Search results for: soil improvement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7093

Search results for: soil improvement

1063 Effect of the Food Distribution on Household Food Security Status in Iran

Authors: Delaram Ghodsi, Nasrin Omidvar, Hassan Eini-Zinab, Arash Rashidian, Hossein Raghfar

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Food supplementary programs are policy approaches that aim to reduce financial barriers to healthy diets and tackle food insecurity. This study aimed to evaluate the effect of the supportive section of Multidisciplinary Supplementary Program for Improvement of Nutritional Status of Children (MuPINSC) on households’ food security status and nutritional status of mothers. MuPINSC is a national integrative program in Iran that distributes supplementary food basket to malnourished or growth retarded children living in low-income families in addition to providing health services, including sanitation, growth monitoring, and empowerment of families. This longitudinal study is part of a comprehensive evaluation of the program. The study participants included 359 mothers of children aged 6 to 72 month under coverage of the supportive section of the program in two provinces of Iran (Semnan and Qazvin). Demographic and economic characteristics of families were assessed by a questionnaire. Data on food security of family was collected by locally adapted Household Food Insecurity Access Scale (HFIAS) at the baseline of the study and six month thereafter. Weight and height of mothers were measured at the baseline and end of the study and mother’s BMI was calculated. Data were analysed, using paired t-test, GEE (Generalized Estimating Equation), and Chi-square tests. Based on the findings, at the baseline, only 4.7% of families were food-secure, while 13.1%, 38.7% and, 43.5% were categorized as mild, moderate and severe food insecure. After six months follow up, the distribution of different levels of food security changed significantly (P<0.001) to 7.9%, 11.6%, 42.6%, and 38%, respectively. At the end of the study, the chance of food insecurity was significantly 20% lower than the beginning (OR=0.796; 0.653-0.971). No significant difference was observed in maternal BMI based on food security (P>0.05). The findings show that the food supplementary program for children improved household food security status in the studied households. Further research is needed to assess other factors that affect the effectiveness of this large scale program on nutritional status and household’s food security.

Keywords: food security, food supplementary program, household, malnourished children

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1062 Cauda Equina Syndrome: An Audit on Referral Adequacy and its Impact on Delay to Surgery

Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

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PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

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1061 Applying the Eye Tracking Technique for the Evaluation of Oculomotor System in Patients Survived after Cerebellar Tumors

Authors: Marina Shurupova, Victor Anisimov, Alexander Latanov

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Background: The cerebellar lesions inevitably provoke oculomotor impairments in patients of different age. Symptoms of subtentorial tumors, particularly medulloblastomas, include static and dynamic coordination disorders (ataxia, asynergia, imbalance), hypo-muscle tonus, disruption of the cranial nerves, and within the oculomotor system - nystagmus (fine or gross). Subtentorial tumors can also affect the areas of cerebellum that control the oculomotor system. The noninvasive eye-tracking technology allows obtaining multiple oculomotor characteristics such as the number of fixations and their duration, amplitude, latency and velocity of saccades, trajectory and scan path of gaze during the process of the visual field navigation. Eye tracking could be very useful in clinical studies serving as convenient and effective tool for diagnostics. The aim: We studied the dynamics of oculomotor system functioning in patients undergoing remission from cerebellar tumors removal surgeries and following neurocognitive rehabilitation. Methods: 38 children (23 boys, 15 girls, 9-17 years old) that have recovered from the cerebellar tumor-removal surgeries, radiation therapy and chemotherapy and were undergoing course of neurocognitive rehabilitation participated in the study. Two tests were carried out to evaluate oculomotor performance - gaze stability test and counting test. The monocular eye movements were recorded with eye tracker ArringtonResearch (60 Hz). Two experimental sessions with both tests were conducted before and after rehabilitation courses. Results: Within the final session of both tests we observed remarkable improvement in oculomotor performance: 1) in the gaze stability test the spread of gaze positions significantly declined compared to the first session, and 2) the visual path in counting test significantly shortened both compared to the first session. Thus, neurocognitive rehabilitation improved the functioning of the oculomotor system in patients following the cerebellar tumor removal surgeries and subsequent therapy. Conclusions: The experimental data support the effectiveness of the utilization of the eye tracking technique as diagnostic tool in the field of neurooncology.

Keywords: eye tracking, rehabilitation, cerebellar tumors, oculomotor system

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1060 Monitoring Potential Temblor Localities as a Supplemental Risk Control System

Authors: Mikhail Zimin, Svetlana Zimina, Maxim Zimin

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Without question, the basic method of prevention of human and material losses is the provision for adequate strength of constructions. At the same time, seismic load has a stochastic character. So, at all times, there is little danger of earthquake forces exceeding the selected design load. This risk is very low, but the consequences of such events may be extremely serious. Very dangerous are also occasional mistakes in seismic zoning, soil conditions changing before temblors, and failure to take into account hazardous natural phenomena caused by earthquakes. Besides, it is known that temblors detrimentally affect the environmental situation in regions where they occur, resulting in panic and worsening various disease courses. It may lead to mistakes of personnel of hazardous production facilities like the production and distribution of gas and oil, which may provoke severe accidents. In addition, gas and oil pipelines often have long mileage and cross many perilous zones by contrast with buildings. This situation increases the risk of heavy accidents. In such cases, complex monitoring of potential earthquake localities would be relevant. Even though the number of successful real-time forecasts of earthquakes is not great, it is well in excess, such as may be under random guessing. Experimental performed time-lapse study and analysis consist of searching seismic, biological, meteorological, and light earthquake precursors, processing such data with the help of fuzzy sets, collecting weather information, utilizing a database of terrain, and computing risk of slope processes under the temblor in a given setting. Works were done in a real-time environment and broadly acceptable results took place. Observations from already in-place seismic recording systems are used. Furthermore, a look back study of precursors of known earthquakes is done. Situations before Ashkhabad, Tashkent, and Haicheng seismic events are analyzed. Fairish findings are obtained. Results of earthquake forecasts can be used for predicting dangerous natural phenomena caused by temblors such as avalanches and mudslides. They may also be utilized for prophylaxis of some diseases and their complications. Relevant software is worked out too. It should be emphasized that such control does not require serious financial expenses and can be performed by a small group of professionals. Thus, complex monitoring of potential earthquake localities, including short-term earthquake forecasts and analysis of possible hazardous consequences of temblors, may further the safety of pipeline facilities.

