees often work on unplanned tasks and multiple projects. Conclusions derived from the theme 'communication methods used to align sales management department with operations' are that communication is not good throughout the organisation. This means that information often stays with management, and does not reach non-management employees. This also means that there is a lack of smooth synergy as expected and a lack of good communication between the sales department and the projects office. This has a direct impact on the delivery of projects to customers by the operations department. The conclusions derived from the theme ‘employee reward systems’ are that employees are motivated, and feel that they add value in their current functions. There are currently no measures in place to identify unhappy employees, and there are also no proper reward systems in place which are linked to a performance management system. The research has made a contribution to the body of research by exploring the impact of the four sub-variables and their interaction on the challenges of organisational productivity, in particular where an organisation experiences a capacity problem during its growth stage during tough economic conditions. Recommendations were made which, if implemented by management, could further enhance the organisation’s sustained competitive operations.Keywords: high demand for products, high organisational performance, limited production capacity, limited resources
Procedia PDF Downloads 143168 The Relationship between Depression, HIV Stigma and Adherence to Antiretroviral Therapy among Adult Patients Living with HIV at a Tertiary Hospital in Durban, South Africa: The Mediating Roles of Self-Efficacy and Social Support
Authors: Muziwandile Luthuli
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Although numerous factors predicting adherence to antiretroviral therapy (ART) among people living with HIV/AIDS (PLWHA) have been broadly studied on both regional and global level, up-to-date adherence of patients to ART remains an overarching, dynamic and multifaceted problem that needs to be investigated over time and across various contexts. There is a rarity of empirical data in the literature on interactive mechanisms by which psychosocial factors influence adherence to ART among PLWHA within the South African context. Therefore, this study was designed to investigate the relationship between depression, HIV stigma, and adherence to ART among adult patients living with HIV at a tertiary hospital in Durban, South Africa, and the mediating roles of self-efficacy and social support. The health locus of control theory and the social support theory were the underlying theoretical frameworks for this study. Using a cross-sectional research design, a total of 201 male and female adult patients aged between 18-75 years receiving ART at a tertiary hospital in Durban, KwaZulu-Natal were sampled, using time location sampling (TLS). A self-administered questionnaire was employed to collect the data in this study. Data were analysed through SPSS version 27. Several statistical analyses were conducted in this study, namely univariate statistical analysis, correlational analysis, Pearson’s chi-square analysis, cross-tabulation analysis, binary logistic regression analysis, and mediational analysis. Univariate analysis indicated that the sample mean age was 39.28 years (SD=12.115), while most participants were females 71.0% (n=142), never married 74.2% (n=147), and most were also secondary school educated 48.3% (n=97), as well as unemployed 65.7% (n=132). The prevalence rate of participants who had high adherence to ART was 53.7% (n=108), and 46.3% (n=93) of participants had low adherence to ART. Chi-square analysis revealed that employment status was the only statistically significant socio-demographic influence of adherence to ART in this study (χ2 (3) = 8.745; p < .033). Chi-square analysis showed that there was a statistically significant difference found between depression and adherence to ART (χ2 (4) = 16.140; p < .003), while between HIV stigma and adherence to ART, no statistically significant difference was found (χ2 (1) = .323; p >.570). Binary logistic regression indicated that depression was statistically associated with adherence to ART (OR= .853; 95% CI, .789–.922, P < 001), while the association between self-efficacy and adherence to ART was statistically significant (OR= 1.04; 95% CI, 1.001– 1.078, P < .045) after controlling for the effect of depression. However, the findings showed that the effect of depression on adherence to ART was not significantly mediated by self-efficacy (Sobel test for indirect effect, Z= 1.01, P > 0.31). Binary logistic regression showed that the effect of HIV stigma on adherence to ART was not statistically significant (OR= .980; 95% CI, .937– 1.025, P > .374), but the effect of social support on adherence to ART was statistically significant, only after the effect of HIV stigma was controlled for (OR= 1.017; 95% CI, 1.000– 1.035, P < .046). This study promotes behavioral and social change effected through evidence-based interventions by emphasizing the need for additional research that investigates the interactive mechanisms by which psychosocial factors influence adherence to ART. Depression is a significant predictor of adherence to ART. Thus, to alleviate the psychosocial impact of depression on adherence to ART, effective interventions must be devised, along with special consideration of self-efficacy and social support. Therefore, this study is helpful in informing and effecting change in health policy and healthcare services through its findingsKeywords: ART adherence, depression, HIV/AIDS, PLWHA
Procedia PDF Downloads 180167 The Interrelation of Institutional Care and Successful Aging
Authors: Naphaporn Sapsopha
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Aging population has been growing rapidly in Thailand due to several factors – namely, the declining size of the average Thai family, changing family structure, higher survival rates of women, and job migration patterns – there are fewer working-age citizens who are able to care for and support their aging family members. When a family can no longer provide for their elders, the responsibility shifts to the government. Many non-profit institutional care facilities for older adults have already been established, but having such institutions are not enough. In addition to the provisions that a reliable shelter can provide, older adults also need efficient social services, physical wellness, and mental health, all of which are crucial for successful aging. Yet, to date, there is no consensus or a well-accepted definition of what constitutes successful aging. The issue is further complicated by cultural expectations, and the gendered experience of the older adults. These issues need to be better understood to promote effective care and wellness. This qualitative research investigates the relationship between institutional care and successful aging among the institutionalized Thai older adults at a non-profit facility in Bangkok, Thailand. Specifically, it examines: a) How do institutionalized older adults define successful aging?, b) What factors do they believe contribute to successful aging?, and c) Do their beliefs vary by gender? Data was collected using a phenomenological research approach that included focus groups and in-depth interviews using open-ended questions, conducted on 10 institutionalized older adults (5 men and 5 women) ages 60 or over. Interview transcripts were coded and analyzed using grounded theory methodology. The participants aged between 70-91 years old, and they varied in terms of gender, education, occupation, and life background. The results revealed that Thai institutionalized older adults viewed successful aging as a result of multiple interrelated factors: maintaining physical health, good mental and cognitive abilities. Remarkably, the participants identified as successful aging include independence for self-care and financial support, adhering to moral principles and religious practice, seeing the success of their loved ones, and making social contributions to their community. In addition, three primary themes were identified as a coping strategy to age successfully: self-acceptance by being sufficient and satisfied with all aspects of life, preparedness and adaptation for every stage of life, and self-esteem by maintaining their self. These beliefs are shared across gender and age differences. However, participants highlighted the importance of the interrelationship among these attributes similar to the need for a secure environment, the thoughtfulness and social support of institutional care in order to maintain positive attitude and well-being. With highly increased Thai aging population, many of these older adults will find themselves living in the institutional care; therefore, it is important to intensively understand how older adults viewed successful aging, what constituted successful aging and what could be done to promote it. Interventions to enhance successful aging may include meaningful practice and along with an effective coping strategy in order to lead a better quality of life those living in institutional care.Keywords: institutional care, older adults, self-acceptant, successful aging
