Search results for: animals healthcare dealing with proper sanitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5401

Search results for: animals healthcare dealing with proper sanitation

511 Bringing the World to Net Zero Carbon Dioxide by Sequestering Biomass Carbon

Authors: Jeffrey A. Amelse

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Many corporations aspire to become Net Zero Carbon Carbon Dioxide by 2035-2050. This paper examines what it will take to achieve those goals. Achieving Net Zero CO₂ requires an understanding of where energy is produced and consumed, the magnitude of CO₂ generation, and proper understanding of the Carbon Cycle. The latter leads to the distinction between CO₂ and biomass carbon sequestration. Short reviews are provided for prior technologies proposed for reducing CO₂ emissions from fossil fuels or substitution by renewable energy, to focus on their limitations and to show that none offer a complete solution. Of these, CO₂ sequestration is poised to have the largest impact. It will just cost money, scale-up is a huge challenge, and it will not be a complete solution. CO₂ sequestration is still in the demonstration and semi-commercial scale. Transportation accounts for only about 30% of total U.S. energy demand, and renewables account for only a small fraction of that sector. Yet, bioethanol production consumes 40% of U.S. corn crop, and biodiesel consumes 30% of U.S. soybeans. It is unrealistic to believe that biofuels can completely displace fossil fuels in the transportation market. Bioethanol is traced through its Carbon Cycle and shown to be both energy inefficient and inefficient use of biomass carbon. Both biofuels and CO₂ sequestration reduce future CO₂ emissions from continued use of fossil fuels. They will not remove CO₂ already in the atmosphere. Planting more trees has been proposed as a way to reduce atmospheric CO₂. Trees are a temporary solution. When they complete their Carbon Cycle, they die and release their carbon as CO₂ to the atmosphere. Thus, planting more trees is just 'kicking the can down the road.' The only way to permanently remove CO₂ already in the atmosphere is to break the Carbon Cycle by growing biomass from atmospheric CO₂ and sequestering biomass carbon. Sequestering tree leaves is proposed as a solution. Unlike wood, leaves have a short Carbon Cycle time constant. They renew and decompose every year. Allometric equations from the USDA indicate that theoretically, sequestrating only a fraction of the world’s tree leaves can get the world to Net Zero CO₂ without disturbing the underlying forests. How can tree leaves be permanently sequestered? It may be as simple as rethinking how landfills are designed to discourage instead of encouraging decomposition. In traditional landfills, municipal waste undergoes rapid initial aerobic decomposition to CO₂, followed by slow anaerobic decomposition to methane and CO₂. The latter can take hundreds to thousands of years. The first step in anaerobic decomposition is hydrolysis of cellulose to release sugars, which those who have worked on cellulosic ethanol know is challenging for a number of reasons. The key to permanent leaf sequestration may be keeping the landfills dry and exploiting known inhibitors for anaerobic bacteria.

Keywords: carbon dioxide, net zero, sequestration, biomass, leaves

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510 Respiratory Health and Air Movement Within Equine Indoor Arenas

Authors: Staci McGill, Morgan Hayes, Robert Coleman, Kimberly Tumlin

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The interaction and relationships between horses and humans have been shown to be positive for physical, mental, and emotional wellbeing, however equine spaces where these interactions occur do include some environmental risks. There are 1.7 million jobs associated with the equine industry in the United States in addition to recreational riders, owners, and volunteers who interact with horses for substantial amounts of time daily inside built structures. One specialized facility, an “indoor arena” is a semi-indoor structure used for exercising horses and exhibiting skills during competitive events. Typically, indoor arenas have a sand or sand mixture as the footing or surface over which the horse travels, and increasingly, silica sand is being recommended due to its durable nature. It was previously identified in a semi-qualitative survey that the majority of individuals using indoor arenas have environmental concerns with dust. 27% (90/333) of respondents reported respiratory issues or allergy-like symptoms while riding with 21.6% (71/329) of respondents reporting these issues while standing on the ground observing or teaching. Frequent headaches and/or lightheadedness was reported in 9.9% (33/333) of respondents while riding and in 4.3% 14/329 while on the ground. Horse respiratory health is also negatively impacted with 58% (194/333) of respondents indicating horses cough during or after time in the indoor arena. Instructors who spent time in indoor arenas self-reported more respiratory issues than those individuals who identified as smokers, highlighting the health relevance of understanding these unique structures. To further elucidate environmental concerns and self-reported health issues, 35 facility assessments were conducted in a cross-sectional sampling design in the states of Kentucky and Ohio (USA). Data, including air speeds, were collected in a grid fashion at 15 points within the indoor arenas and then mapped spatially using krigging in ARCGIS. From the spatial maps, standard variances were obtained and differences were analyzed using multivariant analysis of variances (MANOVA) and analysis of variances (ANOVA). There were no differences for the variance of the air speeds in the spaces for facility orientation, presence and type of roof ventilation, climate control systems, amount of openings, or use of fans. Variability of the air speeds in the indoor arenas was 0.25 or less. Further analysis yielded that average air speeds within the indoor arenas were lower than 100 ft/min (0.51 m/s) which is considered still air in other animal facilities. The lack of air movement means that dust clearance is reliant on particle size and weight rather than ventilation. While further work on respirable dust is necessary, this characterization of the semi-indoor environment where animals and humans interact indicates insufficient air flow to eliminate or reduce respiratory hazards. Finally, engineering solutions to address air movement deficiencies within indoor arenas or mitigate particulate matter are critical to ensuring exposures do not lead to adverse health outcomes for equine professionals, volunteers, participants, and horses within these spaces.

Keywords: equine, indoor arena, ventilation, particulate matter, respiratory health

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509 Study of Ion Density Distribution and Sheath Thickness in Warm Electronegative Plasma

Authors: Rajat Dhawan, Hitendra K. Malik

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Electronegative plasmas comprising electrons, positive ions, and negative ions are advantageous for their expanding applications in industries. In plasma cleaning, plasma etching, and plasma deposition process, electronegative plasmas are preferred because of relatively less potential developed on the surface of the material under investigation. Also, the presence of negative ions avoid the irregularity in etching shapes and also enhance the material working during the fabrication process. The interaction of metallic conducting surface with plasma becomes mandatory to understand these applications. A metallic conducting probe immersed in a plasma results in the formation of a thin layer of charged species around the probe called as a sheath. The density of the ions embedded on the surface of the material and the sheath thickness are the important parameters for the surface-plasma interaction. Sheath thickness will give rise to the information of affected plasma region due to conducting surface/probe. The knowledge of the density of ions in the sheath region is advantageous in plasma nitriding, and their temperature is equally important as it strongly influences the thickness of the modified layer during surface plasma interaction. In the present work, we considered a negatively biased metallic probe immersed in a warm electronegative plasma. For this system, we adopted the continuity equation and momentum transfer equation for both the positive and negative ions, whereas electrons are described by Boltzmann distribution. Finally, we use the Poisson’s equation. Here, we assumed the spherical geometry for small probe radius. Poisson’s equation reveals the behaviour of potential surrounding a conducting metallic probe along with the use of the continuity and momentum transfer equations, with the help of proper boundary conditions. In turn, it gives rise to the information about the density profile of charged species and most importantly the thickness of the sheath. By keeping in mind, the well-known Bohm-Sheath criterion, all calculations are done. We found that positive ion density decreases with an increase in positive ion temperature, whereas it increases with the higher temperature of the negative ions. Positive ion density decreases as we move away from the center of the probe and is found to show a discontinuity at a particular distance from the center of the probe. The distance where discontinuity occurs is designated as sheath edge, i.e., the point where sheath ends. These results are beneficial for industrial applications, as the density of ions embedded on material surface is strongly affected by the temperature of plasma species. It has a drastic influence on the surface properties, i.e., the hardness, corrosion resistance, etc. of the materials.

