Search results for: urban background sites
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9673

Search results for: urban background sites

1903 Investigation of Projected Organic Waste Impact on a Tropical Wetland in Singapore

Authors: Swee Yang Low, Dong Eon Kim, Canh Tien Trinh Nguyen, Yixiong Cai, Shie-Yui Liong

Abstract:

Nee Soon swamp forest is one of the last vestiges of tropical wetland in Singapore. Understanding the hydrological regime of the swamp forest and implications for water quality is critical to guide stakeholders in implementing effective measures to preserve the wetland against anthropogenic impacts. In particular, although current field measurement data do not indicate a concern with organic pollution, reviewing the ways in which the wetland responds to elevated organic waste influx (and the corresponding impact on dissolved oxygen, DO) can help identify potential hotspots, and the impact on the outflow from the catchment which drains into downstream controlled watercourses. An integrated water quality model is therefore developed in this study to investigate spatial and temporal concentrations of DO levels and organic pollution (as quantified by biochemical oxygen demand, BOD) within the catchment’s river network under hypothetical, projected scenarios of spiked upstream inflow. The model was developed using MIKE HYDRO for modelling the study domain, as well as the MIKE ECO Lab numerical laboratory for characterising water quality processes. Model parameters are calibrated against time series of observed discharges at three measurement stations along the river network. Over a simulation period of April 2014 to December 2015, the calibrated model predicted that a continuous spiked inflow of 400 mg/l BOD will elevate downstream concentrations at the catchment outlet to an average of 12 mg/l, from an assumed nominal baseline BOD of 1 mg/l. Levels of DO were decreased from an initial 5 mg/l to 0.4 mg/l. Though a scenario of spiked organic influx at the swamp forest’s undeveloped upstream sub-catchments is currently unlikely to occur, the outcomes nevertheless will be beneficial for future planning studies in understanding how the water quality of the catchment will be impacted should urban redevelopment works be considered around the swamp forest.

Keywords: hydrology, modeling, water quality, wetland

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1902 Role of Symbolism in the Journey towards Spirituality: A Case Study of Mosque Architecture in Bahrain

Authors: Ayesha Agha Shah

Abstract:

The purpose of a mosque or a place of worship is to build a spiritual relation with God. If the sense of spirituality is not achieved, then sacred architecture appears to be lacking depth. Form and space play a significant role to enhance the architectural quality to impart a divine feel to a place. To achieve this divine feeling, form and space, and unity of opposites, either abstract or symbolic can be employed. It is challenging to imbue the emptiness of a space with qualitative experience. Mosque architecture mostly entails traditional forms and design typology. This approach for Muslim worship produces distinct landmarks in the urban neighborhoods of Muslim societies, while creating a great sense of spirituality. The universal symbolic characters in the mosque architecture had prototype geometrical forms for a long time in history. However, modern mosques have deviated from this approach to employ different built elements and symbolism, which are often hard to be identified as related to mosques or even as Islamic. This research aims to explore the sense of spirituality in modern mosques and questions whether the modification of geometrical features produce spirituality in the same manner. The research also seeks to investigate the role of ‘geometry’ in the modern mosque architecture. The research employs the analytical study of some modern mosque examples in the Kingdom of Bahrain, reflecting on the geometry and symbolism adopted in the new mosque architecture design. It buttresses the analysis by the engagement of people’s perceptions derived using a survey of opinions. The research expects to see the significance of geometrical architectural elements in the mosque designs. It will find answers to the questions such as; what is the role of the form of the mosque, interior spaces and the effect of the modified symbolic features in the modern mosque design? How can the symbolic geometry, forms and spaces of a mosque invite a believer to leave the worldly environment behind and move towards spirituality?

Keywords: geometry, mosque architecture, spirituality, symbolism

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1901 Association of a Genetic Polymorphism in Cytochrome P450, Family 1 with Risk of Developing Esophagus Squamous Cell Carcinoma

Authors: Soodabeh Shahid Sales, Azam Rastgar Moghadam, Mehrane Mehramiz, Malihe Entezari, Kazem Anvari, Mohammad Sadegh Khorrami, Saeideh Ahmadi Simab, Ali Moradi, Seyed Mahdi Hassanian, Majid Ghayour-Mobarhan, Gordon A. Ferns, Amir Avan

Abstract:

Background Esophageal cancer has been reported as the eighth most common cancer universal and the seventh cause of cancer-related death in men .recent studies have revealed that cytochrome P450, family 1, subfamily B, polypeptide 1, which plays a role in metabolizing xenobiotics, is associated with different cancers. Therefore in the present study, we investigated the impact of CYP1B1-rs1056836 on esophagus squamous cell carcinoma (ESCC) patients. Method: 317 subjects, with and without ESCC were recruited. DNA was extracted and genotyped via Real-time PCR-Based Taq Man. Kaplan Meier curves were utilized to assess overall and progression-free survival. To evaluate the relationship between patients clinicopathological data, genotypic frequencies, disease prognosis, and patients survival, Pearson chi-square and t-test were used. Logistic regression was utilized to assess the association between the risk of ESCC and genotypes. Results: the genotypic frequency for GG, GC, and CC are respectively 58.6% , 29.8%, 11.5% in the healthy group and 51.8%, 36.14% and 12% in ESCC group. With respect to the recessive genetic inheritance model, an association between the GG genotype and stage of ESCC were found. Also, statistically significant results were not found for this variation and risk of ESCC. Patients with GG genotype had a decreased risk of nodal metastasis in comparison with patients with CC/CG genotype, although this link was not statistically significant. Conclusion: Our findings illustrated the correlation of CYP1B1-rs1056836 as a potential biomarker for ESCC patients, supporting further studies in larger populations in different ethnic groups. Moreover, further investigations are warranted to evaluate the association of emerging marker with dietary intake and lifestyle.