Keywords: risk, earthquake, monitoring, forecast, precursor

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1059 The Reality of Teaching Arabic for Specific Purposes in Educational Institutions

Authors: Mohammad Anwarul Kabir, Fayezul Islam

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Language invariably is learned / taught to be used primarily as means of communications. Teaching a language for its native audience differs from teaching it to non-native audience. Moreover, teaching a language for communication only is different from teaching it for specific purposes. Arabic language is primarily regarded as the language of the Quran and the Sunnah (Prophetic tradition). Arabic is, therefore, learnt and spread all over the globe. However, Arabic is also a cultural heritage shared by all Islamic nations which has used Arabic for a long period to record the contributions of Muslim thinkers made in the field of wide spectrum of knowledge and scholarship. That is why the phenomenon of teaching Arabic by different educational institutes became quite rife, and the idea of teaching Arabic for specific purposes is heavily discussed in the academic sphere. Although the number of learners of Arabic is increasing consistently, yet their purposes vary. These include religious purpose, international trade, diplomatic purpose, better livelihood in the Arab world extra. By virtue of this high demand for learning Arabic, numerous institutes have been established all over the world including Bangladesh. This paper aims at focusing on the current status of the language institutes which has been established for learning Arabic for specific purposes in Bangladesh including teaching methodology, curriculum, and teachers’ quality. Such curricula and using its materials resulted in a lot of problems. The least, it confused teachers and students as well. Islamic educationalists have been working hard to professionally meet the need. They are following a systematic approach of stating clear and achievable goals, building suitable content, and applying new technology to present these learning experiences and evaluate them. It also suggests a model for designing instructional systems that responds to the need of non-Arabic speaking Islamic communities and provide the knowledge needed in both linguistic and cultural aspects. It also puts forward a number of suggestions for the improvement of the teaching / learning Arabic for specific purposes in Bangladesh after a detailed investigation in the following areas: curriculum, teachers’ skills, method of teaching and assessment policy.

Keywords: communication, Quran, sunnah, educational institutes, specific purposes, curriculum, method of teaching

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1058 Application of Bundle Care to Reduce Invasive Catheter-Associated Infection in High Risk Units at a Medical Center

Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng

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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.

Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work

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1057 Quantitative Analysis of Three Sustainability Pillars for Water Tradeoff Projects in Amazon

Authors: Taha Anjamrooz, Sareh Rajabi, Hasan Mahmmud, Ghassan Abulebdeh

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Water availability, as well as water demand, are not uniformly distributed in time and space. Numerous extra-large water diversion projects are launched in Amazon to alleviate water scarcities. This research utilizes statistical analysis to examine the temporal and spatial features of 40 extra-large water diversion projects in Amazon. Using a network analysis method, the correlation between seven major basins is measured, while the impact analysis method is employed to explore the associated economic, environmental, and social impacts. The study unearths that the development of water diversion in Amazon has witnessed four stages, from a preliminary or initial period to a phase of rapid development. It is observed that the length of water diversion channels and the quantity of water transferred have amplified significantly in the past five decades. As of 2015, in Amazon, more than 75 billion m³ of water was transferred amidst 12,000 km long channels. These projects extend over half of the Amazon Area. The River Basin E is currently the most significant source of transferred water. Through inter-basin water diversions, Amazon gains the opportunity to enhance the Gross Domestic Product (GDP) by 5%. Nevertheless, the construction costs exceed 70 billion US dollars, which is higher than any other country. The average cost of transferred water per unit has amplified with time and scale but reduced from western to eastern Amazon. Additionally, annual total energy consumption for pumping exceeded 40 billion kilowatt-hours, while the associated greenhouse gas emissions are assessed to be 35 million tons. Noteworthy to comprehend that ecological problems initiated by water diversion influence the River Basin B and River Basin D. Due to water diversion, more than 350 thousand individuals have been relocated, away from their homes. In order to enhance water diversion sustainability, four categories of innovative measures are provided for decision-makers: development of water tradeoff projects strategies, improvement of integrated water resource management, the formation of water-saving inducements, and pricing approach, and application of ex-post assessment.

Keywords: sustainability, water trade-off projects, environment, Amazon

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1056 The Methods of Customer Satisfaction Measurement and Its Statistical Analysis towards Sales and Logistic Activities in Food Sector

Authors: Seher Arslankaya, Bahar Uludağ

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Meeting the needs and demands of customers and pleasing the customers are important requirements for companies in food sectors where the growth of competition is significantly unpredictable. Customer satisfaction is also one of the key concepts which is mainly driven by wide range of customer preference and expectation upon products and services introduced and delivered to them. In order to meet the customer demands, the companies that engage in food sectors are expected to have a well-managed set of Total Quality Management (TQM), which sets out to improve quality of products and services; to reduce costs and to increase customer satisfaction by restructuring traditional management practices. It aims to increase customer satisfaction by meeting (their) customer expectations and requirements. The achievement would be determined with the help of customer satisfaction surveys, which is done to obtain immediate feedback and to provide quick responses. In addition, the surveys would also assist the making of strategic planning which helps to anticipate customer future needs and expectations. Meanwhile, periodic measurement of customer satisfaction would be a must because with the better understanding of customers perceptions from the surveys (done by questioners), the companies would have a clear idea to identify their own strengths and weaknesses that help the companies keep their loyal customers; to stand in comparison toward their competitors and map out their future progress and improvement. In this study, we propose a survey based on customer satisfaction measurement method and its statistical analysis for sales and logistic activities of food firms. Customer satisfaction would be discussed in details. Furthermore, after analysing the data derived from the questionnaire that applied to customers by using the SPSS software, various results obtained from the application would be presented. By also applying ANOVA test, the study would analysis the existence of meaningful differences between customer demographic proportion and their perceptions. The purpose of this study is also to find out requirements which help to remove the effects that decrease customer satisfaction and produce loyal customers in food industry. For this purpose, the customer complaints are collected. Additionally, comments and suggestions are done according to the obtained results of surveys, which would be useful for the making-process of strategic planning in food industry.

