Search results for: investment project
607 Retrospective Demographic Analysis of Patients Lost to Follow-Up from Antiretroviral Therapy in Mulanje Mission Hospital, Malawi
Authors: Silas Webb, Joseph Hartland
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Background: Long-term retention of patients on ART has become a major health challenge in Sub-Saharan Africa (SSA). In 2010 a systematic review of 39 papers found that 30% of patients were no longer taking their ARTs two years after starting treatment. In the same review, it was noted that there was a paucity of data as to why patients become lost to follow-up (LTFU) in SSA. This project was performed in Mulanje Mission Hospital in Malawi as part of Swindon Academy’s Global Health eSSC. The HIV prevalence for Malawi is 10.3%, one of the highest rates in the world, however prevalence soars to 18% in the Mulanje. Therefore it is essential that patients at risk of being LTFU are identified early and managed appropriately to help them continue to participate in the service. Methodology: All patients on adult antiretroviral formulations at MMH, who were classified as ‘defaulters’ (patients missing a scheduled follow up visit by more than two months) over the last 12 months were included in the study. Demographic varibales were collected from Mastercards for data analysis. A comparison group of patients currently not lost to follow up was created by using all of the patients who attended the HIV clinic between 18th-22nd July 2016 who had never defaulted from ART. Data was analysed using the chi squared (χ²) test, as data collected was categorical, with alpha levels set at 0.05. Results: Overall, 136 patients had defaulted from ART over the past 12 months at MMH. Of these, 43 patients had missing Mastercards, so 93 defaulter datasets were analysed. In the comparison group 93 datasets were also analysed and statistical analysis done using Chi-Squared testing. A higher proportion of men in the defaulting group was noted (χ²=0.034) and defaulters tended to be younger (χ²=0.052). 94.6% of patients who defaulted were taking Tenofovir, Lamivudine and Efavirenz, the standard first line ART therapy in Malawi. The mean length of time on ART was 39.0 months (RR: -22.4-100.4) in the defaulters group and 47.3 months (RR: -19.71-114.23) in the control group, with a mean difference of 8.3 less months in the defaulters group (χ ²=0.056). Discussion: The findings in this study echo the literature, however this review expands on that and shows the demographic for the patient at most risk of defaulting and being LTFU would be: a young male who has missed more than 4 doses of ART and is within his first year of treatment. For the hospital, this data is important at it identifies significant areas for public health focus. For instance, fear of disclosure and stigma may be disproportionately affecting younger men, so interventions can be aimed specifically at them to improve their health outcomes. The mean length of time on medication was 8.3 months less in the defaulters group, with a p-value of 0.056, emphasising the need for more intensive follow-up in the early stages of treatment, when patients are at the highest risk of defaulting.Keywords: anti-retroviral therapy, ART, HIV, lost to follow up, Malawi
Procedia PDF Downloads 186606 Cellulolytic and Xylanolytic Enzymes from Mycelial Fungi
Authors: T. Sadunishvili, L. Kutateladze, T. Urushadze, R. Khvedelidze, N. Zakariashvili, M. Jobava, G. Kvesitadze
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Multiple repeated soil-climatic zones in Georgia determines the diversity of microorganisms. Hundreds of microscopic fungi of different genera have been isolated from different ecological niches, including some extreme environments. Biosynthetic ability of microscopic fungi has been studied. Trichoderma ressei, representative of the Ascomycetes secrete cellulolytic and xylanolytic enzymes that act in synergy to hydrolyze polysaccharide polymers to glucose, xylose and arabinose, which can be fermented to biofuels. The other mesophilic strains producing cellulases are Allesheria terrestris, Chaetomium thermophile, Fusarium oxysporium, Piptoporus betulinus, Penicillium echinulatum, P. purpurogenum, Aspergillus niger, A. wentii, A. versicolor, A. fumigatus etc. In the majority of the cases the cellulases produced by strains of genus Aspergillus usually have high β-glucosidase activity and average endoglucanases levels (with some exceptions), whereas strains representing Trichoderma have high endo enzyme and low β-glucosidase, and hence has limited efficiency in cellulose hydrolysis. Six producers of stable cellulases and xylanases from mesophilic and thermophilic fungi have been selected. By optimization of submerged cultivation conditions, high activities of cellulases and xylanases were obtained. For enzymes purification, their sedimentation by organic solvents such as ethyl alcohol, acetone, isopropanol and by ammonium sulphate in different ratios have been carried out. Best results were obtained with precipitation by ethyl alcohol (1:3.5) and ammonium sulphate. The yields of enzyme according to cellulase activities were 80-85% in both cases. Cellulase activity of enzyme preparation obtained from the strain Trichoderma viride X 33 is 126 U/g, from the strain Penicillium canescence D 85–185U/g and from the strain Sporotrichum pulverulentum T 5-0 110 U/g. Cellulase activity of enzyme preparation obtained from the strain Aspergillus sp. Av10 is 120 U/g, xylanase activity of enzyme preparation obtained from the strain Aspergillus niger A 7-5–1155U/g and from the strain Aspergillus niger Aj 38-1250 U/g. Optimum pH and temperature of operation and thermostability, of the enzyme preparations, were established. The efficiency of hydrolyses of different agricultural residues by the microscopic fungi cellulases has been studied. The glucose yield from the residues as a result of enzymatic hydrolysis is highly determined by the ratio of enzyme to substrate, pH, temperature, and duration of the process. Hydrolysis efficiency was significantly increased as a result of different pretreatment of the residues by different methods. Acknowledgement: The Study was supported by the ISTC project G-2117, funded by Korea.Keywords: cellulase, xylanase, microscopic fungi, enzymatic hydrolysis
Procedia PDF Downloads 392605 Dangerous Words: A Moral Economy of HIV/AIDS in Swaziland
Authors: Robin Root
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A fundamental premise of medical anthropology is that clinical phenomena are simultaneously cultural, political, and economic: none more so than the linked acronyms HIV/AIDS. For the medical researcher, HIV/AIDS signals an epidemiological pandemic and a pathophysiology. For persons diagnosed with an HIV-related condition, the acronym often conjures dread, too often marking and marginalizing the afflicted irretrievably. Critical medical anthropology is uniquely equipped to theorize the linkages that bind individual and social wellbeing to global structural and culture-specific phenomena. This paper reports findings from an anthropological study of HIV/AIDS in Swaziland, site of the highest HIV prevalence in the world. The project, initiated in 2005, has documented experiences of HIV/AIDS, religiosity, and treatment and care as well as drought and famine. Drawing on interviews with Swazi religious and traditional leaders about their experiences of leadership amidst worsening economic conditions, environmental degradation, and an ongoing global health crisis, the paper provides uncommon insights for global health practitioners whose singular paradigm for designing and delivering interventions is biomedically-based. In contrast, this paper details the role of local leaders in mediating extreme social suffering and resilience in ways that medical science cannot model but which radically impact how sickness is experienced and health services are delivered and accessed. Two concepts help to organize the paper’s argument. First, a ‘moral economy of language’ is central to showing up the implicit ‘technologies of knowledge’ that inhere in scientific and religious discourses of HIV/AIDS; people draw upon these discourses strategically to navigate highly vulnerable conditions. Second, Paulo Freire’s ethnographic focus on a culture’s 'dangerous words' opens up for examination how ‘sex’ is dangerous for religion and ‘god’ is dangerous for science. The paper interrogates hegemonic and ‘lived’ discourses, both biomedical and religious, and contributes to an important literature on the moral economies of health, a framework of explication and, importantly, action appropriate to a wide-range of contemporary global health phenomena. The paper concludes by asserting that it is imperative that global health planners reflect upon and ‘check’ their hegemonic policy platforms by, one, collaborating with local authoritative agents of ‘what sickness means and how it is best treated,’ and, two, taking account of the structural barriers to achieving good health.Keywords: Africa, biomedicine, HIV/AIDS, qualitative research , religion
Procedia PDF Downloads 103604 Experiment-Based Teaching Method for the Varying Frictional Coefficient
Authors: Mihaly Homostrei, Tamas Simon, Dorottya Schnider