Keywords: electronegative plasmas, plasma surface interaction positive ion density, sheath thickness

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508 A Hybrid Artificial Intelligence and Two Dimensional Depth Averaged Numerical Model for Solving Shallow Water and Exner Equations Simultaneously

Authors: S. Mehrab Amiri, Nasser Talebbeydokhti

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Modeling sediment transport processes by means of numerical approach often poses severe challenges. In this way, a number of techniques have been suggested to solve flow and sediment equations in decoupled, semi-coupled or fully coupled forms. Furthermore, in order to capture flow discontinuities, a number of techniques, like artificial viscosity and shock fitting, have been proposed for solving these equations which are mostly required careful calibration processes. In this research, a numerical scheme for solving shallow water and Exner equations in fully coupled form is presented. First-Order Centered scheme is applied for producing required numerical fluxes and the reconstruction process is carried out toward using Monotonic Upstream Scheme for Conservation Laws to achieve a high order scheme.  In order to satisfy C-property of the scheme in presence of bed topography, Surface Gradient Method is proposed. Combining the presented scheme with fourth order Runge-Kutta algorithm for time integration yields a competent numerical scheme. In addition, to handle non-prismatic channels problems, Cartesian Cut Cell Method is employed. A trained Multi-Layer Perceptron Artificial Neural Network which is of Feed Forward Back Propagation (FFBP) type estimates sediment flow discharge in the model rather than usual empirical formulas. Hydrodynamic part of the model is tested for showing its capability in simulation of flow discontinuities, transcritical flows, wetting/drying conditions and non-prismatic channel flows. In this end, dam-break flow onto a locally non-prismatic converging-diverging channel with initially dry bed conditions is modeled. The morphodynamic part of the model is verified simulating dam break on a dry movable bed and bed level variations in an alluvial junction. The results show that the model is capable in capturing the flow discontinuities, solving wetting/drying problems even in non-prismatic channels and presenting proper results for movable bed situations. It can also be deducted that applying Artificial Neural Network, instead of common empirical formulas for estimating sediment flow discharge, leads to more accurate results.

Keywords: artificial neural network, morphodynamic model, sediment continuity equation, shallow water equations

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507 Archaic Ontologies Nowadays: Music of Rituals

Authors: Luminiţa Duţică, Gheorghe Duţică

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Many of the interrogations or dilemmas of the contemporary world found the answer in what was generically called the appeal to matrix. This genuine spiritual exercise of re-connection of the present to origins, to the primary source, revealed the ontological condition of timelessness, ahistorical, immutable (epi)phenomena, of those pure essences concentrated in the archetypal-referential layer of the human existence. The musical creation was no exception to this trend, the impasse generated by the deterministic excesses of the whole serialism or, conversely, by some questionable results of the extreme indeterminism proper to the avant-garde movements, stimulating the orientation of many composers to rediscover a universal grammar, as an emanation of a new ‘collective’ order (reverse of the utopian individualism). In this context, the music of oral tradition and therefore the world of the ancient modes represented a true revelation for the composers of the twentieth century, who were suddenly in front of some unsuspected (re)sources, with a major impact on all levels of edification of the musical work: morphology, syntax, timbrality, semantics etc. For the contemporary Romanian creators, the music of rituals, existing in the local archaic culture, opened unsuspected perspectives for which it meant to be a synthetic, inclusive and recoverer vision, where the primary (archetypal) genuine elements merge with the latest achievements of language of the European composers. Thus, anchored in a strong and genuine modal source, the compositions analysed in this paper evoke, in a manner as modern as possible, the atmosphere of some ancestral rituals such as: the invocation of rain during the drought (Paparudele, Scaloianul), funeral ceremony (Bocetul), traditions specific to the winter holidays and new year (Colinda, Cântecul de stea, Sorcova, Folklore traditional dances) etc. The reactivity of those rituals in the sound context of the twentieth century meant potentiating or resizing the archaic spirit of the primordial symbolic entities, in terms of some complexity levels generated by the technique of harmonies of chordal layers, of complex aggregates (gravitational or non-gravitational, geometric), of the mixture polyphonies and with global effect (group, mass), by the technique of heterophony, of texture and cluster, leading to the implementation of some processes of collective improvisation and instrumental theatre.

Keywords: archetype, improvisation, polyphony, ritual, instrumental theatre

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506 Analyze the Properties of Different Surgical Sutures

Authors: Doaa H. Elgohary, Tamer F. Khalifa, Mona M. Salem, M. A. Saad, Ehab Haider Sherazy

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Textiles have conquered new areas over the past three decades, including agriculture, transportation, filtration, military, and medicine. The use of textiles in the medical field has increased significantly in recent years and covers almost everything. Medical textiles represent a huge market as they are widely used not only in hospitals, hygiene, and healthcare but also in hotels and other environments where hygiene is required. However, not all fibers are suitable for the manufacture of medical textile products. Some special properties are required for the manufactured materials, e.g. Strength, elasticity, spinnability, etc. In addition to the usual properties of medical fibers, non-toxicity, sterilizability, biocompatibility, biodegradability, good absorbability, softness, and freedom from additives, etc., desirable properties include impurities. Stitching is one of the most common practices in the medical field. as it is a biomaterial device, either natural or synthetic, used to connect blood vessels and connect tissues. In addition to being very strong, suture material should easily dissolve in bodily fluids and lose strength as the tissue gains strength. In this work, a study to select the most used materials for sutures, it was found that silk, VICRYL and polypropylene were the most used materials in varying numbers. The research involved the analysis of 36 samples from three different materials (mostly commonly used), the tests were carried out on 36 imported samples for four different companies. Each company supplied three different materials (silk, VICRYL and polypropylene) with three different gauges (4, 3.5 and 3 metric). The results of the study were tabulated, presented, and discussed. Practical statistical science serves to support the practical analysis of experimental work products and the various relationships between variables to achieve the best sampling performance with the functional purpose generated for it. Analysis of the imported sutures shows that VICRYL sutures had the highest tensile strength, toughness, knot tensile strength and knot toughness, followed by polypropylene and silk. As yarn counts, weight and diameter increase, its tensile strength and toughness increase while its elongation and knot tension decrease. The multifilament yarn construction (silk and VICRYL) scores higher compared to the monofilament construction (polypropylene), resulting in increases in tenacity, toughness, knot tensile strength and knot toughness.

