Search results for: elderly care facilities

Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

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Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink

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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.

Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development

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Authors: Suneet Jagdev, Hrishabh Amrodia, Siddharth Menon, Abhishek Singh, Mansi Shivhare

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Delhi, the National Capital, has undergone a surge in development rate, consequently engendering an unprecedented increase in population. Over the years the city has transformed into a car-centric infrastructure with high-speed corridors, flyovers and fast lanes. A considerable section of the population is hankering to rehabilitate to the good old cycling days, in order to contribute towards a green environment as well as to maintain their physical well-being. Furthermore, an extant section of Delhi’s population relies on cycles as their primary means of commuting in the city. Delhi has the highest number of cyclists and second highest number of pedestrians in the country. However, the tumultuous problems of unregulated traffic, inadequate space on roads, adverse weather conditions stifle them to opt for cycling. Lately, the city has been facing a conglomeration of problems such as haphazard traffic movement, clogged roads, congestion, pollution, accidents, safety issues, etc. In 1957, Delhi’s cyclists accounted for 36 per cent of trips which dropped down to a mere 4 per cent in 2008. The declining rate is due to unsafe roads and lack of proper cycle lanes. Now as the 10 percent of the city has cycle tracks. There is also a lack of public recreational activities in the city. These conundrums incite the need of a covered elevated cycling bridge track to facilitate the safe and smooth cycle commutation in the city which would also serve the purpose of an alternate urban public space over the cycle bridge reducing the cost as well as the space requirement for the same, developing a user–friendly transportation and public interaction system for urban areas in the city. Based on the archival research methodologies, the following research draws information and extracts records from the data accounts of the Delhi Metro Rail Corporation Ltd. as well as the Centre for Science and Environment, India. This research will predominantly focus on developing a prototype design for high speed elevated bicycle lanes based on different road typologies, which can be replicated with minor variations in similar situations, all across the major cities of our country including the proposed smart cities. Furthermore, how these cycling lanes could be utilized for the place making process accommodating cycle parking and renting spaces, public recreational spaces, food courts as well as convenient shopping facilities with appropriate optimization. How to preserve and increase the share of smooth and safe cycling commute cycling for the routine transportation of the urban community of the polluted capital which has been on a steady decline over the past few decades.

Keywords: bicycle track, prototype, road safety, urban spaces

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Authors: O. Fatemi

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Considering growing building construction industry in developing countries and sustainable development concept, as well as the importance of taking care of the future generations, codifying buildings scoring system based on environmental criteria, has always been a subject for discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables. In this article, the most important common LEED (Leadership in Energy and Environmental Design) and BREEAM (Building Research Establishment Environmental Assessment Method) common and Global environmental scoring systems, used in UK, USA, and Japan, respectively, have been discussed and compared with a special focus on CASBEE (Comprehensive Assessment System for Built Environment Efficiency), to credit assigning field (weighing and scores systems) as well as sustainable development criteria in each system. Then, converging and distinct fields of the foregoing systems are examined considering National Iranian Building Code. Furthermore, the common credits in the said systems not mentioned in National Iranian Building Code have been identified. These credits, which are generally included in well-known fundamental principles in sustainable development, may be considered as offered options for the Iranian building environmental scoring system. It is suggested that one of the globally and commonly accepted systems is chosen considering national priorities in order to offer an effective method for buildings environmental scoring, and then, a part of credits is added and/or removed, or a certain credit score is changed, and eventually, a new scoring system with a new title is developed for the country. Evidently, building construction industry highly affects the environment, economy, efficiency, and health of the relevant occupants. Considering the growing trend of cities and construction, achieving building scoring systems based on environmental criteria has always been a matter of discussion. The existing systems cannot be used for all the regions due to several reasons, including but not limited to variety in regional variables.

Keywords: scoring system, sustainability assessment, water efficiency, national Iranian building code

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Authors: Hadi Chahal, Irini Djeran-Maigre

