Search results for: cardio-metabolic risk factors

Authors: Mathew Nyashanu, George K. Kiggundu, Mandu S. Ekpenyong

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There is an increased number of young people engaging in early sexual relationships worldwide. Furthermore, statistics for early pregnancy among young people have also increased, especially in low and middle-income countries. This has health implications for both the parents and the baby. High uptake in family planning contraception among young people can reduce early pregnancy and subsequent negative health outcomes on the young parents and the baby. This study was set to explore the factors influencing the uptake of family planning contraceptive services among young people (18-24 years) at a community level in rural Budaka district, Uganda. The study utilised an explorative qualitative approach. The study found out that religion, partner resistance; perceived loss of libido, perceived barren, long waiting time and distance from the health facility, lack of privacy/confidentiality, excessive menstrual bleeding, cancer, and fear of having disabled babies, limited the utilisation of family planning contraceptive services while contraception as HIV prevention and child spacing encouraged young people to use family planning contraceptive services. There is a need for a culturally orientated community-based contraceptive health promotion approach to increase the uptake of family planning contraception services among young people.

Keywords: Young people, Family Planning, Contraceptives, Black sub-Sahara African

Procedia PDF Downloads 141

Authors: Lucas B. Naves, Maria José Abreu

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Reprocessing single-use device has attracted interesting on the medical environment over the last decades. The reprocessing technique was sought in order to reduce the cost of purchasing the new medical device, which can achieve almost double of the price of the reprocessed product. In this manuscript, we have done a literature review, aiming the reuse of medical device that was firstly designed for single use only, but has become, more and more, effective on its reprocessing procedure. We also show the regulation, the countries which allows this procedure, the classification of these device and also the most important issue concerning the re-utilization of medical device, how to minimizing the risk of gram positive and negative bacteria, avoid cross-contamination, hepatitis B (HBV), and C (HCV) virus, and also human immunodeficiency virus (HIV).

Keywords: reusing, reprocessing, single-use medical device, HIV, hepatitis B and C

Procedia PDF Downloads 397

Authors: Kebede Mairie, Getahun Belete, Mitike Abeba

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Background: Leishmania aethiopica is a peculiar parasite causing cutaneous leishmaniasis in Ethiopia and its mainstay treatment is Sodium Stibogluconate. However, its treatment outcome in Ethiopia is not well documented. Objectives: To determine the treatment outcome of admitted cutaneous leishmaniasis patients and its associated factors in Addis Ababa, Ethiopia. Methods: A retrospective study was conducted from 1st November 2021 to 30th March 2022. Medical records of all cutaneous leishmaniasis-diagnosed and admitted patients who received parenteral sodium stibogluconate at All Africa Leprosy Rehabilitation and Training Center (ALERT) hospital, the main Leishmania treatment center in Ethiopia from July 2011 to September 2021 were reviewed. Results: A total of 827 charts of admitted cases from July 2011 to September 2021 were retrieved, but 667 (80.65%) were reviewed. Improvement in the treatment outcome was recorded in 93.36 % in the first course of SSG treatment and 96.23%, 94.62%, and 96.97% subsequently in the second, third and fourth treatment courses, respectively. Female gender and diffuse cutaneous leishmaniasis were the two predictive determinants in the treatment of cutaneous leishmaniasis. Conclusion: The study shows that parenteral sodium stibogluconate therapy treats hospitalized cutaneous leishmaniasis patients well, with female gender and diffuse cutaneous leishmaniasis having poor outcomes suggesting the need for a different approach for diffuse cutaneous leishmaniasis patients.

Keywords: cutaneous leishmaniasis, leishmania aethiopica, sodium stibogluconate, diffuse cutaneous leishmaniasis, pentostam

Procedia PDF Downloads 80

Authors: Kimberley Rain Miner, Karl Kreutz, Larry LeBlanc

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During the period of 1950-1970 persistent organic pollutants such as DDT, dioxin and PCB were released in the atmosphere and distributed through precipitation into glaciers throughout the world. Recent abrupt climate change is increasing the melt rate of these glaciers, introducing the toxins to the watershed. Studies have shown the existence of legacy pollutants in glacial ice, but neither the impact nor quantity of these toxins on downstream populations has been assessed. If these pollutants are released at toxic levels it will be necessary to create a mitigation plan to lower their impact on the affected communities.

Keywords: climate change, adaptation, mitigation, risk management

Procedia PDF Downloads 364

Authors: Zhen Li, Chang Liu, Ping Zhang

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These Glaciers are thought of as natural water reservoirs and are of vital importance to hydrological models and industrial production, and glacial changes act as significant indicators of climate change. The glacier snowline can be used as an indicator of the equilibrium line, which may be a key parameter to study the effect of climate change on glaciers. Using Google Earth Engine, we select optical satellite imageries and implement the Otsu thresholding method on a near-infrared band to detect snowline altitudes (SLAs) of 26 glaciers in three regions of the eastern Tibetan Plateau. Three different study regions in the eastern Tibetan Plateau have different climate regimes, which are Sepu Kangri (SK, maritime glacier), Bu’Gyai Kangri (BK, continental glacier) and west of Qiajajima (WQ, continental glacier), along a latitudinal transect from south to north. We analyzed the effects of climatic factors on the SLA changes from 1995 to 2016. SLAs are fluctuating upward, and the rising values are 100 m, 60 m, and 34 m from south to north during the 22 years. We also observed that the climatic factor that affects the variability of SLA gradually changes from precipitation to temperature from south to north. The northern continental glaciers are mainly affected by temperature, and the southern maritime glaciers affected by precipitation. Owing to the influence of primary climatic factors, continental glaciers are found to have higher SLAs on the south slope, while maritime glaciers have higher SLAs on the north slope.