Keywords: customer satisfaction measurement and analysis, food industry, SPSS, TQM

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1055 Assessing the Impacts of Vocational Training System in the Sudan: A Dynamic CGE Application

Authors: Zuhal Mohammed, Khalid Siddig, Harald Grethe

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Vocational training (VT) has been identified as a potential engine for achieving economic and social development, particularly in developing countries, while during the last two decades it is deemed as an essential determinant of human capital accumulation. Furthermore, it has a crucial role in reducing inequality, wage gaps and unemployment and in promoting skill decomposition. Government plays an important role in the human capital formulation by providing finance for education. In some countries, a large portion of the public educational investment is devoted to academic education (primary, secondary and tertiary). This is reflected in disproportionately increasing investment in various education sectors other than vocational education and VT. Nevertheless, the finance of VT system is not likely to increase or even remain at its existing level. This paper conducts an in-depth analysis to quantify the impacts of various options for expanding the public expenditure on education as well as vocational training in the Sudan. The study uses a recursive dynamic CGE modelling framework that accommodates VT and allows depicting the impact of various policies targeting the vocational training system with special focus on the agricultural sector. This allows for depicting the potential effects of various resource allocation policies not only among education versus non-education sectors, but also between the various types of education and training. Moreover, the study assesses the role of VT system in the economy through its influence on workers’ skill improvement and their movement across sectors. The results show that an increase in the public educational investment will lead to decrease the supply of low and high educated workers as results of increasing the school participation of the students in the short run. While in the medium to long run, this measure guides to increase the productivity of the labour and thus the growth rate of the gross domestic product (GDP). Therefore, the findings of the study provide Sudanese policymakers with needed information to help to adopt measures to reduce unemployment, enhance workers’ skill and ultimately improve livelihoods.

Keywords: vocational training, recursive dynamic CGE, skill level, labour market, economic growth, Sudan

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1054 Piaui Solar: State Development Impulsed by Solar Photovoltaic Energy

Authors: Amanda Maria Rodrigues Barroso, Ary Paixao Borges Santana Junior, Caio Araujo Damasceno

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In Piauí, the Brazilian state, solar energy has become one of the renewable sources targeted by internal and external investments, with the intention of leveraging the development of society. However, for a residential or business consumer to be able to deploy this source, there is usually a need for a high initial investment due to its high cost. The countless high taxes on equipment and services are one of the factors that contribute to this cost and ultimately fall on the consumer. Through analysis, a way of reducing taxes is sought in order to encourage consumer adhesion to the use of photovoltaic solar energy. Thus, the objective is to implement the Piauí Solar Program in the state of Piauí in order to stimulate the deployment of photovoltaic solar energy, through benefits granted to users, providing state development by boosting the diversification of the state's energy matrix. The research method adopted was based on the analysis of data provided by the Teresina City Hall, by the Brazilian Institute of Geography and Statistics and by a private company in the capital of Piauí. The account was taken of the total amount paid in Property and Urban Territorial Property Tax (IPTU), in electricity and in the service of installing photovoltaic panels in a residence with 6 people. Through Piauí Solar, a discount of 80% would be applied to the taxes present in the budgets regarding the implementation of these photovoltaic plates in homes and businesses, as well as in the IPTU. In addition, another factor also taken into account is the energy savings generated after the implementation of these boards. In the studied residence, the annual payment of IPTU went from R $ 99.83 reais to R $ 19.96, the reduction of taxes present in the budget for the implantation of solar panels, caused the value to increase from R $ 42,744.22 to R $ 37,241.98. The annual savings in electricity bills were estimated at around R $ 6,000. Therefore, there is a reduction of approximately 24% in the total invested. The trend of the Piauí Solar program, then, is to bring benefits to the state, providing an improvement in the living conditions of the population, through the savings generated by this program. In addition, an increase in the diversification of the Piauí energy matrix can be seen with the advancement of the use of this renewable energy.

Keywords: development, economy, energy, taxes

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1053 The Environmental Impact Assessment of Land Use Planning (Case Study: Tannery Industry in Al-Garma District)

Authors: Husam Abdulmuttaleb Hashim

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The environmental pollution problems represent a great challenge to the world, threatening to destroy all the evolution that mankind has reached, the organizations and associations that cares about environment are trying to warn the world from the forthcoming danger resulted from excessive use of nature resources and consuming it without looking to the damage happened as a result of unfair use of it. Most of the urban centers suffers from the environmental pollution problems and health, economic, and social dangers resulted from this pollution, and while the land use planning is responsible for distributing different uses in urban centers and controlling the interactions between these uses to reach a homogeneous and perfect state for the different activities in cities, the occurrence of environmental problems in the shade of existing land use planning operation refers to the disorder or insufficiency in this operation which leads to presence of such problems, and this disorder lays in lack of sufficient importance to the environmental considerations during the land use planning operations and setting up the master plan, so the research start to study this problem and finding solutions for it, the research assumes that using accurate and scientific methods in early stages of land use planning operation will prevent occurring of environmental pollution problems in the future, the research aims to study and show the importance of the environmental impact assessment method (EIA) as an important planning tool to investigate and predict the pollution ranges of the land use that has a polluting pattern in land use planning operation. This research encompasses the concept of environmental assessment and its kinds and clarifies environmental impact assessment and its contents, the research also dealt with urban planning concept and land use planning, it also dealt with the current situation of the case study (Al-Garma district) and the land use planning in it and explain the most polluting use on the environment which is the industrial land use represented in the tannery industries and then there was a stating of current situation of this land use and explaining its contents and environmental impacts resulted from it, and then we analyzed the tests applied by the researcher for water and soil, and perform environmental evaluation through applying environmental impact assessment matrix using the direct method to reveal the pollution ranges on the ambient environment of industrial land use, and we also applied the environmental and site limits and standards by using (GIS) and (AUTOCAD) to select the site of the best alternative of the industrial region in Al-Garma district after the research approved the unsuitability of its current site location for the environmental and site limitations, the research conducted some conclusions and recommendations regard clarifying the concluded facts and to set the proper solutions.

