Search results for: care home service
Commenced in January 2007
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Edition: International
Paper Count: 7824

Search results for: care home service

774 Standardizing and Achieving Protocol Objectives for ChestWall Radiotherapy Treatment Planning Process using an O-ring Linac in High-, Low- and Middle-income Countries

Authors: Milton Ixquiac, Erick Montenegro, Francisco Reynoso, Matthew Schmidt, Thomas Mazur, Tianyu Zhao, Hiram Gay, Geoffrey Hugo, Lauren Henke, Jeff Michael Michalski, Angel Velarde, Vicky de Falla, Franky Reyes, Osmar Hernandez, Edgar Aparicio Ruiz, Baozhou Sun

Abstract:

Purpose: Radiotherapy departments in low- and middle-income countries (LMICs) like Guatemala have recently introduced intensity-modulated radiotherapy (IMRT). IMRT has become the standard of care in high-income countries (HIC) due to reduced toxicity and improved outcomes in some cancers. The purpose of this work is to show the agreement between the dosimetric results shown in the Dose Volume Histograms (DVH) to the objectives proposed in the adopted protocol. This is the initial experience with an O-ring Linac. Methods and Materials: An O-Linac Linac was installed at our clinic in Guatemala in 2019 and has been used to treat approximately 90 patients daily with IMRT. This Linac is a completely Image Guided Device since to deliver each radiotherapy session must take a Mega Voltage Cone Beam Computerized Tomography (MVCBCT). In each MVCBCT, the Linac deliver 9 UM, and they are taken into account while performing the planning. To start the standardization, the TG263 was employed in the nomenclature and adopted a hypofractionated protocol to treat ChestWall, including supraclavicular nodes achieving 40.05Gy in 15 fractions. The planning was developed using 4 semiarcs from 179-305 degrees. The planner must create optimization volumes for targets and Organs at Risk (OARs); the difficulty for the planner was the dose base due to the MVCBCT. To evaluate the planning modality, we used 30 chestwall cases. Results: The plans created manually achieve the protocol objectives. The protocol objectives are the same as the RTOG1005, and the DHV curves look clinically acceptable. Conclusions: Despite the O-ring Linac doesn´t have the capacity to obtain kv images, the cone beam CT was created using MV energy, the dose delivered by the daily image setup process still without affect the dosimetric quality of the plans, and the dose distribution is acceptable achieving the protocol objectives.

Keywords: hypofrationation, VMAT, chestwall, radiotherapy planning

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773 Using Nature-Based Solutions to Decarbonize Buildings in Canadian Cities

Authors: Zahra Jandaghian, Mehdi Ghobadi, Michal Bartko, Alex Hayes, Marianne Armstrong, Alexandra Thompson, Michael Lacasse

Abstract:

The Intergovernmental Panel on Climate Change (IPCC) report stated the urgent need to cut greenhouse gas emissions to avoid the adverse impacts of climatic changes. The United Nations has forecasted that nearly 70 percent of people will live in urban areas by 2050 resulting in a doubling of the global building stock. Given that buildings are currently recognised as emitting 40 percent of global carbon emissions, there is thus an urgent incentive to decarbonize existing buildings and to build net-zero carbon buildings. To attain net zero carbon emissions in communities in the future requires action in two directions: I) reduction of emissions; and II) removal of on-going emissions from the atmosphere once de-carbonization measures have been implemented. Nature-based solutions (NBS) have a significant role to play in achieving net zero carbon communities, spanning both emission reductions and removal of on-going emissions. NBS for the decarbonisation of buildings can be achieved by using green roofs and green walls – increasing vertical and horizontal vegetation on the building envelopes – and using nature-based materials that either emit less heat to the atmosphere thus decreasing photochemical reaction rates, or store substantial amount of carbon during the whole building service life within their structure. The NBS approach can also mitigate urban flooding and overheating, improve urban climate and air quality, and provide better living conditions for the urban population. For existing buildings, de-carbonization mostly requires retrofitting existing envelopes efficiently to use NBS techniques whereas for future construction, de-carbonization involves designing new buildings with low carbon materials as well as having the integrity and system capacity to effectively employ NBS. This paper presents the opportunities and challenges in respect to the de-carbonization of buildings using NBS for both building retrofits and new construction. This review documents the effectiveness of NBS to de-carbonize Canadian buildings, identifies the missing links to implement these techniques in cold climatic conditions, and determine a road map and immediate approaches to mitigate the adverse impacts of climate change such as urban heat islanding. Recommendations are drafted for possible inclusion in the Canadian building and energy codes.

Keywords: decarbonization, nature-based solutions, GHG emissions, greenery enhancement, buildings

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772 Central Line Stock and Use Audit in Adult Patients: A Quality Improvement Project on Central Venous Catheter Standardisation Across Hospital Departments

Authors: Gregor Moncrieff, Ursula Bahlmann

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A number of incident reports were filed from the intensive care unit with regards to adult patients admitted following operations who had a central venous catheter inserted of the incorrect length for the relevant anatomical site and catheters not compatible with pressurised injection inserted whilst in theatre. Incorrect catheter length can lead to a variety of complications and pressurised injection is a requirement for contrast enhanced computerised tomography scans. This led to several patients having a repeat procedure to insert a catheter of the correct length and also compatible with pressurised injection. This project aimed to identify the types of central venous catheters used in theatres and ensure the correct equipment would be stocked and used in future cases in accordance the existing Association of Anaesthetics of Great Britain and Northern Ireland guidelines. A questionnaire was sent out to all of the anaesthetic department in our hospital aiming to determine what types of central venous catheters were preferably used by anaesthetists and why these had been chosen. We also explored any concerns regarding introduction of standardised, pressure injectable central venous catheters to the theatre department which were already in use in other parts of the hospital and in keeping with national guidance. A total of 56 responses were collected. 64% of respondents routinely used a central venous catheter which was significantly shorter than the national recommended guidance with a further 4 different types of central venous catheters used which were different to other areas of the hospital and not pressure injectable. 75% of respondents were in agreement to standardised introduction of the pressure injectable catheters of the recommended length in accordance with national guidance. Reasons why 25% respondents were opposed to introduction of these catheters were explored and discussed. We were successfully able to introduce the standardised central catheters to the theatre department following presentation at the local anaesthetic quality and safety meeting. Reasons against introduction of the catheters were discussed and a compromise was reached that the existing catheters would continue to be stocked but would only be available on request, with a focus on encouraging use of the standardised catheters. Additional changes achieved included removing redundant catheters from the theatre stock. Ongoing data is being collected to analyse positive and negative feedback from use of the introduced catheters.

Keywords: central venous catheter, medical equipment, medical safety, quality improvement

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771 Detection and Identification of Antibiotic Resistant Bacteria Using Infra-Red-Microscopy and Advanced Multivariate Analysis

Authors: Uraib Sharaha, Ahmad Salman, Eladio Rodriguez-Diaz, Elad Shufan, Klaris Riesenberg, Irving J. Bigio, Mahmoud Huleihel

Abstract:

Antimicrobial drugs have an important role in controlling illness associated with infectious diseases in animals and humans. However, the increasing resistance of bacteria to a broad spectrum of commonly used antibiotics has become a global health-care problem. Rapid determination of antimicrobial susceptibility of a clinical isolate is often crucial for the optimal antimicrobial therapy of infected patients and in many cases can save lives. The conventional methods for susceptibility testing like disk diffusion are time-consuming and other method including E-test, genotyping are relatively expensive. Fourier transform infrared (FTIR) microscopy is rapid, safe, and low cost method that was widely and successfully used in different studies for the identification of various biological samples including bacteria. The new modern infrared (IR) spectrometers with high spectral resolution enable measuring unprecedented biochemical information from cells at the molecular level. Moreover, the development of new bioinformatics analyses combined with IR spectroscopy becomes a powerful technique, which enables the detection of structural changes associated with resistivity. The main goal of this study is to evaluate the potential of the FTIR microscopy in tandem with machine learning algorithms for rapid and reliable identification of bacterial susceptibility to antibiotics in time span of few minutes. The bacterial samples, which were identified at the species level by MALDI-TOF and examined for their susceptibility by the routine assay (micro-diffusion discs), are obtained from the bacteriology laboratories in Soroka University Medical Center (SUMC). These samples were examined by FTIR microscopy and analyzed by advanced statistical methods. Our results, based on 550 E.coli samples, were promising and showed that by using infrared spectroscopic technique together with multivariate analysis, it is possible to classify the tested bacteria into sensitive and resistant with success rate higher than 85% for eight different antibiotics. Based on these preliminary results, it is worthwhile to continue developing the FTIR microscopy technique as a rapid and reliable method for identification antibiotic susceptibility.