Keywords: climate change, glacier, snowline altitude, tibetan plateau

Procedia PDF Downloads 155

Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli

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Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.

Keywords: physicians, e-prescribing, health care system, pharmacists

Procedia PDF Downloads 131

Authors: Alireza Behfar, Mohammad Mahdavi

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Nowadays, in the light of progress in the world of science, technology and communications, mastery of learning international languages is a sure and needful matter. In learning any language as a second language, progress and achieving a desirable level in speaking is indeed important for approximately all learners. In this research, we find out how preparation can influence L2 learners' oral fluency with respect to individual differences in working memory capacity. The participants consisted of sixty-one advanced L2 learners including MA students of TEFL at Isfahan University as well as instructors teaching English at Sadr Institute in Isfahan. The data collection consisted of two phases: A working memory test (reading span test) and a picture description task, with a one-month interval between the two tasks. Speaking was elicited through speech generation task in which the individuals were asked to discuss four topics emerging in two pairs. The two pairs included one simple and one complex topic and was accompanied by planning time and without any planning time respectively. Each topic was accompanied by several relevant pictures. L2 fluency was assessed based on preparation. The data were then analyzed in terms of the number of syllables, the number of silent pauses, and the mean length of pauses produced per minute. The study offers implications for strategies to improve learners’ both fluency and working memory.

Keywords: two factors, fluency, working memory capacity, preparation, L2 speech production reading span test picture description

Procedia PDF Downloads 235

Authors: Goran Sporiš, Dinko Vuleta, Stefan Lovro

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The purpose of the present study was to determine the associations between health-related quality of life (HRQOL) and physical activity (PA) in different domains. In this cross-sectional study, participants were 169 Croatian police officers (mean age 35.14±8.95 yrs, mean height 180.93±7.53 cm, mean weight 88.39±14.05 kg, mean body-mass index 26.90±3.39 kg/m2). The dependent variables were two general domains extracted from the HRQOL questionnaire: (1) physical component scale (PCS) and (2) mental component scale (MCS). The independent variables were job-related, transport, domestic and leisure-time PA, along with other factors: age, body-mass index, smoking status, psychological distress, socioeconomic status and time spent in sedentary behaviour. The associations between dependent and independent variables were analyzed by using multiple regression analysis. Significance was set up at p < 0.05. PCS was positively associated with leisure-time PA (β 0.28, p < 0.001) and socioeconomic status (SES) (β 0.16, p=0.005), but inversely associated with job-related PA (β -0.15, p=0.012), domestic-time PA (β -0.14, p=0.014), age (β -0.12, p=0.050), psychological distress (β -0.43, p<0.001) and sedentary behaviour (β -0.15, p=0.009). MCS was positively associated with leisure-time PA (β 0.19, p=0.013) and SES (β 0.20, p=0.002), while inversely associated with age (β -0.23, p=0.001), psychological distress (β -0.27, p<0.001) and sedentary behaviour (β -0.22, p=0.001). Our results added new information about the associations between domain-specific PA and both physical and mental component scale in police officers. Future studies should deal with the same associations in other stressful occupations.

Keywords: health, fitness, police force, relations

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Authors: Theresa Chinyere ONU

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This paper examines the effect of social terrorism on education in Nigeria. The article looked into some prevailing conditions of international political unrest and insecurity. The fear and risk of these conditions to national security and the struggle for power establishment which has further intensified and taken the shape of terrorism has imposed devastating effects on the growth and prosperity of Nigeria; as traffic patterns get disturbed, hospitals and schools get dysfunctional. This has also affected the educational standard in Nigeria as parents are no longer comfortable in sending their children to schools in some states for the fear of terrorist attacks. The study emphasized the integrated the effort of the government management institutions.

