Search results for: emergency period

Authors: Sadie Namani, Lindita Ajazaj, Arjeta Zogaj, Vera Berisha, Bahrije Halili, Luljeta Hasani, Ajete Aliu

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Background: The outcome of bacterial meningitis is strongly related to the resistance of bacterial pathogens to the initial antimicrobial therapy. The objective of the study was to analyze the initial antimicrobial therapy, the resistance of meningeal pathogens and the outcome of adults bacterial meningitis cases. Materials/methods: This prospective study enrolled 46 adults older than 16 years of age, treated for bacterial meningitis during the years 2009 and 2010 at the infectious diseases clinic in Prishtinë. Patients are categorized into specific age groups: > 16-26 years of age (10 patients), > 26-60 years of age (25 patients) and > 60 years of age (11 patients). All p-values < 0.05 were considered statistically significant. Data were analyzed using Stata 7.1 and SPSS 13. Results: During the two year study period 46 patients (28 males) were treated for bacterial meningitis. 33 patients (72%) had a confirmed bacterial etiology; 13 meningococci, 11 pneumococci, 7 gram-negative bacilli (Ps. aeruginosa 2, Proteus sp. 2, Acinetobacter sp. 2 and Klebsiella sp. 1 case) and 2 staphylococci isolates were found. Neurological complications developed in 17 patients (37%) and the overall mortality rate was 13% (6 deaths). Neurological complications observed were: cerebral abscess (7/46; 15.2%), cerebral edema (4/46; 8.7%); haemiparesis (3/46; 6.5%); recurrent seizures (2/46; 4.3%), and single cases of thrombosis sinus cavernosus, facial nerve palsy and decerebration (1/46; 2.1%). The most common meningeal pathogens were meningococcus in the youngest age group, gram negative-bacilli in second age group and pneumococcus in eldery age group. Initial single-agent antibiotic therapy (ceftriaxone) was used in 17 patients (37%): in 60% of patients in the youngest age group and in 44% of cases in the second age group. 29 patients (63%) were treated with initial dual-agent antibiotic therapy; ceftriaxone in combination with vancomycin or ampicillin. Ceftriaxone and ampicillin were the most commonly used antibiotics for the initial empirical therapy in adults > 50 years of age. All adults > 60 years of age were treated with the initial dual-agent antibiotic therapy as in this age group was recorded the highest mortality rate (M=27%) and adverse outcome (64%). Resistance of pathogens to antimicrobics was recorded in cases caused by gram-negative bacilli and was associated with greater risk for developing neurological complications (p=0.09). None of the gram-negative bacilli were resistant to carbapenems; all were resistant to ampicillin while 5/7 isolates were resistant to cefalosporins. Resistance of meningococci and pneumococci to beta-lactams was not recorded. There were no statistical differences in the occurrence of neurological complications (p > 0.05), resistance of meningeal pathogens to antimicrobics (p > 0.05) and the inital antimicrobial therapy (one vs. two antibiotics) concerning group-ages in adults. Conclusions: The initial antibiotic therapy with ceftriaxone alone or in combination with vancomycin or ampicillin did not cover cases caused by gram-negative bacilli.

Keywords: adults, bacterial meningitis, outcomes, therapy

Procedia PDF Downloads 173

Authors: Emma S. Bowers

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Perturbations in global environments and temperatures have heightened the urgency of creating cost-efficient, energy-neutral building techniques. Structural responses to this thermal crisis have included designs (including those of the building standard PassivHaus) with airtightness, window placement, insulation, solar orientation, shading, and heat-exchange ventilators as potential solutions or interventions. Limitations in the predictability of the circulation of cooled air through the ambient temperature gradients throughout a structure are one of the major obstacles facing these enhanced building methods. A diverse range of air-cooling devices utilizing varying technologies is implemented around the world. Many of them worsen the problem of climate change by consuming energy. Using natural ventilation principles of air buoyancy and density to circulate fresh air throughout a building with no energy input can combat these obstacles. A unique prototype of an energy-neutral air-circulation system was constructed in order to investigate potential temperature and pressure gradients related to the stack effect (updraft of air through a building due to changes in air pressure). The stack effect principle maintains that since warmer air rises, it will leave an area of low pressure that cooler air will rush in to fill. The result is that warmer air will be expelled from the top of the building as cooler air is directed through the bottom, creating an updraft. Stack effect can be amplified by cooling the air near the bottom of a building and heating the air near the top. Using readily available, mostly recyclable or biodegradable materials, an insulated building module was constructed. A tri-part construction model was utilized: a subterranean earth-tube heat exchanger constructed of PVC pipe and placed in a horizontally oriented trench, an insulated, airtight cube aboveground to represent a building, and a solar chimney (painted black to increase heat in the out-going air). Pressure and temperature sensors were placed at four different heights within the module as well as outside, and data was collected for a period of 21 days. The air pressures and temperatures over the course of the experiment were compared and averaged. The promise of this design is that it represents a novel approach which directly addresses the obstacles of air flow and expense, using the physical principle of stack effect to draw a continuous supply of fresh air through the structure, using low-cost and readily available materials (and zero manufactured energy). This design serves as a model for novel approaches to creating temperature controlled buildings using zero energy and opens the door for future research into the effects of increasing module scale, increasing length and depth of the earth tube, and shading the building. (Model can be provided).

Keywords: air circulation, PassivHaus, stack effect, thermal gradient

Procedia PDF Downloads 154

Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

Procedia PDF Downloads 175

Authors: Jin-Hee Ahn, Seok-Hyeon Jeon, Young-Bin Lee, Min-Gyun Ha, Yu-Chan Hong

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Corrosion durability of steel bridges can be generally affected by atmospheric environments of bridge installation, since corrosion problem is related to environmental factors such as humidity, temperature, airborne salt, chemical components as SO₂, chlorides, etc. Thus, atmospheric environment condition should be measured to estimate corrosion condition of steel bridges as well as measurement of actual corrosion damage of structural members of steel bridge. Even in the same atmospheric environment, the corrosion environment may be different depending on the installation direction of structural members. In this study, therefore, atmospheric corrosion monitoring was conducted using atmospheric corrosion monitoring sensor, hygrometer, thermometer and airborne salt collection device to examine the corrosion durability of steel bridges. As a target steel bridge for corrosion durability monitoring, a cable-stayed bridge with truss steel members was selected. This cable-stayed bridge was located on the coast to connect the islands with the islands. Especially, atmospheric corrosion monitoring was carried out depending on structural direction of a cable-stayed bridge with truss type girders since it consists of structural members with various directions. For atmospheric corrosion monitoring, daily average electricity (corrosion current) was measured at each monitoring members to evaluate corrosion environments and corrosion level depending on structural members with various direction which have different corrosion environment in the same installed area. To compare corrosion durability connected with monitoring data depending on corrosion monitoring members, monitoring steel plate was additionally installed in same monitoring members. Monitoring steel plates of carbon steel was fabricated with dimension of 60mm width and 3mm thickness. And its surface was cleaned for removing rust on the surface by blasting, and its weight was measured before its installation on each structural members. After a 3 month exposure period on real atmospheric corrosion environment at bridge, surface condition of atmospheric corrosion monitoring sensors and monitoring steel plates were observed for corrosion damage. When severe deterioration of atmospheric corrosion monitoring sensors or corrosion damage of monitoring steel plates were found, they were replaced or collected. From 3month exposure tests in the actual steel bridge with various structural member with various direction, the rust on the surface of monitoring steel plate was found, and the difference in the corrosion rate was found depending on the direction of structural member from their visual inspection. And daily average electricity (corrosion current) was changed depending on the direction of structural member. However, it is difficult to identify the relative differences in corrosion durability of steel structural members using short-term monitoring results. After long exposure tests in this corrosion environments, it can be clearly evaluated the difference in corrosion durability depending on installed conditions of steel bridges. Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03028755).

