Search results for: impacted teeth
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 771

Search results for: impacted teeth

171 Deep Injection Wells for Flood Prevention and Groundwater Management

Authors: Mohammad R. Jafari, Francois G. Bernardeau

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With its arid climate, Qatar experiences low annual rainfall, intense storms, and high evaporation rates. However, the fast-paced rate of infrastructure development in the capital city of Doha has led to recurring instances of surface water flooding as well as rising groundwater levels. Public Work Authority (PWA/ASHGHAL) has implemented an approach to collect and discharge the flood water into a) positive gravity systems; b) Emergency Flooding Area (EFA) – Evaporation, Infiltration or Storage off-site using tankers; and c) Discharge to deep injection wells. As part of the flood prevention scheme, 21 deep injection wells have been constructed to discharge the collected surface and groundwater table in Doha city. These injection wells function as an alternative in localities that do not possess either positive gravity systems or downstream networks that can accommodate additional loads. These injection wells are 400-m deep and are constructed in a complex karstic subsurface condition with large cavities. The injection well system will discharge collected groundwater and storm surface runoff into the permeable Umm Er Radhuma Formation, which is an aquifer present throughout the Persian Gulf Region. The Umm Er Radhuma formation contains saline water that is not being used for water supply. The injection zone is separated by an impervious gypsum formation which acts as a barrier between upper and lower aquifer. State of the art drilling, grouting, and geophysical techniques have been implemented in construction of the wells to assure that the shallow aquifer would not be contaminated and impacted by injected water. Injection and pumping tests were performed to evaluate injection well functionality (injectability). The results of these tests indicated that majority of the wells can accept injection rate of 200 to 300 m3 /h (56 to 83 l/s) under gravity with average value of 250 m3 /h (70 l/s) compared to design value of 50 l/s. This paper presents design and construction process and issues associated with these injection wells, performing injection/pumping tests to determine capacity and effectiveness of the injection wells, the detailed design of collection system and conveying system into the injection wells, and the operation and maintenance process. This system is completed now and is under operation, and therefore, construction of injection wells is an effective option for flood control.

Keywords: deep injection well, flood prevention scheme, geophysical tests, pumping and injection tests, wellhead assembly

Procedia PDF Downloads 119
170 Functional Impairment in South African Children with ADHD: Design, Implementation and Evaluation of a Targeted Intervention

Authors: Mareli Fischer, Kevin G. F. Thomas

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Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

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169 Didactic Games for the Development of Reading and Writing: Proeduca Program

Authors: Andreia Osti

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The context experienced in the face of the COVID-19 pandemic substantially changed the way children communicate and the way literacy teaching was carried out. Officially, according to the Brazilian Institute of Geography and Statistics, children who should be literate were seriously impacted by the pandemic, and it was found that the number of illiterate children increased from 1.4 million, in 2019, to 2.4 million in 2021. In this context, this work presents partial results of an intervention project in which classroom monitoring of students in the literacy phase was carried out. Methodologically, pedagogical games were developed that work on specific reading and writing content, such as 1) games with direct regularities and; 2) Games with contextual regularities. The project involves the elaboration and production of games and their application by the classroom teacher. All work focused on literacy and improving understanding of grapheme and phoneme relationships among students, aiming to improve reading and writing comprehension levels. The project, still under development, is carried out in two schools and supports 60 students. The teachers participate in the research, as they apply the games produced at the university and monitor the children's learning process. The project is developed with financial support for research from FAPESP - in the public education improvement program – PROEDUCA. The initial results show that children are more involved in playful activities, that games provide better moments of interaction in the classroom and that they result in effective learning since they constitute a different way of approaching the content to be taught. It is noteworthy that the pedagogical games produced directly involve the teaching and learning processes of curricular components – in this case, reading and writing, which are basic components in elementary education and constitute teaching methodologies as specific and guided activities are planned in literacy methods. In this presentation, some of the materials developed will be shown, as well as the results of the assessments carried out with the students. In relation to the Sustainable Development objectives (SDGs) linked to this project, we have 4 – Quality Education, 10 – Reduction of inequalities. It is noteworthy that the research seeks to improve Public Education and promote the articulation between theory and practice in the educational context with a view to consolidating the tripod of teaching, research and university extension and promoting a humanized education.

Keywords: didactic, teaching, games, learning, literacy

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168 Identification of Igneous Intrusions in South Zallah Trough-Sirt Basin

Authors: Mohamed A. Saleem

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Using mostly seismic data, this study intends to show some examples of igneous intrusions found in some areas of the Sirt Basin and explore the period of their emplacement as well as the interrelationships between these sills. The study area is located in the south of the Zallah Trough, south-west Sirt basin, Libya. It is precisely between the longitudes 18.35ᵒ E and 19.35ᵒ E, and the latitudes 27.8ᵒ N and 28.0ᵒ N. Based on a variety of criteria that are usually used as marks on the igneous intrusions, twelve igneous intrusions (Sills), have been detected and analysed using 3D seismic data. One or more of the following were used as identification criteria: the high amplitude reflectors paired with abrupt reflector terminations, vertical offsets, or what is described as a dike-like connection, the violation, the saucer form, and the roughness. Because of their laying between the hosting layers, the majority of these intrusions are classified as sills. Another distinguishing feature is the intersection geometry link between some of these sills. Every single sill has given a name just to distinguish the sills from each other such as S-1, S-2, and …S-12. To avoid the repetition of description, the common characteristics and some statistics of these sills are shown in summary tables, while the specific characters that are not common and have been noticed for each sill are shown individually. The sills, S-1, S-2, and S-3, are approximately parallel to one other, with the shape of these sills being governed by the syncline structure of their host layers. The faults that dominated the strata (pre-upper Cretaceous strata) have a significant impact on the sills; they caused their discontinuity, while the upper layers have a shape of anticlines. S-1 and S-10 are the group's deepest and highest sills, respectively, with S-1 seated near the basement's top and S-10 extending into the sequence of the upper cretaceous. The dramatic escalation of sill S-4 can be seen in N-S profiles. The majority of the interpreted sills are influenced and impacted by a large number of normal faults that strike in various directions and propagate vertically from the surface to the basement's top. This indicates that the sediment sequences were existed before the sill’s intrusion, were deposited, and that the younger faults occurred more recently. The pre-upper cretaceous unit is the current geological depth for the Sills S-1, S-2 … S-9, while Sills S-10, S-11, and S-12 are hosted by the Cretaceous unit. Over the sills S-1, S-2, and S-3, which are the deepest sills, the pre-upper cretaceous surface has a slightly forced folding, these forced folding is also noticed above the right and left tips of sill S-8 and S-6, respectively, while the absence of these marks on the above sequences of layers supports the idea that the aforementioned sills were emplaced during the early upper cretaceous period.

