Search results for: peripartal period

Authors: Dina Dahood Dabash

Abstract:

Refugee camps are habitually defined as receptive sites, transient spaces of exile and nondescript depoliticized places of exception. However, such arguments form partial sides of reality, especially in countries that are geopolitically challenged and rely immensely on international aid. In Jordan, the dynamics brought with the floating population of refugees (Palestinian amongst others) have resulted in spatial after-effects that cannot be easily overlooked. For instance, Palestine refugee camps have turned by time into socioeconomic centers of gravity and cores of spatial evolution. Yet, such a position is not instantaneous. Amongst various reasons, it can be related, according to this paper, to a distinctive institutional climate that has been co-produced by the refugees, host community and the state. This paper aims to investigate the evolution of urban and spatial regulations in Jordan between 1948 and 1995, more specifically, state regulations, community regulations and refugee-self-regulation that all dynamically interacted that period. The paper aims to unpack the relations between refugee camps and their environs to further explore the agency of such floating populations in establishing rooted networks that extended the time and place boundaries. The paper’s argument stems from the fact that the spatial configuration of urban systems is not only an outcome of a historical evolutionary process but is also a result of interactions between the actors. The research operationalizes Marka camp in Jordan as a case study. Marka Camp is one of the six "emergency" camps erected in 1968 to shelter 15,000 Palestine refugees and displaced persons who left the West Bank and Gaza Strip. Nowadays, camp shelters more than 50,000 refugees in the same area of land. The camp is located in Russeifa, a city in Zarqa Governorate in Jordan. Together with Amman and Zarqa, Russeifa is part of a larger metropolitan area that acts as a home to more than half of Jordan’s businesses. The paper aspires to further understand the post-conflict strategies which were historically applied in Jordan and can be employed to handle more recent geopolitical challenges such as the Syrian refugee crisis. Methodological framework: The paper traces the evolution of the refugee-camp regulating norms in Jordan, parallel with the horizontal and vertical evolution of the Marka camp and its surroundings. Consequently, the main methods employed are historical and mental tracing, Interviews, in addition to using available Aerial and archival photos of the Marka camp and its surrounding.

Keywords: forced migration, Palestine refugee camps, spatial agency, urban regulations

Procedia PDF Downloads 186

Authors: Tania Lisboa, Angela Voyajolu, Adam Ockelford

Abstract:

The positive impact of music on the development of children with autism is widely acknowledged: music offers a unique channel for communication, wellbeing and self-regulation, as well as access to culture and a means of creative engagement. Yet, no coherent program exists for parents, carers and teachers to follow with their children in the early years, when the need for interventions is often most acute. Hence, research and the development of resources is urgently required. Autism is a project with children on the autism spectrum. The project aims at promoting the participants’ engagement with music through involvement in specially-designed musical activities with parents and carers. The main goal of the research is to verify the effectiveness of newly designed resources and strategies, which are based on the Sounds of Intent in the Early Years (SoI-EY) framework of musical development. This is a pilot study, comprising case studies of five children with autism in the early years. The data comprises semi-structured interviews, observations of videos, and feedback from parents on resources. Interpretative Phenomenological Analysis was chosen to analyze the interviews. The video data was coded in relation to the SoI-EY framework. The feedback from parents was used to evaluate the resources (i.e. musical activity cards). The participants’ wider development was also assessed through selected elements of the Early Years Foundation Stage (EYFS), a national assessment framework used in England: specifically, communication, language and social-emotional development. Five families of children on the autism spectrum (aged between 4-8 years) participated in the pilot. The research team visited each family 4 times over a 3-month period, during which the children were observed, and musical activities were suggested based on the child’s assessed level of musical development. Parents then trialed the activities, providing feedback and gathering further video observations of their child’s musical engagement between visits. The results of one case study will be featured in this paper, in which the evidence suggests that specifically tailored musical activity may promote communication and social engagement for a child with language difficulties on the autism spectrum. The resources were appropriate for the children’s involvement in musical activities. Findings suggest that non-specialist musical engagement with family and carers can be a powerful means to foster communication. The case study featured in this paper illustrates this with a child of limited verbal ability. There is a need for further research and development of resources that can be made available to all those working with children on the autism spectrum.

Keywords: autism, development, music education, resources

Procedia PDF Downloads 103

Authors: Vilma Sasyte, Vilma Viliene, Agila Dauksiene, Asta Raceviciute-Stupeliene, Romas Gruzauskas, Saulius Alijosius

Abstract:

The eight-week feeding trial was conducted involving 27-wk-old Isa brown laying hens to study the effect of dry extrusion processing on partial reduction in total glucosinolates content of locally produced rapeseed and on productivity and eggs quality parameters of laying hens. Thirty-six hens were randomly assigned one of three treatments (CONTR, AERS and HERS), each comprising 12, individual caged layers. The main composition of the diets was the same, but extruded soya bean seed were replaced with 2.5% of the extruded rapeseed in the AERS group and 4.5 % in the HERS group. Rapeseed was extruded together with faba beans. Due to extrusion process the glucosinolates content was reduced by 7.83 µmol/g of rapeseed. The results of conducted trial shows, that during all experimental period egg production parameters, such as the average feed intake (6529.17 vs. 6257 g/hen/14 day; P < 0.05) and laying intensity (94.35% vs. 89.29; P < 0.05) were statistically different for HERS and CONTR laying hens respectively. Only the feed conversion ratio to produce 1 kg of eggs, kg in AERS group was by 11 % lower compared to CONTR group (P < 0.05). By analysing the effect of extruded rapeseed on egg mass, the statistical differences between treatments were no determined. The dietary treatments did not affect egg weight, albumen height, haugh units, albumen and yolk pH. However, in the HERS group were get eggs with the more intensive yolk color, higher redness (a) and yellowness (b) values. The inclusion of full-fat extruded rapeseed had no effect on egg shell quality parameters, i.e. shell breaking strength, shell weight with and without coat and shell index, but in the experimental groups were get eggs with the thinner shell (P < 0.05). The internal egg quality analysis showed that with higher content of extruded rapeseed (4.5 %) level in the diet, the total cholesterol in the eggs yolk decreased by 1.92 mg/g in comparison with CONTR group (P < 0.05). Eggs laid by hens fed the diet containing 2.5% and 4.5% had increasing ∑PNRR/∑SRR ratio and decreasing ∑(n-6)/∑(n-3) ratio values of eggs yolk fatty acids than in CONTR group. Eggs of hens fed different amount of extruded rapeseed presented an n-6 : n-3 ratio changed from 5.17 to 4.71. The analysis of the relationship between hypocholesteremia/ hypercholesterolemia fatty acids (H/H), which is based on the functional properties of fatty acids, found that the value of it ratio is significant higher in laying hens fed diets supplemented with 4.5% extruded rapeseed than the CONTR group, demonstrating the positive effects of extruded rapeseed on egg quality. The results of trial confirmed that extruded full fat rapeseed to the 4.5% are suitable to replace soyabean in the compound feed of laying hens.