Keywords: education, social terrorism, women, Nigeria

Procedia PDF Downloads 588

Authors: Aaditya U. Jhamb

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Due to the current energy crisis that many countries are battling, energy-efficient buildings are the subject of extensive research in the modern technological era because of growing worries about energy consumption and its effects on the environment. The paper explores 8 factors that help determine energy efficiency for a building: (relative compactness, surface area, wall area, roof area, overall height, orientation, glazing area, and glazing area distribution), with Tsanas and Xifara providing a dataset. The data set employed 768 different residential building models to anticipate heating and cooling loads with a low mean squared error. By optimizing these characteristics, machine learning algorithms may assess and properly forecast a building's heating and cooling loads, lowering energy usage while increasing the quality of people's lives. As a result, the paper studied the magnitude of the correlation between these input factors and the two output variables using various statistical methods of analysis after determining which input variable was most closely associated with the output loads. The most conclusive model was the Decision Tree Regressor, which had a mean squared error of 0.258, whilst the least definitive model was the Isotonic Regressor, which had a mean squared error of 21.68. This paper also investigated the KNN Regressor and the Linear Regression, which had to mean squared errors of 3.349 and 18.141, respectively. In conclusion, the model, given the 8 input variables, was able to predict the heating and cooling loads of a residential building accurately and precisely.

Keywords: energy efficient buildings, heating load, cooling load, machine learning models

Procedia PDF Downloads 102

Authors: Amin Kaveh Boukani

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Foreign language learning is not straightforward and can be affected by numerous factors, among which personality features like tolerance of ambiguity (TA) are so well-known and important. Such characteristics yet can be affected by other factors like learning additional languages. The current investigation, thus, opted to explore the possible effect of linguistic background (being bilingual or trilingual) on the tolerance of ambiguity (TA) of Iranian EFL learners. Furthermore, the possible mediating effect of TA on multilingual learners' language performance (listening comprehension in this study) was expounded. This research involved 68 EFL learners (32 bilinguals, 29 trilinguals) with the age range of 19-29 doing their degrees in the Department of English Language and Literature of Urmia University. A set of questionnaires, including tolerance of ambiguity (Herman et. al., 2010) and linguistic background information (Modirkhameneh, 2005), as well as the IELTS listening comprehension test, were used for data collection purposes. The results of a set of independent samples t-test and mediation analysis (Hayes, 2022) showed that (1) linguistic background (being bilingual or trilingual) had a significant direct effect on EFL learners' TA, (2) Linguistic background had a significant direct influence on listening comprehension, (3) TA had a substantial direct influence on listening comprehension, and (4) TA moderated the influence of linguistic background on listening comprehension considerably. These results suggest that multilingualism may be considered as an advantageous asset for EFL learners and should be a prioritized characteristic in EFL instruction in multilingual contexts. Further pedagogical implications and suggestions for research are proposed in light of effective EFL instruction in multilingual contexts.

Keywords: tolerance of ambiguity, listening comprehension, multilingualism, bilingual, trilingual

Procedia PDF Downloads 66

Authors: Pedro Augusto Da Silva E Souza Miranda, Niloofar Jalali, Shweta Mistry

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BACKGROUND: Software developers utilize automated solutions to scrape users’ reviews to extract meaningful knowledge to identify problems (e.g., bugs, compatibility issues) and possible enhancements (e.g., users’ requests) to their solutions. However, most of these solutions do not consider the health risk aspects to users. Recent works have shed light on the importance of including health risk considerations in the development cycle of mHealth apps to prevent harm to its users. PROBLEM: The COVID-19 Pandemic in Canada (and World) is currently forcing physical distancing upon the general population. This new lifestyle made the usage of mHealth applications more essential than ever, with a projected market forecast of 332 billion dollars by 2025. However, this new insurgency in mHealth usage comes with possible risks to users’ health due to mHealth apps problems (e.g., wrong insulin dosage indication due to a UI error). OBJECTIVE: These works aim to raise awareness amongst mHealth developers of the importance of considering risks to users’ health within their development lifecycle. Moreover, this work also aims to help mHealth developers with a Proof-of-Concept (POC) solution to understand, process, and identify possible health risks to users of mHealth apps based on users’ reviews. METHODS: We conducted a mixed-method study design. We developed a crawler to mine the negative reviews from two samples of mHealth apps (my fitness, medisafe) from the Google Play store users. For each mHealth app, we performed the following steps: • The reviews are divided into two groups, before starting the COVID-19 (reviews’ submission date before 15 Feb 2019) and during the COVID-19 (reviews’ submission date starts from 16 Feb 2019 till Dec 2020). For each period, the Latent Dirichlet Allocation (LDA) topic model was used to identify the different clusters of reviews based on similar topics of review The topics before and during COVID-19 are compared, and the significant difference in frequency and severity of similar topics are identified. RESULTS: We successfully scraped, filtered, processed, and identified health-related topics in both qualitative and quantitative approaches. The results demonstrated the similarity between topics before and during the COVID-19.