Keywords: corrosion, atmospheric environments, steel bridge, monitoring

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Authors: Louise Bernier

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Under some jurisdictions (including Canada), eligible patients can request and receive medical assistance in dying (MAiD) through lethal injections, inducing their cardiocirculatory death. Those same patients can also wish to donate their organs in the process. If they qualify as organ donors, a clinical and ethical rule called the 'dead donor rule' (DDR) requires the transplant teams to wait after cardiocirculatory death is confirmed, followed by a 'no touch' period (5 minutes in Canada) before they can proceed with organ removal. The medical procedures (lethal injections) as well as the delays associated with the DDR can damage organs (mostly thoracic organs) due to prolonged anoxia. Yet, strong scientific evidences demonstrate that operating differently and reconsidering the DDR would result in more organs of better quality available for transplant. This idea generates discomfort and resistance, but it is also worth considering, especially in a context of chronic shortage of available organs. One option that could be examined for MAiD’ patients who wish and can be organ donors would be to remove vital organs while patients are still alive (and under sedation). This would imply accepting that patient’s death would occur through organ donation instead of lethal injections required under MAiD’ legal rules. It would also mean that patients requesting MAiD and wishing to be organ donors could aspire to donate better quality organs, including their heart, an altruistic gesture that carries important symbolic value for many donors and their families. Following a patient centered approach, our hypothesis is that preventing vital organ donation from a living donor in all circumstance is neither perfectly coherent with how legal mentalities have evolved lately in the field of fundamental rights nor compatible with the clinical and ethical frameworks that shape the landscape in which those complex medical decisions unfold. Through a study of the legal, ethical, and clinical rules in place, both at the national and international levels, this analysis raises questions on the numerous inconsistencies associated with respecting the DDR with patients who have chosen to die through MAiD. We will begin with an assessment of the erosion of certain national legal frameworks that pertain to the sacred nature of the right to life which now also includes the right to choose how one wishes to die. We will then study recent innovative clinical protocols tested in different countries to help address acute organ shortage problems in creative ways. We will conclude this analysis with an ethical assessment of the situation, referring to principles such as justice, autonomy, altruism, beneficence, and non-malfeasance. This study will build a strong argument in favor of starting to allow vital organ donations from living donors in countries where MAiD is already permitted.

Keywords: altruism, autonomy, dead donor rule, medical assistance in dying, non-malfeasance, organ donation

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Authors: Fatemah Al-Baroud, Sudharani Shreenivas Kshatriya

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Kuwait Oil Company (KOC) is one of the companies for gas & oil production in Kuwait. The oil and gas industry is truly global; with operations conducted in every corner of the globe, the global community will rely heavily on oil and gas supplies. KOC has made many commitments to protect all due to KOC’s operations and operational releases. As per KOC’s strategy, the substantial increase in production activities will bring many challenges in managing various environmental hazards and stresses in the company. In order to handle those environmental challenges, the need of implementing effectively the health, safety, and environmental management system (HSEMS) is significant. And by implementing the HSEMS system properly, the environmental aspects of the activities, products, and services were identified, evaluated, and controlled in order to (i) Comply with local regulatory and other obligatory requirements; (ii) Comply with company policy and business requirements; and (iii) Reduce adverse environmental impact, including adverse impact to company reputation. Assessments for the Jurassic Production Facilities are being carried out as a part of the KOC HSEMS procedural requirement and monitoring the implementation of the relevant HSEMS procedures in the facilities. The assessments have been done by conducting series of theme audits using KOC’s audit protocol at JPFs. The objectives of the audits are to evaluate the compliance of the facilities towards the implementation of environmental procedures and the status of the KEPA requirement at all JPFs. The list of the facilities that were covered during the theme audit program are the following: (1) Jurassic Production Facility (JPF) – Sabriya (2) Jurassic Production Facility (JPF) – East Raudhatian (3) Jurassic Production Facility (JPF) – West Raudhatian (4)Early Production Facility (EPF 50). The auditing process comprehensively focuses on the application of KOC HSE MS procedures at JPFs and their ability to reduce the resultant negative impacts on the environment from the operations. Number of findings and observations were noted and highlighted in the audit reports and sent to all concerned controlling teams. The results of these audits indicated that the facilities, in general view, were in line with KOC HSE Procedures, and there were commitments in documenting all the HSE issues in the right records and plans. Further, implemented several control measures at JPFs that minimized/reduced the environmental impact, such as SRU were installed for sulphur recovery. Future scope and monitoring audit after a sufficient period of time will be carried out in conjunction with the controlling teams in order to verify the current status of the recommendations and evaluate the contractors' performance towards the required actions in preserving the environment.

Keywords: assessment of the environmental compliance, environmental and social impact assessment, kuwait environment public authority regulations, health, safety and environment management procedures, jurassic production facilities

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Authors: Navah Z. Ratzon, Talia Glick, Iris Manor

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Attention Deficit Hyperactivity Disorder (ADHD) is a chronic disorder that affects the sufferer’s functioning throughout life and in various spheres of activity, including driving. Difficulties in cognitive functioning and executive functions are often part and parcel of the ADHD diagnosis, and thus form a risk factor in driving. Studies examining the effectiveness of intervention programs for improving and rehabilitating driving in typical teenagers have been conducted in relatively small numbers; while studies on similar programs for teenagers with ADHD have been especially scarce. The aim of the present study has been to examine the effectiveness of a metacognitive occupational therapy intervention program for reducing risk factors in driving among teenagers with ADHD. The present study included 37 teenagers aged 17 to 19. They included 23 teenagers with ADHD divided into experimental (11) and control (12) groups; as well as 14 non-ADHD teenagers forming a second control group. All teenagers taking part in the study were examined in the Tel Aviv University driving lab, and underwent cognitive diagnoses and a driving simulator test. Every subject in the intervention group took part in 3 assessment meetings, and two metacognitive treatment meetings. The control groups took part in two assessment meetings with a follow-up meeting 3 months later. In all the study’s groups, the treatment’s effectiveness was tested by comparing monitoring results on the driving simulator at the first and second evaluations. In addition, the driving of 5 subjects from the intervention group was monitored continuously from a month prior to the start of the intervention, a month during the phase of the intervention and another month until the end of the intervention. In the ADHD control group, the driving of 4 subjects was monitored from the end of the first evaluation for a period of 3 months. The study’s findings were affected by the fact that the ADHD control group was different from the two other groups, and exhibited ADHD characteristics manifested by impaired executive functions and lower metacognitive abilities relative to their peers. The study found partial, moderate, non-significant correlations between driving skills and cognitive functions, executive functions, and perceptions and attitudes towards driving. According to the driving simulator test results and the limited sampling results of actual driving, it was found that a metacognitive occupational therapy intervention may be effective in reducing risk factors in driving among teenagers with ADHD relative to their peers with and without ADHD. In summary, the results of the present study indicate a positive direction that speaks to the viability of using a metacognitive occupational therapy intervention program for reducing risk factors in driving. A further study is required that will include a bigger number of subjects, add actual driving monitoring hours, and assign subjects randomly to the various groups.