Keywords: biodegradable yarns, braided sutures, irritation, knot tying, medical textiles, surgical sutures, wound healing

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505 Forest Fire Burnt Area Assessment in a Part of West Himalayan Region Using Spectral Unmixing Method and Assess the Extent and Severity of the Affected Area Using Neural Network Approach

Authors: Sunil Chandra, Triparna Barman, Vikas Gusain, Himanshu Rawat

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Forest fires are a recurrent phenomenon in the Himalayan region owing to the presence of vulnerable forest types, topographical gradients, climatic weather conditions, and anthropogenic pressure. The present study focuses on the identification of forest fire-affected areas in a small part of the West Himalayan region using a differential normalized burnt ratio method and spectral unmixing methods. The study area has a rugged terrain with the presence of sub-tropical pine forest, montane temperate forest, and sub-alpine forest and scrub. The major reason for fires in this region is anthropogenic in nature, with the practice of human-induced fires for getting fresh leaves, scaring wild animals to protect agricultural crops, grazing practices within the reserved forest, and igniting fires for cooking and other reasons. The fires caused by the above reasons affect a large area on the ground, necessitating its precise estimation for further management and policy making. In the present study, two approaches have been used for carrying out a burnt area analysis. The first approach followed for burnt area analysis uses a differential burnt normalized ratio index (dNBR) approach that uses the burnt ratio values generated using Short Wave Infra Red (SWIR) band and Near Infra Red (NIR) bands of the Sentinel-2A image. The results of the dNBR have been compared with the outputs of the spectral mixing methods. It has been found that the dNBR is able to create good results in fire-affected areas having homogenous forest stratum and with slope degree <5 degrees. However, in a rugged terrain where the landscape is largely influenced by the topographical variations, vegetation types, tree density, the results may be largely influenced by the effects of topography, complexity in tree composition, fuel load composition, and soil moisture. Hence, such variations in the factors influencing burnt area assessment may not be effectively carried out using a dNBR approach which is commonly followed for burnt area assessment over a large area. Hence, another approach that has been attempted in the present study utilizes a spectral mixing method where the individual pixel is tested before assigning an information class to it. The method uses a neural network approach utilizing Sentinel 2A bands. The training and testing data are generated from the sentinel-2A data and the national field inventory, which is further used for generating outputs using ML tools. The analysis of the results indicates that the fire-affected regions and their severity can be better estimated in rugged terrain using spectral unmixing methods which have the capability to resolve the noise in the data and can classify the individual pixel to the precise burnt/unburnt class.

Keywords: dNBR, spectral unmixing, neural network, forest stratum

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504 Health Communication and the Diabetes Narratives of Key Social Media Influencers in the UK

Authors: Z. Sun

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Health communication is essential in promoting healthy lifestyles, managing disease conditions, and eventually reducing health disparities. The key elements of successful health communication always include the development of communication strategies to engage people in thinking about their health, inform them about healthy choices, persuade them to adopt safe and healthy behaviours, and eventually achieve public health objectives. The use of 'Narrative' is recognised as a kind of health communication strategy to enhance personal and public health due to its potential persuasive effect in motivating and supporting individuals change their beliefs and behaviours by inviting them into a narrative world, breaking down their cognitive and emotional resistance and enhance their acceptance of the ideas portrayed in narratives. Meanwhile, the popularity of social media has provided a novel means of communication for both healthcare stakeholders, and a special group of active social media users (influencers) have started playing a pivotal role in providing health ‘solutions’. Such individuals are often referred to as ‘influencers’ because of their central position in the online communication system and the persuasive effect their actions may have on audiences. They may have established a positive rapport with their audience, earned trust and credibility in a specific area, and thus, their audience considers the information they delivered to be authentic and influential. To our best knowledge, to date, there is no published research that examines the effect of diabetes narratives presented by social media influencers and their impacts on health-related outcomes. The primary aim of this study is to investigate the diabetes narratives presented by social media influencers in the UK because of the new dimension they bring to health communication and the potential impact they may have on audiences' health outcomes. This study is situated within the interpretivist and narrative paradigms. A mixed methodology combining both quantitative and qualitative approaches has been adopted. Qualitative data has been derived to provide a better understanding of influencers’ personal experiences and how they construct meanings and make sense of their world, while quantitative data has been accumulated to identify key social media influencers in the UK and measure the impact of diabetes narratives on audiences. Twitter has been chosen as the social media platform to initially identify key influencers. Two groups of participants are the top 10 key social media influencers in the UK and 100 audiences of each influencer, which means a total of 1000 audiences have been invited. This paper is going to discuss, first of all, the background of the research under the context of health communication; Secondly, the necessity and contribution of this research; then, the major research questions being explored; and finally, the methods to be used.

Keywords: diabetes, health communication, narratives, social media influencers

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503 Implementing a Structured, yet Flexible Tool for Critical Information Handover

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

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502 The Features of the Synergistic Approach in Marketing Management to Regional Level

Authors: Evgeni Baratashvili, Anzor Abralava, Rusudan Kutateladze, Nino Pailodze, Irma Makharashvili, Larisa Takalandze

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Sinergy as a neological term is reflected in modern sciences. It can be found in the various fields of science including the humanities and technical sciences. Among them are biology and medicine, philology, economy and etc. Synergy is the received surplus of marginal high total effect of the groups, consolidated by one common idea, received through endeavored applies of their combined tools, via obtained effect of the separate independent actions of the groups. In the conditions of market economy, according the terms of new communication terminology, synergy effects on management and marketing successfully as well as on purity defense of native language. The well-known scientist’s and public figure’s Academician I. Prangishvili’s works are especially valuable in this aspect. In our opinion the entropy research is linked to his name in our country. In modern economy, the current qualitative changes shows us that the most number of factors and issues have been regrouped. They have a great influence and even define the economic development. The declining abilities of traditional recourses of economic growth have been related on the use of their physical abilities and their moving closer to the edge. Also it is related on the reduced effectiveness, which at the same time increases the expenditures. This means that the leading must be the innovative process system of products and services in the economic growth model. In our opinion the above mentioned system is distinguished with the synergistic approach. It should be noted that the main components of the innovative system are technological, scientific and scientific-technical, social-organizational, managerial and cognitive changes. All of them are reflected on scientific works and inventions in the proper dosages, in know-how and material source. At any stage they create the reproduction cycle. The innovations are different from each other by technologies, origination, design, innovation and quality, subject-content structure, by the the spread of economic processes and the impact of the level of it’s distribution. We have presented a generalized statement of an innovative approach, which is not a single act of innovation but it is also targeted system of the development, implementation, reconciling-exploitation, production, diffusion and commercialization of news. The innovative approaches should be considered as the creation of news, in-depth process of creativity as an innovative alternative to the realization of innovative and entrepreneurial efforts and measures, in order to meet the requirements of the permanent process.

Keywords: economic development, leading process, neological term, synergy

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501 Migration, Assimilation and Well-Being of Interstate Migrant Workers in Kerala: A Critical Assessment

Authors: Arun Perumbilavil Anand

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It may no longer be just anecdotal that every twelfth person in Kerala is a migrant worker from outside the state. For the past few years, the state has been witnessing large inflow of migrants from other states of India, which emerged as a result of demographic transition and Gulf emigration. Initially, the migrants were from the neighbouring states but, at a later period, the state started getting migrants from the distant parts of the country. Currently, migrants have turned to be a decisive force in the state and their increasing numbers have already started creating turbulences in the state. Over the past years, the increasing involvement of migrants in unlawful and criminal activities have generated apprehensions on their presence in the state. Moreover, at present, the Kerala society is not just hosting the first generation migrants, but there has been an increase in the second generation migrants making the situations more complex and diverse. In such a paradigm, the study ponders into the issues of migrants concerning their assimilation and well-being in the host society. Also, the study looks into the factors that impede the assimilation process, along with the perceptions of the migrants about the host society and the people. The study also tries to bring out the differences in the levels of assimilation among the migrants along the lines of religion, caste, state of origin, gender, stay duration and education. Methodology: The study is based on the empirical findings obtained out of the primary survey conducted on migrants employed in the Kanjikode industrial area of Kerala. The samples were selected through purposive sampling and the study employed techniques like observation, questionnaire and in-depth interviews. The findings are based on interviews conducted with 100 migrants. Findings and Conclusion: The study was an attempt of its kind in addressing the issues of assimilation and integration of interstate migrants working in the Kerala. As mentioned, the study could bring out differences in the levels of assimilation along the lines of different characteristics. The study could also locate the importance, and the role played by the peer groups and neighborhoods in accelerating the process of assimilation among the migrants. As an extension, the study also looked at the assimilation and educational issues of the migrant children living in Kerala, and it found that the place of birth, age at entry and the peer group plays a pivotal role in the assimilation process. The study through its findings recommends the need for incorporating the concept of inclusive education into the state educational system by giving due emphasis to the needs of the marginalized. The study points out that owing to the existing demographic conditions, the state will inevitably have to depend on migrant labor in future. Moreover, in such a paradigm, the host community and the government should strive to create a conducive environment for the proper assimilation of the migrants and which in turn can be an impetus for the fulfilment of the needs of both the migrants and the state.