Procedia PDF Downloads 311166 ‘Call Before, Save Lives’: Reducing Emergency Department Visits through Effective Communication
Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo
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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24
Procedia PDF Downloads 67165 Potential Assessment and Techno-Economic Evaluation of Photovoltaic Energy Conversion System: A Case of Ethiopia Light Rail Transit System
Authors: Asegid Belay Kebede, Getachew Biru Worku
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The Earth and its inhabitants have faced an existential threat as a result of severe manmade actions. Global warming and climate change have been the most apparent manifestations of this threat throughout the world, with increasingly intense heat waves, temperature rises, flooding, sea-level rise, ice sheet melting, and so on. One of the major contributors to this disaster is the ever-increasing production and consumption of energy, which is still primarily fossil-based and emits billions of tons of hazardous GHG. The transportation industry is recognized as the biggest actor in terms of emissions, accounting for 24% of direct CO2 emissions and being one of the few worldwide sectors where CO2 emissions are still growing. Rail transportation, which includes all from light rail transit to high-speed rail services, is regarded as one of the most efficient modes of transportation, accounting for 9% of total passenger travel and 7% of total freight transit. Nonetheless, there is still room for improvement in the transportation sector, which might be done by incorporating alternative and/or renewable energy sources. As a result of these rapidly changing global energy situations and rapidly dwindling fossil fuel supplies, we were driven to analyze the possibility of renewable energy sources for traction applications. Even a small achievement in energy conservation or harnessing might significantly influence the total railway system and have the potential to transform the railway sector like never before. As a result, the paper begins by assessing the potential for photovoltaic (PV) power generation on train rooftops and existing infrastructure such as railway depots, passenger stations, traction substation rooftops, and accessible land along rail lines. As a result, a method based on a Google Earth system (using Helioscopes software) is developed to assess the PV potential along rail lines and on train station roofs. As an example, the Addis Ababa light rail transit system (AA-LRTS) is utilized. The case study examines the electricity-generating potential and economic performance of photovoltaics installed on AALRTS. As a consequence, the overall capacity of solar systems on all stations, including train rooftops, reaches 72.6 MWh per day, with an annual power output of 10.6 GWh. Throughout a 25-year lifespan, the overall CO2 emission reduction and total profit from PV-AA-LRTS can reach 180,000 tons and 892 million Ethiopian birrs, respectively. The PV-AA-LRTS has a 200% return on investment. All PV stations have a payback time of less than 13 years, and the price of solar-generated power is less than $0.08/kWh, which can compete with the benchmark price of coal-fired electricity. Our findings indicate that PV-AA-LRTS has tremendous potential, with both energy and economic advantages.Keywords: sustainable development, global warming, energy crisis, photovoltaic energy conversion, techno-economic analysis, transportation system, light rail transit
Procedia PDF Downloads 76164 The Network Effect on Green Information on Taiwan Social Network Sites
Authors: Pi Hsia Liang
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The rise of Facebook, Twitter, and other social networks significantly changes in interconnections between people, enhancing the process of information dissemination and amplify the influence of that information. Therefore, to develop informational efficiency or signaling equilibrium type of information environment among social networks, without adverse selection effects, becomes an important issue. Thus, someone may post a piece of intentional information in relation to personal interest for trying to create marginal influence. Therefore, economists are seeking to establish theories of informational efficiency under social network environment in order to resolve adverse selection issues. Reputation could be one of the important factors in the process of creating informational efficiency. Additionally, investors how to process green information, or information of corporate social responsibility is a very important study. This study essentially employs experimental study for examining how investors use stock relevant green information in Facebook and various Taiwan local networks. Facebook, and blogs of Money DJ, Technews and cnYES, respectively, are the primary sites for this examination that also allow to differentiate effects between Facebook and other local social networks. Questionnaire is developed for such an experimental testing. Note that questionnaire allows this study to group, for example, decision frequency and length of time duration focusing on social networks that are used for discriminating investor type and competence of informed investor. This study selects 500 investors that can be separated into two respective 250 samples as the control group and 250 samples in such an experimental. The quantity of sample investor sufficiently results in statistic significance of this experimental study. The empirical results of this study can be used for explaining how financial information in relation to corporate social responsibility would be disseminated in social websites. Therefore, we can lead to better interpretation of price/earnings relationship type of study and empirical studies of green information usefulness or informational efficiency Note that the above mentioned empirical studies did not exist any social network and annual report of corporate social responsibility. This study expects to find the results that both network degree and network cluster significantly affected green information dissemination frequency. In other words, investors with more connections and with high clustered connections might exert a greater influence on their green information dissemination process. The preferred users of financial social networks could make better stock decision that could amplify effects of green information. In addition, Facebook would be more influential than other local Taiwan financial social networks, although Facebook is not a specialized financial social network. In other words, the popularity and reputation effects of Facebook significantly contribute to usefulness of green information and influence of green information. Third, it has a better chance to find rumor or cheating information in local Taiwan financial social networks than Facebook. In other words, Facebook possesses reputation effect, or a better informational efficiency. Or, even though Taiwan local financial social networks have marginal informational effects on stock price, because of shortage of informational efficiency or monitoring system, information could be a tool for those whom owning superior information.Keywords: network effect on financial services, informational efficiency theory, social networks, social websites
Procedia PDF Downloads 246163 Strengthening Facility-Based Systems to Improve Access to In-Patient Care for Sick Newborns in Brong Ahafo Region, Ghana
Authors: Paulina Clara Appiah, Kofi Issah, Timothy Letsa, Kennedy Nartey, Amanua Chinbuah, Adoma Dwomo-Fokuo, Jacqeline G. Asibey
