Search results for: customer service delivery
267 Analysis of Distance Travelled by Plastic Consumables Used in the First 24 Hours of an Intensive Care Admission: Impacts and Methods of Mitigation
Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans
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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.Keywords: CO2, intensive care, plastic, transport
Procedia PDF Downloads 170266 Bioinspired Green Synthesis of Magnetite Nanoparticles Using Room-Temperature Co-Precipitation: A Study of the Effect of Amine Additives on Particle Morphology in Fluidic Systems
Authors: Laura Norfolk, Georgina Zimbitas, Jan Sefcik, Sarah Staniland
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Magnetite nanoparticles (MNP) have been an area of increasing research interest due to their extensive applications in industry, such as in carbon capture, water purification, and crucially, the biomedical industry. The use of MNP in the biomedical industry is rising, with studies on their effect as Magnetic resonance imaging contrast agents, drug delivery systems, and as hyperthermic cancer treatments becoming prevalent in the nanomaterial research community. Particles used for biomedical purposes must meet stringent criteria; the particles must have consistent shape and size between particles. Variation between particle morphology can drastically alter the effective surface area of the material, making it difficult to correctly dose particles that are not homogeneous. Particles of defined shape such as octahedral and cubic have been shown to outperform irregular shaped particles in some applications, leading to the need to synthesize particles of defined shape. In nature, highly homogeneous MNP are found within magnetotactic bacteria, a unique bacteria capable of producing magnetite nanoparticles internally under ambient conditions. Biomineralisation proteins control the properties of the MNPs, enhancing their homogeneity. One of these proteins, Mms6, has been successfully isolated and used in vitro as an additive in room-temperature co-precipitation reactions (RTCP) to produce particles of defined mono-dispersed size & morphology. When considering future industrial scale-up it is crucial to consider the costs and feasibility of an additive, as an additive that is not readily available or easily synthesized at a competitive price will not be sustainable. As such, additives selected for this research are inspired by the functional groups of biomineralisation proteins, but cost-effective, environmentally friendly, and compatible with scale-up. Diethylenetriamine (DETA), triethylenetetramine (TETA), tetraethylenepentamine (TEPA), and pentaethylenehexamine (PEHA) have been successfully used in RTCP to modulate the properties of particles synthesized, leading to the formation of octahedral nanoparticles with no use of organic solvents, heating, or toxic precursors. By extending this principle to a fluidic system, ongoing research will reveal whether the amine additives can also exert morphological control in an environment which is suited toward higher particle yield. Two fluidic systems have been employed; a peristaltic turbulent flow mixing system suitable for the rapid production of MNP, and a macrofluidic system for the synthesis of tailored nanomaterials under a laminar flow regime. The presence of the amine additives in the turbulent flow system in initial results appears to offer similar morphological control as observed under RTCP conditions, with higher proportions of octahedral particles formed. This is a proof of concept which may pave the way to green synthesis of tailored MNP on an industrial scale. Mms6 and amine additives have been used in the macrofluidic system, with Mms6 allowing magnetite to be synthesized at unfavourable ferric ratios, but no longer influencing particle size. This suggests this synthetic technique while still benefiting from the addition of additives, may not allow additives to fully influence the particles formed due to the faster timescale of reaction. The amine additives have been tested at various concentrations, the results of which will be discussed in this paper.Keywords: bioinspired, green synthesis, fluidic, magnetite, morphological control, scale-up
Procedia PDF Downloads 111265 Risk Based Inspection and Proactive Maintenance for Civil and Structural Assets in Oil and Gas Plants
Authors: Mohammad Nazri Mustafa, Sh Norliza Sy Salim, Pedram Hatami Abdullah
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Civil and structural assets normally have an average of more than 30 years of design life. Adding to this advantage, the assets are normally subjected to slow degradation process. Due to the fact that repair and strengthening work for these assets are normally not dependent on plant shut down, the maintenance and integrity restoration of these assets are mostly done based on “as required” and “run to failure” basis. However unlike other industries, the exposure in oil and gas environment is harsher as the result of corrosive soil and groundwater, chemical spill, frequent wetting and drying, icing and de-icing, steam and heat, etc. Due to this type of exposure and the increasing level of structural defects and rectification in line with the increasing age of plants, assets integrity assessment requires a more defined scope and procedures that needs to be based on risk and assets criticality. This leads to the establishment of risk based inspection and proactive maintenance procedure for civil and structural assets. To date there is hardly any procedure and guideline as far as integrity assessment and systematic inspection and maintenance of civil and structural assets (onshore) are concerned. Group Technical Solutions has developed a procedure and guideline that takes into consideration credible failure scenario, assets risk and criticality from process safety and structural engineering perspective, structural importance, modeling and analysis among others. Detailed inspection that includes destructive and non-destructive tests (DT & NDT) and structural monitoring is also being performed to quantify defects, assess severity and impact on integrity as well as identify the timeline for integrity restoration. Each defect and its credible failure scenario is assessed against the risk on people, environment, reputation and production loss. This technical paper is intended to share on the established procedure and guideline and their execution in oil & gas plants. In line with the overall roadmap, the procedure and guideline will form part of specialized solutions to increase production and to meet the “Operational Excellence” target while extending service life of civil and structural assets. As the result of implementation, the management of civil and structural assets is now more systematically done and the “fire-fighting” mode of maintenance is being gradually phased out and replaced by a proactive and preventive approach. This technical paper will also set the criteria and pose the challenge to the industry for innovative repair and strengthening methods for civil & structural assets in oil & gas environment, in line with safety, constructability and continuous modification and revamp of plant facilities to meet production demand.Keywords: assets criticality, credible failure scenario, proactive and preventive maintenance, risk based inspection
Procedia PDF Downloads 394264 The Audiovisual Media as a Metacritical Ludicity Gesture in the Musical-Performatic and Scenic Works of Caetano Veloso and David Bowie
Authors: Paulo Da Silva Quadros
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This work aims to point out comparative parameters between the artistic production of two exponents of the contemporary popular culture scene: Caetano Veloso (Brazil) and David Bowie (England). Both Caetano Veloso and David Bowie were pioneers in establishing an aesthetic game between various artistic expressions at the service of the music-visual scene, that is, the conceptual interconnections between several forms of aesthetic processes, such as fine arts, theatre, cinema, poetry, and literature. There are also correlations in their expressive attitudes of art, especially regarding the dialogue between the fields of art and politics (concern with respect to human rights, human dignity, racial issues, tolerance, gender issues, and sexuality, among others); the constant tension and cunning game between market, free expression and critical sense; the sophisticated, playful mechanisms of metalanguage and aesthetic metacritique. Fact is that both of them almost came to cooperate with each other in the 1970s when Caetano was in exile in England, and when both had at the same time the same music producer, who tried to bring them closer, noticing similar aesthetic qualities in both artistic works, which was later glimpsed by some music critics. Among many of the most influential issues in Caetano's and Bowie's game of artistic-aesthetic expression are, for example, the ideas advocated by the sensation of strangeness (Albert Camus), art as transcendence (Friedrich Nietzsche), the deconstruction and reconstruction of auratic reconfiguration of artistic signs (Walter Benjamin and Andy Warhol). For deepen more theoretical issues, the following authors will be used as supportive interpretative references: Hans-Georg Gadamer, Immanuel Kant, Friedrich Schiller, Johan Huizinga. In addition to the aesthetic meanings of Ars Ludens characteristics of the two artists, the following supporting references will be also added: the question of technique (Martin Heidegger), the logic of sense (Gilles Deleuze), art as an event and the sense of the gesture of art ( Maria Teresa Cruz), the society of spectacle (Guy Debord), Verarbeitung and Durcharbeitung (Sigmund Freud), the poetics of interpretation and the sign of relation (Cremilda Medina). The purpose of such interpretative references is to seek to understand, from a cultural reading perspective (cultural semiology), some significant elements in the dynamics of aesthetic and media interconnections of both artists, which made them as some of the most influential interlocutors in contemporary music aesthetic thought, as a playful vivid experience of life and art.Keywords: Caetano Veloso, David Bowie, music aesthetics, symbolic playfulness, cultural reading
Procedia PDF Downloads 162263 A Comparative Evaluation of Cognitive Load Management: Case Study of Postgraduate Business Students
Authors: Kavita Goel, Donald Winchester