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The topic of oscillation in physics is one of the key ideas which is usually taught based on the concept of harmonic oscillation. It can be an interesting activity to deal with a frictional oscillator in advanced high school classes or in university courses. Its mechanics are investigated in this research, which shows that the motion of the frictional oscillator is more complicated than a simple harmonic oscillator. The physics of the applied model in this study seems to be interesting and useful for undergraduate students. The study presents a well-known physical system, which is mostly discussed theoretically in high school and at the university. The ideal frictional oscillator is normally used as an example of harmonic oscillatory motion, as its theory relies on the constant coefficient of sliding friction. The structure of the system is simple: a rod with a homogeneous mass distribution is placed on two rotating identical cylinders placed at the same height so that they are horizontally aligned, and they rotate at the same angular velocity, however in opposite directions. Based on this setup, one could easily show that the equation of motion describes a harmonic oscillation considering the magnitudes of the normal forces in the system as the function of the position and the frictional forces with a constant coefficient of frictions are related to them. Therefore, the whole description of the model relies on simple Newtonian mechanics, which is available for students even in high school. On the other hand, the phenomenon of the described frictional oscillator does not seem to be so straightforward after all; experiments show that the simple harmonic oscillation cannot be observed in all cases, and the system performs a much more complex movement, whereby the rod adjusts itself to a non-harmonic oscillation with a nonzero stable amplitude after an unconventional damping effect. The stable amplitude, in this case, means that the position function of the rod converges to a harmonic oscillation with a constant amplitude. This leads to the idea of a more complex model which can describe the motion of the rod in a more accurate way. The main difference to the original equation of motion is the concept that the frictional coefficient varies with the relative velocity. This dependence on the velocity was investigated in many different research articles as well; however, this specific problem could demonstrate the key concept of the varying friction coefficient and its importance in an interesting and demonstrative way. The position function of the rod is described by a more complicated and non-trivial, yet more precise equation than the usual harmonic oscillation description of the movement. The study discusses the structure of the measurements related to the frictional oscillator, the qualitative and quantitative derivation of the theory, and the comparison of the final theoretical function as well as the measured position-function in time. The project provides useful materials and knowledge for undergraduate students and a new perspective in university physics education.Keywords: friction, frictional coefficient, non-harmonic oscillator, physics education
Procedia PDF Downloads 192603 Ground Improvement Using Deep Vibro Techniques at Madhepura E-Loco Project
Authors: A. Sekhar, N. Ramakrishna Raju
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This paper is a result of ground improvement using deep vibro techniques with combination of sand and stone columns performed on a highly liquefaction susceptible site (70 to 80% sand strata and balance silt) with low bearing capacities due to high settlements located (earth quake zone V as per IS code) at Madhepura, Bihar state in northern part of India. Initially, it was envisaged with bored cast in-situ/precast piles, stone/sand columns. However, after detail analysis to address both liquefaction and improve bearing capacities simultaneously, it was analyzed the deep vibro techniques with combination of sand and stone columns is excellent solution for given site condition which may be first time in India. First after detail soil investigation, pre eCPT test was conducted to evaluate the potential depth of liquefaction to densify silty sandy soils to improve factor of safety against liquefaction. Then trail test were being carried out at site by deep vibro compaction technique with sand and stone columns combination with different spacings of columns in triangular shape with different timings during each lift of vibro up to ground level. Different spacings and timing was done to obtain the most effective spacing and timing with vibro compaction technique to achieve maximum densification of saturated loose silty sandy soils uniformly for complete treated area. Then again, post eCPT test and plate load tests were conducted at all trail locations of different spacings and timing of sand and stone columns to evaluate the best results for obtaining the required factor of safety against liquefaction and the desired bearing capacities with reduced settlements for construction of industrial structures. After reviewing these results, it was noticed that the ground layers are densified more than the expected with improved factor of safety against liquefaction and achieved good bearing capacities for a given settlements as per IS codal provisions. It was also worked out for cost-effectiveness of lightly loaded single storied structures by using deep vibro technique with sand column avoiding stone. The results were observed satisfactory for resting the lightly loaded foundations. In this technique, the most important is to mitigating liquefaction with improved bearing capacities and reduced settlements to acceptable limits as per IS: 1904-1986 simultaneously up to a depth of 19M. To our best knowledge it was executed first time in India.Keywords: ground improvement, deep vibro techniques, liquefaction, bearing capacity, settlement
Procedia PDF Downloads 197602 Physicians’ Knowledge and Perception of Gene Profiling in Malaysia: A Pilot Study
Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo
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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires was returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age range from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge. However, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non-significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.Keywords: gene profiling, knowledge, Malaysia, physician
Procedia PDF Downloads 326601 Unlocking Intergenerational Abortion Stories in Gardiennes By Fanny Cabon
Authors: Lou Gargouri
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This paper examines how Fanny Cabon's solo performance, Gardiennes (2018) strategically crafts empathetic witnessing through the artist's vocal and physical embodiment of her female ancestors' testimonies, dramatizing the cyclical inheritance of reproductive trauma across generations. Drawing on affect theory and the concept of ethical co-presence, we argue that Cabon's raw voicing of illegal abortions, miscarriages, and abuse through her shape-shifting presence generates an intimate energy loop with the audience. This affective resonance catalyzes recognition of historical injustices, consecrating each singular experience while building collective solidarity. Central to Cabon's political efficacy is her transparent self-revelation through intimate impersonation, which fosters identification with diverse characters as interconnected subjects rather than objectified others. Her solo form transforms the isolation often associated with women's marginalization into radical inclusion, repositioning them from victims to empowered survivors. Comparative analysis with other contemporary works addressing abortion rights illuminates how Gardiennes subverts the traditional medical and clerical gazes that have long governed women's bodies. Ultimately, we contend Gardiennes models the potential of solo performance to harness empathy as a subversive political force. Cabon's theatrical alchemy circulates the effects of injustice through the ethical co-presence of performer and spectator, forging intersubjective connections that reframe marginalized groups traditionally objectified within dominant structures of patriarchal power. In dramatizing how the act of witnessing another's trauma can generate solidarity and galvanize resistance, Cabon's work demonstrates the role of embodied performance in catalyzing social change through the recuperation of women's voices and lived experiences. This paper thus aims to contribute to the emerging field of feminist solo performance criticism by illuminating how Cabon's innovative dramaturgy bridges the personal and the political. Her strategic mobilization of intimacy, identification, and co-presence offers a model for how the affective dynamics of autobiographical performance can be harnessed to confront gendered oppression and imagine more equitable futures. Gardiennes invites us to consider how the circulation of empathy through ethical spectatorship can foster the collective alliances necessary for advancing the unfinished project of women's liberation.Keywords: gender and sexuality studies, solo performance, trauma studies, affect theory
Procedia PDF Downloads 66600 The Advancement of Smart Cushion Product and System Design Enhancing Public Health and Well-Being at Workplace
Authors: Dosun Shin, Assegid Kidane, Pavan Turaga