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Background: The Every Newborn Action Plan provides evidence–based interventions to end preventable deaths in high burden countries. Brong Ahafo Region is one of ten regions in Ghana with less than half of its district hospitals having sick newborn units. Facility-based neonatal care is not prioritized and under-funded, and there is also inadequate knowledge and competence to manage the sick. The aim of this intervention was to make available in–patient care for sick newborns in all 19 district hospitals through the strengthening of facility-based systems. Methods: With the development and dissemination of the National Newborn Strategy and Action Plan 2014-2018, the country was able to attract PATH which provided the region with basic resuscitation equipment, supported hospital providers’ capacity building in Helping Babies Breathe, Essential Care of Every Baby, Infection Prevention and Management and held a symposia on managing the sick newborn. Newborn advocacy was promoted through newborn champions at the facility and community levels. Hospital management was then able to mobilize resources from communities, corporate organizations and from internally generated funds; created or expanded sick newborn care units and provided essential medicines and equipment. Kangaroo Mother Care was initiated in 6 hospitals. Pediatric specialist outreach services initiated comprised telephone consultations, teaching ward rounds and participating in perinatal death audits meetings. Newborn data capture and management was improved through the provision and training on the use of standard registers provided from the national level. Results: From February 2015 to November 2017, hospitals with sick newborn units increased from 7 to 19 (37%-100%). 180 pieces each of newborn ventilation bags and masks size 0, 1 and penguin suction bulbs were distributed to the hospitals, in addition to 20 newborn mannequin sets and 90 small clinical reminder posters. 802 providers (96.9%) were trained in resuscitation, of which 96% were successfully followed up in 6 weeks, 91% in 6 months and 80% in 12 months post-training. 53 clinicians (65%) were trained and mentored to manage sick newborns. 56 specialist teaching ward rounds were conducted. Data completeness improved from 92.6% - 99.9%. Availability of essential medicines improved from 11% to 100%. Number of hospital cots increased from 116 to 248 (214%). Cot occupancy rate increased from 57.4% to 92.5%. Hospitals with phototherapy equipment increased from 0 to 12 (63%). Hospitals with incubators increased from 1 to 12 (5%-63%). Newborn deaths among admissions reduced from 6.3% to 5.4%. Conclusion: Access to in-patient care increased significantly. Newborn advocacy successfully mobilized resources required for strengthening facility –based systems.Keywords: facility-based systems, Ghana, in-patient care, newborn advocacy
Procedia PDF Downloads 249162 Developing and Standardizing Individual Care Plan for Children in Conflict with Law in the State of Kerala
Authors: Kavitha Puthanveedu, Kasi Sekar, Preeti Jacob, Kavita Jangam
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In India, The Juvenile Justice (Care and Protection of Children) Act, 2015, the law related to children alleged and found to be in conflict with law, proposes to address to the rehabilitation of children in conflict with law by catering to the basic rights by providing care and protection, development, treatment, and social re-integration. A major concern in addressing the issues of children in conflict with law in Kerala the southernmost state in India identified were: 1. Lack of psychological assessment for children in conflict with law, 2. Poor psychosocial intervention for children in conflict with law on bail, 3. Lack of psychosocial intervention or proper care and protection of CCL residing at observation and special home, 4. Lack convergence with systems related with mental health care. Aim: To develop individual care plan for children in conflict with law. Methodology: NIMHANS a premier Institute of Mental Health and Neurosciences, collaborated with Social Justice Department, Govt. of Kerala to address this issue by developing a participatory methodology to implement psychosocial care in the existing services by integrating the activities through multidisciplinary and multisectoral approach as per the Sec. 18 of JJAct 2015. Developing individual care plan: Key informant interviews, focus group discussion with multiple stakeholders consisting of legal officers, police, child protection officials, counselors, and home staff were conducted. Case studies were conducted among children in conflict with law. A checklist on 80 psychosocial problems among children in conflict with law was prepared with eight major issues identified through the quantitative process such as family and parental characteristic, family interactions and relationships, stressful life event, social and environmental factors, child’s individual characteristics, education, child labour and high-risk behavior. Standardised scales were used to identify the anxiety, caseness, suicidality and substance use among the children. This provided a background data understand the psychosocial problems experienced by children in conflict with law. In the second stage, a detailed plan of action was developed involving multiple stakeholders that include Special juvenile police unit, DCPO, JJB, and NGOs. The individual care plan was reviewed by a panel of 4 experts working in the area of children, followed by the review by multiple stakeholders in juvenile justice system such as Magistrates, JJB members, legal cum probation officers, district child protection officers, social workers and counselors. Necessary changes were made in the individual care plan in each stage which was pilot tested with 45 children for a period of one month and standardized for administering among children in conflict with law. Result: The individual care plan developed through scientific process was standardized and currently administered among children in conflict with law in the state of Kerala in the 3 districts that will be further implemented in other 14 districts. The program was successful in developing a systematic approach for the psychosocial intervention of children in conflict with law that can be a forerunner for other states in India.Keywords: psychosocial care, individual care plan, multidisciplinary, multisectoral
Procedia PDF Downloads 282161 Introduction of Acute Paediatric Services in Primary Care: Evaluating the Impact on GP Education
Authors: Salman Imran, Chris Healey
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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.Keywords: clinics, education, paediatricians, primary care
Procedia PDF Downloads 163160 A Dynamic Curriculum as a Platform for Continuous Competence Development
Authors: Niina Jallinoja, Anu Moisio
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Focus on adult learning is vital to overcome economic challenges as well as to respond to the demand for new competencies and sustained productivity in the digitalized world economy. Employees of all ages must be able to carry on continuous professional development to remain competitive in the labor market. According to EU policies, countries should offer more flexible opportunities for adult learners who study online and in so-called ‘second chance’ qualification programmes. Traditionally, adult education in Finland has comprised of not only liberal adult education but also the government funding to study for Bachelor, Master's, and Ph.D. degrees in Finnish Universities and Universities of Applied Sciences (UAS). From the beginning of 2021, public funding is allocated not only to degrees but also to courses to achieve new competencies for adult learners in Finland. Consequently, there will be degree students (often younger of age) and adult learners studying in the same evening, online and blended courses. The question is thus: How are combined studies meeting the different needs of degree students and adult learners? Haaga-Helia University of Applied Sciences (UAS), located in the metropolitan area of Finland, is taking up the challenge of continuous learning for adult learners. Haaga-Helia has been reforming the bachelor level education and respective shorter courses from 2019 in the biggest project in its history. By the end of 2023, Haaga-Helia will have a flexible, modular curriculum for the bachelor's degrees of hospitality management, business administration, business information technology, journalism and sports management. Building on the shared key competencies, degree students will have the possibility to build individual study paths more flexibly, thanks to the new modular