Keywords: natural language processing (NLP), topic modeling, mHealth, COVID-19, software engineering, telemedicine, health risks

Procedia PDF Downloads 133

Authors: George Fomunyam Kehdinga

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Assessment is a vital part of the educational process, and formative assessment is a way of ensuring that higher education achieves the desired effects. Different factors influence how students perform in assessments in general, and formative assessment in particular and temperament is one of such determining factors. This paper which is a qualitative case study of four universities in four different countries examines how the temperamental make up of students either empowers them to perform excellently in formative assessment or incapacitates their performance. These four universities were chosen from Cameroon, South Africa, United Kingdom and the United States of America and three students were chosen from each institution, six of which were undergraduate student and six postgraduate students. Data in this paper was generated through qualitative interviews and document analyses which was preceded by a temperament test. From the data generated, it was discovered that cholerics who are natural leaders, hence do not struggle to express themselves often perform excellently in formative assessment while sanguines on the other hand who are also extroverts like cholerics perform relatively well. Phlegmatics and melancholics performed averagely and poorly respectively in formative assessment because they are naturally prone to fear and hate such activities because they like keeping to themselves. The paper, therefore, suggest that temperament is a success determinant in formative assessment. It also proposes that lecturers need and understanding of temperaments to be able to fully administer formative assessment in the lecturer room. It also suggests that assessment should be balance in the classroom so that some students because of their temperamental make-up are not naturally disadvantaged while others are performing excellently. Lastly, the paper suggests that since formative assessment is a process of generating data, it should be contextualised or given and individualised approach so as to ensure that trustworthy data is generated.

Keywords: temperament, formative assessment, academic success, students

Procedia PDF Downloads 250

Authors: Chatcai Tangsri, Onjaree Na-Takuatoong

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This paper aims to present the key factors that support the decision to use the technology and to present the knowledge transformation flow of visually impaired students after the use of virtual knowledge system as proposed as a new service innovation to universities in Thailand. Correspondents of 27 visually impaired students are involved in this research. Total of 25 students are selected from the University that mainly conducts non-classroom teaching environment; while another 2 visually impaired students are selected from classroom teaching environment. All of them are fully involved in the study along 8 weeks duration. All correspondents are classified into 5 small groups in various conditions. The research results revealed that the involvement from knowledge facilitator can push out for the behavioral actual use of the virtual knowledge system although there is no any developed intention to use behaviors. Secondly, the situations that the visually impaired students inadequate of the knowledge sources that usually provided by assistants i.e. peers, audio files etc. In this case, they will use the virtual knowledge system for both knowledge access and knowledge transfer request. With this evidence, the need of knowledge would play a stronger role than all technology acceptance factors. Finally, this paper revealed that the knowledge transfer in the normal method that students have a chance to physically meet up is still confirmed as their preference method. In term of other aspects of technology acceptance, it will be discussed together with challenges and recommendations at the end of this paper.

Keywords: knowledge system, visually impaired students, higher education, knowledge management enable technology, synchronous/asynchronous knowledge access, synchronous/asynchronous knowledge transfer

Procedia PDF Downloads 359

Authors: Farzad Tofigh, Saeideh Najafi, Reza Heidari, Rashid Jamei

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In order to study the effects of magnetic field on the root system and growth of Phaseolus vulgaris, an experiment was conducted in 2012. The possible involvement of magnetic field (MF) pretreatment in physiological factors of Phaseolus vulgaris was investigated. Seeds were subjected to 10 days with 1.8 mT of magnetic field for 1h per day. MF pretreatment decreased the plant height, fresh and dry weight, length of root and length of shoot, Chlorophyll a, Chlorophyll b and carotenoid in 10 days old seedling. In addition, activity of enzymes such as Catalase and Guaiacol peroxidase was decreased due to MF exposure. Also, the total Protein and DPPH content of the treated by magnetic field was not significantly changed in compare to control groups, while the flavonoid, Phenol and prolin content of the treated of the treated by magnetic field was significantly changed in compare to control groups. Lateral branches of roots and secondary roots increased with MF. The results suggest that pretreatment of this MF plays important roles in changes in crop productivity. In all cases there was observed a slight stimulating effect of the factors examined. The growth dynamics were weakened. The plants were shorter. Moreover, the effect of a magnetic field on the crop of Phaseolus vulgaris and its structure was small.

Keywords: carotenoid, chlorophyll a, chlorophyll b, DPPH, enzymes, flavonoid, germination, growth, phenol, proline, protein, magnetic field

Procedia PDF Downloads 509

Authors: Afsaneh Jasmine Majidi

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Language testing is an important part of language teaching experience and language learning process as it presents assessment strategies for teachers to evaluate the efficiency of teaching and for learners to examine their outcomes. However, language testing is demanding and challenging because it should provide the opportunity for proper and objective decision. In addition to all the efforts test designers put to design valid and reliable tests, there are some other determining factors which are even more complex and complicated. These factors affect the educational system, individuals, and society, and the impact of the tests vary according to the scope of the test. Seemingly, the impact of a simple classroom assessment is not the same as that of high stake tests such as International English Language Testing System (IELTS). As the importance of the test increases, it affects wider domain. Accordingly, the impacts of high stake tests are reflected not only in teaching, learning strategies but also in society. Testing experts use the term ‘washback’ or ‘impact’ to define the different effects of a test on teaching, learning, and community. This paper first looks at the theoretical background of ‘washback’ and ‘impact’ in language testing by reviewing of relevant literature in the field and then investigates washback effects of IELTS test of on Iranian IELTS teachers and students. The study found significant relationship between the washback effect of IELTS test and teaching strategies of Iranian IELTS teachers as well as performance of Iranian IELTS candidates and their community.