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According to the National Institute of Health, living a sedentary lifestyle leads to a number of health issues, including increased risk of cardiovascular dis-ease, type 2 diabetes, obesity, and certain types of cancers. This project brings together experts in multiple disciplines to bring product design, sensor design, algorithms, and health intervention studies to develop a product and system that helps reduce the amount of time sitting at the workplace. This paper illustrates ongoing improvements to prototypes the research team developed in initial research; including working prototypes with a software application, which were developed and demonstrated for users. Additional modifications were made to improve functionality, aesthetics, and ease of use, which will be discussed in this paper. Extending on the foundations created in the initial phase, our approach sought to further improve the product by conducting additional human factor research, studying deficiencies in competitive products, testing various materials/forms, developing working prototypes, and obtaining feedback from additional potential users. The solution consisted of an aesthetically pleasing seat cover cushion that easily attaches to common office chairs found in most workplaces, ensuring a wide variety of people can use the product. The product discreetly contains sensors that track when the user sits on their chair, sending information to a phone app that triggers reminders for users to stand up and move around after sitting for a set amount of time. This paper also presents the analyzed typical office aesthetics and selected materials, colors, and forms that complimented the working environment. Comfort and ease of use remained a high priority as the design team sought to provide a product and system that integrated into the workplace. As the research team continues to test, improve, and implement this solution for the sedentary workplace, the team seeks to create a viable product that acts as an impetus for a more active workday and lifestyle, further decreasing the proliferation of chronic disease and health issues for sedentary working people. This paper illustrates in detail the processes of engineering, product design, methodology, and testing results.Keywords: anti-sedentary work behavior, new product development, sensor design, health intervention studies
Procedia PDF Downloads 158599 Analyzing Bridge Response to Wind Loads and Optimizing Design for Wind Resistance and Stability
Authors: Abdul Haq
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The goal of this research is to better understand how wind loads affect bridges and develop strategies for designing bridges that are more stable and resistant to wind. The effect of wind on bridges is essential to their safety and functionality, especially in areas that are prone to high wind speeds or violent wind conditions. The study looks at the aerodynamic forces and vibrations caused by wind and how they affect bridge construction. Part of the research method involves first understanding the underlying ideas influencing wind flow near bridges. Computational fluid dynamics (CFD) simulations are used to model and forecast the aerodynamic behaviour of bridges under different wind conditions. These models incorporate several factors, such as wind directionality, wind speed, turbulence intensity, and the influence of nearby structures or topography. The results provide significant new insights into the loads and pressures that wind places on different bridge elements, such as decks, pylons, and connections. Following the determination of the wind loads, the structural response of bridges is assessed. By simulating their dynamic behavior under wind-induced forces, Finite Element Analysis (FEA) is used to model the bridge's component parts. This work contributes to the understanding of which areas are at risk of experiencing excessive stresses, vibrations, or oscillations due to wind excitations. Because the bridge has inherent modes and frequencies, the study considers both static and dynamic responses. Various strategies are examined to maximize the design of bridges to withstand wind. It is possible to alter the bridge's geometry, add aerodynamic components, add dampers or tuned mass dampers to lessen vibrations, and boost structural rigidity. Through an analysis of several design modifications and their effectiveness, the study aims to offer guidelines and recommendations for wind-resistant bridge design. In addition to the numerical simulations and analyses, there are experimental studies. In order to assess the computational models and validate the practicality of proposed design strategies, scaled bridge models are tested in a wind tunnel. These investigations help to improve numerical models and prediction precision by providing valuable information on wind-induced forces, pressures, and flow patterns. Using a combination of numerical models, actual testing, and long-term performance evaluation, the project aims to offer practical insights and recommendations for building wind-resistant bridges that are secure, long-lasting, and comfortable for users.Keywords: wind effects, aerodynamic forces, computational fluid dynamics, finite element analysis
Procedia PDF Downloads 67598 Knowledge Transfer through Entrepreneurship: From Research at the University to the Consolidation of a Spin-off Company
Authors: Milica Lilic, Marina Rosales Martínez
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Academic research cannot be oblivious to social problems and needs, so projects that have the capacity for transformation and impact should have the opportunity to go beyond the University circles and bring benefit to society. Apart from patents and R&D research contracts, this opportunity can be achieved through entrepreneurship as one of the most direct tools to turn knowledge into a tangible product. Thus, as an example of good practices, it is intended to analyze the case of an institutional entrepreneurship program carried out at the University of Seville, aimed at researchers interested in assessing the business opportunity of their research and expanding their knowledge on procedures for the commercialization of technologies used at academic projects. The program is based on three pillars: training, teamwork sessions and networking. The training includes aspects such as product-client fit, technical-scientific and economic-financial feasibility of a spin-off, institutional organization and decision making, public and private fundraising, and making the spin-off visible in the business world (social networks, key contacts, corporate image and ethical principles). On the other hand, the teamwork sessions are guided by a mentor and aimed at identifying research results with potential, clarifying financial needs and procedures to obtain the necessary resources for the consolidation of the spin-off. This part of the program is considered to be crucial in order for the participants to convert their academic findings into a business model. Finally, the networking part is oriented to workshops about the digital transformation of a project, the accurate communication of the product or service a spin-off offers to society and the development of transferable skills necessary for managing a business. This blended program results in the final stage where each team, through an elevator pitch format, presents their research turned into a business model to an experienced jury. The awarded teams get a starting capital for their enterprise and enjoy the opportunity of formally consolidating their spin-off company at the University. Studying the results of the program, it has been shown that many researchers have basic or no knowledge of entrepreneurship skills and different ways to turn their research results into a business model with a direct impact on society. Therefore, the described program has been used as an example to highlight the importance of knowledge transfer at the University and the role that this institution should have in providing the tools to promote entrepreneurship within it. Keeping in mind that the University is defined by three main activities (teaching, research and knowledge transfer), it is safe to conclude that the latter, and the entrepreneurship as an expression of it, is crucial in order for the other two to comply with their purpose.Keywords: good practice, knowledge transfer, a spin-off company, university
Procedia PDF Downloads 146597 Management of Postoperative Pain, Intercultural Differences Among Registered Nurses: Czech Republic and Kingdom of Saudi Arabia
Authors: Denisa Mackova, Andrea Pokorna
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The management of postoperative pain is a meaningful part of quality care. The experience and knowledge of registered nurses in postoperative pain management can be influenced by local know-how. Therefore, the research helps to understand the cultural differences between two countries with the aim of evaluating the management of postoperative pain management among the nurses from the Czech Republic and the Kingdom of Saudi Arabia. Both countries have different procedures on managing postoperative pain and the research will provide an understanding of both the advantages and disadvantages of the procedures and also highlight the knowledge and experience of registered nurses in both countries. Between the Czech Republic and the Kingdom of Saudi Arabia, the expectation is for differing results in the usage of opioid analgesia for the patients postoperatively and in the experience of registered nurses with Patient Controlled Analgesia. The aim is to evaluate the knowledge and awareness of registered nurses and to merge the data with the postoperative pain management in the early postoperative period in the Czech Republic and the Kingdom of Saudi Arabia. Also, the aim is to assess the knowledge and experience of registered nurses by using Patient Controlled Analgesia and epidural analgesia treatment in the early postoperative period. The criteria for those providing input into the study, are registered nurses, working in surgical settings (standard departments, post-anesthesia care unit, day care surgery or ICU’s) caring for patients in the postoperative period. Method: Research is being conducted by questionnaires. It is a quantitative research, a comparative study of registered nurses in the Czech Republic and the Kingdom of Saudi Arabia. Questionnaire surveys were distributed through an electronic Bristol online survey. Results: The collection of the data in the Kingdom of Saudi Arabia has been completed successfully, with 550 respondents, 77 were excluded and 473 respondents were included for statistical data analysis. The outcome of the research is expected to highlight the differences in treatment through Patient Controlled Analgesia, with more frequent use in the Kingdom of Saudi Arabia. A similar assumption is expected for treatment conducted by analgesia. We predict that opioids will be used more regularly in the Kingdom of Saudi Arabia, whilst therapy through NSAID’s being the most common approach in the Czech Republic. Discussion/Conclusion: The majority of respondents from the Kingdom of Saudi Arabia were female registered nurses from a multitude of nations. We are expecting a similar split in gender between the Czech Republic respondents; however, there will be a smaller number of nationalities. Relevance for research and practice: Output from the research will assess the knowledge, experience and practice of patient controlled analgesia and epidural analgesia treatment. Acknowledgement: This research was accepted and affiliated to the project: Postoperative pain management, knowledge and experience registered nurses (Czech Republic and Kingdom of Saudi Arabia) – SGS05/2019-2020.Keywords: acute postoperative pain, epidural analgesia, nursing care, patient controlled analgesia