structure of the curriculum. They will be able to choose courses across all degrees, and thus, build their own unique competence combinations. All modules can also be offered as separate courses or learning paths to non-degree students, both publicly funded and as commercial services for employers. Consequently, there will be shared course implementations for degree studies and adult learners with various competence requirements. The newly designed courses are piloted in parallel of the designing of the curriculum in Haaga-Helia during 2020 and 2021. Semi-structured online surveys are composed among the participants for the key competence courses. The focus of the research is to understand how students in the bachelor programme and adult learners from Open UAE perceive the learning experience in such a diverse learning group. A comparison is also executed between learning methods of in-site teaching, online implementation, blended learning and virtual self-learning courses to understand how the pedagogy is meeting the learning objectives of these two different groups. The new flexible curricula and the study modules are to be designed to fill the most important competence gaps that exist in the Finnish labor markets. The new curriculum will be dynamic and constantly evolving over time according to the future competence needs in the labor market. This type of approach requires constant dialogue between Haaga-Helia and workplaces during and after designing of the shared curriculum.Keywords: ccompetence development, continuous learning, curriculum, higher education
Procedia PDF Downloads 127159 Supply Chain Improvement of the Halal Goat Industry in the Autonomous Region in Muslim Mindanao
Authors: Josephine R. Migalbin
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Halal is an Arabic word meaning "lawful" or "permitted". When it comes to food and consumables, Halal is the dietary standard of Muslims. The Autonomous Region in Muslim Mindanao (ARMM) has a comparative advantage when it comes to Halal Industry because it is the only Muslim region in the Philippines and the natural starting point for the establishment of a halal industry in the country. The region has identified goat production not only for domestic consumption but for export market. Goat production is one of its strengths due to cultural compatibility. There is a high demand for goats during Ramadhan and Eid ul-Adha. The study aimed to provide an overview of the ARMM Halal Goat Industry; to map out the specific supply chain of halal goat, and to analyze the performance of the halal goat supply chain in terms of efficiency, flexibility, and overall responsiveness. It also aimed to identify areas for improvement in the supply chain such as behavioural, institutional, and process to provide recommendations for improvement in the supply chain towards efficient and effective production and marketing of halal goats, subsequently improving the plight of the actors in the supply chain. Generally, the raising of goats is characterized by backyard production (92.02%). There are four interrelated factors affecting significantly the production of goats which are breeding prolificacy, prevalence of diseases, feed abundance and pre-weaning mortality rate. The institutional buyers are mostly traders, restaurants/eateries, supermarkets, and meat shops, among others. The municipalities of Midsayap and Pikit in another region and Parang are the major goat sources and the municipalities in ARMM among others. In addition to the major supply centers, Siquijor, an island province in the Visayas is becoming a key source of goats. Goats are usually gathered by traders/middlemen and brought to the public markets. Meat vendors purchase them directly from raisers, slaughtered and sold fresh in wet markets. It was observed that there is increased demand at 2%/year and that supply is not enough to meet the demand. Farm gate price is 2.04 USD to 2.11 USD/kg liveweight. Industry information is shared by three key participants - raisers, traders and buyers. All respondents reported that information is through personal built-upon past experiences and that there is no full disclosure of information among the key participants in the chain. The information flow in the industry is fragmented in nature such that no total industry picture exists. In the last five years, numerous local and foreign agencies had undertaken several initiatives for the development of the halal goat industry in ARMM. The major issues include productivity which is the greatest challenge, difficulties in accessing technical support channels and lack of market linkage and consolidation. To address the various issues and concerns of the various industry players, there is a need to intensify appropriate technology transfer through extension activities, improve marketing channels by grouping producers, strengthen veterinary services and provide capital windows to improve facilities and reduce logistics and transaction costs in the entire supply chain.Keywords: autonomous region in Muslim Mindanao, halal, halal goat industry, supply chain improvement
Procedia PDF Downloads 335158 Survey Study of Key Motivations and Drivers for Students to Enroll in Online Programs of Study
Authors: Tina Stavredes
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Increasingly borderless learning opportunities including online learning are expanding. Singapore University of Social Science (SUSS) conducted research in February of 2017 to determine the level of consumer interest in undertaking a completely online distance learning degree program across three countries in the Asian Pacific region. The target audience was potential bachelor degree and post-degree students from Malaysia, Indonesia, and Vietnam. The results gathered were used to assess the market size and ascertain the business potential of online degree programs in Malaysia, Indonesia and Vietnam. Secondly, the results were used to determine the most receptive markets to prioritise entry and identify the most receptive student segments. In order to achieve the key outcomes, the key points of understanding were as follows: -Motivations for higher education & factors that influence the choice of institution, -Interest in online learning, -Interest in online learning from a Singapore university relative to other foreign institutions, -Key drivers and barriers of interest in online learning. An online survey was conducted from from 7th Feb 2017 to 27th Feb 2017 amongst n=600 respondents aged 21yo-45yo, who have a basic command of English, A-level qualifications and above, and who have an intent to further their education in the next 12 months. Key findings from the study regarding enrolling in an online program include the need for a marriage between intrinsic and extrinsic motivation factors and the flexibility and support offered in an online program. Overall, there was a high interest for online learning. Survey participants stated they are intrinsically motivated to learn because of their interest in the program of study and the need for extrinsic rewards including opportunities for employment or salary increment in their current job. Seven out of ten survey participants reported they are motivated to further their education and expand their knowledge to become more employable. Eight in ten claims that the feasibility of furthering their education depends on cost and maintaining a work-life balance. The top 2 programs of interest are business and information and communication technology. They describe their choice of university as a marriage of both motivational and feasibility factors including cost, choice, quality of support facilities, and the reputation of the institution. Survey participants reported flexibility as important and stated that appropriate support assures and grows their intent to enrol in an online program. Respondents also reported the importance of being able to work while studying as the main perceived advantage of online learning. Factors related to the choice of an online university emphasized the quality of support services. Despite concerns, overall there was a high interest for online learning. One in two expressed strong intent to enrol in an online programme of study. However, unfamiliarity with online learning is a concern including the concern with the lack of face-to-face interactions. Overall, the findings demonstrated an interest in online learning. A main driver was the ability to earn a recognised degree while still being able to be with the family and the ability to achieve a ‘better’ early career growth.Keywords: distance education, student motivations, online learning, online student needs