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In a world of information overload and work complexities, academics often struggle to create an online instructional environment enabling efficient and effective student learning. Research has established that students’ learning styles are different, some learn faster when taught using audio and visual methods. Attributes like prior knowledge and mental effort affect their learning. ‘Cognitive load theory’, opines learners have limited processing capacity. Cognitive load depends on the learner’s prior knowledge, the complexity of content and tasks, and instructional environment. Hence, the proper allocation of cognitive resources is critical for students’ learning. Consequently, a lecturer needs to understand the limits and strengths of the human learning processes, various learning styles of students, and accommodate these requirements while designing online assessments. As acknowledged in the cognitive load theory literature, visual and auditory explanations of worked examples potentially lead to a reduction of cognitive load (effort) and increased facilitation of learning when compared to conventional sequential text problem solving. This will help learner to utilize both subcomponents of their working memory. Instructional design changes were introduced at the case site for the delivery of the postgraduate business subjects. To make effective use of auditory and visual modalities, video recorded lectures, and key concept webinars were delivered to students. Videos were prepared to free up student limited working memory from irrelevant mental effort as all elements in a visual screening can be viewed simultaneously, processed quickly, and facilitates greater psychological processing efficiency. Most case study students in the postgraduate programs are adults, working full-time at higher management levels, and studying part-time. Their learning style and needs are different from other tertiary students. The purpose of the audio and visual interventions was to lower the students cognitive load and provide an online environment supportive to their efficient learning. These changes were expected to impact the student’s learning experience, their academic performance and retention favourably. This paper posits that these changes to instruction design facilitates students to integrate new knowledge into their long-term memory. A mixed methods case study methodology was used in this investigation. Primary data were collected from interviews and survey(s) of students and academics. Secondary data were collected from the organisation’s databases and reports. Some evidence was found that the academic performance of students does improve when new instructional design changes are introduced although not statistically significant. However, the overall grade distribution of student’s academic performance has changed and skewed higher which shows deeper understanding of the content. It was identified from feedback received from students that recorded webinars served as better learning aids than material with text alone, especially with more complex content. The recorded webinars on the subject content and assessments provides flexibility to students to access this material any time from repositories, many times, and this enhances students learning style. Visual and audio information enters student’s working memory more effectively. Also as each assessment included the application of the concepts, conceptual knowledge interacted with the pre-existing schema in the long-term memory and lowered student’s cognitive load.Keywords: cognitive load theory, learning style, instructional environment, working memory
Procedia PDF Downloads 135262 Brazilian Transmission System Efficient Contracting: Regulatory Impact Analysis of Economic Incentives
Authors: Thelma Maria Melo Pinheiro, Guilherme Raposo Diniz Vieira, Sidney Matos da Silva, Leonardo Mendonça de Oliveira Queiroz, Mateus Sousa Pinheiro, Danyllo Wenceslau de Oliveira Lopes
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The present article has the objective to describe the regulatory impact analysis (RIA) of the contracting efficiency of the Brazilian transmission system usage. This contracting is made by users connected to the main transmission network and is used to guide necessary investments to supply the electrical energy demand. Therefore, an inefficient contracting of this energy amount distorts the real need for grid capacity, affecting the sector planning accuracy and resources optimization. In order to provide this efficiency, the Brazilian Electricity Regulatory Agency (ANEEL) homologated the Normative Resolution (NR) No. 666, from July 23th of 2015, which consolidated the procedures for the contracting of transmission system usage and the contracting efficiency verification. Aiming for a more efficient and rational transmission system contracting, the resolution established economic incentives denominated as Inefficiency installment for excess (IIE) and inefficiency installment for over-contracting (IIOC). The first one, IIE, is verified when the contracted demand exceeds the established regulatory limit; it is applied to consumer units, generators, and distribution companies. The second one, IIOC, is verified when the distributors over-contract their demand. Thus, the establishment of the inefficiency installments IIE and IIOC intends to avoid the agent contract less energy than necessary or more than it is needed. Knowing that RIA evaluates a regulatory intervention to verify if its goals were achieved, the results from the application of the above-mentioned normative resolution to the Brazilian transmission sector were analyzed through indicators that were created for this RIA to evaluate the contracting efficiency transmission system usage, using real data from before and after the homologation of the normative resolution in 2015. For this, indicators were used as the efficiency contracting indicator (ECI), excess of demand indicator (EDI), and over-contracting of demand indicator (ODI). The results demonstrated, through the ECI analysis, a decrease of the contracting efficiency, a behaviour that was happening even before the normative resolution of 2015. On the other side, the EDI showed a considerable decrease in the amount of excess for the distributors and a small reduction for the generators; moreover, the ODI notable decreased, which optimizes the usage of the transmission installations. Hence, with the complete evaluation from the data and indicators, it was possible to conclude that IIE is a relevant incentive for a more efficient contracting, indicating to the agents that their contracting values are not adequate to keep their service provisions for their users. The IIOC also has its relevance, to the point that it shows to the distributors that their contracting values are overestimated.Keywords: contracting, electricity regulation, evaluation, regulatory impact analysis, transmission power system
Procedia PDF Downloads 116261 Utilization of Functionalized Biochar from Water Hyacinth (Eichhornia crassipes) as Green Nano-Fertilizers
Authors: Adewale Tolulope Irewale, Elias Emeka Elemike, Christian O. Dimkpa, Emeka Emmanuel Oguzie
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As the global population steadily approaches the 10billion mark, the world is currently faced with two major challenges among others – accessing sustainable and clean energy, and food security. Accessing cleaner and sustainable energy sources to drive global economy and technological advancement, and feeding the teeming human population require sustainable, innovative, and smart solutions. To solve the food production problem, producers have relied on fertilizers as a way of improving crop productivity. Commercial inorganic fertilizers, which is employed to boost agricultural food production, however, pose significant ecological sustainability and economic problems including soil and water pollution, reduced input efficiency, development of highly resistant weeds, micronutrient deficiency, soil degradation, and increased soil toxicity. These ecological and sustainability concerns have raised uncertainties about the continued effectiveness of conventional fertilizers. With the application of nanotechnology, plant biomass upcycling offers several advantages in greener energy production and sustainable agriculture through reduction of environmental pollution, increasing soil microbial activity, recycling carbon thereby reducing GHG emission, and so forth. This innovative technology has the potential for a circular economy and creating a sustainable agricultural practice. Nanomaterials have the potential to greatly enhance the quality and nutrient composition of organic biomass which in turn, allows for the conversion of biomass into nanofertilizers that are potentially more efficient. Water hyacinth plant harvested from an inland water at Warri, Delta State Nigeria were air-dried and milled into powder form. The dry biomass were used to prepare biochar at a pre-determined temperature in an oxygen deficient atmosphere. Physicochemical analysis of the resulting biochar was carried out to determine its porosity and general morphology using the Scanning Transmission Electron Microscopy (STEM). The functional groups (-COOH, -OH, -NH2, -CN, -C=O) were assessed using the Fourier Transform InfraRed Spectroscopy (FTIR) while the heavy metals (Cr, Cu, Fe, Pb, Mg, Mn) were analyzed using Inductively Coupled Plasma – Optical Emission Spectrometry (ICP-OES). Impregnation of the biochar with nanonutrients were achieved under varied conditions of pH, temperature, nanonutrient concentrations and resident time to achieve optimum adsorption. Adsorption and desorption studies were carried out on the resulting nanofertilizer to determine kinetics for the potential nutrients’ bio-availability to plants when used as green fertilizers. Water hyacinth (Eichhornia crassipes) which is an aggressively invasive aquatic plant known for its rapid growth and profusion is being examined in this research to harness its biomass as a sustainable feedstock to formulate functionalized nano-biochar fertilizers, offering various benefits including water hyacinth biomass upcycling, improved nutrient delivery to crops and aquatic ecosystem remediation. Altogether, this work aims to create output values in the three dimensions of environmental, economic, and social benefits.Keywords: biochar-based nanofertilizers, eichhornia crassipes, greener agriculture, sustainable ecosystem, water hyacinth
Procedia PDF Downloads 60260 Reliability of Clinical Coding in Accurately Estimating the Actual Prevalence of Adverse Drug Event Admissions
Authors: Nisa Mohan