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This paper focuses on the hydro-mechanical behavior of polychlorinated biphenyl (PCB) polluted sediments when stored in landfills and the interaction between PCBs and geosynthetic clay liners (GCL) with respect to hydraulic performance of the liner and the overall performance and stability of landfills. A European decree, adopted in the French regulation forbids the reintroducing of contaminated dredged sediments containing more than 0,64mg/kg Σ 7 PCBs to rivers. At these concentrations, sediments are considered hazardous and a remediation process must be adopted to prevent the release of PCBs into the environment. Dredging and landfilling polluted sediments is considered an eco-environmental remediation solution. French regulations authorize the storage of PCBs contaminated components with less than 50mg/kg in municipal solid waste facilities. Contaminant migration via leachate may be possible. The interactions between PCBs contaminated sediments and the GCL barrier present in the bottom of a landfill for security confinement are not known. Moreover, the hydro-mechanical behavior of stored sediments may affect the performance and the stability of the landfill. In this article, hydro-mechanical characterization of the polluted sediment is presented. This characterization led to predict the behavior of the sediment at the storage site. Chemical testing showed that the concentration of PCBs in sediment samples is between 1.7 and 2,0 mg/kg. Physical characterization showed that the sediment is organic silty sand soil (%Silt=65, %Sand=27, %OM=8) characterized by a high plasticity index (Ip=37%). Permeability tests using permeameter and filter press showed that sediment permeability is in the order of 10-9 m/s. Compressibility tests showed that the sediment is a very compressible soil with Cc=0,53 and Cα =0,0086. In addition, effects of PCB on the swelling behavior of bentonite were studied and the hydraulic performance of the GCL in interaction with PCBs was examined. Swelling tests showed that PCBs don’t affect the swelling behavior of bentonite. Permeability tests were conducted on a 1.0 m pilot scale experiment, simulating a storage facility. PCBs contaminated sediments were directly placed over a passive barrier containing GCL to study the influence of the direct contact of polluted sediment leachate with the GCL. An automatic water system has been designed to simulate precipitation. Effluent quantity and quality have been examined. The sediment settlements and the water level in the sediment have been monitored. The results showed that desiccation affected the behavior of the sediment in the pilot test and that laboratory tests alone are not sufficient to predict the behavior of the sediment in landfill facility. Furthermore, the concentration of PCB in the sediment leachate was very low ( < 0,013 µg/l) and that the permeability of the GCL was affected by other components present in the sediment leachate. Desiccation and cracks were the main parameters that affected the hydro-mechanical behavior of the sediment in the pilot test. In order to reduce these infects, the polluted sediment should be stored at a water content inferior to its shrinkage limit (w=39%). We also propose to conduct other pilot tests with the maximum concentration of PCBs allowed in municipal solid waste facility of 50 mg/kg.

Keywords: geosynthetic clay liners, landfill, polychlorinated biphenyl, polluted dredged materials

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Authors: Paula Marín, Mohammad Saffari, Alvaro de Gracia, Luisa F. Cabeza, Svetlana Ushak

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Climate control represents an important issue when referring to energy consumption of buildings and associated expenses, both in installation or operation periods. The climate control of a building relies on several factors. Among them, localization, orientation, architectural elements, sources of energy used, are considered. In order to study the thermal behaviour of a building set up, the present study proposes the use of energy simulation program Energy Plus. In recent years, energy simulation programs have become important tools for evaluation of thermal/energy performance of buildings and facilities. Besides, the need to find new forms of passive conditioning in buildings for energy saving is a critical component. The use of phase change materials (PCMs) for heat storage applications has grown in importance due to its high efficiency. Therefore, the climatic conditions of Northern Chile: high solar radiation and extreme temperature fluctuations ranging from -10°C to 30°C (Calama city), low index of cloudy days during the year are appropriate to take advantage of solar energy and use passive systems in buildings. Also, the extensive mining activities in northern Chile encourage the use of large numbers of containers to harbour workers during shifts. These containers are constructed with lightweight construction systems, requiring heating during night and cooling during day, increasing the HVAC electricity consumption. The use of PCM can improve thermal comfort and reduce the energy consumption. The objective of this study was to evaluate the thermal and energy performance of containers of 2.5×2.5×2.5 m3, located in four cities of Chile: Antofagasta, Calama, Santiago, and Concepción. Lightweight envelopes, typically used in these building prototypes, were evaluated considering a container without PCM inclusion as the reference building and another container with PCM-enhanced envelopes as a test case, both of which have a door and a window in the same wall, orientated in two directions: North and South. To see the thermal response of these containers in different seasons, the simulations were performed considering a period of one year. The results show that higher energy savings for the four cities studied are obtained when the distribution of door and window in the container is in the north direction because of higher solar radiation incidence. The comparison of HVAC consumption and energy savings in % for north direction of door and window are summarised. Simulation results show that in the city of Antofagasta 47% of heating energy could be saved and in the cities of Calama and Concepción the biggest savings in terms of cooling could be achieved since PCM reduces almost all the cooling demand. Currently, based on simulation results, four containers have been constructed and sized with the same structural characteristics carried out in simulations, that are, containers with/without PCM, with door and window in one wall. Two of these containers will be placed in Antofagasta and two containers in a copper mine near to Calama, all of them will be monitored for a period of one year. The simulation results will be validated with experimental measurements and will be reported in the future.