Procedia PDF Downloads 124157 Evaluation of Sustained Improvement in Trauma Education Approaches for the College of Emergency Nursing Australasia Trauma Nursing Program
Authors: Pauline Calleja, Brooke Alexander
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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education
Procedia PDF Downloads 270156 The Temporal Pattern of Bumble Bees in Plant Visiting
Authors: Zahra Shakoori, Farid Salmanpour
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Pollination services are a vital service for the ecosystem to maintain environmental stability. The decline of pollinators can disrupt the ecological balance by affecting components of biodiversity. Bumble bees are crucial pollinators, playing a vital role in maintaining plant diversity. This study investigated the temporal patterns of their visitation to flowers in Kiasar National Park, Iran. Observations were conducted in Jun 2024, totaling 442 person-minutes of observation. Five species of bumble bees were identified. The study revealed that they consistently visited an average of 12-15 flowers per minute, regardless of species. The findings highlight the importance of protecting natural habitats, where their populations are thriving in the absence of human-induced stressors. This study was conducted in Kiasar National Park, located in the southeast of Mazandaran, northern Iran. The surveyed area, at an altitude of 1800-2200 meters, includes both forest and pasture. Bumble bee surveys were carried out on sunny days from June 2024, starting at dawn and ending at sunset. To avoid double-counting, we systematically searched for foraging habitats on low-sloping ridges with high mud density, frequently moving between patches. We recorded bumble bee visits to flowers and plant species per minute using direct observation, a stopwatch, and a pre-prepared form. We used statistical analysis of variance (ANOVA) with a confidence level of 95% to examine potential differences in foraging rates across different bumble bee species, flowers, plant bases, and plant species visited. Bumble bee identification relied on morphological indicators. A total of 442 person-minutes of bumble bee observations were recorded. Five species of bumble bees (Bombus fragrans, Bombus haematurus, Bombus lucorum, Bombus melanurus, Bombus terrestris) were identified during the study. The results of this study showed that the visits of bumble bees to flower sources were not different from each other. In general, bumble bees visit an average of 12-15 flowers every 60 seconds. In addition, at the same time they visit between 3-5 plant bases. Finally, they visit an average of 1 to 3 plant species per minute. While many taxa contribute to pollination, insects—especially bees—are crucial for maintaining plant diversity and ecosystem functions. As plant diversity increases, the stopping rate of pollinating insects rises, which reduces their foraging activity. Bumble bees, therefore, stop more frequently in natural areas than in agricultural fields due to higher plant diversity. Our findings emphasize the need to protect natural habitats like Kiasar National Park, where bumble bees thrive without human-induced stressors like pesticides, livestock grazing, and pollution. With bumble bee populations declining globally, further research is essential to understand their behavior in different environments and develop effective conservation strategies to protect them.Keywords: bumble bees, pollination, pollinator, plant diversity, Iran
Procedia PDF Downloads 28155 Bacterial Community Diversity in Soil under Two Tillage Systems
Authors: Dalia Ambrazaitienė, Monika Vilkienė, Danute Karcauskienė, Gintaras Siaudinis
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The soil is a complex ecosystem that is part of our biosphere. The ability of soil to provide ecosystem services is dependent on microbial diversity. T Tillage is one of the major factors that affect soil properties. The no-till systems or shallow ploughless tillage are opposite of traditional deep ploughing, no-tillage systems, for instance, increase soil organic matter by reducing mineralization rates and stimulating litter concentrations of the top soil layer, whereas deep ploughing increases the biological activity of arable soil layer and reduces the incidence of weeds. The role of soil organisms is central to soil processes. Although the number of microbial species in soil is still being debated, the metagenomic approach to estimate microbial diversity predicted about 2000 – 18 000 bacterial genomes in 1 g of soil. Despite the key role of bacteria in soil processes, there is still lack of information about the bacterial diversity of soils as affected by tillage practices. This study focused on metagenomic analysis of bacterial diversity in long-term experimental plots of Dystric Epihypogleyic Albeluvisols in western part of Lithuania. The experiment was set up in 2013 and had a split-plot design where the whole-plot treatments were laid out in a randomized design with three replicates. The whole-plot treatments consisted of two tillage methods - deep ploughing (22-25 cm) (DP), ploughless tillage (7-10 cm) (PT). Three subsamples (0-20 cm) were collected on October 22, 2015 for each of the three replicates. Subsamples from the DP and PT systems were pooled together wise to make two composition samples, one representing deep ploughing (DP) and the other ploughless tillage (PT). Genomic DNA from soil sample was extracted from approximately 200 mg field-moist soil by using the D6005 Fungal/Bacterial Miniprep set (Zymo Research®) following the manufacturer’s instructions. To determine bacterial diversity and community composition, we employed a culture – independent approach of high-throughput pyrosequencing of the 16S rRNA gene. Metagenomic sequencing was made with Illumina MiSeq platform in Base Clear Company. The microbial component of soil plays a crucial role in cycling of nutrients in biosphere. Our study was a preliminary attempt at observing bacterial diversity in soil under two common but contrasting tillage practices. The number of sequenced reads obtained for PT (161 917) was higher than DP (131 194). The 10 most abundant genus in soil sample were the same (Arthrobacter, Candidatus Saccharibacteria, Actinobacteria, Acidobacterium, Mycobacterium, Bacillus, Alphaproteobacteria, Longilinea, Gemmatimonas, Solirubrobacter), just the percent of community part was different. In DP the Arthrobacter and Acidobacterium consist respectively 8.4 % and 2.5%, meanwhile in PT just 5.8% and 2.1% of all community. The Nocardioides and Terrabacter were observed just in PT. This work was supported by the project VP1-3.1-ŠMM-01-V-03-001 NKPDOKT and National Science Program: The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems [grant number SIT-9/2015] funded by the Research Council of Lithuania.Keywords: deep ploughing, metagenomics, ploughless tillage, soil community analysis
Procedia PDF Downloads 246154 Changes in Physicochemical Characteristics of a Serpentine Soil and in Root Architecture of a Hyperaccumulating Plant Cropped with a Legume
Authors: Ramez F. Saad, Ahmad Kobaissi, Bernard Amiaud, Julien Ruelle, Emile Benizri
