Search results for: specialty sand

Authors: Michael Adebayo, Saheed Lawal

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The Comprehensive Geriatric Assessment (CGA) is the multidimensional tool used to assess elderly, frail patients either on admission to hospital care or at a community level in primary care. It is a tool designed with the aim of using a holistic approach to managing patients. A Cochrane review of CGA use in 2011 found that the likelihood of being alive and living in their own home rises by 30% post-discharge. RCTs have also discovered 10–15% reductions in readmission rates and reductions in institutionalization, and resource use and costs. Past audit cycles at King’s College Hospital, Denmark Hill had shown inconsistent evidence of CGA completion inpatient discharge summaries (less than 50%). Junior Doctors in the Health and Ageing (HAU) wards have struggled to sustain the efforts of past audit cycles due to the quick turnover in staff (four-month placements for trainees). This 7th cycle created a multi-faceted approach to solving this problem amongst staff and creating lasting change. Methods: 1. We adopted multidisciplinary team involvement to support Doctors. MDT staff e.g. Nurses, Physiotherapists, Occupational Therapists and Dieticians, were actively encouraged to fill in the CGA document. 2. We added a CGA Document Pro-forma to “Sunrise EPR” (Trust computer system). These CGAs were to automatically be included the discharge summary. 3. Prior to assessing uptake, we used a spot audit questionnaire to assess staff awareness/knowledge of what a CGA was. 4. We designed and placed posters highlighting domains of CGA and MDT roles suited to each domain on geriatric “Health and Ageing Wards” (HAU) in the hospital. 5. We performed an audit of % discharge summaries which include CGA and MDT role input. 6. We nominated ward champions on each ward from each multidisciplinary specialty to monitor and encourage colleagues to actively complete CGAs. 7. We initiated further education of ward staff on CGA's importance by discussion at board rounds and weekly multidisciplinary meetings. Outcomes: 1. The majority of respondents to our spot audit were aware of what a CGA was, but fewer had used the EPR document to complete one. 2. We found that CGAs were not being commenced for nearly 50% of patients discharged on HAU wards and the Frailty Assessment Unit.

Keywords: comprehensive geriatric assessment, CGA, multidisciplinary team, quality of life, mortality

Procedia PDF Downloads 83

Authors: Md. Jahidul Islam, A. K. M. Rakinul Islam, M. Salamah Meherier

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This study investigates the suitability of using plastic, such as polyethylene terephthalate (PET), as a partial replacement of natural coarse and fine aggregates (for example, brick chips and natural sand) to produce lightweight concrete for load bearing structural members. The plastic coarse aggregate (PCA) and plastic fine aggregate (PFA) were produced from melted polyethylene terephthalate (PET) bottles. Tests were conducted using three different water–cement (w/c) ratios, such as 0.42, 0.48, and 0.57, where PCA and PFA were used as 50% replacement of coarse and fine aggregate respectively. Fresh and hardened properties of concrete have been compared for natural aggregate concrete (NAC), PCA concrete (PCC) and PFA concrete (PFC). The compressive strength of concrete at 28 days varied with the water–cement ratio for both the PCC and PFC. Between PCC and PFC, PFA concrete showed the highest compressive strength (23.7 MPa) at 0.42 w/c ratio and also the lowest compressive strength (13.7 MPa) at 0.57 w/c ratio. Significant reduction in concrete density was mostly observed for PCC samples, ranging between 1977–1924 kg/m³. With the increase in water–cement ratio PCC achieved higher workability compare to both NAC and PFC. It was found that both the PCA and PFA contained concrete achieved the required compressive strength to be used for structural purpose as partial replacement of the natural aggregate; but to obtain the desired lower density as lightweight concrete the PCA is most suited.

Keywords: polyethylene terephthalate, plastic aggregate, concrete, fresh and hardened properties

Procedia PDF Downloads 439

Authors: M. G. Mostafa, Manjushree Chowdhury, Tapan Kumar Biswas, , Ananda Kumar Saha

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This study focused on effluents characterization and treatment process to reduce of toxicity from tannery effluents. Tanning industry is one of the oldest industries in the world. It is typically characterized as pollutants generated industries which produce wide varieties of high strength toxic chemicals. The study was conducted during the year 2008 to 2009 and the tannery effluents were collected three times in a year from the outlet of some selected leather industries located in Hagaribagh industrial zone Dhaka, Bangladesh. The analysis results of the raw effluents reveal that the effluents were yellowish-brown color, having basic pH, very high value of BOD5¬¬, COD, TDS, TSS, TS, and high concentrations of Cr, Na, SO42-, Cl- and other organic and inorganic constituents. The tannery effluents were treated with various doses of FeCl3 after settling and a subsequent filtration through sand-stone. The study observed that coagulant (FeCl3) 150 mg/L dose around neutral pH showed the best removal efficiency for major physico-chemical parameters. The analysis results of illustrate that the most of the physical and chemical parameters were found well below the prescribed permissible limits for effluent discharged. The study suggests that tannery effluents could be treated by a combined process consisting of settling, filtering and coagulating with FeCl3.