Keywords: ADHD, driving, driving monitoring, metacognitive intervention, occupational therapy, simulator, teenagers

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

Procedia PDF Downloads 58

Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

Procedia PDF Downloads 222

Authors: A. Alyaaria, b, J. P. Wignerona, A. Ducharneb, Y. Kerrc, P. de Rosnayd, R. de Jeue, A. Govinda, A. Al Bitarc, C. Albergeld, J. Sabaterd, C. Moisya, P. Richaumec, A. Mialonc

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Global Level-3 surface soil moisture (SSM) maps from the passive microwave soil moisture and Ocean Salinity satellite (SMOSL3) have been released. To further improve the Level-3 retrieval algorithm, evaluation of the accuracy of the spatio-temporal variability of the SMOS Level 3 products (referred to here as SMOSL3) is necessary. In this study, a comparative analysis of SMOSL3 with a SSM product derived from the observations of the Advanced Microwave Scanning Radiometer (AMSR-E) computed by implementing the Land Parameter Retrieval Model (LPRM) algorithm, referred to here as AMSRM, is presented. The comparison of both products (SMSL3 and AMSRM) were made against SSM products produced by a numerical weather prediction system (SM-DAS-2) at ECMWF (European Centre for Medium-Range Weather Forecasts) for the 03/2010-09/2011 period at global scale. The latter product was considered here a 'reference' product for the inter-comparison of the SMOSL3 and AMSRM products. Three statistical criteria were used for the evaluation, the correlation coefficient (R), the root-mean-squared difference (RMSD), and the bias. Global maps of these criteria were computed, taking into account vegetation information in terms of biome types and Leaf Area Index (LAI). We found that both the SMOSL3 and AMSRM products captured well the spatio-temporal variability of the SM-DAS-2 SSM products in most of the biomes. In general, the AMSRM products overestimated (i.e., wet bias) while the SMOSL3 products underestimated (i.e., dry bias) SSM in comparison to the SM-DAS-2 SSM products. In term of correlation values, the SMOSL3 products were found to better capture the SSM temporal dynamics in highly vegetated biomes ('Tropical humid', 'Temperate Humid', etc.) while best results for AMSRM were obtained over arid and semi-arid biomes ('Desert temperate', 'Desert tropical', etc.). When removing the seasonal cycles in the SSM time variations to compute anomaly values, better correlation with the SM-DAS-2 SSM anomalies were obtained with SMOSL3 than with AMSRM, in most of the biomes with the exception of desert regions. Eventually, we showed that the accuracy of the remotely sensed SSM products is strongly related to LAI. Both the SMOSL3 and AMSRM (slightly better) SSM products correlate well with the SM-DAS2 products over regions with sparse vegetation for values of LAI < 1 (these regions represent almost 50% of the pixels considered in this global study). In regions where LAI>1, SMOSL3 outperformed AMSRM with respect to SM-DAS-2: SMOSL3 had almost consistent performances up to LAI = 6, whereas AMSRM performance deteriorated rapidly with increasing values of LAI.

Keywords: remote sensing, microwave, soil moisture, AMSR-E, SMOS

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Authors: M. Shukry

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According to the United Nations Declaration of Human Rights in 1948, every human being is entitled to rights in life that should be respected by others and protected by the state and community. Such rights are inherent regardless of colour, ethnicity, gender, religion or otherwise, and it is expected that all humans alike have the right to live without discrimination of any sort. However, that has not been the case with Aborigines in Australia. Over a long period of time, the governments of the State and the Territories and the Australian Commonwealth denied the Aboriginal and Indigenous inhabitants of the Torres Strait Islands such rights. Past Australian governments set policies and laws that enabled them to forcefully remove Indigenous children from their parents, which resulted in creating lost generations living the trauma of the loss of cultural identity, alienation and even their own selfhood. Intending to reduce that population of natives and their Aboriginal culture while, on the other hand, assimilate them into mainstream society, they gave themselves the right to remove them from their families with no hope of return. That practice has led to tragic consequences due to the trauma that has affected those children, an experience that is depicted by Jane Harrison in her play Stolen. The drama is the outcome of a six-year project on lost children and which was first performed in 1997 in Melbourne. Five actors only appear on the stage, playing the role of all the different characters, whether the main protagonists or the remaining cast, present or non-present ones as voices. The play outlines the life of five children who have been taken from their parents at an early age, entailing a disastrous negative impact that differs from one to the other. Unknown to each other, what connects between them is being put in a children’s home. The purpose of this paper is to analyse the play’s text in light of the 1948 Declaration of Human Rights, using it as a lens that reflects the atrocities practiced against the Aborigines. It highlights how such practices formed an outrageous violation of those natives’ rights as human beings. Harrison’s dramatic technique in conveying the children’s experiences is through a non-linear structure, fluctuating between past and present that are linked together within each of the five characters, reflecting their suffering and pain to create an emotional link between them and the audience. Her dramatic handling of the issue by fusing tragedy with humour as well as symbolism is a successful technique in revealing the traumatic memory of those children and their present life. The play has made a difference in commencing to address the problem of the right of all children to be with their families, which renders the real meaning of having a home and an identity as people.

Keywords: aboriginal, audience, Australia, children, culture, drama, home, human rights, identity, Indigenous, Jane Harrison, memory, scenic effects, setting, stage, stage directions, Stolen, trauma

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Authors: Alejandro Cittadino, David Allende

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Landfilling of municipal solid waste is a common waste management practice in Argentina as in many parts of the world. There is extensive scientific literature on the potential negative effects of landfill leachates on the environment, so it’s necessary to be rigorous with the control and monitoring systems. Due to the specific municipal solid waste composition in Argentina, local landfill leachates contain large amounts of organic matter (biodegradable, but also refractory to biodegradation), as well as ammonia-nitrogen, small trace of some heavy metals, and inorganic salts. In order to investigate the surface water quality in the Reconquista river adjacent to the Norte III landfill, water samples both upstream and downstream the dumpsite are quarterly collected and analyzed for 43 parameters including organic matter, heavy metals, and inorganic salts, as required by the local standards. The objective of this study is to apply a water quality index that considers the leachate characteristics in order to determine the quality status of the watercourse through the landfill. The water pollution index method has been widely used in water quality assessments, particularly rivers, and it has played an increasingly important role in water resource management, since it provides a number simple enough for the public to understand, that states the overall water quality at a certain location and time. The chosen water quality index (ICA) is based on the values of six parameters: dissolved oxygen (in mg/l and percent saturation), temperature, biochemical oxygen demand (BOD5), ammonia-nitrogen and chloride (Cl-) concentration. The index 'ICA' was determined both upstream and downstream the Reconquista river, being the rating scale between 0 (very poor water quality) and 10 (excellent water quality). The monitoring results indicated that the water quality was unaffected by possible leachate runoff since the index scores upstream and downstream were ranked in the same category, although in general, most of the samples were classified as having poor water quality according to the index’s scale. The annual averaged ICA index scores (computed quarterly) were 4.9, 3.9, 4.4 and 5.0 upstream and 3.9, 5.0, 5.1 and 5.0 downstream the river during the study period between 2014 and 2017. Additionally, the water quality seemed to exhibit distinct seasonal variations, probably due to annual precipitation patterns in the study area. The ICA water quality index appears to be appropriate to evaluate landfill impacts since it accounts mainly for organic pollution and inorganic salts and the absence of heavy metals in the local leachate composition, however, the inclusion of other parameters could be more decisive in discerning the affected stream reaches from the landfill activities. A future work may consider adding to the index other parameters like total organic carbon (TOC) and total suspended solids (TSS) since they are present in the leachate in high concentrations.

