Search results for: treatment based on acceptance and commitment
29884 PID Control of Quad-Rotor Unnamed Vehicle Based on Lagrange Approach Modelling
Authors: A. Benbouali, H. Saidi, A. Derrouazin, T. Bessaad
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Aerial robotics is a very exciting research field dealing with a variety of subjects, including the attitude control. This paper deals with the control of a four rotor vertical take-off and landing (VTOL) Unmanned Aerial Vehicle. The paper presents a mathematical model based on the approach of Lagrange for the flight control of an autonomous quad-rotor. It also describes the controller architecture which is based on PID regulators. The control method has been simulated in closed loop in different situations. All the calculation stages and the simulation results have been detailed.Keywords: quad-rotor, lagrange approach, proportional integral derivate (PID) controller, Matlab/Simulink
Procedia PDF Downloads 40229883 Amsan Syndrome in Emergency Department
Authors: Okan Cakir, Okan Tatli
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Acute motor and sensory axonal neuropathy (AMSAN) syndrome usually occurs following a postviral infection in two to four weeks and is a polyneuropathy characterized by axonal and sensorial degeneration as a rare variant of Gullian-Barre syndrome. In our case, we wanted to mention that a rare case of AMSAN Syndrome due to prior surgery. A 61-year-old male case admitted to emergency department with complaints of weakness in feet, numbness and incapability to walk. In his history, it was learned that endovascular aneurysm repair (EVAR) had applied for abdominal aort aneurysm two weeks ago before admission, his complaints had been for a couple of days increasingly and bilaterally, and there had been no infection disease history for four weeks. In physical examination, general status was good, vital signs were stable, and there was a mild paresis in dorsal flexion of feet in bilaterally lower extremities. No nuchal rigidity was determined. Other system examinations were normal. Urea:52 mg/dL (normal range: 15-44 mg/dL), creatinine: 1,05 mg/dL (normal range: 0,81-1,4 mg/dL), potassium: 3,68 mmol/L (normal range: 3,5-5,5 mmol/L), glycaemia: 142 mg/dL, calcium: 9,71 mg/dL (normal range: 8,5-10,5 mg/dL), erythrocyte sedimentation rate (ESR): 74 mm/h (normal range: 0-15 mm/h) were determined in biochemical tests. The case was consulted to neurology department and hospitalized. In performing electromyography, it was reported as a bilateral significant axonal degeneration with sensory-motor polyneuropathy. Normal ranges of glycaemia and protein levels were detected in lumbal punction. Viral markers and bucella, toxoplasma, and rubella markers were in normal range. Intravenous immunoglobulin (IVIG) was applied as a treatment, physical treatment programme was planned and the case discharged from neurology department. In our case, we mentioned that it should be considered polyneuropathy as an alternative diagnosis in cases admitting symptoms like weakness and numbness had a history of prior surgery.Keywords: AMSAN Syndrome, emergency department, prior surgery, weakness
Procedia PDF Downloads 34429882 Heavy Metal Adsorption from Synthetic Wastewater Using Agro Waste-Based Nanoparticles: A Comparative Study
Authors: Nomthandazo Precious Sibiya, Thembisile Patience Mahlangu, Sudesh Rathilal
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Heavy metal removal is critical in the wastewater treatment process due to its numerous harmful effects on human and aquatic life. There are several chemical and physical techniques for removing heavy metals from wastewater, including ion exchange, reverse osmosis, adsorption, electrodialysis, and ultrafiltration. However, adsorption technology has captivated researchers for years due to its low cost, high efficiency, and compatible with the environment. In this study, the adsorption effectiveness of three modified agro-waste materials was explored for the removal of lead from synthetic wastewater: banana peels (BP), orange peels (OP), and sugarcane bagasse (SB). The magnetite (Fe₃O₄) is incorporated with BP, OP, and SB at a ratio of 1:1 to create magnetic biosorbents. Characterization of biosorbents was carried out using and scanning electron microscopy (SEM) combined with energy-dispersive X-ray (EDX) to investigate surface morphology and elemental compositions, respectively. A series of batch experiments were carried out to investigate the effects of adsorbent mass, agitation time, and initial pH concentration on adsorption behaviour, as well as adsorption isotherms and kinetics. The removal efficiency of lead by the modified agro-waste materials proved to be superior to that of non-modified agro-waste materials. The proof of concept was achieved, and agro-waste materials can be paired with adsorption technology to effectively remove lead from aqueous media. The use of agricultural waste as biosorbents will aid in waste reduction and management.Keywords: adsorption, isotherms, kinetics, agro waste, nanoparticles, batch
Procedia PDF Downloads 7229881 Hydrogen Production Through Thermocatalytic Decomposition of Methane Over Biochar
Authors: Seyed Mohamad Rasool Mirkarimi, David Chiaramonti, Samir Bensaid
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Catalytic methane decomposition (CMD, reaction 4) is a one-step process for hydrogen production where carbon in the methane molecule is sequestered in the form of stable and higher-value carbon materials. Metallic catalysts and carbon-based catalysts are two major types of catalysts utilized for the CDM process. Although carbon-based catalysts have lower activity compared to metallic ones, they are less expensive and offer high thermal stability and strong resistance to chemical impurities such as sulfur. Also, it would require less costly separation methods as some of the carbon-based catalysts may not have an active metal component in them. Since the regeneration of metallic catalysts requires burning of the C on their surfaces, which emits CO/CO2, in some cases, using carbon-based catalysts would be recommended because regeneration can be completely avoided, and the catalyst can be directly used in other processes. This work focuses on the effect of biochar as a carbon-based catalyst for the conversion of methane into hydrogen and carbon. Biochar produced from the pyrolysis of poplar wood and activated biochar are used as catalysts for this process. In order to observe the impact of carbon-based catalysts on methane conversion, methane cracking in the absence and presence of catalysts for a gas stream with different levels of methane concentration should be performed. The results of these experiments prove conversion of methane in the absence of catalysts at 900 °C is negligible, whereas in the presence of biochar and activated biochar, significant growth has been observed. Comparing the results of the tests related to using char and activated char shows the enhancement obtained in BET surface area of the catalyst through activation leads to more than 10 vol.% methane conversion.Keywords: hydrogen production, catalytic methane decomposition, biochar, activated biochar, carbon-based catalyts