Keywords: characterization, effluent, tannery, treatment

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Authors: Mariano Gonzalez Cortina, Pablo Saiz Martinez, Francisco Fernandez Martinez, Antonio Rodriguez Sanchez

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Construction sector incessant activity of the last years preceding the crisis has originated a high waste generation and an increased use of raw materials. The main aim of this research is to compare three types of recycled aggregates and the feasibility to incorporate them into masonry mortar fabrication. The tests were developed using two types of binders: CEM II/B-L 32.5 N and CEM IV/B (V) 32.5 N. 50%, 75% and 100% of natural sand were replaced with three types of recycled aggregates. Cement-to-aggregate by dry weight proportions were 1:3 and 1:4. Physical and chemical characterization of recycled aggregates showed continues particle size distribution curve, lower density and higher absorption, which was the reason to use additive to obtain required mortar consistency. Main crystalline phases determined in the X-Ray diffraction test were calcite, quartz, and gypsum. Performed tests show that cement-based mortars fabricated with CEM IV/B (V) 32. 5 N can incorporate recycled aggregates coming from ceramic, concrete and mixed recycling processes, using 1:3 and 1:4 cement-to-aggregate proportions, complying with the limits established by the Spanish standards. It was concluded that recycled mortar coming from concrete recycling process is the one which presents better characteristics.

Keywords: construction and demolition waste, masonry mortar, mechanical properties, recycled aggregate, waste treatment

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Hitendra Raj Joshi, Bipin Lamichhane

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Groundwater is the main source of water for the industries of Balaju Industrial District (BID) and the denizens of Balaju-Boratar area. The quantity of groundwater is in a fatal condition in the area than earlier days. Water levels in shallow wells have highly lowered and deep wells are not providing an adequate amount of water as before because of higher extraction rate than the recharge rate. The main recharge zone of the shallow aquifer lies at the foot of Nagarjuna mountain, where recent colluvial debris are accumulated. Urbanization in the area is the main reason for decreasing water table. Recharge source for the deep aquifer in the region is aquiclude leakage. Sand layer above the Kalimati clay is the shallow aquifer zone, which is limited only in Balaju and eastern part of the Boratar, while the layer below the Kalimati clay spreading around Gongabu, Machhapohari, and Balaju area is considered as a potential area of deep aquifer. Over extraction of groundwater without considering water balance in the aquifers may dry out the source and can initiate the land subsidence problem. Hence, all the responsible of the industries in BID area and the denizens of Balaju-Boratar area should be encouraged to practice artificial groundwater recharge.

Keywords: aquiclude leakage, Kalimati clay, groundwater recharge

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Authors: Kumar Satyam Das, Murali Raghunathan

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This note discusses the feasibility of field development of a challenging shallow offshore field in South East Asia and how its learnings can be applied to marginal field development across the world especially developing marginal fields in this low oil price world. The field was found to be economically challenging even during high oil prices and the project was put on hold. Shell started development study with the aim to significantly reduce cost through competitively scoping and revive stranded projects. The proposed strategy to achieve this involved Improve Per platform recovery and Reduction in CAPEX. Methodology: Based on various Benchmarking Tool such as Woodmac for similar projects in the region and economic affordability, a challenging target of 50% reduction in unit development cost (UDC) was set for the project. Technical scope was defined to the minimum as to be a wellhead platform with minimum functionality to ensure production. The evaluation of key project decisions like Well location and number, well design, Artificial lift methods and wellhead platform type under different development concept was carried out through integrated multi-discipline approach. Key elements influencing per platform recovery were Wellhead Platform (WHP) location, Well count, well reach and well productivity. Major Findings: Reservoir being shallow posed challenges in well design (dog-leg severity, casing size and the achievable step-out), choice of artificial lift and sand-control method. Integrated approach amongst relevant disciplines with challenging mind-set enabled to achieve optimized set of development decisions. This led to significant improvement in per platform recovery. It was concluded that platform recovery largely depended on the reach of the well. Choice of slim well design enabled designing of high inclination and better productivity wells. However, there is trade-off between high inclination Gas Lift (GL) wells and low inclination wells in terms of long term value, operational complexity, well reach, recovery and uptime. Well design element like casing size, well completion, artificial lift and sand control were added successively over the minimum technical scope design leading to a value and risk staircase. Logical combinations of options (slim well, GL) were competitively screened to achieve 25% reduction in well cost. Facility cost reduction was achieved through sourcing standardized Low Cost Facilities platform in combination with portfolio execution to maximizing execution efficiency; this approach is expected to reduce facilities cost by ~23% with respect to the development costs. Further cost reductions were achieved by maximizing use of existing facilities nearby; changing reliance on existing water injection wells and utilizing existing water injector (W.I.) platform for new injectors. Conclusion: The study provides a spectrum of technically feasible options. It also made clear that different drivers lead to different development concepts and the cost value trade off staircase made this very visible. Scoping of the project through competitive way has proven to be valuable for decision makers by creating a transparent view of value and associated risks/uncertainty/trade-offs for difficult choices: elements of the projects can be competitive, whilst other parts will struggle, even though contributing to significant volumes. Reduction in UDC through proper scoping of present projects and its benchmarking paves as a learning for the development of marginal fields across the world, especially in this low oil price scenario. This way of developing a field has on average a reduction of 40% of cost for the Shell projects.