Keywords: Sirt Basin, Zallah Trough, igneous intrusions, seismic data

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167 Reasons and Complexities around Using Alcohol and Other Drugs among Aboriginal People Experiencing Homelessness

Authors: Mandy Wilson, Emma Vieira, Jocelyn Jones, Alice V. Brown, Lindey Andrews, Louise Southalan, Jackie Oakley, Dorothy Bagshaw, Patrick Egan, Laura Dent, Duc Dau, Lucy Spanswick

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Alcohol and drug dependency are pertinent issues for those experiencing homelessness. This includes Aboriginal and Torres Strait Islander people, Australia’s traditional owners, living in Perth, Western Australia (WA). Societal narratives around the drivers behind drug and alcohol dependency in Aboriginal communities, particularly those experiencing homelessness, have been biased and unchanging, with little regard for complexity. This can include the idea that Aboriginal people have ‘chosen’ to use alcohol or other drugs without consideration for intergenerational trauma and the trauma of homelessness that may influence their choices. These narratives have flow-on impacts on policies and services that directly impact Aboriginal people experiencing homelessness. In 2021, we commenced a project which aimed to listen to and elevate the voices of 70-90 Aboriginal people experiencing homelessness in Perth. The project is community-driven, led by an Aboriginal Community Controlled Organisation in partnership with a university research institute. A community-ownership group of Aboriginal Elders endorsed the project’s methods, chosen to ensure their suitability for the Aboriginal community. In this paper, we detail these methods, including semi-structured interviews influenced by an Aboriginal yarning approach – an important style of conversation for Aboriginal people which follows cultural protocols; and photovoice – supporting people to share their stories through photography. Through these engagements, we detail the reasons Aboriginal people in Perth shared for using alcohol or other drugs while experiencing homelessness. These included supporting their survival on the streets, managing their mental health, and coping while on the journey to finding support. We also detail why they sought to discontinue alcohol and other drug use, including wanting to reconnect with family and changing priorities. Finally, we share how Aboriginal people experiencing homelessness have said they are impacted by their family’s alcohol and other drug use, including feeling uncomfortable living with a family who is drug and alcohol-dependent and having to care for grandchildren despite their own homelessness. These findings provide a richer understanding of alcohol and drug use for Aboriginal people experiencing homelessness in Perth, shedding light on potential changes to targeted policy and service approaches.

Keywords: Aboriginal and Torres Strait Islander peoples, alcohol and other drugs, homelessness, community-led research

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166 The Effect of Combined Fluid Shear Stress and Cyclic Stretch on Endothelial Cells

Authors: Daphne Meza, Louie Abejar, David A. Rubenstein, Wei Yin

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Endothelial cell (ECs) morphology and function is highly impacted by the mechanical stresses these cells experience in vivo. Any change in the mechanical environment can trigger pathological EC responses. A detailed understanding of EC morphological response and function upon subjection to individual and simultaneous mechanical stimuli is needed for advancement in mechanobiology and preventive medicine. To investigate this, a programmable device capable of simultaneously applying physiological fluid shear stress (FSS) and cyclic strain (CS) has been developed, characterized and validated. Its validation was performed both experimentally, through tracer tracking, and theoretically, through the use of a computational fluid dynamics model. The effectiveness of the device was evaluated through EC morphology changes under mechanical loading conditions. Changes in cell morphology were evaluated through: cell and nucleus elongation, cell alignment and junctional actin production. The results demonstrated that the combined FSS-CS stimulation induced visible changes in EC morphology. Upon simultaneous fluid shear stress and biaxial tensile strain stimulation, cells were elongated and generally aligned with the flow direction, with stress fibers highlighted along the cell junctions. The concurrent stimulation from shear stress and biaxial cyclic stretch led to a significant increase in cell elongation compared to untreated cells. This, however, was significantly lower than that induced by shear stress alone, indicating that the biaxial tensile strain may counteract the elongating effect of shear stress to maintain the shape of ECs. A similar trend was seen in alignment, where the alignment induced by the concurrent application of shear stress and cyclic stretch fell in between that induced by shear stress and tensile stretch alone, indicating the opposite role shear stress and tensile strain may play in cell alignment. Junctional actin accumulation was increased upon shear stress alone or simultaneously with tensile stretch. Tensile stretch alone did not change junctional actin accumulation, indicating the dominant role of shear stress in damaging EC junctions. These results demonstrate that the shearing-stretching device is capable of applying well characterized dynamic shear stress and tensile strain to cultured ECs. Using this device, EC response to altered mechanical environment in vivo can be characterized in vitro.

Keywords: cyclic stretch, endothelial cells, fluid shear stress, vascular biology

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165 Mental Health Impacts of COVID-19 on Diverse Youth and Families in Canada

Authors: Lucksini Raveendran

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Introduction: This mixed-methods study focuses on the experiences of ethnocultural youth and families in Canada, identifying key barriers and opportunities to inform service programming and policies that can better meet their mental health needs during the COVID-19 pandemic and beyond. Methods: Mental Health Commission of Canada's Headstrong initiative administered the youth survey (April – June 2020) and family survey (June – August 2020) with a total sample size of 137 and 481 respondents, respectively. Thematic analysis was conducted to identify key challenges faced, coping strategies used, and help-seeking behaviours. A similar approach was also applied to the family survey data, but instead, a representative sample was collated to analyze geographically variable and ethnically diverse subgroups. Results and analysis: Multiple challenges have impacted families, including increased feelings of loneliness and distress from border travel restrictions, especially among those navigating pregnancy alone or managing children with developmental needs, which is often understudied. Also, marginalized groups were disproportionately affected by inequitable access to communication technologies, further deepening the digital divide. Some reported living in congregated homes with regular conflicts, thus leading to increased anxiety and exposure to violence. For many families, urbanicity and ethnicity played a key role in how families reported coping with feelings of uncertainty while managing work commitments, navigating community resources, fulfilling care responsibilities, and homeschooling children of all ages. Despite these challenges, there was evidence of post-traumatic growth and building community resiliency. Conclusions and implications for policy, practice, or additional research: There is a need to foster opportunities to promote and sustain mental health, wellness, and resilience for families through social connections. Also, intersectionality must be embedded in the collection, analysis, and application of data to improve equitable access to evidence-based and recovery-oriented mental health supports among diverse families in Canada. Lastly, address future research on the long-term COVID-19 impacts of travel border restrictions on family wellness.

Keywords: mental health, youth mental health, family wellness, health equity

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164 Parents’ Perceptions of the Consent Arrangements for Dental Public Health Programmes in North London: A Qualitative Exploration

Authors: Charlotte Jeavons, Charitini Stavropoulous, Nicolas Drey

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Background: Over one-third of five-year-olds and almost half of all eight-year-olds in the UK have obvious caries experience that can be detected by visual screening techniques. School-based caries preventions programs to apply fluoride varnish to young children’s teeth operate in many areas in the UK. Their aim is to reduce dental caries in children. The Department of Health guidance (2009) on consent states information must be provided to parents to enable informed autonomous decision-making prior to any treatment involving their young children. Fluoride varnish schemes delivered in primary schools use letters for this purpose. Parents are expected to return these indicating their consent or refusal. A large proportion of parents do not respond. In the absence of positive consent, these children are excluded from the program. Non-response is more common in deprived areas creating inequality. The reason for this is unknown. The consent process used is underpinned by the ethical theory of deontology that is prevalent in clinical dentistry and widely accepted in bio-ethics. Objective: To investigate parents’ views, understanding and experience of the fluoride varnish program taking place in their child’s school, including their views about the practical consent arrangements. Method: Schools participating in the fluoride varnish scheme operating in Enfield, North London, were asked to take part. Parents with children in nursery, reception, or year one were invited to participate via semi-structured interviews and focus groups. Thematic analysis was conducted. Findings: 40 parents were recruited from eight schools. The global theme of ‘trust’ was identified as the strongest influence on parental responses. Six themes were identified; protecting children from harm is viewed by parents as their role, parents have the capability to decide but lack confidence, sharing responsibility for their child’s oral health with the State is welcomed by a parent, existing relationships within parents’ social networks strongly influences consent decisions, official dental information is not communicated effectively, sending a letter to parents’ and excluding them from meeting dental practitioners is ineffective. The information delivered via a letter was not strongly identified by parents as influencing their response. Conclusions: Personal contact with the person(s) providing information and requesting consent has a greater impact on parental consent responses than written information provided alone. This demonstrates that traditional bio-ethical ideas about rational decision-making where emotions are transcended and interference is not justified unless preventing harm to an unaware person are outdated. Parental decision-making is relational and the consent process should be adapted to reflect this. The current system that has a deontology view of decision making at its core impoverishes parental autonomy and may, ultimately, increase dental inequalities as a result.

