Search results for: water treatment utilities

Authors: Sushil Kumar, Mukesh Jain, Vijaya Rani, Vinod Kumar

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The prime importance of tillage is that it prepares the land where the seed easily germinate and later the plant can well establish. Using different types of equipments driven manually or by powered, machines make the soil suitable to place the seeds into the desirable depth. Moreover, tillage loosens the compacted layers. Heavy equipment and tillage implements can cause damage to the soil structure. Effect of various tillage methods on soil compaction was studied in Rabi season of 2013-14 at village Ladwa, Hisar, Haryana (India). The experiments studied the effect of six tillage treatments i.e. no tillage or zero tillage (T1), tillage with rotavator (T2), disc harrow (T3), rotavator + sub soiler (T4), disc harrow + sub soiler (T5) and power harrow (T6) on soil compaction. Soil compaction was measured before tillage and after sowing at 0, 30, 60 and 90 days after sowing. No change in soil resistance was recorded before and after no tillage treatment. Maximum soil resistance was found in zero tillage followed by disc harrow up to 150 mm soil depth. Minimum soil resistance was found in rotavator immediately after the tillage treatment. However, the soil resistance approached the same level as it had been before the tillage after the soil strata where the implement cannot reach.

Keywords: tillage, no tillage, rotavator, subsoiler, compaction

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Authors: Abdul Malik Dawlatzai, Shafiqullah Rahmani

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Splash erosion in field has affected by factors; slope, rain intensity, soil properties, and plant cover. And also, soil erosion affects not only farmland productivity but also water quality downstream. There are a number of potential soil conservation practices, but many of these are complicated and relatively expensive, such as buffer strips, agro-forestry, counter banking, catchment canal, terracing, surface mulching, reduced tillage, etc. However, mitigation soil and water loss in agricultural land, particularly in arid and semi-arid climatic conditions, is indispensable for environmental protection and agricultural production. The objective of this study is to evaluate the effects of adding gypsum mineral on mitigating splash erosion caused by rain drop. The research was conducted in soil laboratory Badam Bagh Agricultural Researching Farm, Kabul, Afghanistan. The stainless steel cores were used, and constant water pressure was controlled by a Mariotte’s bottle with kinetic energy of raindrops 2.36 x 10⁻⁵J. Gypsum mineral was applied at a rate of 5 and 10 t ha⁻¹ and using a sandy loam and loam soil textures. The result was showed an average soil loss from sandy loam soil texture; control was 8.22%, 4.31% and 4.06% similar from loam soil texture, control was 7.26%, 2.89%, and 2.72% respectively. The application of gypsum mineral significantly (P < 0.05) reduced dispersion of soil particles caused by the impact of raindrops compared to control. Therefore, it was concluded that the addition of gypsum was effective as a measure for mitigating splash erosion.

Keywords: gypsum, soil loss, splash erosion, Afghanistan

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Authors: Elham Rezaee, Sayyed Abbas Tabatabai

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Dual inhibition of COX-2 and sEH enzymes represents one of the distinct pharmaceutical approaches for the treatment of inflammation, pain, cancers, and other diseases. The discovery of these inhibitors for treatment is a great deal of attention because of some advantages such as increased efficacy, a promising safety profile, ease of formulation, and better target engagement. In this research, based on the structure-activity relationship of COX-2 and sEH inhibitors, some amide derivatives with oxadiazole and dihydropyrimidinone rings against sEH and COX-2 enzymes were developed. The designed compounds showed high affinity to the active site of both enzymes in docking studies and were synthesized in good yield and characterized by IR, Mass, 1HNMR, and 13CNMR. All of the novel compounds exhibited considerable in-vitro sEH and COX-2 inhibitory activities in comparison with 12-(3-Adamantan-1-yl-ureido)- dodecanoic acid and celecoxib (a potent urea-based sEH inhibitor and selective nonsteroidal anti-inflammatory drug, respectively). Ethyl 6-methyl-4-(4-(4-(methylsulfonyl)benzamido)phenyl)-2-oxo-1,2,3,4-tetrahydropyrimidine-5-carboxylate was found to be the most selective COX-2 inhibitor (COX-2/COX-1 ratio: 683) with IC50 value of 2.1 nM targeting sEH enzyme.

Keywords: COX-2, dual inhibitors, sEH, synthesis

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Authors: Fezzani Boubaker

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In this work, a comprehensive study of respirometric method was performed to assess the biodegradable COD fractions of domestic sewage mixed with baker’s yeast factory effluent treated by wastewater treatment plant (WWTP) of Beja. Three respirometric runs were performed in a closed tank reactor to characterize this mixed raw effluent. Respirometric result indicated that the readily biodegradable fraction (SS) was in range of 6-22%, the slowly biodegradable fraction (Xs) was in range of 33-42%, heterotrophic biomass (XH) was in range of 9-40% and the inert fractions: XI and SI were in range of 2-40% and 6-12% respectively which were high due to the presence of baker’s yeast factory effluent compared to domestic effluent alone. The fractions of the total nitrogen showed that SNO fraction is between 6 and 9% of TKN, the fraction of nitrogen ammonia SNH was ranging from 5 to 68%. The organic fraction divided into two compartments SND (11-85%) and XND (5-20%) the inert particulate nitrogen fraction XNI was between 0.4 and 1% and the inert soluble fraction of nitrogen SNI was ranged from 0.4 to 3%.