Keywords: high stake tests, IELTS, Iranian Candidates, language testing, test impact, washback

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Authors: Yasaman Mohammadi

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Executive functions are a critical component of goal-directed behavior, encompassing a diverse set of cognitive processes such as working memory, cognitive flexibility, and inhibitory control. These functions are known to decline with age, but the precise mechanisms underlying this decline remain unclear. This paper provides an in-depth review of recent research investigating age-related changes in executive functions, drawing on insights from neuroimaging, genetics, and cognitive neuroscience. Through an interdisciplinary approach, this paper offers a nuanced understanding of the complex interplay between neural mechanisms, genetic factors, and cognitive processes that contribute to executive function decline in aging. Here, we investigate how different neuroimaging methods, like functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), have helped scientists better understand the brain bases for age-related declines in executive function. Additionally, we discuss the role of genetic factors in mediating individual differences in executive functions across the lifespan, as well as the potential for cognitive interventions to mitigate age-related decline. Overall, this paper presents a comprehensive and integrative view of the current state of knowledge regarding age-related changes in executive functions. It underscores the need for continued interdisciplinary research to fully understand the complex and dynamic nature of executive function decline in aging, with the ultimate goal of developing effective interventions to promote healthy cognitive aging.

Keywords: executive functions, aging, neuroimaging, cognitive neuroscience, working memory, cognitive training

Procedia PDF Downloads 74

Authors: Mohammad Akbar Paiman, Yasmin Nadeem Parpio, Naureen Akbarali, Khwaja Mir Islam Saeed, Murad Moosa Khan

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Background: Gender-based violence (GBV) is widely considered a significant public health problem that is associated with acute morbidity and mortality. GBV is commonly understood as a physical, sexual, and mental assault from intimate partners, sexual violence by non-partners, sexual assault of girls, and acts like trafficking women for sex. Objective: This study aimed to determine the factors associated with injuries and trauma among victims of GBV in Afghanistan. Method: We conducted a record-based analysis of the data collected by the Gender Department of the Family Protection Centre nationally between November 2013 and October 2019. Cross-tabulation between different variables such as age, sex, marital status, and type of violence and associations between different types of violence, age, gender, and geographical location was determined using the logistic regression model. Results: During the study period, there were a total of 58,160 GBV in Afghanistan. Most of the victims were women 98% with over three-quarters being adults 78%. Most of the victims were married 76%, followed by single 14%, widowed 5%, and engaged 5%. Over three-quarters of the violence, 73% was observed in the victim’s house while nearly one-quarter of the violence 24 % occurred in the perpetrator’s house. Conclusions: GBV is a significant public health problem in Afghanistan that needs to be addressed at multiple levels including policy, state, and community as well as by raising public awareness and education and a strong code of conduct against GBV by all stakeholders.

Keywords: gender-based violence, physical and psychological violence, injuries, Afghanistan

Procedia PDF Downloads 59

Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

Procedia PDF Downloads 238

Authors: Olivera Lupescu, Taina Elena Avramescu, Mihail Nagea, Alexandru Dimitriu

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Acetabular fractures represent a real challenge due to their impact upon the long term function of the hip joint, and due to the risk of intra- and peri-operative complications especially that they affect young, active people. That is why treating these fractures require certain skills which must be exercised, regarding the pre-operative planning, as well as the execution of surgery.The authors retrospectively analyse 38 cases with acetabular fractures operated using the posterior approach in our hospital between 01.01.2013- 01.01.2015 for which complete medical records ensure a follow-up of 24 months, in order to establish the main causes of potential errors and to underline the methods for preventing them. This target is included in the Erasmus + project ‘Collaborative learning for enhancing practical skills for patient-focused interventions in gait rehabilitation after orthopedic surgery COR-skills’. This paper analyses the pitfalls revealed by these cases, as well as the measures necessary to enhance the practical skills of the surgeons who perform acetabular surgery. Pre-op planning matched the intra and post-operative outcome in 88% of the analyzed points, from 72% at the beginning to 94% in the last case, meaning that experience is very important in treating this injury. The main problems detected for the posterior approach were: nervous complications - 3 cases, 1 of them a complete paralysis of the sciatic nerve, which recovered 6 months after surgery, and in other 2 cases intra-articular position of the screws was demonstrated by post-operative CT scans, so secondary screw removal was necessary in these cases. We analysed this incident, too, due to lack of information about the relationship between the screws and the joint secondary to this approach. Septic complications appeared in 3 cases, 2 superficial and 1 profound (requiring implant removal). The most important problems were the reduction of the fractures and the positioning of the screws so as not to interfere with the the articular space. In posterior acetabular fractures, pre-op complex planning is important in order to achieve maximum treatment efficacy with minimum of risk; an optimal training of the surgeons insisting on the main points of potential mistakes ensure the success of the procedure, as well as a favorable outcome for the patient.