Keywords: consent, decision, ethics, fluoride, parents

Procedia PDF Downloads 171
163 The Mediating Role of Positive Psychological Capital in the Relationship between Self-Leadership and Career Maturity among Korean University Students

Authors: Lihyo Sung

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Background: Children and teens in Korea experience extreme levels of academic stress. To perform better on the college entrance exam and gain admission to Korea’s most prestigious universities, they devote a significant portion of their early lives to studying. Because of their excessive preparation for entrance exams, students have become accustomed to passive and involuntary engagement. Any student starting university, however, faces new challenges that require more active involvement and self-regulated practice. As a way to tackle this issue, the study focuses on investigating the mediating effects of positive psychological capital on the relationship between self-leadership and career maturity among Korean university students. Objectives and Hypotheses: The long term goal of this study is to offer insights that promote the use of positive psychological interventions in the development and adaptation of career maturity. The current objective is to assess the role of positive psychological capital as a mediator between self-leadership and career maturity among Korean university students. Based on previous research, the hypotheses are: (a) self-leadership will be positively associated with indices of career maturity, and (b) positive psychological capital will partially or fully mediate the relationship between self-leadership and career maturity. Sample Characteristics and Sample Size: Participants in the current study consisted of undergraduate students enrolled in various courses at 5 large universities in Korea. A total of 181 students participated in the study. Methodology: A quantitative research design was adopted to test the hypotheses proposed in the current study. By using a cross-sectional approach to research, a self-administered questionnaire was used to collect data on indices of positive psychological capital, self-leadership, and career maturity. The data were analyzed by means of Cronbach's alpha, Pierson correlation test, multiple regression, path analysis, and SPSS for Windows version 22.0 using descriptive statistics. Results: Findings showed that positive psychological capital fully mediated the relationship between self-leadership and career maturity. Self-leadership significantly impacted positive psychological capital and career maturity, respectively. Scientific Contribution: The results of the current study provided useful insights into the role of psychological strengths such as positive psychological capital in improving self-leadership and career maturity. Institutions can assist in increasing positive psychological capital through the creation of positive experiences for undergraduate students, such as opportunities for coaching and mentoring.

Keywords: career maturity, mediating role, positive psychological capital, self-leadership

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162 Estimates of Freshwater Content from ICESat-2 Derived Dynamic Ocean Topography

Authors: Adan Valdez, Shawn Gallaher, James Morison, Jordan Aragon

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Global climate change has impacted atmospheric temperatures contributing to rising sea levels, decreasing sea ice, and increased freshening of high latitude oceans. This freshening has contributed to increased stratification inhibiting local mixing and nutrient transport and modifying regional circulations in polar oceans. In recent years, the Western Arctic has seen an increase in freshwater volume at an average rate of 397+-116 km3/year. The majority of the freshwater volume resides in the Beaufort Gyre surface lens driven by anticyclonic wind forcing, sea ice melt, and Arctic river runoff. The total climatological freshwater content is typically defined as water fresher than 34.8. The near-isothermal nature of Arctic seawater and non-linearities in the equation of state for near-freezing waters result in a salinity driven pycnocline as opposed to the temperature driven density structure seen in the lower latitudes. In this study, we investigate the relationship between freshwater content and remotely sensed dynamic ocean topography (DOT). In-situ measurements of freshwater content are useful in providing information on the freshening rate of the Beaufort Gyre; however, their collection is costly and time consuming. NASA’s Advanced Topographic Laser Altimeter System (ATLAS) derived dynamic ocean topography (DOT), and Air Expendable CTD (AXCTD) derived Freshwater Content are used to develop a linear regression model. In-situ data for the regression model is collected across the 150° West meridian, which typically defines the centerline of the Beaufort Gyre. Two freshwater content models are determined by integrating the freshwater volume between the surface and an isopycnal corresponding to reference salinities of 28.7 and 34.8. These salinities correspond to those of the winter pycnocline and total climatological freshwater content, respectively. Using each model, we determine the strength of the linear relationship between freshwater content and satellite derived DOT. The result of this modeling study could provide a future predictive capability of freshwater volume changes in the Beaufort-Chukchi Sea using non in-situ methods. Successful employment of the ICESat-2’s DOT approximation of freshwater content could potentially reduce reliance on field deployment platforms to characterize physical ocean properties.

Keywords: ICESat-2, dynamic ocean topography, freshwater content, beaufort gyre

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161 Learners’ Perceptions of Tertiary Level Teachers’ Code Switching: A Vietnamese Perspective

Authors: Hoa Pham

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The literature on language teaching and second language acquisition has been largely driven by monolingual ideology with a common assumption that a second language (L2) is best taught and learned in the L2 only. The current study challenges this assumption by reporting learners' positive perceptions of tertiary level teachers' code switching practices in Vietnam. The findings of this study contribute to our understanding of code switching practices in language classrooms from a learners' perspective. Data were collected from student participants who were working towards a Bachelor degree in English within the English for Business Communication stream through the use of focus group interviews. The literature has documented that this method of interviewing has a number of distinct advantages over individual student interviews. For instance, group interactions generated by focus groups create a more natural environment than that of an individual interview because they include a range of communicative processes in which each individual may influence or be influenced by others - as they are in their real life. The process of interaction provides the opportunity to obtain the meanings and answers to a problem that are "socially constructed rather than individually created" leading to the capture of real-life data. The distinct feature of group interaction offered by this technique makes it a powerful means of obtaining deeper and richer data than those from individual interviews. The data generated through this study were analysed using a constant comparative approach. Overall, the students expressed positive views of this practice indicating that it is a useful teaching strategy. Teacher code switching was seen as a learning resource and a source supporting language output. This practice was perceived to promote student comprehension and to aid the learning of content and target language knowledge. This practice was also believed to scaffold the students' language production in different contexts. However, the students indicated their preference for teacher code switching to be constrained, as extensive use was believed to negatively impact on their L2 learning and trigger cognitive reliance on the L1 for L2 learning. The students also perceived that when the L1 was used to a great extent, their ability to develop as autonomous learners was negatively impacted. This study found that teacher code switching was supported in certain contexts by learners, thus suggesting that there is a need for the widespread assumption about the monolingual teaching approach to be re-considered.