Keywords: wastewater characterization, COD fractions, respirometry, domestic sewage

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Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

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Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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Authors: Min Sik Kim, Hwa Sung Shin

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From 2013, small eel farms, which are located in Han River Estuary, South Korea suffer damage because of unknown massive perish. In the middle of discussion that the cause of perish could be environmental changes or waste water, a large amount of unknown nemertean was discovered during that time. Some nemerteans are known releasing neurotoxin substance. In this study, we isolated intestinal bacteria using selective media and conducted 16s rDNA microbial identification by gene alignment. As a result, there was a type of bacteria producing TTX, blocks sodium-channel inducing organism’s death. TTX production from the bacteria was confirmed by ELISA and liquid chromatography coupled with mass spectrometer. Additionally, the activated-charcoal which has an ability to absorb small molecules like toxin was applied to fibrous mesh to prevent ingestion of aquatic organisms and increase applicable area. The viability of zebrafish in the water with TTX and charcoal fiber mat were not decreased meaning it could be used for solving the perishing problem in fish farm.

Keywords: nemertean, TTX, fiber mat, activated charcoal, zebrafish

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Authors: Jaspal Rana, Alkem Laboratories, Baddi, Himachal Pradesh, India Chitkara University, Punjab, India

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min followed by 24 h reperfusion was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity was also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rise in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury, which may be attributed to its antioxidant properties.

Keywords: stroke, neuroprotection, ischemia reperfusion, herbal drugs

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Authors: D. G. Rejon-Parra, B. Escobar-Morales, Romeli Barbosa, J. C. Cruz

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In the southeast of Yucatan Peninsula, sedimentary limestone has different degrees of compaction. Due to its recent geological formation (Quaternary) and weathering effects causing an affordable aggregate for local manufacturers of concrete. It is characterized as lightweight aggregates (average density of 2,50), susceptible to abrasion and varying porosities (water content exceeding 7,50 % of its mass, in saturated condition). In this study, local aggregates with two moisture conditions (saturated and dry), have been examined in order to compare them for optimizing the performance of concrete. It is possible that these aggregates favour a phenomenon of mass transport (self-curing by porous aggregate); influencing the water reactions to form crystalline and gel hydration products. Based on the ACI methodology, a concrete mixture of 250 kg/cm2 was designed, with portland blended cement 30R. The bond between the mortar and the coarse aggregate was characterized as physicochemical based on trials which were carefully observed during time span of 28 days. The BET technique was used to analyse the micro porosity and surface areas of contact of the different crystalline phases of the limestone. Its chemical composition and crystal structures were verified with scanning electron microscopy SEM-EDS. On the third day, the samples with saturated aggregate reached 237 kg/cm2 of resistence, nearly the design strength; while samples with dry aggregate, exceeded the design strength, with a capacity of 308 kg/cm2. Aggregates in dry conditions demand a high quantity of water in the initial mixture, causing high resistance at the early stages. In saturated conditions, the development of resistance is progressive but constant.

Keywords: concrete, internal curing, limestone aggregate, porosity

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Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: Maha M.Saber, Eitedal Daoud, Moetazza M. Alshafei, Lobna M. Abd El-Latif

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Children in the third world consumes many food products colored red like sweets and soft drink without knowing its effect on health or the type of color used in these products Erythrosine (ER,FD & C Red No.3) is one of the most common coloring agent used in these products and in coloring cherry in compotes. The possible adverse effect of erythrosine ER on the thyroid gland function is investigated in albino rats. Forty-five adult male albino rats were divided to three groups two groups will receive ER orally in doses 68 and I36mg/kg respectively. Third group will receive distilled water for three months Sections of thyroid glands were examined for histopathological, morphometric analysis and MIB-I Ki67 (proliferative marker). Serum concentration of triiodothyronine (T3), Thyroxin (T4) and thyrotrophin (TSH) were determined, results showed histological changes in the two treatment groups versus control group in the group with 68mg/kg dose show vaculation of the cytoplasm of follicular cells and pleomorphism of their nuclei. While the other treated group {136mg /kg} showed congestion of blood vessels, hyperplasia of the interstitial cells and increased multilayer of the follicular cells. Highly significant increase in the mean area of the thyroid follicles in both treated groups compared to control group.Erythrosine treated groups showed a very highly significant decrease (P < 0.001) in serum concentration of T3 and T 4 while TSH showed a very highly significant increase versus control.

Keywords: erythrosine, thyroid, morphometrics, proliferative marker

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Authors: Bayan Alqassem, Israa A. Othman, Mohammed Abu Haija, Fawzi Banat

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The treatment of wastewater from highly toxic pollutants is one of the most challenging issues for humanity. In this study, the advanced oxidation process (AOP) was employed to study the catalytic degradation of phenol using different ferrite catalysts which are CoFe₂O₄, CrFe₂O₄, CuFe₂O₄, MgFe₂O₄, MnFe₂O₄, NiFe₂O₄ and ZnFe₂O₄. The ferrite catalysts were prepared via sol-gel and co-precipitation methods. Different ferrite composites were also prepared either by varying the metal ratios or incorporating chemically reduced graphene oxide in the ferrite cluster. The effect of phosphoric acid treatment on the copper ferrite activity. All of the prepared catalysts were characterized using infrared spectroscopy (IR), X-ray diffraction (XRD) and scanning electron microscopy (SEM). The ferrites catalytic activities were tested towards phenol degradation using high performance liquid chromatography (HPLC). The experimental results showed that ferrites prepared through sol-gel route were more active than those of the co-precipitation method towards phenol degradation. In both cases, CuFe₂O₄ exhibited the highest degradation of phenol compared to the other ferrites. The photocatalytic properties of the ferrites were also investigated.