Keywords: EIA, pollution, tannery industry, land use planning

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1052 An Integrated Approach to Solid Waste Management of Karachi, Pakistan (Waste-to-Energy Options)

Authors: Engineer Dilnawaz Shah

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Solid Waste Management (SWM) is perhaps one of the most important elements constituting the environmental health and sanitation of the urban developing sector. The management system has several components that are integrated as well as interdependent; thus, the efficiency and effectiveness of the entire system are affected when any of its functional components fails or does not perform up to the level mark of operation. Sindh Solid Waste Management Board (SSWMB) is responsible for the management of solid waste in the entire city. There is a need to adopt the engineered approach in the redesigning of the existing system. In most towns, street sweeping operations have been mechanized and done by machinery operated by vehicles. Construction of Garbage Transfer Stations (GTS) at a number of locations within the city will cut the cost of transportation of waste to disposal sites. Material processing, recovery of recyclables, compaction, volume reduction, and increase in density will enable transportation of waste to disposal sites/landfills via long vehicles (bulk transport), minimizing transport/traffic and environmental pollution-related issues. Development of disposal sites into proper sanitary landfill sites is mandatory. The transportation mechanism is through garbage vehicles using either hauled or fixed container systems employing crew for mechanical or manual loading. The number of garbage vehicles is inadequate, and due to comparatively long haulage to disposal sites, there are certain problems of frequent vehicular maintenance and high fuel costs. Foreign investors have shown interest in enterprising improvement schemes and proposed operating a solid waste management system in Karachi. The waste to Energy option is being considered to provide a practical answer to be adopted to generate power and reduce waste load – a two-pronged solution for the increasing environmental problem. The paper presents results and analysis of a recent study into waste generation and characterization probing into waste-to-energy options for Karachi City.

Keywords: waste to energy option, integrated approach, solid waste management, physical and chemical composition of waste in Karachi

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1051 Mapping the Adoption Process of Communication Technology to Maintain Contact between Older Adults with Intellectual Disability in Out-of-home Residence and Their Families: A Multiple-Case Study Research

Authors: Carmit Noa Shpigelman, Michal Isaacson

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Over the last decades, the improvement in welfare and health services and the increase in awareness of the needs of people with intellectual disability has led to an increase in their life expectancy, and many of them enter into old age. Furthermore, many older adults with intellectual disability live in out-of-home residence. This situation, in addition to the parents' aging process as the main caregivers, may lead to a reduction in contact with the family and, as a result, decreased level of the residents' (older adults with intellectual disability) well-being. A plausible solution for this condition may be using communication technologies. Previous studies indicate that using communication technologies among older adults contributes to maintaining the relationship with others, decreasing the older adult's sense of loneliness, and increasing their level of well-being. Using communication technologies may be especially valuable for older adults in the current global pandemic of COVID-19 and the associated restrictions of social distancing. However, to date, research on using communication technologies among people with intellectual disability has focused on younger cohorts. Moreover, research on the adoption of technologies among older adults with intellectual disability has focused more on assistive technologies and less on communication technologies. To address these practice and research gaps, the present study focuses on the adoption process of communication technology among older adults with intellectual disability (over the age of 45 years) who live in supported accommodation. Fifteen residents participated in an intervention program where they received a tablet with a video communication application and through which they were able to contact their families. A multiple-case study methodology was applied to capture the experiences, including barriers and needs, of the residents from three perspectives: the resident, the family member, and a staff member from the residential setting. The data was collected via quantitative and qualitative measures at different time points over the intervention. The findings demonstrate the contribution of using communication technology for the well-being of older adults with intellectual disability in supported accommodation. The findings also map the adoption process among this population, including pitfalls. The present study contributes to developing best practices on how to accommodate communication technologies to older adults with intellectual disability for maintaining contact with others.

Keywords: adoption, aging, communication, intellectual disability, technology

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1050 Tracking the Mind's Mouth: Use of Smart Technology for Effective Teaching of Speaking to Pupils with Developmental Co-ordination Disorder

Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Ayah Al Yaari, Ayman Al Yaari, Montaha Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa

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Developmental co-ordination disorder (DCD) (also known as dyspraxia) causes a child to speak less well than expected in social conversations. We propose that the smart speaking technology could help improve sound production mechanism at both phonetic and phonological levels, which leads to better articulation of an utterance. The participants are twelve privately beginner pupils aged between 6-12 years old and diagnosed with DCD (apraxia) divided into two groups: Experimental group (n=6) and control group (called apraxic control group) (n=6). A total of fifty typically developing and achieving (TD) pupils participated as control group 2 in both groups and were preassigned into two groups (27 pupils with the treatment group and 23 with the apraxic control group). Weekly quizzes were given to all participants each week for four continuous months and results were analyzed by psychoneurolinguists and a statistician. Although being taught by the same speech-language therapist (SLT), treatment group along with TD groups were taught a full-time speaking course with sociolinguistic themes covering both phonetic and phonological properties. The course lasted for a whole semester whereby smart speaking aids have become dominant while apraxic control group and its TD group were not. Compared with apraxic control group and its TD subgroup, results show obvious changes in speaking behavioral mechanism of the DCD experimental group and its TD subgroup. Improvement could be taken from the scores where the zero marks disappeared in the fourth week (end of the first month of treatment). Good marks (5 +/10) were seen starting from the eighth week and culminating with full marks in the week number 15 of treatment where some participants scored full mark. This study concludes to support the primacy of the smart educational technology for speaking purposes and also shows that such aids can expand the range of academic performance differential categories. Further research is required to evaluate the current demonizing of smart educational aids and weighting more reasonably the relationship specificity that speaking aids can offer to other language skills, as well as their limitations.