Keywords: Cytochrome P450, esophagus squamous cell carcinoma, dietary intake, lifestyle

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1900 Polycyclic Aromatic Hydrocarbons: Pollution and Ecological Risk Assessment in Surface Soil of the Tezpur Town, on the North Bank of the Brahmaputra River, Assam, India

Authors: Kali Prasad Sarma, Nibedita Baul, Jinu Deka

Abstract:

In the present study, pollution level of polycyclic aromatic hydrocarbon (PAH) in surface soil of historic Tezpur town located in the north bank of the River Brahmaputra were evaluated. In order to determine the seasonal distribution and concentration level of 16 USEPA priority PAHs surface soil samples were collected from 12 different sampling sites with various land use type. The total concentrations of 16 PAHs (∑16 PAHs) varied from 242.68µgkg-1to 7901.89µgkg-1. Concentration of total probable carcinogenic PAH ranged between 7.285µgkg-1 and 479.184 µgkg-1 in different seasons. However, the concentration of BaP, the most carcinogenic PAH, was found in the range of BDL to 50.01 µgkg-1. The composition profiles of PAHs in 3 different seasons were characterized by following two different types of ring: (1) 4-ring PAHs, contributed to highest percentage of total PAHs (43.75%) (2) while in pre- and post- monsoon season 3- ring compounds dominated the PAH profile, contributing 65.58% and 74.41% respectively. A high PAHs concentration with significant seasonality and high abundance of LMWPAHs was observed in Tezpur town. Soil PAHs toxicity was evaluated taking toxic equivalency factors (TEFs), which quantify the carcinogenic potential of other PAHs relative to BaP and estimate benzo[a]pyrene-equivalent concentration (BaPeq). The calculated BaPeq value signifies considerable risk to contact with soil PAHs. We applied cluster analysis and principal component analysis (PCA) with multivariate linear regression (MLR) to apportion sources of polycyclic aromatic hydrocarbons (PAHs) in surface soil of Tezpur town, based on the measured PAH concentrations. The results indicate that petrogenic and pyrogenic sources are the important sources of PAHs. A combination of chemometric and molecular indices were used to identify the sources of PAHs, which could be attributed to vehicle emissions, a mixed source input, natural gas combustion, wood or biomass burning and coal combustion. Source apportionment using absolute principle component scores–multiple linear regression showed that the main sources of PAHs are 22.3% mix sources comprising of diesel and biomass combustion and petroleum spill,13.55% from vehicle emission, 9.15% from diesel and natural gas burning, 38.05% from wood and biomass burning and 16.95% contribute coal combustion. Pyrogenic input was found to dominate source of PAHs origin with more contribution from vehicular exhaust. PAHs have often been found to co-emit with other environmental pollutants like heavy metals due to similar source of origin. A positive correlation was observed between PAH with Cr and Pb (r2 = 0.54 and 0.55 respectively) in monsoon season and PAH with Cd and Pb (r2 = 0.54 and 0.61 respectively) indicating their common source. Strong correlation was observed between PAH and OC during pre- and post- monsoon (r2=0.46 and r2=0.65 respectively) whereas during monsoon season no significant correlation was observed (r2=0.24).

Keywords: polycyclic aromatic hydrocarbon, Tezpur town, chemometric analysis, ecological risk assessment, pollution

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1899 Correlation between the Ratios of House Dust Mite-Specific IgE/Total IgE and Asthma Control Test Score as a Biomarker of Immunotherapy Response Effectiveness in Pediatric Allergic Asthma Patients

Authors: Bela Siska Afrida, Wisnu Barlianto, Desy Wulandari, Ery Olivianto

Abstract:

Background: Allergic asthma, caused by IgE-mediated allergic reactions, remains a global health issue with high morbidity and mortality rates. Immunotherapy is the only etiology-based approach to treating asthma, but no standard biomarkers have been established to evaluate the therapy’s effectiveness. This study aims to determine the correlation between the ratios of serum levels of HDM-specific IgE/total IgE and Asthma Control Test (ACT) score as a biomarker of the response to immunotherapy in pediatric allergic asthma patients. Patient and Methods: This retrospective cohort study involved 26 pediatric allergic asthma patients who underwent HDM-specific subcutaneous immunotherapy for 14 weeks at the Pediatric Allergy Immunology Outpatient Clinic at Saiful Anwar General Hospital, Malang. Serum levels of HDM-Specific IgE and Total IgE were measured before and after immunotherapy using Chemiluminescence Immunoassay and Enzyme-linked Immunosorbent Assay (ELISA) method. Changes in asthma control were assessed using the ACT score. The Wilcoxon Signed Ranked Test and Spearman correlation test were used for data analysis. Results: There were 14 boys and 12 girls with a mean age of 6.48 ± 2.54 years. The study showed a significant decrease in serum HMD-specific levels before immunotherapy [9.88 ± 5.74 kuA/L] compared to those of 14 weeks after immunotherapy [4.51 ± 3.98 kuA/L], p = 0.000. Serum Total IgE levels significant decrease before immunotherapy [207.6 ± 120.8IU/ml] compared to those of 14 weeks after immunotherapy [109.83 ± 189.39 IU/mL], p = 0.000. The ratios of serum HDM-specific IgE/total IgE levels significant decrease before immunotherapy [0.063 ± 0.05] compared to those of 14 weeks after immunotherapy [0.041 ± 0.039], p = 0.012. There was also a significant increase in ACT scores before and after immunotherapy (each 15.5 ± 1.79 and 20.96 ± 2.049, p = 0.000). The correlation test showed a weak negative correlation between the ratios of HDM-specific IgE/total IgE levels and ACT score (p = 0.034 and r = -0.29). Conclusion: In conclusion, this study showed that a decrease in HDM-specific IgE levels, total IgE levels, and HDM-specific IgE/total IgE ratios, and an increase in ACT score, was observed after 14 weeks of HDM-specific subcutaneous immunotherapy. The weak negative correlation between the HDM-specific IgE/total IgE ratio and the ACT score suggests that this ratio can serve as a potential biomarker of the effectiveness of immunotherapy in treating pediatric allergic asthma patients.

Keywords: HDM-specific IgE/total IgE ratio, ACT score, immunotherapy, allergic asthma

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1898 Comparison of Patient Satisfaction and Observer Rating of Outpatient Care among Public Hospitals in Shanghai

Authors: Tian Yi Du, Guan Rong Fan, Dong Dong Zou, Di Xue

Abstract:

Background: The patient satisfaction survey is becoming of increasing importance for hospitals or other providers to get more reimbursement and/or more governmental subsidies. However, when the results of patient satisfaction survey are compared among medical institutions, there are some concerns. The primary objectives of this study were to evaluate patient satisfaction in tertiary hospitals of Shanghai and to compare the satisfaction rating on physician services between patients and observers. Methods: Two hundred outpatients were randomly selected for patient satisfaction survey in each of 28 public tertiary hospitals of Shanghai. Four or five volunteers were selected to observe 5 physicians’ practice in each of above hospitals and rated observed physicians’ practice. The outpatients that the volunteers observed their physician practice also filled in the satisfaction questionnaires. The rating scale for outpatient survey and volunteers’ observation was: 1 (very dissatisfied) to 6 (very satisfied). If the rating was equal to or greater than 5, we considered the outpatients and volunteers were satisfied with the services. The validity and reliability of the measure were assessed. Multivariate regressions for each of the 4 dimensions and overall of patient satisfaction were used in analyses. Paired t tests were applied to analyze the rating agreement on physician services between outpatients and volunteers. Results: Overall, 90% of surveyed outpatients were satisfied with outpatient care in the tertiary public hospitals of Shanghai. The lowest three satisfaction rates were seen in the items of ‘Restrooms were sanitary and not crowded’ (81%), ‘It was convenient for the patient to pay medical bills’ (82%), and ‘Medical cost in the hospital was reasonable’ (84%). After adjusting the characteristics of patients, the patient satisfaction in general hospitals was higher than that in specialty hospitals. In addition, after controlling the patient characteristics and number of hospital visits, the hospitals with higher outpatient cost per visit had lower patient satisfaction. Paired t tests showed that the rating on 6 items in the dimension of physician services (total 14 items) was significantly different between outpatients and observers, in which 5 were rated lower by the observers than by the outpatients. Conclusions: The hospital managers and physicians should use patient satisfaction and observers’ evaluation to detect the room for improvement in areas such as social skills cost control, and medical ethics.

Keywords: patient satisfaction, observation, quality, hospital

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1897 Influence of Strengthening of Hip Abductors and External Rotators in Treatment of Patellofemoral Pain Syndrome

Authors: Karima Abdel Aty Hassan Mohamed, Manal Mohamed Ismail, Mona Hassan Gamal Eldein, Ahmed Hassan Hussein, Abdel Aziz Mohamed Elsingerg

Abstract:

Background: Patellofemoral pain (PFP) is a common musculoskeletal pain condition, especially in females. Decreased hip muscle strength has been implicated as a contributing factor, yet the relationships between pain, hip muscle strength and function are not known. Objective: The purpose of this study is to investigate the effects of strengthening hip abductors and lateral rotators on pain intensity, function and hip abductor and hip lateral rotator eccentric and concentric torques in patients with PFPS. Methods: Thirty patients had participated in this study; they were assigned into two experimental groups. With age ranged for eighty to thirty five years. Group A consisted of 15 patients (11females and 4 males) with mean age 20.8 (±2.73) years, received closed kinetic chain exercises program, stretching exercises for tight lower extremity soft tissues, and hip strengthening exercises .Group B consisted of 15 patients (12 females and 3 males) with mean age 21.2(±3.27) years, received closed kinetic chain exercises program and stretching exercises for tight lower extremity soft tissues. Treatment was given 2-3times/week, for 6 weeks. Patients were evaluated pre and post treatment for their pain severity, function of knee joint, hip abductors and external rotators concentric/eccentric peak torque. Result: the results revealed that there were significant differences in pain and function between both groups, while there was improvement for all values for both group. Conclusion: Six weeks rehabilitation program focusing on knee strengthening exercises either supplemented by hip strengthening exercises or not effective in improving function, reducing pain and improving hip muscles torque in patients with PFPS. However, adding hip abduction and lateral rotation strengthening exercises seem to reduce pain and improve function more efficiently.