Keywords: ferrite catalyst, ferrite composites, phenol degradation, photocatalysis

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Authors: M. Miljkovic, A. Urakpo, M. Simic-Koumoutsaris

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Benefit-risk assessment (BRA) is a valuable tool that takes place in multiple stages during a medicine's lifecycle, and this assessment can be conducted in a variety of ways. The aim was to summarize current BRA methods used during approval decisions and in post-approval settings and to see possible future directions. Relevant reviews, recommendations, and guidelines published in medical literature and through regulatory agencies over the past five years have been examined. BRA implies the review of two dimensions: the dimension of benefits (determined mainly by the therapeutic efficacy) and the dimension of risks (comprises the safety profile of a drug). Regulators, industry, and academia have developed various approaches, ranging from descriptive textual (qualitative) to decision-analytic (quantitative) models, to facilitate the BRA of medicines during the product lifecycle (from Phase I trials, to authorization procedure, post-marketing surveillance and health technology assessment for inclusion in public formularies). These approaches can be classified into the following categories: stepwise structured approaches (frameworks); measures for benefits and risks that are usually endpoint specific (metrics), simulation techniques and meta-analysis (estimation techniques), and utility survey techniques to elicit stakeholders’ preferences (utilities). All these approaches share the following two common goals: to assist this analysis and to improve the communication of decisions, but each is subject to its own specific strengths and limitations. Before using any method, its utility, complexity, the extent to which it is established, and the ease of results interpretation should be considered. Despite widespread and long-time use, BRA is subject to debate, suffers from a number of limitations, and currently is still under development. The use of formal, systematic structured approaches to BRA for regulatory decision-making and quantitative methods to support BRA during the product lifecycle is a standard practice in medicine that is subject to continuous improvement and modernization, not only in methodology but also in cooperation between organizations.

Keywords: benefit-risk assessment, benefit-risk profile, product lifecycle, quantitative methods, structured approaches

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Authors: Bernice Jeanne Lottering, Yi-Wen Lin

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Introduction: Chronic pain has a definitive lack of objective parameters in the measurement and treatment efficacy of diseases such as Fibromyalgia (FM). Persistent widespread pain and generalized tenderness are the characteristic symptoms affecting a large majority of the global population, particularly females. This disease has indicated a refractory tendency to conventional treatment ventures, largely resultant from a lack of etiological and pathogenic understanding of the disease development. Emerging evidence indicates that the central nervous system (CNS) plays a critical role in the amplification of pain signals and the neurotransmitters associated therewith. Various stimuli have been found to activate the channels existent on nociceptor terminals, thereby actuating nociceptive impulses along the pain pathways. The transient receptor potential vanalloid 1 (TRPV1) channel functions as a molecular integrator for numerous sensory inputs, such as nociception, and was explored in the current study. Current intervention approaches face a multitude challenges, ranging from effective therapeutic interventions to the limitation of pathognomonic criteria resultant from incomplete understanding and partial evidence on the mechanisms of action of FM. It remains unclear whether electroacupuncture (EA) plays an integral role in the functioning of the TRPV1 pathway, and whether or not it can reduce the chronic pain induced by FM. Aims: The aim of this study was to explore the mechanisms underlying the activation and modulation of the TRPV1 channel pathway in a cold stress model of FM applied to a murine model. Furthermore, the effect of EA in the treatment of mechanical and thermal pain, as expressed in FM was also to be investigated. Methods: 18 C57BL/6 wild type and 6 TRPV1 knockout (KO) mice, aged 8-12 weeks, were exposed to an intermittent cold stress-induced fibromyalgia-like pain model, with or without EA treatment at ZusanLi ST36 (2Hz/20min) on day 3 to 5. Von Frey and Hargreaves behaviour tests were implemented in order to analyze the mechanical and thermal pain thresholds on day 0, 3 and 5 in control group (C), FM group (FM), FM mice with EA treated group (FM + EA) and FM in KO group. Results: An increase in mechanical and thermal hyperalgesia was observed in the FM, EA and KO groups when compared to the control group. This initial increase was reduced in the EA group, which directs focus at the treatment efficacy of EA in nociceptive sensitization, and the analgesic effect EA has attenuating FM associated pain. Discussion: An increase in the nociceptive sensitization was observed through higher withdrawal thresholds in the von Frey mechanical test and the Hargreaves thermal test. TRPV1 function in mice has been scientifically associated with these nociceptive conduits, and the increased behaviour test results suggest that TRPV1 upregulation is central to the FM induced hyperalgesia. This data was supported by the decrease in sensitivity observed in results of the TRPV1 KO group. Moreover, the treatment of EA showed a decrease in this FM induced nociceptive sensitization, suggesting TRPV1 upregulation and overexpression can be attenuated by EA at bilateral ST36. This evidence compellingly implies that the analgesic effect of EA is associated with TRPV1 downregulation.