Procedia PDF Downloads 180596 Miniaturization of Germanium Photo-Detectors by Using Micro-Disk Resonator
Authors: Haifeng Zhou, Tsungyang Liow, Xiaoguang Tu, Eujin Lim, Chao Li, Junfeng Song, Xianshu Luo, Ying Huang, Lianxi Jia, Lianwee Luo, Kim Dowon, Qing Fang, Mingbin Yu, Guoqiang Lo
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Several Germanium photodetectors (PD) built on silicon micro-disks are fabricated on the standard Si photonics multiple project wafers (MPW) and demonstrated to exhibit very low dark current, satisfactory operation bandwidth and moderate responsivity. Among them, a vertical p-i-n Ge PD based on a 2.0 µm-radius micro-disk has a dark current of as low as 35 nA, compared to a conventional PD current of 1 µA with an area of 100 µm2. The operation bandwidth is around 15 GHz at a reverse bias of 1V. The responsivity is about 0.6 A/W. Microdisk is a striking planar structure in integrated optics to enhance light-matter interaction and construct various photonics devices. The disk geometries feature in strongly and circularly confining light into an ultra-small volume in the form of whispering gallery modes. A laser may benefit from a microdisk in which a single mode overlaps the gain materials both spatially and spectrally. Compared to microrings, micro-disk removes the inner boundaries to enable even better compactness, which also makes it very suitable for some scenarios that electrical connections are needed. For example, an ultra-low power (≈ fJ) athermal Si modulator has been demonstrated with a bit rate of 25Gbit/s by confining both photons and electrically-driven carriers into a microscale volume.In this work, we study Si-based PDs with Ge selectively grown on a microdisk with the radius of a few microns. The unique feature of using microdisk for Ge photodetector is that mode selection is not important. In the applications of laser or other passive optical components, microdisk must be designed very carefully to excite the fundamental mode in a microdisk in that essentially the microdisk usually supports many higher order modes in the radial directions. However, for detector applications, this is not an issue because the local light absorption is mode insensitive. Light power carried by all modes are expected to be converted into photo-current. Another benefit of using microdisk is that the power circulation inside avoids any introduction of the reflector. A complete simulation model with all involved materials taken into account is established to study the promise of microdisk structures for photodetector by using finite difference time domain (FDTD) method. By viewing from the current preliminary data, the directions to further improve the device performance are also discussed.Keywords: integrated optical devices, silicon photonics, micro-resonator, photodetectors
Procedia PDF Downloads 407595 Assessment of Community Perceptions of Mangrove Ecosystem Services and Their Link to SDGs in Vanga, Kenya
Authors: Samson Obiene, Khamati Shilabukha, Geoffrey Muga, James Kairo
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Mangroves play a vital role in the achievement of multiple goals of global sustainable development (SDG’s), particularly SDG SDG 14 (life under water). Their management, however, is faced with several shortcomings arising from inadequate knowledge on the perceptions of their ecosystem services, hence a need to map mangrove goods and services within SDGs while interrogating the disaggregated perceptions. This study therefore aimed at exploring the parities and disparities in attitudes and perceptions of mangrove ecosystem services among community members of Vanga and the link of the ecosystem services (ESs) to specific SDG targets. The study was based at the Kenya-Tanzania transboundary area in Vanga; where a carbon-offset project on mangroves is being up scaled. Mixed methods approach employing surveys, focus group discussions (FGDs) and reviews of secondary data were used in the study. A two stage cluster samplings was used to select the study population and the sample size. FGDs were conducted purposively selecting active participants in mangrove related activities with distinct socio-demographic characteristics. Sampled respondents comprised of males and females of different occupations and age groups. Secondary data review was used to select specific SDG targets against which mangrove ecosystem services identified through a value chain analysis were mapped. In Vanga, 20 ecosystem services were identified and categorized under supporting, cultural and aesthetic, provisioning and regulating services. According to the findings of this study, 63.9% (95% ci 56.6-69.3) perceived of the ESs as very important for economic development, 10.3% (95% ci 0-21.3) viewed them as important for environmental and ecological development while 25.8% (95% ci 2.2-32.8) were not sure of any role they play in development. In the social-economic disaggregation, ecosystem service values were found to vary with the level of interaction with the ecosystem which depended on gender and other social-economic classes within the study area. The youths, low income earners, women and those with low education levels were also identified as the primary beneficiaries of mangrove ecosystem services. The study also found that of the 17 SDGs, mangroves have a potential of influencing the achievement 12, including, SDGs 1, 2, 3, 4, 6, 8 10, 12, 13, 14, 15 and 17 either directly or indirectly. Generally therefore, the local community is aware of the critical importance mangroves for enhanced livelihood and ecological services but challenges in sustainability still occur as a result the diverse values and of the services and the contradicting interests of the different actors around the ecosystem. It is therefore important to consider parities in values and perception to avoid a ‘tragedy of the commons’ while striving to enhance sustainability of the Mangrove ecosystem.Keywords: sustainable development, community values, socio-demographics, Vanga, mangrove ecosystem services
Procedia PDF Downloads 152594 Molecular Detection of Staphylococcus aureus in the Pork Chain Supply and the Potential Anti-Staphylococcal Activity of Natural Compounds
Authors: Valeria Velasco, Ana M. Bonilla, José L. Vergara, Alcides Lofa, Jorge Campos, Pedro Rojas-García
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Staphylococcus aureus is both commensal bacterium and opportunistic pathogen that can cause different diseases in humans and can rapidly develop antimicrobial resistance. Since this bacterium has the ability to colonize the nares and skin of humans and animals, there is a risk of contamination of food in different steps of the food chain supply. Emerging strains have been detected in food-producing animals and meat, such as methicillin-resistant S. aureus (MRSA). The aim of this study was to determine the prevalence and oxacillin susceptibility of S. aureus in the pork chain supply in Chile and to suggest some natural antimicrobials for control. A total of 487 samples were collected from pigs (n=332), carcasses (n=85), and retail pork meat (n=70). Presumptive S. aureus colonies were isolated by selective enrichment and culture media. The confirmation was carried out by biochemical testing (Api® Staph) and molecular technique PCR (detection of nuc and mecA genes, associated with S. aureus and methicillin resistance, respectively). The oxacillin (β-lactam antibiotic that replaced methicillin) susceptibility was assessed by minimum inhibitory concentration (MIC) using the Epsilometer test (Etest). A preliminary assay was carried out to test thymol, carvacrol, oregano essential oil (Origanum vulgare L.), Maqui or Chilean wineberry extract (Aristotelia chilensis (Mol.) Stuntz) as anti-staphylococcal agents using the disc diffusion method at different concentrations. The overall prevalence of S. aureus in the pork chain supply reached 33.9%. A higher prevalence of S. aureus was determined in carcasses (56.5%) than in pigs (28.3%) and pork meat (32.9%) (P ≤ 0.05). The prevalence of S. aureus in pigs sampled at farms (40.6%) was higher than in pigs sampled at slaughterhouses (23.3%) (P ≤ 0.05). The contamination of no packaged meat with S. aureus (43.1%) was higher than in packaged meat (5.3%) (P ≤ 0.05). The mecA gene was not detected in S. aureus strains isolated in this study. Two S. aureus strains exhibited oxacillin resistance (MIC ≥ 4µg/mL). Anti-staphylococcal activity was detected in solutions of thymol, carvacrol, and oregano essential oil at all concentrations tested. No anti-staphylococcal activity was detected in Maqui extract. Finally, S. aureus is present in the pork chain supply in Chile. Although the mecA gene was not detected, oxacillin resistance was found in S. aureus and could be attributed to another resistance mechanism. Thymol, carvacrol, and oregano essential oil could be used as anti-staphylococcal agents at low concentrations. Research project Fondecyt No. 11140379.Keywords: antimicrobials, mecA gen, nuc gen, oxacillin susceptibility, pork meat