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Agromining is a new technology that establishes agricultural systems on ultramafic soils in order to produce valuable metal compounds such as nickel (Ni), with the final aim of restoring a soil's agricultural functions. But ultramafic soils are characterized by low fertility levels and this can limit yields of hyperaccumulators and metal phytoextraction. The objectives of the present work were to test if the association of a hyperaccumulating plant (Alyssum murale) and a Fabaceae (Vicia sativa var. Prontivesa) could induce changes in physicochemical characteristics of a serpentine soil and in root architecture of a hyperaccumulating plant then lead to efficient agromining practices through soil quality improvement. Based on standard agricultural systems, consisting in the association of legumes and another crop such as wheat or rape, a three-month rhizobox experiment was carried out to study the effect of the co-cropping (Co) or rotation (Ro) of a hyperaccumulating plant (Alyssum murale) with a legume (Vicia sativa) and incorporating legume biomass to soil, in comparison with mineral fertilization (FMo), on the structure and physicochemical properties of an ultramafic soil and on root architecture. All parameters measured (biomass, C and N contents, and taken-up Ni) on Alyssum murale conducted in co-cropping system showed the highest values followed by the mineral fertilization and rotation (Co > FMo > Ro), except for root nickel yield for which rotation was better than the mineral fertilization (Ro > FMo). The rhizosphere soil of Alyssum murale in co-cropping had larger soil particles size and better aggregates stability than other treatments. Using geostatistics, co-cropped Alyssum murale showed a greater root surface area spatial distribution. Moreover, co-cropping and rotation-induced lower soil DTPA-extractable nickel concentrations than other treatments, but higher pH values. Alyssum murale co-cropped with a legume showed a higher biomass production, improved soil physical characteristics and enhanced nickel phytoextraction. This study showed that the introduction of a legume into Ni agromining systems could improve yields of dry biomass of the hyperaccumulating plant used and consequently, the yields of Ni. Our strategy can decrease the need to apply fertilizers and thus minimizes the risk of nitrogen leaching and underground water pollution. Co-cropping of Alyssum murale with the legume showed a clear tendency to increase nickel phytoextraction and plant biomass in comparison to rotation treatment and fertilized mono-culture. In addition, co-cropping improved soil physical characteristics and soil structure through larger and more stabilized aggregates. It is, therefore, reasonable to conclude that the use of legumes in Ni-agromining systems could be a good strategy to reduce chemical inputs and to restore soil agricultural functions. Improving the agromining system by the replacement of inorganic fertilizers could simultaneously be a safe way of rehabilitating degraded soils and a method to restore soil quality and functions leading to the recovery of ecosystem services.Keywords: plant association, legumes, hyperaccumulating plants, ultramafic soil physicochemical properties
Procedia PDF Downloads 166153 Geotechnical Evaluation and Sizing of the Reinforcement Layer on Soft Soil in the Construction of the North Triage Road Clover, in Brasilia Federal District, Brazil
Authors: Rideci Farias, Haroldo Paranhos, Joyce Silva, Elson Almeida, Hellen Silva, Lucas Silva
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The constant growth of the fleet of vehicles in the big cities, makes that the Engineering is dynamic, with respect to the new solutions for traffic flow in general. In the Federal District (DF), Brazil, it is no different. The city of Brasilia, Capital of Brazil, and Cultural Heritage of Humanity by UNESCO, is projected to 500 thousand inhabitants, and today circulates more than 3 million people in the city, and with a fleet of more than one vehicle for every two inhabitants. The growth of the city to the North region, made that the urban planning presented solutions for the fleet in constant growth. In this context, a complex of viaducts, road accesses, creation of new rolling roads and duplication of the Bragueto bridge over Paranoa lake in the northern part of the city was designed, giving access to the BR-020 highway, denominated Clover of North Triage (TTN). In the geopedological context, the region is composed of hydromorphic soils, with the presence of the water level at some times of the year. From the geotechnical point of view, are soils with SPT < 4 and Resistance not drained, Su < 50 kPa. According to urban planning in Brasília, special art works can not rise in the urban landscape, contrasting with the urban characteristics of the architects Lúcio Costa and Oscar Niemeyer. Architects hired to design the new Capital of Brazil. The urban criterion then created the technical impasse, resulting in the technical need to ‘bury’ the works of art and in turn the access greenhouses at different levels, in regions of low support soil and water level Outcrossing, generally inducing the need for this study and design. For the adoption of the appropriate solution, Standard Penetration Test (SPT), Vane Test, Diagnostic peritoneal lavage (DPL) and auger boring campaigns were carried out. With the comparison of the results of these tests, the profiles of resistance of the soils and water levels were created in the studied sections. Geometric factors such as existing sidewalks and lack of elevation for the discharge of deep drainage water have inhibited traditional techniques for total removal of soft soils, thus avoiding the use of temporary drawdown and shoring of excavations. Thus, a structural layer was designed to reinforce the subgrade by means of the ‘needling’ of the soft soil, without the need for longitudinal drains. In this context, the article presents the geological and geotechnical studies carried out, but also the dimensioning of the reinforcement layer on the soft soil with a view to the main objective of this solution that is to allow the execution of the civil works without the interference in the roads in use, Execution of services in rainy periods, presentation of solution compatible with drainage characteristics and soft soil reinforcement.Keywords: layer, reinforcement, soft soil, clover of north triage
Procedia PDF Downloads 226152 A Functional Analysis of a Political Leader in Terms of Marketing
Authors: Aşina Gülerarslan, M. Faik Özdengül
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The new economic, social and political world order has led to the emergence of a wide range of persuasion strategies and practices based on an ever expanding marketing axis that involves organizations, ideas and persons as well as products and services. It is seen that since the 1990's, a wide variety of competitive marketing ideas have been offered systematically to target audiences in the field of politics as in other fields. When the components of marketing are taken into consideration, all kinds of communication efforts involving “political leaders”, who are conceptualized as products in terms of political marketing, serve a process of social persuasion, which cannot be restricted to election periods only, and a manageable “image”. In this context, image, which is concerned with how the political product is perceived, involves not only the political discourses shared with the public but also all kinds of biographical information about the leader, the leader’s specific way of living and routines and his/her attitudes and behaviors in their private lives, and all these are regarded as components of the “product image”. While on the one hand the leader’s verbal or supra-verbal references serve the way the “spirit of the product” is perceived –just as in brand positioning- they also show their self-esteem levels, in other words how they perceive themselves on the other hand. Indeed, their self-esteem levels are evaluated in three fundamental categories in the “Functional Analysis”, namely parent, child and adult, and it is revealed that the words, tone of voice and body language a person uses makes it easy to understand at what self-esteem level that person is. In this context, words, tone of voice and body language, which provide important clues as to the “self” of the person, are also an indication of how political leaders evaluate both “themselves” and “the mass/audience” in the communication they establish with their audiences. When the matter is taken from the perspective of Turkey, the levels of self-esteem in the relationships that the political leaders establish with the masses are also important in revealing how our society is seen from the perspective of a specific leader. Since the leader is a part of the marketing strategy of a political party as a product, this evaluation is significant in terms of the forms of relationships between political institutions in our country with the society. In this study, the self-esteem level in the documentary entitled “Master’s Story”, where Recep Tayyip Erdoğan’s life history is told, is analyzed in the context of words, tone of voice and body language. Within the scope of the study, at what level of self-esteem Recep Tayyip Erdoğan was in the “Master’s Story”, a documentary broadcast on Beyaz TV, was investigated using the content analysis method. First, based on the Functional Analysis Literature, a transactional approach scale was created regarding parent, adult and child self-esteem levels. On the basis of this scale, the prime minister’s self-esteem level was determined in three basic groups, namely “tone of voice”, “the words he used” and “body language”. Descriptive analyses were made to the data within the framework of these criteria and at what self-esteem level the prime minister spoke throughout the documentary was revealed.Keywords: political marketing, leader image, level of self-esteem, transactional approach
