Search results for: improvement score

Authors: Moses Jenkins

Abstract:

Much of the focus when improving energy efficiency in buildings fall on the raising of standards within new build dwellings. However, as a significant proportion of the building stock across Europe is of historic or traditional construction, there is also a pressing need to improve the thermal performance of structures of this sort. On average, around twenty percent of buildings across Europe are built of historic masonry construction. In order to meet carbon reduction targets, these buildings will require to be retrofitted with insulation to improve their thermal performance. At the same time, there is also a need to balance this with maintaining the ability of historic masonry construction to allow moisture movement through building fabric to take place. This moisture transfer, often referred to as 'breathable construction', is critical to the success, or otherwise, of retrofit projects. The significance of this paper is to demonstrate that substantial thermal improvements can be made to historic buildings whilst avoiding damage to building fabric through surface or interstitial condensation. The paper will analyze the results of a wide range of retrofit measures installed to twenty buildings as part of Historic Environment Scotland's technical research program. This program has been active for fourteen years and has seen interventions across a wide range of building types, using over thirty different methods and materials to improve the thermal performance of historic buildings. The first part of the paper will present the range of interventions which have been made. This includes insulating mass masonry walls both internally and externally, warm and cold roof insulation and improvements to floors. The second part of the paper will present the results of monitoring work which has taken place to these buildings after being retrofitted. This will be in terms of both thermal improvement, expressed as a U-value as defined in BS EN ISO 7345:1987, and also, crucially, will present the results of moisture monitoring both on the surface of masonry walls the following retrofit and also within the masonry itself. The aim of this moisture monitoring is to establish if there are any problems with interstitial condensation. This monitoring utilizes Interstitial Hygrothermal Gradient Monitoring (IHGM) and similar methods to establish relative humidity on the surface of and within the masonry. The results of the testing are clear and significant for retrofit projects across Europe. Where a building is of historic construction the use of materials for wall, roof and floor insulation which are permeable to moisture vapor provides both significant thermal improvements (achieving a u-value as low as 0.2 Wm²K) whilst avoiding problems of both surface and intestinal condensation. As the evidence which will be presented in the paper comes from monitoring work in buildings rather than theoretical modeling, there are many important lessons which can be learned and which can inform retrofit projects to historic buildings throughout Europe.

Keywords: insulation, condensation, masonry, historic

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Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

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Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

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Authors: M. Ghasemi, S.Fazelifar

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Abstract Aim: Over-weight is not desirable and has implications for health and in the case of athletes affects performance. Exercise is a strategy used to counteract overweight owing to create a negative energy balance by increasing energy expenditure and influencing appetite regulating hormones. Interestingly, recent studies have revealed inhibitory effects of exercise on the hunger associated with these hormones in healthy subjects Neuropeptide Y(NPY) is a 36 amino acid protein that is a powerful stimulant appetite. NPY is an important central orexigenic hormone predominantly produced by the hypothalamus, and recently found to be secreted in adipose tissue. This neurotransmitter is secreted in the brain and autonomic nervous system. On the other hand, research has shown that thyme in addition to various properties, also affects the appetite. The purpose of this study was to determine Effects of eight weeks endurance training and thyme consumption on neuropeptide Y in untrained men. Methodology: 36 Healthy untrained men (mean body weight 78.25±3.2 kg, height 176±6.8 cm, age 34.32±4.54 years and BMI 29.1±4.3 kg/m2) voluntarily participated in this study . Subjects were randomly divided into four groups: 1. control, 2. Endurance training, 3. Thyme 4. Endurance training + Thyme. Amount of 10cc Blood sampling were obtained pre-test and post-test (after 8 weeks). The taken blood samples were centrifuged at 1500 × g for 15 min then plasma was stored at -20 °C until analysis. Endurance training consisted three session per week with 60% -75% of reserve heart rate for eight weeks. Exclusion criteria were history of gastrointestinal, endocrine, cardiovascular or psychological disease, and consuming any supplementation, alcohol and tobacco products. Descriptive statistics including means, standard deviations, and ranges were calculated for all measures. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p<0/05 accepted. Results: Results showed that aerobic training significantly reduced body weight, body mass index, percent body fat, but significant increase observed in maximal oxygen consumption level (p ≤ 0/05). The neuropeptide Y levels were significantly increased after exercise. Analysis of data determined that there was no significant difference between the four groups. Conclusion: Appetite control plays a critical role in the competition between energy consumption and energy expenditure. The results of this study showed that endurance training and thyme consumption can be cause improvement in physiological parameters such as increasing aerobic capacity, reduction of fat mass and improve body composition in untrained men.

Keywords: Endurance training, neuropeptide Y, thyme, untrained men

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Authors: Aditi Madan, Jayant Kumar Routray

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Purpose: Over the years flood related risks have compounded due to increasing vulnerability caused by rapid urbanisation and growing population. This increase is an indication of the need for enhancing the preparedness of institutions to respond to floods. The study describes disaster management structure and its linkages with institutions involved in managing disasters. It addresses issues and challenges associated with readiness of disaster management institutions to respond to floods. It suggests policy options for enhancing the current state of readiness of institutions to respond by considering factors like institutional, manpower, financial, technical, leadership & networking, training and awareness programs, monitoring and evaluation. Methodology: The study is based on qualitative data with statements and outputs from primary and secondary sources to understand the institutional framework for disaster management in India. Primary data included field visits, interviews with officials from institutions managing disasters and the affected community to identify the challenges faced in engaging national, state, district and local level institutions in managing disasters. For focus group discussions, meetings were held with district project officers and coordinators, local officials, community based organisation, civil defence volunteers and community heads. These discussions were held to identify the challenges associated with preparedness to respond of institutions to floods. Findings: Results show that disasters are handled by district authority and the role of local institutions is limited to a reactive role during disaster. Data also indicates that although the existing institutional setup is well coordinated at the district level but needs improvement at the local level. Wide variations exist in awareness and perception among the officials engaged in managing disasters. Additionally, their roles and responsibilities need to be clearly defined with adequate budget and dedicated permanent staff for managing disasters. Institutions need to utilise the existing manpower through proper delegation of work. Originality: The study suggests that disaster risk reduction needs to focus more towards inclusivity of the local urban bodies. Wide variations exist in awareness and perception among the officials engaged in managing disasters. In order to ensure community participation, it is important to address their social and economic problems since such issues can overshadow attempts made for reducing risks. Thus, this paper suggests development of direct linkages among institutions and community for enhancing preparedness to respond to floods.