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Adverse drug event (ADE) related hospital admissions are common among older people. The first step in prevention is accurately estimating the prevalence of ADE admissions. Clinical coding is an efficient method to estimate the prevalence of ADE admissions. The objective of the study is to estimate the rate of under-coding of ADE admissions in older people in New Zealand and to explore how clinical coders decide whether or not to code an admission as an ADE. There has not been any research in New Zealand to explore these areas. This study is done using a mixed-methods approach. Two common and serious ADEs in older people, namely bleeding and hypoglycaemia were selected for the study. In study 1, eight hundred medical records of people aged 65 years and above who are admitted to hospital due to bleeding and hypoglycemia during the years 2015 – 2016 were selected for quantitative retrospective medical records review. This selection was made to estimate the proportion of ADE-related bleeding and hypoglycemia admissions that are not coded as ADEs. These files were reviewed and recorded as to whether the admission was caused by an ADE. The hospital discharge data were reviewed to check whether all the ADE admissions identified in the records review were coded as ADEs, and the proportion of under-coding of ADE admissions was estimated. In study 2, thirteen clinical coders were selected to conduct qualitative semi-structured interviews using a general inductive approach. Participants were selected purposively based on their experience in clinical coding. Interview questions were designed in a way to investigate the reasons for the under-coding of ADE admissions. The records review study showed that 35% (Cl 28% - 44%) of the ADE-related bleeding admissions and 22% of the ADE-related hypoglycemia admissions were not coded as ADEs. Although the quality of clinical coding is high across New Zealand, a substantial proportion of ADE admissions were under-coded. This shows that clinical coding might under-estimate the actual prevalence of ADE related hospital admissions in New Zealand. The interviews with the clinical coders added that lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing might be the potential reasons for the under-coding of the ADE admissions. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. These results highlight that further work is needed on interventions to improve the clinical coding of ADE admissions, such as providing education to coders about the importance of ADEs, education to clinicians about the importance of clear and confirmed medical records entries, availing pharmacist service to improve the detection and clear documentation of ADE admissions and including a mandatory field in the discharge summary about external causes of diseases.Keywords: adverse drug events, bleeding, clinical coders, clinical coding, hypoglycemia
Procedia PDF Downloads 124259 Necessity for a Standardized Occupational Health and Safety Management System: An Exploratory Study from the Danish Offshore Wind Sector
Authors: Dewan Ahsan
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Denmark is well ahead in generating electricity from renewable sources. The offshore wind sector is playing the pivotal role to achieve this target. Though there is a rapid growth of offshore wind sector in Denmark, still there is a dearth of synchronization in OHS (occupational health and safety) regulation and standards. Therefore, this paper attempts to ascertain: i) what are the major challenges of the company specific OHS standards? ii) why does the offshore wind industry need a standardized OHS management system? and iii) who can play the key role in this process? To achieve these objectives, this research applies the interview and survey techniques. This study has identified several key challenges in OHS management system which are; gaps in coordination and communication among the stakeholders, gaps in incident reporting systems, absence of a harmonized OHS standard and blame culture. Furthermore, this research has identified eleven key stakeholders who are actively involve with the offshore wind business in Denmark. As noticed, the relationships among these stakeholders are very complex specially between operators and sub-contractors. The respondent technicians are concerned with the compliance of various third-party OHS standards (e.g. ISO 31000, ISO 29400, Good practice guidelines by G+) which are applying by various offshore companies. On top of these standards, operators also impose their own OHS standards. From the technicians point of angle, many of these standards are not even specific for the offshore wind sector. So, it is a big challenge for the technicians and sub-contractors to comply with different company specific standards which also elevate the price of their services offer to the operators. For instance, when a sub-contractor is competing for a bidding, it must fulfill a number of OHS requirements (which demands many extra documantions) set by the individual operator and/the turbine supplier. According to sub-contractors’ point of view these extra works consume too much time to prepare the bidding documents and they also need to train their employees to pass the specific OHS certification courses to accomplish the demand for individual clients and individual project. The sub-contractors argued that in many cases these extra documentations and OHS certificates are inessential to ensure the quality service. So, a standardized OHS management procedure (which could be applicable for all the clients) can easily solve this problem. In conclusion, this study highlights that i) development of a harmonized OHS standard applicable for all the operators and turbine suppliers, ii) encouragement of technicians’ active participation in the OHS management, iii) development of a good safety leadership, and, iv) sharing of experiences among the stakeholders (specially operators-operators-sub contractors) are the most vital strategies to overcome the existing challenges and to achieve the goal of 'zero accident/harm' in the offshore wind industry.Keywords: green energy, offshore, safety, Denmark
Procedia PDF Downloads 210258 Governance of Social Media Using the Principles of Community Radio
Authors: Ken Zakreski
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Regulating Canadian Facebook Groups, of a size and type, when they reach a threshold of audio video content. Consider the evolution of the Streaming Act, Parl GC Bill C-11 (44-1) and the regulations that will certainly follow. The Canadian Heritage Minister's office stipulates, "the Broadcasting Act only applies to audio and audiovisual content, not written journalism.” Governance— After 10 years, a community radio station for Gabriola Island, BC – Canadian Radio-television and Telecommunications Commission (“CRTC”) was approved but never started – became a Facebook Group “Community Bulletin Board - Life on Gabriola“ referred to as CBBlog. After CBBlog started and began to gather real traction, a member of the Group cloned the membership and ran their competing Facebook group under the banner of "free speech”. Here we see an inflection point [change of cultural stewardship] with two different mathematical results [engagement and membership growth]. Canada's telecommunication history of “portability” and “interoperability” made that Facebook Group CBBlog the better option, over broadcast FM radio for a community pandemic information sharing service for Gabriola Island, BC. A culture of ignorance flourishes in social media. Often people do not understand their own experience, or the experience of others because they do not have the concepts needed for understanding. It is thus important they are not denied concepts required for their full understanding. For example, Legislators need to know something about gay culture before they can make any decisions about it. Community Media policies and CRTC regulations are known and regulators can use that history to forge forward with regulations for internet platforms of a size and content type that reach a threshold of audio / video content. Mostly volunteer run media services, provide order of magnitude lower costs over commercial media. (Treating) Facebook Groups as new media.? Cathy Edwards, executive director of the Canadian Association of Community Television Users and Stations (“CACTUS”), calls it new media in that the distribution platform is not the issue. What does make community groups community media? Cathy responded, "... it's bylaws, articles of incorporation that state they are community media, they have accessibility, commitments to skills training, any member of the community can be a member, and there is accountability to a board of directors". Eligibility for funding through CACTUS requires these same commitments. It is risky for a community to invest into a platform as ownership has not been litigated. Is a FaceBook Group an asset of a not for profit society? The memo, from law student, Jared Hubbard summarizes, “Rights and interests in a Facebook group could, in theory, be transferred as property... This theory is currently unconfirmed by Canadian courts. “Keywords: social media, governance, community media, Canadian radio
Procedia PDF Downloads 62257 Understanding Evidence Dispersal Caused by the Effects of Using Unmanned Aerial Vehicles in Active Indoor Crime Scenes
Authors: Elizabeth Parrott, Harry Pointon, Frederic Bezombes, Heather Panter
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Unmanned aerial vehicles (UAV’s) are making a profound effect within policing, forensic and fire service procedures worldwide. These intelligent devices have already proven useful in photographing and recording large-scale outdoor and indoor sites using orthomosaic and three-dimensional (3D) modelling techniques, for the purpose of capturing and recording sites during and post-incident. UAV’s are becoming an established tool as they are extending the reach of the photographer and offering new perspectives without the expense and restrictions of deploying full-scale aircraft. 3D reconstruction quality is directly linked to the resolution of captured images; therefore, close proximity flights are required for more detailed models. As technology advances deployment of UAVs in confined spaces is becoming more common. With this in mind, this study investigates the effects of UAV operation within active crimes scenes with regard to the dispersal of particulate evidence. To date, there has been little consideration given to the potential effects of using UAV’s within active crime scenes aside from a legislation point of view. Although potentially the technology can reduce the likelihood of contamination by replacing some of the roles of investigating practitioners. There is the risk of evidence dispersal caused by the effect of the strong airflow beneath the UAV, from the downwash of the propellers. The initial results of this study are therefore presented to determine the height of least effect at which to fly, and the commercial propeller type to choose to generate the smallest amount of disturbance from the dataset tested. In this study, a range of commercially available 4-inch propellers were chosen as a starting point due to the common availability and their small size makes them well suited for operation within confined spaces. To perform the testing, a rig was configured to support a single motor and propeller powered with a standalone mains power supply and controlled via a microcontroller. This was to mimic a complete throttle cycle and control the device to ensure repeatability. By removing the variances of battery packs and complex UAV structures to allow for a more robust setup. Therefore, the only changing factors were the propeller and operating height. The results were calculated via computer vision analysis of the recorded dispersal of the sample particles placed below the arm-mounted propeller. The aim of this initial study is to give practitioners an insight into the technology to use when operating within confined spaces as well as recognizing some of the issues caused by UAV’s within active crime scenes.Keywords: dispersal, evidence, propeller, UAV
Procedia PDF Downloads 156256 Analysis of Non-Conventional Roundabout Performance in Mixed Traffic Conditions
Authors: Guneet Saini, Shahrukh, Sunil Sharma