Procedia PDF Downloads 228593 Need for a Tailor Made HIV Prevention Services to the Migrants Community: Evidence from Implementing Migrant Service Delivery System (MSDS) among Migrant Workers, National AIDS Control Program, and India
Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal
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Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.Keywords: migrants, migrant service delivery system, risk, vulnerability
Procedia PDF Downloads 271592 Orange Leaves and Rice Straw on Methane Emission and Milk Production in Murciano-Granadina Dairy Goat Diet
Authors: Tamara Romero, Manuel Romero-Huelva, Jose V. Segarra, Jose Castro, Carlos Fernandez
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Many foods resulting from processing and manufacturing end up as waste, most of which is burned, dumped into landfills or used as compost, which leads to wasted resources, and environmental problems due to unsuitable disposal. Using residues of the crop and food processing industries to feed livestock has the advantage to obviating the need for costly waste management programs. The main residue generated in citrus cultivations and rice crop are pruning waste and rice straw, respectively. Within Spain, the Valencian Community is one of the world's oldest citrus and rice production areas. The objective of this experiment found out the effects of including orange leaves and rice straw as ingredients in the concentrate diets of goats, on milk production and methane (CH₄) emissions. Ten Murciano-Granadina dairy goats (45 kg of body weight, on average) in mid-lactation were selected in a crossover design experiment, where each goat received two treatments in 2 periods. Both groups were fed with 1.7 kg pelleted mixed ration; one group (n= 5) was a control (C) and the other group (n= 5) used orange leaves and rice straw (OR). The forage was alfalfa hay, and it was the same for the two groups (1 kg of alfalfa was offered by goat and day). The diets employed to achieve the requirements during lactation period for caprine livestock. The goats were allocated to individual metabolism cages. After 14 days of adaptation, feed intake and milk yield were recorded daily over a 5 days period. Physico-chemical parameters and somatic cell count in milk samples were determined. Then, gas exchange measurements were recorded individually by an open-circuit indirect calorimetry system using a head box. The data were analyzed by mixed model with diet and digestibility as fixed effect and goat as random effect. No differences were found for dry matter intake (2.23 kg/d, on average). Higher milk yield was found for C diet than OR (2.3 vs. 2.1 kg/goat and day, respectively) and, greater milk fat content was observed for OR than C (6.5 vs. 5.5%, respectively). The cheese extract was also greater in OR than C (10.7 vs. 9.6%). Goats fed OR diet produced significantly fewer CH₄ emissions than C diet (27 vs. 30 g/d, respectively). These preliminary results (LIFE Project LOWCARBON FEED LIFE/CCM/ES/000088) suggested that the use of these waste by-products was effective in reducing CH₄ emission without detrimental effect on milk yield.Keywords: agricultural waste, goat, milk production, methane emission
Procedia PDF Downloads 148591 Subjective Realities of Neoliberalized Social Media Natives: Trading Affect for Effect
Authors: Rory Austin Clark
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This primary research represents an ongoing two year inductive mixed-methods project endeavouring to unravel the subjective reality of hyperconnected young adults in Western societies who have come of age with social media and smartphones. It is to be presented as well as analyzed and contextualized through a written master’s thesis as well as a documentary/mockumentary meshed with a Web 2.0 app providing the capacity for prosumer, 'audience 2.0' functionality. The media component seeks to explore not only thematic issues via real-life research interviews and fictional narrative but technical issues within the format relating to the quest for intimate, authentic connection as well as compelling dissemination of scholarly knowledge in an age of ubiquitous personalized daily digital media creation and consumption. The overarching hypothesis is that the aforementioned individuals process and make sense of their world, find shared meaning, and formulate notions-of-self in ways drastically different than pre-2007 via hyper-mediation-of-self and surroundings. In this pursuit, research questions have progressed from examining how young adult digital natives understand their use of social media to notions relating to the potential functionality of Web 2.0 for prosocial and altruistic engagement, on and offline, through the eyes of these individuals no longer understood as simply digital natives, but social media natives, and at the conclusion of that phase of research, as 'neoliberalized social media natives' (NSMN). This represents the two most potent macro factors in the paradigmatic shift in NSMS’s worldview, that they are not just children of social media, but of the palpable shift to neoliberal ways of thinking and being in the western socio-cultures since the 1980s, two phenomena that have a reflexive æffective relationship on their perception of figure and ground. This phase also resulted in the working hypothesis of 'social media comparison anxiety' and a nascent understanding of NSMN’s habitus and habitation in a subjective reality of fully converged online/offline worlds, where any phenomena originating in one realm in some way are, or at the very least can be, re-presented or have effect in the other—creating hyperreal reception. This might also be understood through a 'society as symbolic cyborg model', in which individuals have a 'digital essence'-- the entirety of online content that references a single person, as an auric living, breathing cathedral, museum, gallery, and archive of self of infinite permutations and rhizomatic entry and exit points.Keywords: affect, hyperreal, neoliberalism, postmodernism, social media native, subjective reality, Web 2.0
Procedia PDF Downloads 143590 Study on Reusable, Non Adhesive Silicone Male External Catheter: Clinical Proof of Study and Quality Improvement Project
Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba
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Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.Keywords: CAUTI, male external catheter, reusable, skin adhesive
Procedia PDF Downloads 106589 Student Feedback of a Major Curricular Reform Based on Course Integration and Continuous Assessment in Electrical Engineering
Authors: Heikki Valmu, Eero Kupila, Raisa Vartia
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A major curricular reform was implemented in Metropolia UAS in 2014. The teaching was to be based on larger course entities and collaborative pedagogy. The most thorough reform was conducted in the department of electrical engineering and automation technology. It has been already shown that the reform has been extremely successful with respect to student progression and drop-out rate. The improvement of the results has been much more significant in this department compared to the other engineering departments making only minor pedagogical changes. In the beginning of the spring term of 2017, a thorough student feedback project was conducted in the department. The study consisted of thirty questions about the implementation of the curriculum, the student workload and other matters related to student satisfaction. The reply rate was more than 40%. The students were divided to four different categories: first year students [cat.1] and students of all the three different majors [categories 2-4]. These categories were found valid since all the students have the same course structure in the first two semesters after which they may freely select the major. All staff members are divided into four teams respectively. The curriculum consists of consecutive 15 credit (ECTS) courses each taught by a group of teachers (3-5). There are to be no end exams and continuous assessment is to be employed. In 2014 the different teacher groups were encouraged to employ innovatively different assessment methods within the given specs. One of these methods has been since used in categories 1 and 2. These students have to complete a number of compulsory tasks each week to pass the course and the actual grade is defined by a smaller number of tests throughout the course. The tasks vary from homework assignments, reports and laboratory exercises to larger projects and the actual smaller tests are usually organized during the regular lecture hours. The teachers of the other two majors have been pedagogically more conservative. The student progression has been better in categories 1 and 2 compared to categories 3 and 4. One of the main goals of this survey was to analyze the reasons for the difference and the assessment methods in detail besides the general student satisfaction. The results show that in the categories following more strictly the specified assessment model much more versatile assessment methods are used and the basic spirit of the new pedagogy is followed. Also, the student satisfaction is significantly better in categories 1 and 2. It may be clearly stated that continuous assessment and teacher cooperation improve the learning outcomes, student progression as well as student satisfaction. Too much academic freedom seems to lead to worse results [cat 3 and 4]. A standardized assessment model is launched for all students in autumn 2017. This model is different from the one used so far in categories 1 and 2 allowing more flexibility to teacher groups, but it will force all the teacher groups to follow the general rules in order to improve the results and the student satisfaction further.Keywords: continuous assessment, course integration, curricular reform, student feedback