Keywords: assimilation, integration, Kerala, migrant workers, well-being

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500 Antenatal Monitoring of Pre-Eclampsia in a Low Resource Setting

Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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499 Development of a Bead Based Fully Automated Mutiplex Tool to Simultaneously Diagnose FIV, FeLV and FIP/FCoV

Authors: Andreas Latz, Daniela Heinz, Fatima Hashemi, Melek Baygül

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Introduction: Feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and feline coronavirus (FCoV) are serious infectious diseases affecting cats worldwide. Transmission of these viruses occurs primarily through close contact with infected cats (via saliva, nasal secretions, faeces, etc.). FeLV, FIV, and FCoV infections can occur in combination and are expressed in similar clinical symptoms. Diagnosis can therefore be challenging: Symptoms are variable and often non-specific. Sick cats show very similar clinical symptoms: apathy, anorexia, fever, immunodeficiency syndrome, anemia, etc. Sample volume for small companion animals for diagnostic purposes can be challenging to collect. In addition, multiplex diagnosis of diseases can contribute to an easier, cheaper, and faster workflow in the lab as well as to the better differential diagnosis of diseases. For this reason, we wanted to develop a new diagnostic tool that utilizes less sample volume, reagents, and consumables than multiplesingleplex ELISA assays Methods: The Multiplier from Dynextechonogies (USA) has been used as platform to develop a Multiplex diagnostic tool for the detection of antibodies against FIV and FCoV/FIP and antigens for FeLV. Multiplex diagnostics. The Dynex®Multiplier®is a fully automated chemiluminescence immunoassay analyzer that significantly simplifies laboratory workflow. The Multiplier®ease-of-use reduces pre-analytical steps by combining the power of efficiently multiplexing multiple assays with the simplicity of automated microplate processing. Plastic beads have been coated with antigens for FIV and FCoV/FIP, as well as antibodies for FeLV. Feline blood samples are incubated with the beads. Read out of results is performed via chemiluminescence Results: Bead coating was optimized for each individual antigen or capture antibody and then combined in the multiplex diagnostic tool. HRP: Antibody conjugates for FIV and FCoV antibodies, as well as detection antibodies for FeLV antigen, have been adjusted and mixed. 3 individual prototyple batches of the assay have been produced. We analyzed for each disease 50 well defined positive and negative samples. Results show an excellent diagnostic performance of the simultaneous detection of antibodies or antigens against these feline diseases in a fully automated system. A 100% concordance with singleplex methods like ELISA or IFA can be observed. Intra- and Inter-Assays showed a high precision of the test with CV values below 10% for each individual bead. Accelerated stability testing indicate a shelf life of at least 1 year. Conclusion: The new tool can be used for multiplex diagnostics of the most important feline infectious diseases. Only a very small sample volume is required. Fully automation results in a very convenient and fast method for diagnosing animal diseases.With its large specimen capacity to process over 576 samples per 8-hours shift and provide up to 3,456 results, very high laboratory productivity and reagent savings can be achieved.

Keywords: Multiplex, FIV, FeLV, FCoV, FIP

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498 Environmental Contamination of Water Bodies by Waste Produced by Slaughterhouses and the Prevalence of Waterborne Diseases in Kumba Municipality

Authors: Maturin Désiré Sop Sop, Didien Njumba Besende, Samuel Fosso Wamba

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This study seeks to examine the nexus between drinking water sources in the Kumba municipality and its related health implications vis-à-vis the recurrent incidences of waterborne diseases such as Typhoid, Cholera, Diarrhea, Dysentery, Hepatitis A and malaria. The study adopted a purposive sampling technique in which surveys were conducted between the months of June to December 2022. 150 questionnaires were retrieved from the 210 administered to the affected population of Kosala, Buea Road and Mambanda. Information for the study was collected using surveys, questionnaires, key informant interviews, the laboratory analysis of collected drinking water samples, the researcher’s direct observation as well and hospital reports on the prevalence of waterborne diseases. Water samples from the nearby streams and wells, which were communally used by the local population for drinking, and five slaughterhouses within the affected areas were laboratory tested to determine alterations in their chemical, physical and microbiological characteristics. The collected water samples from all the streams and wells used for drinking were tested for changes in properties such as temperature, turbidity, EC, pH, TDS, TSS, Cl, SO42-, PO43-, NO3-, Fe, Na, BOD, COD, DO, E.coli and total coliform concentration. These results were then compared with the WHO regulations for water quality. The results from the laboratory analysis of drinking water sources, which were at the same time used by the surrounding abattoirs revealed significant alterations in the water quality parameters such as temperature, turbidity, EC, pH, TDS, TSS, Cl, SO42-, PO43-, NO3-, Fe, Na, BOD, COD, DO, E.coli and total coliform concentration. This is due to the channeling of untreated wastes into the different drinking water points as well as the inter-use of dirty utensils such as buckets from slaughterhouses to fetch water from the streams and wells that serve as drinking water sources for the local population. On the human health aspect, the results were later compared with hospital data, and they revealed that the consumption of such contaminated water in the localities of Kosala, Mambanda, and Buea road negatively affected the local population because of the high incidences of Typhoid Cholera, Diarrhea, Dysentery, Hepatitis A and malaria. The poor management of drinking water sources pollutes streams and significantly exposes the local population to lots of waterborne diseases. Efforts should be made to provide clean pipe-borne water to the affected localities of Kumba as well as to ensure the proper management of wastes.

Keywords: drinking water, diseases, Kumba, municipality

Procedia PDF Downloads 51
497 A Dynamic Cardiac Single Photon Emission Computer Tomography Using Conventional Gamma Camera to Estimate Coronary Flow Reserve

Authors: Maria Sciammarella, Uttam M. Shrestha, Youngho Seo, Grant T. Gullberg, Elias H. Botvinick

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Background: Myocardial perfusion imaging (MPI) is typically performed with static imaging protocols and visually assessed for perfusion defects based on the relative intensity distribution. Dynamic cardiac SPECT, on the other hand, is a new imaging technique that is based on time varying information of radiotracer distribution, which permits quantification of myocardial blood flow (MBF). In this abstract, we report a progress and current status of dynamic cardiac SPECT using conventional gamma camera (Infinia Hawkeye 4, GE Healthcare) for estimation of myocardial blood flow and coronary flow reserve. Methods: A group of patients who had high risk of coronary artery disease was enrolled to evaluate our methodology. A low-dose/high-dose rest/pharmacologic-induced-stress protocol was implemented. A standard rest and a standard stress radionuclide dose of ⁹⁹ᵐTc-tetrofosmin (140 keV) was administered. The dynamic SPECT data for each patient were reconstructed using the standard 4-dimensional maximum likelihood expectation maximization (ML-EM) algorithm. Acquired data were used to estimate the myocardial blood flow (MBF). The correspondence between flow values in the main coronary vasculature with myocardial segments defined by the standardized myocardial segmentation and nomenclature were derived. The coronary flow reserve, CFR, was defined as the ratio of stress to rest MBF values. CFR values estimated with SPECT were also validated with dynamic PET. Results: The range of territorial MBF in LAD, RCA, and LCX was 0.44 ml/min/g to 3.81 ml/min/g. The MBF between estimated with PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (p < 0.001). But the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (p = 0.037). The mean stress MBF value was significantly lower for angiographically abnormal than that for the normal (Normal Mean MBF = 2.49 ± 0.61, Abnormal Mean MBF = 1.43 ± 0. 0.62, P < .001). Conclusions: The visually assessed image findings in clinical SPECT are subjective, and may not reflect direct physiologic measures of coronary lesion. The MBF and CFR measured with dynamic SPECT are fully objective and available only with the data generated from the dynamic SPECT method. A quantitative approach such as measuring CFR using dynamic SPECT imaging is a better mode of diagnosing CAD than visual assessment of stress and rest images from static SPECT images Coronary Flow Reserve.