Keywords: egg quality, extruded full-fat rapeseed, laying hens, productivity

Procedia PDF Downloads 215

Authors: Lisa Tragbar

Abstract:

In post-war scenarios, reconstruction is a principle towards creating a Just Peace in order to restore a stable post-war society. Just peace theorists explore normative behaviour after war, including the duties and responsibilities of different actors and peacebuilding strategies to achieve a lasting, positive peace. Environmental peace ethicists have argued for including the role of nature in the Ethics of War and Peace. This text explores the question of why and how to rethink the value of nature in post-war scenarios. The aim is to include the rights of nature within a maximalist account of reconstruction by highlighting sumak kawsay in the post-war period. Destruction of nature is usually considered collateral damage in war scenarios. Common universal standards for post-war reconstruction are restitution, compensation and reparation programmes, which is mostly anthropocentric approach. The problem of reconstruction in the aftermath of war is the instrumental value of nature. The responsibility to rebuild needs to be revisited within a non-anthropocentric context. There is an ongoing debate about a minimalist or maximalist approach to post-war reconstruction. While Michael Walzer argues for minimalist in-and-out interventions, Alex Bellamy argues for maximalist strategies such as the responsibility to protect, a UN-concept on how face mass atrocity crimes and how to reconstruct peace. While supporting the tradition of maximalist responsibility to rebuild, these normative post-Bellum concepts do not yet sufficiently consider the rights of nature in the aftermath of war. While reconstruction of infrastructures seems important and necessary, concepts that strengthen the intrinsic value of nature in post-bellum measures must also be included. Peace is not Just Peace without a thriving nature that provides the conditions and resources to live and guarantee human rights. Ecuador's indigenous philosophy of life can contribute to the restoration of nature after war by changing the perspective on the value of nature. The sumak kawsay includes the de-hierarchisation of humans and nature and the principle of reciprocity towards nature. Transferring this idea of life and interconnectedness to post-war reconstruction practices, post bellum perpetrators have restorative obligations not only to people but also to nature. This maximalist approach would include both a restitutive principle, by restoring the balance between humans and nature, and a retributive principle, by punishing the perpetrators through compensatory duties to nature. A maximalist approach to post-war reconstruction that takes into account the rights of nature expands the normative post-war questions to include a more complex field of responsibilities. After a war, Just Peace is restored once not only human rights but also the rights of nature are secured. A minimalist post-bellum approach to reconstruction does not locate future problems at their source and does not offer a solution for the inclusion of obligations to nature. There is a lack of obligations towards nature after a war, which can be changed through a different perspective: The indigenous philosophy of life provides the necessary principles for a comprehensive reconstruction of Just Peace.

Keywords: normative ethics, peace, post-war, sumak kawsay, applied ethics

Procedia PDF Downloads 78

Authors: Rishana Bilimoria

Abstract:

Darwin’s insightful anthropological theory on the evolution drove mankind’s understanding of our existence in the natural world. Scientists consider analysis of dental and craniofacial remains to be pivotal in uncovering facts about our evolutionary journey. The resilient mineral content of enamel and dentine allow cranial and dental remains to be preserved for millions of years, making it an excellent resource not only in anthropology but other fields of research including forensic dentistry. This literature review aims to chronologically approach each ancestral species, reviewing Australopithecus, Paranthropus, Homo Habilis, Homo Rudolfensis, Homo Erectus, Homo Neanderthalis, and finally Homo Sapiens. Studies included in the review assess the features of cranio-dental remains that are of evolutionary importance, such as microstructure, microwear, morphology, and jaw biomechanics. The article discusses the plethora of analysis techniques employed to study dental remains including carbon dating, dental topography, confocal imaging, DPI scanning and light microscopy, in addition to microwear study and analysis of features such as coronal and root morphology, mandibular corpus shape, craniofacial anatomy and microstructure. Furthermore, results from these studies provide insight into the diet, lifestyle and consequently, ecological surroundings of each species. We can correlate dental fossil evidence with wider theories on pivotal global events, to help us contextualize each species in space and time. Examples include dietary adaptation during the period of global cooling converting the landscape of Africa from forest to grassland. Global migration ‘out of Africa’ can be demonstrated by enamel thickness variation, cranial vault variation over time demonstrates accommodation to larger brain sizes, and dental wear patterns can place the commencement of lithic technology in history. Conclusions from this literature review show that dental evidence plays a major role in painting a phenotypic and all rounded picture of species of the Homo genus, in particular, analysis of coronal morphology through carbon dating and dental wear analysis. With regards to analysis technique, whilst studies require larger sample sizes, this could be unrealistic since there are limitations in ability to retrieve fossil data. We cannot deny the reliability of carbon dating; however, there is certainly scope for the use of more recent techniques, and further evidence of their success is required.

Keywords: cranio-facial, dental remains, evolution, hominids

Procedia PDF Downloads 164

Authors: Juan Manuel Brito-Diaz

Abstract:

The emergence of urban environmentalism in Spain is related to the processes of economic transformation and growing urbanization that occurred during the end of the Franco regime and the democratic transition. This paper analyzes the urban environmental mobilizations and their impacts as relevant democratizing agents in the processes of political change in cities. It’s an under-researched topic and studies on environmental movements in Spain have paid little attention to it. This research takes as its starting point the close link between democratization and environmentalism, since it considers that environmental conflicts are largely a consequence of democratic problems, and that the impacts of environmental movements are directly linked to the democratization. The study argues that the environmental movements that emerged in Spain at the end of the dictatorship and the democratic transition are an important part of the broad and complex associative fabric that promoted the democratization process. The research focuses on investigating the environmental protest in Las Palmas de Gran Canaria—the most important city in the Canary Islands—between 1970 and 1983, concurrently with the last local governments of the dictatorship and the first democratic city councils. As it is a case study, it opens up the possibility to ask multiple specific questions and assess each of the responses obtained. Although several research methodologies have been applied, such as the analysis of historical archives documentation or oral history interviews, mainly a very widespread methodology in the sociology of social movements, although very little used by social historians, has been used: the Protest Event Analysis (PEA). This methodology, which consists of generating a catalog of protest events by coding data around previously established variables, has allowed me to map, analyze and interpret the occurrence of protests over time and space, and associated factors, through content analysis. For data collection, news from local newspapers have provided a large enough sample to analyze the properties of social protest -frequency, size, demands, forms, organizers, etc.—and relate them to another type of information related to political structures and mobilization repertoires, encouraging the establishment of connections between the protest and the political impacts of urban movements. Finally, the study argues that the environmental movements of this period were essential to the construction of the new democratic city in Spain, not only because they established the issues of sustainability and urban environmental justice on the public agenda, but also because they proposed that conflicts derived from such matters should ultimately be resolved through public deliberation and citizen participation.