Keywords: acetabular fractures, articular congruency, surgical skills, vocational training

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Authors: Artsiom Zinchanka

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The world faces now one of the largest migration crisis and the European Union meets challenges in accepting the flow of migrants that could not be handled finally at this step. This crisis is complicated with many factors, such as military conflict in the Middle East; absence of the appropriate conditions in the refugees’ camps; but also with the complicity of the migration flow consisting of the Sub-Saharan migrants. This type of migrants leave their homelands for many reasons including poverty, not appropriate level of social and economic conditions, absence of infrastructure and access to the education and medical care. In practice, when the restrictive approach directed to limit the flow of illicit migration and to send illicit migrants back to their homelands is not always working, the approach directed to the root causes of the migration crisis can be more effective in settling the crisis. The Cotonou Agreement and the following treaties concluded between the European Union, and Sub-Saharan states show that the European Union considers the development of human rights and appropriate social and economic conditions in the Sub-Saharan states as one of the most important factors addressing the migration crisis. The preventive approach as the efforts of the European Union to develop appropriate social and economic conditions in Sub-Saharan states is considered in this article, as well as its evolution and current condition. This article also considers pros and cons of this approach and the obstacles that this approach faces. The research methods include review of literature and documents, analytical and descriptive methods.

Keywords: migration crisis, preventive approach, Sub-Saharan States, the European Union

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Authors: Dharshini M., Hema N. S.

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The project for the production of aniline is done by providing 295.46 tons per day of nitrobenzene as feed. The material and energy balance calculations for the different equipment like distillation column, heat exchangers, reactor and mixer are carried out with simulation via DWSIM. The conversion of nitrobenzene to aniline by hydrogenation process is considered to be 96% and the total production of the plant was found to be 215 TPD. The cost estimation of the process is carried out to estimate the feasibility of the plant. The net profit and percentage return of investment is estimated to be ₹27 crores and 24.6%. The payback period was estimated to be 4.05 years and the unit production cost is ₹113/kg. A techno-economic analysis was performed for the production of aniline; the result includes economic analysis and sensitivity analysis of critical factors. From economic analysis, larger the plant scale increases the total capital investment and annual operating cost, even though the unit production cost decreases. Uncertainty analysis was performed to predict the influence of economic factors on profitability and the scenario analysis is one way to quantify uncertainty. In scenario analysis the best-case scenario and the worst-case scenario are compared with the base case scenario. The best-case scenario was found at a feed rate of 120 kmol/hr with a unit production cost of ₹112.05/kg and the worst-case scenario was found at a feed rate of 60 kmol/hr with a unit production cost of ₹115.9/kg. The base case is closely related to the best case by 99.2% in terms of unit production cost. since the unit production cost is less and the profitability is more with less payback time, it is feasible to construct a plant at this capacity.

Keywords: aniline, nitrobenzene, economic analysis, unit production cost

Procedia PDF Downloads 112

Authors: Emma E. Hellawell, Susan J. Hughes

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BBrownfield sites are currently being redeveloped for residential use. Information on soil contamination on these former industrial sites is collected as part of the planning process by the local government. This research project analyses this untapped resource of environmental data, using site investigation data submitted to a local Borough Council, in Surrey, UK. Over 150 site investigation reports were collected and interrogated to extract relevant information. This study involved three phases. Phase 1 was the development of a database for soil contamination information from local government reports. This database contained information on the source, history, and quality of the data together with the chemical information on the soil that was sampled. Phase 2 involved obtaining site investigation reports for development within the study area and extracting the required information for the database. Phase 3 was the data analysis and interpretation of key contaminants to evaluate typical levels of contaminants, their distribution within the study area, and relating these results to current guideline levels of risk for future site users. Preliminary results for a pilot study using a sample of the dataset have been obtained. This pilot study showed there is some inconsistency in the quality of the reports and measured data, and careful interpretation of the data is required. Analysis of the information has found high levels of lead in shallow soil samples, with mean and median levels exceeding the current guidance for residential use. The data also showed elevated (but below guidance) levels of potentially carcinogenic polyaromatic hydrocarbons. Of particular concern from the data was the high detection rate for asbestos fibers. These were found at low concentrations in 25% of the soil samples tested (however, the sample set was small). Contamination levels of the remaining chemicals tested were all below the guidance level for residential site use. These preliminary pilot study results will be expanded, and results for the whole local government area will be presented at the conference. The pilot study has demonstrated the potential for this extensive dataset to provide greater information on local contamination levels. This can help inform regulators and developers and lead to more targeted site investigations, improving risk assessments, and brownfield development.