Procedia PDF Downloads 203588 Developing Communicative Skills in Foreign Languages by Video Tasks
Authors: Ekaterina G. Lipatova
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The developing potential of a video task in teaching foreign languages involves the opportunities to improve four aspects of speech production process: listening, reading, speaking and writing. A video represents the sequence of actions, realized in the pictures logically connected and verbalized speech flow that simplifies and stimulates the process of perception. In this connection listening skills of students are developed effectively as well as their intellectual properties such as synthesizing, analyzing and generalizing the information. In terms of teaching capacity, a video task, in our opinion, is more stimulating than a traditional listening, since it involves the student into the plot of the communicative situation, emotional background and potentially makes them react to the gist in the cognitive and communicative ways. To be an effective method of teaching the video task should be structured in the way of psycho-linguistic characteristics of speech production process, in other words, should include three phases: before-watching, while-watching and after-watching. The system of tasks provided to each phase might involve the situations on reflecting to the video content in the forms of filling-the-gap tasks, multiple choice, True-or-False tasks (reading skills), exercises on expressing the opinion, project fulfilling (writing and speaking skills). In the before-watching phase we offer the students to adjust their perception mechanism to the topic and the problem of the chosen video by such task as “what do you know about such a problem?”, “is it new for you?”, “have you ever faced the situation of…?”. Then we proceed with the lexical and grammatical analysis of language units that form the body of a speech sample to lessen the perception and develop the student’s lexicon. The goal of while-watching phase is to build the student’s awareness about the problem presented in the video and challenge their inner attitude towards what they have seen by identifying the mistakes in the statements about the video content or making the summary, justifying their understanding. Finally, we move on to development of their speech skills within the communicative situation they observed and learnt by stimulating them to search the similar ideas in their backgrounds and represent them orally or in the written form or express their own opinion on the problem. It is compulsory to highlight, that a video task should contain the urgent, valid and interesting event related to the future profession of the student, since it will help to activate cognitive, emotional, verbal and ethic capacity of students. Also, logically structured video tasks are easily integrated into the system of e-learning and can provide the opportunity for the students to work with the foreign language on their own.Keywords: communicative situation, perception mechanism, speech production process, speech skills
Procedia PDF Downloads 245587 Effect of Packaging Material and Water-Based Solutions on Performance of Radio Frequency Identification for Food Packaging Applications
Authors: Amelia Frickey, Timothy (TJ) Sheridan, Angelica Rossi, Bahar Aliakbarian
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The growth of large food supply chains demanded improved end-to-end traceability of food products, which has led to companies being increasingly interested in using smart technologies such as Radio Frequency Identification (RFID)-enabled packaging to track items. As technology is being widely used, there are several technological or economic issues that should be overcome to facilitate the adoption of this track-and-trace technology. One of the technological challenges of RFID technology is its sensitivity to different environmental form factors, including packaging materials and the content of the packaging. Although researchers have assessed the performance loss due to the proximity of water and aqueous solutions, there is still the need to further investigate the impacts of food products on the reading range of RFID tags. However, to the best of our knowledge, there are not enough studies to determine the correlation between RFID tag performance and food beverages properties. The goal of this project was to investigate the effect of the solution properties (pH and conductivity) and different packaging materials filled with food-like water-based solutions on the performance of an RFID tag. Three commercially available ultra high-frequency RFID tags were placed on three different bottles and filled with different concentrations of water-based solutions, including sodium chloride, citric acid, sucrose, and ethanol. Transparent glass, Polyethylneterephtalate (PET), and Tetrapak® were used as the packaging materials commonly used in the beverage industries. Tag readability (Theoretical Read Range, TRR) and sensitivity (Power on Tag Forward, PoF) were determined using an anechoic chamber. First, the best place to attach the tag for each packaging material was investigated using empty and water-filled bottles. Then, the bottles were filled with the food-like solutions and tested with the three different tags and the PoF and TRR at the fixed frequency of 915MHz. In parallel, the pH and conductivity of solutions were measured. The best-performing tag was then selected to test the bottles filled with wine, orange, and apple juice. Despite various solutions altering the performance of each tag, the change in tag performance had no correlation with the pH or conductivity of the solution. Additionally, packaging material played a significant role in tag performance. Each tag tested performed optimally under different conditions. This study is the first part of comprehensive research to determine the regression model for the prediction of tag performance behavior based on the packaging material and the content. More investigations, including more tags and food products, are needed to be able to develop a robust regression model. The results of this study can be used by RFID tag manufacturers to design suitable tags for specific products with similar properties.Keywords: smart food packaging, supply chain management, food waste, radio frequency identification
Procedia PDF Downloads 114586 Optimism, Skepticism, and Uncertainty: A Qualitative Study on the Knowledge and Perceived Impact of the Affordable Care Act among Adult Patients Seeking Care in a Free Clinic
Authors: Mike Wei, Mario Cedillo, Jiahui Lin, Carol Lorraine Storey-Johnson, Carla Boutin-Foster
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Purpose: The extent to which health insurance enrollment succeeds under the Affordable Care Act (ACA) rests heavily on the ability to reach the uninsured and motivate them to enroll. We sought to identify perceptions about the ACA among uninsured patients at a free clinic in New York City. Background: The ACA holds tremendous promise for reducing the number of uninsured Americans. As of April 2014, nearly 8 million people had signed up for health insurance through the Health Insurance Marketplace. Despite this early success, future and continued enrollment rests heavily on the degree of public awareness. Reaching eligible individuals and increasing their awareness and understanding remains a fundamental challenge to realizing the full potential of the ACA. Reaching out to uninsured patients who are seeking care through safety net facilities such as free clinics may provide important avenues for reaching potential enrollees. This project focuses on the experience at the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic (WCCC), and seeks to understand perceptions about the ACA among its patient population. Methods: This was a cross-sectional study of all patients who visited the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic, from July 2013 to May 2014. Patients who provided informed consent at their visit and completed a semi-structured questionnaire were included (N=62). The questionnaire comprised of questions about demographic characteristics and open-ended questions about their knowledge and perception of the impact of the ACA. Descriptive statistics were used to characterize the population demographics. Qualitative coding techniques were used for open-ended items. Results: Approximately one third of patients surveyed never had health insurance. Of the remaining 65%, 20% lost their insurance within the past year. Only 55% had heard about the ACA, and only 10% knew about the Health Benefits Exchange. Of those who had heard about the ACA, sentiments were tinged with optimistic misperceptions, such as “it will be free health care for all.” While optimistic, most of the responses focused on the economic implications of the ACA. Conclusions: These findings reveal the immense amount of misconception and lack of understanding with regards to the ACA. As such, the study highlights the need to educate and address the concerns of those who remain skeptical or uncertain about the implications of the ACA.Keywords: Affordable Care Act, demographics, free clinics, underserved.