Procedia PDF Downloads 8529880 Antimicrobial Action and Its Underlying Mechanism by Methanolic Seed Extract of Syzygium cumini on Bacillus subtilis
Authors: Alok Kumar Yadav, Saurabh Saraswat, Preeti Sirohi, Manjoo Rani, Sameer Srivastava, Manish Pratap Singh, Nand K. Singh
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The development of antibiotic resistance in bacteria is increasing at an alarming rate, and this is considered as one of the most serious threats in the history of medicine, and an alternative solution should be derived so as to tackle this problem. In many countries, people use the medicinal plants for the treatment of various diseases as these are cheaper, easily available and least toxic. Syzygium cumini is used for the treatment of various kinds of diseases but their mechanism of action is not reported. The antimicrobial activity of Syzygium cumini was tested by the well diffusion assay and zone of inhibition was reported to be 20.06 mm as compared to control with MIC of 0.3 mg/ml. Genomic DNA fragmentation of Bacillus subtilis revealed apoptosis and FE-SEM indicate cell wall cracking on several intervals of time. Propidium iodide staining results showed that few bacterial cells were stained in the control and population of stained cells increase after exposing them for various period of time. Flow cytometric kinetic data analysis on the membrane permeabilization in bacterial cell showed the significant contribution of antimicrobial potential of the seed extract on antimicrobial-induced permeabilization. Two components of Syzygium cumini methanolic seed extract was found to be quite active against four enzymes like PDB ID- 1W5D, 4OX3, 3MFD and 5E2F which have a very crucial role in membrane synthesis in Bacillus subtilis by in silico analysis. Through in silico analysis, lupeol showed highest binding energy for macromolecule 1W5D and 4OX3 whereas stigmasterol showed the highest binding energy for macromolecule 3MFD and 5E2F respectively. It showed that methanolic seed extract of Syzygium cumini can be used for the inhibition of foodborne infections caused by Bacillus subtilis and also as an alternative of prevalent antibiotics.Keywords: antibiotics, Bacillus subtilis, inhibition, Syzygium cumini
Procedia PDF Downloads 20429879 Simulation of Human Heart Activation Based on Diffusion Tensor Imaging
Authors: Ihab Elaff
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Simulating the heart’s electrical stimulation is essential in modeling and evaluating the electrophysiology behavior of the heart. For achieving that, there are two structures in concern: the ventricles’ Myocardium, and the ventricles’ Conduction Network. Ventricles’ Myocardium has been modeled as anisotropic material from Diffusion Tensor Imaging (DTI) scan, and the Conduction Network has been extracted from DTI as a case-based structure based on the biological properties of the heart tissues and the working methodology of the Magnetic Resonance Imaging (MRI) scanner. Results of the produced activation were much similar to real measurements of the reference model that was presented in the literature.Keywords: diffusion tensor, DTI, heart, conduction network, excitation propagation
Procedia PDF Downloads 27129878 Global Based Histogram for 3D Object Recognition
Authors: Somar Boubou, Tatsuo Narikiyo, Michihiro Kawanishi
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In this work, we address the problem of 3D object recognition with depth sensors such as Kinect or Structure sensor. Compared with traditional approaches based on local descriptors, which depends on local information around the object key points, we propose a global features based descriptor. Proposed descriptor, which we name as Differential Histogram of Normal Vectors (DHONV), is designed particularly to capture the surface geometric characteristics of the 3D objects represented by depth images. We describe the 3D surface of an object in each frame using a 2D spatial histogram capturing the normalized distribution of differential angles of the surface normal vectors. The object recognition experiments on the benchmark RGB-D object dataset and a self-collected dataset show that our proposed descriptor outperforms two others descriptors based on spin-images and histogram of normal vectors with linear-SVM classifier.Keywords: vision in control, robotics, histogram, differential histogram of normal vectors
Procedia PDF Downloads 28429877 Effect on Surface Temperature Reduction of Asphalt Pavements with Cement–Based Materials Containing Ceramic Waste Powder
Authors: H. Higashiyama, M. Sano, F. Nakanishi, M. Sugiyama, O. Takahashi, S. Tsukuma
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The heat island phenomenon becomes one of the environmental problems. As countermeasures in the field of road engineering, cool pavements such as water retaining pavements and solar radiation reflective pavements have been developed to reduce the surface temperature of asphalt pavements in the hot summer climate in Japan. The authors have studied on the water retaining pavements with cement–based grouting materials. The cement–based grouting materials consist of cement, ceramic waste powder, and natural zeolite. The ceramic waste powder is collected through the recycling process of electric porcelain insulators. In this study, mixing ratio between the ceramic waste powder and the natural zeolite and a type of cement for the cement–based grouting materials is investigated to measure the surface temperature of asphalt pavements in the outdoor. All of the developed cement–based grouting materials were confirmed to effectively reduce the surface temperature of the asphalt pavements. Especially, the cement–based grouting material using the ultra–rapid hardening cement with the mixing ratio of 0.7:0.3 between the ceramic waste powder and the natural zeolite reduced mostly the surface temperature by 20 °C and more.Keywords: ceramic waste powder, natural zeolite, road surface temperature, water retaining pavements
Procedia PDF Downloads 42229876 Community Based Disaster Risk Reduction in Mizoram, India
Authors: Lalrokima Chenkual
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Legal provision and various guidelines issued by the National Disaster Management Authority in India strives for setting up of disaster management authority from the central government to the district level. Community-Based Disaster Risk Reduction practice is still relevant as the communities are the victim as well as the first responder in any incidents. The primary goal of Community Based Disaster Risk Reduction is to reduce vulnerability of the concerned community and strengthen its existing capacity to cope with disaster. By involving the community in the preparedness phase, it not only increases the likelihood of coordinated action by the communities to help in mitigating disasters and lessening the impact of disaster but also brings the community together to address the issue collectively. Community participation ensures local ownership, addresses local needs, and promotes volunteerism and mutual help to prevent and minimise damage. Community-Based Disaster Risk Reduction is very much relevant for Mizoram as the society is closed knit, population is very less, religion homogeneity i.e Christianity, very active and widespread community-based organization viz, Young Mizo Association, MHIP (Women Federation), MUP (Elders Clubs which are guided together by Mizo code of morals conduct termed as Tlawmngaihna.Keywords: community, close-knit, first responder, Tlawmngaihna