Keywords: Brownfield development, contaminated land, local government planning data, site investigation

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Authors: Ali Alahmari

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Urban drainage in Saudi Arabia is an increasingly challenging issue due to factors such as climate change and rapid urban expansion. The existing infrastructure, based on traditional drainage systems, is not always able to cope with the increased precipitation, sometimes leading to rainwater runoff and floods causing disturbances and damage to property. Therefore, there is a need to find new ways of managing drainage, such as Sustainable Urban Drainage Systems (SUDS). The research has highlighted the main driving forces behind the need for change, revealed by the participants, to the need to adopt new ideas and approaches for urban drainage. However, while moving towards this, certain factors that may hinder the aim of using the experiences of other countries and taking advantage of innovative solutions. The research illustrates an initial conceptual model for these factors emerging from the analysis. It identifies some of the fundamental issues affecting the resistance to change towards the adoption of the concept of sustainability in Saudi Arabia, with Riyadh city as a case study. This was by using a qualitative approach, whereby, through two phases of fieldwork during 2013 and 2014, twenty-six semi-structured interviews were conducted with a number of representative officials and professionals from key government departments and organisations related to urban drainage management. Grounded Theory approach was followed to analyse the qualitative data obtained. Resistance to change was classified to: firstly: individual inertia (e.g. familiarity with the conventional solutions and approaches, lack of awareness, and considering sustainability as a marginal matter in urban planning). This resulted in not paying the desired attention, and impact on planning and setting priorities for development. Secondly: institutionalised inertia (e.g. lack of technical and design specifications for other unconventional drainage solutions, lack of consideration by decision makers in other disciplines such as contributions from environmental and geographical studies, and routine work and bureaucracy). This contributes to the weakness of decision-making, weakness in the role of research, and a lack of human resources. It seems that attitudes towards change may have reduced the ability to move forward towards sustainable development, in addition to contributing towards difficulties in some aspects of the decision-making process. Thus, the chapter provides insights into the current situation in Saudi Arabia and contributes to understanding the decisions that are made regarding change.

Keywords: climate change, new knowledge and approaches, resistance to change, Saudi Arabia, SUDS, urban drainage, urban expansion

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Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

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Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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Authors: Abdul Manan

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The necessity for efficient and cost-effective energy storage devices to intelligently store the inconsistent energy output from modern renewable energy sources is peaked today. The scientific community is struggling to identify the appropriate material system for energy storage applications. Countless contributions by researchers worldwide have now helped us identify the possible snags and limitations associated with each material/method. Energy storage has attracted great attention for its use in portable electronic devices military field. Different devices, such as dielectric capacitors, supercapacitors, and batteries, are used for energy storage. Of these, dielectric capacitors have high energy output, a long life cycle, fast charging and discharging capabilities, work at high temperatures, and excellent fatigue resistance. The energy storage characteristics have been studied to be highly affected by various factors, such as grain size, optimized compositions, grain orientation, energy band gap, processing techniques, defect engineering, core-shell formation, interface engineering, electronegativity difference, the addition of additives, density, secondary phases, the difference of Pmax-Pr, sample thickness, area of the electrode, testing frequency, and AC/DC conditions. The data regarding these parameters/factors are scattered in the literature, and the aim of this study is to gather the data into a single paper that will be beneficial for new researchers in the field of interest. Furthermore, control over and optimizing these parameters will lead to enhancing the energy storage properties.

Keywords: strategies, ceramics, energy storage, capacitors

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Authors: Aliakbar Golshani, Seyyed Mehdi Poorhashemi, Mahsa Gharizadeh

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The under passing tunnels are strongly influenced by the soils around. There are some complexities in the specification of real soil behavior, owing to the fact that lots of uncertainties exist in soil properties, and additionally, inappropriate soil constitutive models. Such mentioned factors may cause incompatible settlements in numerical analysis with the obtained values in actual construction. This paper aims to report a case study on a specific tunnel constructed by NATM. The tunnel has a depth of 11.4 m, height of 12.2 m, and width of 14.4 m with 2.5 lanes. The numerical modeling was based on a 2D finite element program. The soil material behavior was modeled by hardening soil model. According to the field observations, the numerical estimated settlement at the ground surface was approximately four times more than the measured one, after the entire installation of the initial lining, indicating that some unknown factors affect the values. Consequently, the geotechnical parameters are accurately revised by a numerical back-analysis using laboratory and field test data and based on the obtained monitoring data. The obtained result confirms that typically, the soil parameters are conservatively low-estimated. And additionally, the constitutive models cannot be applied properly for all soil conditions.

Keywords: NATM tunnel, initial lining, laboratory test data, numerical back-analysis

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Authors: Jerzy Bański

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The purpose of the paper is to describe the role of urban-rural partnership in social and economic development. The concept of urban-rural collaboration is relatively new and assumes the need to link large metropolitan areas with surrounding rural areas in a number of ways. It is strongly related to the existing concept of polycentric spatial development. At the European Union level, the first document to address the need for urban-rural partnerships was the European Spatial Development Perspective from 1999. The paper focuses on factors that generate social and economic success on examples of several metropolitan territories in Poland (Warsaw, Poznan, Wroclaw, Krakow). A survey focused on rural communes made it possible to assess key success factors (location, social and economic, technological and organizational) that could be later used to determine the right course of action in the area of urban-rural cooperation, with the desired outcome being effective metropolitan area development. The main challenges to urban-rural partnership are issues associated with spatial planning, infrastructure and public services. These are areas of the greatest conflict of interest, too. Any analysis of urban-rural cooperation in metropolitan areas really needs to focus on the unique nature of this type of relationship. This includes issues such as commuting to work in the urban core and vice versa, complementarity of technical infrastructure, and joint strategic planning. Other forms of cooperation should focus on the tourist and recreational aspects of areas surrounding the urban core.