Keywords: democratization, environmental movements, political impacts, social movements

Procedia PDF Downloads 180

Authors: Edson Pierre, Gustavo de Jesus Lopez Nunez

Abstract:

The objective of this work is to analyze how physics can be taught remotely through the use of platforms and software to attract the attention of 2nd-year high school students at Colégio Cívico Militar Professor Carmelita Souza Dias and point out how remote teaching can be a teaching-learning strategy during the period of social distancing. Teaching physics has been a challenge for teachers and students, permeating common sense with the great difficulty of teaching and learning the subject. The challenge increased in 2020 and 2021 with the impact caused by the new coronavirus pandemic (Sars-Cov-2) and its variants that have affected the entire world. With these changes, a new teaching modality emerged: remote teaching. It brought new challenges and one of them was promoting distance research experiences, especially in physics teaching, since there are learning difficulties and it is often impossible for the student to relate the theory observed in class with the reality that surrounds them. Teaching physics in schools faces some difficulties, which makes it increasingly less attractive for young people to choose this profession. Bearing in mind that the study of physics is very important, as it puts students in front of concrete and real situations, situations that physical principles can respond to, helping to understand nature, nourishing and nurturing a taste for science. The use of new platforms and software, such as PhET Interactive Simulations from the University of Colorado at Boulder, is a virtual laboratory that has numerous simulations of scientific experiments, which serve to improve the understanding of the content taught practically, facilitating student learning and absorption of content, being a simple, practical and free simulation tool, attracts more attention from students, causing them to acquire greater knowledge about the subject studied, or even a quiz, bringing certain healthy competitiveness to students, generating knowledge and interest in the themes used. The present study takes the Theory of Social Representations as a theoretical reference, examining the content and process of constructing the representations of teachers, subjects of our investigation, on the evaluation of teaching and learning processes, through a methodology of qualitative. The result of this work has shown that remote teaching was really a very important strategy for the process of teaching and learning physics in the 2nd year of high school. It provided greater interaction between the teacher and the student. Therefore, the teacher also plays a fundamental role since technology is increasingly present in the educational environment, and he is the main protagonist of this process.

Keywords: physics teaching, technologies, remote learning, pandemic

Procedia PDF Downloads 66

Authors: Chong Jiang, Liang Zhao, Hua Jian, Xiaoguang Wang

Abstract:

The belief that there is a strong relationship between reading narrative and morality has generally become the basic assumption of scholars, philosophers, critics, and cultural critics. The virtuality constructed by literary novels inspires readers to regard the narrative as a thinking experiment, creating the distance between readers and events so that they can freely and morally experience the positions of different roles. Therefore, the virtual narrative combined with literary characteristics is always considered as a "moral laboratory." Well-established findings revealed that people show less lying and deceptive behaviors in the morning than in the afternoon, called the morning morality effect. As a limited self-regulation resource, morality will be constantly depleted with the change of time rhythm under the influence of the morning morality effect. It can also be compensated and restored in various ways, such as eating, sleeping, etc. As a common form of entertainment in modern society, literary novel reading gives people more virtual experience and emotional catharsis, just as a relaxing afternoon tea that helps people break away from fast-paced work, restore physical strength, and relieve stress in a short period of leisure. In this paper, inspired by the compensation control theory, we wonder whether reading literary novels in the digital environment could replenish a kind of spiritual energy for self-regulation to compensate for people's moral loss in the afternoon. Based on this assumption, we leverage the social annotation text content generated by readers in digital reading to represent the readers' reading attention. We then recognized the semantics and calculated the readers' moral motivation expressed in the annotations and investigated the fine-grained dynamics of the moral motivation changing in each time slot within 24 hours of a day. Comprehensively comparing the division of different time intervals, sufficient experiments showed that the moral motivation reflected in the annotations in the afternoon is significantly higher than that in the morning. The results robustly verified the hypothesis that reading compensates for moral motivation, which we called the moral afternoon tea effect. Moreover, we quantitatively identified that such moral compensation can last until 14:00 in the afternoon and 21:00 in the evening. In addition, it is interesting to find that the division of time intervals of different units impacts the identification of moral rhythms. Dividing the time intervals by four-hour time slot brings more insights of moral rhythms compared with that of three-hour and six-hour time slot.

Keywords: digital reading, social annotation, moral motivation, morning morality effect, control compensation

Procedia PDF Downloads 149

Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir

Abstract:

Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.

Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar

Procedia PDF Downloads 350

Authors: David M. Gilstrap

Abstract:

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 209

Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

Abstract:

The US Environmental Protection Agency defines indoor air pollution as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. This study attempts to demonstrate the causal relationship between the indoor air pollution and its determining aspects. Detailed indoor air pollution audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavourable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group in the urban area of the metropolitan. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses the relationship between indoor air pollution levels and factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, air pollution, architecture, urban environment

Procedia PDF Downloads 107

Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

Abstract:

Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

Procedia PDF Downloads 119

Authors: Varsha Tol, Laila Garda, Neelam Bhardwaj, Malata Usar

Abstract:

In India, differently- abled girls suffer from a “dual stigma” of being female and physically challenged. The general consensus is that they are incapable of standing on their own two feet. It was observed that these girls do not have access to educational programs as most hostels do not keep them after the tenth grade. They are forced to return to a life of poverty and are often considered a liability by their families. Higher education is completely ignored. Parents focus on finding a husband and passing on their ‘burden’ to someone else. An innovative, intervention for differently-abled adolescent girls with the express purpose of mainstreaming them into society was started by Helplife. The objective was to enrich the lives of these differently abled adolescent girls through precise research, focused intervention and professionalism. This programme addresses physical, mental and social rehabilitation of the girls who come from impoverished backgrounds. These adolescents are reached by word of mouth, snowball technique and through the network of the NGO. Applications are invited from potential candidates which are scrutinized by a panel of experts. Selection criteria include her disability, socio-economic status, and desire and drive to make a difference in her own life. The six main areas of intervention are accommodation, education, health, professional courses, counseling and recreational activities. Each girl on an average resides in Helplife for a period of 2-3 years. Analysis of qualitative data collected at various time points indicates holistic development of character. A quality of life questionnaire showed a significant improvement in scores at three different time points in 75% of the current population under intervention i.e. 19 girls. Till date, 25 girls have successfully passed out from the intervention program completing their graduation/post-graduation. Currently, we have 19 differently abled girls housed in three flats in Pune district of Maharashtra. Out of which 14 girls are pursuing their graduation or post-graduation. Six of the girls are working in jobs in various sectors. In conclusion it may be noted with adequate support and guidance the sky is the limit. This journey of 12 years has been a learning for us with ups and downs modifying the intervention at every step. Helplife has a belief of impacting positively, individual lives of differently abled girls in order to empower them in a holistic manner. The intervention has a positive impact on differently abled girls. They serve as role models to other differently abled girls indicating that this is a road map to success by getting empowered to live with full potential and get integrated in the society in a dignified way.