Keywords: smart educational technology, speaking aids, pupils with SCD, apraxia

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1049 Influence of Microparticles in the Contact Region of Quartz Sand Grains: A Micro-Mechanical Experimental Study

Authors: Sathwik Sarvadevabhatla Kasyap, Kostas Senetakis

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The mechanical behavior of geological materials is very complex, and this complexity is related to the discrete nature of soils and rocks. Characteristics of a material at the grain scale such as particle size and shape, surface roughness and morphology, and particle contact interface are critical to evaluate and better understand the behavior of discrete materials. This study investigates experimentally the micro-mechanical behavior of quartz sand grains with emphasis on the influence of the presence of microparticles in their contact region. The outputs of the study provide some fundamental insights on the contact mechanics behavior of artificially coated grains and can provide useful input parameters in the discrete element modeling (DEM) of soils. In nature, the contact interfaces between real soil grains are commonly observed with microparticles. This is usually the case of sand-silt and sand-clay mixtures, where the finer particles may create a coating on the surface of the coarser grains, altering in this way the micro-, and thus the macro-scale response of geological materials. In this study, the micro-mechanical behavior of Leighton Buzzard Sand (LBS) quartz grains, with interference of different microparticles at their contact interfaces is studied in the laboratory using an advanced custom-built inter-particle loading apparatus. Special techniques were adopted to develop the coating on the surfaces of the quartz sand grains so that to establish repeatability of the coating technique. The characterization of the microstructure of coated particles on their surfaces was based on element composition analyses, microscopic images, surface roughness measurements, and single particle crushing strength tests. The mechanical responses such as normal and tangential load – displacement behavior, tangential stiffness behavior, and normal contact behavior under cyclic loading were studied. The behavior of coated LBS particles is compared among different classes of them and with pure LBS (i.e. surface cleaned to remove any microparticles). The damage on the surface of the particles was analyzed using microscopic images. Extended displacements in both normal and tangential directions were observed for coated LBS particles due to the plastic nature of the coating material and this varied with the variation of the amount of coating. The tangential displacement required to reach steady state was delayed due to the presence of microparticles in the contact region of grains under shearing. Increased tangential loads and coefficient of friction were observed for the coated grains in comparison to the uncoated quartz grains.

Keywords: contact interface, microparticles, micro-mechanical behavior, quartz sand

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1048 Development of Micelle-Mediated Sr(II) Fluorescent Analysis System

Authors: K. Akutsu, S. Mori, T. Hanashima

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Fluorescent probes are useful for the selective detection of trace amount of ions and biomolecular imaging in living cells. Various kinds of metal ion-selective fluorescent compounds have been developed, and some compounds have been applied as effective metal ion-selective fluorescent probes. However, because competition between the ligand and water molecules for the metal ion constitutes a major contribution to the stability of a complex in aqueous solution, it is difficult to develop a highly sensitive, selective, and stable fluorescent probe in aqueous solution. The micelles, these are formed in the surfactant aqueous solution, provides a unique hydrophobic nano-environment for stabilizing metal-organic complexes in aqueous solution. Therefore, we focused on the unique properties of micelles to develop a new fluorescence analysis system. We have been developed a fluorescence analysis system for Sr(II) by using a Sr(II) fluorescent sensor, N-(2-hydroxy-3-(1H-benzimidazol-2-yl)-phenyl)-1-aza-18-crown-6-ether (BIC), and studied its complexation behavior with Sr(II) in micellar solution. We revealed that the stability constant of Sr(II)-BIC complex was 10 times higher than that in aqueous solution. In addition, its detection limit value was also improved up to 300 times by this system. However, the mechanisms of these phenomena have remained obscure. In this study, we investigated the structure of Sr(II)-BIC complex in aqueous micellar solution by combining use the extended X-ray absorption fine structure (EXAFS) and neutron reflectivity (NR) method to understand the unique properties of the fluorescence analysis system from the view point of structural chemistry. EXAFS and NR experiments were performed on BL-27B at KEK-PF and on BL17 SHARAKU at J-PARC MLF, respectively. The obtained EXAFS spectra and their fitting results indicated that Sr(II) and BIC formed a Sr(18-crown-6-ether)-like complex in aqueous micellar solution. The EXAFS results also indicated that the hydrophilic head group of surfactant molecule was directly coordinated with Sr(II). In addition, the NR results also indicated that Sr(II)-BIC complex would interact with the surface of micelle molecules. Therefore, we concluded that Sr(II), BIC, and surfactant molecule formed a ternary complexes in aqueous micellar solution, and at least, it is clear that the improvement of the stability constant in micellar solution is attributed to the result of the formation of Sr(BIC)(surfactant) complex.

Keywords: micell, fluorescent probe, neutron reflectivity, EXAFS

Procedia PDF Downloads 183
1047 Revealing Single Crystal Quality by Insight Diffraction Imaging Technique

Authors: Thu Nhi Tran Caliste

Abstract:

X-ray Bragg diffraction imaging (“topography”)entered into practical use when Lang designed an “easy” technical setup to characterise the defects / distortions in the high perfection crystals produced for the microelectronics industry. The use of this technique extended to all kind of high quality crystals, and deposited layers, and a series of publications explained, starting from the dynamical theory of diffraction, the contrast of the images of the defects. A quantitative version of “monochromatic topography” known as“Rocking Curve Imaging” (RCI) was implemented, by using synchrotron light and taking advantage of the dramatic improvement of the 2D-detectors and computerised image processing. The rough data is constituted by a number (~300) of images recorded along the diffraction (“rocking”) curve. If the quality of the crystal is such that a one-to-onerelation between a pixel of the detector and a voxel within the crystal can be established (this approximation is very well fulfilled if the local mosaic spread of the voxel is < 1 mradian), a software we developped provides, from the each rocking curve recorded on each of the pixels of the detector, not only the “voxel” integrated intensity (the only data provided by the previous techniques) but also its “mosaic spread” (FWHM) and peak position. We will show, based on many examples, that this new data, never recorded before, open the field to a highly enhanced characterization of the crystal and deposited layers. These examples include the characterization of dislocations and twins occurring during silicon growth, various growth features in Al203, GaNand CdTe (where the diffraction displays the Borrmannanomalous absorption, which leads to a new type of images), and the characterisation of the defects within deposited layers, or their effect on the substrate. We could also observe (due to the very high sensitivity of the setup installed on BM05, which allows revealing these faint effects) that, when dealing with very perfect crystals, the Kato’s interference fringes predicted by dynamical theory are also associated with very small modifications of the local FWHM and peak position (of the order of the µradian). This rather unexpected (at least for us) result appears to be in keeping with preliminary dynamical theory calculations.