Keywords: patellofemoral pain syndrome, hip muscles, rehabilitation, isokinetic

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1896 Technology Enriched Classroom for Intercultural Competence Building through Films

Authors: Tamara Matevosyan

Abstract:

In this globalized world, intercultural communication is becoming essential for understanding communication among people, for developing understanding of cultures, to appreciate the opportunities and challenges that each culture presents to people. Moreover, it plays an important role in developing an ideal personification to understand different behaviors in different cultures. Native speakers assimilate sociolinguistic knowledge in natural conditions, while it is a great problem for language learners, and in this context feature films reveal cultural peculiarities and involve students in real communication. As we know nowadays the key role of language learning is the development of intercultural competence as communicating with someone from a different cultural background can be exciting and scary, frustrating and enlightening. Intercultural competence is important in FL learning classroom and here feature films can perform as essential tools to develop this competence and overcome the intercultural gap that foreign students face. Current proposal attempts to reveal the correlation of the given culture and language through feature films. To ensure qualified, well-organized and practical classes on Intercultural Communication for language learners a number of methods connected with movie watching have been implemented. All the pre-watching, while watching and post-watching methods and techniques are aimed at developing students’ communicative competence. The application of such activities as Climax, Role-play, Interactive Language, Daily Life helps to reveal and overcome mistakes of cultural and pragmatic character. All the above-mentioned activities are directed at the assimilation of the language vocabulary with special reference to the given culture. The study dwells into the essence of culture as one of the core concepts of intercultural communication. Sometimes culture is not a priority in the process of language learning which leads to further misunderstandings in real life communication. The application of various methods and techniques with feature films aims at developing students’ cultural competence, their understanding of norms and values of individual cultures. Thus, feature film activities will enable learners to enlarge their knowledge of the particular culture and develop a fundamental insight into intercultural communication.

Keywords: climax, intercultural competence, interactive language, role-play

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1895 A Geospatial Analysis of Residential Conservation-Attitude, Intention and Behavior

Authors: Prami Sengupta, Randall A. Cantrell, Tracy Johns

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A typical US household consumes more energy than households in other countries and is directly responsible for a considerable proportion of the atmospheric concentration of the greenhouse gases. This makes U.S. household a vital target group for energy conservation studies. Positive household behavior is central to residential energy conservation. However, for individuals to conserve energy they must not only know how to conserve energy but be also willing to do so. That is, a positive attitude towards residential conservation and an intention to conserve energy are two of the most important psychological determinants for energy conservation behavior. Most social science studies, to date, have studied the relationships between attitude, intention, and behavior by building upon socio-psychological theories of behavior. However, these frameworks, including the widely used Theory of Planned Behavior and Social Cognitive Theory, lack a spatial component. That is, these studies fail to capture the impact of the geographical locations of homeowners’ residences on their residential energy consumption and conservation practices. Therefore, the purpose of this study is to explore geospatial relationships between homeowners’ residential energy conservation-attitudes, conservation-intentions, and consumption behavior. The study analyzes residential conservation-attitudes and conservation-intentions of homeowners across 63 counties in Florida and compares it with quantifiable measures of residential energy consumption. Empirical findings revealed that the spatial distribution of high and/or low values of homeowners’ mean-score values of conservation-attitudes and conservation-intentions are more spatially clustered than would be expected if the underlying spatial processes were random. On the contrary, the spatial distribution of high and/or low values of households’ carbon footprints was found to be more spatially dispersed than assumed if the underlying spatial process were random. The study also examined the influence of potential spatial variables, such as urban or rural setting and presence of educational institutions and/or extension program, on the conservation-attitudes, intentions, and behaviors of homeowners.

Keywords: conservation-attitude, conservation-intention, geospatial analysis, residential energy consumption, spatial autocorrelation

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1894 "Gurza Incinerator" : Biomass Incinerator Powered by Empty Bunch of Palm Oil Fruits as Electrical Biomass Base Development