Keywords: benchmarking, full field development, CAPEX, feasibility

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Authors: Nancy Ibrahim Abdalla, Abdelaziz Karamalla Gaiballa

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Rangelands in semi-arid areas provide a good source for feeding huge numbers of animals and serving environmental, economic and social importance; therefore, these areas are considered economically very important for the pastoral sector in Sudan. This paper investigates the means of differentiating between different rangelands sites according to soil types using principal component analysis to assist in monitoring and assessment purposes. Three rangeland sites were identified in the study area as flat sandy sites, sand dune site, and hard clay site. Principal component analysis (PCA) was used to reduce the number of factors needed to distinguish between rangeland sites and produce a new set of data including the most useful spectral information to run satellite image processing. It was performed using selected types of data (two vegetation indices, topographic data and vegetation surface reflectance within the three bands of MODIS data). Analysis with PCA indicated that there is a relatively high correspondence between vegetation and soil of the total variance in the data set. The results showed that the use of the principal component analysis (PCA) with the selected variables showed a high difference, reflected in the variance and eigenvalues and it can be used for differentiation between different range sites.

Keywords: principal component analysis, PCA, rangeland sites, semi-arid areas, soil types

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Authors: L. Grinis

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Turbulent flow in complex geometries receives considerable attention due to its importance in many engineering applications. It has been the subject of interest for many researchers. Some of these interests include the design of storm water channels. The design of these channels requires testing through physical models. The main practical limitation of physical models is the so called “scale effect”, that is, the fact that in many cases only primary physical mechanisms can be correctly represented, while secondary mechanisms are often distorted. These observations form the basis of our study, which centered on problems associated with the design of storm water channels near the Dead Sea, in Israel. To help reach a final design decision we used different physical models. Our research showed good coincidence with the results of laboratory tests and theoretical calculations, and allowed us to study different effects of fluid flow in an open channel. We determined that problems of this nature cannot be solved only by means of theoretical calculation and computer simulation. This study demonstrates the use of physical models to help resolve very complicated problems of fluid flow through baffles and similar structures. The study applies these models and observations to different construction and multiphase water flows, among them, those that include sand and stone particles, a significant attempt to bring to the testing laboratory a closer association with reality.

Keywords: open channel, physical modeling, baffles, turbulent flow

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Authors: Abdullah Alhajoj, Bassam Alowaiesh

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This work aims to reduce the risks of discharging olive mill waste directly to the environment without treatment in Sakaka City, KSA. The organic loads expressed by chemical oxygen demand (COD) and biological oxygen demand (BOD) of the produced wastewater (OMWW) as well as the solid waste (OMW) were evaluated. The wastes emitted from the three-phase centrifuge decanters was found to be higher than that emitted from the two-phase centrifuge decanters. The olive mill wastewater (OMWW) was treated using advanced oxidation combined with filtration treatment. The results indicated that the concentration of COD, BOD, TSS, oil and grease and phenol was reduced by using complex sand filtration from 72150, 21660 10256, 36430, and 1470 mg/l to 980, 421, 58, 68, and 0.35 mg/l for three-phase OMWW and from 150562, 17955, 15325, 19658 and 2153 mg/l to 1050, 501, 29, 0.75, and 0.29 mg/l, respectively. While, by using modified trickling filter (packed with the neck of waste plastic bottles the concentration of the previously mentioned parameters was reduced to 1190, 570, 55, 0.85, and 0.3 mg/l, respectively. This work supports the application of such treatment technique for reducing the environmental threats of olive mill waste effluents in Saudi Arabia.

Keywords: two-phase, three-phase, olive mill, olive oil, waste treatment, filtration, advanced oxidation, waste plastic bottles

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Authors: F. A. Ogundolie, F. Okogue, D. V. Adegunloye

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Greywater samples were obtained from three restaurants in the Federal University of Technology; Akure coded SSR, MGR and GGR. Fungi isolates obtained include Rhizopus stolonifer, Aspergillus niger, Mucor mucedo, Aspergillus flavus, Saccharomyces cerevisiae. Of these fungi isolates obtained, R. stolonifer, A. niger and A. flavus showed significant degradation ability on grey water and was used for this research. A simple bioreactor was constructed using biodegradation process in purification of waste water samples. Waste water undergoes primary treatment; secondary treatment involves the introduction of the isolated organisms into the waste water sample and the tertiary treatment which involved the use of filter candle and the sand bed filtration process to achieve the end product without the use of chemicals. A. niger brought about significant reduction in both the bacterial load and the fungi load of the greywater samples of the three respective restaurants with a reduction of (1.29 × 108 to 1.57 × 102 cfu/ml; 1.04 × 108 to 1.12 × 102 cfu/ml and 1.72 × 108 to 1.60 × 102 cfu/ml) for bacterial load in SSR, MGR and GGR respectively. Reduction of 2.01 × 104 to 1.2 × 101; 1.72 × 104 to 1.1 × 101, and 2.50 × 104 to 1.5 × 101 in fungi load from SSR, MGR and GGR respectively. Result of degradation of these selected waste water by the fungi showed that A. niger was probably more potent in the degradation of organic matter and hence, A. niger could be used in the treatment of wastewater.