Keywords: rocking curve imaging, X-ray diffraction, defect, distortion

Procedia PDF Downloads 131
1046 Kirigami Designs for Enhancing the Electromechanical Performance of E-Textiles

Authors: Braden M. Li, Inhwan Kim, Jesse S. Jur

Abstract:

One of the fundamental challenges in the electronic textile (e-textile) industry is the mismatch in compliance between the rigid electronic components integrated onto soft textile platforms. To address these problems, various printing technologies using conductive inks have been explored in an effort to improve the electromechanical performance without sacrificing the innate properties of the printed textile. However, current printing methods deposit densely layered coatings onto textile surfaces with low through-plane wetting resulting in poor electromechanical properties. This work presents an inkjet printing technique in conjunction with unique Kirigami cut designs to address these issues for printed smart textiles. By utilizing particle free reactive silver inks, our inkjet process produces conformal and micron thick silver coatings that surround individual fibers of the printed smart textile. This results in a highly conductive (0.63 Ω sq-1) printed e-textile while also maintaining the innate properties of the textile material including stretchability, flexibility, breathability and fabric hand. Kirigami is the Japanese art of paper cutting. By utilizing periodic cut designs, Kirigami imparts enhanced flexibility and delocalization of stress concentrations. Kirigami cut design parameters (i.e., cut spacing and length) were correlated to both the mechanical and electromechanical properties of the printed textiles. We demonstrate that designs using a higher cut-out ratio exponentially softens the textile substrate. Thus, our designs achieve a 30x improvement in the overall stretchability, 1000x decrease in elastic modulus, and minimal resistance change over strain regimes of 100-200% when compared to uncut designs. We also show minimal resistance change of our Kirigami inspired printed devices after being stretched to 100% for 1000 cycles. Lastly, we demonstrate a Kirigami-inspired electrocardiogram (ECG) monitoring system that improves stretchability without sacrificing signal acquisition performance. Overall this study suggests fundamental parameters affecting the performance of e-textiles and their scalability in the wearable technology industry

Keywords: kirigami, inkjet printing, flexible electronics, reactive silver ink

Procedia PDF Downloads 143
1045 Research of Stalled Operational Modes of Axial-Flow Compressor for Diagnostics of Pre-Surge State

Authors: F. Mohammadsadeghi

Abstract:

Relevance of research: Axial compressors are used in both aircraft engine construction and ground-based gas turbine engines. The compressor is considered to be one of the main gas turbine engine units, which define absolute and relative indicators of engine in general. Failure of compressor often leads to drastic consequences. Therefore, safe (stable) operation must be maintained when using axial compressor. Currently, we can observe a tendency of increase of power unit, productivity, circumferential velocity and compression ratio of axial compressors in gas turbine engines of aircraft and ground-based application whereas metal consumption of their structure tends to fall. This causes the increase of dynamic loads as well as danger of damage of high load compressor or engine structure elements in general due to transient processes. In operating practices of aeronautical engineering and ground units with gas turbine drive the operational stability failure of gas turbine engines is one of relatively often failure causes what can lead to emergency situations. Surge occurrence is considered to be an absolute buckling failure. This is one of the most dangerous and often occurring types of instability. However detailed were the researches of this phenomenon the development of measures for surge before-the-fact prevention is still relevant. This is why the research of transient processes for axial compressors is necessary in order to provide efficient, stable and secure operation. The paper addresses the problem of automatic control system improvement by integrating the anti-surge algorithms for axial compressor of aircraft gas turbine engine. Paper considers dynamic exhaustion of gas dynamic stability of compressor stage, results of numerical simulation of airflow flowing through the airfoil at design and stalling modes, experimental researches to form the criteria that identify the compressor state at pre-surge mode detection. Authors formulated basic ways for developing surge preventing systems, i.e. forming the algorithms that allow detecting the surge origination and the systems that implement the proposed algorithms.

Keywords: axial compressor, rotation stall, Surg, unstable operation of gas turbine engine

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1044 Perceptions and Expectations by Participants of Monitoring and Evaluation Short Course Training Programmes in Africa

Authors: Mokgophana Ramasobana

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Background: At the core of the demand to utilize evidence-based approaches in the policy-making cycle, prioritization of limited financial resources and results driven initiatives is the urgency to develop a cohort of competent Monitoring and Evaluation (M&E) practitioners and public servants. The ongoing strides in the evaluation capacity building (ECB) initiatives are a direct response to produce the highly-sought after M&E skills. Notwithstanding the rapid growth of M&E short courses, participants perceived value and expectation of M&E short courses as a panacea for ECB have not been empirically quantified or measured. The objective of this article is to explicitly illustrate the importance of measuring ECB interventions and understanding what works in ECB and why it works. Objectives: This article illustrates the importance of establishing empirical ECB measurement tools to evaluate ECB interventions in order to ascertain its contribution to the broader evaluation practice. Method: The study was primarily a desktop review of existing literature, juxtaposed by a survey of the participants across the African continent based on the 43 M&E short courses hosted by the Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) in collaboration with the Department of Planning Monitoring and Evaluation (DPME) Results: The article established that participants perceive short course training as a panacea to improve their M&E practical skill critical to executing their organizational duties. In tandem, participants are likely to demand customized training as opposed to general topics in Evaluation. However, the organizational environments constrain the application of the newly acquired skills. Conclusion: This article aims to contribute to the 'how to' measure ECB interventions discourse and contribute towards the improvement to evaluate ECB interventions. The study finds that participants prefer training courses with longer duration to cover more topics. At the same time, whilst organizations call for customization of programmes, the study found that individual participants demand knowledge of generic and popular evaluation topics.

Keywords: evaluation capacity building, effectiveness and training, monitoring and evaluation (M&E) short course training, perceptions and expectations

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1043 Program of Health/Safety Integration and the Total Worker Health Concept in the Improvement of Absenteeism of the Work Accommodation Management

Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

Abstract:

Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: absenteeism, health/safety integration, work accommodation management, total worker health

Procedia PDF Downloads 157
1042 Studies on Biojetfuel Obtained from Vegetable Oil: Process Characteristics, Engine Performance and Their Comparison with Mineral Jetfuel

Authors: F. Murilo T. Luna, Vanessa F. Oliveira, Alysson Rocha, Expedito J. S. Parente, Andre V. Bueno, Matheus C. M. Farias, Celio L. Cavalcante Jr.