Authors: Andi Ismanto

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Indonesia is the largest palm oil producer in the world. The increasing number of palm oil extensification in Indonesia started on 2000-2011. Based on preliminary figures from the Directorate General of Plantation, palm oil area in Indonesia until 2011 is about 8.91 million hectares.On 2011 production of palm oil CPO reaches 22.51 million tons. In the other hands, the increasing palm oil production has impact to environment. The Empty Bunch of Palm Oil (EBPO)waste was increased to 20 million tons in 2009. Utilization of waste EBPO currently only used as an organic fertilizer for plants. But, it was not a good solution, because TKKS that used as organic compost has high content of carbon and hydrogen compound. The EBPO waste has potential used as fuel by gasification because it has short time of decomposition. So, the process will be more efficient in time. Utilization of urban wastehas been created using an incinerator used as a source of electrical energy for household.Usually, waste burning process by incinerator is using diesel fuel and kerosene. It is certainly less effective and not environment friendly, considering the waste incineration process using Incinerator tools are continuously. Considering biomass is a renewable source of energy and the world's energy system must be switch from an energy based on fossil resources into the energy based on renewable resources, the "Gurza Incinerator": Design Build Powerful Biomass Incinerator Empty Bunch of Palm Oil (EBPO) as Elecrical Biomass Base Development, a renewable future technology. The tools is using EBPO waste as source of burning to burn garbage inside the Incinerator hopper. EBPO waste will be processed by means of gasification. Gasification isa process to produce gases that can be used as fuel for electrical power. Hopefully, this technology could be a renewable future energy and also as starting point of electrical biomass base development.

Keywords: incinerator, biomass, empty bunch palm oil, electrical energy

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1893 The Effectiveness of Men Who Have Sex with Men (MSM) Sensitivity Training for Nigerian Health Care Providers (HCPs)

Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

Abstract:

Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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1892 Acquisition and Preservation of Traditional Medicinal Knowledge in Rural Areas of KwaZulu Natal, South Africa

Authors: N. Khanyile, P. Dlamini, M. Masenya

Abstract:

Background: Most of the population in Africa is still dependent on indigenous medicinal knowledge for treating and managing ailments. Indigenous traditional knowledge owners/practitioners who own this knowledge are consulted by communities, but their knowledge is not known how they get it. The question of how knowledge is acquired and preserved remains one of the biggest challenges in traditional healing and treatment with herbal medicines. It is regrettable that despite the importance and recognition of indigenous medicinal knowledge globally, the details of acquirement, storing and transmission, and preservation techniques are not known. Hence this study intends to unveil the process of acquirement and transmission, and preservation techniques of indigenous medical knowledge by its owners. Objectives: This study aims to assess the process of acquiring and preservation of traditional medicinal knowledge by traditional medicinal knowledge owners/practitioners in uMhlathuze Municipality, in the province of KwaZulu-Natal, South Africa. The study was guided by four research objectives which were to: identify the types of traditional medicinal knowledge owners who possess this knowledge, establish the approach used by indigenous medicinal knowledge owners/healers for acquiring medicinal knowledge, identify the process of preservation of medicinal knowledge by indigenous medicinal knowledge owners/healers, and determine the challenges encountered in transferring the knowledge. Method: The study adopted a qualitative research approach, and a snowball sampling technique was used to identify the study population. Data was collected through semi-structured interviews with indigenous medicinal knowledge owners. Results: The findings suggested that uMhlathuze municipality had different types of indigenous medicinal knowledge owners who possess valuable knowledge. These are diviners (Izangoma), faith healers (Abathandazi), and herbalists (Izinyanga). The study demonstrated that indigenous medicinal knowledge is acquired in many different ways, including visions, dreams, and vigorous training. The study also revealed the acquired knowledge is preserved or shared with specially chosen children and trainees. Conclusion: The study concluded that this knowledge is gotten through vigorous training, which requires the learner to be attentive and eager to learn. It was recommended that a study of this nature be conducted but at a broader level to enhance an informed conclusion and recommendations.

Keywords: preserving, indigenous medicinal knowledge, indigenous knowledge, indigenous medicinal knowledge owners/practitioners, acquiring

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1891 Tibial Plateau Fractures During Covid-19 In A Trauma Unit. Impact of Lockdown and The Pressures on the Healthcare Provider

Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi

Abstract:

The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.

Keywords: Covid-19, knee, tibial plateau fracture, trauma

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1890 Quality of Life in People with Hearing Loss: A Study of Patients Referred to an Audiological Service

Authors: Peder O. Laugen Heggdal, Oyvind Nordvik, Jonas Brannstrom, Flemming Vassbotn, Anne Kari Aarstad, Hans Jorgen Aarstad

Abstract:

Background: Hearing loss (HL) affect people of all ages and stages in life. To author's best knowledge, if patients with an HL have reduced Generic Quality of life (QoL), has yet not been answered. Aim: The aim of the present study was to investigate the relationship between HL and generic and disease-specific Health Related Quality of Life (HRQoL) in adult patients (aged 18–78 years) with an HL, seeking Hearing Aid (HA). Material and Methods: 158 adult (aged 18-78 years) patients with HL, referred for HA fitting at Haukeland University Hospital in western Norway, participated in the study. Both first-time users, as well as patients referred for HA renewals, were included. First-time users had been pre-examined by an Ear Nose and Throat specialist. The questionnaires were answered before the actual HA fitting procedure. The pure-tone average (PTA; frequencies 0.5, 1, 2 and 4 kHz) was determined for each ear. The generic European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire general part and a shortened version of the Abbreviated Profile of Hearing Aid Benefit (APHAB) were answered. In addition, EORTC HRQoL answers from a general population and patients with former head and neck cancer served as comparison. Results: In general, no lowered HRQoL scores were determined among HL patients compared to the general population. Patients with unilateral HL to some extent showed lower HRQoL than those with bilateral HL (social function and fatigue). The APHAB scores correlated significantly with the EORTC HRQoL scores. By stepwise linear regression analysis, the APHAB scores were scored secondary to PTA (best ear), cognitive and physical function. Conclusion: HRQoL scores in HL patients, in general, seems to be at the population level, but the unilateral HL patients scored to some extent lower than the bilateral HI patients. APHAB and generic QoL scores levels are associated. Both HRQoL and APHAB scores are generated more complexly than anticipated.