Keywords: differently-abled, dual-stigma, empowerment, youth

Procedia PDF Downloads 172

Authors: K. Azadeh, M. Ghasemi, S. Fazelifar

Abstract:

Aim: Changes in stress hormones can be modify response of immune system. Cortisol as the most important body corticosteroid is anti-inflammatory and immunosuppressive hormone. Normal levels of cortisol in humans has fluctuated during the day, In other words, cortisol is released periodically, and regulate through the release of ACTH circadian rhythm in every day. Therefore, the aim of this study was to determine the effects of Chamomile on serum levels of inflammatory indexes to a bout of eccentric exercise in young women. Methodology: 32 women were randomly divided into 4 groups: high dose of Chamomile, low dose of Chamomile, ibuprofen and placebo group. Eccentric exercise included 5 set and rest period between sets was 1 minute. For this purpose, subjects warm up 10 min and then done eccentric exercise. Each participant completed 15 repetitions with optional 20 kg weight or until can’t continue moving. When the subject was no longer able to continue to move, immediately decreased 5 kg from the weight and the protocol continued until cause exhaustion or complete 15 repetitions. Also, subjects received specified amount of ibuprofen and Chamomile capsules in target groups. Blood samples in 6 stages (pre of starting pill, pre of exercise protocol, 4, 24, 48 and 72 hours after eccentric exercise) was obtained. The levels of cortisol and adrenocorticotropic hormone levels were measured by ELISA way. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p < 0/05 accepted. Results: The results showed that Individual characteristics including height, weight, age and body mass index were not significantly different among the four groups. Analyze of data showed that cortisol and ACTH basic levels significantly decreased after supplementation consumption, but then gradually significantly increased in all stages of post exercise. In High dose of Chamomile group, increasing tendency of post exercise somewhat less than other groups, but not to a significant level. The inter-group analysis results indicate that time effect had a significant impact in different stages of the groups. Conclusion: The results of this study, one session of eccentric exercise increased cortisol and ACTH hormone. The results represent the effect of high dose of Chamomile in the prevention and reduction of increased stress hormone levels. As regards use of medicinal plants and ibuprofen as a pain medication and inflammation has spread among athletes and non-athletes, the results of this research can provide information about the advantages and disadvantages of using medicinal plants and ibuprofen.

Keywords: chamomile, inflammatory indexes, eccentric exercise, young girls

Procedia PDF Downloads 417

Authors: Arif Tri Setyanto, Aditya Nanda Priyatama, Nugraha Arif Karyanta, Fadjri Kirana A., Afia Fitriani, Rini Setyowati, Moh.Abdul Hakim

Abstract:

The Basic Health Research Report by the Ministry of Health (2018) shows an increase in the prevalence of mental health disorders in the adolescent and early adult age ranges. Supporting this finding, data on the psychological examination of the student health service unit at one State University recorded 115 cases of moderate and severe health problems in the period 2016 - 2019. More specifically, the highest number of cases was experienced by clients in the age range of 21-23 years or equivalent, with the mid-semester stage towards the end. Based on the distribution of cases experienced and the disorder becomes a psychological problem experienced by students. A total of 29% or the equivalent of 33 students experienced anxiety disorders, 25% or 29 students experienced problems ranging from mild to severe, as well as other classifications of disorders experienced, including adjustment disorders, family problems, academics, mood disorders, self-concept disorders, personality disorders, cognitive disorders, and others such as trauma and sexual disorders. Various mental health disorders have a significant impact on the academic life of students, such as low GPA, exceeding the limit in college, dropping out, disruption of social life on campus, to suicide. Based on literature reviews and best practices from universities in various countries, one of the effective ways to prevent and treat student mental health disorders is to implement a mental health monitoring system in universities. This study uses a participatory action research approach, with a sample of 423 from a total population of 32,112 students. The scale used in this study is the Beck Depression Inventory (BDI) to measure depression and the Taylor Minnesota Anxiety Scale (TMAS) to measure anxiety levels. This study aims to (1) develop a digital-based health monitoring system for students' mental health situations in the mental health category. , dangers, or those who have mental disorders, especially indications of symptoms of depression and anxiety disorders, and (2) implementing a mental health monitoring system in universities at the beginning and end of each semester. The results of the analysis show that from 423 respondents, the main problems faced by all coursework, such as thesis and academic assignments. Based on the scoring and categorization of the Beck Depression Inventory (BDI), 191 students experienced symptoms of depression. A total of 24.35%, or 103 students experienced mild depression, 14.42% (61 students) had moderate depression, and 6.38% (27 students) experienced severe or extreme depression. Furthermore, as many as 80.38% (340 students) experienced anxiety in the high category. This article will review this review of the student mental health service system on campus.

Keywords: monitoring system, mental health, psychological problems, students

Procedia PDF Downloads 111

Authors: Evrim Colak, Andriy E. Serebryannikov, Pavel V. Usik, Ekmel Ozbay

Abstract:

Working with a dielectric photonic crystal (PC) structure which does not include surface corrugations, unidirectional transmission and dual-beam splitting are observed under normal incidence as a result of the strong diffractions caused by the embedded defect layer. The defect layer has twice the period of the regular PC segments which sandwich the defect layer. Although the PC has even number of rows, the structural symmetry is broken due to the asymmetric placement of the defect layer with respect to the symmetry axis of the regular PC. The simulations verify that efficient splitting and occurrence of strong diffractions are related to the dispersion properties of the Floquet-Bloch modes of the photonic crystal. Unidirectional and bi-directional splitting, which are associated with asymmetric transmission, arise due to the dominant contribution of the first positive and first negative diffraction orders. The effect of the depth of the defect layer is examined by placing single defect layer in varying rows, preserving the asymmetry of PC. Even for deeply buried defect layer, asymmetric transmission is still valid even if the zeroth order is not coupled. This transmission is due to evanescent waves which reach to the deeply embedded defect layer and couple to higher order modes. In an additional selected performance, whichever surface is illuminated, i.e., in both upper and lower surface illumination cases, incident beam is split into two beams of equal intensity at the output surface where the intensity of the out-going beams are equal for both illumination cases. That is, although the structure is asymmetric, symmetric bidirectional transmission with equal transmission values is demonstrated and the structure mimics the behavior of symmetric structures. Finally, simulation studies including the examination of a coupled-cavity defect for two different permittivity values (close to the permittivity values of GaAs or Si and alumina) reveal unidirectional splitting for a wider band of operation in comparison to the bandwidth obtained in the case of a single embedded defect layer. Since the dielectric materials that are utilized are low-loss and weakly dispersive in a wide frequency range including microwave and optical frequencies, the studied structures should be scalable to the mentioned ranges.