Keywords: Aspergillus niger, greywater, bacterial, fungi, microbial load, bioreactor, biodegradation, purification, organic matter and filtration

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Authors: Nor-Edine Abriak, Ilyas Ennahal, Abdeljalil Zri, Mahfoud Benzerzour

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Nord Pas de Calais is one of the French regions that records a large volume of dredged sediment in harbors and waterways. To ensure navigation within ports and waterways, harbor and river managers are forced to find solutions to remove sediment that contamination levels exceed levels established by regulations. Therefore, this non- submersible sediment must be managed on land and will be subject to the waste regulation. In this paper, some examples of concrete achievements and experiments of reusing dredged sediment in civil engineering and sector will be illustrated. These achievements are alternative solutions to sediment landfilling and guarantee the reuse of this material in a logic of circular economy and ecological transition. It permits to preserve the natural resources increasingly scarce and resolve issues related to the accumulation of sediments in the harbor basins, rivers, dams, and lakes, etc. Examples of beneficial use of dredged material illustrated in this paper are the result of different projects reusing harbor and waterways sediments in several applications. These projects were funded under the national SEDIMATERIAUX approach. Thus the technical and environmental feasibility of the reuse of dredged sediment is demonstrated and verified; the dredged sediment reusing would meet multiple challenges of sustainable development in relation to environmental, economic, social and societal.

Keywords: circular economy, sediment, SEDIMATERIAUX, waterways

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Authors: Malik Abdul Jabbar Zen, Wiwik Misaco Yuniarti, Azisya Amalia Karimasari, Novita Priandini

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Zoonos is as an infectiontransmitted froma nimals to human sand vice versa currently having increased in the last 20 years. The experts/scientists predict that zoonosis will be a threat to the community in the future since it leads on 70% emerging infectious diseases (EID) and the high mortality of 50%-90%. The zoonosis’ spread from animal to human is caused by contaminated food known as foodborne disease. One World One Health, as the conceptual prevention toward zoonosis, requires the crossed disciplines cooperation to accelerate and streamlinethe handling ofanimal-based disease. E-Vet Smart Rapid System is an integrated innovation in the veterinary expertise application is able to facilitate the prevention, treatment, and educationagainst pandemic diseases and zoonosis. This system is constructed by Decision Support System (DSS) method provides a database of knowledge that is expected to facilitate the identification of disease rapidly, precisely, and accurately as well as to identify the deduction. The testingis conducted through a black box test case and questionnaire (N=30) by validity and reliability approach. Based on the black box test case reveals that E-Vet Rapid System is able to deliver the results in accordance with system design, and questionnaire shows that this system is valid (r > 0.361) and has a reliability (α > 0.3610).

Keywords: diagnosis, disease, expert systems, livestock, zoonosis

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Authors: Faruk Elaldi

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There are lots of concrete columns and beams around in our living cities. Those columns are mostly open to aggressive environmental conditions and earthquakes. Mostly, they are deteriorated by sand, wind, humidity and other external applications at times. After a while, these beams and columns need to be repaired. Within the scope of this study, for reinforcement of concrete columns, samples were designed and fabricated to be strengthened with carbon fiber reinforced composite materials and conventional concrete encapsulation and followed by, and they were put into the axial compression test to determine load-carrying performance before column failure. In the first stage of this study, concrete column design and mold designs were completed for a certain load-carrying capacity. Later, the columns were exposed to environmental deterioration in order to reduce load-carrying capacity. To reinforce these damaged columns, two methods were applied, “concrete encapsulation” and the other one “wrapping with carbon fiber /epoxy” material. In the second stage of the study, the reinforced columns were applied to the axial compression test and the results obtained were analyzed. Cost and load-carrying performance comparisons were made and it was found that even though the carbon fiber/epoxy reinforced method is more expensive, this method enhances higher load-carrying capacity and reduces the reinforcement processing period.

Keywords: column reinforcement, composite, earth quake, carbon fiber reinforced

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Authors: Sao-Jeng Chao, Wen-Cheng Chen, Wei-Humg Lu

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In order to prevent encountering unpredictable factors, geotechnical engineers always conduct numerical analysis for braced excavation design. Simulation work in advance can predict the response of subsequent excavation and thus will be designed to increase the security coefficient of construction. The parameters that are considered include geological conditions, soil properties, soil distributions, loading types, and the analysis and design methods. National Ilan University is located on the LanYang plain, mainly deposited by clayey soil and loose sand, and thus is vulnerable to external influence displacement. National Ilan University experienced a construction of braced excavation with a complete program of monitoring excavation. This study takes advantage of a one-dimensional finite element method RIDO to simulate the excavation process. The predicted results from numerical simulation analysis are compared with the monitored results of construction to explore the differences between them. Numerical simulation analysis of the excavation process can be used to analyze retaining structures for the purpose of understanding the relationship between the displacement and supporting system. The resulting deformation and stress distribution from the braced excavation cab then be understand in advance. The problems can be prevented prior to the construction process, and thus acquire all the affected important factors during design and construction.

Keywords: excavation, numerical simulation, RIDO, retaining structure

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Authors: V. Revathi, J. Thaarrini, M. Venkob Rao

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This paper presents a study on use of alkali activated bottom ash (BA) and ground granulated blast furnace slag (GGBS) blend in paver blocks. A preliminary effort on alkali-activated bottom ash, blast furnace slag based geopolymer (BA-GGBS-GP) mortar with river sand was carried out to identify the suitable mix for paver block. Several mixes were proposed based on the combination of BA-GGBS. The percentage ratio of BA:GGBS was selected as 100:0, 75:25, 50:50, 25:75 and 0:100 for the source material. Sodium based alkaline activators were used for activation. The molarity of NaOH was considered as 8M. The molar ratio of SiO2 to Na2O was varied from 1 to 4. Two curing mode such as ambient and steam curing 60°C for 24 hours were selected. The properties of paver block such as compressive strength split tensile strength, flexural strength and water absorption were evaluated as per IS15658:2006. Based on the preliminary study on BA-GGBS-GP mortar, the combinations of 25% BA with 75% GGBS mix for M30 and 75% BA with 25% GGBS mix for M35 grade were identified for paver block. Test results shows that the combination of BA-GGBS geopolymer paver blocks attained remarkable compressive strength under steam curing as well as in ambient mode at 3 days. It is noteworthy to know BA-GGBS-GP has promising future in the construction industry.