Procedia PDF Downloads 14629875 Examining Contraceptive Ideational Disparities Among Adolescents and Young Women in Nigeria using Multivariate Analysis
Authors: Oluwayemisi D. Ishola, Lekan Ajijola
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Nigeria faces a demographic challenge characterized by a burgeoning youth population and an escalating fertility rate. A notable decline in the use of modern contraceptives among adolescent girls and young women compounds the challenge. The youthful demographic stands at a critical juncture in the nation's pursuit to fulfill its pledge of achieving a 27% modern contraceptive rate by 2030, embodying the potential to translate this ambitious commitment into a tangible reality. This research undertook a multi-dimensional examination to scrutinize contraceptive ideational disparities among adolescents and young women in Nigeria, with a particular emphasis on ideational factors. The data underpinning this study were drawn from a cross-sectional household survey carried out in the Nigerian states of Edo, Ogun, Plateau, and Niger between October 2019 and January 2020. The survey encompassed 2,857 sexually active women aged 15-24 years. Employing an ideational framework focusing on behavior that accentuates psychosocial factors, the study dissected nine unique ideational variables into three principal domains: social, cognitive, and emotional. Multivariate logistics regression analyses were used to assess associations between ideational elements and contraceptive use within the total sample and specific age brackets (adolescents of 15-19 years and youth of 20-24 years). For this study, a p-value less than 0.05 was considered indicative of statistical significance. The study's results revealed significant associations between the ideational variables and contraceptive use in total sample and among adolescent and youth, ranging from p < .05 to p < .001. The influence of each domain's predictors on Family Planning (FP) manifested variations when assessed separately and across the different age groups. Notably, cognitive and emotional domains were found to be the strongest predictor of contraceptive use when compared with social domains in the general sample and among youth. This study’s findings highlight the complex interplay of social, cognitive, and emotional factors in contraceptive use among young individuals. Understanding these dynamics is crucial in developing effective strategies to overcome barriers and improve access to contraceptive services among young women in Nigeria.Keywords: adolescents, contraception, ideation, youth
Procedia PDF Downloads 7729874 Energy Conversion for Sewage Sludge by Microwave Heating Pyrolysis and Gasification
Authors: Young Nam Chun, Soo Hyuk Yun, Byeo Ri Jeong
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The recent gradual increase in the energy demand is mostly met by fossil fuel, but the research on and development of new alternative energy sources is drawing much attention due to the limited fossil fuel supply and the greenhouse gas problem. Biomass is an eco-friendly renewable energy that can achieve carbon neutrality. The conversion of the biomass sludge wastes discharged from a wastewater treatment plant to clean energy is an important green energy technology in an eco-friendly way. In this NRF study, a new type of microwave thermal treatment was developed to apply the biomass-CCS technology to sludge wastes. For this, the microwave dielectric heating characteristics were examined to investigate the energy conversion mechanism for the combined drying-pyrolysis/gasification of the dewatered wet sludge. The carbon dioxide gasification was tested using the CO2 captured from the pre-combustion capture process. In addition, the results of the pyrolysis and gasification test with the wet sludge were analyzed to compare the microwave energy conversion results with the results of the use of the conventional heating method. Gas was the largest component of the product of both pyrolysis and gasification, followed by sludge char and tar. In pyrolysis, the main components of the producer gas were hydrogen and carbon monoxide, and there were some methane and hydrocarbons. In gasification, however, the amount of carbon monoxide was greater than that of hydrogen. In microwave gasification, a large amount of heavy tar was produced. The largest amount of benzene among light tar was produced in both pyrolysis and gasification. NH3 and HCN which are the precursors of NOx, generated as well. In microwave heating, the sludge char had a smooth surface, like that of glass, and in the conventional heating method with an electric furnace, deep cracks were observed in the sludge char. This indicates that the gas obtained from the microwave pyrolysis and gasification of wet sewage sludge can be used as fuel, but the heavy tar and NOx precursors in the gas must be treated. Sludge char can be used as solid fuel or as a tar reduction adsorbent in the process if necessary. This work supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2015R1R1A2A2A03003044).Keywords: microwave heating, pyrolysis gasification, precombustion CCS, sewage sludge, biomass energy
Procedia PDF Downloads 32629873 Pregnant Individuals in Rural Areas Benefit from Cognitive Behavioral Therapy: A Literature Review
Authors: Kushal Patel, Manasa Dittakavi, Cyrus Falsafi, Gretchen Lovett
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Rural America has seen a surge in opioid addiction rates and overdose deaths in recent years, becoming a significant public health crisis. This may be due to a variety of factors, such as lack of access to healthcare or other economic and social factors that can contribute to addiction such as poverty, unemployment, and social isolation. As the opioid epidemic has disproportionately affected rural communities, pregnant women in these areas may be highly susceptible and face additional difficulties in facing the appropriate care they need. Opioid use disorder has many negative effects on prenatal infants. These include changes in their microbiome, mental health, neurodevelopment and cognition. These can affect how the child performs in various activities in life and how they interact with others. It has been demonstrated that using cognitive behavioral therapy improves not just pain-related results but also mobility, quality of life, disability, and mood outcomes. This indicates that cognitive behavioral therapy (CBT) may be a useful therapeutic strategy for enhancing general health and wellbeing in people with opioid use problems. In terms of treating psychiatric diseases, CBT carries fewer dangers than opioids. One study that illustrates the potential for CBT to promote a reduction in opioid use disorder used self-reported drug use patterns 6 months prior to and during their pregnancy. At the beginning of the study, participants reported an average of 3.78 drug or alcohol use days in the previous 28 days, which decreased to 1.63 days after treatment. The study also found a decrease in depression scores, as measured by IDS scores, from 23.9 to 17.1 at the end of treatment. These and other results show that CBT can have meaningful impacts on pregnant women in Rural America who struggle with an opioid use disorder. This project has been approved by the West Virginia School of Osteopathic Medicine- Office of Research and Sponsored Programs and deemed non-research scholarly work.Keywords: appalachia, CBT, opiods, pregnancy