Keywords: landfill, leachate, surface water, water quality index

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Authors: Bikash Ranjan Mishra, Lopamudra D. Satpathy

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In the wake of the phenomenal surge in international business in the last decades or more, both the developed and developing economies around the world are in massive competition to attract more and more FDI flows. While the developed countries have marched ahead in the race, the developing countries, especially those of Asian economies, have followed them at a rapid pace. While most of the previous studies have analysed the role of institutional quality in the promotion of FDI flows in developing countries, very few studies have taken an integrated approach of examining the comprehensive impact of institutional quality, globalization pattern and domestic financial development on FDI flows. In this context, the paper contributes to the literature in two important ways. Firstly, two composite indices of institutional quality and domestic financial development for the Asian countries are constructed in comparison to earlier studies that resort to a single variable for indicating the institutional quality and domestic financial development. Secondly, the impact of these variables on FDI flows through their interaction with geographical region is investigated. The study uses panel data covering the time period of 1996 to 2012 by selecting twenty Asian developing countries by emphasizing the quality of institutions from the geographical regions of eastern, south-eastern, southern and western Asia. Control of corruption, better rule of law, regulatory quality, effectiveness of the government, political stability and voice and accountability are used as indicators of institutional quality. Besides these, the study takes into account the domestic credits in the hands of public, private sectors and in stock markets as domestic financial indicators. First in the specification of model, a factor analysis is performed to reduce the vast determinants, which are highly correlated with each other, to a manageable size. Afterwards, a reduced version of the model is estimated with the extracted factors in the form of index as independent variables along with a set of control variables. It is found that the institutional quality index and index of globalization exert a significant effect on FDI inflows of the host countries; in contrast, the domestic financial index does not seem to play much worthy role. Finally, some robustness tests are performed to make sure that the results are not sensitive to temporal and spatial unobserved heterogeneity. On the basis of the above study, one general inference can be drawn from the policy prescription point of view that the government of these developing countries should strengthen their domestic institution, both financial and non-financial. In addition to these, welfare policies should also target for rapid globalization. If the financial and non-financial institutions of these developing countries become sound and grow more globalized in the economic, social and political domain, then they can appeal to more amounts of FDI inflows that will subsequently result in advancement of these economies.

Keywords: Asian developing economies, FDI, institutional quality, panel data

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Authors: Michael McTighe

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Background: The COVID-19 pandemic caused the cancellation of many large-scale in-person sporting events, which led to an increase in the availability of virtual ultra-marathons. This study intended to assess how participation in virtual long distances races relates to levels of physical activity for an extended period of time. Moreover, traditional ultra-marathons are known for being not only physically demanding, but also mentally and emotionally challenging. A second component of this study was to assess how psychological contructs related to emotion regulation and mental toughness predict overall performance in the sport. Method: 83 virtual runners participating in a four-month 1000-kilometer race with the option to exceed 1000 kilometers completed a questionnaire exploring demographics, their performance, and experience in the virtual race. Participants also completed the Difficulties in Emotions Regulation Scale (DERS) and the Sports Mental Toughness Questionnaire (SMTQ). Logistics regressions assessed these constructs’ utility in predicting completion of the 1000-kilometer distance in the time allotted. Multiple regression was employed to predict the total distance traversed during the fourmonth race beyond 1000-kilometers. Result: Neither mental toughness nor emotional regulation was a significant predictor of completing the virtual race’s basic 1000-kilometer finish. However, both variables included together were marginally significant predictors of total miles traversed over the entire event beyond 1000 K (p = .051). Additionally, participation in the event promoted an increase in healthy activity with participants running and walking significantly more in the four months during the event than the four months leading up to it. Discussion: This research intended to explore how psychological constructs relate to performance in a virtual type of endurance event, and how involvement in these types of events related to levels of activity. Higher levels of mental toughness and lower levels in difficulties in emotion regulation were associated with greater performance, and participation in the event promoted an increase in athletic involvement. Future psychological skill training aimed at improving emotion regulation and mental toughness may be used to enhance athletic performance in these sports, and future investigations into these events could explore how general participation may influence these constructs over time. Finally, these results suggest that participation in this logistically accessible, and affordable type of sport can promote greater involvement in healthy activities related to running and walking.

Keywords: virtual races, emotion regulation, mental toughness, ultra-marathon, predictors in performance

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Authors: Magdalena Grudzińska

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Passive systems allow solar radiation to be converted into thermal energy thanks to appropriate building construction. Greenhouse systems are particularly worth attention, due to the low costs of their realization and strong architectural appeal. The paper discusses the energy effects of using passive greenhouse systems, such as glazed balconies, in an example residential building. The research was carried out for five localities in Poland, belonging to climatic zones different in terms of external air temperature and insolation: Koszalin, Poznań, Lublin, Białystok and Zakopane The analysed apartment had a floor area of approximately 74 m² Three thermal zones were distinguished in the flat - the balcony, the room adjacent to it, and the remaining space, for which various internal conditions were defined. Calculations of the energy demand were made using the dynamic simulation program, based on the control volume method. The climatic data were represented by Typical Meteorological Years, prepared on the basis of source data collected from 1971 to 2000. In each locality, the introduction of a passive greenhouse system led to a lower demand for heating in the apartment, and the shortening of the heating season. The smallest effectiveness of passive solar energy systems was noted in Białystok. Demand for heating was reduced there by 14.5% and the heating season remained the longest, due to low temperatures of external air and small sums of solar radiation intensity. In Zakopane, energy savings came to 21% and the heating season was reduced to 107 days, thanks to the greatest insolation during winter. The introduction of greenhouse systems caused an increase in cooling demand in the warmer part of the year, but total energy demand declined in each of the discussed places. However, potential energy savings are smaller if the building's annual life cycle is taken into consideration, and amount from 5.6% up to 14%. Koszalin and Zakopane are localities in which the greenhouse system allows the best energy results to be achieved. It should be emphasized that favourable conditions for introducing greenhouse systems are connected with different climatic conditions. In the seaside area (Koszalin) they result from high temperatures in the heating season and the smallest insolation in the summer period, while in the mountainous area (Zakopane) they result from high insolation in the winter and low temperatures in the summer. In the region of middle and middle-eastern Poland active systems (such as solar energy collectors or photovoltaic panels) could be more beneficial, due to high insolation during summer. It is assessed that passive systems do not eliminate the need for traditional heating in Poland. They can, however, substantially contribute to lower use of non-renewable fuels and the shortening of the heating season. The calculations showed diversification in the effectiveness of greenhouse systems resulting from climatic conditions, and allowed to identify areas which are the most suitable for the passive use of solar radiation.