Keywords: fibromyalgia, electroacupuncture, TRPV1, nociception

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Authors: Masoud Soltani Hosseini, Fereshteh Rahmani, Mohammad Tajik Mansouri, Ali Zolghadr

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Climate change is accompanied with ambient temperature increase and water accessibility limitation. The main objective of this paper is to investigate the effects of climate change on thermal power plants including gas turbines, steam and combined cycle power plants in Iran. For this purpose, the ambient temperature increase and water accessibility will be analyzed and their effects on power output and efficiency of thermal power plants will be determined. According to the results, the ambient temperature has high effect on steam power plants with indirect cooling system (Heller). The efficiency of this type of power plants decreases by 0.55 percent per 1oC ambient temperature increase. This amount is 0.52 and 0.2 percent for once-through and wet cooling systems, respectively. The decrease in power output covers a range of 0.2% to 0.65% for steam power plant with wet cooling system and gas turbines per 1oC air temperature increase. Based on the thermal power plants distribution in Iran and different scenarios of climate change, the total amount of power output decrease falls between 413 and 1661 MW due to ambient temperature increase. Another limitation incurred by climate change is water accessibility. In optimistic scenario, the power output of steam plants decreases by 1450 MW in dry and hot climate areas throughout next decades. The remaining scenarios indicate that the amount of decrease in power output would be by 4152 MW in highlands and cold climate. Therefore, it is necessary to consider appropriate solutions to overcome these limitations. Considering all the climate change effects together, the actual power output falls in range of 2465 and 7294 MW and efficiency loss covers the range of 0.12 to .56 % in different scenarios.

Keywords: climate, change, thermal, power plants

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Authors: Jyoti Kumari, Pavuluri Srinivasa Rao

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Jackfruit (ArtocarpusheterophyllusL.) is an underutilized yet highly nutritious fruit with unique flavour, known for its therapeutic and culinary properties. Fresh jackfruit bulb has a very short shelf life due to high moisture and sugar content leading to microbial and enzymatic browning, hindering its consumer acceptability and marketability. An attempt has been made for the preservation of the ripe jackfruit bulbs, by the application of high pressure (HP) over a range of 200-500 MPa at ambient temperature for dwell times ranging from 5 to 20 min. The physicochemical properties of jackfruit bulbs such as the pH, TSS, and titrable acidity were not affected by the pressurization process. The ripening index of the fruit bulb also decreased following HP treatment. While the ascorbic acid and antioxidant activity of jackfruit bulb were well retained by high pressure processing (HPP), the total phenols and carotenoids showed a slight increase. The HPP significantly affected the colour and textural properties of jackfruit bulb. High pressure processing was highly effective in reducing the browning index of jackfruit bulbs in comparison to untreated bulbs. The firmness of the bulbs improved upon the pressure treatment with longer dwelling time. The polyphenol oxidase has been identified as the most prominent oxidative enzyme in the jackfruit bulb. The enzymatic activity of polyphenol oxidase and peroxidase were significantly reduced by up to 40% following treatment at 400 MPa/15 min. HPP of jackfruit bulbs at ambient temperatures is shown to be highly beneficial in improving the shelf stability, retaining its nutrient profile, color, and appearance while ensuring the maximum inactivation of the spoilage enzymes.

Keywords: antioxidant capacity, ascorbic acid, carotenoids, color, HPP-high pressure processing, jackfruit bulbs, polyphenol oxidase, peroxidase, total phenolic content

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Authors: Hamidoddin Yousefi, Ahmad Nikbakht

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The Sistan Plain, situated in the Balochistan region of southeastern Iran, is renowned for its arid climatic conditions and prevailing winds that persist for approximately 120 days annually. The region faces multiple challenges, including drought susceptibility, exacerbated by wind erosion, temperature fluctuations, and the influence of policies implemented by neighboring Afghanistan and Iran. This study focuses on investigating the characteristics of jet streams within the Sistan Plain and their implications for global climate change. Various models are employed to analyze convective mass fluxes, horizontal moisture transport, temporal variance, and the calculation of radiation convective equilibrium within the atmosphere. Key considerations encompass the distribution of relative humidity, dry air, and absolute humidity. Moreover, the research aims to predict the interplay between jet streams and human activities, particularly regarding their environmental impacts and water scarcity. The investigation encompasses both local and global environmental consequences, drawing upon historical climate change data and comprehensive field research. The anticipated outcomes of this study hold substantial potential for mitigating global climate change and its associated environmental ramifications. By comprehending the dynamics of jet streams and their interconnections with human activities, effective strategies can be formulated to address water scarcity and minimize environmental degradation.

Keywords: Sistani plain, Baluchistan, Hamoun lake, climate change, jet streams, environmental impact, water scarcity, mitigation

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Authors: Yuri S. Djikaev

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A large subset of aqueous aerosols can be initially (immediately upon formation) coated with various organic amphiphilic compounds whereof the hydrophilic moieties are attached to the aqueous aerosol core while the hydrophobic moieties are exposed to the air thus forming a hydrophobic coating thereupon. We study the thermodynamics of water condensation on such an aerosol whereof the hydrophobic organic coating is being concomitantly processed by chemical reactions with atmospheric reactive species. Such processing (chemical aging) enables the initially inert aerosol to serve as a nucleating center for water condensation. The most probable pathway of such aging involves atmospheric hydroxyl radicals that abstract hydrogen atoms from hydrophobic moieties of surface organics (first step), the resulting radicals being quickly oxidized by ubiquitous atmospheric oxygen molecules to produce surface-bound peroxyl radicals (second step). Taking these two reactions into account, we derive an expression for the free energy of formation of an aqueous droplet on an organic-coated aerosol. The model is illustrated by numerical calculations. The results suggest that the formation of aqueous cloud droplets on such aerosols is most likely to occur via Kohler activation rather than via nucleation. The model allows one to determine the threshold parameters necessary for their Kohler activation. Numerical results also corroborate previous suggestions that one can neglect some details of aerosol chemical composition in investigating aerosol effects on climate.