Procedia PDF Downloads 9629872 Case Study Hyperbaric Oxygen Therapy for Idiopathic Sudden Sensorineural Hearing Loss
Authors: Magdy I. A. Alshourbagi
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Background: The National Institute for Deafness and Communication Disorders defines idiopathic sudden sensorineural hearing loss as the idiopathic loss of hearing of at least 30 dB across 3 contiguous frequencies occurring within 3 days.The most common clinical presentation involves an individual experiencing a sudden unilateral hearing loss, tinnitus, a sensation of aural fullness and vertigo. The etiologies and pathologies of ISSNHL remain unclear. Several pathophysiological mechanisms have been described including: vascular occlusion, viral infections, labyrinthine membrane breaks, immune associated disease, abnormal cochlear stress response, trauma, abnormal tissue growth, toxins, ototoxic drugs and cochlear membrane damage. The rationale for the use of hyperbaric oxygen to treat ISSHL is supported by an understanding of the high metabolism and paucity of vascularity to the cochlea. The cochlea and the structures within it require a high oxygen supply. The direct vascular supply, particularly to the organ of Corti, is minimal. Tissue oxygenation to the structures within the cochlea occurs via oxygen diffusion from cochlear capillary networks into the perilymph and the cortilymph. . The perilymph is the primary oxygen source for these intracochlear structures. Unfortunately, perilymph oxygen tension is decreased significantly in patients with ISSHL. To achieve a consistent rise of perilymph oxygen content, the arterial-perilymphatic oxygen concentration difference must be extremely high. This can be restored with hyperbaric oxygen therapy. Subject and Methods: A 37 year old man was presented at the clinic with a five days history of muffled hearing and tinnitus of the right ear. Symptoms were sudden onset, with no associated pain, dizziness or otorrhea and no past history of hearing problems or medical illness. Family history was negative. Physical examination was normal. Otologic examination revealed normal tympanic membranes bilaterally, with no evidence of cerumen or middle ear effusion. Tuning fork examination showed positive Rinne test bilaterally but with lateralization of Weber test to the left side, indicating right ear sensorineural hearing loss. Audiometric analysis confirmed sensorineural hearing loss across all frequencies of about 70- dB in the right ear. Routine lab work were all within normal limits. Clinical diagnosis of idiopathic sudden sensorineural hearing loss of the right ear was made and the patient began a medical treatment (corticosteroid, vasodilator and HBO therapy). The recommended treatment profile consists of 100% O2 at 2.5 atmospheres absolute for 60 minutes daily (six days per week) for 40 treatments .The optimal number of HBOT treatments will vary, depending on the severity and duration of symptomatology and the response to treatment. Results: As HBOT is not yet a standard for idiopathic sudden sensorineural hearing loss, it was introduced to this patient as an adjuvant therapy. The HBOT program was scheduled for 40 sessions, we used a 12-seat multi place chamber for the HBOT, which was started at day seven after the hearing loss onset. After the tenth session of HBOT, improvement of both hearing (by audiogram) and tinnitus was obtained in the affected ear (right). Conclusions: In conclusion, HBOT may be used for idiopathic sudden sensorineural hearing loss as an adjuvant therapy. It may promote oxygenation to the inner ear apparatus and revive hearing ability. Patients who fail to respond to oral and intratympanic steroids may benefit from this treatment. Further investigation is warranted, including animal studies to understand the molecular and histopathological aspects of HBOT and randomized control clinical studies.Keywords: idiopathic sudden sensorineural hearing loss (issnhl), hyperbaric oxygen therapy (hbot), the decibel (db), oxygen (o2)
Procedia PDF Downloads 43529871 Evaluation of Stress Relief using Ultrasonic Peening in GTAW Welding and Stress Corrosion Cracking (SCC) in Stainless Steel, and Comparison with the Thermal Method
Authors: Hamidreza Mansouri
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In the construction industry, the lifespan of a metal structure is directly related to the quality of welding. In most metal structures, the welded area is considered critical and is one of the most important factors in design. To date, many fracture incidents caused by these types of cracks have occurred. Various methods exist to increase the lifespan of welds to prevent failure in the welded area. Among these methods, the application of ultrasonic peening, in addition to the stress relief process, can manually and more precisely adjust the geometry of the weld toe and prevent stress concentration in this part. This research examined Gas Tungsten Arc Welding (GTAW) on common structural steels and 316 stainless steel, which require precise welding, to predict the optimal condition. The GTAW method was used to create residual stress; two samples underwent ultrasonic stress relief, and for comparison, two samples underwent thermal stress relief. Also, no treatment was considered for two samples. The residual stress of all six pieces was measured by X-Ray Diffraction (XRD) method. Then, the two ultrasonically stress-relieved samples and two untreated samples were exposed to a corrosive environment to initiate cracking and determine the effectiveness of the ultrasonic stress relief method. Thus, the residual stress caused by GTAW in the samples decreased by 3.42% with thermal treatment and by 7.69% with ultrasonic peening. Furthermore, the results show that the untreated sample developed cracks after 740 hours, while the ultrasonically stress-relieved piece showed no cracks. Given the high costs of welding and post-welding zone modification processes, finding an economical, effective, and comprehensive method that has the least limitations alongside a broad spectrum of usage is of great importance. Therefore, the impact of various ultrasonic peening stress relief parameters and the selection of the best stress relief parameter to achieve the longest lifespan for the weld area is highly significant.Keywords: GTAW welding, stress corrosion cracking(SCC), thermal method, ultrasonic peening.