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Traffic congestion is the most critical issue faced by those in the transportation profession today. Over the past few years, roundabouts have been recognized as a measure to promote efficiency at intersections globally. In developing countries like India, this type of intersection still faces a lot of issues, such as bottleneck situations, long queues and increased waiting times, due to increasing traffic which in turn affect the performance of the entire urban network. This research is a case study of a non-conventional roundabout, in terms of geometric design, in a small town in India. These types of roundabouts should be analyzed for their functionality in mixed traffic conditions, prevalent in many developing countries. Microscopic traffic simulation is an effective tool to analyze traffic conditions and estimate various measures of operational performance of intersections such as capacity, vehicle delay, queue length and Level of Service (LOS) of urban roadway network. This study involves analyzation of an unsymmetrical non-circular 6-legged roundabout known as “Kala Aam Chauraha” in a small town Bulandshahr in Uttar Pradesh, India using VISSIM simulation package which is the most widely used software for microscopic traffic simulation. For coding in VISSIM, data are collected from the site during morning and evening peak hours of a weekday and then analyzed for base model building. The model is calibrated on driving behavior and vehicle parameters and an optimal set of calibrated parameters is obtained followed by validation of the model to obtain the base model which can replicate the real field conditions. This calibrated and validated model is then used to analyze the prevailing operational traffic performance of the roundabout which is then compared with a proposed alternative to improve efficiency of roundabout network and to accommodate pedestrians in the geometry. The study results show that the alternative proposed is an advantage over the present roundabout as it considerably reduces congestion, vehicle delay and queue length and hence, successfully improves roundabout performance without compromising on pedestrian safety. The study proposes similar designs for modification of existing non-conventional roundabouts experiencing excessive delays and queues in order to improve their efficiency especially in the case of developing countries. From this study, it can be concluded that there is a need to improve the current geometry of such roundabouts to ensure better traffic performance and safety of drivers and pedestrians negotiating the intersection and hence this proposal may be considered as a best fit.Keywords: operational performance, roundabout, simulation, VISSIM
Procedia PDF Downloads 136255 Delivering Safer Clinical Trials; Using Electronic Healthcare Records (EHR) to Monitor, Detect and Report Adverse Events in Clinical Trials
Authors: Claire Williams
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Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials
Procedia PDF Downloads 80254 IEEE802.15.4e Based Scheduling Mechanisms and Systems for Industrial Internet of Things
Authors: Ho-Ting Wu, Kai-Wei Ke, Bo-Yu Huang, Liang-Lin Yan, Chun-Ting Lin
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With the advances in advanced technology, wireless sensor network (WSN) has become one of the most promising candidates to implement the wireless industrial internet of things (IIOT) architecture. However, the legacy IEEE 802.15.4 based WSN technology such as Zigbee system cannot meet the stringent QoS requirement of low powered, real-time, and highly reliable transmission imposed by the IIOT environment. Recently, the IEEE society developed IEEE 802.15.4e Time Slotted Channel Hopping (TSCH) access mode to serve this purpose. Furthermore, the IETF 6TiSCH working group has proposed standards to integrate IEEE 802.15.4e with IPv6 protocol smoothly to form a complete protocol stack for IIOT. In this work, we develop key network technologies for IEEE 802.15.4e based wireless IIoT architecture, focusing on practical design and system implementation. We realize the OpenWSN-based wireless IIOT system. The system architecture is divided into three main parts: web server, network manager, and sensor nodes. The web server provides user interface, allowing the user to view the status of sensor nodes and instruct sensor nodes to follow commands via user-friendly browser. The network manager is responsible for the establishment, maintenance, and management of scheduling and topology information. It executes centralized scheduling algorithm, sends the scheduling table to each node, as well as manages the sensing tasks of each device. Sensor nodes complete the assigned tasks and sends the sensed data. Furthermore, to prevent scheduling error due to packet loss, a schedule inspection mechanism is implemented to verify the correctness of the schedule table. In addition, when network topology changes, the system will act to generate a new schedule table based on the changed topology for ensuring the proper operation of the system. To enhance the system performance of such system, we further propose dynamic bandwidth allocation and distributed scheduling mechanisms. The developed distributed scheduling mechanism enables each individual sensor node to build, maintain and manage the dedicated link bandwidth with its parent and children nodes based on locally observed information by exchanging the Add/Delete commands via two processes. The first process, termed as the schedule initialization process, allows each sensor node pair to identify the available idle slots to allocate the basic dedicated transmission bandwidth. The second process, termed as the schedule adjustment process, enables each sensor node pair to adjust their allocated bandwidth dynamically according to the measured traffic loading. Such technology can sufficiently satisfy the dynamic bandwidth requirement in the frequently changing environments. Last but not least, we propose a packet retransmission scheme to enhance the system performance of the centralized scheduling algorithm when the packet delivery rate (PDR) is low. We propose a multi-frame retransmission mechanism to allow every single network node to resend each packet for at least the predefined number of times. The multi frame architecture is built according to the number of layers of the network topology. Performance results via simulation reveal that such retransmission scheme is able to provide sufficient high transmission reliability while maintaining low packet transmission latency. Therefore, the QoS requirement of IIoT can be achieved.Keywords: IEEE 802.15.4e, industrial internet of things (IIOT), scheduling mechanisms, wireless sensor networks (WSN)
Procedia PDF Downloads 156253 Challenges of Strategies for Improving Sustainability in Urban Historical Context in Developing Countries: The Case of Shiraz Bein Al-Haramein
Authors: Amir Hossein Ashari, Sedighe Erfan Manesh
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One of the problems in developing countries is renovating the historical context and inducing behaviors appropriate to modern life to such a context. This study was conducted using field and library methods in 2012. Similar cases carried out in Iran and developing countries were compared to unveil the strengths and weaknesses of these projects. At present, in the historical context of Shiraz, the distance between two religious shrines of Shahcheragh (Ahmad ibn Musa) and Astaneh (Sayed Alaa al-Din Hossein), which are significant places in religious, cultural, social, and economic terms, is an area full of historic places called Bein Al-Haramein. Unfortunately, some of these places have been worn out and are not appropriate for common uses. The basic strategy of Bein Al-Haramein was to improve social development of Shiraz, to enhance the vitality and dynamism of the historical context of Bein Al-Haramein and to create tourist attractions in order to boost the city's economic and social stability. To this end, the project includes the huge Bein Al-Haramein Commercial Complex which is under construction now. To construct the complex, officials have decided to demolish places of historical value which can lead to irreparable consequences. Iranian urban design has always been based on three elements of bazaars, mosques and government facilities with bazaars being the organic connector of the other elements. Therefore, the best strategy in the above case is to provide for a commercial connection between the two poles. Although this strategy is included in the project, lack of attention to renovation principles in this area and complete destruction of the context will lead to its irreversible damage and will destroy its cultural and historical identity. In urban planning of this project, some important issues have been neglected including: preserving valuable buildings and special old features of the city, rebuilding worn buildings and context to attract trust and confidence of the people, developing new models according to changes, improving the structural position of old context with minimal degradation, attracting partnerships of residents and protecting their rights and finally using potential facilities of the old context. The best strategy for achieving sustainability in Bein Al-Haramein can be the one used in the distance between Santa Maria Novella and Santa Maria Del Fiore churches in historical context where while protecting the historic context and constructions, old buildings were renovated and given different commercial and service uses making them sustainable and dynamic places. Similarly, in Bein Al-Haramein, renovating old constructions and monuments and giving different commercial and other uses to them can help improve the economic and social sustainability of the area.Keywords: Bein Al-Haramein, sustainability, historical context, historical context
Procedia PDF Downloads 437252 Magnetic Single-Walled Carbon Nanotubes (SWCNTs) as Novel Theranostic Nanocarriers: Enhanced Targeting and Noninvasive MRI Tracking
Authors: Achraf Al Faraj, Asma Sultana Shaik, Baraa Al Sayed