Keywords: preparedness, response, disaster, flood, community, institution

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Authors: Itze Coronel Salomon

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The rise of organized crime and violence related to drug cartels in Mexico has created serious challenges for the authorities to provide security to those who live within its borders. However, to achieve a significant improvement in security is absolute respect for fundamental human rights by the authorities. Irregular migrants in Mexico are at serious risk of abuse. Research by Amnesty International as well as reports of the NHRC (National Human Rights) in Mexico, have indicated the major humanitarian crisis faced by thousands of migrants traveling in the shadows. However, the true extent of the problem remains invisible to the general population. The fact that federal and state governments leave no proper record of abuse and do not publish reliable data contributes to ignorance and misinformation, often spread by the media that portray migrants as the source of crime rather than their victims. Discrimination and intolerance against irregular migrants can generate greater hostility and exclusion. According to the modus operandi that has been recorded criminal organizations and criminal groups linked to drug trafficking structures deprive migrants of their liberty for forced labor and illegal activities related to drug trafficking, even some have been kidnapped for be trained as murderers . If the victim or their family cannot pay the ransom, the kidnapped person may suffer torture, mutilation and amputation of limbs or death. Migrant women are victims of sexual abuse during her abduction as well. In 2011, at least 177 bodies were identified in the largest mass grave found in Mexico, located in the town of San Fernando, in the border state of Tamaulipas, most of the victims were killed by blunt instruments, and most seemed to be immigrants and travelers passing through the country. With dozens of small graves discovered in northern Mexico, this may suggest a change in tactics between organized crime groups to the different means of obtaining revenue and reduce murder profile methods. Competition and conflict over territorial control drug trafficking can provide strong incentives for organized crime groups send signals of violence to the authorities and rival groups. However, as some Mexican organized crime groups are increasingly looking to take advantage of income and vulnerable groups, such as Central American migrants seem less interested in advertising his work to authorities and others, and more interested in evading detection and confrontation. This paper pretends to analyze the introduction of this new trend of kidnapping migrants for forced labors by drug cartels in Mexico into the forms of contemporary slavery and its implications.

Keywords: international law, migration, transnational organized crime

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Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

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Authors: Kever Gomes, Rosana Martins

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The use of environmental indicators is today an important strategy for analyzing the sustainability of agricultural systems. Despite of the considerable importance of family agriculture for Brazilian economy, sustainable agricultural practices are still weakly known, and the known ones, underused. Currently, economic aspects of the relationship between man and nature lead to the destruction of natural ecosystems, which justifies the urgent need for dissemination and usage of new sustainable production techniques. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture. This study aimed to investigate aspects related to the perception of sustainable agriculture, especially on agroforestry systems in farms of farmers from Distrito Federal-Brazil. Agro-social characteristics of farmers were systematized considering their perceptions about agroforestry systems for the preparation of proposal for a program of Environmental Services Payment, intended for families who are involved in the various activities of home gardens. This study used qualitative methodological approaches of quantitative research, using descriptive exploratory research. To get the necessary elements for the intended analysis, interviews were conducted at 40 heads of households of which 15 were men and 25 women. The results were analyzed using descriptive statistics, having been considered in the analysis the frequency, consistency, coherence and originality of responses. It was found that the lack of financial resources and lack of technical assistance are limiting factors for the dissemination and use of sustainable agricultural practices. Considering the great number of species found for the main categories of use, it can be inferred that the home gardens play important functions for the interviewed families, contributing for the food and medicine production destined for the consumption by the families themselves, and also playing an important esthetic function thanks to the variety of their ornamental plants. The wealth of these home gardens may be related to the rural origin and to the culture of the owners, who still keep a cultivation tradition. It was found that the products obtained from the home gardens contributed for the diet’s variety of the informants, representing a promising potential for the improvement of the population alimentation. The study reached the conclusion over the need to motivate the interest of these farmers to seek information and resources to enable the implementation of Agroforestry projects, including the recovery of areas in their properties, even those distinct from their backyards. The study shows the agro-social and social-cultural trajectory of the farmers and hypothesis are advanced on what would imply the adoption of agroforestry systems in family agriculture.

Keywords: agro-biodiversity, natural conservation, silviculture, urban agriculture

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Authors: Ruth Green, Samantha Milton, Rinal Desai

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Background/Aims: Eye pain/swelling/redness is a common presentation to Barnet General Hospital (a district general hospital), pediatric emergency department, and is managed by both the pediatric and emergency teams. The management of each child differs dramatically depending on the healthcare professional who reviews them. There also appears to be confusion in diagnosis between periorbital cellulitis, pre-septal cellulitis, and orbital cellulitis. Pre septal cellulitis refers to an inflammation of the eyelids and soft tissue anterior to the orbital septum. In contrast, orbital cellulitis is a serious, rapidly progressive infection of soft tissues located posterior to the orbital septum. Pre-septal cellulitis is more prevalent and less serious than orbital cellulitis, although it may be part of a continuous spectrum if untreated. Pre-septal cellulitis should there be diagnosed and treated urgently to prevent spread to the septum. For the purpose of the audit, the term periorbital cellulitis has been used as an umbrella term for all spectrums of this infection. The audit aimed to look at, how as a whole, the department is diagnosing and managing orbital and pre-septal cellulitis. Gold Standard: Patients of the same age and diagnosis should be treated with the same medication, advice, and follow-up. Method: Data was collected retrospectively from pediatric patients ( < 18years) who attended the emergency department from June 2019 to February 2020 who had been coded as pre-septal cellulitis, periorbital cellulitis, orbital cellulitis, or eye pain/swelling/redness. Demographics, signs and symptoms, management, and follow-up were recorded for all patients with any of the diagnoses of pre-septal, periorbital, or orbital cellulitis. A Microsoft Excel spreadsheet was used to record the anonymised data. Results: There were vast discrepancies in the diagnosis, management, and follow-up of patients with periorbital cellulitis. Conclusion/Discussion: The audit concluded there is no uniform approach to managing periorbital cellulitis in Barnet General Hospital Paediatric Emergency Department. Healthcare professionals misdiagnosed conjunctivitis as periorbital cellulitis, and adequate steps did not appear to be documented on excluding red flag signs and symptoms of patients presenting. There was no consistency in follow-up, with some patients having timely phone reviews or clinical reviews for mild symptoms. Advice given by the staff was appropriate, and patients did return when symptoms got worse and were treated accordingly. Plan: Given the inconsistency, a gold standard care pathway or local easily accessible clinical guideline can be developed to help with the diagnosis and management of periorbital cellulitis. Along with this, a teaching session can be carried out for the staff of the pediatric team and emergency department to disseminate the teaching. Following the introduction of a guideline and teaching sessions, patients notes can be re-reviewed to check improvement in patient care.