Keywords: antibiotics, E. coli, FTIR, multivariate analysis, susceptibility

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770 Policy Implications of Cashless Banking on Nigeria’s Economy

Authors: Oluwabiyi Adeola Ayodele

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This study analysed the Policy and general issues that have arisen over time in Nigeria’ Cashless banking environment as a result of the lack of a Legal framework on Electronic banking in Nigeria. It undertook an in-depth study of the cashless banking system. It discussed the evolution, growth and development of cashless banking in Nigeria; It revealed the expected benefits of the cashless banking system; It appraised regulatory issues and other prevalent problems on cashless banking in Nigeria; and made appropriate recommendations where necessary. The study relied on primary and secondary sources of information. The primary sources included the Constitution of the Federal Republic of Nigeria, Statutes, Conventions and Judicial decisions, while the secondary sources included Books, Journals Articles, Newspapers and Internet Materials. The study revealed that cashless banking has been adopted in Nigeria but still at the developing stage. It revealed that there is no law for the regulation of cashless banking in Nigeria, what Nigeria relies on for regulation is the Central Bank of Nigeria’s Cashless Policy, 2014. The Banks and Other Financial Institutions Act Chapter B3, LFN, 2004 of Nigeria lack provision to accommodate issues on Internet banking. However, under the general principles of legality in criminal law, and by the provisions of the Nigerian Constitution, a person can only be punished for conducts that have been defined to be criminal by written laws with the penalties specifically stated in the law. Although Nigeria has potent laws for the regulation of paper banking, these laws cannot be substituted for paperless transactions. This is because the issues involved in both transactions vary. The study also revealed that the absence of law in the cashless banking environment in Nigeria will subject consumers to endless risks. This study revealed that the creation of banking markets via the Internet relies on both available technologies and appropriate laws and regulations. It revealed however that Law of some of the countries considered on cashless banking has taken care of most of the legal issues and other problems prevalent in the cashless banking environment. The study also revealed some other problems prevalent in the Nigerian cashless banking environment. The study concluded that for Nigeria to find solutions to the legal issues raised in its cashless banking environment and other problems of cashless banking, it should have a viable legal Frame work for internet banking. The study concluded that the Central Bank of Nigeria’s Policy on Cashless banking is not potent enough to tackle the challenges posed to cashless banking in Nigeria because policies only have a persuasive effect and not a binding effect. There is, therefore, a need for appropriate Laws for the regulation of cashless Banking in Nigeria. The study also concluded that there is a need to create more awareness of the system among Nigerians and solve infrastructural problems like prevalent power outage which often have been creating internet network problem.

Keywords: cashless-banking, Nigeria, policies, laws

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769 An Analytical Approach for the Fracture Characterization in Concrete under Fatigue Loading

Authors: Bineet Kumar

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Many civil engineering infrastructures frequently encounter repetitive loading during their service life. Due to the inherent complexity observed in concrete, like quasi-brittle materials, understanding the fatigue behavior in concrete still posesa challenge. Moreover, the fracture process zone characteristics ahead of the crack tip have been observed to be different in fatigue loading than in the monotonic cases. Therefore, it is crucial to comprehend the energy dissipation associated with the fracture process zone (FPZ) due to repetitive loading. It is well known that stiffness degradation due to cyclic loadingprovides a better understanding of the fracture behavior of concrete. Under repetitive load cycles, concrete members exhibit a two-stage stiffness degradation process. Experimentally it has been observed that the stiffness decreases initially with an increase in crack length and subsequently increases. In this work, an attempt has been made to propose an analytical expression to predict energy dissipation and later the stiffness degradation as a function of crack length. Three-point bend specimens have been considered in the present work to derive the formulations. In this approach, the expression for the resultant stress distribution below the neutral axis has been derived by correlating the bending stress with the cohesive stresses developed ahead of the crack tip due to the existence of the fracture process zone. This resultant stress expression is utilized to estimate the dissipated energydue to crack propagation as a function of crack length. Further, the formulation for the stiffness degradation has been developed by relating the dissipated energy with the work done. It can be used to predict the critical crack length and fatigue life. An attempt has been made to understand the influence of stress amplitude on the damage pattern by using the information on the rate of stiffness degradation. It has been demonstrated that with the increase in the stress amplitude, the damage/FPZ proceeds more in the direction of crack propagation compared to the damage in the direction parallel to the span of the beam, which causes a lesser rate of stiffness degradation for the incremental crack length. Further, the effect of loading frequency has been investigated in terms of stiffness degradation. Under low-frequency loading cases, the damage/FPZ has been found to spread more in the direction parallel to the span, in turn reducing the critical crack length and fatigue life. In such a case, a higher rate of stiffness degradation has been observed in comparison to the high-frequency loading case.

Keywords: fatigue life, fatigue, fracture, concrete

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768 Diabetes and Medical Plant's Treatment: Ethnobotanical Studies Carried out in Morocco

Authors: Jamila Fakchich, Mostafa Jamila Lazaar Elachouri, Lakhder Fakchich, Fatna Ouali, Abd Errazzak Belkacem

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Diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients as well as the health care system. By its nature diabetes, is a multisystem disease with wide-ranging complication that span nearly all region of the body. This epidemic problem, however, is not unique to the industrialized society, but has also hardly struck the developing countries. In Morocco, as developing country, there is an epidemic rise in diabetes, with ensuing concern about the management and control of this disease; it began a chronic burdensome disease of largely middle-aged and elderly people, with a long course and serious complications often resulting in high death-rate, the treatment of diabetes spent vast amount of resources including medicines, diets, physical training. Treatment of this disease is considered problematic due to the lack of effective and safe drugs capable of inducing sustained clinical, biochemical, and histological cure. In Moroccan society, the phytoremedies are some times the only affordable sources of healthcare, particularly for the people in remote areas. In this paper, we present a synthesis work obtained from the ethnobotanical data reported in different specialized journals. A Synthesis of four published ethnobotanical studies that have been carried out in different region of Morocco by different team seekers during the period from 1997 to 2015. Medicinal plants inventoried by different seekers in four Moroccan’s areas have been regrouped and codified, then, Factorial Analysis (FA) and Principal Components Analysis (PCA) are used to analyse the aggregated data from the four studies and plants are classified according to their frequency of use by population. Our work deals with an attempt to gather information on some traditional uses of medicinal plants from different regions of Morocco, also, it was designed to give a set of medicinal plants commonly used by Moroccan people in the treatment of diabetes; In this paper, we intended to provide a basic knowledge about plant species used by Moroccan society for treatment of diabetes. One of the most interesting aspects of this type of works is to assess the relative cultural importance of medicinal plants for specific illnesses and exploring its usefulness in the context of diabetes.