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Specific and effective targeting of drug delivery systems (DDS) to cancerous sites remains a major challenge for a better diagnostic and therapy. Recently, SWCNTs with their unique physicochemical properties and the ability to cross the cell membrane show promising in the biomedical field. The purpose of this study was first to develop a biocompatible iron oxide tagged SWCNTs as diagnostic nanoprobes to allow their noninvasive detection using MRI and their preferential targeting in a breast cancer murine model by placing an optimized flexible magnet over the tumor site. Magnetic targeting was associated to specific antibody-conjugated SWCNTs active targeting. The therapeutic efficacy of doxorubicin-conjugated SWCNTs was assessed, and the superiority of diffusion-weighted (DW-) MRI as sensitive imaging biomarker was investigated. Short Polyvinylpyrrolidone (PVP) stabilized water soluble SWCNTs were first developed, tagged with iron oxide nanoparticles and conjugated with Endoglin/CD105 monoclonal antibodies. They were then conjugated with doxorubicin drugs. SWCNTs conjugates were extensively characterized using TEM, UV-Vis spectrophotometer, dynamic light scattering (DLS) zeta potential analysis and electron spin resonance (ESR) spectroscopy. Their MR relaxivities (i.e. r1 and r2*) were measured at 4.7T and their iron content and metal impurities quantified using ICP-MS. SWCNTs biocompatibility and drug efficacy were then evaluated both in vitro and in vivo using a set of immunological assays. Luciferase enhanced bioluminescence 4T1 mouse mammary tumor cells (4T1-Luc2) were injected into the right inguinal mammary fat pad of Balb/c mice. Tumor bearing mice received either free doxorubicin (DOX) drug or SWCNTs with or without either DOX or iron oxide nanoparticles. A multi-pole 10x10mm high-energy flexible magnet was maintained over the tumor site during 2 hours post-injections and their properties and polarity were optimized to allow enhanced magnetic targeting of SWCNTs toward the primary tumor site. Tumor volume was quantified during the follow-up investigation study using a fast spin echo MRI sequence. In order to detect the homing of SWCNTs to the main tumor site, susceptibility-weighted multi-gradient echo (MGE) sequence was used to generate T2* maps. Apparent diffusion coefficient (ADC) measurements were also performed as a sensitive imaging biomarker providing early and better assessment of disease treatment. At several times post-SWCNT injection, histological analysis were performed on tumor extracts and iron-loaded SWCNT were quantified using ICP-MS in tumor sites, liver, spleen, kidneys, and lung. The optimized multi-poles magnet revealed an enhanced targeting of magnetic SWCNTs to the primary tumor site, which was found to be much higher than the active targeting achieved using antibody-conjugated SWCNTs. Iron-loading allowed their sensitive noninvasive tracking after intravenous administration using MRI. The active targeting of doxorubicin through magnetic antibody-conjugated SWCNTs nanoprobes was found to considerably decrease the primary tumor site and may have inhibited the development of metastasis in the tumor-bearing mice lung. ADC measurements in DW-MRI were found to significantly increase in a time-dependent manner after the injection of DOX-conjugated SWCNTs complexes.Keywords: single-walled carbon nanotubes, nanomedicine, magnetic resonance imaging, cancer diagnosis and therapy
Procedia PDF Downloads 323251 Validating the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire for Use in Sri Lanka
Authors: Shyamani Hettiarachchi, Gopi Kitnasamy
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Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.Keywords: cerebral palsy, CPQOL, culture, quality of life
Procedia PDF Downloads 341250 Regional Review of Outcome of Cervical Smears Reported with Cytological Features of Non Cervical Glandular Neoplasia
Authors: Uma Krishnamoorthy, Vivienne Beavers, Janet Marshall
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Introduction: Cervical cytology showing features raising the suspicion of non cervical glandular neoplasia are reported as code 0 under the United Kingdom National Health Service Cervical screening programme ( NHSCSP). As the suspicion is regarding non cervical neoplasia, smear is reported as normal and patient informed that cervical screening result is normal. GP receives copy of results where it states further referral is indicated in small font within text of report. Background: There were several incidents of delayed diagnosis of endometrial cancer in Lancashire which prompted this Northwest Regional review to enable an understanding of underlying pathology outcome of code zero smears to raise awareness and also to review whether further action on wording of smear results was indicated to prevent such delay. Methodology: All Smears reported at the Manchester cytology centre who process cytology for Lancashire population from March 2013 to March 2014 were reviewed and histological diagnosis outcome of women in whom smear was reported as code zero was reviewed retrospectively . Results: Total smears reported by the cytology centre during this period was approximately 109400. Reports issued with result code 0 among this during this time period was 49.Results revealed that among three fourth (37) of women with code zero smear (N=49), evidence of underlying pathology of non cervical origin was confirmed. Of this, 73 % (36) were due to endometrial pathology with 49 % (24) endometrial carcinoma, 12 % (6)polyp, 4 % atypical endometrial hyperplasia (2), 6 % endometrial hyperplasia without atypia (3), and 2 % adenomyosis (1 case) and 2 % ( 1 case) due to ovarian adenocarcinoma. Conclusion: This review demonstrated that more than half (51 %) of women with a code 0 smear report were diagnosed with underlying carcinoma and 75 % had a confirmed underlying pathology contributory to code 0 smear findings. Recommendations and Action Plan: A local rapid access referral and management pathway for this group of women was implemented as a result of this in our unit. The findings and Pathway were shared with other regional units served by the cytology centre through the Pan Lancashire cervical screening board and through the Cytology centre. Locally, the smear report wording was updated to include a rubber stamp/ print in "Red Bold letters" stating that " URGENT REFERRAL TO GYNAECOLOGY IS INDICATED". Findings were also shared through the Pan Lancashire board with National cervical screening programme board, and revisions to wording of code zero smear reports to highlight the need for Urgent referral has now been agreed at National level to be implemented.Keywords: code zero smears, endometrial cancer, non cervical glandular neoplasia, ovarian cancer
Procedia PDF Downloads 287249 The Church of San Paolo in Ferrara, Restoration and Accessibility
Authors: Benedetta Caglioti
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The ecclesiastical complex of San Paolo in Ferrara represents a monument of great historical, religious and architectural importance. Its long and articulated story, over time, is already manifested by the mere reading of its planimetric and altimetric configuration, apparently unitary but, in reality, marked by modifications and repeated additions, even of high quality. It follows, in terms of protection, restoration and enhancement, a commitment of due respect for how the ancient building was built and enriched over its centuries of life. Hence a rigorous methodological approach, while being aware of the fact that every monument, in order to live and make use of the indispensable maintenance, must always be enjoyed and visited, therefore it must enjoy, in the right measure and compatibly with its nature, the possibility of improvements and functional, distributive, technological adjustments and related to the safety of people and things. The methodological approach substantiates the different elements of the project (such as distribution functionality, safety, structural solidity, environmental comfort, the character of the site, building and urban planning regulations, financial resources and materials, the same organization methods of the construction site) through the guiding principles of restoration, defined for a long time: the 'minimum intervention,' the 'recognisability' or 'distinguishability' of old and new, the Physico-chemical and figurative 'compatibility,' the 'durability' and the, at least potential, 'reversibility' of what is done, leading to the definition of appropriate "critical choices." The project tackles, together with the strictly functional ones, also the directly conservative and restoration issues, of a static, structural and material technology nature, with special attention to precious architectural surfaces, In order to ensure the best architectural quality through conscious enhancement, the project involves a redistribution of the interior and service spaces, an accurate lighting system inside and outside the church and a reorganization of the adjacent urban space. The reorganization of the interior is designed with particular attention to the issue of accessibility for people with disabilities. To accompany the community to regain possession of the use of the church's own space, already in its construction phase, the project proposal has hypothesized a permeability and flexibility in the management of the works such as to allow the perception of the found Monument to gradually become more and more familiar at the citizenship. Once the interventions have been completed, it is expected that the Church of San Paolo, second in importance only to the Cathedral, from which it is a few steps away, will be inserted in an already existing circuit of use of the city which over the years has systematized the different aspects of culture, the environment and tourism for the creation of greater awareness in the perception of what Ferrara can offer in cultural terms.Keywords: conservation, accessibility, regeneration, urban space
Procedia PDF Downloads 102248 Accessibility of Social Justice through Social Security in Indian Organisations: Analysis Based on Workforce
Authors: Neelima Rashmi Lakra
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India was among one of the highly developed economy up to 1850 due to its cottage industries. During the end of the 18th century, modern industrial enterprises began with the first cotton mill in Bombay, the jute mill near Calcutta and the coal mine in Raniganj. This was counted as the real beginning of industry in 1854 in India. Prior to this period people concentrated only to agriculture, menial service or handicraft, and the introduction of industries exposed them to the disciplines of factory which was very tedious for them. With increasing number of factories been setup adding on to mining and introduction of railway, World War Period (1914-19), Second World War Period (1939-45) and the Great Depression (1929-33) there were visible change in the nature of work for the people, which resulted in outburst of strike for various reasons in these factories. Here, with India’s independence there was emergence of public sector industries and labour legislations were introduced. Meanwhile, trade unions came to notice to the rescue of the oppressed but failed to continue till long. Soon after, with the New Economic Policy organisations came across to face challenges to perform their best, where social justice for the workmen was in question. On these backdrops, studies were found discussing the central human capabilities which could be addressed through Social Security schemes. Therefore, this study was taken up to look at the reforms and legislations mainly meant for the welfare of the labour. This paper will contribute to the large number of Indian population who are serving in public sectors in India since the introduction of industries and will complement the issue of social justice through social security measures among this huge crowd serving the nation. The objectives of the study include; to find out what labour Legislations have already been existing in India, the role of Trade Union Movement, to look at the effects of New Economic Policy on these reforms and its effects and measures taken for the workforce employed in the public sectors and finally, if these measures fulfil the social justice aspects for the larger society on whole. The methodology followed collection of data from books, journal articles, reports, company reports and manuals focusing mainly on Indian studies and the data was analysed following content analysis method. The findings showed the measures taken for Social Security, but there were also reflections of very few particular additions or amendments to these Acts and provisions with the onset of New Liberalisation Policy. Therefore, the study concluded examining the social justice aspects in the context of a developing economy and discussing the recommendations.Keywords: public sectors, social justice, social security schemes, trade union movement