Keywords: asymmetric transmission, beam deflection, blazing, bi-directional splitting, defect layer, dual beam splitting, Floquet-Bloch modes, isofrequency contours, line defect, oblique incidence, photonic crystal, unidirectionality

Procedia PDF Downloads 184

Authors: Sumeyra Yakar

Abstract:

The idea of this research had its genesis from the writer's interest in Shi'i school and religio-political atmosphere in contemporary Iran. The research aims to identify how the past dynamics between political and legal figures and their relationship between each other affect contemporary relationship between political and religious authorities at the local and global level. It attempts to explore religio-politic Shi'i figures and their relationship with the official jurisprudence from the 15th century to the contemporary period. The mutual interaction between the opinion and acts of political figures and jurisprudential institutions enlightens the role of religious values to control the mass population. After the collapse of the Safawīd Dynasty, Shi'i believers lost their political guardian and legal independence, and the situation gave them the inspiration to create unique ideologies or political approaches to solve the governance crisis. The analysis of authoritative political figures and their scholastic contributions elucidate the connection between political powers and religious doctrines under the protection of sectarian oriented theocratic governments. Additionally, understanding the incremental influence of political (historical) Shi'i figures into religious doctrines shed lights on the chronological development of peculiar government style and authoritative hierarchy in contemporary Shi’i communities. The research as being interdisciplinary one offers to create an academic awareness between legal and political factors in Shi’i school of thought and encompasses political, religious, social, financial and cultural atmospheres of the countries in which the political figures lived. The Iranian regime enshrines the principle of vilāyāt-i faqīh (guardianship of the jurist) which enables jurists to solve the conflict between law as an ideal system, in theory, and law in practice. The paper aims to show how the religious, educational system works in harmony with the governmental authorities with the concept of vilāyāt-i faqīh in Iran and contributes to the creation of religious custom in the society. Contemporary relationship between the political figures and religious authorities in Iran will be explained by religio-legal dimensions. The methodology that will be applied by the study has been chosen in order to acquire information and deduce conclusions from the opinions of the scholars. Thus, the research method is mainly descriptive and qualitative. Three lines of description are pursued throughout the study; the explanation of political ideas belonging to the religio-political figures theoretically depending on written texts; the description of approaches adopted by contemporary Iranian and Saudi scholars relating to the legal systems (theoretically); and the explanation of the responses of governmental authorities.

Keywords: clergy (‘ulamā), guardianship of the jurist (vilāyāt-i faqīh), Iran, Shi’i figures

Procedia PDF Downloads 126

Authors: L. Sierra, N. Gambetta, M. A. Garcia-Benau, M. Orta

Abstract:

Financial scandals and financial crisis have led to an international debate on the value of auditing. In recent years there have been significant legislative reforms aiming to increase markets’ confidence in audit services. In particular, there has been a significant debate on the need to improve the communication of auditors with audit reports users as a way to improve its informative value and thus, to improve audit quality. The International Auditing and Assurance Standards Board (IAASB) has proposed changes to the audit report standards. The International Standard on Auditing 701, Communicating Key Audit Matters (KAM) in the Independent Auditor's Report, has introduced new concepts that go beyond the auditor's opinion and requires to disclose the risks that, from the auditor's point of view, are more significant in the audited company information. Focusing on the companies included in the Financial Times Stock Exchange 100 index, this study aims to focus on the analysis of the determinants of the number of KAM disclosed by the auditor in the audit report and moreover, the analysis of the determinants of the different type of KAM reported during the period 2013-2015. To test the hypotheses in the empirical research, two different models have been used. The first one is a linear regression model to identify the client’s characteristics, industry sector and auditor’s characteristics that are related to the number of KAM disclosed in the audit report. Secondly, a logistic regression model is used to identify the determinants of the number of each KAM type disclosed in the audit report; in line with the risk-based approach to auditing financial statements, we categorized the KAM in 2 groups: Entity-level KAM and Accounting-level KAM. Regarding the auditor’s characteristics impact on the KAM disclosure, the results show that PwC tends to report a larger number of KAM while KPMG tends to report less KAM in the audit report. Further, PwC reports a larger number of entity-level risk KAM while KPMG reports less account-level risk KAM. The results also show that companies paying higher fees tend to have more entity-level risk KAM and less account-level risk KAM. The materiality level is positively related to the number of account-level risk KAM. Additionally, these study results show that the relationship between client’s characteristics and number of KAM is more evident in account-level risk KAM than in entity-level risk KAM. A highly leveraged company carries a great deal of risk, but due to this, they are usually subject to strong capital providers monitoring resulting in less account-level risk KAM. The results reveal that the number of account-level risk KAM is strongly related to the industry sector in which the company operates assets. This study helps to understand the UK audit market, provides information to auditors and finally, it opens new research avenues in the academia.

Keywords: FTSE 100, IAS 701, key audit matters, auditor’s characteristics, client’s characteristics

Procedia PDF Downloads 231

Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris

Abstract:

Background: Physical activity is an important factor in the treatment and prevention of type 2 diabetes mellitus (T2DM). Reduction in HbA1c level, an important diabetes biomarker, was reported in patients who increased their daily physical activity. Although the ambient temperature was reported to be positively correlated to a negative impact on health and increase the incidences of diabetes, the exposure to bright sunlight was recently found to be associated with enhanced insulin sensitivity and improved beta-cell function. How Ramadan alters physical activity, and especially sunlight exposure, has not been adequately investigated. Aim: This study aimed to assess the physical activity and sun exposure of Saudis with T2DM over different periods (before, during, and after Ramadan) and related this to HbA1c levels. Methods: This study recruited 82 Saudis with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for this study were obtained from De Montfort University and Saudi Ministry of Health. Physical activity and sun exposure were assessed by a self-administered questionnaire. Physical activity was estimated using the International Physical Activity Questionnaire (IPAQ), while the sun exposure was assessed by asking the patients about their hours per week of direct exposure to the sun, and daily hours spent outdoors. Blood samples were collected in each period for measuring HbA1c. Results: Low physical activity was observed in more than 60% of the patients, with no significant changes between periods. There were no significant variances between periods in the daily hours spent outdoors and the total number of weekly hours of direct exposure to the sun. The majority of patients reported only few hours of exposure to the sun (1h or less per week) and time spent outdoors (1h or less per day). The mean HbA1c significantly changed between periods (P = 0.001), with lowest level during Ramadan. There were significant differences in the mean HbA1c between the groups for the level of physical activity (P < 0.001), with significant lower mean HbA1c in the higher-level group. There were no significant variances in the mean of HbA1c between the groups for the daily hours spent outdoors. The mean HbA1c of the patients, who reported never in their total weekly hours of exposure to the sun, was significantly lower than the mean HbA1c of those who reported 1 hour or less (P = 0.001). Conclusion: Physical inactivity was prevalent among the study population with very little exposure to the sun or time spent outdoors. Higher level of physical activity was associated with lower mean HbA1c levels. Encouraging T2DM patients to achieve the recommended levels of physical activity may help them to obtain greater benefits of Ramadan fasting, such as reducing their HbA1c levels. The impact of low direct exposure to the sun and the time spent outdoors needs to be further investigated in both healthy and diabetic patients.