Keywords: Morocco, medicinal plants, ethnobotanical, diabetes, phytoremedies

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767 The Effect of Organizational Justice on Management by Values Perception and Intention to Leave: A Study among Nurses

Authors: Arzu K. Harmanci Seren, Burcu Alacam, Serap Altuntas, Ulku Baykal

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Organizational justice has been evaluated as a concept related to rules developed with regards to distributing gains and making decisions of distribution such as duty, goods, service, reward, punishment, fee, organizational position, opportunity or role among those working in that organization, and to social norms on which these rules are based. Studies of organizational justice are crucial for analyzing the organizational life. It is considered that organization justice will be positively influential upon organizational behaviours such as employees’ level of work satisfaction, their performance, and behaviours of organization citizenship, management by values perception, tendency towards cooperation, and towards quitting their jobs. However, when the literature related to health and nurse management is examined, authors could not reach enough findings related to the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. For that reason, this study has been carried out with the purpose of determining the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values. The study has been carried out with 176 nurses working in a university hospital in Istanbul and a private hospital who accepted to take part in the study, and it is definitive and relation-seeking. Before the data has been collected, ethics committee approval and institutional permissions have been taken, Organizational Justice Scale, Management by Values, Intention to Leave Scale with a questionnaire including 8 questions that aims at defining the personal and professional characteristics of the nurses have been used as a means of data collection. The data collected between 1 May and 20 June 2016 have been evaluated by the researchers in a computer via definitive, relation-seeking and psychometric statistic. As a result of the study, it has been determined that most of the nurses are working in a university hospital (70.5%), that they are 30 and over (49.4%), women (91.5%), single (52.8%) and have a Bachelor’s Degree (48.3%), working in a surgery unit (17.6), have 5 year or less institutional experience (44.9%), 11 year or more professional experience. Cronbach alpha values of the scales used in this study are .94, .95 and .56. Nurses’ average scores of Organizational Justice Scale is M= 3.35±.96, Management by Values Scale is M=3.30±.74, Intention to Leave Scale is M=8.36±3.14. As a result of the analysis carried out in order to determine the influence of nurses’ perception of organizational justice upon the perception of management and the intention of quitting in accordance with the values, it has been pointed out that the Perception of Organizational Justice influenced the perception of Management by Values positively, Intention to Leave negatively.

Keywords: intention to leave, management by values, nursing, organizational justice

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766 Prioritizing Ecosystem Services for South-Central Regions of Chile: An Expert-Based Spatial Multi-Criteria Approach

Authors: Yenisleidy Martinez Martinez, Yannay Casas-Ledon, Jo Dewulf

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The ecosystem services (ES) concept has contributed to draw attention to the benefits ecosystems generate for people and how necessary natural resources are for human well-being. The identification and prioritization of the ES constitute the first steps to undertake conservation and valuation initiatives on behalf of people. Additionally, mapping the supply of ES is a powerful tool to support decision making regarding the sustainable management of landscape and natural resources. In this context, the present study aimed to identify, prioritize and map the primary ES in Biobio and Nuble regions using a methodology that combines expert judgment, multi-attribute evaluation methods, and Geographic Information Systems (GIS). Firstly, scores about the capacity of different land use/cover types to supply ES and the importance attributed to each service were obtained from experts and stakeholders via an online survey. Afterward, the ES assessment matrix was constructed, and the weighted linear combination (WLC) method was applied to mapping the overall capacity of supply of provisioning, regulating and maintenance, and cultural services. Finally, prioritized ES for the study area were selected and mapped. The results suggest that native forests, wetlands, and water bodies have the highest supply capacities of ES, while urban and industrial areas and bare areas have a very low supply of services. On the other hand, fourteen out of twenty-nine services were selected by experts and stakeholders as the most relevant for the regions. The spatial distribution of ES has shown that the Andean Range and part of the Coastal Range have the highest ES supply capacity, mostly regulation and maintenance and cultural ES. This performance is related to the presence of native forests, water bodies, and wetlands in those zones. This study provides specific information about the most relevant ES in Biobio and Nuble according to the opinion of local stakeholders and the spatial identification of areas with a high capacity to provide services. These findings could be helpful as a reference by planners and policymakers to develop landscape management strategies oriented to preserve the supply of services in both regions.

Keywords: ecosystem services, expert judgment, mapping, multi-criteria decision making, prioritization

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765 Cluster Randomized Trial of 'Ready to Learn': An After-School Literacy Program for Children Starting School

Authors: Geraldine Macdonald, Oliver Perra, Nina O’Neill, Laura Neeson, Kathryn Higgins

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Background: Despite improvements in recent years, almost one in six children in Northern Ireland (NI) leaves primary school without achieving the expected level in English and Maths. By early adolescence, this ratio is one in five. In 2010-11, around 9000 pupils in NI had failed to achieve the required standard in literacy and numeracy by the time they left full-time education. This paper reports the findings of an experimental evaluation of a programmed designed to improve educational outcomes of a cohort of children starting primary school in areas of high social disadvantage in Northern Ireland. The intervention: ‘Ready to Learn’ comprised two key components: a literacy-rich After School programme (one hour after school, three days per week), and a range of activities and support to promote the engagement of parents with their children’s learning, in school and at home. The intervention was delivered between September 2010 and August 2013. Study aims and objectives: The primary aim was to assess whether, and to what extent, ‘Ready to Learn’ improved the literacy of socially disadvantaged children entering primary schools compared with children in schools without access to the programme. Secondary aims included assessing the programme’s impact on children’s social, emotional and behavioural regulation, and parents’ engagement with their children’s learning. In total, 505 children (almost all) participated in the baseline assessment for the study, with good retention over seven sweeps of data collection. Study design: The intervention was evaluated by means of a cluster randomized trial, with schools as the unit of randomization and analysis. It included a qualitative component designed to examine process and implementation, and to explore the concept of parental engagement. Sixteen schools participated, with nine randomized to the experimental group. As well as outcome data relating to children, 134 semi-structured interviews were conducted with parents over the three years of the study, together with 88 interviews with school staff. Results: Given the children’s ages, not all measures used were direct measures of reading. Findings point to a positive impact of “Ready to Learn” on children’s reading achievement (comprehension and fluency), as assessed by the York Assessment of Reading Comprehension (YARC) and decoding, assessed using the Word Recognition and Phonic Skills (WRaPS3). Effects were not large, but evidence suggests that it is unusual for an after school programme to clearly to demonstrate effects on reading skills. No differences were found on three other measures of literacy-related skills: British Picture Vocabulary Scale (BPVS-II), Naming Speed and Non-word Reading Tests from the Phonological Assessment Battery (PhAB) or Concepts about Print (CAP) – the last due to an age-related ceiling effect). No differences were found between the two groups on measures of social, emotional and behavioural regulation, and due to low levels of participation, it was not possible directly to assess the contribution of the parent component to children’s outcomes. The qualitative data highlighted conflicting concepts of engagement between parents and school staff. Ready to Learn is a promising intervention that merits further support and evaluation.

Keywords: after-school, education, literacy, parental engagement

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764 Grain Structure Evolution during Friction-Stir Welding of 6061-T6 Aluminum Alloy

Authors: Aleksandr Kalinenko, Igor Vysotskiy, Sergey Malopheyev, Sergey Mironov, Rustam Kaibyshev

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From a thermo-mechanical standpoint, friction-stir welding (FSW) represents a unique combination of very large strains, high temperature and relatively high strain rate. The material behavior under such extreme deformation conditions is not studied well and thus, the microstructural examinations of the friction-stir welded materials represent an essential academic interest. Moreover, a clear understanding of the microstructural mechanisms operating during FSW should improve our understanding of the microstructure-properties relationship in the FSWed materials and thus enables us to optimize their service characteristics. Despite extensive research in this field, the microstructural behavior of some important structural materials remains not completely clear. In order to contribute to this important work, the present study was undertaken to examine the grain structure evolution during the FSW of 6061-T6 aluminum alloy. To provide an in-depth insight into this process, the electron backscatter diffraction (EBSD) technique was employed for this purpose. Microstructural observations were conducted by using an FEI Quanta 450 Nova field-emission-gun scanning electron microscope equipped with TSL OIMTM software. A suitable surface finish for EBSD was obtained by electro-polishing in a solution of 25% nitric acid in methanol. A 15° criterion was employed to differentiate low-angle boundaries (LABs) from high-angle boundaries (HABs). In the entire range of the studied FSW regimes, the grain structure evolved in the stir zone was found to be dominated by nearly-equiaxed grains with a relatively high fraction of low-angle boundaries and the moderate-strength B/-B {112}<110> simple-shear texture. In all cases, the grain-structure development was found to be dictated by an extensive formation of deformation-induced boundaries, their gradual transformation to the high-angle grain boundaries. Accordingly, the grain subdivision was concluded to the key microstructural mechanism. Remarkably, a gradual suppression of this mechanism has been observed at relatively high welding temperatures. This surprising result has been attributed to the reduction of dislocation density due to the annihilation phenomena.