Procedia PDF Downloads 444247 Corrosion Protection and Failure Mechanism of ZrO₂ Coating on Zirconium Alloy Zry-4 under Varied LiOH Concentrations in Lithiated Water at 360°C and 18.5 MPa
Authors: Guanyu Jiang, Donghai Xu, Huanteng Liu
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After the Fukushima-Daiichi accident, the development of accident tolerant fuel cladding materials to improve reactor safety has become a hot topic in the field of nuclear industry. ZrO₂ has a satisfactory neutron economy and can guarantee the fission chain reaction process, which enables it to be a promising coating for zirconium alloy cladding. Maintaining a good corrosion resistance in primary coolant loop during normal operations of Pressurized Water Reactors is a prerequisite for ZrO₂ as a protective coating on zirconium alloy cladding. Research on the corrosion performance of ZrO₂ coating in nuclear water chemistry is relatively scarce, and existing reports failed to provide an in-depth explanation for the failure causes of ZrO₂ coating. Herein, a detailed corrosion process of ZrO₂ coating in lithiated water at 360 °C and 18.5 MPa was proposed based on experimental research and molecular dynamics simulation. Lithiated water with different LiOH solutions in the present work was deaerated and had a dissolved oxygen concentration of < 10 ppb. The concentration of Li (as LiOH) was determined to be 2.3 ppm, 70 ppm, and 500 ppm, respectively. Corrosion tests were conducted in a static autoclave. Modeling and corresponding calculations were operated on Materials Studio software. The calculation of adsorption energy and dynamics parameters were undertaken by the Energy task and Dynamics task of the Forcite module, respectively. The protective effect and failure mechanism of ZrO₂ coating on Zry-4 under varied LiOH concentrations was further revealed by comparison with the coating corrosion performance in pure water (namely 0 ppm Li). ZrO₂ coating provided a favorable corrosion protection with the occurrence of localized corrosion at low LiOH concentrations. Factors influencing corrosion resistance mainly include pitting corrosion extension, enhanced Li+ permeation, short-circuit diffusion of O²⁻ and ZrO₂ phase transformation. In highly-concentrated LiOH solutions, intergranular corrosion, internal oxidation, and perforation resulted in coating failure. Zr ions were released to coating surface to form flocculent ZrO₂ and ZrO₂ clusters due to the strong diffusion and dissolution tendency of α-Zr in the Zry-4 substrate. Considering that primary water of Pressurized Water Reactors usually includes 2.3 ppm Li, the stability of ZrO₂ make itself a candidate fuel cladding coating material. Under unfavorable conditions with high Li concentrations, more boric acid should be added to alleviate caustic corrosion of ZrO₂ coating once it is used. This work can provide some references to understand the service behavior of nuclear coatings under variable water chemistry conditions and promote the in-pile application of ZrO₂ coating.Keywords: ZrO₂ coating, Zry-4, corrosion behavior, failure mechanism, LiOH concentration
Procedia PDF Downloads 76246 Reframing Physical Activity for Health
Authors: M. Roberts
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We Are Undefeatable - is a mass marketing behaviour change campaign that aims to support the least active people living with long term health conditions to be more active. This is an important issue to address because people with long term conditions are an historically underserved community for the sport and physical activity sector and the least active of those with long term conditions have the most to gain in health and wellbeing benefits. The campaign has generated a significant change in the way physical activity is communicated and people with long term conditions are represented in the media and marketing. The goal is to create a social norm around being active. The campaign is led by a unique partnership of organisations: the Richmond Group of Charities (made up of Age UK, Alzheimer’s Society, Asthma + Lung UK, Breast Cancer Now, British Heart Foundation, British Red Cross, Diabetes UK, Macmillan Cancer Support, Rethink Mental Illness, Royal Voluntary Service, Stroke Association, Versus Arthritis) along with Mind, MS Society, Parkinson’s UK and Sport England, with National Lottery Funding. It is underpinned by the COM-B model of behaviour change. It draws on the lived experience of people with multiple long term conditions to shape the look and feel of the campaign and all the resources available. People with long term conditions are the campaign messengers, central to the ethos of the campaign by telling their individual stories of overcoming barriers to be active with their health conditions. The central messaging is about finding a way to be active that works for the individual. We Are Undefeatable is evaluated through a multi-modal approach, including regular qualitative focus groups and a quantitative evaluation tracker undertaken three times a year. The campaign has highlighted the significant barriers to physical activity for people with long term conditions. This has changed the way our partnership talks about physical activity but has also had an impact on the wider sport and physical activity sector, prompting an increasing departure from traditional messaging and marketing approaches for this audience of people with long term conditions. The campaign has reached millions of people since its launch in 2019, through multiple marketing and partnership channels including primetime TV advertising and promotion through health professionals and in health settings. Its diverse storytellers make it relatable to its target audience and the achievable activities highlighted and inclusive messaging inspire our audience to take action as a result of seeing the campaign. The We Are Undefeatable campaign is a blueprint for physical activity campaigns; it not only addresses individual behaviour change but plays a role in addressing systemic barriers to physical activity by sharing the lived experience insight to shape policy and professional practice.Keywords: behaviour change, long term conditions, partnership, relatable
Procedia PDF Downloads 60245 Case Report: Peripartum Cardiomyopathy, a Rare but Fatal Condition in Pregnancy and Puerperium
Authors: Sadaf Abbas, HimGauri Sabnis
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Introduction: Peripartum cardiomyopathy is a rare but potentially life-threatening condition that presents as heart failure during the last month of pregnancy or within five months postpartum. The incidence of postpartum cardiomyopathy ranges from 1 in 1300 to 1 in 15,000 pregnancies. Risk factors include multiparty, advanced maternal age, multiple pregnancies, pre-eclampsia, and chronic hypertension. Study: A 30-year-old Para3+0 presented to the Emergency Department of St’Marry Hospital, Isle of Wight, on the seventh day postpartum, with acute shortness of breath (SOB), chest pain, cough, and a temperature of 38 degrees. The risk factors were smoking and class II obesity (BMI of 40.62). The patient had mild pre-eclampsia in the last pregnancy and was on labetalol and aspirin during an antenatal period, which was stopped postnatally. There was also a history of pre-eclampsia and haemolysis, elevated liver enzymes, low platelets (HELLP syndrome) in previous pregnancies, which led to preterm delivery at 35 weeks in the second pregnancy, and the first baby was stillborn at 24 weeks. On assessment, there was a national early warning score (NEWS score) of 3, persistent tachycardia, and mild crepitation in the lungs. Initial investigations revealed an enlarged heart on chest X-ray, and a CT pulmonary angiogram indicated bilateral basal pulmonary congestion without pulmonary embolism, suggesting fluid overload. Laboratory results showed elevated CRP and normal troponin levels initially, which later increased, indicating myocardial involvement. Echocardiography revealed a severely dilated left ventricle with an ejection fraction (EF) of 31%, consistent with severely impaired systolic function. The cardiology team reviewed the patient and admitted to the Coronary Care Unit. As sign and symptoms were suggestive of fluid overload and congestive cardiac failure, management was done with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), proton pump inhibitors, and supportive care. During admission, there was complications such as acute kidney injury, but then recovered well. Chest pain had resolved following the treatment. After being admitted for eight days, there was an improvement in the symptoms, and the patient was discharged home with a further plan of cardiac MRI and genetic testing due to a family history of sudden cardiac death. Regular appointment has been made with the Cardiology team to follow-up on the symptoms. Since discharge, the patient made a good recovery. A cardiac MRI was done, which showed severely impaired left ventricular function, ejection fraction (EF) of 38% with mild left ventricular dilatation, and no evidence of previous infarction. Overall appearance is of non-ischemic dilated cardiomyopathy. The main challenge at the time of admission was the non-availability of a cardiac radiology team, so the definitive diagnosis was delayed. The long-term implications include risk of recurrence, chronic heart failure, and, consequently, an effect on quality of life. Therefore, regular follow-up is critical in patient’s management. Conclusions: Peripartum cardiomyopathy is one of the cardiovascular diseases whose causes are still unknown yet and, in some cases, are uncontrolled. By raising awareness about the symptoms and management of this complication it will reduce morbidity and mortality rates and also the length of stay in the hospital.Keywords: cardiomyopathy, cardiomegaly, pregnancy, puerperium
Procedia PDF Downloads 15244 Ocean Planner: A Web-Based Decision Aid to Design Measures to Best Mitigate Underwater Noise
Authors: Thomas Folegot, Arnaud Levaufre, Léna Bourven, Nicolas Kermagoret, Alexis Caillard, Roger Gallou