Keywords: bottom ash, GGBS, alkali activation, paver block

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Authors: Abdulsalam Turkmani, Mohammed Khaled Yezbek, Farouk Al Imadi

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Geological surveys in the southwestern part of Syria showed the presence of sedimentary-pyroclastic deposits, volcanic tuff, to the age of the Upper Pliocene and contain the following minerals according petrographical study and XRD, SEM, XRF analysis and surface properties. X-Ray diffraction results indicate the presence of analcime, phillipsite and chabazite in in all the studied localities. There are also amorphous materials and clay minerals such as illite and montmorillonite. The non-zeolite constituents include olivine, clinopyroxene orthopyroxene and spinel, and less of magnetite and feldspar. Some major oxides were determined through XRF geochemical analyses which include SiO₂, Al₂O₃, K₂O, Fe₂O₃, and CaO for volcanic tuff and zeolite. The formation of these depositions can be summarized in the following stages during the Pliocene: Volcanic activity at the edges of Al Rutba uplift and Jabal Al Arab depression was a rich by tuff bearing ultra basic and basic xenoliths plus second phase by scoria, during the early Pliocene. Volcanic calm with the activity of erosion and form lakes in which deposition of a set of wastes, including olivine resulting from the disintegration of xenoliths during the middle Pliocene. Zeolites minerals form later, which make up about 15-20% and increase and decrease in reverse relation with the olivine sand. Zeolite is formed from volcanic glass, and the results of SEM show that the zeolites minerals very well crystallized.

Keywords: minerals, origin, pyroclastic, zeolite

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Authors: Paul Holmes, Mike N. G.

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Foundation-year doctors face increased stress, pressure and uncertainty when starting new rotations throughout their first years of work. This research questionnaire resulted in an induction cheat sheet and induction video that enhanced the Junior doctor's understanding of how to work effectively within the plastic surgery department at NHS Tayside. The objectives and goals were to improve the transition between cohorts of junior doctors in ward 26 at Ninewells Hospital. Before this quality improvement project, the induction pack was 74 pages long and over eight years old. With the support of consultant Mike Ng a new up-to-date induction was created. This involved a questionnaire and cheat sheet being developed. The questionnaire covered clerking, venipuncture, ward pharmacy, theatres, admissions, specialties on the ward, the cardiac arrest trolley, clinical emergencies, discharges and escalation. This audit has three completed cycles between August 2022 and August 2023. The cheat sheet developed a concise two-page A4 document designed for doctors to be able to reference easily and understand the essentials. The document format is a table containing ward layout; specialty; location; physician associate, shift patterns; ward rounds; handover location and time; hours coverage; senior escalation; nights; daytime duties, meetings/MDTs/board meetings, important bleeps and codes; department guidelines; boarders; referrals and patient stream; pharmacy; absences; rota coordinator; annual leave; top tips. The induction video is a 10-minute in-depth explanation of all aspects of the ward. The video explores in more depth the contents of the cheat sheet. This alternative visual format familiarizes the junior doctor with all aspects of the ward. These were provided to all foundation year 1 and 2 doctors on ward 26 at Ninewells Hospital at NHS Tayside Scotland. This work has since been adopted by the General Surgery Department, which extends to six further wards and has improved the effective handing over of the junior doctor’s role between cohorts. There is potential to further expand the cheat sheet to other departments as the concise document takes around 30 minutes to complete by a doctor who is currently on that ward. The time spent filling out the form provides vital information to the incoming junior doctors, which has a significant possibility to improve patient care.

Keywords: induction, junior doctor, handover, plastic surgery

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Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

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Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

Procedia PDF Downloads 320

Authors: Raisibe V. Mathabatha, Phatu W. Mashela, Nehemiah M. Mokgalong

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Occasional incidence of phytotoxicity in Nemarioc-BL and Nemafric-AL phytonematicides to crops raises credibility challenges that could negate their registration as commercial products. Responses of plants to phytonematicides are characterized by the existence of stimulation, neutral and inhibition phases, with the mid-point of the former being referred to as the Mean Concentration Stimulation Point (MSCP = Dm + Rh/2). The objective of this study was to determine the MCSP and the overall sensitivity (∑k) of Nemarioc-AL and Nemafric-BL phytonematicides to rough lemon seedling rootstocks using the Curve-fitting Allelochemical Response Dosage (CARD) computer-based model. Two parallel greenhouse experiments were initiated, with seven dilutions of each phytonematicide arranged in a randomised complete block design, replicated nine times. Six-month-old rough lemon seedlings were transplanted into 20-cm-diameter plastic pots, filled with steam-pasteurised river sand (300°C for 3 h) and Hygromix-T growing mixture. Treatments at 0, 2, 4, 8, 16, 32 and 164% dilutions were applied weekly at 300 ml/plant. At 84 days after the treatments, analysis of variance-significant plant variables was subjected to the CARD model to generate appropriate biological indices. Computed MCSP values for Nemarioc-AL and Nemafric-BL phytonematicides on rough lemon were 29 and 38%, respectively, whereas ∑k values were 1 and 0, respectively. At the applied concentrations, rough lemon seedlings were highly sensitive to Nemarioc-AL and Nemafric-BL phytonematicides.