Keywords: quality of life, hearing loss, hearing impairment, distress, depression, anxiety, hearing aid

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1889 Water Harvest and Recycling with Principles of Permaculture in Rural Buildings in Southeastern Anatolia Region, Turkey

Authors: Muhammed Gündoğan

Abstract:

Permaculture is an important source of science and experience that can ensure the integration of sustainable architecture with nature. Since the past, many applications have been applied in rural areas for generations with the principle of benefiting from the self-renewal potential of nature. This culture, which has been transferred from generation to generation with architectural disciplines, has the potential to significantly improve the sustainability of the rural area and is an important guide with its nature-based solution proposals. Şanlıurfa has arid and semi-arid climate characteristics. Although it has substantial agricultural potential, water is limited, especially in rural areas. In the region, rainwater harvesting practices such as artificial water canals and cisterns have been used for a long time. However, these solutions remained mostly at the urban scale, and their reflections at the building scale were restricted and inadequate solutions. Impermeable surfaces are required for water harvesting, but water harvesting is not possible as rural buildings are mostly surrounded by cultivated land. Therefore, existing structures are important in terms of applicability. In this context, considering the typology of Traditional Şanlıurfa Houses, the aim of the project was to create a proposal for limited potable and utility water, which is a serious problem, especially for rural buildings in Şanlıurfa. In the project proposal, roof systems that can work integrated with the structural shape of Traditional Şanlıurfa Houses, rainwater collection systems in the inner courtyard, and greywater recycling were provided. While the average precipitation amount was 453.7 kg/m3 between 1929 and 2012, this value was measured as 622.7 kg/m3 in 2012. Greywater was used to produce natural fertilizers and compost for small-scale fruit and vegetable gardens, and it was combined with the principles of Permaculture to make it a lifestyle. As a result, it has been estimated that a total of 976.4 m3 kg of water can be saved, with an annual average of 158.8 m3 of rainwater recycling and 817.6 m3 of greywater recycling within the scope of the project.

Keywords: rural, traditional residential building, permaculture, rainwater harvesting, greywater recycling

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1888 Using Linear Logistic Regression to Evaluation the Patient and System Delay and Effective Factors in Mortality of Patients with Acute Myocardial Infarction

Authors: Firouz Amani, Adalat Hoseinian, Sajjad Hakimian

Abstract:

Background: The mortality due to Myocardial Infarction (MI) is often occur during the first hours after onset of symptom. So, for taking the necessary treatment and decreasing the mortality rate, timely visited of the hospital could be effective in this regard. The aim of this study was to investigate the impact of effective factors in mortality of MI patients by using Linear Logistic Regression. Materials and Methods: In this case-control study, all patients with Acute MI who referred to the Ardabil city hospital were studied. All of died patients were considered as the case group (n=27) and we select 27 matched patients without Acute MI as a control group. Data collected for all patients in two groups by a same checklist and then analyzed by SPSS version 24 software using statistical methods. We used the linear logistic regression model to determine the effective factors on mortality of MI patients. Results: The mean age of patients in case group was significantly higher than control group (75.1±11.7 vs. 63.1±11.6, p=0.001).The history of non-cardinal diseases in case group with 44.4% significantly higher than control group with 7.4% (p=0.002).The number of performed PCIs in case group with 40.7% significantly lower than control group with 74.1% (P=0.013). The time distance between hospital admission and performed PCI in case group with 110.9 min was significantly upper than control group with 56 min (P=0.001). The mean of delay time from Onset of symptom to hospital admission (patient delay) and the mean of delay time from hospital admissions to receive treatment (system delay) was similar between two groups. By using logistic regression model we revealed that history of non-cardinal diseases (OR=283) and the number of performed PCIs (OR=24.5) had significant impact on mortality of MI patients in compare to other factors. Conclusion: Results of this study showed that of all studied factors, the number of performed PCIs, history of non-cardinal illness and the interval between onset of symptoms and performed PCI have significant relation with morality of MI patients and other factors were not meaningful. So, doing more studies with a large sample and investigated other involved factors such as smoking, weather and etc. is recommended in future.