Keywords: aqueous aerosols, organic coating, chemical aging, cloud condensation nuclei, Kohler activation, cloud droplets

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Authors: Brian Bacia, Esther Githaiga, Teresia Kabucho, Paul Moses Ndegwa, Lucy Gichohi

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Purpose: The aim of the study is to ensure an appropriate mix of evidence-based prevention strategies geared towards the reduction of new HIV infections and the incidence of Sexually transmitted Illnesses Background: In Nakuru County, more than 90% of all HIV-infected patients are adults and on a single-dose medication-one pill that contains a combination of several different HIV drugs. Nakuru town has been identified as the hardest hit by HIV/Aids in the County according to the latest statistics from the County Aids and STI group, with a prevalence rate of 5.7 percent attributed to the high population and an active urban center. Method: 2 key studies were carried out to provide evidence for the effectiveness of antiretroviral therapy (ART) when used optimally on preventing sexual transmission of HIV. Discussions based on an examination, assessments of successes in planning, program implementation, and ultimate impact of prevention and treatment were undertaken involving health managers, health workers, community health workers, and people living with HIV/AIDS between February -August 2021. Questionnaires were carried out by a trained duo on ethical procedures at 15 HIV treatment clinics targeting patients on ARVs and caregivers on ARV prevention and treatment of pediatric HIV infection. Findings: Levels of AIDS awareness are extremely high. Advances in HIV treatment have led to an enhanced understanding of the virus, improved care of patients, and control of the spread of drug-resistant HIV. There has been a tremendous increase in the number of people living with HIV having access to life-long antiretroviral drugs (ARV), mostly on generic medicines. Healthcare facilities providing treatment are stressed challenging the administration of the drugs, which require a clinical setting. Women find it difficult to take a daily pill which reduces the effectiveness of the medicine. ART adherence can be strengthened largely through the use of innovative digital technology. The case management approach is useful in resource-limited settings. The county has made tremendous progress in mother-to-child transmission reduction through enhanced early antenatal care (ANC) attendance and mapping of pregnant women Recommendations: Treatment reduces the risk of transmission to the child during pregnancy, labor, and delivery. Promote research of medicines through patients and community engagement. Reduce the risk of transmission through breastfeeding. Enhance testing strategies and strengthen health systems for sustainable HIV service delivery. Need exists for improved antenatal care and delivery by skilled birth attendants. Develop a comprehensive maternal reproductive health policy covering equitability, efficient and effective delivery of services. Put in place referral systems.

Keywords: evidence-based prevention strategies, service delivery, human management, integrated approach

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Authors: Wesley A. Saltarelli, Nicolas R. Finkler, Adriana C. P. Miwa, Maria C. Calijuri, Davi G. F. Cunha

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The metabolism of the streams is an indicator of ecosystem disturbance due to the influences of the catchment on the structure of the water bodies. The study of the respiration and photosynthesis allows the estimation of energy fluxes through the food webs and the analysis of the autotrophic and heterotrophic processes. We aimed at evaluating the metabolism in streams located in the Brazilian savannah, Cerrado (Sao Carlos, SP), by determining and modeling the daily changes of dissolved oxygen (DO) in the water during one year. Three water bodies with minimal anthropogenic interference in their surroundings were selected, Espraiado (ES), Broa (BR) and Canchim (CA). Every two months, water temperature, pH and conductivity are measured with a multiparameter probe. Nitrogen and phosphorus forms are determined according to standard methods. Also, canopy cover percentages are estimated in situ with a spherical densitometer. Stream flows are quantified through the conservative tracer (NaCl) method. For the metabolism study, DO (PME-MiniDOT) and light (Odyssey Photosynthetic Active Radiation) sensors log data for at least three consecutive days every ten minutes. The reaeration coefficient (k2) is estimated through the method of the tracer gas (SF6). Finally, we model the variations in DO concentrations and calculate the rates of gross and net primary production (GPP and NPP) and respiration based on the one station method described in the literature. Three sampling were carried out in October and December 2015 and February 2016 (the next will be in April, June and August 2016). The results from the first two periods are already available. The mean water temperatures in the streams were 20.0 +/- 0.8C (Oct) and 20.7 +/- 0.5C (Dec). In general, electrical conductivity values were low (ES: 20.5 +/- 3.5uS/cm; BR 5.5 +/- 0.7uS/cm; CA 33 +/- 1.4 uS/cm). The mean pH values were 5.0 (BR), 5.7 (ES) and 6.4 (CA). The mean concentrations of total phosphorus were 8.0ug/L (BR), 66.6ug/L (ES) and 51.5ug/L (CA), whereas soluble reactive phosphorus concentrations were always below 21.0ug/L. The BR stream had the lowest concentration of total nitrogen (0.55mg/L) as compared to CA (0.77mg/L) and ES (1.57mg/L). The average discharges were 8.8 +/- 6L/s (ES), 11.4 +/- 3L/s and CA 2.4 +/- 0.5L/s. The average percentages of canopy cover were 72% (ES), 75% (BR) and 79% (CA). Significant daily changes were observed in the DO concentrations, reflecting predominantly heterotrophic conditions (respiration exceeded the gross primary production, with negative net primary production). The GPP varied from 0-0.4g/m2.d (in Oct and Dec) and the R varied from 0.9-22.7g/m2.d (Oct) and from 0.9-7g/m2.d (Dec). The predominance of heterotrophic conditions suggests increased vulnerability of the ecosystems to artificial inputs of organic matter that would demand oxygen. The investigation of the metabolism in the pristine streams can help defining natural reference conditions of trophic state.