Keywords: codeswitching, L1 use, L2 teaching, learners’ perception

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160 At the Intersection of Race and Gender in Social Work Education

Authors: LaShawnda N. Fields, Valandra

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There remains much to learn about the experiences of Black women within social work education. Higher education, in general, has a strained relationship with this demographic and while social work has espoused a code of ethics and core values, Black women report inequitable experiences similar to those in other disciplines. Research-intensive (R-1) Carnegie-designated institutions typically have lower representation of those with historically marginalized identities; this study focuses on Black women in these schools of social work. This study presents qualitative findings from 9 in-depth interviews with Black women faculty members as well as interviews with 11 Black women doctoral students at R-1 universities. Many of the poor professional outcomes for Black women in academia are a result of their experiences with imposter syndrome and feeling as though they cannot present their authentic selves. The finding of this study highlighted the many ways imposter syndrome manifests within these study participants, from an inability to be productive to overproducing in an effort to win the respect and support of colleagues. Being scrutinized and seen as unprofessional when being authentic has led to some Black women isolating themselves and struggling to remain in academia. Other Black women have decided that regardless of the backlash they may receive, they will proudly present their authentic selves and allow their work to speak for itself rather than conform to the dominant White culture. These semi-structured, in-depth interviews shined a spotlight on the ways Black women doctoral students were denied inclusion throughout their programs. These students often believed both faculty members and peers seemed to actively work to ensure discomfort in these women. In response to these negative experiences and a lack of support, many of these Black women doctoral students created their own networks of support. These networks of support often included faculty members within social work but also beyond their discipline and outside of the academy at large. The faculty members who offered support to this demographic typically shared their race and gender identities. Both Black women faculty members and doctoral students historically have been forced to prioritize surviving, not thriving as a result of toxic environments within their schools of social work. This has negatively impacted their mental health and their levels of productivity. It is necessary for these institutions to build trust with these women by respecting their diverse backgrounds, supporting their race-related research interests, and honoring the rigor in a range of methodologies if substantial, sustainable change is to be achieved.

Keywords: education, equity, inclusion, intersectionality

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159 Modification of Hyrax Expansion Screw to Be Used as an Intro-Oral Distractor for Anterior Maxillary Distraction in a Patient with Cleft Lip and Palate: A Case Report

Authors: Ananya Hazare, Ranjit Kamble

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Introduction: Patients with Cleft lip and palate (CL/P) can present with a maxillary retrution after cleft repair. Anterior Maxillary distraction osteogenesis (AMD) is a technique that provides simultaneous skeletal advancement and expansion of the soft tissues related to an anterior segment of the maxilla. This case presented is a case of AMD. The advantage of this technique is that the occlusion in the posterior segment can be maintained, and only the segment in cross bite is advanced for correction of the midfacial deficiency. The other alternative treatment is anterior movement by a Lefort 1 osteotomy. When a Lefort 1 osteotomy is compared with the Distraction osteogenesis or AMD, the disadvantages of the Le Fort 1 include a higher risk of morbidity, requirement of fixation, relapse tendency and unexpected changes in the nasal form. These complications were eliminated by AMD technique. This was followed by placement of the implant in the bone formed after AMD. Hence complete surgical, orthodontic and prosthodontics rehabilitation of the patient was done by an interdisciplinary approach. Methods: Patient presented with repaired UCL/P of the right side with midfacial retrusion. Intro-oral examination revealed a good occlusion in the posterior arch and anterior Crossbite from canine to canine. Patient's both maxillary lateral incisors were missing. The lower arch was well aligned with all teeth present. The study models when scored according to GOSLON yardstick received a score of 4. After pre-surgical orthodontic phase was completed an intraoral distractor was fabricated by modification of HYRAX expansion screw. After surgery, low subapical osteotomy cuts were placed and the distractor was fixed. The latency period of 5 days was observed after which the distraction was started. Distraction was done at a rate of 1 mm/day with a rhythm of 0.5mm in morning and 0.5mm in the evening. The total distraction of 12 mm was done. After a consolidation period, the distractor was removed, and retention by a removable partial denture was given. Radiographic examination confirmed mature bone formation in the distracted segment. Implants were placed and allowed to osseointegrate for approximately 4 months and were then loaded with abutments. Results: Total distraction done was 12mm and after relapse it was 8mm. After consolidation phase the radiographic examination revealed a B2 quality of bone according to the Misch's classification and sufficient height from the maxillary sinus. These findings were indicative for placement of implants in the distracted bone formed in premolar region. Implants were placed and after radiographic evidence of osseointegration was seen they were loaded with abutments. Thus resulting in a complete rehabilitation of a cleft patient by an interdisciplinary approach. Conclusion: Anterior maxillary distraction can be used as an alternative method instead of complete distraction osteogenesis or Lefort 1 advancement of maxilla in cases where the advancement needed is minimum. Use of HYRAX expansion screw modified as intra-oral distractor can be used in such cases, which significantly reduces the cost of treatment, as expensive distractors are not used. This technique is very useful and efficient in countries like India where the patient cannot afford expensive treatment options.

Keywords: cleft lip and palate, distraction osteogenesis, anterior maxillary distraction, orthodontics and dentofacial orthopaedics, hyrax expansion screw modification

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158 The Impact of Floods and Typhoons on Housing Welfare: Case Study of Thua Thien Hue Province, Vietnam

Authors: Seyeon Lee, Suyeon Lee, Julia Rogers

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This research investigates and records post-flood and typhoon conditions of low income housing in the Thua Thien Hue Province, Vietnam; area prone to extreme flooding in Central Vietnam. The cost of rebuilding houses after flood and typhoon has been always a burden for low income households. These costs often lead to the elimination of essential construction practices for disaster resistance. Despite relief efforts from international non-profit organizations and Vietnam government, the impacts of flood and typhoon damages to residential construction has been reoccurring to the same neighborhood annually. Notwithstanding its importance, this topic has not been systematically investigated. The study is limited to assistance provided to low income households documenting existing conditions of low income homes impacted by post flood and typhoon conditions in the Thua Thien Hue Province. The research identifies leading causes of the building failure from the natural disasters. Relief efforts and progress made since the last typhoon is documented. The quality of construction and repairs are assessed based on Home Builders Guide to Coastal Construction by Federal Emergency Management Agency. Focus group discussions and individual interviews with local residents from four different communities were conducted to get incites on repair effort by the non-profit organizations and Vietnam government, and their needs post flood and typhoon. The findings from the field study informed that many of the local people are now aware of the importance of improving housing conditions as one of the key coping strategies to withstand flood and typhoon events as it makes housing and community more resilient to future events. While there has been a remarkable improvement of housing and infrastructure with the support from the local government as well as the non-profit organizations, many households in the study areas are found to still live in weak and fragile housing conditions without gaining access to the aid to repair and strengthen the houses. Given that the major immediate recovery action taken by the local people tends to focus on repairing damaged houses, and on this ground, low-income households spend a considerable amount of their income on housing repair, providing proper and applicable construction practices will not only improve the housing condition, but also contribute to reducing poverty in Vietnam.