Procedia PDF Downloads 388585 Explore and Reduce the Performance Gap between Building Modelling Simulations and the Real World: Case Study
Authors: B. Salehi, D. Andrews, I. Chaer, A. Gillich, A. Chalk, D. Bush
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With the rapid increase of energy consumption in buildings in recent years, especially with the rise in population and growing economies, the importance of energy savings in buildings becomes more critical. One of the key factors in ensuring energy consumption is controlled and kept at a minimum is to utilise building energy modelling at the very early stages of the design. So, building modelling and simulation is a growing discipline. During the design phase of construction, modelling software can be used to estimate a building’s projected energy consumption, as well as building performance. The growth in the use of building modelling software packages opens the door for improvements in the design and also in the modelling itself by introducing novel methods such as building information modelling-based software packages which promote conventional building energy modelling into the digital building design process. To understand the most effective implementation tools, research projects undertaken should include elements of real-world experiments and not just rely on theoretical and simulated approaches. Upon review of the related studies undertaken, it’s evident that they are mostly based on modelling and simulation, which can be due to various reasons such as the more expensive and time-consuming nature of real-time data-based studies. Taking in to account the recent rise of building energy software modelling packages and the increasing number of studies utilising these methods in their projects and research, the accuracy and reliability of these modelling software packages has become even more crucial and critical. This Energy Performance Gap refers to the discrepancy between the predicted energy savings and the realised actual savings, especially after buildings implement energy-efficient technologies. There are many different software packages available which are either free or have commercial versions. In this study, IES VE (Integrated Environmental Solutions Virtual Environment) is used as it is a common Building Energy Modeling and Simulation software in the UK. This paper describes a study that compares real time results with those in a virtual model to illustrate this gap. The subject of the study is a north west facing north-west (345°) facing, naturally ventilated, conservatory within a domestic building in London is monitored during summer to capture real-time data. Then these results are compared to the virtual results of IES VE, which is a commonly used building energy modelling and simulation software in the UK. In this project, the effect of the wrong position of blinds on overheating is studied as well as providing new evidence of Performance Gap. Furthermore, the challenges of drawing the input of solar shading products in IES VE will be considered.Keywords: building energy modelling and simulation, integrated environmental solutions virtual environment, IES VE, performance gap, real time data, solar shading products
Procedia PDF Downloads 139584 Is Obesity Associated with CKD-(unknown) in Sri Lanka? A Protocol for a Cross Sectional Survey
Authors: Thaminda Liyanage, Anuga Liyanage, Chamila Kurukulasuriya, Sidath Bandara
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Background: The burden of chronic kidney disease (CKD) is growing rapidly around the world, particularly in Asia. Over the last two decades Sri Lanka has experienced an epidemic of CKD with ever growing number of patients pursuing medical care due to CKD and its complications, specially in the “Mahaweli” river basin in north central region of the island nation. This was apparently a new form of CKD which was not attributable to conventional risk factors such as diabetes mellitus, hypertension or infection and widely termed as “CKD-unknown” or “CKDu”. In the past decade a number of small scale studies were conducted to determine the aetiology, prevalence and complications of CKDu in North Central region. These hospital-based studies did not provide an accurate estimate of the problem as merely 10% or less of the people with CKD are aware of their diagnosis even in developed countries with better access to medical care. Interestingly, similar observations were made on the changing epidemiology of obesity in the region but no formal study was conducted to date to determine the magnitude of obesity burden. Moreover, if increasing obesity in the region is associated with CKD epidemic is yet to be explored. Methods: We will conduct an area wide cross sectional survey among all adult residents of the “Mahaweli” development project area 5, in the North Central Province of Sri Lanka. We will collect relevant medical history, anthropometric measurements, blood and urine for hematological and biochemical analysis. We expect a participation rate of 75%-85% of all eligible participants. Participation in the study is voluntary, there will be no incentives provided for participation. Every analysis will be conducted in a central laboratory and data will be stored securely. We will calculate the prevalence of obesity and chronic kidney disease, overall and by stage using total number of participants as the denominator and report per 1000 population. The association of obesity and CKD will be assessed with regression models and will be adjusted for potential confounding factors and stratified by potential effect modifiers where appropriate. Results: This study will provide accurate information on the prevalence of obesity and CKD in the region. Furthermore, this will explore the association between obesity and CKD, although causation may not be confirmed. Conclusion: Obesity and CKD are increasingly recognized as major public health problems in Sri Lanka. Clearly, documenting the magnitude of the problem is the essential first step. Our study will provide this vital information enabling the government to plan a coordinated response to tackle both obesity and CKD in the region.Keywords: BMI, Chronic Kidney Disease, obesity, Sri Lanka
Procedia PDF Downloads 270583 Production of Ferroboron by SHS-Metallurgy from Iron-Containing Rolled Production Wastes for Alloying of Cast Iron
Authors: G. Zakharov, Z. Aslamazashvili, M. Chikhradze, D. Kvaskhvadze, N. Khidasheli, S. Gvazava
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Traditional technologies for processing iron-containing industrial waste, including steel-rolling production, are associated with significant energy costs, the long duration of processes, and the need to use complex and expensive equipment. Waste generated during the industrial process negatively affects the environment, but at the same time, it is a valuable raw material and can be used to produce new marketable products. The study of the effectiveness of self-propagating high-temperature synthesis (SHS) methods, which are characterized by the simplicity of the necessary equipment, the purity of the final product, and the high processing speed, is under the wide scientific and practical interest to solve the set problem. The work presents technological aspects of the production of Ferro boron by the method of SHS - metallurgy from iron-containing wastes of rolled production for alloying of cast iron and results of the effect of alloying element on the degree of boron assimilation with liquid cast iron. Features of Fe-B system combustion have been investigated, and the main parameters to control the phase composition of synthesis products have been experimentally established. Effect of overloads on patterns of cast ligatures formation and mechanisms structure formation of SHS products was studied. It has been shown that an increase in the content of hematite Fe₂O₃ in iron-containing waste leads to an increase in the content of phase FeB and, accordingly, the amount of boron in the ligature. Boron content in ligature is within 3-14%, and the phase composition of obtained ligatures consists of Fe₂B and FeB phases. Depending on the initial composition of the wastes, the yield of the end product reaches 91 - 94%, and the extraction of boron is 70 - 88%. Combustion processes of high exothermic mixtures allow to obtain a wide range of boron-containing ligatures from industrial wastes. In view of the relatively low melting point of the obtained SHS-ligature, the positive dynamics of boron absorption by liquid iron is established. According to the obtained data, the degree of absorption of the ligature by alloying gray cast iron at 1450°C is 80-85%. When combined with the treatment of liquid cast iron with magnesium, followed by alloying with the developed ligature, boron losses are reduced by 5-7%. At that, uniform distribution of boron micro-additives in the volume of treated liquid metal is provided. Acknowledgment: This work was supported by Shota Rustaveli Georgian National Science Foundation of Georgia (SRGNSFG) under the GENIE project (grant number № CARYS-19-802).Keywords: self-propagating high-temperature synthesis, cast iron, industrial waste, ductile iron, structure formation
Procedia PDF Downloads 123582 Evaluation of Regional Anaesthesia Practice in Plastic Surgery: A Retrospective Cross-Sectional Study
Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam
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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia
Procedia PDF Downloads 84581 A World Map of Seabed Sediment Based on 50 Years of Knowledge
Authors: T. Garlan, I. Gabelotaud, S. Lucas, E. Marchès