Keywords: low-order streams, metabolism, net primary production, trophic state

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Authors: M. López-Moreno, L. Lugo Avilés, F. Román, J. Lugo Rosas, J. Hernández-Viezcas Jr., Peralta-Videa, J. Gardea-Torresdey

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Degradation of agricultural soils has increased rapidly during the last 20 years due to the indiscriminate use of pesticides and other anthropogenic activities. Currently, there is an urgent need of soil restoration to increase agricultural production. Utilization of sewage sludge or municipal solid waste is an important way to recycle nutrient elements and improve soil quality. With these amendments, nutrient availability in the aqueous phase might be increased and production of healthier crops can be accomplished. This research project aimed to achieve sustainable management of tropical agricultural soils, specifically in Puerto Rico, through the amendment of water treatment plant sludge’s. This practice avoids landfill disposal of sewage sludge and at the same time results cost-effective practice for recycling solid waste residues. Coriander sativum was cultivated in a compost-soil-sludge mixture at different proportions. Results showed that Coriander grown in a mixture of 25% compost+50% Voladora soi+25% sludge had the best growth and development. High chlorophyll content (33.01 ± 0.8) was observed in Coriander plants cultivated in 25% compost+62.5% Coloso soil+ 12.5% sludge compared to plants grown with no sludge (32.59 ± 0.7). ICP-OES analysis showed variations in mineral element contents (macro and micronutrients) in coriander plant grown I soil amended with sludge and compost.

Keywords: compost, Coriandrum sativum, nutrients, waste sludge

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Authors: Jilu David

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Background: Schizophrenia is one of the most misunderstood mental illnesses across the globe. Lack of understanding about mental illnesses often delay treatment, severely affects the functionality of the person, and causes distress to the family. The study, Video-based Psychoeducation for Caregivers of Persons with Schizophrenia, consisted of developing a psychoeducational video about Schizophrenia, its symptoms, causes, treatment, and the importance of family support. Methodology: A quasi-experimental pre-post design was used to understand the feasibility of the study. Qualitative analysis strengthened the feasibility outcomes. Knowledge About Schizophrenia Interview was used to assess the level of knowledge of 10 participants, before and after the screening of the video. Results: Themes of usefulness, length, content, educational component, format of the intervention, and language emerged in the qualitative analysis. There was a statistically significant difference in the knowledge level of participants before and after the video screening. Conclusion: The statistical and qualitative analysis revealed that the video-based psychoeducation program was feasible and that it facilitated a general improvement in knowledge of the participants.

Keywords: Schizophrenia, mental illness, psychoeducation, video-based psychoeducation, family support

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Authors: Rakesh Namdeti

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The liquid waste-wastewater- is essentially the water supply of the community after it has been used in a variety of applications. In recent years, heavy metal concentrations, besides other pollutants, have increased to reach dangerous levels for the living environment in many regions. Among the heavy metals, Lead has the most damaging effects on human health. It can enter the human body through the uptake of food (65%), water (20%), and air (15%). In this background, certain low-cost and easily available biosorbent was used and reported in this study. The scope of the present study is to remove Lead from its aqueous solution using Olea EuropaeaResin as biosorbent. The results showed that the biosorption capacity of Olea EuropaeaResin biosorbent was more for Lead removal. The Langmuir, Freundlich, Tempkin, and Dubinin-Radushkevich (D-R) models were used to describe the biosorption equilibrium of Lead Olea EuropaeaResin biosorbent, and the biosorption followed the Langmuir isotherm. The kinetic models showed that the pseudo-second-order rate expression was found to represent well the biosorption data for the biosorbent.

Keywords: novel biosorbent, central composite design, Lead, isotherms, kinetics

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Authors: Hamide Aydin, Banu Karaman, Ayhan Bozkurt, Umran Kurtan

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Recently, Proton Conducting Gel Polymer Electrolytes (GPEs) have drawn much attention in supercapacitor applications due to their physical and electrochemical characteristics and stability conditions for low temperatures. In this research, PVA-H2SO4-H3BO3 GPE has been used for electric-double layer capacitor (EDLCs) application, in which electrospun free-standing carbon nanofibers are used as electrodes. Introduced PVA-H2SO4-H3BO3 GPE behaves as both separator and the electrolyte in the supercapacitor. Symmetric Swagelok cells including GPEs were assembled via using two electrode arrangements and the electrochemical properties were searched. Electrochemical performance studies demonstrated that PVA-H2SO4-H3BO3 GPE had a maximum specific capacitance (Cs) of 134 F g-1 and showed great capacitance retention (%100) after 1000 charge/discharge cycles. Furthermore, PVA-H2SO4-H3BO3 GPE yielded an energy density of 67 Wh kg-1 with a corresponding power density of 1000 W kg-1 at a current density of 1 A g-1. PVA-H2SO4 based polymer electrolyte was produced according to following procedure; Firstly, 1 g of commercial PVA was dissolved in distilled water at 90°C and stirred until getting transparent solution. This was followed by addition of the diluted H2SO4 (1 g of H2SO4 in a distilled water) to the solution to obtain PVA-H2SO4. PVA-H2SO4-H3BO3 based polymer electrolyte was produced by dissolving H3BO3 in hot distilled water and then inserted into the PVA-H2SO4 solution. The mole fraction was arranged to ¼ of the PVA repeating unit. After the stirring 2 h at RT, gel polymer electrolytes were obtained. The final electrolytes for supercapacitor testing included 20% of water in weight. Several blending combinations of PVA/H2SO4 and H3BO3 were studied to observe the optimized combination in terms of conductivity as well as electrolyte stability. As the amount of boric acid increased in the matrix, excess sulfuric acid was excluded due to cross linking, especially at lower solvent content. This resulted in the reduction of proton conductivity. Therefore, the mole fraction of H3BO3 was chosen as ¼ of PVA repeating unit. Within this optimized limits, the polymer electrolytes showed better conductivities as well as stability.