Keywords: periorbital cellulitis, preseptal cellulitis, orbital cellulitis, erythematous eyelid

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Authors: Matias Hargreaves, Martin Del Valle, Diego Rodriguez, Riveros Jose Luis

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Trough years, all kind of social development projects have tried to solve social problems such as hunger, poverty, malnutrition, food insecurity, among others, with poor success. Both private and state initiatives have invested resources in several countries and communities. Nevertheless, most of these initiatives are scientific or external developers-centered, with a lack of local participation. This compromises the sustainability of any intervention and also leads to a poor empowerment of local community. The participatory approach aims to rescue and enhance the local knowledge since it recognizes that this kind of problems are better known by native actors. The objective of the study was to describe the role played by the community empowerment on food security improvement in the NGO “O Viveiro” (15°43'37.77"S; 32°46'27.53"E) and Barrio Broma village (15°43'58.78"S; 32°46'7.27"E) in Chitima, Mozambique. A center for training in goat livestock and orchard was build. A community orchard was co-constructed between foreign technicians and local actors. The prototype was installed in February, 2016 by the technician team and local community with 16 m2 as a nursery garden. Two orchard workshops were conducted in order to design a sustainable productive model which mixes both local and technological approaches. Two goat meat workshops were conducted in order to describe local methods and train the community to conduce their own techniques with high sanitary and productive standards. Technician team stayed in Mozambique until May, 2016. The quorum for the orchard workshops was 20 and 14 persons respectively, which represents 100% and 70%of the total requested quorum (20). For the goat meat workshops were 4 and 5 persons, which representa80% and 100% of the total requested quorum (5). Until August, 2016, the orchard is 3.219 m2 and it grows several vegetables as beans, chili pepper, garlic, onion, tomatoes, lettuce, sweet potato, yuca potato, cabbage, eggplant, papaya trees, mango, and cassava. The process of increasing in size and diversification of vegetables grown was led entirely by the local community. In connection with this, the local community started to harvest and began to sell the vegetable products at the local market. At the meat goat workshops, local participants rescued a local knowledge by describing and practicing a traditional way to process goat meat by drying it outdoors and then doing a smoked treatment. This information might contribute to describe the level of empowerment of this community, and thus give evidence of acceptance of foreign intervention for improving their own proceedings and traditions.

Keywords: children malnutrition, food security, Local community, participatory approach

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Authors: Shaher A. I. Shalfawi, Fredrik Hviding, Bjornar Kjellstadli

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The main purpose of this study was to measure the effect of two different strength training methods on muscle strength, muscle mass, fat mass and endurance factors. Fourteen physical education students accepted to participate in this study. The participants were then randomly divided into three groups, traditional training group (TTG), cluster training group (CTG) and control group (CG). TTG consisted of 4 participants aged ( ± SD) (22.3 ± 1.5 years), body mass (79.2 ± 15.4 kg) and height (178.3 ± 11.9 cm). CTG consisted of 5 participants aged (22.2 ± 3.5 years), body mass (81.0 ± 24.0 kg) and height (180.2 ± 12.3 cm). CG consisted of 5 participants aged (22 ± 2.8 years), body mass (77 ± 19 kg) and height (174 ± 6.7 cm). The participants underwent a hypertrophy strength training program twice a week consisting of 4 sets of 10 reps at 70% of one-repetition maximum (1RM), using barbell squat and barbell bench press for 8 weeks. The CTG performed 2 x 5 reps using 10 s recovery in between repetitions and 50 s recovery between sets, while TTG performed 4 sets of 10 reps with 90 s recovery in between sets. Pre- and post-tests were administrated to assess body composition (weight, muscle mass, and fat mass), 1RM (bench press and barbell squat) and a laboratory endurance test (Bruce Protocol). Instruments used to collect the data were Tanita BC-601 scale (Tanita, Illinois, USA), Woodway treadmill (Woodway, Wisconsin, USA) and Vyntus CPX breath-to-breath system (Jaeger, Hoechberg, Germany). Analysis was conducted at all measured variables including time to peak VO2, peak VO2, heart rate (HR) at peak VO2, respiratory exchange ratio (RER) at peak VO2, and number of breaths per minute. The results indicate an increase in 1RM performance after 8 weeks of training. The change in 1RM squat was for the TTG = 30 ± 3.8 kg, CTG = 28.6 ± 8.3 kg and CG = 10.3 ± 13.8 kg. Similarly, the change in 1RM bench press was for the TTG = 9.8 ± 2.8 kg, CTG = 7.4 ± 3.4 kg and CG = 4.4 ± 3.4 kg. The within-group analysis from the oxygen consumption measured during the incremental exercise indicated that the TTG had only a statistical significant increase in their RER from 1.16 ± 0.04 to 1.23 ± 0.05 (P < 0.05). The CTG had a statistical significant improvement in their HR at peak VO2 from 186 ± 24 to 191 ± 12 Beats Per Minute (P < 0.05) and their RER at peak VO2 from 1.11 ± 0.06 to 1.18 ±0.05 (P < 0.05). Finally, the CG had only a statistical significant increase in their RER at peak VO2 from 1.11 ± 0.07 to 1.21 ± 0.05 (P < 0.05). The between-group analysis showed no statistical differences between all groups in all the measured variables from the oxygen consumption test during the incremental exercise including changes in muscle mass, fat mass, and weight (kg). The results indicate a similar effect of hypertrophy strength training irrespective of the methods of the training used on untrained subjects. Because there were no notable changes in body-composition measures, the results suggest that the improvements in performance observed in all groups is most probably due to neuro-muscular adaptation to training.

Keywords: hypertrophy strength training, cluster set, Bruce protocol, peak VO2

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Authors: Ahmed Hossam ElMolla, Mohamed Hatem Saleh, Hamza Mostafa, Lara Mamdouh, Yassin Wael

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Artificial intelligence (AI) is reshaping industries, and its potential to revolutionize renewable energy and data center operations is immense. By harnessing AI's capabilities, we can optimize energy consumption, predict fluctuations in renewable energy generation, and improve the efficiency of data center infrastructure. This convergence of technologies promises a future where energy is managed more intelligently, sustainably, and cost-effectively. The integration of AI into renewable energy systems unlocks a wealth of opportunities. Machine learning algorithms can analyze vast amounts of data to forecast weather patterns, solar irradiance, and wind speeds, enabling more accurate energy production planning. AI-powered systems can optimize energy storage and grid management, ensuring a stable power supply even during intermittent renewable generation. Moreover, AI can identify maintenance needs for renewable energy infrastructure, preventing costly breakdowns and maximizing system lifespan. Data centers, which consume substantial amounts of energy, are prime candidates for AI-driven optimization. AI can analyze energy consumption patterns, identify inefficiencies, and recommend adjustments to cooling systems, server utilization, and power distribution. Predictive maintenance using AI can prevent equipment failures, reducing energy waste and downtime. Additionally, AI can optimize data placement and retrieval, minimizing energy consumption associated with data transfer. As AI transforms renewable energy and data center operations, modified Key Performance Indicators (KPIs) will emerge. Traditional metrics like energy efficiency and cost-per-megawatt-hour will continue to be relevant, but additional KPIs focused on AI's impact will be essential. These might include AI-driven cost savings, predictive accuracy of energy generation and consumption, and the reduction of carbon emissions attributed to AI-optimized operations. By tracking these KPIs, organizations can measure the success of their AI initiatives and identify areas for improvement. Ultimately, the synergy between AI, renewable energy, and data centers holds the potential to create a more sustainable and resilient future. By embracing these technologies, we can build smarter, greener, and more efficient systems that benefit both the environment and the economy.