Keywords: energy saving, lightweight construction, PCM, simulation

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Authors: Balkibekova Venera Serikpaevna

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Background: Autism Spectrum Disorder (ASD) poses significant challenges in both diagnosis and treatment. Existing therapeutic interventions often target specific symptoms, necessitating the exploration of alternative approaches. This study investigates the RITM (Rhythm Integration Tapping Music) developed by Balkibekova, aiming to create imitation, social engagement and a wide range of emotions through brain development. Methods: A randomized controlled trial was conducted with 100 participants diagnosed with ASD, aged 1 to 4 years. Participants were randomly assigned to either the RITM therapy group or a control group receiving standard care. The RITM therapy, rooted in tapping rhythm to music such as: marche on the drums, waltz on bells, lullaby on musical triangle, dancing on tambourine, polka on wooden spoons. Therapy sessions were conducted over a 3 year period, with assessments at baseline, midpoint, and post-intervention. Results: Preliminary analyses reveal promising outcomes in the RITM therapy group. Participants demonstrated significant improvements in social interactions, speech understanding, birth of speech, and adaptive behaviors compared to the control group. Careful examination of subgroup analyses provides insights into the differential effectiveness of the RITM approach across various ASD profiles. Conclusions: The findings suggest that RITM therapy, as developed by Balkibekova, holds promise as intervention for ASD. The integrative nature of the approach, addressing multiple domains simultaneously, may contribute to its efficacy. Further research is warranted to validate these preliminary results and explore the long-term impact of RITM therapy on individuals with ASD. This abstract presents a snapshot of the research, emphasizing the significance, methodology, key findings, and implications of the RITM therapy method for consideration in an autism conference.

Keywords: RITM therapy, tapping rhythm, autism, mirror neurons, bright emotions, social interactions, communications

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Authors: L. K. Shitole

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Usually on the face of it, personality is regarded as the external appearance of an individual. In psychology, the personality is not viewed merely as self or external appears, but it adds much more. Human resources development encompasses the personality development of the students. The student’s development starts right from the childhood and gradually continues right up to the completion of education in professional courses. This paper attempts to find out the role of the educational institutions in shaping the personality of the students from the rural area. Schools and colleges have infrastructural limitations, obtaining good quality and devoted teaching staff poses problems and even outside the school environment there are no private classes which may take care of this deficiency. The researcher has used the standardized test namely “Vyaktitva Shodhika” developed by Gyan Prabodhini, Pune for the students in Daund Taluka. There are 68 objective types of questions in the said questionnaire. Totally a sample size of 4191 students was selected. The sample was quite representative. It is observed that by and large the response indicates that the educational institutions are taking sincere efforts in shaping the personality of the students. In the semi-urban area i.e. at educational institutions of all levels, the performance on this front is excellent and at rest of Daund Taluka there is scope for improvement. Educational institutions of all levels are showing excellent performance in ensuring availability of the requisite infrastructure conducive for the development of the personality of the students. In rest of Daund Taluka there is ample scope for improving the situation. As far as data relating to role of co-curricular activities and sports programs in mental and physical development at various educational institutions is concerned Daund educational institutions have repeated their performance in securing “A” category, while in the rural area of Daund Taluka, there is need to step up the efforts in this regard. In today’s world of knowledge industry, one cannot ignore the importance of education and thereby the personality growth of the students. Accordingly, the educational institutions should undertake consistent research and extension activities in the area of personality development.

Keywords: personality, attitude, infrastructure, quality of education, learning environment, teacher’s contribution, family and society’s role

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Authors: Inna R. Edara, Haw-Lin Wu

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Positive psychology investigates human strengths and virtues and promotes well-being. Relying on this assumption, positive interventions have been continuously designed to build pleasure and happiness, joy and contentment, engagement and meaning, hope and optimism, satisfaction and gratitude, spirituality, and various other positive measures of well-being. In line with this model of positive psychology and interventions, this study investigated certain measures of well-being in a group of 45 students enrolled in an 18-week positive psychology course and simultaneously engaged in service-oriented interventions that they chose for themselves based on the course content and individual interests. Students’ well-being was measured at the beginning and end of the course. The well-being indicators included positive automatic thoughts, optimism and hope, satisfaction with life, and spirituality. A paired-samples t-test conducted to evaluate the impact of class content and service-oriented interventions on students’ scores of well-being indicators indicated statistically significant increase from pre-class to post-class scores. There were also significant gender differences in post-course well-being scores, with females having higher levels of well-being than males. A two-way between groups analysis of variance indicated a significant interaction effect of age by gender on the post-course well-being scores, with females in the age group of 56-65 having the highest scores of well-being in comparison to the males in the same age group. Regression analyses indicated that positive automatic thought significantly predicted hope and satisfaction with life in the pre-course analysis. In the post-course regression analysis, spiritual transcendence made a significant contribution to optimism, and positive automatic thought made a significant contribution to both hope and satisfaction with life. Finally, a significant test between pre-course and post-course regression coefficients indicated that the regression coefficients at pre-course were significantly different from post-course coefficients, suggesting that the positive psychology course and the interventions were helpful in raising the levels of well-being. The overall results suggest a substantial increase in the participants’ well-being scores after engaging in the positive-oriented interventions, implying a need for designing more positive interventions in education to promote well-being.  