Procedia PDF Downloads 337151 Addressing Sustainable Development Goals in Palestine: Conflict, Sustainability, and Human Rights
Authors: Nowfiya Humayoon
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The Sustainable Development Goals were launched by the UNO in 2015 as a global initiative aimed at eradicating poverty, safeguarding the environment, and promoting peace and prosperity with the target year of 2030. SDGs are vital for achieving global peace, prosperity, and sustainability. Like all nations of the world, these goals are crucial to Palestine but challenging due to the ongoing crisis. Effective action toward achieving each Sustainable Development Goals (SDGs) in Palestine has been severely challenged due to political instability, limited access to resources, International Aid Constraints, Economic blockade, etc., right from the beginning. In the context of the ongoing conflict, there are severe violations of international humanitarian law, which include targeting civilians, using excessive force, and blocking humanitarian aid, which has led to significant civilian casualties, sufferings, and deaths. Therefore, addressing the Sustainable Development Goals is imperative in ensuring human rights, combating violations and fostering sustainability. Methodology: The study adopts a historical, analytical and quantitative approach to evaluate the impact of the ongoing conflict on SDGs in Palestine, with a focus on sustainability and human rights. It examines historical documents, reports of international organizations and regional organizations, recent journal and newspaper articles, and other relevant literature to trace the evolution and the on-ground realities of the conflict and its effects. Quantitative data are collected by analyzing statistical reports from government agencies, non-governmental organizations (NGOs) and international bodies. Databases from World Bank, United Nations and World Health Organizations are utilized. Various health and economic indicators on mortality rates, infant mortality rates and income levels are also gathered. Major Findings: The study reveals profound challenges in achieving the Sustainable Development Goals (SDGs) in Palestine, which include economic blockades and restricted access to resources that have left a substantial portion of the population living below the poverty line, overburdened healthcare facilities struggling to cope with the demands, shortages of medical supplies, disrupted educational systems, with many schools destroyed or repurposed, and children facing significant barriers to accessing quality education, damaged infrastructure, restricted access to clean water and sanitation services and limited access to reliable energy sources . Conclusion: The ongoing crisis in Palestine has drastically affected progress towards the Sustainable Development Goals (SDGs), causing innumerable crises. Violations of international humanitarian law have caused substantial suffering and loss of life. Immediate and coordinated global action and efforts are crucial in addressing these challenges in order to uphold humanitarian values and promote sustainable development in the region.Keywords: genocide, human rights, occupation, sustainable development goals
Procedia PDF Downloads 14150 Nature of Forest Fragmentation Owing to Human Population along Elevation Gradient in Different Countries in Hindu Kush Himalaya Mountains
Authors: Pulakesh Das, Mukunda Dev Behera, Manchiraju Sri Ramachandra Murthy
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Large numbers of people living in and around the Hindu Kush Himalaya (HKH) region, depends on this diverse mountainous region for ecosystem services. Following the global trend, this region also experiencing rapid population growth, and demand for timber and agriculture land. The eight countries sharing the HKH region have different forest resources utilization and conservation policies that exert varying forces in the forest ecosystem. This created a variable spatial as well altitudinal gradient in rate of deforestation and corresponding forest patch fragmentation. The quantitative relationship between fragmentation and demography has not been established before for HKH vis-à-vis along elevation gradient. This current study was carried out to attribute the overall and different nature in landscape fragmentations along the altitudinal gradient with the demography of each sharing countries. We have used the tree canopy cover data derived from Landsat data to analyze the deforestation and afforestation rate, and corresponding landscape fragmentation observed during 2000 – 2010. Area-weighted mean radius of gyration (AMN radius of gyration) was computed owing to its advantage as spatial indicator of fragmentation over non-spatial fragmentation indices. Using the subtraction method, the change in fragmentation was computed during 2000 – 2010. Using the tree canopy cover data as a surrogate of forest cover, highest forest loss was observed in Myanmar followed by China, India, Bangladesh, Nepal, Pakistan, Bhutan, and Afghanistan. However, the sequence of fragmentation was different after the maximum fragmentation observed in Myanmar followed by India, China, Bangladesh, and Bhutan; whereas increase in fragmentation was seen following the sequence of as Nepal, Pakistan, and Afghanistan. Using SRTM-derived DEM, we observed higher rate of fragmentation up to 2400m that corroborated with high human population for the year 2000 and 2010. To derive the nature of fragmentation along the altitudinal gradients, the Statistica software was used, where the user defined function was utilized for regression applying the Gauss-Newton estimation method with 50 iterations. We observed overall logarithmic decrease in fragmentation change (area-weighted mean radius of gyration), forest cover loss and population growth during 2000-2010 along the elevation gradient with very high R2 values (i.e., 0.889, 0.895, 0.944 respectively). The observed negative logarithmic function with the major contribution in the initial elevation gradients suggest to gap filling afforestation in the lower altitudes to enhance the forest patch connectivity. Our finding on the pattern of forest fragmentation and human population across the elevation gradient in HKH region will have policy level implication for different nations and would help in characterizing hotspots of change. Availability of free satellite derived data products on forest cover and DEM, grid-data on demography, and utility of geospatial tools helped in quick evaluation of the forest fragmentation vis-a-vis human impact pattern along the elevation gradient in HKH.Keywords: area-weighted mean radius of gyration, fragmentation, human impact, tree canopy cover
Procedia PDF Downloads 215149 Crisis Management and Corporate Political Activism: A Qualitative Analysis of Online Reactions toward Tesla
Authors: Roxana D. Maiorescu-Murphy
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In the US, corporations have recently embraced political stances in an attempt to respond to the external pressure exerted by activist groups. To date, research in this area remains in its infancy, and few studies have been conducted on the way stakeholder groups respond to corporate political advocacy in general and in the immediacy of such a corporate announcement in particular. The current study aims to fill in this research void. In addition, the study contributes to an emerging trajectory in the field of crisis management by focusing on the delineation between crises (unexpected events related to products and services) and scandals (crises that spur moral outrage). The present study looked at online reactions in the aftermath of Elon Musk’s endorsement of the Republican party on Twitter. Two data sets were collected from Twitter following two political endorsements made by Elon Musk on May 18, 2022, and June 15, 2022, respectively. The total sample of analysis stemming from the data two sets consisted of N=1,374 user comments written as a response to Musk’s initial tweets. Given the paucity of studies in the preceding research areas, the analysis employed a case study methodology, used in circumstances in which the phenomena to be studied had not been researched before. According to the case study methodology, which answers the questions of how and why a phenomenon occurs, this study responded to the research