Keywords: electron backscatter diffraction, friction-stir welding, heat-treatable aluminum alloys, microstructure

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763 Effects of Bedside Rehabilitation of Stroke Patients in Activities and Daily Living Function

Authors: Chiung-Hua Chan, Fang-Yuan Chang, Li-Chi Huang

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Stroke patients received regular rehabilitation therapy have measurable advancement in muscle strength, balance, control upper and lower physical activity, walking speed and endurance. This study aimed to investigate the relationship between increases in bedside rehabilitation time and the function of activities and daily living (ADL) in stroke patients. The study was quasi-experimental research design and randomized sampling. The researcher collected 12 stroke patients of stroke patients transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. All participants then were assigned to case group and control group. Data collection was through direct observation of assessment ADL of stroke patients by researchers on Day 1. Case group received regular rehabilitation, exercises in increase of bedside rehabilitation schedules exercise programs by ward nurses. Bedside rehabilitation exercise content with physical, functional and linguistic frequency and time, Control group only give routine rehabilitation schedule care. This was a randomized study performed in 12 patients who were stroke patients and transferred to rehabilitation ward unit of a medical center during 1 January to 31 March 2017. First, the researcher explained the purpose and method of the study to the patients or the family members. All participants completed a consent informed before participation. Patients were randomly assigned to a ‘bedside rehabilitation program’ (BRP) group and a control (C) group. The BRP group received bedside rehabilitation schedules exercise programs by ward nurses. while the C group did not. Both groups received routine rehabilitation schedule. The Functional Independence Measure was used to measure outcome at the first, 14th and the 28th day of rehabilitation ward admitted. Data were analyzed using SPSS 22.0. After implementation of standardized ‘‘bedside rehabilitation program’, the results were: (1) the increasing of bedside rehabilitation had significant difference (p<.05) in promotion ADL function of stroke patients (2) the extend time of the bedside rehabilitation has significant difference (p<.05) in promotion ADL function of stroke patients compared with the control group. This study demonstrated that the ‘bedside rehabilitation program’ enhanced the ADL function in stroke patients. The nurses and rehabilitation ward managers need to understand that the extend time and frequency of rehabilitation provide a chance to enhanced the ADL function of stroke patients.

Keywords: stroke, bedside rehabilitation, functional activity, ADL

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762 Learning to Teach in Large Classrooms: Training Faculty Members from Milano Bicocca University, from Didactic Transposition to Communication Skills

Authors: E. Nigris, F. Passalacqua

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Relating to the recent researches in the field of faculty development, this paper aims to present a pilot training programme realized at the University of Milano-Bicocca to improve teaching skills of faculty members. A total of 57 professors (both full professors and associate professors) were trained during the pilot programme in three editions of the workshop, focused on promoting skills for teaching large classes. The study takes into account: 1) the theoretical framework of the programme which combines the recent tradition about professional development and the research on in-service training of school teachers; 2) the structure and the content of the training programme, organized in a 12 hours-full immersion workshop and in individual consultations; 3) the educational specificity of the training programme which is based on the relation between 'general didactic' (active learning metholodies; didactic communication) and 'disciplinary didactics' (didactic transposition and reconstruction); 4) results about the impact of the training programme, both related to the workshop and the individual consultations. This study aims to provide insights mainly on two levels of the training program’s impact ('behaviour change' and 'transfer') and for this reason learning outcomes are evaluated by different instruments: a questionnaire filled out by all 57 participants; 12 in-depth interviews; 3 focus groups; conversation transcriptions of workshop activities. Data analysis is based on a descriptive qualitative approach and it is conducted through thematic analysis of the transcripts using analytical categories derived principally from the didactic transposition theory. The results show that the training programme developed effectively three major skills regarding different stages of the 'didactic transposition' process: a) the content selection; a more accurated selection and reduction of the 'scholarly knowledge', conforming to the first stage of the didactic transposition process; b) the consideration of students’ prior knowledge and misconceptions within the lesson design, in order to connect effectively the 'scholarly knowledge' to the 'knowledge to be taught' (second stage of the didactic transposition process); c) the way of asking questions and managing discussion in large classrooms, in line with the transformation of the 'knowledge to be taught' in 'taught knowledge' (third stage of the didactic transposition process).

Keywords: didactic communication, didactic transposition, instructional development, teaching large classroom

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761 Land Suitability Analysis Based on Ecosystems Service Approach for Wind Farm Location in South-Central Chile: Net Primary Production as Proxy

Authors: Yenisleidy Martínez-Martínez, Yannay Casas-Ledón, Jo Dewulf

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Wind power constitutes a cleaner energy source with smaller unfavorable impacts on the environment than fossil fuels. Its development could be an alternative to fight climate change while meeting energy demands. However, wind energy development requires first determining the existing potential and areas with aptitude. Also, potential socio-economic and environmental impacts should be analyzed to prevent social rejection of this technology. In this context, this work performs a suitability assessment on a GIS environment to locate suitable areas for wind energy expansion in South-Central Chile. In addition, suitable areas were characterized in terms of potential goods and services to be produced as a proxy for analyzing potential impacts and trade-offs. First, layers of annual wind speed were generated as they represent the resource potential, and layer representing previously defined territorial constraints were created. Zones depicting territorial constraints were removed from resource measurement layers to identify suitable sites. Then, the appropriation of the primary production in suitable sites was determined to measure potential ecosystem services derived from human interventions in those areas. Results show that approximately 52% of the total surface of the study area has a good aptitude to install wind farms. In this area, provisioning services like food crops production, timber, and other forest resources like firewood play a key role in the regional economy and thus are the main cause of human interventions. This is reflected by human appropriation of the primary production values of 0.71 KgC/m².yr, 0.36 KgC/m².yr, and 0.14 KgC/m².yr, respectively. In this sense, wind energy development could be compatible with croplands, which is the predominant land use in suitable areas, and provide farmers with cheaper energy and extra income. Also, studies have reported changes in local temperature associated with wind turbines, which could be beneficial to crop growth. The results obtained in this study prove to be useful for identifying available areas for wind development, which could be very useful in decision-making processes related to energy planning.