Keywords: dynamic SPECT, clinical SPECT/CT, selective coronary angiograph, ⁹⁹ᵐTc-Tetrofosmin

Procedia PDF Downloads 138
496 Isolation and Transplantation of Hepatocytes in an Experimental Model

Authors: Inas Raafat, Azza El Bassiouny, Waldemar L. Olszewsky, Nagui E. Mikhail, Mona Nossier, Nora E. I. El-Bassiouni, Mona Zoheiry, Houda Abou Taleb, Noha Abd El-Aal, Ali Baioumy, Shimaa Attia

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Background: Orthotopic liver transplantation is an established treatment for patients with severe acute and end-stage chronic liver disease. The shortage of donor organs continues to be the rate-limiting factor for liver transplantation throughout the world. Hepatocyte transplantation is a promising treatment for several liver diseases and can, also, be used as a "bridge" to liver transplantation in cases of liver failure. Aim of the work: This study was designed to develop a highly efficient protocol for isolation and transplantation of hepatocytes in experimental Lewis rat model to provide satisfactory guidelines for future application on humans.Materials and Methods: Hepatocytes were isolated from the liver by double perfusion technique and bone marrow cells were isolated by centrifugation of shafts of tibia and femur of donor Lewis rats. Recipient rats were subjected to sub-lethal dose of irradiation 2 days before transplantation. In a laparotomy operation the spleen was injected by freshly isolated hepatocytes and bone marrow cells were injected intravenously. The animals were sacrificed 45 day latter and splenic sections were prepared and stained with H & E, PAS AFP and Prox1. Results: The data obtained from this study showed that the double perfusion technique is successful in separation of hepatocytes regarding cell number and viability. Also the method used for bone marrow cells separation gave excellent results regarding cell number and viability. Intrasplenic engraftment of hepatocytes and live tissue formation within the splenic tissue were found in 70% of cases. Hematoxylin and eosin stained splenic sections from 7 rats showed sheets and clusters of cells among the splenic tissues. Periodic Acid Schiff stained splenic sections from 7 rats showed clusters of hepatocytes with intensely stained pink cytoplasmic granules denoting the presence of glycogen. Splenic sections from 7 rats stained with anti-α-fetoprotein antibody showed brownish cytoplasmic staining of the hepatocytes denoting positive expression of AFP. Splenic sections from 7 rats stained with anti-Prox1 showed brownish nuclear staining of the hepatocytes denoting positive expression of Prox1 gene on these cells. Also, positive expression of Prox1 gene was detected on lymphocytes aggregations in the spleens. Conclusions: Isolation of liver cells by double perfusion technique using collagenase buffer is a reliable method that has a very satisfactory yield regarding cell number and viability. The intrasplenic route of transplantation of the freshly isolated liver cells in an immunocompromised model was found to give good results regarding cell engraftment and tissue formation. Further studies are needed to assess function of engrafted hepatocytes by measuring prothrombin time, serum albumin and bilirubin levels.

Keywords: Lewis rats, hepatocytes, BMCs, transplantation, AFP, Prox1

Procedia PDF Downloads 298
495 Exploring the Impact of Input Sequence Lengths on Long Short-Term Memory-Based Streamflow Prediction in Flashy Catchments

Authors: Farzad Hosseini Hossein Abadi, Cristina Prieto Sierra, Cesar Álvarez Díaz

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Predicting streamflow accurately in flashy catchments prone to floods is a major research and operational challenge in hydrological modeling. Recent advancements in deep learning, particularly Long Short-Term Memory (LSTM) networks, have shown to be promising in achieving accurate hydrological predictions at daily and hourly time scales. In this work, a multi-timescale LSTM (MTS-LSTM) network was applied to the context of regional hydrological predictions at an hourly time scale in flashy catchments. The case study includes 40 catchments allocated in the Basque Country, north of Spain. We explore the impact of hyperparameters on the performance of streamflow predictions given by regional deep learning models through systematic hyperparameter tuning - where optimal regional values for different catchments are identified. The results show that predictions are highly accurate, with Nash-Sutcliffe (NSE) and Kling-Gupta (KGE) metrics values as high as 0.98 and 0.97, respectively. A principal component analysis reveals that a hyperparameter related to the length of the input sequence contributes most significantly to the prediction performance. The findings suggest that input sequence lengths have a crucial impact on the model prediction performance. Moreover, employing catchment-scale analysis reveals distinct sequence lengths for individual basins, highlighting the necessity of customizing this hyperparameter based on each catchment’s characteristics. This aligns with well known “uniqueness of the place” paradigm. In prior research, tuning the length of the input sequence of LSTMs has received limited focus in the field of streamflow prediction. Initially it was set to 365 days to capture a full annual water cycle. Later, performing limited systematic hyper-tuning using grid search, revealed a modification to 270 days. However, despite the significance of this hyperparameter in hydrological predictions, usually studies have overlooked its tuning and fixed it to 365 days. This study, employing a simultaneous systematic hyperparameter tuning approach, emphasizes the critical role of input sequence length as an influential hyperparameter in configuring LSTMs for regional streamflow prediction. Proper tuning of this hyperparameter is essential for achieving accurate hourly predictions using deep learning models.

Keywords: LSTMs, streamflow, hyperparameters, hydrology

Procedia PDF Downloads 39
494 The Study of Difficulties of Understanding Idiomatic Expressions Encountered by Translators 2021

Authors: Mohamed Elmogbail

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The present study aimed at investigating difficulties those Translators encounter in understanding idiomatic expressions between Arabic and English languages. To achieve this goal, the researcher raised the three questions are:(1) What are the major difficulties that translators encounter in translating idiomatic expressions? (2) What factors cause such difficulties that translators encountered in translating idiomatic expressions? (3) What are the possible techniques that should be followed to overcome these difficulties? To answer these questions, the researcher designed questionnaire Table (2) and mentioned tables related to Test Show the second question in the study is about the factors that stand behind the challenges. Translators encounter while translating idiomatic expressions. The translators asked Provided the following factors:1- Because of lack of exposure to the source culture, they do not know the connotations of the cultural words that are related to the environment, food, folklore 2- Misusing dictionaries made the participants unable to find a proper target language idiomatic expression. 3-Lack of using idiomatic expressions in daily life. Table (3): (Questionnaire) Results to the table (3) Questions Of the study are About suggestions that can be inferred to handle these challenges. The questioned translators provided the following solutions:1- translators must be exposed to source language culture, including religion, habits, and traditions.2- translators should also be exposed to source language idiomatic expressions by introducing English culture in textbooks and through participating in extensive English culture courses.3- translators should be familiar with the differences between source and target language cultures.4- translators should avoid literal translation that results in most cases in wrong or poor translation.5- Schools, universities, and institutions should introduce translators to English culture.6- translators should participate in cultural workshops at universities.7- translators should try to use idiomatic expressions in everyday situations.8- translators should read more idiomatic expressions books. And researcher also designed a translation test consisted of 40 excerpts given to a random sample of 100 Translators in Khartoum capital of Sudan to translate them. After Collected data for the study, the researcher proceeded to a more detailed analysis, the methodology used in the analysis of idiomatic expressions Is empirical and descriptive. This study is qualitative by nature, but the quantitative method used the analysis of the data. Some figure and statistics are used, such as (statistical package for the social sciences). The researcher calculated the percentage proportion of each translation expressions. And compared them to each other. The finding of the study showed that most translations are inadequate as the translators faced difficulties while communication, these difficulties were mostly due to their unfamiliarity with idiomatic expressions producing improper equivalence in the communication, and not being able to use translation techniques as required, and resorted to literal translation, furthermore, the study recommended that more comprehensive studies to executed on translating idiomatic expressions to enrich the translation field.