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Concern for negative impacts of anthropogenic noise on the ocean’s ecosystems has increased over the recent decades. This concern leads to a similar increased willingness to regulate noise-generating activities, of which shipping is one of the most significant. Dealing with ship noise requires not only knowledge about the noise from individual ships, but also how the ship noise is distributed in time and space within the habitats of concern. Marine mammals, but also fish, sea turtles, larvae and invertebrates are mostly dependent on the sounds they use to hunt, feed, avoid predators, during reproduction to socialize and communicate, or to defend a territory. In the marine environment, sight is only useful up to a few tens of meters, whereas sound can propagate over hundreds or even thousands of kilometers. Directive 2008/56/EC of the European Parliament and of the Council of June 17, 2008 called the Marine Strategy Framework Directive (MSFD) require the Member States of the European Union to take the necessary measures to reduce the impacts of maritime activities to achieve and maintain a good environmental status of the marine environment. The Ocean-Planner is a web-based platform that provides to regulators, managers of protected or sensitive areas, etc. with a decision support tool that enable to anticipate and quantify the effectiveness of management measures in terms of reduction or modification the distribution of underwater noise, in response to Descriptor 11 of the MSFD and to the Marine Spatial Planning Directive. Based on the operational sound modelling tool Quonops Online Service, Ocean-Planner allows the user via an intuitive geographical interface to define management measures at local (Marine Protected Area, Natura 2000 sites, Harbors, etc.) or global (Particularly Sensitive Sea Area) scales, seasonal (regulation over a period of time) or permanent, partial (focused to some maritime activities) or complete (all maritime activities), etc. Speed limit, exclusion area, traffic separation scheme (TSS), and vessel sound level limitation are among the measures supported be the tool. Ocean Planner help to decide on the most effective measure to apply to maintain or restore the biodiversity and the functioning of the ecosystems of the coastal seabed, maintain a good state of conservation of sensitive areas and maintain or restore the populations of marine species.Keywords: underwater noise, marine biodiversity, marine spatial planning, mitigation measures, prediction
Procedia PDF Downloads 119243 The Procedural Sedation Checklist Manifesto, Emergency Department, Jersey General Hospital
Authors: Jerome Dalphinis, Vishal Patel
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The Bailiwick of Jersey is an island British crown dependency situated off the coast of France. Jersey General Hospital’s emergency department sees approximately 40,000 patients a year. It’s outside the NHS, with secondary care being free at the point of care. Sedation is a continuum which extends from a normal conscious level to being fully unresponsive. Procedural sedation produces a minimally depressed level of consciousness in which the patient retains the ability to maintain an airway, and they respond appropriately to physical stimulation. The goals of it are to improve patient comfort and tolerance of the procedure and alleviate associated anxiety. Indications can be stratified by acuity, emergency (cardioversion for life-threatening dysrhythmia), and urgency (joint reduction). In the emergency department, this is most often achieved using a combination of opioids and benzodiazepines. Some departments also use ketamine to produce dissociative sedation, a cataleptic state of profound analgesia and amnesia. The response to pharmacological agents is highly individual, and the drugs used occasionally have unpredictable pharmacokinetics and pharmacodynamics, which can always result in progression between levels of sedation irrespective of the intention. Therefore, practitioners must be able to ‘rescue’ patients from deeper sedation. These practitioners need to be senior clinicians with advanced airway skills (AAS) training. It can lead to adverse effects such as dangerous hypoxia and unintended loss of consciousness if incorrectly undertaken; studies by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) have reported avoidable deaths. The Royal College of Emergency Medicine, UK (RCEM) released an updated ‘Safe Sedation of Adults in the Emergency Department’ guidance in 2017 detailing a series of standards for staff competencies, and the required environment and equipment, which are required for each target sedation depth. The emergency department in Jersey undertook audit research in 2018 to assess their current practice. It showed gaps in clinical competency, the need for uniform care, and improved documentation. This spurred the development of a checklist incorporating the above RCEM standards, including contraindication for procedural sedation and difficult airway assessment. This was approved following discussion with the relevant heads of departments and the patient safety directorates. Following this, a second audit research was carried out in 2019 with 17 completed checklists (11 relocation of joints, 6 cardioversions). Data was obtained from looking at the controlled resuscitation drugs book containing documented use of ketamine, alfentanil, and fentanyl. TrakCare, which is the patient electronic record system, was then referenced to obtain further information. The results showed dramatic improvement compared to 2018, and they have been subdivided into six categories; pre-procedure assessment recording of significant medical history and ASA grade (2 fold increase), informed consent (100% documentation), pre-oxygenation (88%), staff (90% were AAS practitioners) and monitoring (92% use of non-invasive blood pressure, pulse oximetry, capnography, and cardiac rhythm monitoring) during procedure, and discharge instructions including the documented return of normal vitals and consciousness (82%). This procedural sedation checklist is a safe intervention that identifies pertinent information about the patient and provides a standardised checklist for the delivery of gold standard of care.Keywords: advanced airway skills, checklist, procedural sedation, resuscitation
Procedia PDF Downloads 111242 Cardiolipin-Incorporated Liposomes Carrying Curcumin and Nerve Growth Factor to Rescue Neurons from Apoptosis for Alzheimer’s Disease Treatment
Authors: Yung-Chih Kuo, Che-Yu Lin, Jay-Shake Li, Yung-I Lou
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Curcumin (CRM) and nerve growth factor (NGF) were entrapped in liposomes (LIP) with cardiolipin (CL) to downregulate the phosphorylation of mitogen-activated protein kinases for Alzheimer’s disease (AD) management. AD belongs to neurodegenerative disorder with a gradual loss of memory, yielding irreversible dementia. CL-conjugated LIP loaded with CRM (CRM-CL/LIP) and that with NGF (NGF-CL/LIP) were applied to AD models of SK-N-MC cells and Wistar rats with an insult of β-amyloid peptide (Aβ). Lipids comprising 1,2-dipalmitoyl-sn-glycero-3- phosphocholine (Avanti Polar Lipids, Alabaster, AL), 1',3'-bis[1,2- dimyristoyl-sn-glycero-3-phospho]-sn-glycerol (CL; Avanti Polar Lipids), 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine-N- [methoxy(polyethylene glycol)-2000] (Avanti Polar Lipids), 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[carboxy(polyethylene glycol)-2000] (Avanti Polar Lipids) and CRM (Sigma–Aldrich, St. Louis, MO) were dissolved in chloroform (J. T. Baker, Phillipsburg, NJ) and condensed using a rotary evaporator (Panchum, Kaohsiung, Taiwan). Human β-NGF (Alomone Lab, Jerusalem, Israel) was added in the aqueous phase. Wheat germ agglutinin (WGA; Medicago AB, Uppsala, Sweden) was grafted on LIP loaded with CRM for (WGA-CRM-LIP) and CL-conjugated LIP loaded with CRM (WGA-CRM-CL/LIP) using 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (Sigma–Aldrich) and N-hydroxysuccinimide (Alfa Aesar, Ward Hill, MA). The protein samples of SK-N-MC cells (American Type Tissue Collection, Rockville, MD) were used for sodium dodecyl sulfate (Sigma–Aldrich) polyacrylamide gel (Sigma–Aldrich) electrophoresis. In animal study, the LIP formulations were administered by intravenous injection via a tail vein of male Wistar rats (250–280 g, 8 weeks, BioLasco, Taipei, Taiwan), which were housed in the Animal Laboratory of National Chung Cheng University in accordance with the institutional guidelines and the guidelines of Animal Protection Committee under the Council of Agriculture of the Republic of China. We found that CRM-CL/LIP could inhibit the expressions of phosphorylated p38 (p-p38), p-Jun N-terminal kinase (p-JNK), and p-tau protein at serine 202 (p-Ser202) to retard the neuronal apoptosis. Free CRM and released CRM from CRM-LIP and CRM-CL/LIP were not in a straightforward manner to effectively inhibit the expression of p-p38 and p-JNK in the cytoplasm. In addition, NGF-CL/LIP enhanced the quantities of p-neurotrophic tyrosine kinase receptor type 1 (p-TrkA) and p-extracellular-signal-regulated kinase 5 (p-ERK5), preventing the Aβ-induced degeneration of neurons. The membrane fusion of NGF-LIP activated the ERK5 pathway and the targeting capacity of NGF-CL/LIP enhanced the possibility of released NGF to affect the TrkA level. Moreover, WGA-CRM-LIP improved the permeation of CRM across the blood–brain barrier (BBB) and significantly reduced the Aβ plaque deposition and malondialdehyde level and increased the percentage of normal neurons and cholinergic function in the hippocampus of AD rats. This was mainly because the encapsulated CRM was protected by LIP against a rapid degradation in the blood. Furthermore, WGA on LIP could target N-acetylglucosamine on endothelia and increased the quantity of CRM transported across the BBB. In addition, WGA-CRM-CL/LIP could be effective in suppressing the synthesis of acetylcholinesterase and reduced the decomposition of acetylcholine for better neurotransmission. Based on the in vitro and in vivo evidences, WGA-CRM-CL/LIP can rescue neurons from apoptosis in the brain and can be a promising drug delivery system for clinical AD therapy.Keywords: Alzheimer’s disease, β-amyloid, liposome, mitogen-activated protein kinase
Procedia PDF Downloads 328241 A Study on Development Strategies of Marine Leisure Tourism Using AHP
Authors: Da-Hye Jang, Woo-Jeong Cho