Procedia PDF Downloads 5829870 Identifying the Challenges and Opportunities of Using Lesson Study in English Language Teaching Through the Lenses of In-Service Ecuadorian EFL Teachers
Authors: Cherres Sara, Cajas Diego
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This paper explores how EFL teachers understand the process of Lesson Study in Ecuadorian schools and the challenges and opportunities that it brings to the improvement of their teaching practice. Using a narrative research methodology, this study presents the results of the application of the four steps of Lesson Study carried out by seven teachers in four different schools located in the Southern part of Ecuador during four months. Before starting the implementation of the lesson study, 30 teachers were trained on this model. This training was opened to EFL teachers working in public and private schools without any charge. The criteria to select these teachers were first, to be minimum a one-year in-service teacher, second, to have a b2 level of English, and third, to be able to commit to follow the course guidelines. After the course, seven teachers decided to continue with the implementation of the Lesson Study in their respective institutions. During the implementation of the Lesson Study, data was collected through observations, in-depth interviews and teachers’ planning meetings; and analyzed using a thematic analysis. The results of this study are presented using the lenses of seven EFL teachers that explained the challenges and opportunities that the implementation of Lesson Study conveyed. The challenges identified were the limited capacity of reflection and recognition of the activities that required improvement after the class, limited capacity to provide truthful peer feedback, teachers wrong notions about their performance in their classes, difficulties to follow a collaborative lesson plan; and, the disconnection between class activities and the class content. The opportunities identified were teachers’ predisposition to collaborate, teachers’ disposition to attend professional development courses, their commitment to work extra hours in planning meetings, their openness and their desired to be observed in their classes; and, their willingness to share class materials and knowledge. On the other hand, the results show that there is a disconnection between teachers’ knowledge of ELT and its proper application in class (from theory to practice). There are also, rigid institutional conceptions of teaching that do not allow teaching innovations. The authors concluded that there is a disconnection between teachers’ knowledge of ELT and its proper application in class (from theory to practice). There are also, rigid institutional conceptions of teaching that do not allow teaching innovations for example: excessive institutional paperwork and activities that are not connected to the development of students’ competences.Keywords: ELT, lesson study, teachers’ professional development, teachers’ collaboration
Procedia PDF Downloads 7429869 Use of Radiation Chemistry Instrumental Neutron Activation Analysis (INAA) and Atomic Absorption Spectroscopy (AAS) for the Elemental Analysis Medicinal Plants from India Used in the Treatment of Heart Diseases
Authors: B. M. Pardeshi
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Introduction: Minerals and trace elements are chemical elements required by our bodies for numerous biological and physiological processes that are necessary for the maintenance of health. Medicinal plants are highly beneficial for the maintenance of good health and prevention of diseases. They are known as potential sources of minerals and vitamins. 30 to 40% of today’s conventional drugs used in the medicinal and curative properties of various plants are employed in herbal supplement botanicals, nutraceuticals and drug. Aim: The authors explored the mineral element content of some herbs, because mineral elements may have significant role in the development and treatment of gastrointestinal diseases, and a close connection between the presence or absence of mineral elements and inflammatory mediators was noted. Methods: Present study deals with the elemental analysis of medicinal plants by Instrumental Neutron activation Analysis and Atomic Absorption Spectroscopy. Medicinal herbals prescribed for skin diseases were purchased from markets and were analyzed by Instrumental Neutron Activation Analysis (INAA) using 252Cf Californium spontaneous fission neutron source (flux * 109 n s-1) and the induced activities were counted by γ-ray spectrometry and Atomic Absorption Spectroscopy (AAS) techniques (Perkin Elmer 3100 Model) available at Department of Chemistry University of Pune, INDIA, was used for the measurement of major, minor and trace elements. Results: 15 elements viz. Al, K, Cl, Na, Mn by INAA and Cu, Co, Pb, Ni, Cr, Ca, Fe, Zn, Hg and Cd by AAS were analyzed from different medicinal plants from India. A critical examination of the data shows that the elements Ca , K, Cl, Al, and Fe are found to be present at major levels in most of the samples while the other elements Na, Mn, Cu, Co, Pb, Ni, Cr, Ca, Zn, Hg and Cd are present in minor or trace levels. Conclusion: The beneficial therapeutic effect of the studied herbs may be related to their mineral element content. The elemental concentration in different medicinal plants is discussed.Keywords: instrumental neutron activation analysis, atomic absorption spectroscopy, medicinal plants, trace elemental analysis, mineral contents
Procedia PDF Downloads 33529868 Exploring the Role of Immune-Modulators in Pathogen Recognition Receptor NOD2 Mediated Protection against Visceral Leishmaniasis
Authors: Junaid Jibran Jawed, Prasanta Saini, Subrata Majumdar
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Background: Leishmania donovani infection causes severe host immune-suppression through the modulation of pathogen recognition receptors. Apart from TLRs (Toll Like Receptor), recent studies focus on the important contribution of NLR (NOD-Like Receptor) family member NOD1 and NOD2 as these receptors are capable of triggering host innate immunity. The aim of this study was to decipher the role of NOD1/NOD2 receptors during experimental visceral leishmaniasis (VL) and the important link between host failure and parasite evasion strategy. Method: The status of NOD1 and NOD2 receptors were analysed in uninfected and infected cells through western blotting and RT-PCR. The active contributions of these receptors in reducing parasite burden were confirmed by siRNA mediated silencing, and over-expression studies and the parasite numbers were calculated through microscopic examination of the Giemsa-stained slides. In-vivo studies were done by using non-toxic dose of Mw (Mycobacterium indicus pranii), Ara-LAM(Arabinoasylated lipoarabinomannan) along with MDP (Muramyl dipeptide) administration. Result: Leishmania donovani infection of the macrophages reduced the expression of NOD2 receptors whereas NOD1 remain unaffected. MDP, a NOD2-ligand, treatment during over-expression of NOD2, reduced the parasite burden effectively which was associated with increased pro-inflammatory cytokine generation and NO production. In experimental mouse model, Ara-LAM treatment increased the expression of NOD2 and in combination with MDP it showed active therapeutic potential against VL and found to be more effective than Mw which was already reported to be involved in NOD2 modulation. Conclusion: This work explores the essential contribution of NOD2 during experimental VL and mechanistic understanding of Ara-LAM + MDP combination therapy to work against this disease and highlighted NOD2 as an essential therapeutic target.Keywords: Ara-LAM (Arabinoacylated Lipoarabinomannan), NOD2 (nucleotide binding oligomerization receptor 2), MDP (muramyl di peptide), visceral Leishmaniasis
Procedia PDF Downloads 17929867 Effects of Foliar Application of Glycine Betaine under Nickel Toxicity of Oat (Avena Sativa L.)