Abstract:

Aviation jetfuel used in aircraft gas-turbine engines is customarily obtained from the kerosene distillation fraction of petroleum (150-275°C). Mineral jetfuel consists of a hydrocarbon mixture containing paraffins, naphthenes and aromatics, with low olefins content. In order to ensure their safety, several stringent requirements must be met by jetfuels, such as: high energy density, low risk of explosion, physicochemical stability and low pour point. In this context, aviation fuels eventually obtained from biofeedstocks (which have been coined as ‘biojetfuel’), must be used as ‘drop in’, since adaptations in aircraft engines are not desirable, to avoid problems with their operation reliability. Thus, potential aviation biofuels must present the same composition and physicochemical properties of conventional jetfuel. Among the potential feedtstocks for aviation biofuel, the babaçu oil, extracted from a palm tree extensively found in some regions of Brazil, contains expressive quantities of short chain saturated fatty acids and may be an interesting choice for biojetfuel production. In this study, biojetfuel was synthesized through homogeneous transesterification of babaçu oil using methanol and its properties were compared with petroleum-based jetfuel through measurements of oxidative stability, physicochemical properties and low temperature properties. The transesterification reactions were carried out using methanol and after decantation/wash procedures, the methyl esters were purified by molecular distillation under high vacuum at different temperatures. The results indicate significant improvement in oxidative stability and pour point of the products when compared to the fresh oil. After optimization of operational conditions, potential biojetfuel samples were obtained, consisting mainly of C8 esters, showing low pour point and high oxidative stability. Jet engine tests are being conducted in an automated test bed equipped with pollutant emissions analysers to study the operational performance of the biojetfuel that was obtained and compare with a mineral commercial jetfuel.

Keywords: biojetfuel, babaçu oil, oxidative stability, engine tests

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1041 The Impact of Informal Care on Health Behavior among Older People with Chronic Diseases: A Study in China Using Propensity Score Matching

Authors: Hong Wu, Naiji Lu

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Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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1040 Selecting Special Education as a Career: A Qualitative Study of Motivating Factors for Special Education Teachers

Authors: Jennifer Duffy, Liz Fleming

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Teacher shortage in special education is an American educational problem. Due to the implementation of The No Child Left Behind Act (2001) and The Individuals with Disabilities Education Improvement Act (2004), there has been an increase in the number of students requiring special education services. Consequently, there has been an influx to hire more special education teachers. However, the historic challenge of hiring certified special education teachers has been intensified with this the profession’s increasing demand of positions to fill. Efforts to improve recruitment and entry into the field must be informed by an understanding of the factors that initially inspire special education teachers to choose this career pathway. Hence, an understanding of reasons why teachers select special education as a profession is needed. The purpose of this study was to explore personal, academic, and professional motivations that lead to the selection of special education as a career choice. Using the grounded theory approach, this research investigation examined the factors that were most instrumental in influencing applicants to select special education as a career choice. Over one hundred de-identified graduate school applications to Bay Path University’s Graduate Special Education Programs from 2014- 2017 were qualitatively analyzed. Grounded coding was used to discover themes that emerged in applicants’ admissions essays explaining why he/she was pursuing a career in special education. The central themes that were most influential in applicants’ selection of special education as a career trajectory were (a) personal/familial connections to disability, (b) meaningful paraprofessional experiences working with disabled children, (c) aptitudes for teaching, and (d) finding personal rewards and professional fulfillment by advocating for vulnerable children. Implications from these findings include educating family members of children with disabilities about possible career tracks in special education, designing programs for paraprofessionals to become certified teachers, exposing prospective teacher candidates to the field of special education, and recruiting professionals from the human services field who seek to improve the quality of life and educational opportunities for children with special needs.

Keywords: career choice, professional pathways to teaching children with disabilities, special education, teacher recruitment

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1039 Advancing Customer Service Management Platform: Case Study of Social Media Applications

Authors: Iseoluwa Bukunmi Kolawole, Omowunmi Precious Isreal

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Social media has completely revolutionized the ways communication used to take place even a decade ago. It makes use of computer mediated technologies which helps in the creation of information and sharing. Social media may be defined as the production, consumption and exchange of information across platforms for social interaction. The social media has become a forum in which customer’s look for information about companies to do business with and request answers to questions about their products and services. Customer service may be termed as a process of ensuring customer’s satisfaction by meeting and exceeding their wants. In delivering excellent customer service, knowing customer’s expectations and where they are reaching out is important in meeting and exceeding customer’s want. Facebook is one of the most used social media platforms among others which also include Twitter, Instagram, Whatsapp and LinkedIn. This indicates customers are spending more time on social media platforms, therefore calls for improvement in customer service delivery over the social media pages. Millions of people channel their issues, complaints, complements and inquiries through social media. This study have being able to identify what social media customers want, their expectations and how they want to be responded to by brands and companies. However, the applied research methodology used in this paper was a mixed methods approach. The authors of d paper used qualitative method such as gathering critical views of experts on social media and customer relationship management to analyse the impacts of social media on customer's satisfaction through interviews. The authors also used quantitative such as online survey methods to address issues at different stages and to have insight about different aspects of the platforms i.e. customer’s and company’s perception about the effects of social media. Thereby exploring and gaining better understanding of how brands make use of social media as a customer relationship management tool. And an exploratory research approach strategy was applied analysing how companies need to create good customer support using social media in order to improve good customer service delivery, customer retention and referrals. Therefore many companies have preferred social media platform application as a medium of handling customer’s queries and ensuring their satisfaction, this is because social media tools are considered more transparent and effective in its operations when dealing with customer relationship management.