Keywords: hope, optimism, positive automatic thoughts, satisfaction with life, spirituality, well-being

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Authors: Nupur Karmaker, Hasin Aupama Azhari, Abdul Al Mortuza, Abhijit Chanda, Golam Abu Zakaria

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Purpose: The purpose of gait analysis is to determine the biomechanics of the joint, phases of gait cycle, graphical and analytical analysis of degree of rotation, analysis of the electrical activity of muscles and force exerted on the hip joint at different locomotion during walking, running and cart pulling. Methods and Materials: Visual gait analysis and electromyography method has been used to detect the degree of rotation of joints and electrical activity of muscles. In cinematography method an object is observed from different sides and takes its video. Cart pulling length has been divided into frames with respect to time by using video splitter software. Phases of gait cycle, degree of rotation of joints, EMG profile and force analysis during walking and running has been taken from different papers. Gait cycle and degree of rotation of joints during cart pulling has been prepared by using video camera, stop watch, video splitter software and Microsoft Excel. Results and Discussion: During the cart pulling the force exerted on hip is the resultant of various forces. The force on hip is the vector sum of the force Fg= mg, due the body of weight of the person and Fa= ma, due to the velocity. Maximum stance phase shows during cart pulling and minimum shows during running. During cart pulling shows maximum degree of rotation of hip joint, knee: running, and ankle: cart pulling. During walking, it has been observed minimum degree of rotation of hip, ankle: during running. During cart pulling, dynamic force depends on the walking velocity, body weight and load weight. Conclusions: 80% people suffer gait related disease with increasing their age. Proper care should take during cart pulling. It will be better to establish the gait laboratory to determine the gait related diseases. If the way of cart pulling is changed i.e the design of cart pulling machine, load bearing system is changed then it would possible to reduce the risk of limb loss, flat foot syndrome and varicose vein in lower limb.

Keywords: kinematic, gait, gait lab, phase, force analysis

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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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

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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

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Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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Authors: Ayush Aditya

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In today's digitised world, the extent of an individual’s social involvement is largely determined by their interaction over the internet. The Internet has emerged as a primary source of information consumption and a reliable medium for receiving updates on everyday activities. Owing to this change in the information consumption pattern, the internet has also emerged as a hotbed of misinformation. Experts are of the view that media literacy has emerged as one of the most effective strategies for addressing the issue of misinformation. This paper aims to study the evolution of the Kerala government's media literacy policy, its implementation strategy, challenges and opportunities. The objective of this paper is to create a conceptual framework containing details of the implementation strategy based on the Kerala model. Extensive secondary research of literature, newspaper articles, and other online sources was carried out to locate the timeline of this policy. This was followed by semi-structured interview discussions with government officials from Kerala to trace the origin and evolution of this policy. Preliminary findings based on the collected data suggest that this policy is a case of policy by chance, as the officer who headed this policy during the state level implementation was the one who has already piloted a media literacy program in a district called Kannur as the district collector. Through this paper, an attempt is made to trace the history of the media literacy policy starting from the Kannur intervention in 2018, which was started to address the issue of vaccine hesitancy around measles rubella(MR) vaccination. If not for the vaccine hesitancy, this program would not have been rolled out in Kannur. Interviews with government officials suggest that when authorities decided to take up this initiative in 2020, a huge amount of misinformation emerging during the COVID-19 pandemic was the trigger. There was misinformation regarding government orders, healthcare facilities, vaccination, and lockdown regulations, which affected everyone, unlike the case of Kannur, where it was only a certain age group of kids. As a solution to this problem, the state government decided to create a media literacy curriculum to be taught in all government schools of the state starting from standard 8 till graduation. This was a tricky task, as a new course had to be immediately introduced in the school curriculum amid all the disruptions in the education system caused by the pandemic. It was revealed during the interview that in the case of the state-wide implementation, every step involved multiple checks and balances, unlike the earlier program where stakeholders were roped-in as and when the need emerged. On the pedagogy, while the training during the pilot could be managed through PowerPoint presentation, designing a state-wide curriculum involved multiple iterations and expert approvals. The reason for this is COVID-19 related misinformation has lost its significance. In the next phase of the research, an attempt will be made to compare other aspects of the pilot implementation with the state-wide implementation.