Keywords: electrical double layer capacitor, energy density, gel polymer electrolyte, ultracapacitor

Procedia PDF Downloads 187

Authors: Reza Behtash, Enayat Enayati

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The pool condenser is in principal a horizontal reactor, containing a bundle of U-tubes for heat exchange, coupling to low pressure steam drum. Condensation of gas takes place in a condensed pool around the tubes of the condenser. The heat of condensation is removed by the generation of low pressure steam on the inner tube side of the bundle. A circulation pump transfers ample boiler feed water to these tubes. The pressure of the steam generated influenced the heat flux. Changing the steam pressure means changing the steam condensate temperature and therefore the temperature difference between the tube side and the shell side. 2NH3 + CO2 ↔ NH2COONH4 + Heat. This reaction is exothermic and according to Le Chatelier's Principle if the heat is not removed enough, it will come back to left side and generate of the gas and so the Urea synthesis pressure will rise. The most principal reasons for high Urea synthesis pressure are non proportional of Ammonia/Dioxide Carbon ratio and too high a pressure in low pressure steam drum. Proportional of Ammonia/Dioxide Carbon ratio is 3.0 and normal pressure for low pressure steam drum is 4.5 bar. As regards these conditions were proportional but we could not control the synthesis pressure the plant endangered, therefore we had to control the steam drum pressure at about 3.5 bar. While we opened the pool condenser, we found the partition plate used to divide inlet and outlet boiler feed water to tubes, was broken partially and so amount of boiler feed water bypass the tubes and the heat was not removed totally and it resulted in the generation of gases and high pressure in synthesis.

Keywords: boiler, pressure, pool condenser, partition plate

Procedia PDF Downloads 357

Authors: Esmaeil Kouhgardi, Elaheh Shakerdargah

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The mangrove ecosystem is a complex of various inter-related elements in the land-sea interface zone which is linked with other natural systems of the coastal region such as corals, sea-grass, coastal fisheries and beach vegetation. The mangrove ecosystem consists of water, muddy soil, trees, shrubs, and their associated flora, fauna and microbes. It is a very productive ecosystem sustaining various forms of life. Its waters are nursery grounds for fish, crustacean, and mollusk and also provide habitat for a wide range of aquatic life, while the land supports a rich and diverse flora and fauna, but pollutions may affect these characteristics. Iran has the lowest share of Persian Gulf pollution among the eight littoral states; environmental experts are still deeply concerned about the serious consequences of the pollution in the oil-rich gulf. Prolongation of critical conditions in the Persian Gulf has endangered its aquatic ecosystem. Water purification equipment, refineries, wastewater emitted by onshore installations, especially petrochemical plans, urban sewage, population density and extensive oil operations of Arab states are factors contaminating the Persian Gulf waters. Population density has been the major cause of pollution and environmental degradation in the Persian Gulf. Persian Gulf is a closed marine environment which is connected to open waterways only from one way. It usually takes between three and four years for the gulf's water to be completely replaced. Therefore, any pollution entering the water will remain there for a relatively long time. Presently, the high temperature and excessive salt level in the water have exposed the marine creatures to extra threats, which mean they have to survive very tough conditions. The natural environment of the Persian Gulf is very rich with good fish grounds, extensive coral reefs and pearl oysters in abundance, but has become increasingly under pressure due to the heavy industrialization and in particular the repeated major oil spillages associated with the various recent wars fought in the region. Pollution may cause the mortality of mangrove forests by effect on root, leaf and soil of the area. Study was showed the high correlation between industrial pollution and mangrove forests health in south of Iran and increase of population, coupled with economic growth, inevitably caused the use of mangrove lands for various purposes such as construction of roads, ports and harbors, industries and urbanization.

Keywords: Mangrove forest, pollution, Persian Gulf, population, environment

Procedia PDF Downloads 375

Authors: Nasreen Thebo, W. Shaikh, A. J. Laghari, P. Nangni

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Prunus dulcis (Almond) shell extract is demonstrated for its biomedical applications. Shell extract prepared by soxhlet method and further characterized by UV-Visible spectrophotometer, atomic absorption spectrophotometer (AAS), FTIR, GC-MS techniques. In this study, the antifungal activity of almond shell extract was observed against clinically isolated pathogenic fungi by strip method. The antioxidant potential of crude shell extract of was evaluated by using DPPH (2-2-diphenyl-1-picryhydrazyl) and radical scavenging system. The possibility of short term therapy was only 20 days. The total antioxidant activity varied from 94.38 to 95.49% and total phenolic content was found as 4.455 mg/gm in almond shell extract. Finally the results provide a great therapeutic potential against Tinea capitis infection of scalp. Included in this study of shell extract that show scientific evidence for clinical efficacy, as well as found to be more useful in the treatment of dermatologic disorders and without any doubt it can be recommended to be Patent.