Keywords: net primary productivity, provisioning services, suitability assessment, wind energy

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760 Experimental Study of Moisture Effect on the Mechanical Behavior of Flax Fiber Reinforcement

Authors: Marwa Abida, Florian Gehring, Jamel Mars, Alexandre Vivet, Fakhreddine Dammak, Mohamed Haddar

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The demand for bio-based materials in semi-structural and structural applications is constantly growing to conform to new environmental policies. Among them, Plant Fiber Reinforced Composites (PFRC) are attractive for the scientific community as well as the industrial world. Due to their relatively low densities and low environmental impact, vegetal fibers appear to be suitable as reinforcing materials for polymers. However, the major issue of plant fibers and PFRC in general is their hydrophilic behavior (high affinity to water molecules). Indeed, when absorbed, water causes fiber swelling and a loss of mechanical properties. Thus, the environmental loadings (moisture, temperature, UV) can strongly affect their mechanical properties and therefore play a critical role in the service life of PFRC. In order to analyze the influence of conditioning at relative humidity on the behavior of flax fiber reinforced composites, a preliminary study on flax fabrics has been conducted. The conditioning of the fabrics in different humid atmospheres made it possible to study the influence of the water content on the hygro-mechanical behavior of flax reinforcement through mechanical tensile tests. This work shows that increasing the relative humidity of the atmosphere induces an increase of the water content in the samples. It also brings up the significant influence of water content on the stiffness and elongation at break of the fabric, while no significant change of the breaking load is detected. Non-linear decrease of flax fabric rigidity and increase of its elongation at maximal force with the increase of water content are observed. It is concluded that water molecules act as a softening agent on flax fabrics. Two kinds of typical tensile curves are identified. Most of the tensile curves of samples show one unique linear region where the behavior appears to be linear prior to the first yarn failure. For some samples in which water content is between 2.7 % and 3.7 % (regardless the conditioning atmosphere), the emergence of a two-linear region behavior is pointed out. This phenomenon could be explained by local heterogeneities of water content which could induce premature local plasticity in some regions of the flax fabric sample behavior.

Keywords: hygro-mechanical behavior, hygroscopy, flax fabric, relative humidity, mechanical properties

Procedia PDF Downloads 174
759 Fast Track to the Physical Internet: A Cross-Industry Project from Upper Austria

Authors: Laura Simmer, Maria Kalt, Oliver Schauer

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Freight transport is growing fast, but many vehicles are empty or just partially loaded. The vision and concepts of the Physical Internet (PI) proposes to eliminate these inefficiencies. Aiming for a radical sustainability improvement, the PI – inspired by the Digital Internet – is a hyperconnected global logistic system, enabling seamless asset sharing and flow consolidation. The implementation of a PI in its full expression will be a huge challenge: the industry needs innovation and implementation support including change management approaches, awareness creation and good practices diffusion, legislative actions to remove antitrust and international commerce barriers, standardization and public incentives policies. In order to take a step closer to this future the project ‘Atropine - Fast Track to the Physical Internet’ funded under the Strategic Economic and Research Program ‘Innovative Upper Austria 2020’ was set up. The two-year research project unites several research partners in this field, but also industrial partners and logistics service providers. With Atropine, the consortium wants to actively shape the mobility landscape in Upper Austria and make an innovative contribution to an energy-efficient, environmentally sound and sustainable development in the transport area. This paper should, on the one hand, clarify the questions what the project Atropine is about and, on the other hand, how a proof of concept will be reached. Awareness building plays an important role in the project as the PI requires a reorganization of the supply chain and the design of completely new forms of inter-company co-operation. New business models have to be developed and should be verified by simulation. After the simulation process one of these business models will be chosen and tested in real life with the partner companies. The developed results - simulation model and demonstrator - are used to determine how the concept of the PI can be applied in Upper Austria. Atropine shall pave the way for a full-scale development of the PI vision in the next few decades and provide the basis for pushing the industry toward a new level of co-operation with more shared resources and increased standardization.

Keywords: Atropine, inter-company co-operation, Physical Internet, shared resources, sustainable logistics

Procedia PDF Downloads 205
758 Assessing In-Country Public Health Training Needs: Workforce Development to Meet Sustainable Development Goals

Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

Procedia PDF Downloads 179
757 Traditional Wisdom of Indigenous Vernacular Architecture as Tool for Climate Resilience Among PVTG Indigenous Communities in Jharkhand, India

Authors: Ankush, Harshit Sosan Lakra, Rachita Kuthial

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Climate change poses significant challenges to vulnerable communities, particularly indigenous populations in ecologically sensitive regions. Jharkhand, located in the heart of India, is home to several indigenous communities, including the Particularly Vulnerable Tribal Groups (PVTGs). The Indigenous architecture of the region functions as a significant reservoir of climate adaptation wisdom. It explores the architectural analysis encompassing the construction materials, construction techniques, design principles, climate responsiveness, cultural relevance, adaptation, integration with the environment and traditional wisdom that has evolved through generations, rooted in cultural and socioeconomic traditions, and has allowed these communities to thrive in a variety of climatic zones, including hot and dry, humid, and hilly terrains to withstand the test of time. Despite their historical resilience to adverse climatic conditions, PVTG tribal communities face new and amplified challenges due to the accelerating pace of climate change. There is a significant research void that exists in assimilating their traditional practices and local wisdom into contemporary climate resilience initiatives. Most of the studies place emphasis on technologically advanced solutions, often ignoring the invaluable Indigenous Local knowledge that can complement and enhance these efforts. This research gap highlights the need to bridge the disconnect between indigenous knowledge and contemporary climate adaptation strategies. The study aims to explore and leverage indigenous knowledge of vernacular architecture as a strategic tool for enhancing climatic resilience among PVTGs of the region. The first objective is to understand the traditional wisdom of vernacular architecture by analyzing and documenting distinct architectural practices and cultural significance of PVTG communities, emphasizing construction techniques, materials and spatial planning. The second objective is to develop culturally sensitive climatic resilience strategies based on findings of vernacular architecture by employing a multidisciplinary research approach that encompasses ethnographic fieldwork climate data assessment considering multiple variables such as temperature variations, precipitation patterns, extreme weather events and climate change reports. This will be a tailor-made solution integrating indigenous knowledge with modern technology and sustainable practices. With the involvement of indigenous communities in the process, the research aims to ensure that the developed strategies are practical, culturally appropriate, and accepted. To foster long-term resilience against the global issue of climate change, we can bridge the gap between present needs and future aspirations with Traditional wisdom, offering sustainable solutions that will empower PVTG communities. Moreover, the study emphasizes the significance of preserving and reviving traditional Architectural wisdom for enhancing climatic resilience. It also highlights the need for cooperative endeavors of communities, stakeholders, policymakers, and researchers to encourage integrating traditional Knowledge into Modern sustainable design methods. Through these efforts, this research will contribute not only to the well-being of PVTG communities but also to the broader global effort to build a more resilient and sustainable future. Also, the Indigenous communities like PVTG in the state of Jharkhand can achieve climatic resilience while respecting and safeguarding the cultural heritage and peculiar characteristics of its native population.

Keywords: vernacular architecture, climate change, resilience, PVTGs, Jharkhand, indigenous people, India

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756 Examination of Teacher Candidates Attitudes Towards Disabled Individuals Employment in terms of Various Variables

Authors: Tuna Şahsuvaroğlu

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The concept of disability is a concept that has been the subject of many studies in national and international literature with its social, sociological, political, anthropological, economic and social dimensions as well as with individual and social consequences. A disabled person is defined as a person who has difficulties in adapting to social life and meeting daily needs due to loss of physical, mental, spiritual, sensory and social abilities to various degrees, either from birth or for any reason later, and they are in need of protection, care, rehabilitation, counseling and support services. The industrial revolution and the rapid industrialization it brought with it led to an increase in the rate of disabilities resulting from work accidents, in addition to congenital disabilities. This increase has resulted in disabled people included in the employment policies of nations as a disadvantaged group. Although the participation of disabled individuals in the workforce is of great importance in terms of both increasing their quality of life and their integration with society and although disabled individuals are willing to participate in the workforce, they encounter with many problems. One of these problems is the negative attitudes and prejudices that develop in society towards the employment of disabled individuals. One of the most powerful ways to turn these negative attitudes and prejudices into positive ones is education. Education is a way of guiding societies and transferring existing social characteristics to future generations. This can be maintained thanks to teachers, who are one of the most dynamic parts of society and act as the locomotive of education driven by the need to give direction and transfer and basically to help and teach. For this reason, there is a strong relationship between the teaching profession and the attitudes formed in society towards the employment of disabled individuals, as they can influence each other. Therefore, the purpose of this study is to examine teacher candidates' attitudes towards the employment of disabled individuals in terms of various variables. The participants of the study consist of 665 teacher candidates studying at various departments at Marmara University Faculty of Education in the 2022-2023 academic year. The descriptive survey model of the general survey model was used in this study as it intends to determine the attitudes of teacher candidates towards the employment of disabled individuals in terms of different variables. The Attitude Scale Towards Employment of Disabled People was used to collect data. The data were analyzed according to the variables of age, gender, marital status, the department, and whether there is a disabled relative in the family, and the findings were discussed in the context of further research.