Keywords: media literacy, digital media literacy, curriculum based media literacy intervention, misinformation

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Authors: Mengdan Guo, Zongmin Wang, Haibo Yang

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Drought is one of the most complex and destructive natural disasters, with a huge impact on both nature and society. In recent years, adverse climate conditions and uncontrolled human activities have exacerbated the occurrence of global droughts, among which socio-economic droughts are closely related to human survival. The study of socio-economic drought risk assessment is crucial for sustainable social development. Therefore, this study comprehensively considered the risk of disaster causing factors, the exposure level of the disaster-prone environment, and the vulnerability of the disaster bearing body to construct a socio-economic drought risk assessment model for Chuxiong Prefecture in Yunnan Province. Firstly, a threedimensional frequency analysis of intensity area duration drought was conducted, followed by a statistical analysis of the drought risk of the socio-economic system. Secondly, a grid analysis model was constructed to assess the exposure levels of different agents and study the effects of drought on regional crop growth, industrial economic growth, and human consumption thresholds. Thirdly, an agricultural vulnerability model for different irrigation levels was established by using the DSSAT crop model. Industrial economic vulnerability and domestic water vulnerability under the impact of drought were investigated by constructing a standardized socio-economic drought index and coupling water loss. Finally, the socio-economic drought risk was assessed by combining hazard, exposure, and vulnerability. The results show that the frequency of drought occurrence in Chuxiong Prefecture, Yunnan Province is relatively high, with high population and economic exposure concentrated in urban areas of various counties and districts, and high agricultural exposure concentrated in mountainous and rural areas. Irrigation can effectively reduce agricultural vulnerability in Chuxiong, and the yield loss rate under the 20mm winter irrigation scenario decreased by 10.7% compared to the rain fed scenario. From the perspective of comprehensive risk, the distribution of long-term socio-economic drought risk in Chuxiong Prefecture is relatively consistent, with the more severe areas mainly concentrated in Chuxiong City and Lufeng County, followed by counties such as Yao'an, Mouding and Yuanmou. Shuangbai County has the lowest socio-economic drought risk, which is basically consistent with the economic distribution trend of Chuxiong Prefecture. And in June, July, and August, the drought risk in Chuxiong Prefecture is generally high. These results can provide constructive suggestions for the allocation of water resources and the construction of water conservancy facilities in Chuxiong Prefecture, and provide scientific basis for more effective drought prevention and control. Future research is in the areas of data quality and availability, climate change impacts, human activity impacts, and countermeasures for a more comprehensive understanding and effective response to drought risk in Chuxiong Prefecture.

Keywords: DSSAT model, risk assessment, socio-economic drought, standardized socio-economic drought index

Procedia PDF Downloads 28

Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya

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Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.

Keywords: pregnant women, prevalence, risk factor, UTIs

Procedia PDF Downloads 122

Authors: Sam Bartlett, Thomas Bacquart, Arul Murugan, Abigail Morris

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Fuel cell electric vehicles provide the potential to decarbonise road transport, create new economic opportunities, diversify national energy supply, and significantly reduce the environmental impacts of road transport. A potential issue, however, is that the catalyst used at the fuel cell cathode is susceptible to degradation by impurities, especially sulphur-containing compounds. A recent European Directive (2014/94/EU) stipulates that, from November 2017, all hydrogen provided to fuel cell vehicles in Europe must comply with the hydrogen purity specifications listed in ISO 14687-2; this includes reactive and toxic chemicals such as ammonia and total sulphur-containing compounds. This requirement poses great analytical challenges due to the instability of some of these compounds in calibration gas standards at relatively low amount fractions and the difficulty associated with undertaking measurements of groups of compounds rather than individual compounds. Without the available reference materials and analytical infrastructure, hydrogen refuelling stations will not be able to demonstrate compliance to the ISO 14687 specifications. The hydrogen purity laboratory at NPL provides world leading, accredited purity measurements to allow hydrogen refuelling stations to evidence compliance to ISO 14687. Utilising state-of-the-art methods that have been developed by NPL’s hydrogen purity laboratory, including a novel method for measuring total sulphur compounds at 4 nmol/mol and a hydrogen impurity enrichment device, we provide the capabilities necessary to achieve these goals. An overview of these capabilities will be given in this paper. As part of the EMPIR Hydrogen co-normative project ‘Metrology for sustainable hydrogen energy applications’, NPL are developing a validated analytical methodology for the measurement of speciated sulphur-containing compounds in hydrogen at low amount fractions pmol/mol to nmol/mol) to allow identification and measurement of individual sulphur-containing impurities in real samples of hydrogen (opposed to a ‘total sulphur’ measurement). This is achieved by producing a suite of stable gravimetrically-prepared primary reference gas standards containing low amount fractions of sulphur-containing compounds (hydrogen sulphide, carbonyl sulphide, carbon disulphide, 2-methyl-2-propanethiol and tetrahydrothiophene have been selected for use in this study) to be used in conjunction with novel dynamic dilution facilities to enable generation of pmol/mol to nmol/mol level gas mixtures (a dynamic method is required as compounds at these levels would be unstable in gas cylinder mixtures). Method development and optimisation are performed using gas chromatographic techniques assisted by cryo-trapping technologies and coupled with sulphur chemiluminescence detection to allow improved qualitative and quantitative analyses of sulphur-containing impurities in hydrogen. The paper will review the state-of-the art gas standard preparation techniques, including the use and testing of dynamic dilution technologies for reactive chemical components in hydrogen. Method development will also be presented highlighting the advances in the measurement of speciated sulphur compounds in hydrogen at low amount fractions.