Keywords: Tinea capitis, DPPH, FTIR, GC-MS therapeutic treatment

Procedia PDF Downloads 351

Authors: Rajesha Kumar Alambi, Mansour Ahmed, Garudachari Bhadrachari, Safiyah Al-Muqahwi, Mansour Al-Rughaib, Jibu P. Thomas

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Membrane-based pressure assisted osmosis (PAO) for seawater desalination has the potential to overcome the challenges of forward osmosis technology. PAO technology is gaining interest among the research community to ensure the sustainability of freshwater with a significant reduction in energy. The requirements of PAO membranes differ from the FO membrane; as it needs a slightly higher porous with sufficient mechanical strength to overcome the applied hydraulic pressure. The porous metal-organic framework (MOF) as a filler for the membrane synthesis has demonstrated a great potential to generate new channels for water transport, high selectivity, and reduced fouling propensity. Accordingly, this study is aimed at fabricating the UiO-66 MOF-based thin film nanocomposite membranes with specific characteristics for water desalination by PAO. A PAO test unit manufactured by Trevi System, USA, was used to determine the performance of the synthesized membranes. Further, the synthesized membranes were characterized in terms of morphological features, hydrophilicity, surface roughness, and mechanical properties. The 0.05 UiO-66 loaded membrane produced highest flux of 38L/m2h and with low reverse salt leakage of 2.1g/m²h for the DI water as feed solution and 2.0 M NaCl as draw solutions at the inlet feed pressure of 0.6 MPa. The new membranes showed a good tolerance toward the applied hydraulic pressure attributed to the fabric support used during the membrane synthesis.

Keywords: metal organic framework, composite membrane, desalination, salt rejection, flux

Procedia PDF Downloads 107

Authors: Sunil Kumar, Rajesh Sharma

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Toxic epidermal necrolysis, pruritis, rashes, lichen planus like eruption, hyper pigmentation of skin are rare toxic effects of choloroquine used over a long time. Skin and mucus membrane hyper pigmentation is generally of a bluish black or grayish color and irreversible after discontinuation of the drug. According to Ayurveda, Dushivisha is the name given to any poisonous substance which is not fully endowed with the qualities of poison by nature (i.e. it acts as an impoverished or weak poison) and because of its mild potency, it remains in the body for many years causing various symptoms, one among them being discoloration of skin.The objective of this case report is to investigate the effect of Ayurvedic management of chloroquine induced hyper-pigmentation on the line of treatment of Dushivisha. Case Report: A 26-year-old female was suffering from hyper-pigmentation of the skin over the neck, forehead, temporo-mandibular joints, upper back and posterior aspect of both the arms since 8 years had history of taking Chloroquine came to Out Patient Department of National Institute of Ayurveda, Jaipur, India in Jan. 2015. The routine investigations (CBC, ESR, Eosinophil count) were within normal limits. Punch biopsy skin studied for histopathology under hematoxylin and eosin staining showed epidermis with hyper-pigmentation of the basal layer. In the papillary dermis as well as deep dermis there were scattered melanophages along with infiltration by mononuclear cells. There was no deposition of amyloid-like substances. These histopathological findings were suggestive of Chloroquine induced hyper-pigmentation. The case was treated on the line of treatment of Dushivisha and was given Vamana and Virechana (therapeutic emesis and purgation) every six months followed by Snehana karma (oleation therapy) with Panchatikta Ghrit and Swedana (sudation). Arogyavardhini Vati -1 g, Dushivishari Vati 500 mg, Mahamanjisthadi Quath 20 ml were given twelve hourly and Aragwadhadi Quath 25 ml at bed time orally. The patient started showing lightening of the pigments after six months and almost complete remission after 12 months of the treatment. Conclusion: This patient presented with the Dushivisha effect of Chloroquineandwas administered two relevant procedures from Panchakarma viz. Vamana and Virechana. Both Vamana and Virechanakarma here referred to Shodhana karma (purification procedures) eliminates accumulated toxins from the body. In this process, oleation dislodge the toxins from the tissues and sudation helps to bring them to the alimentary tract. The line of treatment did not target direct hypo pigmentary effects; rather aimed to eliminate the Dushivisha. This gave promising results in this condition.

Keywords: Ayurveda, chloroquine, Dushivisha, hyper-pigmentation

Procedia PDF Downloads 214

Authors: Supat Chaiyakul, Direk Sukkasem, Patnachapa Natthapanpaisith

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Sinlek rice flour beverage or instant product is a dietary supplement for dysphagia, or difficulty swallowing. It is also consumed by individuals who need to consume supplements to maintain their calorific needs. This product provides protein, fat, iron, and a high concentration of carbohydrate from rice flour. However, the application of native flour is limited due to its high viscosity. Starch modification by controlling starch retrogradation was used in this study. The research studies the effects of rice flour concentration and retrogradation treatment on the physical properties of instant Sinlek brown rice. The native rice flour, gelatinized rice flour, and flour gels retrograded under 4 °C for 3 and 7 days were investigated. From the statistical results, significant differences between native and retrograded flour were observed. The concentration of rice flour was the main factor influencing the swelling power, solubility, and pasting properties. With the increase in rice flour content from 10 to 15%, swelling power, peak viscosity, trough, and final viscosity decreased; but, solubility, pasting temperature, peak time, breakdown, and setback increased. The peak time, pasting temperature, peak viscosity, trough, and final viscosity decreased as the storage period increased from 3 to 7 days. The retrograded rice flour powders had lower pasting temperature, peak viscosity, breakdown, and final viscosity than the gelatinized and native flour powders. Reduction of starch viscosity by gelatinization and controlling starch retrogradation could allow for increased quantities of rice flour in instant rice beverages. Also, the treatment could increase the energy and nutrient densities of rice beverages without affecting the viscosity of this product.

Keywords: instant rice, pasting properties, pregelatinization, retrogradation

Procedia PDF Downloads 220

Authors: Elzbieta Sikorska-Simmons

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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

Procedia PDF Downloads 100