Keywords: partnership, rural areas, urbanization, metropolitan areas, Poland

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Authors: Arosha Rashmi De Silva, Ananda Chandrasekara

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This study seeks to comprehensively examine the influence of fast-food consumption and physical activity levels on the body weight of young employees within the private sector of Sri Lanka. The escalating popularity of fast food has raised concerns about its nutritional content and associated health ramifications. To investigate this phenomenon, a cohort of 100 individuals aged between 25 and 45, employed in Sri Lanka's private sector, participated in this research. These participants provided socio-demographic data through a standardized questionnaire, enabling the characterization of their backgrounds. Additionally, participants disclosed their frequency of fast-food consumption and engagement in physical activities, utilizing validated assessment tools. The collected data was meticulously compiled into an Excel spreadsheet and subjected to rigorous statistical analysis. Descriptive statistics, such as percentages and proportions, were employed to delineate the body weight status of the participants. Employing chi-square tests, our study identified significant associations between fast-food consumption, levels of physical activity, and body weight categories. Furthermore, through binary logistic regression analysis, potential risk factors contributing to overweight and obesity within the young employee cohort were elucidated. Our findings revealed a disconcerting trend, with 6% of participants classified as underweight, 32% within the normal weight range, and a substantial 62% categorized as overweight or obese. These outcomes underscore the alarming prevalence of overweight and obesity among young private-sector employees, particularly within the bustling urban landscape of Colombo, Sri Lanka. The data strongly imply a robust correlation between fast-food consumption, sedentary behaviors, and higher body weight categories, reflective of the evolving lifestyle patterns associated with the nation's economic growth. This study emphasizes the urgent need for effective interventions to counter the detrimental effects of fast-food consumption. The implementation of awareness campaigns elucidating the adverse health consequences of fast food, coupled with comprehensive nutritional education, can empower individuals to make informed dietary choices. Workplace interventions, including the provision of healthier meal alternatives and the facilitation of physical activity opportunities, are essential in fostering a healthier workforce and mitigating the escalating burden of overweight and obesity in Sri Lanka

Keywords: fast food consumption, obese, overweight, physical activity level

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Authors: Nadzeya Marozkina, Joe Zein, Benjamin Gaston

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Introduction: We have observed that many patients with Primary Ciliary Dyskinesia (PCD) benefit from asthma medications. In healthy airways, the ciliary function is normal. Antigens and irritants are rapidly cleared, and NO enters the gas phase normally to be exhaled. In the PCD airways, however, antigens, such as Dermatophagoides, are not as well cleared. This defect leads to oxidative stress, marked by increased DUOX1 expression and decreased superoxide dismutase [SOD] activity (manuscript under revision). H₂O₂, in high concentrations in the PCD airway, injures the airway. NO is oxidized rather than being exhaled, forming cytotoxic peroxynitrous acid. Thus, antigen stasis on PCD airway epithelium leads to airway injury and may predispose PCD patients to asthma. Indeed, recent population genetics suggest that PCD genes may be associated with asthma. We therefore hypothesized that PCD patients would be predisposed to having asthma. Methods. We analyzed our database of 18 million individual electronic medical records (EMRs) in the Indiana Network for Patient Care research database (INPCR). There is not an ICD10 code for PCD itself; code Q34.8 is most commonly used clinically. To validate analysis of this code, we queried patients who had an ICD10 code for both bronchiectasis and situs inversus totalis in INPCR. We also studied a validation cohort using the IBM Explorys® database (over 80 million individuals). Analyses were adjusted for age, sex and race using a 1 PCD: 3 controls matching method in INPCR and multivariable logistic regression in the IBM Explorys® database. Results. The prevalence of asthma ICD10 codes in subjects with a code Q34.8 was 67% vs 19% in controls (P < 0.0001) (Regenstrief Institute). Similarly, in IBM*Explorys, the OR [95% CI] for having asthma if a patient also had ICD10 code 34.8, relative to controls, was =4.04 [3.99; 4.09]. For situs inversus alone the OR [95% CI] was 4.42 [4.14; 4.71]; and bronchiectasis alone the OR [95% CI] =10.68 (10.56; 10.79). For both bronchiectasis and situs inversus together, the OR [95% CI] =28.80 (23.17; 35.81). Conclusions: PCD causes antigen stasis in the human airway (under review), likely predisposing to asthma in addition to oxidative and nitrosative stress and to airway injury. Here, we show that, by several different population-based metrics, and using two large databases, patients with PCD appear to have between a three- and 28-fold increased risk of having asthma. These data suggest that additional studies should be undertaken to understand the role of ciliary dysfunction in the pathogenesis and genetics of asthma. Decreased antigen clearance caused by ciliary dysfunction may be a risk factor for asthma development.

Keywords: antigen, PCD, asthma, nitric oxide

Procedia PDF Downloads 111