Authors: Khizar Hayat Bhatti, Fiza Javed, Misbah Zafar
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Oat (Avena sativa L.) is a major cereal plant belonging to the family Poaceae. It is a very important source of carbohydrates, starch, minerals, vitamins and proteins that are beneficial for general health. Plants grow in the heavy metals contaminated soils that results in decline in growth. Glycine betaine application may improve plant growth, survival and resistance to metabolic disturbances due to stresses. Heavy metals, like nickels, have been accumulated for a long time in the soil because of industrial waste and sewage. The experiment was intended to alleviate the detrimental effects of heavy metal nickel stress on two oat varieties ‘Sgd-2011 and Hay’ using Glycine betain. Nickel was induced through soil application while GB was applied as foliar spray. After 10 days of nickel treatment, an exogenous spray of glycine betaine on the intact plant leaves. Data analysis was carried out using a Completely Randomized Design (CRD) with three replications in this study. For the analysis of all the data of the current research, Mini-Tab 19 software was used to compare the mean value of all treatments and Microsoft Excel software for generating the bars graphs. Significant accelerated plant growth was recorded when Ni exposed plants were treated with GB. Based on data findings, 3mM GB caused significant recovery from Ni stress doses. Overall results also demonstrated that the sgd-2011 variety of oats had the greatest outcomes for all parameters.Keywords: CRD, foliar spray method, glycine betaine, heavy metals, nickel, ROS
Procedia PDF Downloads 1529866 Histone Deacetylases Inhibitor - Valproic Acid Sensitizes Human Melanoma Cells for alkylating agent and PARP inhibitor
Authors: Małgorzata Drzewiecka, Tomasz Śliwiński, Maciej Radek
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The inhibition of histone deacetyles (HDACs) holds promise as a potential anti-cancer therapy because histone and non-histone protein acetylation is frequently disrupted in cancer, leading to cancer initiation and progression. Additionally, histone deacetylase inhibitors (HDACi) such as class I HDAC inhibitor - valproic acid (VPA) have been shown to enhance the effectiveness of DNA-damaging factors, such as cisplatin or radiation. In this study, we found that, using of VPA in combination with talazoparib (BMN-637 – PARP1 inhibitor – PARPi) and/or Dacarabazine (DTIC - alkylating agent) resulted in increased DNA double strand break (DSB) and reduced survival (while not affecting primary melanocytes )and proliferation of melanoma cells. Furthermore, pharmacologic inhibition of class I HDACs sensitizes melanoma cells to apoptosis following exposure to DTIC and BMN-637. In addition, inhibition of HDAC caused sensitization of melanoma cells to dacarbazine and BMN-637 in melanoma xenografts in vivo. At the mRNA and protein level histone deacetylase inhibitor downregulated RAD51 and FANCD2. This study provides that combining HDACi, alkylating agent and PARPi could potentially enhance the treatment of melanoma, which is known for being one of the most aggressive malignant tumors. The findings presented here point to a scenario in which HDAC via enhancing the HR-dependent repair of DSBs created during the processing of DNA lesions, are essential nodes in the resistance of malignant melanoma cells to methylating agent-based therapies.Keywords: melanoma, hdac, parp inhibitor, valproic acid
Procedia PDF Downloads 8629865 Perception and Effect of Gender-Based Violence on Sustainable Development and Education of Girl-Child in Southwestern Nigeria
Authors: Afolabi Comfort Yemisi
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Gender-based violence remains a serious threat to the growth, health, and safety of women and girls globally, including Nigeria. The rising violence of various shades of violence, especially against women and girls in the guise of cultural preservation, raised serious concerns. The challenge of this harmful gender narrative is more critical in attaining the Sustainable Development Goals and Goal 4 (Quality Education) in Nigeria. The study investigated the perception and effects of gender-based violence on sustainable development and education of the girl-child in Southwestern Nigeria. Primary and Secondary data were used for the study. Primary data were obtained using a structured questionnaire administered to young females in tertiary institutions, secondary schools, non-governmental organizations, and government institutions dealing with gender-based violence in the study area, while the secondary data were sourced from journals, books and dailies. A multistage random sampling technique was employed to select a sample of 360 respondents who completed the questionnaire for the study. Descriptive statistics and regression analysis were applied to the data collected. The result revealed a high prevalence of gender-based violence, and it was perceived to be culturally motivated. Sexual violence, sexual harassment and psychological violence were the significant forms of gender-based violence that adversely affected the Sustainable Development Goal 4. The result further revealed that loss of concentration, shame and depression, school drop-out, poor academic performance and inferiority complex were the major effects of gender-based violence on the education of girl-child in the study area. The study recommended that to avert catastrophic damages and adverse effects of gender-based violence on the girl-child, there is a need for thorough awareness and sensitization programmes to build their resilience. Also, enforcement of established laws against gender-based violence by both government and non-governmental institutions is sacrosanct.Keywords: perception, effects, gender-based violence, sustainable development, education, girl-child, sensitisation
Procedia PDF Downloads 2029864 An Analytical View of Albanian and French Legislation on Access to Health Care Benefits
Authors: Oljana Hoxhaj
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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.Keywords: effective service, harmonization level, innovation, reform
Procedia PDF Downloads 11629863 Diversity of Microbial Ground Improvements
Authors: V. Ivanov, J. Chu, V. Stabnikov
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Low cost, sustainable, and environmentally friendly microbial cements, grouts, polysaccharides and bioplastics are useful in construction and geotechnical engineering. Construction-related biotechnologies are based on activity of different microorganisms: urease-producing, acidogenic, halophilic, alkaliphilic, denitrifying, iron- and sulphate-reducing bacteria, cyanobacteria, algae, microscopic fungi. The bio-related materials and processes can be used for the bioaggregation, soil biogrouting and bioclogging, biocementation, biodesaturation of water-satured soil, bioencapsulation of soft clay, biocoating, and biorepair of the concrete surface. Altogether with the most popular calcium- and urea based biocementation, there are possible and often are more effective such methods of ground improvement as calcium- and magnesium based biocementation, calcium phosphate strengthening of soil, calcium bicarbonate biocementation, and iron- or polysaccharide based bioclogging. The construction-related microbial biotechnologies have a lot of advantages over conventional construction materials and processes.Keywords: ground improvement, biocementation, biogrouting, microorganisms
Procedia PDF Downloads 23329862 Impact of Web 2.0 on Digital Divide in Azad Jammu and Kashmir
Authors: Sana Shokat, Rabia Riaz, Raja Shoaib Hussain, Saba Shabir
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Digital divide is usually measured in terms of gap between those who can efficiently use new technological tools, such as Internet, and those who cannot. It is also hypothesized that web 2.0 tools motivate people to use technology i.e. Social networking sites can play an important role in bridging digital gap. This study was to determine the presence of digital divide in urban and rural areas of district Muzaffrabad, Azad Jammu & Kashmir taking internet usage as the key element. A cross-sectional community based survey was conducted involving 384 respondents from city Muzaffrabad and village Garhi Doppta. The existence of digital divide was accessed on the basis of the questionnaires given. Chi- square test was used to find the association of different demographic and ICT related factors with internet usage. Age based and area based divide still exist among the targeted population but gender based digital divide is vanishing from the intended area of study. Outcomes of the survey also revealed that web 2.0-based web sites are also becoming popular and attracting people to use internet. Trend of using internet and communication technologies can be increased by solving the highlighted problems.Keywords: Azad Jammu and Kashmir, digital divide, ICT, information and communication technology, Web2.0