Keywords: solar energy, passive greenhouse systems, glazed balconies, climatic conditions

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Authors: Amany Abdelrazek

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Fashion is considered the main feature of modern and postmodern capitalist and consumerist society. Consumer historians maintain that fashion, namely, a sector of people embracing a prevailing clothing style for a short period, started during the Middle Ages but gained popularity later. It symbolised the transition from a medieval society with its solid fixed religious values into a modern society with its secular consumer dynamic culture. Renaissance society was a modern secular society concerning its preoccupation with daily life and changing circumstances. Yet, the late 18th-century industrial revolution revolutionised thought and ideology in Europe. The Industrial Revolution reinforced the Western belief in rationality and strengthened the position of science. In such a rational Western society, modernity, with its new ideas, came to challenge the whole idea of old fixed norms, reflecting the modern secular, rational culture and renouncing the medieval pious consumer. In modern society, supported by the industrial revolution and mass production, fashion encouraged broader sectors of society to integrate into fashion reserved for the aristocracy and royal courts. Moreover, the fashion project emphasizes the human body and its beauty, contradicting Judeo-Christian culture, which tends to abhor and criticize interest in sensuality and hedonism. In mainstream Western discourse, fashionable dress differentiates between emancipated stylish consumerist secular modern female and the assumed oppressed traditional modest religious female. Opposing this discourse, I look at the controversy over what has been called "Islamic fashion" that started during the 1980s and continued to gain popularity in contemporary Egyptian society. I discuss the challenges of being a fashionable and Muslim practicing female in light of two prominent models for female "Islamic fashion" in postcolonial Egypt; Jasmin Mohshen, the first hijabi model in Egypt and Manal Rostom, the first Muslim woman to represent the Nike campaign in the Middle East. The research employs fashion and postcolonial theories to rethink current Muslim women's position on women's emancipation, Western modernity and practising faith in postcolonial Egypt. The paper argues that Muslim women's current innovative and fashionable dress can work as a counter-discourse to the Orientalist and exclusive representation of non-Western Muslim culture as an inherently inert timeless culture. Furthermore, "Islamic" fashionable dress as an aesthetic medium for expressing ideas and convictions in contemporary Egypt interrogates the claim of universal secular modernity and Western fashion theorists' reluctance to consider Islamic fashion as fashion.

Keywords: fashion, muslim women, modernity, secularism

Procedia PDF Downloads 129

Authors: Isaac Kwabena Adubofour, Esther Serwaah Afreh

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Political speeches are structured in ways that ensure that the ideology of the leader is communicated in ways that the opinions of the audience are influenced towards certain lines of action, and in crisis situations like the outbreak of a global pandemic, public opinion and action are influenced through speeches. The foregoing explains the presence of metaphors in presidential speeches. Crises require, among other things, that the thoughts, emotions, and actions of the population are controlled in dealing with the problems at hand. The primary question this study assesses is how the use of metaphors in crisis situations, like the COVID-19 pandemic, influences thought, determines the policies a government adopts, and influences the reactions of the people. The study focused on twenty-four (24) addresses of the President of Ghana, Nana Addo Danquah Akuffo-Addo, on the COVID-19 pandemic and his government’s efforts to manage the crisis. The nature and relevance of presidential speeches and the presence of metaphors in such speeches have been investigated. However, there is a paucity of research on the connection between the presence of metaphors in presidential speeches and their influence on thought and action. Especially within the crisis of the COVID-19 pandemic, it is pertinent to investigate how the presence of metaphors in presidential addresses influences social thought and action. Thus, the current study sought to investigate the potential for metaphor use to influence thought and action on a national scale during the COVID crisis. The speeches were collected from the website of the presidency. The analysis was done using Metaphor Identification Process by the Praglejazz Group (2007) with conceptual metaphor theory (Lakoff & Johnson, 1980) as the theoretical foundation. The findings of the study show that the President’s adoption of war metaphors may not have been ideal since it triggered thoughts, policies, and social actions in line with war. For instance, the reference to health workers as heroes, heroines, and frontline workers praised the efforts of these workers over the efforts of the rest of the population, and that may have contributed to the apathy that arose among the citizens in dealing with the pandemic. This prioritization of the frontline workers explains why their taxes were forgiven for a considerable period. The government further absorbed utility bills of citizens during the pandemic. All these financial commitments may not have been advisable for a developing country like Ghana, but the authors argue that the actions may have been influenced by the metaphor that was adopted. Another finding that is explored is the problem of stigmatization in the country during the pandemic and its connection with the war metaphor. This investigation expands the research on metaphors, social thought and action, and crisis communication. Its contribution to metaphor use, thought, and action suggest its potential implication for education and other fields.

Keywords: conceptual metaphor theory, COVID-19, crisis communication, presidential addresses, risk communication

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Authors: Sunil Sangwan, Narayan Chandra Nayak

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Over the last few decades, Indian banking system has achieved remarkable growth in its credit volume. However, one of the most disturbing facts about this growth is the uneven distribution of financial services across regions. Having witnessed limited success from all the earlier efforts towards financial inclusion targeting the rural poor and the underprivileged, provision of microfinance, of late, has emerged as a supplementary mechanism. There are two prominent modes of microfinance distribution in India namely Bank-SHG linkage (SBLP) and private Microfinance Institutions (MFIs). Ironically, such efforts also seem to have failed to achieve the desired targets as the microfinance services have witnessed skewed distribution across the states of the country. This study attempts to make a comparative analysis of the geographical skew of the SBLP and MFI in India and examine the factors influencing their regional distribution. The results indicate that microfinance services are largely concentrated in the southern region, accounting for about 50% of all microfinance clients and 49% of all microfinance loan portfolios. This is distantly followed by an eastern region where client outreach is close to 25% only. The north-eastern, northern, central, and western regions lag far behind in microfinance sectors, accounting for only 4%, 4%, 10%, and 7 % client outreach respectively. The penetration of SHGs is equally skewed, with the southern region accounting for 46% of client outreach and 70% of loan portfolios followed by an eastern region with 21% of client outreach and 13% of the loan portfolio. Contrarily, north-eastern, northern, central, western and eastern regions account for 5%, 5%, 10%, and 13% of client outreach and 3%, 3%, 7%, and 4% of loan portfolios respectively. The study examines the impact of literacy rate, rural poverty, population density, primary sector share, non-farm activities, loan default behavior and bank penetration on the microfinance penetration. The study is limited to 17 major states of the country over the period 2008-2014. The results of the GMM estimation indicate the significant positive impact of literacy rate, non-farm activities and population density on microfinance penetration across the states, while the rise in loan default seems to deter it. Rural poverty shows the significant negative impact on the spread of SBLP, while it has a positive impact on MFI penetration, hence indicating the policy of exclusion being adhered to by the formal financial system especially towards the poor. However, MFIs seem to be working as substitute mechanisms to banks to fill the gap. The findings of the study are a pointer towards enhancing financial literacy, non-farm activities, rural bank penetration and containing loan default for achieving greater microfinance prevalence.

Keywords: bank penetration, literacy rate, microfinance, primary sector share, rural non-farm activities, rural poverty

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Authors: Doni Dermawan

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Modern sports competition as a consequence of the increase in the value of the business and entertainment in the field of sport has been demanding athletes to always have excellent physical endurance performance. Physical exercise is done in a long time, and intensive may pose a risk of muscle tissue damage caused by the increase of the enzyme creatine kinase. Branched Chain Amino Acids (BCAA) is an essential amino acid that is composed of leucine, isoleucine, and valine which serves to maintain muscle tissue, keeping the immune system, and prevent further loss of coordination and muscle pain. Pea (Pisum sativum L.) is a kind of leguminous plants that are rich in Branched Chain Amino Acids (BCAA) where every one gram of protein pea contains 82.7 mg of leucine; 56.3 mg isoleucine; and 56.0 mg of valine. This research aims to develop Branched Chain Amino Acids (BCAA) from pea extract is applied in dosage forms Gel PVP Kinesio Tape technology using Ultrasound-assisted Extraction. The method used in the writing of this paper is the Cochrane Collaboration Review that includes literature studies, testing the quality of the study, the characteristics of the data collection, analysis, interpretation of results, and clinical trials as well as recommendations for further research. Extraction of BCAA in pea done using ultrasound-assisted extraction technology with optimization variables includes the type of solvent extraction (NaOH 0.1%), temperature (20-250C), time (15-30 minutes) power (80 watt) and ultrasonic frequency (35 KHz). The advantages of this extraction method are the level of penetration of the solvent into the membrane of the cell is high and can increase the transfer period so that the BCAA substance separation process more efficient. BCAA extraction results are then applied to the polymer PVP (Polyvinylpyrrolidone) Gel powder composed of PVP K30 and K100 HPMC dissolved in 10 mL of water-methanol (1: 1) v / v. Preparations Kinesio Tape Gel PVP is the BCAA in the gel are absorbed into the muscle tissue, and joints through tensile force then provides stimulation to the muscle circulation with variable pressure so that the muscle can increase the biomechanical movement and prevent damage to the muscle enzyme creatine kinase. Analysis and evaluation of test preparation include interaction, thickness, weight uniformity, humidity, water vapor permeability, the levels of the active substance, content uniformity, percentage elongation, stability testing, release profile, permeation in vitro and in vivo skin irritation testing.