Keywords: crude extracts, cucurbitacins, effective microbes, fruit extracts

Procedia PDF Downloads 146

Authors: Mohd Asim, K. Nageswara Rao

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The present work was carried out on River Yamuna passing through Delhi- National Capital Region (Delhi-NCR) of India for a stretch of about 130 km to assess the anthropogenic impact on the channel migration process for a period of 200 years with the help of satellite data and topographical maps with integration of geographic information system environment. Digital Shoreline Analysis System (DSAS) application was used to quantify river channel migration in ArcGIS environment. The average river channel migration was calculated to be 22.8 m/year for the entire study area. River channel migration was found to be moving in westward and eastward direction. Westward migration is more than 4 km maximum in length and eastward migration is about 4.19 km. The river has migrated a total of 32.26 sq. km of area. The results reveal that the river is being impacted by various human activities. The impact indicators include engineering structures, sand mining, embankments, urbanization, land use/land cover, canal network. The DSAS application was also used to predict the position of river channel in future for 2032 and 2042 by analyzing the past and present rate and direction of movement. The length of channel in 2032 and 2042 will be 132.5 and 141.6 km respectively. The channel will migrate maximum after crossing Okhla Barrage near Faridabad for about 3.84 sq. km from 2022 to 2042 from west to east.

Keywords: river migration, remote sensing, river Yamuna, anthropogenic impacts, DSAS, Delhi-NCR

Procedia PDF Downloads 124

Authors: Khasim Munir Bhasha Shaik

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Veligonda and adjoining hill range spread along about 170 Km North to South in Kadapa and Nellore Districts stretching a little further into Prakasam District. The latitude in general ranges up to 1000m. The forests are generally dry deciduous type. Veligonda and adjoining hill ranges comprise of Palakonda, Seshachalam, Lankamala and the terminal part of Nallamalais from mid-region of Southern Eastern Ghats. The Veligonda range which separates the Nellore district from Kadapa and Kurnool is the backbone of the Eastern Ghats, starting from Nagari promontory in Chittoor district. It runs in a northerly direction along the western border of the Nellore district, with a raising elevation of 3,626 ft at Penchalakona in Raipur thaluk. Veligonda hill ranges are high in altitude and have deep valleys. Among the Veligondas range of hills the Durgam in Venkatagiri range and Penchalakona are the most prominent and are situated 914 meters above mean sea level. It has more than 3000 species of plants along with 500 animal species. The unique specialty of this region is the presence of Pterocarpus santalinus(endangered) and Santalum album (vulnerable). In the present study, an attempt is made to assess the efforts that are going on to conserve the biodiversity of flora and fauna of this region. Various conservation strategies were suggested to protect the biodiversity and richness of Veligonda forest, hill region of Eastern Ghats of Andhra Pradesh. The major threats and the reasons for the dwindling species richness are poor rainfall, adverse climatic conditions, robbery of Red sanders and poaching of animals by the local tribals. Efforts are to be made to conserve some of the animals by both in situ and ex-situ methods. More awareness is to be developed among the local communities who are dwelling in the vicinity and importance of conservation is to be emphasized to them. Anthropogenic attachments are to be made by introducing more numbers of sacred groves. Gross enforcement of law is to be made to protect the various forest resources in this area. The important species with the medicinal values are to be identified. It was found that two important wildlife sanctuaries named Sri Lankamalleswarawildlife sanctuary and Sripenusila Narasimha wildlife sanctuary are working for the comprehensive conservation of the environment in this area. Apart from this more than 38 important sacred grooves are there where the plants and animals are protected by local Yanadi and other communities.