Procedia PDF Downloads 37329861 Utilizing Quick Response (QR) Codes and Uniform Resource Locator (URL) links in Printed Discharge Instructions for Chronic Pain Patients
Authors: Jawad Arshad
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Back and neck pain result in more than 3 million Emergency Department (ED) visits per year. Approximately 10-20% of patients with acute low back pain will continue to have moderate to severe pain after 3 months and 30% will develop chronic functional impairment. Strategies for analgesia for musculoskeletal pain upon ED discharge have been shown to be highly variable and provider dependent. The American College of Physicians, United Kingdom and Danish treatment guidelines all recommend exercise as the first line treatment for low back pain present >12 weeks and as an adjunctive treatment to education and encouraging continued mobility in acute low back pain. URL links and QR codes were embedded in Epic’s Electronic Medical Record (EMR) for seamless integration into discharge instructions. To our knowledge, this is the first time QR codes have been embedded and used as an adjunct to computer generated discharge instructions into an EMR nationwide. Materials and Methods: Eleven two-minute physical therapy (PT) videos treating a variety of common painful musculoskeletal conditions were prepared in collaboration between the Pain Management and Physical Therapy departments of a large academic center. The videos were hosted and made available on Vimeo for free public access. Dynamic QR codes and URL links were created for each video and integrated into the EPIC Electronic Medical Record discharge instructions. Both data from physician prescribed PT videos and results of public searches are included. As the case report is devoid of patient identifiable information, it is exempt from IRB review requirements as per IRB policy. Results/Case Report: From 2/6/2021 to 5/19/21, the videos were prescribed on Epic a total of 76 times, the dynamic QR codes were scanned a total of 84 times. Low back (n=32) followed by neck (n=8), shoulder (n=7) and radicular low back pain (n=7) were the most common painful complaints prescribed a PT video. The videos were played on Vimeo 790 times with 83% (n=656) being unique views and 17% returning users. Shoulder pain (n=489) followed by neck (n=36) and low back pain (n=37) were the most commonly played videos. Discussion: Patients are viewing their physical therapy videos via QR codes provided by their physicians. The large number of public views of the physical therapy videos are either from patients sharing the link/QR code or patients not affiliated with our institution are searching for videos to treat their painful complaints. The data suggests there is a need for reputable home PT videos to treat commonly encountered painful complaints with 17% of viewers returning for repeat view. The shoulder pain video was played significantly more than the others despite not being given to patients more frequently, which raised suspicion it may have received increased traffic via an outside affiliate, website or influencer. When eliminating shoulder pain from the data, individuals watched 67% of the entire video on average, indicating high engagement.Keywords: pain, EMR, emergency medicine, discharge
Procedia PDF Downloads 1029860 Laparoscopic Management of Cysts Mimicking Hepatic Cystic Echinococcosis in Children (A Case Series)
Authors: Assia Haif, Djelloul Achouri, Zineddine Soualili
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Introduction: Laparoscopic treatment of liver echinococcosis cyst has become popular. In parallel, the diagnostic approach of cystic liver lesions is based on the number of lesions and their distribution. The etiologies of cystic masses in children are different, and the role of imaging in their characterization and pre-therapeutic evaluation is essential. The main differential diagnoses of hepatic hydatid cysts can be discovered intraoperatively by minimally invasive surgery. Methods: The clinical data contained seven patients with hepatic cystic who underwent laparoscopic surgery in the Department of Pediatric Surgery, SETIF, Algeria, from 2015 to 2022. Results: Of reported seven patients, five are male, and the remaining two are female. Abdominal pain was the most frequent clinical signs. Biological parameters were within normal limits, Abdominal ultrasound, practiced in all cases, completed by abdominal computed tomography (CT), showed a hydatid cystic. For all patients, surgical procedures were performed under laparoscopy. Total cystectomy in four patients, fenestration or subtotal cystectomy in three patients, respectively. A histopathological feature confirmed the nature of the cysts. During the follow-up period, there was no recurrence. Conclusions: Laparoscopic liver surgery is a safe and effective approach, it is an alternative to conventional surgery and a reproducible method. Laparoscopic surgery approach should follow the same principals with those of open surgery. This surgical technique can rectify the diagnosis of hydatid cyst, the histopathological examination confirms the nature of the cystic lesion.Keywords: children, cyst, echinococcosis, laparoscopic, liver
Procedia PDF Downloads 14229859 Efficiency of Information Technology Based Learning and Teaching in Higher Educations
Authors: Mahalingam Palaniandi
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Higher education plays vital role in the nation building process for a country and the rest of world. The higher education sector develops the change-agents for the various fields which will help the human-kind wheel to run further. Conventional and traditional class-room based learning and teaching was followed in many decades which is one-to-one and one-to-many. In a way, these are simplest form of learners to be assembled in a class room wherein the teacher used the blackboard to demonstrate the theory and laboratories used for practical. As the technology evolved tremendously for the last 40 years, the teaching and learning environment changed slowly, wherein, the learning community will be anywhere in the world and teacher deliver the content through internet based tools such as video conferencing, web based conferencing tools or E-learning platforms such as Blackboard or noodle. Present day, the mobile technologies plays an important tool to deliver the teaching content on-the-go. Both PC based and mobile based learning technology brought the learning and teaching community together in various aspects. However, as the learning technology also brought various hurdles for learning processes such as plagiarism and not using the reference books entirely as most of the students wants the information instantaneously using internet without actually going to the library to take the notes from the millions of the books which are not available online as e-books which result lack of fundamental knowledge of the concepts complex theories. However, technology is inseparable in human life, now-a-days and every part of it contains piece of information technology right from computers to home appliances. To make use of the IT based learning and teaching at most efficiency, we should have a proper framework and recommendations laid to the learning community in order to derive the maximum efficiency from the IT based teaching and leaning. This paper discusses various IT based tools available for the learning community, efficiency from its usage and recommendations for the suitable framework that needs to be implemented at higher education institutions which makes the learners stronger in both theory as well as real-time knowledge of their studies that is going to be used in their future for the better world.Keywords: higher education, e-learning, teaching learning, eLearning tools
Procedia PDF Downloads 43429858 The Role and Challenges of Social Workers in Child Protection: The Case of Indonesia
Authors: B. Rusyidi