Keywords: disaster coping mechanism, housing welfare, low-income housing, recovery reduction

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157 An Investigation into the Impact of Brexit on Consumer Perception of Trust in the Food Industry

Authors: Babatope David Omoniyi, Fiona Lalor, Sinead Furey

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This ongoing project investigates the impact of Brexit on consumer perceptions of trust in the food industry. Brexit has significantly impacted the food industry, triggering a paradigm shift in the movement of food/agricultural produce, regulations, and cross-border collaborations between Great Britain, Northern Ireland, and the Republic of Ireland. In a world where the dynamics have shifted because of regulatory changes that impact trade and the free movement of foods and agricultural produce between these three countries, monitoring and controlling every stage of the food supply chain have become challenging, increasing the potential for food fraud and food safety incidents. As consumers play a pivotal role in shaping the market, understanding any shifts in trust post-Brexit enables them to navigate the market with confidence and awareness. This study aims to explore the complexities of consumer perceptions, focusing on trust as a cornerstone of consumer confidence in the post-Brexit food landscape. The objectives include comparing trust in official controls pre- and post-Brexit, determining consumer awareness of food fraud, and devising recommendations that reflect the evidence from this primary research regarding consumer trust in food authenticity post-Brexit. The research design follows an exploratory sequential mixed methods approach, incorporating qualitative methods such as focus groups and structured interviews, along with quantitative research through a large-scale survey. Participants from UCD and Ulster University campuses, comprising academic and non-academic staff, students, and researchers, will provide insights into the impact of Brexit on consumer trust. Preliminary findings from focus groups and interviews highlight changes in labelling, reduced quantity and quality of foods in both Northern Ireland and the Republic of Ireland, fewer food choices, and increased food prices since Brexit. The study aims to further investigate and quantify these impacts through a comprehensive large-scale survey involving participants from Northern Ireland and the Republic of Ireland. The results will inform official controls and consumer-facing messaging contributing valuable insights to navigate the evolving post-Brexit food landscape.

Keywords: Brexit, consumer trust, food fraud, food authenticity, food safety, food industry

Procedia PDF Downloads 47
156 Comics as an Intermediary for Media Literacy Education

Authors: Ryan C. Zlomek

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The value of using comics in the literacy classroom has been explored since the 1930s. At that point in time researchers had begun to implement comics into daily lesson plans and, in some instances, had started the development process for comics-supported curriculum. In the mid-1950s, this type of research was cut short due to the work of psychiatrist Frederic Wertham whose research seemingly discovered a correlation between comic readership and juvenile delinquency. Since Wertham’s allegations the comics medium has had a hard time finding its way back to education. Now, over fifty years later, the definition of literacy is in mid-transition as the world has become more visually-oriented and students require the ability to interpret images as often as words. Through this transition, comics has found a place in the field of literacy education research as the shift focuses from traditional print to multimodal and media literacies. Comics are now believed to be an effective resource in bridging the gap between these different types of literacies. This paper seeks to better understand what students learn from the process of reading comics and how those skills line up with the core principles of media literacy education in the United States. In the first section, comics are defined to determine the exact medium that is being examined. The different conventions that the medium utilizes are also discussed. In the second section, the comics reading process is explored through a dissection of the ways a reader interacts with the page, panel, gutter, and different comic conventions found within a traditional graphic narrative. The concepts of intersubjective acts and visualization are attributed to the comics reading process as readers draw in real world knowledge to decode meaning. In the next section, the learning processes that comics encourage are explored parallel to the core principles of media literacy education. Each principle is explained and the extent to which comics can act as an intermediary for this type of education is theorized. In the final section, the author examines comics use in his computer science and technology classroom. He lays out different theories he utilizes from Scott McCloud’s text Understanding Comics and how he uses them to break down media literacy strategies with his students. The article concludes with examples of how comics has positively impacted classrooms around the United States. It is stated that integrating comics into the classroom will not solve all issues related to literacy education but, rather, that comics can be a powerful multimodal resource for educators looking for new mediums to explore with their students.

Keywords: comics, graphics novels, mass communication, media literacy, metacognition

Procedia PDF Downloads 298
155 The Impact of Hormone Suppressive Therapy on Quality of Life of Patients with Nodular Goiter

Authors: Emil Iskandarov, Nazrin Agayeva

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Background: The effectiveness of hormone suppressive therapy (HST) in patients with nodular goiter (NG) is controversial. The aim of this study was to identify the impact of long-time HST on the Quality of Life (QoL) of patients with NG. Material and Methods: A retrospective analysis of 146 patients with NG showed treated with HST showed that in 38,4% of cases, HST was not effective. Nodules were increased in size and moreover, and new nodules were developed. Statistical procedure identified the predictors of resistant nodules: only one nodule in the left lobe; nodule size >17mm; calcinate within the nodule. 174 patients with NG, by whom predictors of resistant nodules were established, were informed about the results of previous research and surgery was suggested. Eighty-eight patients (the basic group) agreed with surgery and thyroidectomy was led. 86 patients (control group) ignored the suggestion and wished to receive HST. 3, 6 and 12 months after starting HST; control group patients were examined. HST was non-effective and patients, due to developing symptoms, were operated on. Patients in both groups were followed up 3, 6 and 12 months after thyroidectomy. Quality of Life was checked with the SF-36 survey form and compared between groups. The statistical analysis was performed with the non-parametric Mann–Whitney U test and with the Student t-test. P values <0.05 were considered statistically significant. Results and Discussions: QoL of patients in the basic and control groups 3 months after surgery was almost the same. However, Emotional problems severely interfered with patients in a control group with normal social activities with family, friends, and neighbors. The causes were related to the non-effective HST treatment before surgery: stress for forgetting to take drugs timely every day for a long time; blood tests for thyroid hormone level; needle biopsies of nodules for cancer screening and regular ultrasound investigations, which showed that nodules not diminished in size. Changing the treatment method after 1-year non-effective HST and delayed surgery negatively impacted patient's QoL. Social role functioning and mental health in the control group were also impaired and the difference between the results in the basic group was statistically significant (p <0.05). Conclusion: Predictors, such as only one nodule, the width of nodules more than 17mm, and the existence of calcinate within the nodule, are able to forecast the resistant nodules. HST in patients with resistant nodules is non-effective and surgery is suggested in patients with resistant nodules in the thyroid gland. Long time HST has a negative impact on the QoL patient after surgery.

Keywords: thyroid gland, nodule, hormone suppressive therapy, quality of life

Procedia PDF Downloads 129
154 Resilience of the American Agriculture Sector

Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

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This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

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153 Positive Shock: The PhD Journey of International Students at UK Universities: A Qualitative Interpretative Phenomenological Study

Authors: Dounyazad Sour

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This research examines international doctoral students’ reflections on their journey and experiences of studying for a PhD in the UK. Since the early 1990s, the international students’ number in the UK has increased. The significant contribution of these international students to the cultural and academic diversity of the UK universities’ doctoral programmes is widely acknowledged. The substantial fees these students bring to British Higher Education institutions is also much appreciated. The rationale for undertaking this study grew from personal experience of studying in the UK. Through membership in different groups both online and, when regulations permitted it, face to face social groups, it quickly became apparent that among all students, there were both shared and individual experiences of struggles and triumphs. This insight led to the decision to investigate these matters in greater detail. This in-depth qualitative interpretative study, inspired by a phenomenological approach, offers fresh insights into academic, social and cultural experiences of international PhD students in the UK. Data collection was carried out in the UK over a period of three months, deploying focus groups, individual semi-structured interviews, and images selected by participants that represent their feelings towards their experiences. The ten participants are attending different UK universities, studying a range of disciplines and have diverse backgrounds. Interviews and discussions took place in the participants' preferred languages; Arabic, English and French. The analysis shows that the participants had experienced two types of shock: negative and positive. Negative shocks, which have seen considerable attention in the field of international students’ experiences, relate to unexpected incidents that happened to the participants in relation to their interactions with others: people from different backgrounds and people from the same background. This impacted their experience negatively through experiencing feelings of anxiety, stress, low self-esteem and xenophobia, all these hindering factors contribute to make international students struggle to adapt to the new environment. Positive shocks, which have remained largely under-researched in the field of international students’ experiences, refer to all the positive occurrences that participants experienced. For instance, a shop assistant saying: “do you need any help, honey?” which brought a sense of belonging, feeling home, safety, and satisfaction to the respondents, and made their experiences less challenging. This investigation will offer insights into the PhD international students’ experiences and shed new light on the shocks that can work as facilitators, rather than as inhibitors.