Keywords: diabetes, fasting, physical activity, sunlight, Ramadan

Procedia PDF Downloads 160

Authors: Adam Aboalkaz, Rana Shamoon, Duncan Meikle, James Lewis

Abstract:

Background and aims: In orthopaedic theatres, radiological screening during operations is a commonly used and useful technique to visualise and guide the operating surgeon. Within any theatre using ionising radiation, it is imperative that the use of protective equipment and the wearing of a dosimeter at all times. 1. To assess compliance with use of protective equipment during orthopaedic procedures involving ionising radiation. 2. To assess the radiation risk knowledge of staff members regularly present in an orthopaedic theatre of a national major trauma centre, in accordance to the ionising radiation regulation (2000) guidelines. Method: We conducted an Observational study of 21 operations at the University Hospital of Wales, which is a major trauma centre, recording the compliance with use of protective equipment (lead aprons and thyroid shields) and dosimeters. The observations were performed sporadically over a two week period to ensure that all staff in monitored operating theatres were not aware of the ongoing study, as to avoid bias. A questionnaire testing the knowledge of trainees and staff within the orthopaedic department was given following completion of the initial phase of the study, with 19 responses. The questions were based on knowledge of ionising radiation exposure and monitoring. The questions also tested the general staff knowledge of what equipment should be worn and where to locate such equipment. Results: This study found that only 25% of staff members were wearing thyroid protectors when less than 1 meter from the radiation source and only 50% were wearing appropriate lead aprons whilst in this same vicinity. The study also showed that 0% of all staff members used a dosimeter whilst in an area of radiation exposure. From the distributed questionnaires, only 40% of staff understood where to stand whilst radiation was being used, and only 25% of staff knew where to find protective equipment. Conclusion: Overall our audit showed poor compliance with regards to the National and local policies, due to lack of awareness of the policy and lack of basic ionising radiation exposure knowledge. It was evident from the observational study and questionnaire that staff were not fully aware of what equipment should be worn, where to find such equipment and did not appreciate that the distance from the ionising radiation source altered its exposure effect. This lack of knowledge may affect the staff health and safety after long term exposure. Changes to clinical practice: From the outcome of this study, we managed to drastically increase awareness of ionising radiation within the orthopaedic department. A mandatory teaching session on the safety of ionising radiation has been incorporated into the orthopaedic induction week for all staff. The dosimeters have been moved to a visible location within the trauma operating theatre and all staff made aware of where to find protective equipment.

Keywords: audit, ionising radiation, observational study, protection

Procedia PDF Downloads 256

Authors: Sevdenur Onger, Ali Asram Sagiroglu

Abstract:

Hyperpigmentation is a cosmetically unappealing skin problem caused by an overabundance of melanin in the skin. Its pathophysiology is caused by melanocytes being exposed to paracrine melanogenic stimuli, which can upregulate melanogenesis-related enzymes (such as tyrosinase) and cause melanosome formation. Tyrosinase is linked to the development of melanosomes biochemically, and it is the main target of hyperpigmentation treatment. therefore, decreasing tyrosinase activity to reduce melanosomes has become the main target of hyperpigmentation treatment. Niacinamide (NA) is a natural chemical found in a variety of plants that is used as a skin-whitening ingredient in cosmetic formulations. NA decreases melanogenesis in the skin by inhibiting melanosome transfer from melanocytes to covering keratinocytes. Furthermore, NA protects the skin from reactive oxygen species and acts as a main barrier with the skin, reducing moisture loss by increasing ceramide and fatty acid synthesis. However, it is very difficult for hydrophilic compounds such as NA to penetrate deep into the skin. Furthermore, because of the nicotinic acid in NA, it is an irritant. As a result, we've concentrated on strategies to increase NA skin permeability while avoiding its irritating impacts. Since nanotechnology can affect drug penetration behavior by controlling the release and increasing the period of permanence on the skin, it can be a useful technique in the development of whitening formulations. Liposomes have become increasingly popular in the cosmetics industry in recent years due to benefits such as their lack of toxicity, high penetration ability in living skin layers, ability to increase skin moisture by forming a thin layer on the skin surface, and suitability for large-scale production. Therefore, liposomes containing NA were developed for this study. Different formulations were prepared by varying the amount of phospholipid and cholesterol and examined in terms of particle sizes, polydispersity index (PDI) and pH values. The pH values of the produced formulations were determined to be suitable with the pH value of the skin. Particle sizes were determined to be smaller than 250 nm and the particles were found to be of homogeneous size in the formulation (pdi<0.30). Despite the important advantages of liposomal systems, they have low viscosity and stability for topical use. For these reasons, in this study, liposomal cream formulations have been prepared for easy topical application of liposomal systems. As a result, liposomal cream formulations containing NA have been successfully prepared and characterized. Following the in-vitro release and ex-vivo diffusion studies to be conducted in the continuation of the study, it is planned to test the formulation that gives the most appropriate result on the volunteers after obtaining the approval of the ethics committee.

Keywords: delivery systems, hyperpigmentation, liposome, niacinamide

Procedia PDF Downloads 112

Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

Abstract:

Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

Procedia PDF Downloads 84

Authors: Rocío González-Sánchez, Sara Alonso-Muñoz

Abstract:

Food waste implies an inefficient management of the final stages in the food supply chain. Referring to Sustainable Development Goals (SDGs) by United Nations, the SDG 12.3 proposes to halve per capita food waste at the retail and consumer level and to reduce food losses. In the linear system, food waste is disposed and, to a lesser extent, recovery or reused after consumption. With the negative effect on stocks, the current food consumption system is based on ‘produce, take and dispose’ which put huge pressure on raw materials and energy resources. Therefore, greater focus on the circular management of food waste will mitigate the environmental, economic, and social impact, following a Triple Bottom Line (TBL) approach and consequently the SDGs fulfilment. A mixed methodology is used. A total sample of 311 publications from Web of Science database were retrieved. Firstly, it is performed a bibliometric analysis by SciMat and VOSviewer software to visualise scientific maps about co-occurrence analysis of keywords and co-citation analysis of journals. This allows for the understanding of the knowledge structure about this field, and to detect research issues. Secondly, a systematic literature review is conducted regarding the most influential articles in years 2020 and 2021, coinciding with the most representative period under study. Thirdly, to support the development of this field it is proposed an agenda according to the research gaps identified about circular economy and food waste management. Results reveal that the main topics are related to waste valorisation, the application of waste-to-energy circular model and the anaerobic digestion process towards fossil fuels replacement. It is underlined that the use of food as a source of clean energy is receiving greater attention in the literature. There is a lack of studies about stakeholders’ awareness and training. In addition, available data would facilitate the implementation of circular principles for food waste recovery, management, and valorisation. The research agenda suggests that circularity networks with suppliers and customers need to be deepened. Technological tools for the implementation of sustainable business models, and greater emphasis on social aspects through educational campaigns are also required. This paper contributes on the application of circularity to food waste management by abandoning inefficient linear models. Shedding light about trending topics in the field guiding to scholars for future research opportunities.