Keywords: teacher candidates, disabled, attitudes towards the employment of disabled people, attitude scale towards the employment of disabled people

Procedia PDF Downloads 49
755 Shades of Violence – Risks of Male Violence Exposure for Mental and Somatic-Disorders and Risk-Taking Behavior: A Prevalence Study

Authors: Dana Cassandra Winkler, Delia Leiding, Rene Bergs, Franziska Kaiser, Ramona Kirchhart, Ute Habel

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Background: Violence is a multidimensional phenomenon, affecting people of every age, socio-economic status and gender. Nevertheless, most studies primarily focus on men perpetrating women. Aim of the present study is to identify the likelihood of mental and somatic disorders and risk-taking behavior in male violence affected. In addition, the relationship between age of violence experience and the risk for health-related problems was analyzed. Method: On the basis of current evidence, a questionnaire was developed focusing on demographic background, health status, risk-taking behavior, and active and passive violence exposure. In total, 5221 males (Mean: 56,1 years, SD: 17,6) were consulted. To account for the time of violence experience in an efficient way, age clusters ‘0-12 years’, ‘13-20 years’, ‘21-35 years’, ‘36-65 years’ and ‘over 65 years’ were defined. A binary logistic regression was calculated to reveal differences in violence-affected and non-violence affected males regarding health and risk-taking factors. Males who experienced violence on a daily/ almost daily basis vs. males who reported violence occurrence once/ several times a month/ year were compared with respect to health factors and risk-taking behavior. Data of males, who indicated active and passive violence exposure, were analyzed by a chi²-analysis, to investigate a possible relation between the age of victimization and violence perpetration. Findings: Results imply that general violence experience, independent of active and passive violence exposure increases the likelihood in favor of somatic-, psychosomatic- and mental disorders as well as risk-taking behavior in males. Experiencing violence on a daily or almost daily basis in childhood and adolescence may serve as a predictor for increased health problems and risk-taking behavior. Furthermore, the violence experience and perpetration occur significantly within the same age cluster. This underlines the importance of a near-term intervention to minimize the risk, that victims become perpetrators later. Conclusion: The present study reveals predictors concerning health risk factors as well as risk-taking behavior in males with violence exposure. The results of this study may underscore the benefit of intervention and regular health care approaches in violence-affected males and underline the importance of acknowledging the overlap of violence experience and perpetration for further research.

Keywords: health disease, male, mental health, prevalence, risk-taking behavior, violence

Procedia PDF Downloads 195
754 Carbapenem Usage in Medical Wards: An Antibiotic Stewardship Feedback Project

Authors: Choon Seong Ng, P. Petrick, C. L. Lau

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Background: Carbapenem-resistant isolates have been increasingly reported recently. Carbapenem stewardship is designed to optimize its usage particularly among medical wards with high prevalence of carbapenem prescriptions to combat such emerging resistance. Carbapenem stewardship programmes (CSP) can reduce antibiotic use but clinical outcome of such measures needs further evaluation. We examined this in a prospective manner using feedback mechanism. Methods: Our single-center prospective cohort study involved all carbapenem prescriptions across the medical wards (including medical patients admitted to intensive care unit) in a tertiary university hospital setting. The impact of such stewardship was analysed according to the accepted and the rejected groups. The primary endpoint was safety. Safety measure applied in this study was the death at 1 month. Secondary endpoints included length of hospitalisation and readmission. Results: Over the 19 months’ period, input from 144 carbapenem prescriptions was analysed on the basis of acceptance of our CSP recommendations on the use of carbapenems. Recommendations made were as follows : de-escalation of carbapenem; stopping the carbapenem; use for a short duration of 5-7 days; required prolonged duration in the case of carbapenem-sensitive Extended Spectrum Beta-Lactamases bacteremia; dose adjustment; and surgical intervention for removal of septic foci. De-escalation, shorten duration of carbapenem and carbapenem cessation comprised 79% of the recommendations. Acceptance rate was 57%. Those who accepted CSP recommendations had no increase in mortality (p = 0.92), had a shorter length of hospital stay (LOS) and had cost-saving. Infection-related deaths were found to be higher among those in the rejected group. Moreover, three rejected cases (6%) among all non-indicated cases (n = 50) were found to have developed carbapenem-resistant isolates. Lastly, Pitt’s bacteremia score appeared to be a key element affecting the carbapenem prescription’s behaviour in this trial. Conclusions: Carbapenem stewardship program in the medical wards not only saves money, but most importantly it is safe and does not harm the patients with added benefits of reducing the length of hospital stay. However, more time is needed to engage the primary clinical teams by formal clinical presentation and immediate personal feedback by senior Infectious Disease (ID) personnel to increase its acceptance.

Keywords: audit and feedback, carbapenem stewardship, medical wards, university hospital

Procedia PDF Downloads 192
753 Social Participation and Associated Life Satisfaction among Older Adults in India: Moderating Role of Marital Status and Living Arrangements

Authors: Varsha Pandurang Nagargoje, K. S. James

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Background: Social participation is considered as one of the central components of successful and healthy aging. This study aimed to examine the moderating role of marital status and living arrangement in the relationship between social participation and life satisfaction and other potential factors associated with life satisfaction of Indian older adults. Method: For analyses, the nationally representative study sample of 31,464 adults aged ≥60 years old was extracted from the Longitudinal Ageing Study in India (LASI) wave 1, 2017-18. Descriptive statistics and bivariate analysis have been performed to determine the proportion of life satisfaction. The first set of multivariable linear regression analyses examined Diener’s Satisfaction with Life Scale and its association with various predictor variables, including social participation, marital status, living arrangements, socio-demographic, economic, and health-related variables. Further, the second and third sets of regression investigated the moderating role of marital status and living arrangements respectively in the association of social participation and level of life satisfaction among Indian older adults. Results: Overall, the proportion of life satisfaction among older men was relatively higher than women counterparts in most background characteristics. Regression results stressed the importance of older adults’ involvement in social participation [β = 0.39, p < 0.05], being in marital union [β = 0.68, p < 0.001] and co-residential living arrangements either only with spouse [β = 1.73, p < 0.001] or with other family members [β = 2.18, p < 0.001] for the improvement of life satisfaction. Results also showed that some factors were significant for life satisfaction: in particular, increased age, having a higher level of educational status, MPCE quintile, and caste category. Higher risk of life dissatisfaction found among Indian older adults who were exposed to vulnerabilities like consuming tobacco, poor self-rated health, having difficulty in performing ADL and IADL were of major concern. The interaction effect of social participation with marital status or with living arrangements explained that currently married older individuals, and those older adults who were either co-residing with their spouse only or with other family members irrespective of their involvement in social participation remained an important modifiable factor for life satisfaction. Conclusion: It would be crucial for policymakers and practitioners to advocate social policy programs and service delivery oriented towards meaningful social connections, especially for those Indian older adults who were staying alone or currently not in the marital union to enhance their overall life satisfaction.