Keywords: biodiversity, wild life sanctuary, habitat destruction, eastern Ghats

Procedia PDF Downloads 155

Authors: Mehmet Salih Bayraktutan

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Geomechanical properties of Rock Salt Deposits in Tuzluca Salt Mine Area (Eastern Turkey) are studied for modeling the operation- excavation strategy. The purpose of this research focused on calculating the critical value of span height- which will meet the safety requirements. The Mine Site Tuzluca Hills consist of alternating parallel bedding of Salt ( NaCl ) and Gypsum ( CaS04 + 2 H20) rocks. Rock Salt beds are more resistant than narrow Gypsum interlayers. Rock Salt beds formed almost 97 percent of the total height of the Hill. Therefore, the geotechnical safety of Galleries depends on the mechanical criteria of Rock Salt Cores. General deposition of Tuzluca Basin was finally completed by Tuzluca Evaporites, as for the uppermost stratigraphic unit. They are currently running mining operations performed by classic mechanical excavation, room and pillar method. Rooms and Pillars are currently experiencing an initial stage of fracturing in places. Geotechnical safety of the whole mining area evaluated by Rock Mass Rating (RMR), Rock Quality Designation (RQD) spacing of joints, and the interaction of groundwater and fracture system. In general, bedded rock salt Show large lateral deformation capacity (while deformation modulus stays in relative small values, here E= 9.86 GPa). In such litho-stratigraphic environments, creep is a critical mechanism in failure. Rock Salt creep rate in steady-state is greater than interbedding layers. Under long-lasted compressive stresses, creep may cause shear displacements, partly using bedding planes. Eventually, steady-state creep in time returns to accelerated stages. Uniaxial compression creep tests on specimens were performed to have an idea of rock salt strength. To give an idea, on Rock Salt cores, average axial strength and strain are found as 18 - 24 MPa and 0.43-0.45 %, respectively. Uniaxial Compressive strength of 26- 32 MPa, from bedded rock salt cores. Elastic modulus is comparatively low, but lateral deformation of the rock salt is high under the uniaxial compression stress state. Poisson ratio = 0.44, break load = 156 kN, cohesion c= 12.8 kg/cm2, specific gravity SG=2.17 gr/cm3. Fracture System; spacing of fractures, joints, faults, offsets are evaluated under acting geodynamic mechanism. Two sand beds, each 4-6 m thick, exist near to upper level and at the top of the evaporating sequence. They act as aquifers and keep infiltrated water on top for a long duration, which may result in the failure of roofs or pillars. Two major active seismic ( N30W and N70E ) striking Fault Planes and parallel fracture strands have seismically triggered moderate risk of structural deformation of rock salt bedding sequence. Earthquakes and Floods are two prevailing sources of geohazards in this region—the seismotectonic activity of the Mine Site based on the crossing framework of Kagizman Faults and Igdir Faults. Dominant Hazard Risk sources include; a) Weak mechanical properties of rock salt, gypsum, anhydrite beds-creep. b) Physical discontinuities cutting across the thick parallel layers of Evaporite Mass, c) Intercalated beds of weak cemented or loose sand, clayey sandy sediments. On the other hand, absorbing the effects of salt-gyps parallel bedded deposits on seismic wave amplitudes has a reducing effect on the Rock Mass.

Keywords: bedded rock salt, creep, failure mechanism, geotechnical safety

Procedia PDF Downloads 190

Authors: Horesh Reinman Netta

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Objectives: To examine the relationship between stressful life events and recurrent major depressive disorders Methods: Three groups of 50 subjects were assessed. One group had a recurrent major depressive disorder with melancholic features; the second group met the criteria for borderline personality disorder, and the third consisted of healthy controls. The Structured Clinical Interview for AXIS I DSM-IV Disorders sand the Structured Clinical Interview for AXIS II DSM-IV Disorders were used for diagnosis. The Israel Psychiatric Epidemiology Research Interview (IPERI) Life Event Scale and the Coddington Life Events Schedule (CLES) were used to measure life events which were confirmed with a confirmatory semi-structured interview. The Beck Depression Inventory and the Satisfaction from Life scales were also administered. Results : The total number of loss-related events in childhood and in the year preceding the first episode was significantly higher in the affective disorder group than in the two control groups. Total number of LE, uncontrolled and independent events were also more common in the depressed patients in the year preceding the first episode. No category of SLE was differentiated among any of the three groups during any period of time following the first depressive episode. Conclusions: SLE play an important role in the onset of affective disorders. There appear to be specific kinds of SLE occurring in childhood and in the year preceding a first episode that have particular significance. SLE may have a lesser role in the maintenance of this illness.

Keywords: modd dosorders, recurrent depression, stress, life events

Procedia PDF Downloads 108

Authors: Mona Fawzy Aldaghma

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Helical piles are gaining popularity as a viable deep foundation alternative due to their quick installation and multipurpose use in compression and tension. These piles are commonly used as foundations for constructions such as solar panels, wind turbines and offshore platforms. These structures typically transfer various combinations of loads to their helical-pile foundations, including axial and lateral loads. Further research is needed to determine the effects of loading patterns that may act on helical piles as compounds of axial compression and lateral stresses. Multi helical piles are used to increase the efficiency of these piles. In this study, it investigate the behavior of laterally loaded helical piles with multiple helices when subjected to vertical loading conditions in both cohesive and cohesionless soils. Two models of intermediate shaft rigidity are studied with either two or three helices. Additionally, the vertical loading conditions were altered between successive and simultaneous loading. The cohesionless soil is sand with medium density and the cohesive soil is clay with medium cohesion. The study will carried out with numerical analysis using PLAXIS 3D and will be verified by an experimental tests. The numerical simulations reveal that helical piles exhibit different behavior in cohesive soil compared to cohesionless soil.

Keywords: helical piles, multi-helix, numerical modeling, PLAXIS 3D, cohesive soil, cohesionless soil, experimental

Procedia PDF Downloads 36

Authors: Mustafa Col, Funda Gul Koc, Merve Yangaz, Eylem Subasi, Can Akbasoglu

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G38NiCrMo8-4-4 steel is widely used in mining industries, machine parts, gears due to its high strength and toughness properties. In this study, microstructure, wear and mechanical properties of G38NiCrMo8-4-4 steel modified with boron used in the mining industry were investigated. For this purpose, cast materials were alloyed by melting in an induction furnace to include boron with the rates of 0 ppm, 15 ppm, and 50 ppm (wt.) and were formed in the dimensions of 150x200x150 mm by casting into the sand mould. Homogenization heat treatment was applied to the specimens at 1150˚C for 7 hours. Then all specimens were austenitized at 930˚C for 1 hour, quenched in the polymer solution and tempered at 650˚C for 1 hour. Microstructures of the specimens were investigated by using light microscope and SEM to determine the effect of boron and heat treatment conditions. Changes in microstructure properties and material hardness were obtained due to increasing boron content and heat treatment conditions after microstructure investigations and hardness tests. Wear tests were carried out using a pin-on-disc tribometer under dry sliding conditions. Charpy V notch impact test was performed to determine the toughness properties of the specimens. Fracture and worn surfaces were investigated with scanning electron microscope (SEM). The results show that boron element has a positive effect on the hardness and wear properties of G38NiCrMo8-4-4 steel.