Keywords: international students, PhD journey, phenomenological approach, positive shock

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152 Antibiotic Prophylaxis Habits in Oral Implant Surgery in the Netherlands: A Cross-Sectional Survey

Authors: Fabio Rodriguez Sanchez, Josef Bruers, Iciar Arteagoitia, Carlos Rodriguez Andres

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Background: Oral implants are a routine treatment to replace lost teeth. Although they have a high rate of success, implant failures do occur. Perioperative antibiotics have been suggested to prevent postoperative infections and dental implant failures, but they remain a controversial treatment among healthy patients. The objective of this study was to determine whether antibiotic prophylaxis is a common treatment in the Netherlands among general dentists, maxillofacial-surgeons, periodontists and implantologists in conjunction with oral implant surgery among healthy patients and to assess the nature of antibiotics prescriptions in order to evaluate whether any consensus has been reached and the current recommendations are being followed. Methodology: Observational cross-sectional study based on a web-survey reported according to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. A validated questionnaire, developed by Deeb et al. (2015), was translated and slightly adjusted to circumstances in the Netherlands. It was used with the explicit permission of the authors. This questionnaire contained both close-ended and some open-ended questions in relation to the following topics: demographics, qualification, antibiotic type, prescription-duration and dosage. An email was sent February 2018 to a sample of 600 general dentists and all 302 oral implantologists, periodontists and maxillofacial surgeons who were recognized by the Dutch Association of Oral Implantology (NVOI) as oral health care providers placing oral implants. The email included a brief introduction about the study objectives and a link to the web questionnaire, which could be filled in anonymously. Overall, 902 questionnaires were sent. However, 29 questionnaires were not correctly received due to an incorrect email address. So a total number of 873 professionals were reached. Collected data were analyzed using SPSS (IBM Corp., released 2012, Armonk, NY). Results: The questionnaire was sent back by a total number of 218 participants (response rate=24.2%), 45 female (20.8%) and 171 male (79.2%). Two respondents were excluded from the study group because they were not currently working as oral health providers. Overall 151 (69.9%) placed oral implants on regular basis. Approximately 79 (52.7%) of these participants prescribed antibiotics only in determined situations, 66 (44.0%) prescribed antibiotics always and 5 dentists (3.3%) did not prescribe antibiotics at all when placing oral implants. Overall, 83 participants who prescribed antibiotics, did so both pre- and postoperatively (58.5%), 12 exclusively postoperative (8.5%), and 47 followed an exclusive preoperative regime (33.1%). A single dose of 2,000 mg amoxicillin orally 1-hour prior treatment was the most prescribed preoperative regimen. The most frequent prescribed postoperative regimen was 500 mg amoxicillin three times daily for 7 days after surgery. On average, oral health professionals prescribed 6,923 mg antibiotics in conjunction with oral implant surgery, varying from 500 to 14,600 mg. Conclusions: Antibiotic prophylaxis in conjunction with oral implant surgery is prescribed in the Netherlands on a rather large scale. Dutch professionals might prescribe antibiotics more cautiously than in other countries and there seems to be a lower range on the different antibiotic types and regimens being prescribed. Anyway, recommendations based on last-published evidence are frequently not being followed.

Keywords: clinical decision making, infection control, antibiotic prophylaxis, dental implants

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151 Relativity in Toddlers' Understanding of the Physical World as Key to Misconceptions in the Science Classroom

Authors: Michael Hast

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Within their first year, infants can differentiate between objects based on their weight. By at least 5 years children hold consistent weight-related misconceptions about the physical world, such as that heavy things fall faster than lighter ones because of their weight. Such misconceptions are seen as a challenge for science education since they are often highly resistant to change through instruction. Understanding the time point of emergence of such ideas could, therefore, be crucial for early science pedagogy. The paper thus discusses two studies that jointly address the issue by examining young children’s search behaviour in hidden displacement tasks under consideration of relative object weight. In both studies, they were tested with a heavy or a light ball, and they either had information about one of the balls only or both. In Study 1, 88 toddlers aged 2 to 3½ years watched a ball being dropped into a curved tube and were then allowed to search for the ball in three locations – one straight beneath the tube entrance, one where the curved tube lead to, and one that corresponded to neither of the previous outcomes. Success and failure at the task were not impacted by weight of the balls alone in any particular way. However, from around 3 years onwards, relative lightness, gained through having tactile experience of both balls beforehand, enhanced search success. Conversely, relative heaviness increased search errors such that children increasingly searched in the location immediately beneath the tube entry – known as the gravity bias. In Study 2, 60 toddlers aged 2, 2½ and 3 years watched a ball roll down a ramp and behind a screen with four doors, with a barrier placed along the ramp after one of four doors. Toddlers were allowed to open the doors to find the ball. While search accuracy generally increased with age, relative weight did not play a role in 2-year-olds’ search behaviour. Relative lightness improved 2½-year-olds’ searches. At 3 years, both relative lightness and relative heaviness had a significant impact, with the former improving search accuracy and the latter reducing it. Taken together, both studies suggest that between 2 and 3 years of age, relative object weight is increasingly taken into consideration in navigating naïve physical concepts. In particular, it appears to contribute to the early emergence of misconceptions relating to object weight. This insight from developmental psychology research may have consequences for early science education and related pedagogy towards early conceptual change.

Keywords: conceptual development, early science education, intuitive physics, misconceptions, object weight

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150 The Decision-Making Process of the Central Banks of Brazil and India in Regional Integration: A Comparative Analysis of MERCOSUR and SAARC (2003-2014)

Authors: Andre Sanches Siqueira Campos

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Central banks can play a significant role in promoting regional economic and monetary integration by strengthening the payment and settlement systems. However, close coordination and cooperation require facilitating the implementation of reforms at domestic and cross-border levels in order to benchmark with international standards and commitments to the liberal order. This situation reflects the normative power of the regulatory globalization dimension of strong states, which may drive or constrain regional integration. In the MERCOSUR and SAARC regions, central banks have set financial initiatives that could facilitate South America and South Asia regions to move towards convergence integration and facilitate trade and investments connectivities. This is qualitative method research based on a combination of the Process-Tracing method with Qualitative Comparative Analysis (QCA). This research approaches multiple forms of data based on central banks, regional organisations, national governments, and financial institutions supported by existing literature. The aim of this research is to analyze the decision-making process of the Central Bank of Brazil (BCB) and the Reserve Bank of India (RBI) towards regional financial cooperation by identifying connectivity instruments that foster, gridlock, or redefine cooperation. The BCB and The RBI manage the monetary policy of the largest economies of those regions, which makes regional cooperation a relevant framework to understand how they provide an effective institutional arrangement for regional organisations to achieve some of their key policies and economic objectives. The preliminary conclusion is that both BCB and RBI demonstrate a reluctance to deepen regional cooperation because of the existing economic, political, and institutional asymmetries. Deepening regional cooperation is constrained by the interests of central banks in protecting their economies from risks of instability due to different degrees of development between countries in their regions and international financial crises that have impacted the international system in the 21st century. Reluctant regional integration also provides autonomy for national development and political ground for the contestation of Global Financial Governance by Brazil and India.