Keywords: bibliometric analysis, circular economy, food waste management, future research lines

Procedia PDF Downloads 112

Authors: Aprajeeta Jha, Punyadarshini P. Tripathy

Abstract:

Drying technologies for various food processing operations shares an inevitable linkage with energy, cost and environmental sustainability. Hence, solar drying of food grains has become imperative choice to combat duo challenges of meeting high energy demand for drying and to address climate change scenario. But performance and reliability of solar dryers depend hugely on sunshine period, climatic conditions, therefore, offer a limited control over drying conditions and have lower efficiencies. Solar drying technology, supported by Photovoltaic (PV) power plant and hybrid type solar air collector can potentially overpower the disadvantages of solar dryers. For development of such robust hybrid dryers; to ensure quality and shelf-life of paddy grains the optimization of process parameter becomes extremely critical. Investigation of the moisture distribution profile within the grains becomes necessary in order to avoid over drying or under drying of food grains in hybrid solar dryer. Computational simulations based on finite element modeling can serve as potential tool in providing a better insight of moisture migration during drying process. Hence, present work aims at optimizing the process parameters and to develop a 3-dimensional (3D) finite element model (FEM) for predicting moisture profile in paddy during solar drying. COMSOL Multiphysics was employed to develop a 3D finite element model for predicting moisture profile. Furthermore, optimization of process parameters (power level, air velocity and moisture content) was done using response surface methodology in design expert software. 3D finite element model (FEM) for predicting moisture migration in single kernel for every time step has been developed and validated with experimental data. The mean absolute error (MAE), mean relative error (MRE) and standard error (SE) were found to be 0.003, 0.0531 and 0.0007, respectively, indicating close agreement of model with experimental results. Furthermore, optimized process parameters for drying paddy were found to be 700 W, 2.75 m/s at 13% (wb) with optimum temperature, milling yield and drying time of 42˚C, 62%, 86 min respectively, having desirability of 0.905. Above optimized conditions can be successfully used to dry paddy in PV integrated solar dryer in order to attain maximum uniformity, quality and yield of product. PV-integrated hybrid solar dryers can be employed as potential and cutting edge drying technology alternative for sustainable energy and food security.

Keywords: finite element modeling, moisture migration, paddy grain, process optimization, PV integrated hybrid solar dryer

Procedia PDF Downloads 150

Authors: Sylvain Perrin, Thomas Saillour

Abstract:

The Grande-Motte port and seafront development project on the French Mediterranean coastline entailed evaluating wave impact loads (pressures and forces) on the new beach seawall and comparing the resulting scour potential at the base of the existing and new seawall. A physical model was built at ARTELIA’s hydraulics laboratory in Grenoble (France) to provide insight into the evolution of scouring overtime at the front of the wall, quasi-static and impulsive wave force intensity and distribution on the wall, and water and sand overtopping discharges over the wall. The beach was constituted of fine sand and approximately 50 m wide above mean sea level (MSL). Seabed slopes were in the range of 0.5% offshore to 1.5% closer to the beach. A smooth concrete structure will replace the existing concrete seawall with an elevated curved crown wall. Prior the start of breaking (at -7 m MSL contour), storm-driven maximum spectral significant wave heights of 2.8 m and 3.2 m were estimated for the benchmark historical storm event dated of 1997 and the 50-year return period storms respectively, resulting in 1 m high waves at the beach. For the wave load assessment, a tensor scale measured wave forces and moments and five piezo / piezo-resistive pressure sensors were placed on the wall. Light-weight sediment physical model and pressure and force measurements were performed with scale 1:18. The polyvinyl chloride light-weight particles used to model the prototype silty sand had a density of approximately 1 400 kg/m3 and a median diameter (d50) of 0.3 mm. Quantitative assessments of the seabed evolution were made using a measuring rod and also a laser scan survey. Testing demonstrated the occurrence of numerous impulsive wave impacts on the reflector (22%), induced not by direct wave breaking but mostly by wave run-up slamming on the top curved part of the wall. Wave forces of up to 264 kilonewtons and impulsive pressure spikes of up to 127 kilonewtons were measured. Maximum scour of -0.9 m was measured for the new seawall versus -0.6 m for the existing seawall, which is imputable to increased wave reflection (coefficient was 25.7 - 30.4% vs 23.4 - 28.6%). This paper presents a methodology for the setup and operation of a physical model in order to assess the hydrodynamic and morphodynamic processes at a beach seawall during storms events. It discusses the pros and cons of such methodology versus others, notably regarding structures peculiarities and model effects.

Keywords: beach, impacts, scour, seawall, waves

Procedia PDF Downloads 153

Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

Abstract:

Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

Procedia PDF Downloads 228

Authors: Michelle Blewitt, Scott P. Wilson, Heidi Tait, Juniper Riordan

Abstract:

Rubber crumb is a physical and chemical pollutant of concern for the environment and human health, warranting immediate investigations into its pathways to the environment and potential impacts. This emerging microplastic is created by shredding end-of-life tyres into ‘rubber crumb’ particles between 1-5mm used on synthetic turf fields and soft-fall playgrounds as a solution to intensifying tyre waste worldwide. Despite having known toxic and carcinogenic properties, studies into the transportation pathways and movement patterns of rubber crumbs from these surfaces remain in their infancy. To address this deficit, AUSMAP, the Australian Microplastic Assessment Project, in partnership with the Tangaroa Blue Foundation, conducted a study to quantify crumb loss from soft-fall surfaces. To our best knowledge, this is the first of its kind, with funding for the audits being provided by the Australian Government’s Reef Trust. Sampling occurred at 12 soft-fall playgrounds within the Great Barrier Reef Catchment Area on Australia’s North-East coast, in close proximity to the United Nations World Heritage Listed Reef. Samples were collected over a 12-month period using randomized sediment cores at 0, 2 and 4 meters away from the playground edge along a 20-meter transect. This approach facilitated two objectives pertaining to particle movement: to establish that crumb loss is occurring and that it decreases with distance from the soft-fall surface. Rubber crumb abundance was expressed as a total value and used to determine an expected average of rubber crumb loss per m2. An Analysis of Variance (ANOVA) was used to compare the differences in crumb abundance at each interval from the playground. Site characteristics, including surrounding sediment type, playground age, degree of ultra-violet exposure and amount of foot traffic, were additionally recorded for the comparison. Preliminary findings indicate that crumb is being lost at considerable rates from soft-fall playgrounds in the region, emphasizing an urgent need to further examine it as a potential source of aquatic pollution, soil contamination and threat to individuals who regularly utilize these surfaces. Additional implications for the future of rubber crumbs as a fit-for-purpose recycling initiative will be discussed with regard to industry, governments and the economic burden of surface maintenance and/ or replacement.