Keywords: Indian, older adults, social participation, life satisfaction, marital status, living arrangement

Procedia PDF Downloads 116
752 Nanorods Based Dielectrophoresis for Protein Concentration and Immunoassay

Authors: Zhen Cao, Yu Zhu, Junxue Fu

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Immunoassay, i.e., antigen-antibody reaction, is crucial for disease diagnostics. To achieve the adequate signal of the antigen protein detection, a large amount of sample and long incubation time is needed. However, the amount of protein is usually small at the early stage, which makes it difficult to detect. Unlike cells and DNAs, no valid chemical method exists for protein amplification. Thus, an alternative way to improve the signal is through particle manipulation techniques to concentrate proteins, among which dielectrophoresis (DEP) is an effective one. DEP is a technique that concentrates particles to the designated region through a force created by the gradient in a non-uniform electric field. Since DEP force is proportional to the cube of particle size and square of electric field gradient, it is relatively easy to capture larger particles such as cells. For smaller ones like proteins, a super high gradient is then required. In this work, three-dimensional Ag/SiO2 nanorods arrays, fabricated by an easy physical vapor deposition technique called as oblique angle deposition, have been integrated with a DEP device and created the field gradient as high as of 2.6×10²⁴ V²/m³. The nanorods based DEP device is able to enrich bovine serum albumin (BSA) protein by 1800-fold and the rate has reached 180-fold/s when only applying 5 V electric potential. Based on the above nanorods integrated DEP platform, an immunoassay of mouse immunoglobulin G (IgG) proteins has been performed. Briefly, specific antibodies are immobilized onto nanorods, then IgG proteins are concentrated and captured, and finally, the signal from fluorescence-labelled antibodies are detected. The limit of detection (LoD) is measured as 275.3 fg/mL (~1.8 fM), which is a 20,000-fold enhancement compared with identical assays performed on blank glass plates. Further, prostate-specific antigen (PSA), which is a cancer biomarker for diagnosis of prostate cancer after radical prostatectomy, is also quantified with a LoD as low as 2.6 pg/mL. The time to signal saturation has been significantly reduced to one minute. In summary, together with an easy nanorod fabrication and integration method, this nanorods based DEP platform has demonstrated highly sensitive immunoassay performance and thus poses great potentials in applications for early point-of-care diagnostics.

Keywords: dielectrophoresis, immunoassay, oblique angle deposition, protein concentration

Procedia PDF Downloads 88
751 The Use of Venous Glucose, Serum Lactate and Base Deficit as Biochemical Predictors of Mortality in Polytraumatized Patients: Acomparative with Trauma and Injury Severity Score and Acute Physiology and Chronic Health Evalution IV

Authors: Osama Moustafa Zayed

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Aim of the work: To evaluate the effectiveness of venous glucose, levels of serum lactate and base deficit in polytraumatized patients as simple parameters to predict the mortality in these patients. Compared to the predictive value of Trauma and injury severity (TRISS) and Acute Physiology And Chronic Health Evaluation IV (APACHE IV). Introduction: Trauma is a serious global health problem, accounting for approximately one in 10 deaths worldwide. Trauma accounts for 5 million deaths per year. Prediction of mortality in trauma patients is an important part of trauma care. Several trauma scores have been devised to predict injury severity and risk of mortality. The trauma and injury severity score (TRISS) was most common used. Regardless of the accuracy of trauma scores, is based on an anatomical description of every injury and cannot be assigned to the patients until a full diagnostic procedure has been performed. So we hypothesized that alterations in admission glucose, lactate levels and base deficit would be an early and easy rapid predictor of mortality. Patient and Method: a comparative cross-sectional study. 282 Polytraumatized patients attended to the Emergency Department(ED) of the Suez Canal university Hospital constituted. The period from 1/1/2012 to 1/4/2013 was included. Results: We found that the best cut off value of TRISS probability of survival score for prediction of mortality among poly-traumatized patients is = 90, with 77% sensitivity and 89% specificity using area under the ROC curve (0.89) at (95%CI). APACHE IV demonstrated 67% sensitivity and 95% specificity at 95% CI at cut off point 99. The best cutoff value of Random Blood Sugar (RBS) for prediction of mortality was>140 mg/dl, with 89%, sensitivity, 49% specificity. The best cut off value of base deficit for prediction of mortality was less than -5.6 with 64% sensitivity, 93% specificity. The best cutoff point of lactate for prediction of mortality was > 2.6 mmol/L with 92%, sensitivity, 42% specificity. Conclusion: According to our results from all evaluated predictors of mortality (laboratory and scores) and mortality based on the estimated cutoff values using ROC curves analysis, the highest risk of mortality was found using a cutoff value of 90 in TRISS score while with laboratory parameters the highest risk of mortality was with serum lactate > 2.6 . Although that all of the three parameter are accurate in predicting mortality in poly-traumatized patients and near with each other, as in serum lactate the area under the curve 0.82, in BD 0.79 and 0.77 in RBS.

Keywords: APACHE IV, emergency department, polytraumatized patients, serum lactate

Procedia PDF Downloads 278
750 Interactive Garments: Flexible Technologies for Textile Integration

Authors: Anupam Bhatia

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Upon reviewing the literature and the pragmatic work done in the field of E- textiles, it is observed that the applications of wearable technologies have found a steady growth in the field of military, medical, industrial, sports; whereas fashion is at a loss to know how to treat this technology and bring it to market. The purpose of this paper is to understand the practical issues of integration of electronics in garments; cutting patterns for mass production, maintaining the basic properties of textiles and daily maintenance of garments that hinder the wide adoption of interactive fabric technology within Fashion and leisure wear. To understand the practical hindrances an experimental and laboratory approach is taken. “Techno Meets Fashion” has been an interactive fashion project where sensor technologies have been embedded with textiles that result in set of ensembles that are light emitting garments, sound sensing garments, proximity garments, shape memory garments etc. Smart textiles, especially in the form of textile interfaces, are drastically underused in fashion and other lifestyle product design. Clothing and some other textile products must be washable, which subjects to the interactive elements to water and chemical immersion, physical stress, and extreme temperature. The current state of the art tends to be too fragile for this treatment. The process for mass producing traditional textiles becomes difficult in interactive textiles. As cutting patterns from larger rolls of cloth and sewing them together to make garments breaks and reforms electronic connections in an uncontrolled manner. Because of this, interactive fabric elements are integrated by hand into textiles produced by standard methods. The Arduino has surely made embedding electronics into textiles much easier than before; even then electronics are not integral to the daily wear garments. Soft and flexible interfaces of MEMS (micro sensors and Micro actuators) can be an option to make this possible by blending electronics within E-textiles in a way that’s seamless and still retains functions of the circuits as well as the garment. Smart clothes, which offer simultaneously a challenging design and utility value, can be only mass produced if the demands of the body are taken care of i.e. protection, anthropometry, ergonomics of human movement, thermo- physiological regulation.