Keywords: gas chromatography, hydrogen purity, ISO 14687, sulphur chemiluminescence detector

Procedia PDF Downloads 201

Authors: Christopher S. Perez, Kendal C. Boyd

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global suicide rates have decreased in recent decades, rates in the United States have increased by 35.2 percent since 1999.American Indians and Alaska Natives (AI/AN) have the highest rates of suicide in the U.S., with approximately 22 suicides per 100,000 people as of 2019. AI/AN have experienced significant historical trauma resulting in disproportionate rates of substance abuse and mental disorders. This literature review aimed to identify the demographic and clinical risk and protective factors for American Indians and Alaska Natives and provide an overview of suicidality in this population. The literature reflected varying definitions of suicidality depending on region, with some AI/AN tribesconceptualizing suicide through a spiritual framework, while others defined suicide in the biomedical sense. Furthermore, AI/AN adults and adolescents experienced higher rates of suicidal ideation when compared to other racial groups. Religious preference, sexual orientation, prior suicidal behavior, psychiatric admission, history of abuse, substance abuse, family history of mental illness, family history of substance abuse, family history of suicidal behaviors, domestic violence, and trauma were discussed as factors related to suicidality. Recommendations included increasing access to and utilization of mental health and medical services, culturally adapting suicide prevention programs to AI/AN communities, increasing support for LGBTQ+ AI/AN, providing opportunities that reinforce ethnic identity, and post-hospitalization follow-up care. The following databases were utilized to obtain peer-reviewed articles for this literature review: Complementary Index, Academic Search Premier, Science Direct, PsycInfo, Social Sciences Citation Index, PsycArticles, PubMed, EbscoHost, and PsycBooks. Articles that examined Native populations outside of the United States did not cite a primary source and/or were published before 1990 were excluded.

Keywords: alaska native, american indian, protective factors, risk factors, suicidality, suicide

Procedia PDF Downloads 82

Authors: Reda A. Elkhyat, Mahmoud Nasr, Amel A. Tammam, Mohamed A. Ghazy

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Pharmaceuticals and personal care products (PPCPs) are a unique group of emerging contaminants continuously introduced into the aquatic ecosystem at concentrations capable of inducing adverse effects on humans and aquatic organisms, even at trace levels ranging from ppt to ppm. Amongst the common pharmaceutical emerging pollutants detected in several aquatic environments, acetaminophen has been recognized for its high toxicity. Once released into the aquatic environment, acetaminophen could be degraded by the microbial community and adsorption/ uptake by the plants. Although many studies have investigated the hazard risks of acetaminophen pollutants on aquatic animals, the number of studies demonstrating its removal efficiency and effects on the aquatic plant still needs to be expanded. In this context, this study aims to apply the aquatic plant-based phytoremediation system to eliminate this emerging contaminant from domestic wastewater. The phytoremediation experiment was performed in a hydroponic system containing Eichhornia crassipes and operated under the natural environment at 25°C to 30°C. This system was subjected to synthetic domestic wastewater with the maximum initial chemical oxygen demand (COD) of 390 mg/L and three different acetaminophen concentrations of 25, 50, and 200 mg/L. After 17 d of operation, the phytoremediation system achieved removal efficiencies of about 100% and 85.6±4.2% for acetaminophen and COD, respectively.Moreover, the Eichhornia crassipes could withstand the toxicity associated with increasing the acetaminophen concentrations from 25 to 200 mg/L. This high treatment performance could be assigned to the well-adaptation of the water hyacinth to the phytoremediation factors. Moreover, it has been proposed that this phytoremediation system could be largely supported by phytodegradation and plant uptaking mechanisms; however, detecting the generated intermediates, metabolites, and degradation products are still under investigation. Applying this free-floating plant in wastewater treatment and reducing emerging contaminants would meet the targets of SDGs 3, 6, and. 14. The cost-benefit analysis was performed for the phytoremediation system. The phytoremediation system is financially viable as the net profit was 2921 US $/ y with a payback period of nine years.

Keywords: domestic wastewater, emerging pollutants, hydrophyte Eichhornia crassipes, paracetamol removal efficiency, sustainable development goals (SDGs)

Procedia PDF Downloads 95

Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp

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Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.

Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task

Procedia PDF Downloads 39

Authors: Lim Pey Huan

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In the second half of the 19th century, Vietnam has long been influenced by Han culture, so there are many similarities in religion and folk beliefs. Even after the acceptance process of the Catholic Church introduced from Europe is quite similar. Therefore, in the spiritual life of Vietnamese civil society, Confucianism, Buddhism, Taoism, Christianity, Islam, and folk beliefs can be said to be the main trend, but in the twentieth century, two indigenous new religions were born: Caodai and He Hao Jiao, both of which are produced and developed in the south, each of which has millions of believers and become important Vietnamese religions. Their political participation has a major impact on the development of the Republic of Vietnam, and their fate is also in the north and south. Significant changes have taken place after reunification. Caodai was later approved by the colonial authorities and became the third largest religion in Vietnam. The teachings of Caodai teach the ideas of the major religions of the world. The classics used in the teachings also contain important theories of various religions, with particular emphasis on the comprehensiveness of the three sects of Confucianism, Buddhism, and Taoism. The obvious manifestation lies in the interpretation of the important proposition of 'opening the three religions and returning to the five branches.' The full name of Caodaism is 'Da Dao San Qi Pu Du Gao Tai Jiao'. This name coincides with the 'Longhua Club' and the 'San Qi Mo Jie' idea and the consistent central idea. The emerging road of Caodai advocates to lead the sentient beings back to their original missions; the sentient beings will be centered on people, and the nature of the talks is nothing more than the original mission and standard. There are many opinions about the introduction of Caodaism into southern Vietnam. Caodai believers believe that Caodaism is an emerging new religion in Vietnam. If we further explore the teachings and religious rituals of Caodai, it is not difficult to find that many Chinese sects have been introduced to Vietnam. Some of the colors can be discussed from the spread and influence of Congenital Road in Vietnam. This article will present the author's analysis of the actual process of tutoring in Vietnam's Caodai, and then compare it with the consistent religious experience, trying to explore the Yi-Kuan-Tao and consistent Yi-Kuan-Tao rituals, religious organization, religious teachings, religious life care, and Funeral rituals and other comparative studies.

Keywords: Vietnam, Caodaism, Yi-Kuan-Tao, religious rituals

Procedia PDF Downloads 105

Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

Procedia PDF Downloads 67

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

Procedia PDF Downloads 42

Authors: Bandar A. Alkhayyal

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Modern supply chains are typically linear, transforming virgin raw materials into products for end consumers, who then discard them after use to landfills or incinerators. Nowadays, there are major efforts underway to create a circular economy to reduce non-renewable resource use and waste. One important aspect of these efforts is the development of Green Supply Chain (GSC) systems which enables a reverse flow of used products from consumers back to manufacturers, where they can be refurbished or remanufactured, to both economic and environmental benefit. This paper develops novel multi-objective optimization models to inform GSC system design at multiple levels: (1) strategic planning of facility location and transportation logistics; (2) tactical planning of optimal pricing; and (3) policy planning to account for potential valuation of GSC emissions. First, physical linear programming was applied to evaluate GSC facility placement by determining the quantities of end-of-life products for transport from candidate collection centers to remanufacturing facilities while satisfying cost and capacity criteria. Second, disassembly and remanufacturing processes have received little attention in industrial engineering and process cost modeling literature. The increasing scale of remanufacturing operations, worth nearly $50 billion annually in the United States alone, have made GSC pricing an important subject of research. A non-linear physical programming model for optimization of pricing policy for remanufactured products that maximizes total profit and minimizes product recovery costs were examined and solved. Finally, a deterministic equilibrium model was used to determine the effects of internalizing a cost of GSC greenhouse gas (GHG) emissions into optimization models. Changes in optimal facility use, transportation logistics, and pricing/profit margins were all investigated against a variable cost of carbon, using case study system created based on actual data from sites in the Boston area. As carbon costs increase, the optimal GSC system undergoes several distinct shifts in topology as it seeks new cost-minimal configurations. A comprehensive study of quantitative evaluation and performance of the model has been done using orthogonal arrays. Results were compared to top-down estimates from economic input-output life cycle assessment (EIO-LCA) models, to contrast remanufacturing GHG emission quantities with those from original equipment manufacturing operations. Introducing a carbon cost of $40/t CO2e increases modeled remanufacturing costs by 2.7% but also increases original equipment costs by 2.3%. The assembled work advances the theoretical modeling of optimal GSC systems and presents a rare case study of remanufactured appliances.