Keywords: microplastics, toxic rubber crumb, litter pathways, marine environment

Procedia PDF Downloads 91

Authors: Adrián Esteban Ortiz-Valera, Angélica Lozano

Abstract:

In developing countries, informal trade is relevant, but it has been little studied in urban freight transport (UFT) context, although it is a challenge due to the non- contemplated demand it produces and the operational limitations it imposes. Hence, UFT operational improvements (initiatives) and freight attraction models must consider informal trade for developing countries. Afour phasesapproach for characterizing the commercial areas in developing countries (considering both formal and informal establishments) is proposed and applied to ten areas in Mexico City. This characterization is required to calculate real freight trip attraction and then select and/or adapt suitable initiatives. Phase 1 aims the delimitation of the study area. The following information is obtained for each establishment of a potential area: location or geographic coordinates, industrial sector, industrial subsector, and number of employees. Phase 2 characterizes the study area and proposes a set of indicators. This allows a broad view of the operations and constraints of UFT in the study area. Phase 3 classifies the study area according to seven indicators. Each indicator represents a level of conflict in the area due to the presence of formal (registered) and informal establishments on the sidewalks and streets, affecting urban freight transport (and other activities). Phase 4 determines preliminary initiatives which could be implemented in the study area to improve the operation of UFT. The indicators and initiatives relation allows a preliminary initiatives selection. This relation requires to know the following: a) the problems in the area (congested streets, lack of parking space for freight vehicles, etc.); b) the factors which limit initiatives due to informal establishments (reduced streets for freight vehicles; mobility and parking inability during a period, among others), c) the problems in the area due to its physical characteristics; and d) the factors which limit initiatives due to regulations of the area. Several differences in the study areas were observed. As the indicators increases, the areas tend to be less ordered, and the limitations for the initiatives become higher, causing a smaller number of susceptible initiatives. In ordered areas (similar to the commercial areas of developed countries), the current techniquesfor estimating freight trip attraction (FTA) can bedirectly applied, however, in the areas where the level of order is lower due to the presence of informal trade, this is not recommended because the real FTA would not be estimated. Therefore, a technique, which consider the characteristics of the areas in developing countries to obtain data and to estimate FTA, is required. This estimation can be the base for proposing feasible initiatives to such zones. The proposed approach provides a wide view of the needs of the commercial areas of developing countries. The knowledge of these needs would allow UFT´s operation to be improved and its negative impacts to be minimized.

Keywords: freight initiatives, freight trip attraction, informal trade, urban freight transport

Procedia PDF Downloads 141

Authors: Asrarul H. Jeelani

Abstract:

Arsenic contamination of groundwater and its’ health implications in lower Gangetic plain of Indian states started reporting in the 1980s. The same period was declared as the first water decade (1981-1990) to achieve ‘water for all.’ To fulfill the aim, the Indian government, with the support of international agencies installed millions of hand-pumps through water resources development programs. The hand-pumps improve the accessibility if the groundwater, but over-extraction of it increases the chances of mixing of trivalent arsenic which is more toxic than pentavalent arsenic of dug well water in Gangetic plain and has different physical manifestations. Now after three decades, Bihar (middle Gangetic plain) is also facing arsenic contamination of groundwater and its’ health implications. Objective: This interdisciplinary research attempts to understand the health and social implications of arsenicosis among different castes in Haldi Chhapra village and to find the association of ramifications with water resources development. Methodology: The Study used concurrent quantitative dominant mix method (QUAN+qual). The researcher had employed household survey, social mapping, interviews, and participatory interactions. However, the researcher used secondary data for retrospective analysis of hand-pumps and implications of arsenicosis. Findings: The study found 88.5% (115) household have hand-pumps as a source of water however 13.8% uses purified supplied water bottle and 3.6% uses combinations of hand-pump, bottled water and dug well water for drinking purposes. Among the population, 3.65% of individuals have arsenicosis, and 2.72% of children between the age group of 5 to 15 years are affected. The caste variable has also emerged through quantitative as well as geophysical locations analysis as 5.44% of arsenicosis manifested individual belong to scheduled caste (SC), 3.89% to extremely backward caste (EBC), 2.57% to backward caste (BC) and 3% to other. Among three clusters of arsenic poisoned locations, two belong to SC and EBC. The village as arsenic affected is being discriminated, whereas the affected individual is also facing discrimination, isolation, stigma, and problem in getting married. The forceful intervention to install hand-pumps in the first water decades and later restructuring of the dug well destroyed a conventional method of dug well cleaning. Conclusion: The common manifestation of arsenicosis has increased by 1.3% within six years of span in the village. This raised the need for setting up a proper surveillance system in the village. It is imperative to consider the social structure for arsenic mitigation program as this research reveals caste as a significant factor. The health and social implications found in the study; retrospectively analyzed as the collateral impact of water resource development programs in the village.

Keywords: arsenicosis, caste, collateral impact, water resources

Procedia PDF Downloads 108

Authors: Rui Huang, Thomas Richard, Masood Mostofi

Abstract:

The lifetime of impregnated diamond bits and their drilling efficiency are in part governed by the bit wear conditions, not only the extent of the diamonds’ wear but also their exposure or protrusion out of the matrix bonding. As much as individual diamonds wear, the bonding matrix does also wear through two-body abrasion (direct matrix-rock contact) and three-body erosion (cuttings trapped in the space between rock and matrix). Although there is some work dedicated to the study of diamond bit wear, there is still a lack of understanding on how matrix erosion and diamond exposure relate to the bit drilling response and drilling efficiency, as well as no literature on the process that governs bit sharpening a procedure commonly implemented by drillers when the extent of diamond polishing yield extremely low rate of penetration. The aim of this research is (i) to derive a correlation between the wear state of the bit and the drilling performance but also (ii) to gain a better understanding of the process associated with tool sharpening. The research effort combines specific drilling experiments and precise mapping of the tool-cutting face (impregnated diamond bits and segments). Bit wear is produced by drilling through a rock sample at a fixed rate of penetration for a given period of time. Before and after each wear test, the bit drilling response and thus efficiency is mapped out using a tailored design experimental protocol. After each drilling test, the bit or segment cutting face is scanned with an optical microscope. The test results show that, under the fixed rate of penetration, diamond exposure increases with drilling distance but at a decreasing rate, up to a threshold exposure that corresponds to the optimum drilling condition for this feed rate. The data further shows that the threshold exposure scale with the rate of penetration up to a point where exposure reaches a maximum beyond which no more matrix can be eroded under normal drilling conditions. The second phase of this research focuses on the wear process referred as bit sharpening. Drillers rely on different approaches (increase feed rate or decrease flow rate) with the aim of tearing worn diamonds away from the bit matrix, wearing out some of the matrix, and thus exposing fresh sharp diamonds and recovering a higher rate of penetration. Although a common procedure, there is no rigorous methodology to sharpen the bit and avoid excessive wear or bit damage. This paper aims to gain some insight into the mechanisms that accompany bit sharpening by carefully tracking diamond fracturing, matrix wear, and erosion and how they relate to drilling parameters recorded while sharpening the tool. The results show that there exist optimal conditions (operating parameters and duration of the procedure) for sharpening that minimize overall bit wear and that the extent of bit sharpening can be monitored in real-time.

Keywords: bit sharpening, diamond exposure, drilling response, impregnated diamond bit, matrix erosion, wear rate

Procedia PDF Downloads 99