Keywords: data center, artificial intelligence, renewable energy, energy efficiency, sustainability, optimization, predictive analytics, energy consumption, energy storage, grid management, data center optimization, key performance indicators, carbon emissions, resiliency

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Authors: Abdulwakeel B. Raji

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This paper introduces a concept of an intelligent virtual learning environment that involves communication between learners and an artificially intelligent teaching agent in an attempt to replicate classroom learning interactions. The benefits of this technology over current e-learning practices is that it creates a virtual classroom where real time adaptive learning interactions are made possible. This is a move away from the static learning practices currently being adopted by e-learning systems. Over the years, artificial intelligence has been applied to various fields, including and not limited to medicine, military applications, psychology, marketing etc. The purpose of e-learning applications is to ensure users are able to learn outside of the classroom, but a major limitation has been the inability to fully replicate classroom interactions between teacher and students. This study used comparative surveys to gain information and understanding of the current learning practices in Nigerian universities and how they compare to these practices compare to the use of a developed e-learning system. The study was conducted by attending several lectures and noting the interactions between lecturers and tutors and as an aftermath, a software has been developed that deploys the use of an artificial intelligent teaching-agent alongside an e-learning system to enhance user learning experience and attempt to create the similar learning interactions to those found in classroom and lecture hall settings. Dialogflow has been used to implement a teaching-agent, which has been developed using JSON, which serves as a virtual teacher. Course content has been created using HTML, CSS, PHP and JAVASCRIPT as a web-based application. This technology can run on handheld devices and Google based home technologies to give learners an access to the teaching agent at any time. This technology also implements the use of definite clause grammars and natural language processing to match user inputs and requests with defined rules to replicate learning interactions. This technology developed covers familiar classroom scenarios such as answering users’ questions, asking ‘do you understand’ at regular intervals and answering subsequent requests, taking advanced user queries to give feedbacks at other periods. This software technology uses deep learning techniques to learn user interactions and patterns to subsequently enhance user learning experience. A system testing has been undergone by undergraduate students in the UK and Nigeria on the course ‘Introduction to Database Development’. Test results and feedback from users shows that this study and developed software is a significant improvement on existing e-learning systems. Further experiments are to be run using the software with different students and more course contents.

Keywords: virtual learning, natural language processing, definite clause grammars, deep learning, artificial intelligence

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Authors: Preetinder Kaur Randhawa

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The rural areas can be differentiated from urban areas in terms of their economic activities as rural areas are primarily involved in agricultural sector and provide natural resources whereas, urban areas are primarily involved in infrastructure sector and provide manufacturing services. Census of India defines a Census Town as an area which satisfies the following three criteria i.e. population exceeds 5000, at least 75 percent of male population engaged in non-agricultural sector and minimum population density of 400 persons per square kilometers. Urban areas can be attributed to the improvement of transport facilities, the massive decline in agricultural, especially male workers and workers shift to non-agricultural activities. This study examines the pattern, process of rural areas transformed into urban areas/ census town. The study has analyzed the various factors which are responsible for land transformation as well as the socio-economic transformation of the village population. Nilpur (CT) which belongs to Rajpura Tehsil in Patiala district, Punjab has been selected for the present study. The methodology adopted includes qualitative and quantitative research design, methods based on secondary data. Secondary data has been collected from unpublished revenue record office of Rajpura Tehsil and Primary Census Abstract of Patiala district, Census of India 2011. The results have showed that rate of transformation of a village to census town in Rajpura Tehsil has been one of highest among other villages. The census town has evolved through the evolutionary process of human settlement which grows in size, population and physical development. There must be a complete economic transformation and attainment of high level of technological development. Urban design and construction of buildings and infrastructure can be carried out better and faster and can be used to aid human habitation with the enhancement of quality of life. The study has concluded that in the selected area i.e Nilpur (CT) literacy rate has increased to 72.1 percent in year 2011 from 67.6 percent in year 2001. Similarly non-agricultural work force has increased to 95.2 percent in year 2011 from 81.1 percent in year 2001. It is very much clear that the increased literacy rate has put a positive impact on the involvement of non-agricultural workers have enhanced. The study has concluded that rural-urban linkages are important tools for understanding complexities of people livelihood and their strategies which involve mobility migration and the diversification of income sources and occupations.

Keywords: Census Town, India, Nilpur, Punjab

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Authors: R. M. Kilonzo, S. Bedingfield, K. Smith, K. Hudgins Smith, K. Couper, R. Ratley, Z. Taylor, A. Engelman, M. Renne

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Introduction: The mental health needs of university students continue to evolve, necessitating a strategic approach to service delivery. The East Tennessee State University (ETSU) Counseling Center developed its inaugural Strategic Plan (2024-2028) to enhance student mental health services. The plan focuses on improving access, quality of care, and service visibility, aligning with the university’s mission to support academic success and student well-being. Aim: This strategic plan aims to establish a comprehensive framework for delivering high-quality, evidence-based mental health services to ETSU students, addressing current challenges, and anticipating future needs. Methods: The development of the strategic plan was a collaborative effort involving the Counseling Center’s leadership, staff, with technical support from Doctor of Public Health-community and behavioral health intern. Multiple workshops, online/offline reviews, and stakeholder consultations were held to ensure a robust and inclusive process. A SWOT analysis and stakeholder mapping were conducted to identify strengths, weaknesses, opportunities, and challenges. Key performance indicators (KPIs) were set to measure service utilization, satisfaction, and outcomes. Results: The plan resulted in four strategic priorities: service application, visibility/accessibility, safety and satisfaction, and training programs. Key objectives include expanding counseling services, improving service access through outreach, reducing stigma, and increasing peer support programs. The plan also focuses on continuous quality improvement through data-driven assessments and research initiatives. Immediate outcomes include expanded group therapy, enhanced staff training, and increased mental health literacy across campus. Conclusion and Recommendation: The strategic plan provides a roadmap for addressing the mental health needs of ETSU students, with a clear focus on accessibility, inclusivity, and evidence-based practices. Implementing the plan will strengthen the Counseling Center’s capacity to meet the diverse needs of the student population. To ensure sustainability, it is recommended that the center continuously assess student needs, foster partnerships with university and external stakeholders, and advocate for increased funding to expand services and staff capacity.