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Production of a global sedimentological seabed map has been initiated in 1995 to provide the necessary tool for searches of aircraft and boats lost at sea, to give sedimentary information for nautical charts, and to provide input data for acoustic propagation modelling. This original approach had already been initiated one century ago when the French hydrographic service and the University of Nancy had produced maps of the distribution of marine sediments of the French coasts and then sediment maps of the continental shelves of Europe and North America. The current map of the sediment of oceans presented was initiated with a UNESCO's general map of the deep ocean floor. This map was adapted using a unique sediment classification to present all types of sediments: from beaches to the deep seabed and from glacial deposits to tropical sediments. In order to allow good visualization and to be adapted to the different applications, only the granularity of sediments is represented. The published seabed maps are studied, if they present an interest, the nature of the seabed is extracted from them, the sediment classification is transcribed and the resulted map is integrated in the world map. Data come also from interpretations of Multibeam Echo Sounder (MES) imagery of large hydrographic surveys of deep-ocean. These allow a very high-quality mapping of areas that until then were represented as homogeneous. The third and principal source of data comes from the integration of regional maps produced specifically for this project. These regional maps are carried out using all the bathymetric and sedimentary data of a region. This step makes it possible to produce a regional synthesis map, with the realization of generalizations in the case of over-precise data. 86 regional maps of the Atlantic Ocean, the Mediterranean Sea, and the Indian Ocean have been produced and integrated into the world sedimentary map. This work is permanent and permits a digital version every two years, with the integration of some new maps. This article describes the choices made in terms of sediment classification, the scale of source data and the zonation of the variability of the quality. This map is the final step in a system comprising the Shom Sedimentary Database, enriched by more than one million punctual and surface items of data, and four series of coastal seabed maps at 1:10,000, 1:50,000, 1:200,000 and 1:1,000,000. This step by step approach makes it possible to take into account the progresses in knowledge made in the field of seabed characterization during the last decades. Thus, the arrival of new classification systems for seafloor has improved the recent seabed maps, and the compilation of these new maps with those previously published allows a gradual enrichment of the world sedimentary map. But there is still a lot of work to enhance some regions, which are still based on data acquired more than half a century ago.Keywords: marine sedimentology, seabed map, sediment classification, world ocean
Procedia PDF Downloads 232580 Architectural Design as Knowledge Production: A Comparative Science and Technology Study of Design Teaching and Research at Different Architecture Schools
Authors: Kim Norgaard Helmersen, Jan Silberberger
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Questions of style and reproducibility in relation to architectural design are not only continuously debated; the very concepts can seem quite provocative to architects, who like to think of architectural design as depending on intuition, ideas, and individual personalities. This standpoint - dominant in architectural discourse - is challenged in the present paper presenting early findings from a comparative STS-inspired research study of architectural design teaching and research at different architecture schools in varying national contexts. In philosophy of science framework, the paper reflects empirical observations of design teaching at the Royal Academy of Fine Arts in Copenhagen and presents a tentative theoretical framework for the on-going research project. The framework suggests that architecture – as a field of knowledge production – is mainly dominated by three epistemological positions, which will be presented and discussed. Besides serving as a loosely structured framework for future data analysis, the proposed framework brings forth the argument that architecture can be roughly divided into different schools of thought, like the traditional science disciplines. Without reducing the complexity of the discipline, describing its main intellectual positions should prove fruitful for the future development of architecture as a theoretical discipline, moving an architectural critique beyond discussions of taste preferences. Unlike traditional science disciplines, there is a lack of a community-wide, shared pool of codified references in architecture, with architects instead referencing art projects, buildings, and famous architects, when positioning their standpoints. While these inscriptions work as an architectural reference system, to be compared to codified theories in academic writing of traditional research, they are not used systematically in the same way. As a result, architectural critique is often reduced to discussions of taste and subjectivity rather than epistemological positioning. Architects are often criticized as judges of taste and accused that their rationality is rooted in cultural-relative aesthetical concepts of taste closely linked to questions of style, but arguably their supposedly subjective reasoning, in fact, forms part of larger systems of thought. Putting architectural ‘styles’ under a loop, and tracing their philosophical roots, can potentially open up a black box in architectural theory. Besides ascertaining and recognizing the existence of specific ‘styles’ and thereby schools of thought in current architectural discourse, the study could potentially also point at some mutations of the conventional – something actually ‘new’ – of potentially high value for architectural design education.Keywords: architectural theory, design research, science and technology studies (STS), sociology of architecture
Procedia PDF Downloads 130579 Impact of Terrorism as an Asymmetrical Threat on the State's Conventional Security Forces
Authors: Igor Pejic
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The main focus of this research will be on analyzing correlative links between terrorism as an asymmetrical threat and the consequences it leaves on conventional security forces. The methodology behind the research will include qualitative research methods focusing on comparative analysis of books, scientific papers, documents and other sources, in order to deduce, explore and formulate the results of the research. With the coming of the 21st century and the rising multi-polar, new world threats quickly emerged. The realistic approach in international relations deems that relations among nations are in a constant state of anarchy since there are no definitive rules and the distribution of power varies widely. International relations are further characterized by egoistic and self-orientated human nature, anarchy or absence of a higher government, security and lack of morality. The asymmetry of power is also reflected on countries' security capabilities and its abilities to project power. With the coming of the new millennia and the rising multi-polar world order, the asymmetry of power can be also added as an important trait of the global society which consequently brought new threats. Among various others, terrorism is probably the most well-known, well-based and well-spread asymmetric threat. In today's global political arena, terrorism is used by state and non-state actors to fulfill their political agendas. Terrorism is used as an all-inclusive tool for regime change, subversion or a revolution. Although the nature of terrorist groups is somewhat inconsistent, terrorism as a security and social phenomenon has a one constant which is reflected in its political dimension. The state's security apparatus, which was embodied in the form of conventional armed forces, is now becoming fragile, unable to tackle new threats and to a certain extent outdated. Conventional security forces were designed to defend or engage an exterior threat which is more or less symmetric and visible. On the other hand, terrorism as an asymmetrical threat is a part of hybrid, special or asymmetric warfare in which specialized units, institutions or facilities represent the primary pillars of security. In today's global society, terrorism is probably the most acute problem which can paralyze entire countries and their political systems. This problem, however, cannot be engaged on an open field of battle, but rather it requires a different approach in which conventional armed forces cannot be used traditionally and their role must be adjusted. The research will try to shed light on the phenomena of modern day terrorism and to prove its correlation with the state conventional armed forces. States are obliged to adjust their security apparatus to the new realism of global society and terrorism as an asymmetrical threat which is a side-product of the unbalanced world.Keywords: asymmetrical warfare, conventional forces, security, terrorism
Procedia PDF Downloads 262578 Physical Model Testing of Storm-Driven Wave Impact Loads and Scour at a Beach Seawall
Authors: Sylvain Perrin, Thomas Saillour
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The Grande-Motte port and seafront development project on the French Mediterranean coastline entailed evaluating wave impact loads (pressures and forces) on the new beach seawall and comparing the resulting scour potential at the base of the existing and new seawall. A physical model was built at ARTELIA’s hydraulics laboratory in Grenoble (France) to provide insight into the evolution of scouring overtime at the front of the wall, quasi-static and impulsive wave force intensity and distribution on the wall, and water and sand overtopping discharges over the wall. The beach was constituted of fine sand and approximately 50 m wide above mean sea level (MSL). Seabed slopes were in the range of 0.5% offshore to 1.5% closer to the beach. A smooth concrete structure will replace the existing concrete seawall with an elevated curved crown wall. Prior the start of breaking (at -7 m MSL contour), storm-driven maximum spectral significant wave heights of 2.8 m and 3.2 m were estimated for the benchmark historical storm event dated of 1997 and the 50-year return period storms respectively, resulting in 1 m high waves at the beach. For the wave load assessment, a tensor scale measured wave forces and moments and five piezo / piezo-resistive pressure sensors were placed on the wall. Light-weight sediment physical model and pressure and force measurements were performed with scale 1:18. The polyvinyl chloride light-weight particles used to model the prototype silty sand had a density of approximately 1 400 kg/m3 and a median diameter (d50) of 0.3 mm. Quantitative assessments of the seabed evolution were made using a measuring rod and also a laser scan survey. Testing demonstrated the occurrence of numerous impulsive wave impacts on the reflector (22%), induced not by direct wave breaking but mostly by wave run-up slamming on the top curved part of the wall. Wave forces of up to 264 kilonewtons and impulsive pressure spikes of up to 127 kilonewtons were measured. Maximum scour of -0.9 m was measured for the new seawall versus -0.6 m for the existing seawall, which is imputable to increased wave reflection (coefficient was 25.7 - 30.4% vs 23.4 - 28.6%). This paper presents a methodology for the setup and operation of a physical model in order to assess the hydrodynamic and morphodynamic processes at a beach seawall during storms events. It discusses the pros and cons of such methodology versus others, notably regarding structures peculiarities and model effects.Keywords: beach, impacts, scour, seawall, waves
Procedia PDF Downloads 153