Keywords: translation, translators, idioms., expressions

Procedia PDF Downloads 134
493 An Interesting Case of Management of Life Threatening Calcium Disequilibrium in a Patient with Parathyroid Tumor

Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

Procedia PDF Downloads 105
492 Impact of Financial and Nutrition Support on Blood Health, Dietary Intake, and Well-Being among Female Student-Athletes

Authors: Kaila A. Vento

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Within the field of sports science, financial situations have been reported as a key barrier in purchasing high-quality foods. A lack of proper nutrition leads to insecurities of health, impairs training, and diminishes optimal performances. Consequently, insufficient nutrient intake, disordered eating patterns, and eating disorders may arise, leading to poor health and well-being. Athletic scholarships, nutrition resources, and meal programs are available, yet are disproportionally allocated, favoring male sports, Caucasian athletes, and higher sport levels. Direct athlete finances towards nutrition at various sport levels and the role race influences aid received has yet to be examined. Additionally, a diverse female athlete population is missing in the sports science literature, specifically in nutrition. To address this gap, the current project assesses how financial and nutrition support and nutrition knowledge impacts physical health, dietary intake, and overall quality of life of a diverse sample of female athletes at the National Collegiate Athletic Association (NCAA), National Junior Collegiate Athletic Association (NJCAA), and cub sport levels. The project will identify differences in financial support in relation to race, as well. Approximately (N = 120) female athletes will participate in a single 30-minute lab visit. At this visit, body composition (i.e., height, weight, body mass index, and fat percent), blood health indicators (fasted blood glucose and lipids), and resting blood pressure are measured. In addition, three validated questionnaires pertaining to nutrition knowledge (Sports Nutrition Knowledge Questionnaire; SNKQ), dietary intake (Rapid Eating Assessment for Participants; REAP), and quality of life (World Health Organization Quality of Life Brief; WHOQL-B) are gathered. Body composition and blood health indicators will be compared with the results of self-reported sports nutrition knowledge, dietary intake, and quality of life questionnaires. It is hypothesized that 1) financial and nutrition support and nutrition knowledge will differ between the sport levels and 2) financial and nutrition support and nutrition knowledge will have a positive association with quality of dietary intake and blood health indicators, 3) financial and nutrition support will differ significantly among racial background across the various competition levels, and 4) dietary intake will influence blood health indicators and quality of life. The findings from this study could have positive implications on athletic associations' policies on equity of financial and nutrition support to improve the health and safety of all female athletes across several sport levels.

Keywords: athlete, equity, finances, health, resources

Procedia PDF Downloads 88
491 Application of Micro-Tunneling Technique to Rectify Tilted Structures Constructed on Cohesive Soil

Authors: Yasser R. Tawfic, Mohamed A. Eid

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Foundation differential settlement and supported structure tilting is an occasionally occurred engineering problem. This may be caused by overloading, changes in ground soil properties or unsupported nearby excavations. Engineering thinking points directly toward the logic solution for such problem by uplifting the settled side. This can be achieved with deep foundation elements such as micro-piles and macro-piles™, jacked piers and helical piers, jet grouted soil-crete columns, compaction grout columns, cement grouting or with chemical grouting, or traditional pit underpinning with concrete and mortar. Although, some of these techniques offer economic, fast and low noise solutions, many of them are quite the contrary. For tilted structures, with limited inclination, it may be much easier to cause a balancing settlement on the less-settlement side which shall be done carefully in a proper rate. This principal has been applied in Leaning Tower of Pisa stabilization with soil extraction from the ground surface. In this research, the authors attempt to introduce a new solution with a different point of view. So, micro-tunneling technique is presented in here as an intended ground deformation cause. In general, micro-tunneling is expected to induce limited ground deformations. Thus, the researchers propose to apply the technique to form small size ground unsupported holes to produce the target deformations. This shall be done in four phases: •Application of one or more micro-tunnels, regarding the existing differential settlement value, under the raised side of the tilted structure. •For each individual tunnel, the lining shall be pulled out from both sides (from jacking and receiving shafts) in slow rate. •If required, according to calculations and site records, an additional surface load can be applied on the raised foundation side. •Finally, a strengthening soil grouting shall be applied for stabilization after adjustment. A finite element based numerical model is presented to simulate the proposed construction phases for different tunneling positions and tunnels group. For each case, the surface settlements are calculated and induced plasticity points are checked. These results show the impact of the suggested procedure on the tilted structure and its feasibility. Comparing results also show the importance of the position selection and tunnels group gradual effect. Thus, a new engineering solution is presented to one of the structural and geotechnical engineering challenges.

Keywords: differential settlement, micro-tunneling, soil-structure interaction, tilted structures

Procedia PDF Downloads 194
490 Multicenter Baseline Survey to Outline Antimicrobial Prescribing Practices at Six Public Sectortertiary Care Hospitals in a Low Middle Income Country

Authors: N. Khursheed, M. Fatima, S. Jamal, A. Raza, S. Rattani, Q. Ahsan, A. Rasheed, M. Jawed

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Introduction: Antibiotics are among the commonly prescribed medicines to treat bacterial infections. Their misuse intensifies resistance, and overuse incurs heavy losses to the healthcare system in terms of increased treatment costs and enhanced disease burden. Studies show that 40% of empirically used antibiotics are irrationally utilized. The objective of this study was to evaluate prescribing pattern of antibiotics at six public sector tertiary care hospitals across Pakistan. Methods: A multicenter cross-sectional point prevalence survey (PPS) was conducted in selected wards of six public sector tertiary care hospitals in Pakistan as part of the Clinical Engagement program by Fleming Fund Country Grant Pakistan in collaboration with Indus Hospital & Health Network (IHHN) from February to March 2021, these included Jinnah Postgraduate Medical Center and Dr. Ruth K. M. Pfau Civil Hospital from Karachi, Sheikh Zayed Hospital Lahore, Nishtar Medical University Hospital Multan, Medical Teaching Institute Hayatabad Medical Complex Peshawar, and Provincial Headquarters Hospital Gilgit. WHO PPS methodology was used for data collection (Hospital, ward, and patient level data was collected). Data was entered into the open-source Kobo Collect application and was analyzed using SPSS (version 22.0). Findings: Medical records of 837 in-patients were surveyed, of which the prevalence of antibiotics use was 78.5%. The most commonly prescribed antimicrobial was Ceftriaxone (21.7%) which is categorized in the Watch group of WHO AWaRe Classification, followed by Metronidazole (17.3%), Cefoperazone/Sulbactam (8.4%), Co-Amoxiclav (6.3%) and Piperacillin/Tazobactam (5.9%). The antibiotics were prescribed largely for surgical prophylaxis (36.7%), followed by community-acquired infections (24.7%). One antibiotic was prescribed to 46.7%, two to 39.9%, and three or more to 12.5 %. Two of six (30%) hospitals had functional drug and therapeutic committees, three (50%) had infection prevention and control committees, and one facility had an antibiotic formulary. Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasizes the importance of expanding the antimicrobial stewardship program. Mentoring clinical teams will help to rationalize antimicrobial use.