Keywords: strategic plan, university counseling center, mental health, students

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Authors: Khaled M. Khader, Mamdouh I. Elimy, Omayma A. Nada

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Sustainable development is the nominal goal of most countries at present. In general, fossil fuels are the development mainstay of most world countries. Regrettably, the fossil fuel consumption rate is very high, and the world is facing the problem of conventional fuels depletion soon. In addition, there are many problems of environmental pollution resulting from the emission of harmful gases and vapors during fuel burning. Thus, clean, renewable energy became the main concern of most countries for filling the gap between available energy resources and their growing needs. There are many renewable energy sources such as wind, solar and wave energy. Energy can be obtained from the motion of sea waves almost all the time. However, power generation from solar or wind energy is highly restricted to sunny periods or the availability of suitable wind speeds. Moreover, energy produced from sea wave motion is one of the cheapest types of clean energy. In addition, renewable energy usage of sea waves guarantees safe environmental conditions. Cheap electricity can be generated from wave energy using different systems such as oscillating bodies' system, pendulum gate system, ocean wave dragon system and oscillating water column device. In this paper, a multi-criteria model has been developed using Analytic Hierarchy Process (AHP) to support the decision of selecting the most effective system for generating power from sea waves. This paper provides a widespread overview of the different design alternatives for sea wave energy converter systems. The considered design alternatives have been evaluated using the developed AHP model. The multi-criteria assessment reveals that the off-shore Oscillating Water Column (OWC) system is the most appropriate system for generating power from sea waves. The OWC system consists of a suitable hollow chamber at the shore which is completely closed except at its base which has an open area for gathering moving sea waves. Sea wave's motion pushes the air up and down passing through a suitable well turbine for generating power. Improving the power generation capability of the OWC system is one of the main objectives of this research. After investigating the effect of some design modifications, it has been concluded that selecting the appropriate settings of some effective design parameters such as the number of layers of Wells turbine fans and the intermediate distance between the fans can result in significant improvements. Moreover, simple dynamic analysis of the Wells turbine is introduced. Furthermore, this paper strives for comparing the theoretical and experimental results of the built experimental prototype.

Keywords: renewable energy, oscillating water column, multi-criteria selection, Wells turbine

Procedia PDF Downloads 162

Authors: Thitima Plejai

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The practice in the operating room has been continually performed according to standards of services; however, undesirable incidents from surgical services are found such as surgical complications in the operating room. This participation action research aimed to develop practice guidelines for surgical safety management to reduce undesirable incidents from surgical services in the operating room of Songkhla Hospital. The target population was all 84 members of the multidisciplinary team who were involved in surgical services in the operating room consisting of 28 surgeons from five branches of surgery, 27 anesthetists and nurse anesthetists, and 29 surgical nurses. The data were collected through in-depth interviews, and non-participatory observations. The research instrument was tested by three experts, and the steps of the development consisted of four cycles, each consisting of assessment, planning, practice, practice reflection, and improvement until every step is practicable. The data were validated through triangulation research method, analyzed through content analysis and statistical analysis with number and percentage. The results of the development of practice guidelines surgical safety management to reduce undesirable incidents from surgical services could be concluded as follows. 1) The multidisciplinary team in surgery participated in the needs assessment for development of practice guidelines for surgical patient safety, and agreed on adapting the WHO Surgical Safety Checklists for use. 2) The WHO Surgical Safety Checklists was implemented, and meetings were held for the multidisciplinary team in surgery and the organizational risk committee to improve the practice guidelines to make them more practicable. 3) The multidisciplinary team consisting of surgeons from five branches of surgery, anesthetists, nurse anesthetists, surgical nurses, and the organizational risk committee announced policy on safety for surgical patients; the organizational risk committee designated the Surgical Safety Checklist as an instrument for surgical patient safety. The results of the safety management found that the surgical team members who could follow 100 percent of the guidelines were: professional nurses who checked patient identity and information before taking the patient to the operating room and kept complete records of data on the patients; surgical nurses who checked readiness of the patient before surgery; nurse anesthetists who assessed readiness before administering anesthetic drugs, and confirmed correctness of the patient; and circulating perioperative nurses who gave confirmation to the surgical team after completion of the surgery. The rates of undesirable incidents (surgical complications rates) before and after the implementation of the surgical safety management were 1.60 percent and 0.66 percent, respectively. The satisfaction of the surgery-related teams towards the use of the guidelines was 89 percent. The practice guidelines for surgical safety management to reduce undesirable incidents were taken as guidelines for surgical safety that the multidisciplinary team involved in the surgical process implemented correctly and in the same direction and clearly reduced undesirable incidents in surgical patients.

Keywords: practice guidelines, surgical safety management, reduce undesirable incidents, operating Room

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Authors: Jacob Dangerfield, Jacob Pollard, Jennifer DeCou

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Introduction: Burnout, anxiety, and depression are three conditions that are prevalent in medical providers. This is especially the case in the field of anesthesia, which has a high number of providers suffering from burnout and burnout syndrome. A major contributor to this issue is isolation in the workplace, with a perceived lack of peer support as a major risk factor for burnout. Two organizational interventions that can be done to help improve this issue are small group sessions and providing affordable mental health services. Per American College of Graduate Medical Education (ACGME) Guidelines, these affordable mental health services are a requirement of all residency programs, but for a variety of reasons, many residents do not access them. As physicians, we are often not good at asking for help. With this in mind, we hypothesized that carrying out small group resiliency sessions facilitated by Graduate Medical Education (GME) Wellness Counselors would improve both resident peer support as well as the likelihood that a resident will reach out to GME Wellness in a time of need. Methods: We held small group resiliency sessions with the GME Wellness Mental Health Professionals during protected didactic time. These sessions were small groups, including the members of one’s class (i.e., first-year residents on their own), and were facilitated by 1-2 mental health professionals. After these sessions, we surveyed residents who attended using a short Google Forms survey and using a 5-point Likert Scale, asked residents about some outcomes from the session. A “strongly agree” or “agree” was considered a positive response. Results: Results from our survey showed that the resident sessions had multiple positive outcomes. This survey was sent to 29 residents, and we had a 62% response rate. We found out through this survey that these small group sessions had a perceived positive impact on resident personal well-being, increased perceived peer support from classmates, and made residents more likely to reach out to GME Wellness in the future. Perceived positive impact on well-being was found in 83% of resident respondents, improved perceived peer support in 83% of respondents, and 78% of resident respondents stated that this session increased their likelihood of reaching out to mental health professionals. Conclusions: Through this study, we can conclude that our hypothesis was correct in that Small Group Resiliency Sessions that are facilitated by GME Wellness Counselors improve both resident peer support as well as the likelihood a resident reaches out to these mental health professionals in time of need. We believe these findings are very important as they address two important factors that can aid in decreasing a provider’s risk of experiencing burnout. Through this simple means, we believe other residency programs can help the well-being of their residents, and together, we can decrease the number of cases of burnout in anesthesia.

Keywords: anesthesiology, burnout, wellness, depression, residents, trainees, mental health

Procedia PDF Downloads 54

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

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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.

Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan

Procedia PDF Downloads 164

Authors: Sergey N. Ermoliev, Margarita A. Belousova, Aida D. Goncharenko

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Application of the diagnostic complex of highly informative functional methods (electromyography, reodentography, laser Doppler flowmetry, reoperiodontography, vital computer capillaroscopy, optical tissue oximetry, laser fluorescence diagnosis) allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment. Introduction. It is necessary to create a complex of innovative highly informative and safe functional diagnostic methods for improvement of the quality of patient treatment by the early detection of stomatologic diseases. The purpose of the present study was to investigate the etiology and pathogenesis of functional disorders identified in the pathology of hard tissue, dental pulp, periodontal, oral mucosa and chewing function, and the creation of new approaches to the diagnosis of dental diseases. Material and methods. 172 patients were examined. Density of hard tissues of the teeth and jaw bone was studied by intraoral ultrasonic densitometry (USD). Electromyographic activity of masticatory muscles was assessed by electromyography (EMG). Functional state of dental pulp vessels assessed by reodentography (RDG) and laser Doppler flowmetry (LDF). Reoperiodontography method (RPG) studied regional blood flow in the periodontal tissues. Microcirculatory vascular periodontal studied by vital computer capillaroscopy (VCC) and laser Doppler flowmetry (LDF). The metabolic level of the mucous membrane was determined by optical tissue oximetry (OTO) and laser fluorescence diagnosis (LFD). Results and discussion. The results obtained revealed changes in mineral density of hard tissues of the teeth and jaw bone, the bioelectric activity of masticatory muscles, regional blood flow and microcirculation in the dental pulp and periodontal tissues. LDF and OTO methods estimated fluctuations of saturation level and oxygen transport in microvasculature of periodontal tissues. With LFD identified changes in the concentration of enzymes (nicotinamide, flavins, lipofuscin, porphyrins) involved in metabolic processes Conclusion. Our preliminary results confirmed feasibility and safety the of intraoral ultrasound densitometry technique in the density of bone tissue of periodontium. Conclusion. Application of the diagnostic complex of above mentioned highly informative functional methods allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment.

Keywords: electromyography (EMG), reodentography (RDG), laser Doppler flowmetry (LDF), reoperiodontography method (RPG), vital computer capillaroscopy (VCC), optical tissue oximetry (OTO), laser fluorescence diagnosis (LFD)

Procedia PDF Downloads 280

Authors: Shams Khaled Abdelrahman Abdallah Elbaz, Alaa Aldeen Abd Al Hakeem Balbaa

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Purpose: The purpose of this study was to compare the effects of Positional Release Technique versus Kinesio Tape on pain level, pressure pain threshold level and functional disability in patients with back myofascial pain syndrome at iliocostalis lumborum. Backgrounds/significance: Myofascial Pain Syndrome is a common muscular pain syndrome that arises from trigger points which are hyperirritable, painful and tender points within a taut band of skeletal muscle. In more recent literature, about 75% of patients with musculoskeletal pain presenting to a community medical centres suffer from myofascial pain syndrome.Iliocostalis lumborum are most likely to develop active trigger points. Subjects: Thirty patients diagnosed as back myofascial pain syndrome with active trigger points in iliocostalis lumborum muscle bilaterally had participated in this study. Methods and materials: Patients were randomly distributed into two groups. The first group consisted of 15 patients (8 males and 7 females) with mean age 30.6 (±3.08) years, they received positional release technique which was applied 3 times per session, 3/week every other day for 2 weeks. The second group consisted of 15 patients(5 males, 10 females) with a mean age 30.4 (±3.35) years, they received kinesio tape which was applied and changed every 3 days with one day off for a total 3 times in 2 weeks. Both techniques were applied over trigger points of the iliocostalis lumborum bilaterally. Patients were evaluated pretreatment and posttreatment program for Pain intensity (Visual analogue scale), pressure pain threshold (digital pressure algometry), and functional disability (The Oswestry Disability Index). Analyses: Repeated measures MANOVA was used to detect differences within and between groups pre and post treatment. Then the univariate ANOVA test was conducted for the analysis of each dependant variable within and between groups. All statistical analyses were done using SPSS. with significance level set at p<0.05 throughout all analyses. Results: The results revealed that there was no significant difference between positional release technique and kinesio tape technique on pain level, pressure pain threshold and functional activities (p > 0.05). Both groups of patients showed significant improvement in all the measured variables (p < 0.05) evident by significant reduction of both pain intensity and functional disability as well as significant increase of pressure pain threshold Conclusions : Both positional release technique and kinesio taping technique are effective in reducing pain level, improving pressure pain threshold and improving function in treating patients who suffering from back myofascial pain syndrome at iliocostalis lumborum. As there was no statistically significant difference was proven between both of them.

Keywords: positional release technique, kinesio tape, myofascial pain syndrome, Iliocostalis lumborum

Procedia PDF Downloads 231

Authors: Tomas Makaras, Gintaras Svecevičius

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Landfill waste is a common problem as it has an economic and environmental impact even if it is closed. Landfill waste contains a high density of various persistent compounds such as heavy metals, organic and inorganic materials. As persistent compounds are slowly-degradable or even non-degradable in the environment, they often produce sublethal or even lethal effects on aquatic organisms. The aims of the present study were to estimate sublethal effects of the Kairiai landfill (WGS: 55°55‘46.74“, 23°23‘28.4“) leachate on the locomotor activity of rainbow trout Oncorhynchus mykiss juveniles using the original system package developed in our laboratory for automated monitoring, recording and analysis of aquatic organisms’ activity, and to determine patterns of fish behavioral response to sublethal effects of leachate. Four different concentrations of leachate were chosen: 0.125; 0.25; 0.5 and 1.0 mL/L (0.0025; 0.005; 0.01 and 0.002 as part of 96-hour LC50, respectively). Locomotor activity was measured after 5, 10 and 30 minutes of exposure during 1-minute test-periods of each fish (7 fish per treatment). The threshold-effect-concentration amounted to 0.18 mL/L (0.0036 parts of 96-hour LC50). This concentration was found to be even 2.8-fold lower than the concentration generally assumed to be “safe” for fish. At higher concentrations, the landfill leachate solution elicited behavioral response of test fish to sublethal levels of pollutants. The ability of the rainbow trout to detect and avoid contaminants occurred after 5 minutes of exposure. The intensity of locomotor activity reached a peak within 10 minutes, evidently decreasing after 30 minutes. This could be explained by the physiological and biochemical adaptation of fish to altered environmental conditions. It has been established that the locomotor activity of juvenile trout depends on leachate concentration and exposure duration. Modeling of these parameters showed that the activity of juveniles increased at higher leachate concentrations, but slightly decreased with the increasing exposure duration. Experiment results confirm that the behavior of rainbow trout juveniles is a sensitive and rapid biomarker that can be used in combination with the system for fish behavior monitoring, registration and analysis to determine sublethal concentrations of pollutants in ambient water. Further research should be focused on software improvement aimed to include more parameters of aquatic organisms’ behavior and to investigate the most rapid and appropriate behavioral responses in different species. In practice, this study could be the basis for the development and creation of biological early-warning systems (BEWS).

Keywords: fish behavior biomarker, landfill leachate, locomotor activity, rainbow trout juveniles, sublethal effects

Procedia PDF Downloads 271

Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers

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Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.

Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands

Procedia PDF Downloads 229

Authors: Samir Ranjbar, Nasrullah Istanekzai

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According to a report published in The Guardian, Kabul, the capital city of Afghanistan is the fifth fastest growing city in the world, whose population has increased fourfold since 2001 from 1.2 million to 4.8 million people. The main reason for this increment is identified as the return of Afghans migrated during the civil war. In addition to the return of immigrants, a steep economic growth due to foreign assistance in last decade creating lots of job opportunities in Kabul resulted in the attraction of individuals from the neighboring provinces as well. However, the development of urban facilities such as water supply system, housing transportation and waste management systems has yet to catch up with this rapid increase in population. Since Kabul city has developed traditionally and municipal governance had very limited capacity to implement municipal bylaws. As an unwanted consequence of this growth 70% of Kabul citizens contributed to developing informal settlement for which we can say that around three million people living in informally settled areas, lacking the very vital social and physical infrastructures of livelihood. This research focuses on a region with 30 ha area and 2100 people residents in the center of Kabul city. A comprehensive land readjustment concept plan has been formulated for this area. Through this concept plan, physical and social infrastructure has been demonstrated and analyzed. Findings of this paper propose a solution for the problems of this unplanned area in Kabul which is readjusting of unplanned area by a self-supporting process. This process does not need governmental budget and can be applied by government, private sectors and landowner associations. Furthermore, by implementing the Land Readjustment process, conceptual plans can be built for unplanned areas, maximum facilities can be brought to the residents’ urban life, improve the environment for the users’ benefit, promote the culture and sense of cooperation, participation and coexistence in the mind of people, improving the transport system, improvement in economic status (the value of land increases due to infrastructure availability and land legalization). In addition to all these benefits for the public, we can raise the revenue of government by collecting the taxes from landowners. This process is implemented in most of countries of the world, it was implemented for the first time in Germany and after that in most cities of Japan as well, and is known as one of the effective processes for infrastructural development. To sum up, the notable characteristic of the Land readjustment process is that it works on the concept of mutual interest in which both landowners and the government take advantage. However, in this process, the engagement of community is very important and without public cooperation, this process can face the failure.

Keywords: land readjustment, informal settlement, Kabul, Afghanistan

Procedia PDF Downloads 252

Authors: Sundaresan Soundararajan, Chor Ngee Tan

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Introduction: Pyogenic spondylitis, otherwise treated conservatively with long term antibiotics, would require surgical debridement and reconstruction in about 10% to 20% of cases. The classical approach adopted many surgeons have always been anterior approach in ensuring thorough and complete debridement. This, however, comes with high rates of morbidity due to the nature of its access. Direct lateral retroperitoneal approach, which has been growing in usage in degenerative lumbar diseases, has the potential in treating pyogenic spondylitis with its ease of approach and relatively low risk of complications. Aims/Objectives: The objective of this study was to evaluate the effectiveness and clinical outcome of using lateral approach surgery in the surgical management of pyogenic spondylitis of the lumbar spine. Methods: Retrospective chart analysis was done on all patients who presented with pyogenic spondylitis (lumbar discitis/vertebral osteomyelitis) and had undergone direct lateral retroperitoneal lumbar vertebral debridement and posterior instrumentation between 2014 and 2016. Data on blood loss, surgical operating time, surgical complications, clinical outcomes and fusion rates were recorded. Results: A total of 6 patients (3 male and 3 female) underwent this procedure at a single institution by a single surgeon during the defined period. One patient presented with infected implant (PLIF) and vertebral osteomyelitis while the other five presented with single level spondylodiscitis. All patients underwent lumbar debridement, iliac strut grafting and posterior instrumentation (revision of screws for infected PLIF case). The mean operating time was 308.3 mins for all 6 cases. Mean blood loss was reported at 341cc (range from 200cc to 600cc). Presenting symptom of back pain resolved in all 6 cases while 2 cases that presented with lower limb weakness had improvement of neurological deficits. One patient had dislodged strut graft while performing posterior instrumentation and needed graft revision intraoperatively. Infective markers normalized for all patients subsequently. All subjects also showed radiological evidence of fusion on 6 months follow up. Conclusions: Lateral approach in treating pyogenic spondylitis is a viable option as it allows debridement and reconstruction without the risk that comes with other anterior approaches. It allows efficient debridement, short surgical time, moderate blood loss and low risk of vascular injuries. Clinical outcomes and fusion rates by this approach also support its use as practical MIS option surgery for such infection cases.

Keywords: lateral approach, minimally invasive, pyogenic spondylitis, XLIF

Procedia PDF Downloads 177

Authors: Qiuhu Shao

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Community home-based care service system, which is based on the family pension, supported by community pension and supplied by institutions pension, is an effective pension system to solve the current situation of China's accelerated aging. However, due to the fundamental realities of our country, the government is not able to bear the unilateral supply of the old-age service of the community. Therefore, based on the theory of welfare pluralism, the participation of social organizations in the home-based care service center has become an important part of the diversified supply of the old-age service for the elderly. Meanwhile, the home-based care service industry is still in the early stage, the management is relatively rough, which resulted in a large number of social resources waste. Thus, scientific, objective and long-term implementation is needed for social organizations to participate in home-based care services to guide its performance management. In order to realize the design of the performance management system, the author has done a research work that clarifies the research status of social organization's participation in home-based care service. Relevant theories such as welfare pluralism, community care theory, and performance management theory have been used to demonstrate the feasibility of data envelopment analysis method in social organization performance research. This paper analyzes the characteristics of the operation mode of the home-based care service center, and hackles the national as well as local documents, standards and norms related to the development of the home-based care industry, particularly studies those documents in Nanjing. Based on this, the paper designed a set of performance management PDCA system for home-based care service center in Nanjing and clarified each step of the system in detail. Subsequently, the research methods of performance evaluation and performance management and feedback, which are two core steps of performance management have been compared and screened in order to establish the overall framework of the performance management system of the home-based care service center. Through a large number of research, the paper summarized and analyzed the characteristics of the home-based care service center. Based on the research results, combined with the practice of the industry development in Nanjing, the paper puts forward a targeted performance evaluation index system of home-based care service center in Nanjing. Finally, the paper evaluated and sub-filed the performance of 186 home-based care service centers in Nanjing and then designed the performance optimization direction and performance improvement path based on the results. This study constructs the index system of performance evaluation of home-based care service and makes the index detailed to the implementation level, and constructs the evaluation index system which can be applied directly. Meanwhile, the quantitative evaluation of social organizations participating in the home-based care service changed the subjective impression in the previous practice of evaluation.

Keywords: data envelopment analysis, home-based care, performance management, social organization

Procedia PDF Downloads 269

Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

Procedia PDF Downloads 203

Authors: Aziza Barnawi

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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.

Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease

Procedia PDF Downloads 72

Authors: J. Bastos, P. Marques, S. Batterman, F. Freire

Abstract:

Due to demands of a growing urban population, it is crucial to manage urban development and its associated environmental impacts. While most of the environmental analyses have addressed buildings and transportation separately, both the design and location of a building affect environmental performance and focusing on one or the other can shift impacts and overlook improvement opportunities for more sustainable urban development. Recently, several life-cycle (LC) studies of residential buildings have integrated user transportation, focusing exclusively on primary energy demand and/or greenhouse gas emissions. Additionally, most papers considered only private transportation (mainly car). Although it is likely to have the largest share both in terms of use and associated impacts, exploring the variability associated with mode choice is relevant for comprehensive assessments and, eventually, for supporting decision-makers. This paper presents a life-cycle assessment (LCA) of a residential building in Lisbon (Portugal), addressing building construction, use and user transportation (commuting with private and public transportation). Five environmental indicators or categories are considered: (i) non-renewable primary energy (NRE), (ii) greenhouse gas intensity (GHG), (iii) eutrophication (EUT), (iv) acidification (ACID), and (v) ozone layer depletion (OLD). In a first stage, the analysis addresses the overall life-cycle considering the statistical model mix for commuting in the residence location. Then, a comparative analysis compares different available transportation modes to address the influence mode choice variability has on the results. The results highlight the large contribution of transportation to the overall LC results in all categories. NRE and GHG show strong correlation, as the three LC phases contribute with similar shares to both of them: building construction accounts for 6-9%, building use for 44-45%, and user transportation for 48% of the overall results. However, for other impact categories there is a large variation in the relative contribution of each phase. Transport is the most significant phase in OLD (60%); however, in EUT and ACID building use has the largest contribution to the overall LC (55% and 64%, respectively). In these categories, transportation accounts for 31-38%. A comparative analysis was also performed for four alternative transport modes for the household commuting: car, bus, motorcycle, and company/school collective transport. The car has the largest results in all impact categories. When compared to the overall LC with commuting by car, mode choice accounts for a variability of about 35% in NRE, GHG and OLD (the categories where transportation accounted for the largest share of the LC), 24% in EUT and 16% in ACID. NRE and GHG show a strong correlation because all modes have internal combustion engines. The second largest results for NRE, GHG and OLD are associated with commuting by motorcycle; however, for ACID and EUT this mode has better performance than bus and company/school transport. No single transportation mode performed best in all impact categories. Integrated assessments of buildings are needed to avoid shifts of impacts between life-cycle phases and environmental categories, and ultimately to support decision-makers.

Keywords: environmental impacts, LCA, Lisbon, transport

Procedia PDF Downloads 362

Authors: Adam Gushgari

Abstract:

The SARS-CoV-2 pandemic has catalyzed the rapid adoption of wastewater-based epidemiology (WBE) methodologies both domestically and internationally. To support the rapid scale-up of pandemic-response wastewater surveillance systems, multiple federal agencies (i.e. US CDC), non-government organizations (i.e. Water Environment Federation), and private charities (i.e. Bill and Melinda Gates Foundation) have funded over $220 million USD supporting development and expanding equitable access of surveillance methods. Funds were primarily distributed directly to municipalities under the CARES Act (90.6%), followed by academic projects (7.6%), and initiatives developed by private companies (1.8%). In addition to federal funding for wastewater monitoring primarily conducted at wastewater treatment plants, state/local governments and private companies have leveraged wastewater sampling to obtain health and lifestyle data on student, prison inmate, and employee populations. We explore the viable paths for expansion of the WBE m1ethodology across a variety of analytical methods; the development of WBE-specific samplers and real-time wastewater sensors; and their application to various governments and private sector industries. Considerable investment in, and public acceptance of WBE suggests the methodology will be applied to other future notifiable diseases and health risks. Early research suggests that WBE methods can be applied to a host of additional “biological insults” including communicable diseases and pathogens, such as influenza, Cryptosporidium, Giardia, mycotoxin exposure, hepatitis, dengue, West Nile, Zika, and yellow fever. Interest in chemical insults is also likely, providing community health and lifestyle data on narcotics consumption, use of pharmaceutical and personal care products (PPCP), PFAS and hazardous chemical exposure, and microplastic exposure. Successful application of WBE to monitor analytes correlated with carcinogen exposure, community stress prevalence, and dietary indicators has also been shown. Additionally, technology developments of in situ wastewater sensors, WBE-specific wastewater samplers, and integration of artificial intelligence will drastically change the landscape of WBE through the development of “smart sewer” networks. The rapid expansion of the WBE field is creating significant business opportunities for professionals across the scientific, engineering, and technology industries ultimately focused on community health improvement.

Keywords: wastewater surveillance, wastewater-based epidemiology, smart cities, public health, pandemic management, substance abuse

Procedia PDF Downloads 108

Authors: Gerald Amatre, Julius Bunny Lejju, Morgan Andama

Abstract:

Despite several interventions, jigger flea infestations continue to be reported in the Busoga sub-region in Eastern Uganda. The purpose of this study was to identify factors that expose the indigenous people to jigger flea infestations and evaluate the effectiveness of any indigenous materials used in flea control by the affected communities. Flea compositions in residences were described, factors associated with flea infestation and indigenous materials used in flea control were evaluated. Field surveys were conducted in the affected communities after obtaining preliminary information on jigger infestation from the offices of the District Health Inspectors to identify the affected villages and households. Informed consent was then sought from the local authorities and household heads to conduct the study. Focus group discussions were conducted with key district informants, namely, the District Health Inspectors, District Entomologists and representatives from the District Health Office. A GPS coordinate was taken at central point at every household enrolled. Fleas were trapped inside residences using Kilonzo traps. A Kilonzo Trap comprised a shallow pan, about three centimetres deep, filled to the brim with water. The edges of the pan were smeared with Vaseline to prevent fleas from crawling out. Traps were placed in the evening and checked every morning the following day. The trapped fleas were collected in labelled vials filled with 70% aqueous ethanol and taken to the laboratory for identification. Socio-economic and environmental data were collected. The results indicate that the commonest flea trapped in the residences was the cat flea (Ctenocephalides felis) (50%), followed by Jigger flea (Tunga penetrans) (46%) and rat flea (Xenopsylla Cheopis) (4%), respectively. The average size of residences was seven squire metres with a mean of six occupants. The residences were generally untidy; with loose dusty floors and the brick walls were not plastered. The majority of the jigger affected households were headed by peasants (86.7%) and artisans (13.3%). The household heads mainly stopped at primary school level (80%) and few at secondary school level (20%). The jigger affected households were mainly headed by peasants of low socioeconomic status. The affected community members use soil-cow dung-ash mixture to smear floors of residences as the only measure to control fleas. This method was found to be ineffective in controlling the insects. The study recommends that home improvement campaigns be continued in the affected communities to improve sanitation and hygiene in residences as one of the interventions to combat flea infestations. Other cheap, available and effective means should be identified to curb jigger flea infestations.

Keywords: cow dung-soil-ash mixture, infestations, jigger flea, Tunga penetrans

Procedia PDF Downloads 135