Keywords: G38NiCrMo8-4-4 steel, boron, heat treatment, microstructure, wear, mechanical properties

Procedia PDF Downloads 195

Authors: Anthony El Hachem, Hosam Salman

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Selecting the most effective construction method for drilled shafts under the high phreatic surface can be a challenging task that requires effective communication between the design and construction teams. Slurry placement, temporary casing, and permanent casing are the three most commonly used installation techniques to ensure the stability of the drilled hole before casting the concrete. Each one of these methods has its implications on the installation and performance of the drilled piers. Drilled shafts were designed to support a fire wall for an Energy project in Central Texas. The subsurface consisted of interlayers of sands and clays of varying shear strengths. The design recommended that the shafts be installed with temporary casing or slurry displacement due to the anticipated groundwater seepage through granular soils. During the foundation construction, it was very difficult to maintain the stability of the hole, and the contractor requested to install the shafts using permanent casings. Therefore, the foundation design was modified to ensure that the cased shafts achieve the required load capacity. Effective and continuous communications between the owner, contractor and design team during field shaft installations to mitigate the unforeseen challenges helped the team to successfully complete the project.

Keywords: construction challenges, deep foundations, drilled shafts, loose sands underwater table, permanent casing

Procedia PDF Downloads 193

Authors: Seyed Ali Mohammad, Modarres Sanavy, Hamed Keshavarz, Ali Mokhtassi-Bidgoli

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One of the biggest challenges for the current and future generations is to produce sufficient food for the world population with the existing limited available water resources. Peppermint is a specialty crop used for food and medicinal purposes. Its main component is menthol. It is used predominantly for oral hygiene, pharmaceuticals, and foods. Although drought stress is considered as a negative factor in agriculture, being responsible for severe yield losses; medicinal plants grown under semi-arid conditions usually produce higher concentrations of active substances than same species grown under moderate climates. Nitrogen (N) fertilizer management is central to the profitability and sustainability of forage crop production. Sub-optimal N supply will result in poor yields, and excess N application can lead to nitrate leaching and environmental pollution. In order to determine the response of peppermint to drought stress and different fertilizer treatments, a field experiment with peppermint was conducted in a sandy loam soil at a site of the Tarbiat Modares University, Agriculture Faculty, Tehran, Iran. The experiment used a complete randomized block design, with six rates of fertilizer strategies (F1: control, F2: Urea, F3: 75% urea + 25% vermicompost, F4: 50% urea + 50% vermicompost, F5: 25% urea + 75% vermicompost and F6: vermicompost) and three irrigation regime (S1: 45%, S2: 60% and S3: 75% FC) with three replication. The traits such as nitrogen, chlorophyll, carotenoids, anthocyanin, flavonoid and fresh biomass were studied. The results showed that the treatments had a significant effect on the studied traits as drought stress reduced photosynthetic pigment concentration. Also, drought stress reduced fresh yield of peppermint. Non stress condition had the greater amount of chlorophyll and fresh yield more than other irrigation treatments. The highest concentration of chlorophyll and the fresh biomass was obtained in F2 fertilizing treatments. Sever water stress (S1) produced decreased photosynthetic pigment content fresh yield of peppermint. Supply of N could improve photosynthetic capacity by enhancing photosynthetic pigment content. Perhaps application of vermicompost significantly improved the organic carbon, available N, P and K content in soil over urea fertilization alone. To get sustainable production of peppermint, application of vermicompost along with N through synthetic fertilizer is recommended for light textured sandy loam soils.

Keywords: fresh yield, peppermint, synthetic nitrogen, vermicompost, water stress

Procedia PDF Downloads 217

Authors: R. K. D. G. Kaluarachchi

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The generation of solid waste and its effective management are debated topics in Sri Lanka as well as in the global environment. It was estimated that the most of the waste generated in global was originated from construction and demolition of buildings. Thus, the proportion of construction waste in solid waste generation cannot be underestimated. The construction waste, which is the by-product generated and removed from work sites is collected in direct and indirect processes. Hence, the objectives of this research are to identify the proportion of construction waste which can be reused and identify the methods to reduce the waste generation without reducing the quality of the process. A 6-storey building construction site was selected for this research. The site was divided into six zones depending on the process. Ten waste materials were identified by considering the adverse effects on safety and health of people and the economic value of them. The generated construction waste in each zone was recorded per week for a period of five months. The data revealed that sand, cement, wood used for form work and rusted steel rods were the generated waste which has higher economic value in all zones. Structured interviews were conducted to gather information on how the materials are categorized as waste and the capability of reducing, reusing and recycling the waste. It was identified that waste is generated in following processes; ineffective storage of material for a longer time and improper handling of material during the work process. Further, the alteration of scheduled activities of construction work also yielded more waste. Finally, a proper management of construction waste is suggested to reduce and reuse waste.

Keywords: construction-waste, effective management, reduce, reuse

Procedia PDF Downloads 200