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Marine leisure tourism contributes greatly to the national economy in which the sea is located nearby and many countries are using marine tourism to create value added. The interest and investment of government and local governments on marine leisure tourism growing as a major trend of marine tourism is steadily increasing. But indiscriminate investment in marine leisure tourism such as duplicated business wastes limited resources. In other words, government and local governments need to select and concentrate on the goal they pursue by drawing priority on maritime leisure tourism policies. The purpose of this study is to analyze development strategies on supplier for marine leisure tourism and thus provide a comprehensive and rational framework for developing marine leisure tourism. In order to achieve the purpose, this study is to analyze priorities for each evaluation criterion of marine leisure tourism development policies using Analytic Hierarchy Process. In this study, a questionnaire was used as the survey tool and was developed based on the previous studies, government report, regional report, related thesis and literature for marine leisure tourism. The questionnaire was constructed by verifying the validity of contents from the expert group related to marine leisure tourism after conducting the first and second preliminary surveys. The AHP survey was conducted to experts (university professors, researchers, field specialists and related public officials) from April 6, 2018 to April 30, 2018 by visiting in person or e-mail. This study distributed 123 questionnaires and 68 valid questionnaires were used for data analysis. As a result, 4 factors with 12 detail strategies were analyzed using Excel. Extracted factors of development strategies of marine leisure tourism are consist of 4 factors such as infrastructure, popularization, law & system improvement and advancement. In conclusion, the results of the pairwise comparison of the four major factor on the first class were infrastructure, popularization, law & system improvement and advancement in order. Second, marine water front space maintenance had higher priority than marina facilities expansion and the establishment of marine leisure education center. Third, marine leisure safety·culture improvement had higher priority than strengthening experience·education program and the upkeep and open promotion event. Fourth, specialization·cluster of marine leisure tourism had higher priority than business support system of marine leisure tourism. Fifth, the revision of water-related leisure activities safety act had higher priority than an enactment of marine tourism promotion act and the foster of marina service industry. Finally, marine water front space maintenance was the most important development plan to boost marine leisure tourism.Keywords: marine leisure tourism, marine leisure, marine tourism, analytic hierarchy process
Procedia PDF Downloads 159240 Working Capital Management Practices in Small Businesses in Victoria
Authors: Ranjith Ihalanayake, Lalith Seelanatha, John Breen
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In this study, we explored the current working capital management practices as applied in small businesses in Victoria, filling an existing theoretical and empirical gap in literature in general and in Australia in particular. Amidst the current global competitive and dynamic environment, the short term insolvency of small businesses is very critical for the long run survival. A firm’s short-term insolvency is dependent on the availability of sufficient working capital for feeding day to day operational activities. Therefore, given the reliance for short-term funding by small businesses, it has been recognized that the efficient management of working capital is crucial in respect of the prosperity and survival of such firms. Against this background, this research was an attempt to understand the current working capital management strategies and practices used by the small scale businesses. To this end, we conducted an internet survey among 220 small businesses operating in Victoria, Australia. The survey results suggest that the majority of respondents are owner-manager (73%) and male (68%). Respondents participated in this survey mostly have a degree (46%). About a half of respondents are more than 50 years old. Most of respondents (64%) have business management experience more than ten years. Similarly, majority of them (63%) had experience in the area of their current business. Types of business of the respondents are: Private limited company (41%), sole proprietorship (37%), and partnership (15%). In addition, majority of the firms are service companies (63%), followed by retailed companies (25%), and manufacturing (17%). Size of companies of this survey varies, 32% of them have annual sales $100,000 or under, while 22% of them have revenue more than $1,000,000 every year. In regards to the total assets, majority of respondents (43%) have total assets $100,000 or less while 20% of respondents have total assets more than $1,000,000. In regards to WCMPs, results indicate that almost 70% of respondents mentioned that they are responsible for managing their business working capital. The survey shows that majority of respondents (65.5%) use their business experience to identify the level of investment in working capital, compared to 22% of respondents who seek advice from professionals. The other 10% of respondents, however, follow industry practice to identify the level of working capital. The survey also shows that more than a half of respondents maintain good liquidity financial position for their business by having accounts payable less than accounts receivable. This study finds that majority of small business companies in western area of Victoria have a WCM policy but only about 8 % of them have a formal policy. Majority of the businesses (52.7%) have an informal policy while 39.5% have no policy. Of those who have a policy, 44% described their working capital management policies as a compromise policy while 35% described their policy as a conservative policy. Only 6% of respondents apply aggressive policy. Overall the results indicate that the small businesses pay less attention into the management of working capital of their business despite its significance in the successful operation of the business. This approach may be adopted during favourable economic times. However, during relatively turbulent economic conditions, such an approach could lead to greater financial difficulties i.e. short-term financial insolvency.Keywords: small business, working capital management, Australia, sufficient, financial insolvency
Procedia PDF Downloads 348239 “Student Veterans’ Transition to Nursing Education: Barriers and Facilitators
Authors: Bruce Hunter
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Background: The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that support their success. Methods: This study utilizes an explanatory mixed-methods approach. The research participants include student veterans enrolled in nursing programs across three academic institutions in the Southeastern United States. Quantitative Phase: A Likert scale instrument is distributed to a sample of student veterans in nursing programs. The survey assesses demographic information, academic experiences, social experiences, and perceptions of institutional support. Quantitative data is analyzed using descriptive statistics to assess demographics and to identify barriers and facilitators to the transition. Qualitative Phase: Two open-ended questions were posed to student veterans to explore their lived experiences, barriers, and facilitators during the transition to nursing education and to further explain the quantitative findings. Thematic analysis with line-by-line coding is employed to identify recurring themes and narratives that may shed light on the barriers and facilitators encountered. Results: This study found that the successful academic integration of student veterans lies in recognizing the diversity of values and attitudes among student veterans, understanding the potential challenges they face, and engaging in initiative-taking steps to create an inclusive and supportive academic environment that accommodates the unique experiences of this demographic. Addressing these academic and social integration concerns can contribute to a more understanding environment for student veterans in the BSN program. Conclusion: Providing support during this transitional period is crucial not only for retaining veterans, but also for bolstering their success in achieving the status of registered nurses. Acquiring an understanding of military culture emerges as an essential initial step for nursing faculty in student veteran retention and for successful completion of their programs. Participants found that their transition experience lacked meaningful social interactions, which could foster a positive learning environment, enhance their emotional well-being, and could contribute significantly to their overall success and satisfaction in their nursing education journey. Recognizing and promoting academic and social integration is important in helping veterans experience a smooth transition into and through the unfamiliar academic environment of nursing education.Keywords: nursing, education, student veterans, barriers, facilitators
Procedia PDF Downloads 45238 Basal Cell Carcinoma: Epidemiological Analysis of a 5-Year Period in a Brazilian City with a High Level of Solar Radiation
Authors: Maria E. V. Amarante, Carolina L. Cerdeira, Julia V. Cortes, Fiorita G. L. Mundim
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Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in humans. It arises from the basal cells of the epidermis and cutaneous appendages. The role of sunlight exposure as a risk factor for BCC is very well defined due to its power to influence genetic mutations, in addition to having a suppressor effect on the skin immune system. Despite showing low metastasis and mortality rates, the tumor is locally infiltrative, aggressive, and destructive. Considering the high prevalence rate of this carcinoma and the importance of early detection, a retrospective study was carried out in order to correlate the clinical data available on BBC, characterize it epidemiologically, and thus enable effective prevention measures for the population. Data on the period from January 2015 to December 2019 were collected from the medical records of patients registered at one pathology service located in the southeast region of Brazil, known as SVO, which delivers skin biopsy results. The study was aimed at correlating the variables, sex, age, and subtypes found. Data analysis was performed using the chi-square test at a nominal significance level of 5% in order to verify the independence between the variables of interest. Fisher's exact test was applied in cases where the absolute frequency in the cells of the contingency table was less than or equal to five. The statistical analysis was performed using the R® software. Ninety-three basal cell carcinoma were analyzed, and its frequency in the 31-to 45-year-old age group was 5.8 times higher in men than in women, whereas, from 46 to 59 years, the frequency was found 2.4 times higher in women than in men. Between the ages of 46 to 59 years, it should be noted that the sclerodermiform subtype appears more than the solid one, with a difference of 7.26 percentage points. Reversely, the solid form appears more frequently in individuals aged 60 years or more, with a difference of 8.57 percentage points. Among women, the frequency of the solid subtype was 9.93 percentage points higher than the sclerodermiform frequency. In males, the same percentage difference is observed, but sclerodermiform is the most prevalent subtype. It is concluded in this study that, in general, there is a predominance of basal cell carcinoma in females and in individuals aged 60 years and over, which demonstrates the tendency of this tumor. However, when rarely found in younger individuals, the male gender prevailed. The most prevalent subtype was the solid one. It is worth mentioning that the sclerodermiform subtype, which is more aggressive, was seen more frequently in males and in the 46-to 59-year-old range.Keywords: basal cell carcinoma, epidemiology, sclerodermiform basal cell carcinoma, skin cancer, solar radiation, solid basal cell carcinoma
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