Keywords: antimicrobial resistance, antimicrobial stewardship, point prevalence survey, antibiotics

Procedia PDF Downloads 91
489 Towards Better Integration: Qualitative Study on Perceptions of Russian-Speaking Immigrants in Australia

Authors: Oleg Shovkovyy

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This research conducted in response to one of the most pressing questions on the agenda of many public administration offices around the world: “What could be done for better integration and assimilation of immigrants into hosting communities?” In author’s view, the answer could be suggested by immigrants themselves. They, often ‘bogged down in the past,’ snared by own idols and demons, perceive things differently, which, in turn, may result in their inability to integrate smoothly into hosting communities. Brief literature review suggests that perceptions of immigrants are completely neglected or something unsought in the current research on migrants, which, often, based on opinion polls by members of hosting communities themselves or superficial research data by various research organizations. Even those specimens that include voices of immigrants, unlikely to shed any additional light onto the problem simply because certain things are not made to speak out loud, especially to those in whose hands immigrants’ fate is (authorities). In this regard, this qualitative study, conducted by an insider to a few Russian-speaking communities, represents a unique opportunity for all stakeholders to look at the question of integration through the eyes of immigrants, from a different perspective and thus, makes research findings especially valuable for better understanding of the problem. Case study research employed ethnographic methods of gathering data where, approximately 200 Russian-speaking immigrants of first and second generations were closely observed by the Russian-speaking researcher in their usual setting, for eight months, and at different venues. The number of informal interviews with 27 key informants, with whom the researcher managed to establish a good rapport and who were keen enough to share their experiences voluntarily, were conducted. The field notes were taken at 14 locations (study sites) within the Brisbane region of Queensland, Australia. Moreover, all this time, researcher lived in dwelling of one of the immigrants and was an active participant in the social life (worship, picnics, dinners, weekend schools, concerts, cultural events, social gathering, etc.) of observed communities, whose members, to a large extent, belong to various religious lines of the Russian and Protestant Church. It was found that the majority of immigrants had experienced some discrimination in matters of hiring, employment, recognition of educational qualifications from home countries, and simply felt a sort of dislike from society in various everyday situations. Many noted complete absences or very limited state assistance in terms of employment, training, education, and housing. For instance, the Australian Government Department of Human Services not only does not stimulate job search but, on the contrary, encourages to refuse short-term works and employment. On the other hand, offered free courses on adaptation, and the English language proved to be ineffective and unpopular amongst immigrants. Many interviewees have reported overstated requirements for English proficiency and local work experience, whereas it was not critical for the given task or job. Based on the result of long-term monitoring, the researcher also had the courage to assert the negative and decelerating roles of immigrants’ communities, particularly religious communities, on processes of integration and assimilation. The findings suggest that governments should either change current immigration policies in the direction of their toughening or to take more proactive and responsible role in dealing with immigrant-related issues; for instance, increasing assistance and support to all immigrants and probably, paying more attention to and taking stake in managing and organizing lives of immigrants’ communities rather, simply leaving it all to chance.

Keywords: Australia, immigration, integration, perceptions

Procedia PDF Downloads 206
488 Using Repetition of Instructions in Course Design to Improve Instructor Efficiency and Increase Enrollment in a Large Online Course

Authors: David M. Gilstrap

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Designing effective instructions is a critical dimension of effective teaching systems. Due to a void in interpersonal contact, online courses present new challenges in this regard, especially with large class sizes. This presentation is a case study in how the repetition of instructions within the course design was utilized to increase instructor efficiency in managing a rapid rise in enrollment. World of Turf is a two-credit, semester-long elective course for non-turfgrass majors at Michigan State University. It is taught entirely online and solely by the instructor without any graduate teaching assistants. Discussion forums about subject matter are designated for each lecture, and those forums are moderated by a few undergraduate turfgrass majors. The instructions as to the course structure, navigation, and grading are conveyed in the syllabus and course-introduction lecture. Regardless, students email questions about such matters, and the number of emails increased as course enrollment grew steadily during the first three years of its existence, almost to a point that the course was becoming unmanageable. Many of these emails occurred because the instructor was failing to update and operate the course in a timely and proper fashion because he was too busy answering emails. Some of the emails did help the instructor ferret out poorly composed instructions, which he corrected. Beginning in the summer semester of 2015, the instructor overhauled the course by segregating content into weekly modules. The philosophy envisioned and embraced was that there can never be too much repetition of instructions in an online course. Instructions were duplicated within each of these modules as well as associated modules for syllabus and schedules, getting started, frequently asked questions, practice tests, surveys, and exams. In addition, informational forums were created and set aside for questions about the course workings and each of the three exams, thus creating even more repetition. Within these informational forums, students typically answer each other’s questions, which demonstrated to the students that that information is available in the course. When needed, the instructor interjects with corrects answers or clarifies any misinformation which students might be putting forth. Increasing the amount of repetition of instructions and strategic enhancements to the course design have resulted in a dramatic decrease in the number of email replies necessitated by the instructor. The resulting improvement in efficiency allowed the instructor to raise enrollment limits thus effecting a ten-fold increase in enrollment over a five-year period with 1050 students registered during the most recent academic year, thus becoming easily the largest online course at the university. Because of the improvement in course-delivery efficiency, sufficient time was created that allowed the instructor to development and launch an additional online course, hence further enhancing his productivity and value in terms of the number of the student-credit hours for which he is responsible.

Keywords: design, efficiency, instructions, online, repetition

Procedia PDF Downloads 191
487 Spatial Analysis in the Impact of Aquifer Capacity Reduction on Land Subsidence Rate in Semarang City between 2014-2017

Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

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The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

Procedia PDF Downloads 168
486 Integrating Geographic Information into Diabetes Disease Management

Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

Procedia PDF Downloads 267
485 Process Improvement and Redesign of the Immuno Histology (IHC) Lab at MSKCC: A Lean and Ergonomic Study

Authors: Samantha Meyerholz

Abstract:

MSKCC offers patients cutting edge cancer care with the highest quality standards. However, many patients and industry members do not realize that the operations of the Immunology Histology Lab (IHC) are the backbone for carrying out this mission. The IHC lab manufactures blocks and slides containing critical tissue samples that will be read by a Pathologist to diagnose and dictate a patient’s treatment course. The lab processes 200 requests daily, leading to the generation of approximately 2,000 slides and 1,100 blocks each day. Lab material is transported through labeling, cutting, staining and sorting manufacturing stations, while being managed by multiple techs throughout the space. The quality of the stain as well as wait times associated with processing requests, is directly associated with patients receiving rapid treatments and having a wider range of care options. This project aims to improve slide request turnaround time for rush and non-rush cases, while increasing the quality of each request filled (no missing slides or poorly stained items). Rush cases are to be filled in less than 24 hours, while standard cases are allotted a 48 hour time period. Reducing turnaround times enable patients to communicate sooner with their clinical team regarding their diagnosis, ultimately leading faster treatments and potentially better outcomes. Additional project goals included streamlining tech and material workflow, while reducing waste and increasing efficiency. This project followed a DMAIC structure with emphasis on lean and ergonomic principles that could be integrated into an evolving lab culture. Load times and batching processes were analyzed using process mapping, FMEA analysis, waste analysis, engineering observation, 5S and spaghetti diagramming. Reduction of lab technician movement as well as their body position at each workstation was of top concern to pathology leadership. With new equipment being brought into the lab to carry out workflow improvements, screen and tool placement was discussed with the techs in focus groups, to reduce variation and increase comfort throughout the workspace. 5S analysis was completed in two phases in the IHC lab, helping to drive solutions that reduced rework and tech motion. The IHC lab plans to continue utilizing these techniques to further reduce the time gap between tissue analysis and cancer care.