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Since 2009, the Indonesian Ministry of Social Affairs has been implementing Program Kesejahteraan Sosial Anak (PKSA) (Child Welfare Program) a conditional cash transfer program that targets neglected children, children with disabilities, street children, children in conflict with the law, and children in need of special protection, all from poor households. PKSA integrates three elements: Transfer of cash, care and social services through social workers, and institutional childcare assistance. This qualitative study analyzed the roles and the challenges of social workers in implementing PKSA and lays out recommendations to inform policy changes. Data were collected in late 2014 from national and local government and non-government child welfare agencies, social workers, and childcare institution representatives through interviews and Focused Group Discussions (FGDs). Field work took place in six districts in the provinces of Jakarta, Central Java and South Sulawesi. The study found that the social workers’ role was significant in facilitating cash transfer, providing education and guidance, and linking children and families to basic social services. This improved utilization of basic social services enhanced children and families’ behaviors and contributed to the well being of the children. However, only a small number of childcare institutions have social workers, leaving many children and families without care and social service linkages, depriving them of rehabilitative components to help them regain their social functions. Some social workers reported their struggles with heavy workloads, lack of professional competencies and training, limited job security, and inadequate professional acknowledgment from other professions. Parts of those challenges were due to the centralized nature of the program and the lack of shared vision and commitment about the child protection system among related government agencies both at the national and local levels. The study highlights the necessity to implement an integrated child protection system, decentralize the PKSA program, and increase the number, competence, case management, and management and monitoring of social workers. The most recent progress of the program and its impacts on social workers are also discussed.Keywords: child protection, conditional cash transfer, program decentralization, social worker, working conditions
Procedia PDF Downloads 21929857 Home-based Production of the Southern Dialect Dong Minority Women in Rural Hunan, China
Authors: Sze Wai Veera Fung, Peter W. Ferretto
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Since the economic reform in 1980s, many men and women of the southern dialect Dong minority have migrated to coastal cities for employment. Responding to the outgoing providers of the families, women, especially those at the middle age, resort to the informal home-based services and goods production for income generation. Homework, therefore, becomes a key economic strategy in supporting the household expenses in rural China, where formal employment is often inadequate for local women. This paper seeks to examine the intersection between gender and household strategy in the broader economic context of rural China. Based on the interviews and site survey in Tongdao Dong Autonomous County, the study analyses the variety of the home-based production activities, the experience of women in the production process, and the impact on familial relation and gender division of labor at home. The objective of this research is to advance the understanding of the informal economic landscape in the contemporary rural China, through which an alternative and possibly a more appropriate mode of development can be investigated.Keywords: gender relation, home-based production, household strategy, informal economy, rural China, dong minority
Procedia PDF Downloads 13629856 Planning Sustainable Urban Communities through Nature-Based Solutions: Perspectives from the Global South
Authors: Nike Jacobs, Elizelle Juanee Cilliers
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In recent decades there has been an increasing strive towards broader sustainable planning practices. A wide range of literature suggests that nature-based solutions (including Green Infrastructure planning) may lead towards socio-economically and environmentally sustainable urban communities. Such research is however mainly based on practices from the Global North with very little reference to the Global South. This study argues that there is a need for Global North knowledge to be translated to Global South context, and interpreted within this unique environment, acknowledging historical and cultural differences between Global North and Global South, and ultimately providing unique solutions for the unique urban reality. This research primarily focuses on nature-based solutions for sustainable urban communities and considers a broad literature review on Global North knowledge regarding such, substantiated by an analysis of purposefully selected case studies. The investigation identifies best practices which could be translated and place such in the context of current Global South perspectives.Keywords: global south, green infrastructure planning, nature-based solutions, sustainable urbanism, urban sustainability
Procedia PDF Downloads 26129855 Clinically-Based Improvement Project Focused on Reducing Risks Associated with Diabetes Insipidus, Syndrome of Inappropriate ADH, and Cerebral Salt Wasting in Paediatric Post-Neurosurgical and Traumatic Brain Injury Patients
Authors: Shreya Saxena, Felix Miller-Molloy, Phillipa Bowen, Greg Fellows, Elizabeth Bowen
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Background: Complex fluid balance abnormalities are well-established post-neurosurgery and traumatic brain injury (TBI). The triple-phase response requires fluid management strategies reactive to urine output and sodium homeostasis as patients shift between Diabetes Insipidus (DI) and Syndrome of Inappropriate ADH (SIADH). It was observed, at a tertiary paediatric center, a relatively high prevalence of the above complications within a cohort of paediatric post-neurosurgical and TBI patients. An audit of the clinical practice against set institutional guidelines was undertaken and analyzed to understand why this was occurring. Based on those results, new guidelines were developed with structured educational packages for the specialist teams involved. This was then reaudited, and the findings were compared. Methods: Two independent audits were conducted across two time periods, pre and post guideline change. Primary data was collected retrospectively, including both qualitative and quantitative data sets from the CQUIN neurosurgical database and electronic medical records. All paediatric patients post posterior fossa (PFT) or supratentorial surgery or with a TBI were included. A literature review of evidence-based practice, initial audit data, and stakeholder feedback was used to develop new clinical guidelines and nursing standard operation procedures. Compliance against these newly developed guidelines was re-assessed and a thematic, trend-based analysis of the two sets of results was conducted. Results: Audit-1 January2017-June2018, n=80; Audit-2 January2020-June2021, n=30 (reduced operative capacity due to COVID-19 pandemic). Overall, improvements in the monitoring of both fluid balance and electrolyte trends were demonstrated; 51% vs. 77% and 78% vs. 94%, respectively. The number of clear fluid management plans documented postoperatively also increased (odds ratio of 4), leading to earlier recognition and management of evolving fluid-balance abnormalities. The local paediatric endocrine team was involved in the care of all complex cases and notified sooner for those considered to be developing DI or SIADH (14% to 35%). However, significant Na fluctuations (>12mmol in 24 hours) remained similar – 5 vs six patients – found to be due to complex pituitary hypothalamic pathology – and the recommended adaptive fluid management strategy was still not always used. Qualitative data regarding useability and understanding of fluid-balance abnormalities and the revised guidelines were obtained from health professionals via surveys and discussion in the specialist teams providing care. The feedback highlighted the new guidelines provided a more consistent approach to the post-operative care of these patients and was a better platform for communication amongst the different specialist teams involved. The potential limitation to our study would be the small sample size on which to conduct formal analyses; however, this reflects the population that we were investigating, which we cannot control. Conclusion: The revised clinical guidelines, based on audited data, evidence-based literature review and stakeholder consultations, have demonstrated an improvement in understanding of the neuro-endocrine complications that are possible, as well as increased compliance to post-operative monitoring of fluid balance and electrolytes in this cohort of patients. Emphasis has been placed on preventative rather than treatment of DI and SIADH. Consequently, this has positively impacted patient safety for the center and highlighted the importance of educational awareness and multi-disciplinary team working.Keywords: post-operative, fluid-balance management, neuro-endocrine complications, paediatric
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