Keywords: acute MI, mortality, heart failure, arrhythmia

Procedia PDF Downloads 117
1887 Psychological Intervention for Partners Post-Stroke: A Case Study

Authors: Natasha Yasmin Felles, Gerard Riley

Abstract:

Background and Aims: Relationship breakdown is typical when one partner lives with an acquired brain injury caused by issues like a stroke. Research has found that the perception of relationship satisfaction decreases following such an injury among non-injured partners. Non-injured partners also are found to experience caregiver stress/burden as they immediately have to take the role of a caregiver along with being a partner of the injured. Research has also found that the perception of a continuous relationship, i.e. the perception of the relationship to be essentially the same as it was before the injury, also changes among those caregiving partners. However, there is a lack of available intervention strategies that can help those partners with both individual and relationship difficulties. The aim of this case study was to conduct a pilot test of an intervention aimed to explore whether it is possible to support a partner to experience greater continuity within the relationship poststroke, and what benefits such a change might have. Method: A couple, where one partner experienced an acquired brain injury poststroke were provided with Integrated Behavioural Couples Therapy for 3-months. The intervention addressed goals identified as necessary by the couple and by the formulation of their individual and relationship difficulties, alongside the goal of promoting relationship continuity. Before and after measures were taken using a battery of six questionnaires to evaluate changes in perceptions of continuity, stress, and other aspects of the relationship. Results: Both quantitative and qualitative data showed that relationship continuity was improved after the therapy, as were the measures of stress and other aspects of the relationship. The stress felt by the person with the acquired brain injury also showed some evidence of improvement. Conclusion: The study found that perceptions of relationship continuity can be improved by therapy and that improving these might have a beneficial impact on the stress felt by the carer, their satisfaction with the relationship and overall levels of conflict and closeness within the relationship. The study suggested the value of further research on enhancing perceptions of continuity in the relationship after an acquired brain injury. Currently, the findings of the study have been used to develop a pilot feasibility study to collect substantive evidence on the impact of the intervention on the couples and assess its feasibility and acceptability, which will help in further developing a specific generalized relationship continuity intervention, that will be beneficial in preventing relationship breakdown in the future.

Keywords: acquired brain injury, couples therapy, relationship continuity, stroke

Procedia PDF Downloads 117
1886 Comparison with Two Clinical Cases of Plasma Cell Neoplasm by Using the Method of Capillary Electrophoresis

Authors: Kai Pai Huang

Abstract:

Background: There are several types of plasma cell neoplasms including multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma, and monoclonal gammopathy of undetermined significance (MGUS) are found in our lab. Today, we want to compare with two cases using the method of capillary electrophoresis. Method: Serum is prepared and electrophoresis is performed at alkaline PH in a capillary using the Sebia® Capillary 2. Albumin and globulins are detected by the detector which is located in the cathode of the capillary and the signals are transformed to peaks. Serum was treated with beta-mercaptoethanol which reducing the polymerized immunoglobulin to monomer immunoglobulin to clarify two M-protein are secreted from the same plasma cell clone in bone marrow. Result: Case 1: A 78-year-old female presenting dysuria, oliguria and leg edema for several months. Laboratory data showed proteinuria, leukocytosis, results of high serum IgA and lambda light chain. A renal biopsy found amyloid fibrils in the glomerular mesangial area. Serum protein electrophoresis shows a major monoclonal peak in the β region and minor small peak in gamma region, and the immunotyping studies for serum showed two IgA/λ type. Case 2: A 55-year-old male presenting abdominal distension and low back pain for more than one month. Laboratory data showed T12 T8 compression fracture, results of high serum IgM and kappa light chain. Bone marrow aspiration showed the cells from the bone marrow are B cells with monotypic kappa chain expression. Bone marrow biopsy found this is lymphoplasmacytic lymphoma (Waldenstrom macroglobulin). Serum protein electrophoresis shows a monoclonal peak in the β region and the immunotyping studies for serum showed IgM/κ type. Conclusion: Plasma cell neoplasm can be diagnosed by many examinations. Among them, using capillary electrophoresis by a lab can separate several types of gammopathy and the quantification of a monoclonal peak can be used to evaluate the patients’ prognosis or treatment.

Keywords: plasma cell neoplasm, capillary electrophoresis, serum protein electrophoresis, immunotyping

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1885 Exercise in Extreme Conditions: Leg Cooling and Fat/Carbohydrate Utilization

Authors: Anastasios Rodis

Abstract:

Background: Case studies of walkers, climbers, and campers exposed to cold and wet conditions without limb water/windproof protection revealed experiences of muscle weakness and fatigue. It is reasonable to assume that a part of the fatigue could occur due to an alteration in substrate utilization, since reduction of performance in extreme cold conditions, may partially be explained by higher anaerobic glycolysis, reflecting higher carbohydrate oxidation and an increase accumulation rate of blood lactate. The aim of this study was to assess the effects of pre-exercise lower limb cooling on substrate utilization rate during sub-maximal exercise. Method: Six male university students (mean (SD): age, 21.3 (1.0) yr; maximal oxygen uptake (V0₂ max), 49.6 (3.6) ml.min⁻¹; and percentage of body fat, 13.6 (2.5) % were examined in random order after either 30min cold water (12°C) immersion utilized as the cooling strategy up to the gluteal fold, or under control conditions (no precooling), with tests separated by minimum of 7 days. Exercise consisted of 60min cycling at 50% V0₂ max, in a thermoneutral environment of 20°C. Subjects were also required to record a diet diary over the 24hrs prior to the each trial. Means (SD) for the three macronutrients during the 1 day prior to each trial (expressed as a percentage of total energy) 52 (3) % carbohydrate, 31 (4) % fat, and 17 (± 2) % protein. Results: The following responses to lower limb cooling relative to control trial during exercise were: 1) Carbohydrate (CHO) oxidation, and blood lactate (Bₗₐc) concentration were significantly higher (P < 0.05); 2) rectal temperature (Tᵣₑc) was significantly higher (P < 0.05), but skin temperature was significantly lower (P < 0.05); no significant differences were found in blood glucose (Bg), heart rate (HR) and oxygen consumption (V0₂). Discussion: These data suggested that lower limb cooling prior to submaximal exercise will shift metabolic processes from Fat oxidation to CHO oxidation. This shift from Fat to CHO oxidation will probably have important implications in the surviving scenario, since people facing accidental localized cooling of their limbs either through wading/falling in cold water or snow even if they do not perform high intensity activity, they have to rely on CHO availability.