Keywords: engineering, ergonomics, healthcare, lean

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484 Modelling Optimal Control of Diabetes in the Workplace

Authors: Eunice Christabel Chukwu

Abstract:

Introduction: Diabetes is a chronic medical condition which is characterized by high levels of glucose in the blood and urine; it is usually diagnosed by means of a glucose tolerance test (GTT). Diabetes can cause a range of health problems if left unmanaged, as it can lead to serious complications. It is essential to manage the condition effectively, particularly in the workplace where the impact on work productivity can be significant. This paper discusses the modelling of optimal control of diabetes in the workplace using a control theory approach. Background: Diabetes mellitus is a condition caused by too much glucose in the blood. Insulin, a hormone produced by the pancreas, controls the blood sugar level by regulating the production and storage of glucose. In diabetes, there may be a decrease in the body’s ability to respond to insulin or a decrease in insulin produced by the pancreas which will lead to abnormalities in the metabolism of carbohydrates, proteins, and fats. In addition to the health implications, the condition can also have a significant impact on work productivity, as employees with uncontrolled diabetes are at risk of absenteeism, reduced performance, and increased healthcare costs. While several interventions are available to manage diabetes, the most effective approach is to control blood glucose levels through a combination of lifestyle modifications and medication. Methodology: The control theory approach involves modelling the dynamics of the system and designing a controller that can regulate the system to achieve optimal performance. In the case of diabetes, the system dynamics can be modelled using a mathematical model that describes the relationship between insulin, glucose, and other variables. The controller can then be designed to regulate the glucose levels to maintain them within a healthy range. Results: The modelling of optimal control of diabetes in the workplace using a control theory approach has shown promising results. The model has been able to predict the optimal dose of insulin required to maintain glucose levels within a healthy range, taking into account the individual’s lifestyle, medication regimen, and other relevant factors. The approach has also been used to design interventions that can improve diabetes management in the workplace, such as regular glucose monitoring and education programs. Conclusion: The modelling of optimal control of diabetes in the workplace using a control theory approach has significant potential to improve diabetes management and work productivity. By using a mathematical model and a controller to regulate glucose levels, the approach can help individuals with diabetes to achieve optimal health outcomes while minimizing the impact of the condition on their work performance. Further research is needed to validate the model and develop interventions that can be implemented in the workplace.

Keywords: mathematical model, blood, insulin, pancreas, model, glucose

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483 Hybrid Model of Strategic and Contextual Leadership in Pluralistic Organizations- A Qualitative Multiple Case Study

Authors: Ergham Al Bachir

Abstract:

This study adopts strategic leadership (Upper Echelons) as the core theory and contextual leadership theory as the research lens. This research asks how the external context impacts strategic leadership effectiveness to achieve the outcomes in pluralistic organizations (PO). The study explores how the context influences the selection of CEOs, top management teams (TMT), and their leadership effectiveness. POs are characterized by the multiple objectives of their top management teams, divergent objectives, multiple strategies, and multiple governing authorities. The research question is explored by means of a qualitative multiple-case study focusing on healthcare, real estate, and financial services organizations. The data sources are semi-structured interviews, documents, and direct observations. The data analysis strategy is inductive and deploys thematic analysis and cross-case synthesis. The findings differentiate between national and international CEOs' delegation of authority and relationship with the Board of Directors. The findings identify the elements of the dynamic context that influence TMT and PO outcomes. The emergent hybrid strategic and contextual leadership framework shows how the different contextual factors influence strategic direction, PO context, selection of CEOs and TMT, and the outcomes in four pluralistic organizations. The study offers seven theoretical contributions to Upper Echelons, strategic leadership, and contextual leadership research. (1) The integration of two theories revealed how CEO’s impact on the organization is complementary to the contextual impact. (2) Conducting this study in the Middle East contributes to strategic leadership and contextual leadership research. (3) The demonstration of the significant contextual effects on the selection of CEOs. (4 and 5) Two contributions revealed new links between the context, the Board role, internal versus external CEOs, and national versus international CEOs. (6 and 7) This study offered two definitions: what accounts for CEO leadership effectiveness and organizational outcomes. Two methodological contributions were also identified: (1) Previous strategic leadership and Upper Echelons research are mainly quantitative, while this study adopts qualitative multiple-case research with face-to-face interviews. (2) The extrication of the CEO from the TMT advanced the data analysis in strategic leadership research. Four contributions are offered to practice: (1) The CEO's leadership effectiveness inside and outside the organization. (2) Rapid turnover of predecessor CEOs signifies the need for a strategic and contextual approach to CEOs' succession. (3) TMT composition and education impact on TMT-CEO and TMT-TMT interface. (4) Multilevel strategic contextual leadership development framework.

Keywords: strategic leadership, contextual leadership, upper echelons, pluralistic organizations, cross-cultural leadership

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482 Groundwater Quality Assessment in the Vicinity of Tannery Industries in Warangal, India

Authors: Mohammed Fathima Shahanaaz, Shaik Fayazuddin, M. Uday Kiran

Abstract:

Groundwater quality is deteriorating day by day in different parts of the world due to various reasons, toxic chemicals are being discharged without proper treatment into inland water bodies and land which in turn add pollutants to the groundwater. In this kind of situation, the rural communities which do not have municipal drinking water have to rely on groundwater though it is polluted for various uses. Tannery industry is one of the major industry which provides economy and employment to India. Since most of the developed countries stopped using chemicals which are toxic, the tanning industry which uses chromium as its major element are being shifted towards developing countries. Most of the tanning industries in India can be found in clusters concentrated mainly in states of Tamilnadu, West Bengal, Uttar Pradesh and limited places of Punjab. Limited work is present in the case of tanneries of Warangal. There exists 18 group of tanneries in Desaipet, Enamamula region of Warangal, out of which 4 are involved in dry process and are low responsible for groundwater pollution. These units of tanneries are discharging their effluents after treatment into Sai Cheruvu. Though the treatment effluents are being discharged, the Sai Cheruvu is turned in to Pink colour, with higher levels of BOD, COD, chromium, chlorides, total hardness, TDS and sulphates. An attempt was made to analyse the groundwater samples around this polluted Sai Cheruvu region since literature shows that a single tannery can pollute groundwater to a radius of 7-8 kms from the point of disposal. Sample are collected from 6 different locations around Sai Cheruvu. Analysis was performed for determining various constituents in groundwater such as pH, EC, TDS, TH, Ca+2, Mg+2, HCO3-, Na+, K+, Cl-, SO42-, NO3-, F and Cr+6. The analysis of these constitutes gave values greater than permissible limits. Even chromium is also present in groundwater samples which is exceeding permissible limits People in Paidepally and Sardharpeta villages already stopped the usage of groundwater. They are buying bottle water for drinking purpose. Though they are not using groundwater for drinking purpose complaints are made about using this water for washing also. So treatment process should be adopted for groundwater which should be simple and efficient. In this study rice husk silica (RHS) is used to treat pollutants in groundwater with varying dosages of RHS and contact time. Rice husk is treated, dried and place in a muffle furnace for 6 hours at 650°C. Reduction is observed in total hardness, chlorides and chromium levels are observed after the application RHS. Pollutants reached permissible limits for 27.5mg/l and 50 mg/l of dosage for a contact time of 130 min at constant pH and temperature.

Keywords: chromium, groundwater, rice husk silica, tanning industries

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