Keywords: branched chain amino acid, BCAA, Kinesio tape, pea, PVP gel, ultrasound-assisted extraction

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Authors: Nadeem Munawar, Tariq Mahmood, Paula Rivadeneira, Ali Akhter

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In this paper, we review on rodent species which are common inhabitants of agricultural landscapes where they are an important prey source for a wide variety of avian, reptilian, and mammalian predators. Agricultural fields are surrounded by fallow land, which provide suitable sites for shelter and breeding for rodents, while shrubs, grasses, annual weeds and forbs may provide supplementary food. The assemblage of rodent’s fauna in the cropland habitats including cropped fields, meadows and adjacent field structures like hedgerows, woodland and field margins fluctuates seasonally. The mature agricultural crops provides good source of food and shelter to the rodents and these factors along with favorable climatic factors/season facilitate breeding activities of these rodent species. Changes in vegetation height and vegetative cover affect two important aspects of a rodent’s life: food and shelter. In addition, during non-crop period vegetation can be important for building nests above or below ground and it provides thermal protection for rodents from heat and cold. The review revealed that rodents form a very diverse group of mammals, ranging from tiny pigmy mice to big capybaras, from arboreal flying squirrels to subterranean mole rats, from opportunistic omnivores (e.g. Norway rats) to specialist feeders (e.g. the North African fat sand rats that feed on a single family of plants only). It is therefore no surprise that some species thrive well under the conditions that are found in agricultural fields. The review on the population dynamics of the rodent species indicated that they are agricultural pests probably due to the heterogeneous landscape and to the high rotativity of vegetable crop cultivation. They also cause damage to various crops, directly and indirectly, by gnawing, spoilage, contamination and hoarding activities, besides this behavior they have also significance importance in agricultural habitat. The burrowing activities of rodents alter the soil properties around their burrows which improve its aeration, infiltration, increase the water holding capacity and thus encourage plant growth. These properties are beneficial for the soil because they affect absorption of phosphorus, absorption zinc, copper, other nutrients and the uptake of water and thus rodents are known as indicator species in agricultural fields. Our review suggests that wide crop field’s borders, particularly those contiguous to various cropland fields, should be understood as priority sites for nesting, feeding, and cover for the rodent’s fauna. The goal of this review paper is to provide a comprehensive synthesis of understanding regarding rodent habitat and biodiversity in agricultural landscapes.

Keywords: agricultural landscapes, food, indicator species, shelter

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Authors: Mohammad Moridzadeh, Gholamreza Mesri

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The effectiveness of lime treatment of soils has been commonly evaluated in terms of improved workability and increased undrained unconfined compressive strength in connection to road and airfield construction. The most common method of strength measurement has been the unconfined compression test. However, if the objective of lime treatment is to improve long-term stability of first-time or reactivated landslides in stiff clays and shales, permanent changes in the size and shape of clay particles must be realized to increase drained frictional resistance. Lime-soil interactions that may produce less platy and larger soil particles begin and continue with time under the highly alkaline pH environment. In this research, pH measurements are used to monitor chemical environment and progress of reactions. Atterberg limits are measured to identify changes in particle size and shape indirectly. Also, fully softened and residual strength measurements are used to examine an improvement in frictional resistance due to lime-soil interactions. The main variables are soil plasticity and mineralogy, lime content, water content, and curing period. Lime effect on frictional resistance is examined using samples of clays with different mineralogy and characteristics which may react with lime to various extents. Drained direct shear tests on reconstituted lime-treated clay specimens with various properties have been performed to measure fully softened shear strength. To measure residual shear strength, drained multiple reversal direct shear tests on precut specimens were conducted. This way, soil particles are oriented along the direction of shearing to the maximum possible extent and provide minimum frictional resistance. This is applicable to reactivated and part of first-time landslides. The Brenna clay, which is the highly plastic lacustrine clay of Lake Agassiz causing slope instability along the banks of the Red River, is one of the soil samples used in this study. The Brenna Formation characterized as a uniform, soft to firm, dark grey, glaciolacustrine clay with little or no visible stratification, is full of slickensided surfaces. The major source of sediment for the Brenna Formation was the highly plastic montmorillonitic Pierre Shale bedrock. The other soil used in this study is one of the main sources of slope instability in Harris County Flood Control District (HCFCD), i.e. the Beaumont clay. The shear strengths of untreated and treated clays were obtained under various normal pressures to evaluate the shear envelope nonlinearity.

Keywords: Brenna clay, friction resistance, lime treatment, residual

Procedia PDF Downloads 159

Authors: Dejene Ermias Mekango, Mussie Alemayehu, Gebremedhin Berhe Gebregergs, Araya Abrha Medhanye, Gelila Goba

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Background: Maternal near miss (MNM) can be used as a proxy indicator of maternal mortality ratio. There is a huge gap in life time risk between Sub-Saharan Africa and developed countries. In Ethiopia, a significant number of women die each year from complications during pregnancy, childbirth and the post-partum period. Besides, a few studies have been performed on MNM, and little is known regarding determinant factors. This study aims to identify determinants of MNM among women in Tigray region, Northern Ethiopia. Methods: a case-control study in hospital found in Tigray region, Ethiopia was conducted from January 30 - March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric care at six public hospitals. Clients having a life-threatening obstetric complication including haemorrhage, hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women without haemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls. Cases were selected based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (odds ratio) analyses were calculated with 95% CI. Results: The largest proportion of cases and controls was among the ages of20–29 years, accounting for37.9 %( 39) of cases and 31.7 %( 65) of controls. Roughly 90% of cases and controls were married. About two-thirds of controls and 45.6 %( 47) of cases had gestational age between 37-41 weeks. History of chronic medical conditions was reported in 55.3 %(57) of cases and 33.2%(68) of controls. Women with no formal education [AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced labor[AOR=3; 95%CI:1.44, 6.17], history of Cesarean section (C-section) [AOR=4.6; 95%CI: 1.98, 7.61] or chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM. Conclusions: The Government of Ethiopia should continue its effort to address the lack of road and health facility access as well as education, which will help reduce MNM. Work should also be continued to educate women and providers about common predictors of MNM like the history of C-section, chronic illness, and teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. The targeted follow-up to women with a history of chronic disease and C-section could also be a practical way to reduce MNM.

Keywords: maternal near miss, severe obstetric hemorrhage, hypertensive disorder, c-section, Tigray, Ethiopia

Procedia PDF Downloads 222

Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey

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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.

Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing

Procedia PDF Downloads 152

Authors: Julien Benomar

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The World Bank report published in April 2023 called “Migrants, Refugees and Society” allows us to first distinguish migrants in search of economic opportunities and refugees that flee a situation of danger and choose their destination based on their immediate need for safety. Amongst those two categories, the report distinguished people having professional skills adapted to the labor market of the host country and those who have not. Out of that distinction of four categories, we choose to focus our research on refugees that do not have professional skills adapted to the labor market of the host country. Given that refugees generally have no recourse to public assistance schemes and cannot count on the support of their entourage or support network, we propose to examine the extent to which external assistance, such as international humanitarian action, is likely to accompany refugees' transition to financial empowerment through entrepreneurship. To this end, we propose to carry out a case study structured in three stages: (i) an exchange with a Non-Governmental Organisation (NGO) active in supporting refugee populations from Congo and Burundi to Rwanda, enabling us to (i.i) define together a financial empowerment income, and (i. ii) learn about the content of the support measures taken for the beneficiaries of the humanitarian project; (ii) monitor the population of 118 beneficiaries, including 73 refugees and 45 Rwandans (reference population); (iii) conduct a participatory analysis to identify the level of performance of the project and areas for improvement. The case study thus involved the staff of an international NGO active in helping refugees from Rwanda since 2015 and the staff of a Luxembourg NGO that has been funding this economic aid project through entrepreneurship since 2021. The case study thus involved the staff of an international NGO active in helping refugees from Rwanda since 2015 and the staff of a Luxembourg NGO, which has been funding this economic aid through an entrepreneurship project since 2021, and took place over a 48-day period between April and May 2023. The main results are of two types: (i) the need to associate indicators for monitoring the impact of the project on the indirect beneficiaries of the project (refugee community) and (ii) the identification of success factors making it possible to bring concrete and relevant responses to the constraints encountered. The first result thus made it possible to identify the following indicators: Indicator of community potential ((jobs, training or mentoring) promoted by the activity of the entrepreneur), Indicator of social contribution (tax paid by the entrepreneur), Indicator of resilience (savings and loan capacity generated, and finally impact on social cohesion. The second result made it possible to identify that among the 7 success factors tested, the sector of activity chosen and the level of experience in the sector of the future activity are those that stand out the most clearly.

Keywords: entrepreuneurship, refugees, financial empowerment, international aid

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Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei

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Physiological changes during pregnancy, such as alterations in the circulatory, respiratory, and musculoskeletal systems, can negatively impact daily physical activity. This reduced activity is often associated with an increased risk of adverse maternal health outcomes, particularly gestational diabetes mellitus (GDM) and excessive weight gain. This meta-analysis aims to evaluate the effectiveness of structured physical exercise interventions during pregnancy in reducing the risk of GDM and managing maternal weight gain. A comprehensive search was conducted across six major databases: PubMed, Cochrane Library, EMBASE, Web of Science, ScienceDirect, and ClinicalTrials.gov, covering the period from database inception until 2023. Randomized controlled trials (RCTs) that explored the effects of physical exercise programs on pregnant women with low physical activity levels were included. The search was performed using EndNote and results were managed using RevMan (Review Manager) for meta-analysis. RCTs involving healthy pregnant women with low levels of physical activity or sedentary lifestyles were selected. These RCTs must have incorporated structured exercise programs during pregnancy and reported on outcomes related to GDM and maternal weight gain. From an initial pool of 5,112 articles, 65 RCTs (involving 11,400 pregnant women) met the inclusion criteria. Data extraction was performed, followed by a quality assessment of the selected studies using the Cochrane Risk of Bias tool. The meta-analysis was conducted using RevMan software, where pooled relative risks (RR) and weighted mean differences (WMD) were calculated using a random-effects model to address heterogeneity across studies. Sensitivity analyses, subgroup analyses (based on factors such as exercise intensity, duration, and pregnancy stage), and publication bias assessments were also conducted. Structured physical exercise during pregnancy led to a significant reduction in the risk of developing GDM (RR = 0.68; P < 0.001), particularly when the exercise program was performed throughout the pregnancy (RR = 0.62; P = 0.035). In addition, maternal weight gain was significantly reduced (WMD = −1.18 kg; 95% CI −1.54 to −0.85; P < 0.001). There were no significant adverse effects reported for either the mother or the neonate, confirming that exercise interventions are safe for both. This meta-analysis highlights the positive impact of regular moderate physical activity during pregnancy in reducing the risk of GDM and managing maternal weight gain. These findings suggest that physical exercise should be encouraged as a routine part of prenatal care. However, more research is required to refine exercise recommendations and determine the most effective interventions based on individual risk factors and pregnancy stages.

Keywords: gestational diabetes, maternal weight management, meta-analysis, randomized controlled trials

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Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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Authors: Yanxue Shang, Jingbin Zeng

Abstract:

Chlorobenzene homologues (CBHs) are a category of environmental pollutants that can not be ignored. They can stay in the environment for a long period and are potentially carcinogenic. The traditional degradation method of CBHs is dechlorination followed by sample preparation and analysis. This is not only time-consuming and laborious, but the detection and analysis processes are used in conjunction with large-scale instruments. Therefore, this can not achieve rapid and low-cost detection. Compared with traditional sensing methods, colorimetric sensing is simpler and more convenient. In recent years, chromaticity sensors based on fluorescence have attracted more and more attention. Compared with sensing methods based on changes in fluorescence intensity, changes in color gradients are easier to recognize by the naked eye. Accordingly, this work proposes to use single drop microextraction (SDME) technology to solve the above problems. After the dechlorination reaction was completed, the organic droplet extracts Cl⁻ and realizes fluorescence colorimetric sensing at the same time. This method was integrated sample processing and visual in-situ detection, simplifying the detection process. As a fluorescence colorimetric sensor material, CsPbBr₃ was encapsulated in MOF-5 to construct CsPbBr₃@MOF-5 fluorescence colorimetric composite. Then the fluorescence colorimetric sensor was constructed by dispersing the composite in SDME organic droplets. When the Br⁻ in CsPbBr₃ exchanges with Cl⁻ produced by the dechlorination reactions, it is converted into CsPbCl₃. The fluorescence color of the single droplet of SDME will change from green to blue emission, thereby realizing visual observation. Therein, SDME can enhance the concentration and enrichment of Cl⁻ and instead of sample pretreatment. The fluorescence color change of CsPbBr₃@MOF-5 can replace the detection process of large-scale instruments to achieve real-time rapid detection. Due to the absorption ability of MOF-5, it can not only improve the stability of CsPbBr₃, but induce the adsorption of Cl⁻. Simultaneously, accelerate the exchange of Br- and Cl⁻ in CsPbBr₃ and the detection process of Cl⁻. The absorption process was verified by density functional theory (DFT) calculations. This method exhibits exceptional linearity for Cl⁻ in the range of 10⁻² - 10⁻⁶ M (10000 μM - 1 μM) with a limit of detection of 10⁻⁷ M. Whereafter, the dechlorination reactions of different kinds of CBHs were also carried out with this method, and all had satisfactory detection ability. Also verified the accuracy by gas chromatography (GC), and it was found that the SDME we developed in this work had high credibility. In summary, the in-situ visualization method of dechlorination reaction detection was a combination of sample processing and fluorescence colorimetric sensing. Thus, the strategy researched herein represents a promising method for the visual detection of dechlorination reactions and can be extended for applications in environments, chemical industries, and foods.