Keywords: ambient intelligence, proximity sensors, shape memory materials, sound sensing garments, wearable technology

Procedia PDF Downloads 374
749 Yoga as a Tool for Public Health

Authors: Divya Kanchibhotla

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Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

Procedia PDF Downloads 175
748 Feasibility of Online Health Coaching for Canadian Armed Forces Personnel Receiving Treatment for Depression, Anxiety and PTSD

Authors: Noah Wayne, Andrea Tuka, Adrian Norbash, Bryan Garber, Paul Ritvo

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Program/Intervention Description: The Canadian Armed Forces(CAF) Mental Health Clinicstreat a full spectrum of mental disorder, addictions, and psychosocial issues that include Major Depressive Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, and other diagnoses. We evaluated the feasibility of an online health coach interventiondelivering mindfulness based cognitive behavioral therapy (M-CBT) and behaviour changesupport for individuals receiving treatment at CAF Clinics. Participants were provided accounts on NexJ Connected Wellness, a digital health platform, and 16 weeks of phone-based health coaching,emphasizingmild to moderate aerobic exercise, a healthy diet, and M-CBT content. The primary objective was to assess the feasibility of the online deliverywith CAF members. Evaluation Methods: Feasibility was evaluated in terms of recruitment, engagement, and program satisfaction. Weadditionallyevaluatedhealth behavior change, program completion, and mental health symptoms (i.e. PHQ-9, GAD-7, PCL-5) at three time points. Results: Service members were referred from Vancouver, Esquimalt, and Edmonton CAF bases between August 2020 and January 2021. N=106 CAF personnel were referred, and n=77 consented.N=66 participated, and n=44 completed 4-month and follow-up measures. The platform received a mean rating of76.5 on the System Usability Scale, and health coaching was judged the most helpful program feature (95.2% endorsement), while reminders (53.7%), secure messaging (51.2%), and notifications (51.2%) were also identified. Improvements in mental health status during active interventions were observed on the PHQ-9 (-5.4, p<0.001), GAD-7 (-4.0, p<0.001), and PCL-5 (-4.1, p<0.05). Conclusion: Online health coaching was well-received amidst the COVID-19 pandemic and related lockdowns. Uptake and engagement were positively reported. Participants valuedcontacts and reported strong therapeutic alliances with coaches. Healthy diet, regular exercise, and mindfulness practice are important for physical and mental health. Engagements in these behaviors are associated with reduced symptoms. An online health coach program appears feasible for assisting Canadian Armed Forces personnel.

Keywords: coaching, CBT, military, depression, mental health, digital

Procedia PDF Downloads 140
747 The Awareness of Sustainability Concerns in Design Studio Education Process: A Case from TOBB ETU University, Interior Architecture Department in Turkey

Authors: Pelin Atav, Gözen Güner Aktaş, Nur Ayalp

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Today’s world has started to develop design process within an interdisciplinary working environment. There is an aim of creating the most permanent design for the future. While satisfying people’s needs, environment and people relationships should be considered. When this relationship was considered for the future, the sustainability term comes to mind. The term Sustainability has been adapted very well by designer and architects. It is also one of the main and significant parts of the design process. As the education process cultivates the future professionals, the awareness of those concepts in the education process has a vital importance. The question is stated as thus: Are the 3rd and 4th year design studio students, familiar and sensitive to the concept of sustainability in the TOBB ETU University Interior Design Studio. Design studios and the instructors should be taken into consideration while this sustainability term is taught. The term "Sustainability" can not be learned without making any application in the actual real world. While students make this study, They can have the chance to search the topic of sustainability step by step. Due to having various extent, sustainability term becomes quite a comprehensive issue. In order not to create negative consequences, designers and architects work by adapting this term. In terms of material, construction process, lighting, building service, furniture, systems that are used, energy consumption issues that are considered and creating positive drawbacks for the future are aimed. This research is aimed at how university education shapes designer’s works in terms of sustainability. By giving a project that is a main interest in the field of sustainability, students are expected to reach well-thought-of results and analysis. Project process were conducted with instructor and student studies together. According to critics from their instructors, students try to product well- designed results. TOBB University was choosen as a research area situated in Ankara in Turkey. Third and fourth class (interior designer/architect department) students who are from the Faculty of Fine Arts Design and Architecture are the subject group selected for this study. Aim of this study is demonstrating sustainability as a term having application in design studio. Thus, awareness of sustainability terms will be evaluated and its development process in the university education will be observed. Consequently, results that are expected is how sustainability term is conducted in project and for the sustainability term awareness in design studios and their projects have been sufficient or not.

Keywords: design education, design process, interior design studios, sustainability

Procedia PDF Downloads 269
746 Numerical Modelling and Experiment of a Composite Single-Lap Joint Reinforced by Multifunctional Thermoplastic Composite Fastener

Authors: Wenhao Li, Shijun Guo

Abstract:

Carbon fibre reinforced composites are progressively replacing metal structures in modern civil aircraft. This is because composite materials have large potential of weight saving compared with metal. However, the achievement to date of weight saving in composite structure is far less than the theoretical potential due to many uncertainties in structural integrity and safety concern. Unlike the conventional metallic structure, composite components are bonded together along the joints where structural integrity is a major concern. To ensure the safety, metal fasteners are used to reinforce the composite bonded joints. One of the solutions for a significant weight saving of composite structure is to develop an effective technology of on-board Structural Health Monitoring (SHM) System. By monitoring the real-life stress status of composite structures during service, the safety margin set in the structure design can be reduced with confidence. It provides a means of safeguard to minimize the need for programmed inspections and allow for maintenance to be need-driven, rather than usage-driven. The aim of this paper is to develop smart composite joint. The key technology is a multifunctional thermoplastic composite fastener (MTCF). The MTCF will replace some of the existing metallic fasteners in the most concerned locations distributed over the aircraft composite structures to reinforce the joints and form an on-board SHM network system. Each of the MTCFs will work as a unit of the AU and AE technology. The proposed MTCF technology has been patented and developed by Prof. Guo in Cranfield University, UK in the past a few years. The manufactured MTCF has been successfully employed in the composite SLJ (Single-Lap Joint). In terms of the structure integrity, the hybrid SLJ reinforced by MTCF achieves 19.1% improvement in the ultimate failure strength in comparison to the bonded SLJ. By increasing the diameter or rearranging the lay-up sequence of MTCF, the hybrid SLJ reinforced by MTCF is able to achieve the equivalent ultimate strength as that reinforced by titanium fastener. The predicted ultimate strength in simulation is in good agreement with the test results. In terms of the structural health monitoring, a signal from the MTCF was measured well before the load of mechanical failure. This signal provides a warning of initial crack in the joint which could not be detected by the strain gauge until the final failure.

Keywords: composite single-lap joint, crack propagation, multifunctional composite fastener, structural health monitoring

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745 Evaluating the Impact of Judicial Review of 2003 “Radical Surgery” Purging Corrupt Officials from Kenyan Courts

Authors: Charles A. Khamala

Abstract:

In 2003, constrained by an absent “rule of law culture” and negative economic growth, the new Kenyan government chose to pursue incremental judicial reforms rather than comprehensive constitutional reforms. President Mwai Kibaki’s first administration’s judicial reform strategy was two pronged. First, to implement unprecedented “radical surgery,” he appointed a new Chief Justice who instrumentally recommended that half the purportedly-corrupt judiciary should be removed by Presidential tribunals of inquiry. Second, the replacement High Court judges, initially, instrumentally-endorsed the “radical surgery’s” administrative decisions removing their corrupt predecessors. Meanwhile, retention of the welfare-reducing Constitution perpetuated declining public confidence in judicial institutions culminating in refusal by the dissatisfied opposition party to petition the disputed 2007 presidential election results, alleging biased and corrupt courts. Fatefully, widespread post-election violence ensued. Consequently, the international community prompted the second Kibaki administration to concede to a new Constitution. Suddenly, the High Court then adopted a non-instrumental interpretation to reject the 2003 “radical surgery.” This paper therefore critically analyzes whether the Kenyan court’s inconsistent interpretations–pertaining to the constitutionality of the 2003 “radical surgery” removing corruption from Kenya’s courts–was predicated on political expediency or human rights principles. If justice “must also seen to be done,” then pursuit of the CJ’s, Judicial Service Commission’s and president’s political or economic interests must be limited by respect for the suspected judges and magistrates’ due process rights. The separation of powers doctrine demands that the dismissed judges should have a right of appeal which entails impartial review by a special independent oversight mechanism. Instead, ignoring fundamental rights, Kenya’s new Supreme Court’s interpretation of another round of vetting under the new 2010 Constitution, ousts the High Court’s judicial review jurisdiction altogether, since removal of judicial corruption is “a constitutional imperative, akin to a national duty upon every judicial officer to pave way for judicial realignment and reformulation.”

Keywords: administrative decisions, corruption, fair hearing, judicial review, (non) instrumental

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