Keywords: Brazil, central banks, decision-making process, global financial governance, India, MERCOSUR, connectivity, payment system, regional cooperation, SAARC

Procedia PDF Downloads 114
149 Building Resilient Communities: The Traumatic Effect of Wildfire on Mati, Greece

Authors: K. Vallianou, T. Alexopoulos, V. Plaka, M. K. Seleventi, V. Skanavis, C. Skanavis

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The present research addresses the role of place attachment and emotions in community resiliency and recovery within the context of a disaster. Natural disasters represent a disruption in the normal functioning of a community, leading to a general feeling of disorientation. This study draws on the trauma caused by a natural hazard such as a forest fire. The changes of the sense of togetherness are being assessed. Finally this research determines how the place attachment of the inhabitants was affected during the reorientation process of the community. The case study area is Mati, a small coastal town in eastern Attica, Greece. The fire broke out on July 23rd, 2018. A quantitative research was conducted through questionnaires via phone interviews, one year after the disaster, to address community resiliency in the long-run. The sample was composed of 159 participants from the rural community of Mati plus 120 coming from Skyros Island that was used as a control group. Inhabitants were prompted to answer items gauging their emotions related to the event, group identification and emotional significance of their community, and place attachment before and a year after the fire took place. Importantly, the community recovery and reorientation were examined within the context of a relative absence of government backing and official support. Emotions related to the event were aggregated into 4 clusters related to: activation/vigilance, distress/disorientation, indignation, and helplessness. The findings revealed a decrease in the level of place attachment in the impacted area of Mati as compared to the control group of Skyros Island. Importantly, initial distress caused by the fire prompted the residents to identify more with their community and to report more positive feelings toward their community. Moreover, a mediation analysis indicated that the positive effect of community cohesion on place attachment one year after the disaster was mediated by the positive feelings toward the community. Finally, place attachment contributes to enhanced optimism and a more positive perspective concerning Mati’s future prospects. Despite an insufficient state support to this affected area, the findings suggest an important role of emotions and place attachment during the process of recovery. Implications concerning the role of emotions and social dynamics in meshing place attachment during the disaster recovery process as well as community resiliency are discussed.

Keywords: community resilience, natural disasters, place attachment, wildfire

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148 Asthma Nurse Specialist Improves the Management of Acute Asthma in a University Teaching Hospital: A Quality Improvement Project

Authors: T. Suleiman, C. Mchugh, H. Ranu

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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

Procedia PDF Downloads 379
147 Study of the Combinatorial Impact of Substrate Properties on Mesenchymal Stem Cell Migration Using Microfluidics

Authors: Nishanth Venugopal Menon, Chuah Yon Jin, Samantha Phey, Wu Yingnan, Zhang Ying, Vincent Chan, Kang Yuejun

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Cell Migration is a vital phenomenon that the cells undergo in various physiological processes like wound healing, disease progression, embryogenesis, etc. Cell migration depends primarily on the chemical and physical cues available in the cellular environment. The chemical cue involves the chemokines secreted and gradients generated in the environment while physical cues indicate the impact of matrix properties like nanotopography and stiffness on the cells. Mesenchymal Stem Cells (MSCs) have been shown to have a role wound healing in vivo and its migration to the site of the wound has been shown to have a therapeutic effect. In the field of stem cell based tissue regeneration of bones and cartilage, one approach has been to introduce scaffold laden with MSCs into the site of injury to enable tissue regeneration. In this work, we have studied the combinatorial impact of the substrate physical properties on MSC migration. A microfluidic in vitro model was created to perform the migration studies. The microfluidic model used is a three compartment device consisting of two cell seeding compartments and one migration compartment. Four different PDMS substrates with varying substrate roughness, stiffness and hydrophobicity were created. Its surface roughness and stiffness was measured using Atomic Force Microscopy (AFM) while its hydrphobicity was measured from the water contact angle using an optical tensiometer. These PDMS substrates are sealed to the microfluidic chip following which the MSCs are seeded and the cell migration is studied over the period of a week. Cell migration was quantified using fluorescence imaging of the cytoskeleton (F-actin) to find out the area covered by the cells inside the migration compartment. The impact of adhesion proteins on cell migration was also quantified using a real-time polymerase chain reaction (qRT PCR). These results suggested that the optimal substrate for cell migration would be one with an intermediate level of roughness, stiffness and hydrophobicity. A higher or lower value of these properties affected cell migration negatively. These observations have helped us in understanding that different substrate properties need to be considered in tandem, especially while designing scaffolds for tissue regeneration as cell migration is normally impacted by the combinatorial impact of the matrix. These observations may lead us to scaffold optimization in future tissue regeneration applications.

Keywords: cell migration, microfluidics, in vitro model, stem cell migration, scaffold, substrate properties

Procedia PDF Downloads 557
146 Assessing Solid Waste Management Practices in Port Harcourt City, Nigeria

Authors: Perpetual Onyejelem, Kenichi Matsui

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Solid waste management is one essential area for urban administration to achieve environmental sustainability. Proper solid waste management (SWM) improves the environment by reducing diseases and increasing public health. On the other way, improper SWM practices negatively impact public health and environmental sustainability. This article evaluates SWM in Port Harcourt, Nigeria, with the goal of determining the current solid waste management practices and their health implications. This study used secondary data, which relies on existing published literature and official documents. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and its four-stage inclusion/exclusion criteria were utilized as part of a systematic literature review technique to locate the literature that concerns SWM practices and the implementation of solid waste management policies between 2014-2023 in PortHarcourt and its health effects from specific databases (Scopus and Google Scholar). The results found that despite the existence and implementation of the Rivers State Waste Management Policy and the formulation of the National Policy on Solid Waste Management in Port Harcourt, residents continued to dump waste in drainages. They were unaware of waste sorting and dumped waste haphazardly. This trend has persisted due to a lack of political commitment to the effective implementation and monitoring of policies and strategies and a lack of training provided to waste collectors regarding the SWM approach, which involves sorting and separating waste. In addition, inadequate remuneration for waste collectors, the absence of community participation in policy formulation, and insufficient awareness among residents regarding the 3R approach are also contributory factors. This caused the emergence of vector-borne diseases such as malaria, lassa fever, and cholera in Port Harcourt, increasing the expense of healthcare for locals, particularly low-income households. The study urges the government to prioritize protecting the health of its citizens by studying the methods other nations have taken to address the problem of solid waste management and adopting those that work best for their region. The bottom-up strategy should be used to include locals in developing solutions. However, citizens who are always the most impacted by this issue should launch initiatives to address it and put pressure on the government to assist them when they have limitations.