Keywords: chlorobenzene homologues, colorimetric sensor, metal halide perovskite, metal-organic frameworks, single drop microextraction

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Authors: Mas Pertiwi I. G. AG Istri, Sri Kristinayanti Wayan, Oka Aryawan I. Gede Made

Abstract:

Ability of government to meet the needs of infrastructure investment constrained by the size of the budget commitments for other sectors. Another barrier is the complexity of the process of land acquisition. Public Private Partnership can help bridge the investment gap by including the amount of funding from the private sector, shifted the responsibility of financing, construction of the asset, and the operation and post-project design and care to them. In principle, a construction project implementation always requires the investor as a party to provide resources in the form of funding which it must be contained in a successor agreement in the form of a contract. In general, construction contracts consist of contracts which passed in Indonesia and contract International. One source of funding used in the implementation of construction projects comes from funding that comes from the collaboration between the government and the private sector, for example with the system: BLT (Build Lease Transfer), BOT (Build Operate Transfer), BTO (Build Transfer Operate) and BOO (Build Operate Own). And form of payment under a construction contract can be distinguished several ways: monthly payment, payments based on progress and payment after completed projects (Turn Key). One of the tools used to analyze the feasibility of the investment is to use financial models. The financial model describes the relationship between different variables and assumptions used. From a financial model will be known how the cash flow structure of the project, which includes revenues, expenses, liabilities to creditors and the payment of taxes to the government. Net cash flow generated from the project will be used as a basis for analyzing the feasibility of investment source of project financing Public Private Partnership could come from equity or debt. The proportion of funding according to its source is a comparison of a number of investment funds originating from each source of financing for a total investment cost during the construction period by selected the contract system and several alternative financing percentage ratio determined according to sources will generate cash flow structure that is different. Of the various possibilities for the structure of the cash flow generated will be analyzed by software is to test T Paired to compared the contract system used by various alternatives comparison of financing to determine the effect of the contract system and the comparison of such financing for the feasibility of investment toll road construction project for the economic life of 20 (twenty) years. In this use case studies of toll road contruction project Bali Mandara. And in this analysis only covered two systems contracts, namely Build Operate Transfer and Turn Key. Based on the results obtained by analysis of the variable investment feasibility of the NPV, BCR and IRR between the contract system Build Operate Transfer and contract system Turn Key on the interest rate of 9%, 12% and 15%.

Keywords: contract system, financing, internal rate of return, net present value

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Authors: Dimitri Bacco, Arianna Trentini, Fabiana Scotto, Flavio Rovere, Daniele Foscoli, Cinzia Para, Paolo Veronesi, Silvia Sandrini, Claudia Zigola, Michela Comandini, Marilena Montalti, Marco Zamagni, Vanes Poluzzi

Abstract:

The Po Valley, in the north of Italy, is one of the most polluted areas in Europe. The air quality of the area is linked not only to anthropic activities but also to its geographical characteristics and stagnant weather conditions with frequent inversions, especially in the cold season. Even the coastal areas present high values of particulate matter (PM10 and PM2.5) because the area closed between the Adriatic Sea and the Apennines does not favor the dispersion of air pollutants. The aim of the present work was to identify the main sources of particulate matter in Rimini, a tourist city in northern Italy. Two sampling campaigns were carried out in 2018, one in winter (60 days) and one in summer (30 days), in 4 sites: an urban background, a city hotspot, a suburban background, and a rural background. The samples are characterized by the concentration of the ionic composition of the particulates and of the main a hydro-sugars, in particular levoglucosan, a marker of the biomass burning, because one of the most important anthropogenic sources in the area, both in the winter and surprisingly even in the summer, is the biomass burning. Furthermore, three sampling points were chosen in order to maximize the contribution of a specific biomass source: a point in a residential area (domestic cooking and domestic heating), a point in the agricultural area (weed fires), and a point in the tourist area (restaurant cooking). In these sites, the analyzes were enriched with the quantification of the carbonaceous component (organic and elemental carbon) and with measurement of the particle number concentration and aerosol size distribution (6 - 600 nm). The results showed a very significant impact of the combustion of biomass due to domestic heating in the winter period, even though many intense peaks were found attributable to episodic wood fires. In the summer season, however, an appreciable signal was measured linked to the combustion of biomass, although much less intense than in winter, attributable to domestic cooking activities. Further interesting results were the verification of the total absence of sea salt's contribution in the particulate with the lower diameter (PM2.5), and while in the PM10, the contribution becomes appreciable only in particular wind conditions (high wind from north, north-east). Finally, it is interesting to note that in a small town, like Rimini, in summer, the traffic source seems to be even more relevant than that measured in a much larger city (Bologna) due to tourism.

Keywords: aerosol, biomass burning, seacoast, urban area

Procedia PDF Downloads 128

Authors: Khalid A. Salman, Shereen Wagih, Tariq Munshi, Musaed Almalki, Safwan Zatari, Zahid Khan

Abstract:

Aim: To measure exposure levels to family members and caregivers of Saudi patients treated with low dose I131 therapy, and household radiation exposure rate to predict different factors that can affect radiation exposure. Patients and methods: All adult self dependent patients with hyperthyroidism or cancer thyroid referred for low dose radioactive I131 therapy on outpatient basis are included. Radiation protection procedures are given to the participant and family members in details. TLD’s were dispensed to each participant in sufficient quantity for his/her family members living in the household. TLD’s are collected at fifth days post-dispense from patients who agreed to have a home visit during which the household is inspected and level of radiation contamination of surfaces was measured. Results: Thirty-two patients were enrolled in the current study, with a mean age of 43.1± 17.1 years Out of them 25 patients (78%) are females. I131 therapy was given in twenty patients (63%) for cancer thyroid of and for toxic goiter in the remaining twelve patients (37%), with an overall mean I131 dose of 24.1 ± 7.5mCi that is relatively higher in the former. The overall number of household family members and helpers of patients are 139, out of them77 are females (55.4%) & 62 are males (44.6%) with a mean age of 29.8± 17.6. The mean period of contact with the patient is 7.6 ±5.6hours. The cumulative radiation exposure shows that radiation exposure to all family members is below the exposure constraint (1mSv), with a range of 109 to 503uSv, and a mean value of 220.9±91 uSv. Numerical data shows a little higher exposure rate for family members of those who receive higher dose of I131 (patients with thyroid cancer) and household members who spent longer time with the patient, yet, the difference is statistically insignificant (P>0.05). Besides, no significant correlation was found between the degree of cumulative exposure of the family members to their gender, age, socioeconomic standard, educational level and residential factors. In the 21 home visits all data from bedrooms, reception areas and kitchens are below hazardous limits (0.5uSv/h) apart from bathrooms that give a slightly higher reading of 0.57±0.39 uSv/h in those with cancer thyroid who receive a higher radiation dose. A statistically significant difference was found between radiation exposure rate in bathrooms used by the patient versus those used by family members only, with a mean value of exposure rate of 0.701±0.21 uSv/h and 0.17±0.82 uSv/h respectively, with a p-value of 0.018 (<0.05). Conclusion: Family members of patients treated with low dose I131 on outpatient basis have a good compliance to radiation protection instruction if given properly with a cumulative radiation exposure rate evidently beyond the radiation exposure constraints of 1 mSv. Given I131 dose, hours spent with the patient, age, gender, socioeconomic standard, educational level and residential factors have no significant correlation with the cumulative radiation exposure. The patient bathroom exhibits more radiation exposure rate, needing more strict instructions for patient bathroom use and health hygiene.

Keywords: family members, radiation exposure, radioactive iodine therapy, radiation safety

Procedia PDF Downloads 276