Keywords: circular economy, extended producer responsibility, greenhouse gas emissions, industrial ecology, low carbon logistics, green supply chains

Procedia PDF Downloads 150

Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

Procedia PDF Downloads 58

Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

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Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

Procedia PDF Downloads 145

Authors: Masoud Swalehe, Semra Günay

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Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

Procedia PDF Downloads 285

Authors: Jungyeol Hong, Dongjoo Park

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The urban transit system is a critical part of a solution to the economic, energy, and environmental challenges. Furthermore, it ultimately contributes the improvement of people’s quality of lives. For taking these kinds of advantages, the city of Seoul has tried to construct an integrated transit system including both subway and buses. The effort led to the fact that approximately 6.9 million citizens use the integrated transit system every day for their trips. Diagnosing the current transit network is a significant task to provide more convenient and pleasant transit environment. Therefore, the critical objective of this study is to establish a methodological framework for the analysis of an integrated bus-subway network and to examine the relationship between subway ridership and parameters such as network topology measures, bus demand, and a variety of commercial business facilities. Regarding a statistical approach to estimate subway ridership at a station level, many previous studies relied on Ordinary Least Square regression, but there was lack of studies considering the endogeneity issues which might show in the subway ridership prediction model. This study focused on both discovering the impacts of integrated transit network topology measures and endogenous effect of bus demand on subway ridership. It could ultimately contribute to developing more accurate subway ridership estimation accounting for its statistical bias. The spatial scope of the study covers Seoul city in South Korea, and it includes 243 subway stations and 10,120 bus stops with the temporal scope set during twenty-four hours with one-hour interval time panels each. The subway and bus ridership information in detail was collected from the Seoul Smart Card data in 2015 and 2016. First, integrated subway-bus network topology measures which have characteristics regarding connectivity, centrality, transitivity, and reciprocity were estimated based on the complex network theory. The results of integrated transit network topology analysis were compared to subway-only network topology. Also, the non-recursive approach which is Three-Stage Least Square was applied to develop the daily subway ridership model as capturing the endogeneity between bus and subway demands. Independent variables included roadway geometry, commercial business characteristics, social-economic characteristics, safety index, transit facility attributes, and dummies for seasons and time zone. Consequently, it was found that network topology measures were significant size effect. Especially, centrality measures showed that the elasticity was a change of 4.88% for closeness centrality, 24.48% for betweenness centrality while the elasticity of bus ridership was 8.85%. Moreover, it was proved that bus demand and subway ridership were endogenous in a non-recursive manner as showing that predicted bus ridership and predicted subway ridership is statistically significant in OLS regression models. Therefore, it shows that three-stage least square model appears to be a plausible model for efficient subway ridership estimation. It is expected that the proposed approach provides a reliable guideline that can be used as part of the spectrum of tools for evaluating a city-wide integrated transit network.

Keywords: integrated transit system, network topology measures, three-stage least squared, endogeneity, subway ridership

Procedia PDF Downloads 158

Authors: Salma Akter, Md. Kamal Uddin

Abstract:

This study aims to demonstrate how top-down shelter policy and its resultant dwelling environment leads to ‘everyday compromise’ by the grassroots according to subjective (satisfaction) and objective (physical design elements and physical environmental elements) indicators, which are measured across three levels of the settlement; macro (Community), meso (Neighborhood or shelter/built environment) and micro (family). Ashrayan Prakalpa is a resettlement /housing project of Government of Bangladesh for providing shelters and human resources development activities like education, microcredit, and training programme to landless, homeless and rootless people. Despite the integrated nature of the shelter policies (comprises poverty alleviation, employment opportunity, secured tenure, and livelihood training), the ‘quality of life’ issue at the different levels of settlements becomes questionable. As dwellers of shelter units (although formally termed as ‘barracks’ rather shelter or housing) remain on the receiving end of government’s resettlement policies, they often involve with spatial-physical and socio-economic negotiation and assume curious forms of spatial practice, which often upholds contradiction with policy planning. Thus, policy based shelter force dwellers to persistently compromise with their provided built environments both in overtly and covertly. Compromising with prescribed designed space and facilities across living places articulated their negotiation with the quality of allocated space, built form and infrastructures, which in turn exert as less quality of life. The top-down shelter project, Dakshin Chandani Mahal Ashrayan Prakalpa at Dighalia Upazila, the study area located at the Eastern fringe area of Khulna, Bangladesh, is still in progress to resettle internally displaced and homeless people. In terms of methodology, this research is primarily exploratory and adopts a case study method, and an analytical framework is developed through the deductive approach for evaluating the quality of life. Secondary data have been obtained from housing policy analysis and relevant literature review, while key informant interview, focus group discussion, necessary drawings and photographs and participant observation across dwelling, neighborhood, and community level have also been administered as primary data collection methodology. Findings have revealed that various shortages, inadequacies, and negligence of policymakers force to compromise with allocated designed space, physical infrastructure and economic opportunities across dwelling, neighborhood and mostly community level. Thus, the outcome of this study can be beneficial for a global-level understating of the compromising the ‘quality of life’ under top-down shelter policy. Locally, for instance, in the context of Bangladesh, it can help policymakers and concerned authorities to formulate the shelter policies and take initiatives to improve the well-being of marginalized.

Keywords: Ashrayan Prakalpa, compromise, displaced people, quality of life

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