Keywords: health effects, solid waste management practices, environmental pollution, Port-Harcourt

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145 Achieving Product Robustness through Variation Simulation: An Industrial Case Study

Authors: Narendra Akhadkar, Philippe Delcambre

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In power protection and control products, assembly process variations due to the individual parts manufactured from single or multi-cavity tooling is a major problem. The dimensional and geometrical variations on the individual parts, in the form of manufacturing tolerances and assembly tolerances, are sources of clearance in the kinematic joints, polarization effect in the joints, and tolerance stack-up. All these variations adversely affect the quality of product, functionality, cost, and time-to-market. Variation simulation analysis may be used in the early product design stage to predict such uncertainties. Usually, variations exist in both manufacturing processes and materials. In the tolerance analysis, the effect of the dimensional and geometrical variations of the individual parts on the functional characteristics (conditions) of the final assembled products are studied. A functional characteristic of the product may be affected by a set of interrelated dimensions (functional parameters) that usually form a geometrical closure in a 3D chain. In power protection and control products, the prerequisite is: when a fault occurs in the electrical network, the product must respond quickly to react and break the circuit to clear the fault. Usually, the response time is in milliseconds. Any failure in clearing the fault may result in severe damage to the equipment or network, and human safety is at stake. In this article, we have investigated two important functional characteristics that are associated with the robust performance of the product. It is demonstrated that the experimental data obtained at the Schneider Electric Laboratory prove the very good prediction capabilities of the variation simulation performed using CETOL (tolerance analysis software) in an industrial context. Especially, this study allows design engineers to better understand the critical parts in the product that needs to be manufactured with good, capable tolerances. On the contrary, some parts are not critical for the functional characteristics (conditions) of the product and may lead to some reduction of the manufacturing cost, ensuring robust performance. The capable tolerancing is one of the most important aspects in product and manufacturing process design. In the case of miniature circuit breaker (MCB), the product's quality and its robustness are mainly impacted by two aspects: (1) allocation of design tolerances between the components of a mechanical assembly and (2) manufacturing tolerances in the intermediate machining steps of component fabrication.

Keywords: geometrical variation, product robustness, tolerance analysis, variation simulation

Procedia PDF Downloads 164
144 Enhancing Nursing Students’ Communication Using TeamSTEPPS to Improve Patient Safety

Authors: Stefanie Santorsola, Natasha Frank

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Improving healthcare safety necessitates examining current trends and beliefs about safety and devising strategies to improve. Errors in healthcare continue to increase and be experienced by patients, which is preventable and directly correlated to a breakdown in healthcare communication. TeamSTEPPS is an evidence-based process designed to improve the quality and safety of healthcare by improving communication and team processes. Communication is at the core of effective team collaboration and is vital for patient safety. TeamSTEPPS offers insights and strategies for improving communication and teamwork and reducing preventable errors to create a safer healthcare environment for patients. The academic, clinical, and educational environment for nursing students is vital in preparing them for professional practice by providing them with foundational knowledge and abilities. This environment provides them with a prime opportunity to learn about errors and the importance of effective communication to enhance patient safety, as nursing students are often unprepared to deal with errors. Proactively introducing and discussing errors through a supportive culture during the nursing student’s academic beginnings has the potential to carry key concepts into practice to improve and enhance patient safety. TeamSTEPPS has been used globally and has collectively positively impacted improvements in patient safety and teamwork. A workshop study was introduced in winter 2023 of registered practical nurses (RPN) students bridging to the baccalaureate nursing program; the majority of the RPNs in the bridging program were actively employed in a variety of healthcare facilities during the semester. The workshop study did receive academic institution ethics board approval, and participants signed a consent form prior to participating in the study. The premise of the workshop was to introduce TeamSTEPPS and a variety of strategies to these students and have students keep a reflective journal to incorporate the presented communication strategies in their practicum setting and keep a reflective journal on the effect and outcomes of the strategies in the healthcare setting. Findings from the workshop study supported the objective of the project, resulting in students verbalizing notable improvements in team functioning in the healthcare environment resulting from the incorporation of enhanced communication strategies from TeamSTEPPS that they were introduced to in the workshop study. Implication for educational institutions is the potential of further advancing the safety literacy and abilities of nursing students in preparing them for entering the workforce and improving safety for patients.

Keywords: teamstepps, education, patient safety, communication

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143 Community Engagement in Child Centered Space at Disaster Events: A Case Story of Sri Lanka

Authors: Wasantha Pushpakumara Hitihami Mudiyanselage

Abstract:

Since recent past, Sri Lanka is highly vulnerable to reoccurring climate shocks that severely impact the food security, loss of human & animal lives, destructions of human settlements, displacement of people and damaging properties. Hence, the Government of Sri Lanka has taken important steps towards strengthening legal and institutional arrangements for Disaster Risks management in the country in May 2005. Puttalam administrative district is one of the disaster prone districts in Sri Lanka which constantly face the devastating consequences of the increasing natural disasters annually. Therefore disaster risk management will be a timely intervention in the area to minimize the adverse impacts of the disasters. The few functioning Disaster Risk management networks do not take children’s specific needs and vulnerabilities during emergencies into account. The most affected children and their families were evacuated to the government schools and temples and it was observed that children were left to roaming around as their parents were busy queuing up for relief goods and other priorities. In this sense, VOICE understands that the community has vital role that has to be played in facing challenges of disaster management in the area. During and after the disaster, it was viewed that some children were having psychological disorders which could be impacted negatively to children well–being. Need of child friendly space at emergency is a must action in the area to turn away negative impact coming from the hazards. VOICE with the support of national & international communities have established safer places for the children (Child Centered Spaces – CCS) and their families at emergencies. Village religious venues and schools were selected and equipped with necessary materials to be used for the children at emergency. Materials such as tools, stationeries, play materials, which couldn’t be easily found in surrounding environment, were provided for CCS centers. Village animators, youth and elders were given comprehensive training on Disaster management and their role at CCS. They did the facilitation in keeping children without fear and stress at flooding occurred in 2015 as well as they were able to improve their skills when working with children. Flooding in 2016, the government agencies have taken service of these village animators at early stage of flooding to make all disaster-related recovery actions productively & efficiently. This mechanism is sustained at village level that can be used for disaster events.

Keywords: child centered space, impacts, psychological disorders, village animators

Procedia PDF Downloads 132
142 Laser Paint Stripping on Large Zones on AA 2024 Based Substrates

Authors: Selen Unaldi, Emmanuel Richaud, Matthieu Gervais, Laurent Berthe

Abstract:

Aircrafts are painted with several layers to guarantee their protection from external attacks. For aluminum AA 2024-T3 (metallic structural part of the plane), a protective primer is applied to ensure its corrosion protection. On top of this layer, the top coat is applied for aesthetic aspects. During the lifetime of an aircraft, top coat stripping has an essential role which should be operated as an average of every four years. However, since conventional stripping processes create hazardous disposals and need long hours of labor work, alternative methods have been investigated. Amongst them, laser stripping appears as one of the most promising techniques not only because of the reasons mentioned above but also its controllable and monitorable aspects. The application of a laser beam from the coated side provides stripping, but the depth of the process should be well controlled in order to prevent damage to a substrate and the anticorrosion primer. Apart from that, thermal effects should be taken into account on the painted layers. As an alternative, we worked on developing a process that includes the usage of shock wave propagation to create the stripping via mechanical effects with the application of the beam from the substrate side (back face) of the samples. Laser stripping was applied on thickness-specified samples with a thickness deviation of 10-20%. First, the stripping threshold is determined as a function of power density which is the first flight off of the top coats. After obtaining threshold values, the same power densities were applied to specimens to create large stripping zones with a spot overlap of 10-40%. Layer characteristics were determined on specimens in terms of physicochemical properties and thickness range both before and after laser stripping in order to validate the substrate material health and coating properties. The substrate health is monitored by measuring the roughness of the laser-impacted zones and free surface energy tests (both before and after laser stripping). Also, Hugoniot Elastic Limit (HEL) is determined from VISAR diagnostic on AA 2024-T3 substrates (for the back face surface deformations). In addition, the coating properties are investigated as a function of adhesion levels and anticorrosion properties (neutral salt spray test). The influence of polyurethane top-coat thickness is studied in order to verify the laser stripping process window for industrial aircraft applications.

Keywords: aircraft coatings, laser stripping, laser adhesion tests, epoxy, polyurethane

Procedia PDF Downloads 78