questions of how online users perceived Tesla and why they did so. The data were analyzed in NVivo by the use of the grounded theory methodology, which implied multiple exposures to the text and the undertaking of an inductive-deductive approach. Through multiple exposures to the data, the researcher ascertained the common themes and subthemes in the online discussion. Each theme and subtheme were later defined and labeled. Additional exposures to the text ensured that these were exhaustive. The results revealed that the CEO’s political endorsements triggered moral outrage, leading to Tesla’s facing a scandal as opposed to a crisis. The moral outrage revolved around the stakeholders’ predominant rejection of a perceived intrusion of an influential figure on a domain reserved for voters. As expected, Musk’s political endorsements led to polarizing opinions, and those who opposed his views engaged in online activism aimed to boycott the Tesla brand. These findings reveal that the moral outrage that characterizes a scandal requires communication practices that differ from those that practitioners currently borrow from the field of crisis management. Specifically, because scandals flourish in online settings, practitioners should regularly monitor stakeholder perceptions and address them in real-time. While promptness is essential when managing crises, it becomes crucial to respond immediately as a scandal is flourishing online. Finally, attempts should be made to distance a brand, its products, and its CEO from the latter’s political views.Keywords: crisis management, communication management, Tesla, corporate political activism, Elon Musk
Procedia PDF Downloads 91148 Index of Suitability for Culex pipiens sl. Mosquitoes in Portugal Mainland
Authors: Maria C. Proença, Maria T. Rebelo, Marília Antunes, Maria J. Alves, Hugo Osório, Sofia Cunha, REVIVE team
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The environment of the mosquitoes complex Culex pipiens sl. in Portugal mainland is evaluated based in its abundance, using a data set georeferenced, collected during seven years (2006-2012) from May to October. The suitability of the different regions can be delineated using the relative abundance areas; the suitablility index is directly proportional to disease transmission risk and allows focusing mitigation measures in order to avoid outbreaks of vector-borne diseases. The interest in the Culex pipiens complex is justified by its medical importance: the females bite all warm-blooded vertebrates and are involved in the circulation of several arbovirus of concern to human health, like West Nile virus, iridoviruses, rheoviruses and parvoviruses. The abundance of Culex pipiens mosquitoes were documented systematically all over the territory by the local health services, in a long duration program running since 2006. The environmental factors used to characterize the vector habitat are land use/land cover, distance to cartographed water bodies, altitude and latitude. Focus will be on the mosquito females, which gonotrophic cycle mate-bloodmeal-oviposition is responsible for the virus transmission; its abundance is the key for the planning of non-aggressive prophylactic countermeasures that may eradicate the transmission risk and simultaneously avoid chemical ambient degradation. Meteorological parameters such as: air relative humidity, air temperature (minima, maxima and mean daily temperatures) and daily total rainfall were gathered from the weather stations network for the same dates and crossed with the standardized females’ abundance in a geographic information system (GIS). Mean capture and percentage of above average captures related to each variable are used as criteria to compute a threshold for each meteorological parameter; the difference of the mean capture above/below the threshold was statistically assessed. The meteorological parameters measured at the net of weather stations all over the country are averaged by month and interpolated to produce raster maps that can be segmented according to the meaningful thresholds for each parameter. The intersection of the maps of all the parameters obtained for each month show the evolution of the suitable meteorological conditions through the mosquito season, considered as May to October, although the first and last month are less relevant. In parallel, mean and above average captures were related to the physiographic parameters – the land use/land cover classes most relevant in each month, the altitudes preferred and the most frequent distance to water bodies, a factor closely related with the mosquito biology. The maps produced with these results were crossed with the meteorological maps previously segmented, in order to get an index of suitability for the complex Culex pipiens evaluated all over the country, and its evolution from the beginning to the end of the mosquitoes season.Keywords: suitability index, Culex pipiens, habitat evolution, GIS model
Procedia PDF Downloads 576147 ADAM10 as a Potential Blood Biomarker of Cognitive Frailty
Authors: Izabela P. Vatanabe, Rafaela Peron, Patricia Manzine, Marcia R. Cominetti
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Introduction: Considering the increase in life expectancy of world population, there is an emerging concern in health services to allocate better care and care to elderly, through promotion, prevention and treatment of health. It has been observed that frailty syndrome is prevalent in elderly people worldwide and this complex and heterogeneous clinical syndrome consist of the presence of physical frailty associated with cognitive dysfunction, though in absence of dementia. This can be characterized by exhaustion, unintentional weight loss, decreased walking speed, weakness and low level of physical activity, in addition, each of these symptoms may be a predictor of adverse outcomes such as hospitalization, falls, functional decline, institutionalization, and death. Cognitive frailty is a recent concept in literature, which is defined as the presence of physical frailty associated with mild cognitive impairment (MCI) however in absence of dementia. This new concept has been considered as a subtype of frailty, which along with aging process and its interaction with physical frailty, accelerates functional declines and can result in poor quality of life of the elderly. MCI represents a risk factor for Alzheimer's disease (AD) in view of high conversion rate for this disease. Comorbidities and physical frailty are frequently found in AD patients and are closely related to heterogeneity and clinical manifestations of the disease. The decreased platelets ADAM10 levels in AD patients, compared to cognitively healthy subjects, matched by sex, age and education. Objective: Based on these previous results, this study aims to evaluate whether ADAM10 platelet levels of could act as a biomarker of cognitive frailty. Methods: The study was approved by Ethics Committee of Federal University of São Carlos (UFSCar) and conducted in the municipality of São Carlos, headquarters of Federal University of São Carlos (UFSCar). Biological samples of subjects were collected, analyzed and then stored in a biorepository. ADAM10 platelet levels were analyzed by western blotting technique in subjects with MCI and compared to subjects without cognitive impairment, both with and without presence of frailty. Statistical tests of association, regression and diagnostic accuracy were performed. Results: The results have shown that ADAM10/β-actin ratio is decreased in elderly individuals with cognitive frailty compared to non-frail and cognitively healthy controls. Previous studies performed by this research group, already mentioned above, demonstrated that this reduction is still higher in AD patients. Therefore, the ADAM10/β-actin ratio appears to be a potential biomarker for cognitive frailty. The results bring important contributions to an accurate diagnosis of cognitive frailty from the perspective of ADAM10 as a biomarker for this condition, however, more experiments are being conducted, using a high number of subjects, and will help to understand the role of ADAM10 as biomarker of cognitive frailty and contribute to the implementation of tools that work in the diagnosis of cognitive frailty. Such tools can be used in public policies for the diagnosis of cognitive frailty in the elderly, resulting in a more adequate planning for health teams and better quality of life for the elderly.Keywords: ADAM10, biomarkers, cognitive frailty, elderly
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