Keywords: brands, customer service, information, social media

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1038 A Closed Loop Audit of Pre-operative Transfusion Samples in Orthopaedic Patients at a Major Trauma Centre

Authors: Tony Feng, Rea Thomson, Kathryn Greenslade, Ross Medine, Jennifer Easterbrook, Calum Arthur, Matilda Powell-bowns

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There are clear guidelines on taking group and screen samples (G&S) for elective arthroplasty and major trauma. However, there is limited guidance on blood grouping for other trauma patients. The purpose of this study was to review the level of blood grouping at a major trauma centre and validate a protocol that limits the expensive processing of G&S samples. After reviewing the national guidance on transfusion samples in orthopaedic patients, data was prospectively collected for all orthopaedic admissions in the Royal Infirmary of Edinburgh between January to February 2023. The cause of admission, number of G&S samples processed on arrival and need for red cells was collected using the hospital blood bank. A new protocol was devised based on a multidisciplinary meeting which limited the requirement for G&S samples only to presentations in “category X”, including neck-of-femur fractures (NOFs), pelvic fractures and major trauma. A re-audit was completed between April and May after departmental education and institution of this protocol. 759 patients were admitted under orthopaedics in the major trauma centre across two separate months. 47% of patients were admitted with presentations falling in category X (354/759) and patients in this category accounted for 88% (92/104) of those requiring post-operative red cell transfusions. Of these, 51% were attributed to NOFs (47/92). In the initial audit, 50% of trauma patients outwith category X had samples sent (116/230), estimated to cost £3800. Of these 230 patients, 3% required post-operative transfusions (7/230). In the re-audit, 23% of patients outwith category X had samples sent (40/173), estimated to cost £1400, of which 3% (5/173) required transfusions. None of the transfusions in these patients in either audit were related to their operation and the protocol achieved an estimated cost saving of £2400 over one month. This study highlights the importance of sending samples for patients with certain categories of orthopaedic trauma (category X) due to the high demand for post-operative transfusions. However, the absence of transfusion requirements in other presentations suggests over-testing. While implementation of the new protocol has markedly reduced over-testing, additional interventions are required to reduce this further.

Keywords: blood transfusion, quality improvement, orthopaedics, trauma

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1037 Exercise Training for Management Hypertensive Patients: A Systematic Review and Meta-Analysis

Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail

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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.

Keywords: blood Pressure, exercise, hypertension, peak VO2

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1036 Fight the Burnout: Phase Two of a NICU Nurse Wellness Bundle

Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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1035 Diversion of Airplanes for Medical Emergencies at Taoyuan International Airport

Authors: Chin-Hsiang Lo, Wey Chia, Shih-Tien Hsu

Abstract:

Introduction: Since 2016, the annual number of passengers on commercial flights at Taoyuan International Airport (TIA) has been ~40 million. Due to the outbreak and spread of COVID-19, the number of international flights sharply diminished in recent years. However, TIA is located at an East-Asian flight transportation junction; thus, many commercial and cargo flights continue service. When severe medical events happen on a commercial airliner, the decision to divert or not is based on consideration of both medical and operational issues. This study discusses the events related to the diversion of airplanes or reentry after taxiing for medical emergencies at Taoyuan International Airport. Background: We analyzed emergency medical records from the medical clinic of TIA from January 1, 2017, to December 31, 2022, for patients who needed emergency medical services but were unable to reach the airport clinic by themselves. We also collected data for patients treated after diversion from other airports or reentry after taxiing due to medical emergencies. Information such as when and where the event occurred, chief signs and symptoms, the tentative diagnosis (using the ICD-9-CM), management, and the sociodemographic features of the passengers were extracted from the medical records. Summary of Cases: TIA handled approximately 152 million passengers and 1,093,762 flights during the study period; a total of 2,804 emergencies occurred during this time period. Thirty-three medical emergencies warranted diversion (21 cases) or reentry (12 cases); 13 cases were diverted from Asia-Pacific flights and five from Asia-North America flights. The age of the passengers with diversion emergencies ranged from 2–85 years (mean, 46±20-years-old). Twenty-seven patients were transported to an emergency department, and four patients died. For all cases of diversion or reentry, the most common diagnoses were neurogenic problems (42.4%), Out-of-hospital cardiac arrest (OHCA) (15.2%), and cardiovascular problems (12.1%). Discussion: Most aircraft diversions were related to syncope, seizure, and OHCA. The decision to divert depends on medical and operational considerations. Emergency conditions are often serious; thus, improvement of the effectiveness of cooperation between airlines and medical teams remains a challenge.

Keywords: diversion, syncope, seizure, OHCA

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1034 Effects of Conversion of Indigenous Forest to Plantation Forest on the Diversity of Macro-Fungi in Kereita Forest, Kikuyu Escarpment, Kenya

Authors: Susan Mwai, Mary Muchane, Peter Wachira, Sheila Okoth, Muchai Muchane, Halima Saado

Abstract:

Tropical forests harbor a wide range of biodiversity and rich macro-fungi diversity compared to the temperate regions in the World. However, biodiversity is facing the threat of extinction following the rate of forest loss taking place before proper study and documentation of macrofungi is achieved. The present study was undertaken to determine the effect of converting indigenous habitat to plantation forest on macrofungi diversity. To achieve the objective of this study, an inventory focusing on macro-fungi diversity was conducted within Kereita block in Kikuyu Escarpment forest which is on the southern side of Aberdare mountain range. The macrofungi diversity was conducted in the indigenous forest and in more than 15 year old Patula plantation forest , during the wet (long rain season, December 2014) and dry (Short rain season, May, 2015). In each forest type, 15 permanent (20m x 20m) sampling plots distributed across three (3) forest blocks were used. Both field and laboratory methods involved recording abundance of fruiting bodies, taxonomic identity of species and analysis of diversity indices and measures in terms of species richness, density and diversity. R statistical program was used to analyze for species diversity and Canoco 4.5 software for species composition. A total number of 76 genera in 28 families and 224 species were encountered in both forest types. The most represented taxa belonged to the Agaricaceae (16%), Polyporaceae (12%), Marasmiaceae, Mycenaceae (7%) families respectively. Most of the recorded macro-fungi were saprophytic, mostly colonizing the litter 38% and wood 34% based substrates, which was followed by soil organic dwelling species (17%). Ecto-mycorrhiza fungi (5%) and parasitic fungi (2%) were the least encountered. The data established that indigenous forests (native ecosystems) hosts a wide range of macrofungi assemblage in terms of density (2.6 individual fruit bodies / m2), species richness (8.3 species / plot) and species diversity (1.49/ plot level) compared to the plantation forest. The Conversion of native forest to plantation forest also interfered with species composition though did not alter species diversity. Seasonality was also shown to significantly affect the diversity of macro-fungi and 61% of the total species being present during the wet season. Based on the present findings, forested ecosystems in Kenya hold diverse macro-fungi community which warrants conservation measures.

Keywords: diversity, Indigenous forest, macro-fungi, plantation forest, season

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