Keywords: exercise in wet conditions, leg cooling, outdoors exercise, substrate utilization

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1884 TP53 Mutations in Molecular Subtypes of Breast Cancer in Young Pakistani Patients

Authors: Nadia Naseem, Farwa Batool, Nasir Mehmood, AbdulHannan Nagi

Abstract:

Background: The incidence and mortality of breast cancer vary significantly in geographically distinct populations. In Pakistan, breast cancer has shown an increase in incidence in young females and is characterized by more aggressive behavior. The tumor suppressor TP53 gene is a crucial genetic factor that plays a significant role in breast carcinogenesis. This study investigated the TP53 mutations in molecular subtypes of both nodes negative and positive breast cancer in young Pakistani patients. Material and Methods: p53, Estrogen Receptor (ER), Progesterone Receptor (PR), Her-2 neu and Ki 67 expressions were analyzed immunohistochemically in a series of 75 node negative (A) and 75 node positive (B) young (aged: 19-40 years) breast cancer patients diagnosed between 2014 to 2017 at two leading hospitals of Punjab, Pakistan. Tumor tissue specimens and peripheral blood samples were examined for TP53 mutations by direct sequencing of the gene (exons 4-9). The relation of TP53 mutations to these markers and clinicopathological data was investigated. Results: Mean age of the patients was 32.4 + 9.1 SD. Invasive breast carcinoma was the most frequent histological variant (A=92%, B=94.6%). Grade 3 carcinoma was the commonest grade (A=72%, B=81.3%). Triple negative cases (ER-, PR-, Her-2) formed most of the molecular subtypes (A=44%, B=50.6%). A total of 17.2% (A: 6.6%, B: 10.6%) patients showed TP53 mutations. Mutations were significantly more frequent in triple negative cases (A: 74.8%, B: 62.2%) compared to HER2-positive patients (P < 0.0001). In the multivariate analysis of the whole patient group, the independent prognosticator were triple negative cases (P=0.021), TP53 overexpression by IHC (P=0.001) and advanced-stage disease (P=0.007). No statistically significant correlation between TP53 mutations and clinicopathological parameters was found (P < 0.05). Conclusions: It is concluded that TP53 mutations are infrequently present in breast carcinoma of young Pakistani population and there was no significant correlation between p53 mutation and early onset disease. Immunohistochemically detected TP53 expression in our resource-constrained to set up can be beneficial in predicting mutations at the younger age in our population.

Keywords: immunohistochemistry (IHC), invasive breast carcinoma (IBC), Pakistan, TP53

Procedia PDF Downloads 147
1883 Investigation of Yard Seam Workings for the Proposed Newcastle Light Rail Project

Authors: David L. Knott, Robert Kingsland, Alistair Hitchon

Abstract:

The proposed Newcastle Light Rail is a key part of the revitalisation of Newcastle, NSW and will provide a frequent and reliable travel option throughout the city centre, running from Newcastle Interchange at Wickham to Pacific Park in Newcastle East, a total of 2.7 kilometers in length. Approximately one-third of the route, along Hunter and Scott Streets, is subject to potential shallow underground mine workings. The extent of mining and seams mined is unclear. Convicts mined the Yard Seam and overlying Dudley (Dirty) Seam in Newcastle sometime between 1800 and 1830. The Australian Agricultural Company mined the Yard Seam from about 1831 to the 1860s in the alignment area. The Yard Seam was about 3 feet (0.9m) thick, and therefore, known as the Yard Seam. Mine maps do not exist for the workings in the area of interest and it was unclear if both or just one seam was mined. Information from 1830s geological mapping and other data showing shaft locations were used along Scott Street and information from the 1908 Royal Commission was used along Hunter Street to develop an investigation program. In addition, mining was encountered for several sites to the south of the alignment at depths of about 7 m to 25 m. Based on the anticipated depths of mining, it was considered prudent to assess the potential for sinkhole development on the proposed alignment and realigned underground utilities and to obtain approval for the work from Subsidence Advisory NSW (SA NSW). The assessment consisted of a desktop study, followed by a subsurface investigation. Four boreholes were drilled along Scott Street and three boreholes were drilled along Hunter Street using HQ coring techniques in the rock. The placement of boreholes was complicated by the presence of utilities in the roadway and traffic constraints. All the boreholes encountered the Yard Seam, with conditions varying from unmined coal to an open void, indicating the presence of mining. The geotechnical information obtained from the boreholes was expanded by using various downhole techniques including; borehole camera, borehole sonar, and downhole geophysical logging. The camera provided views of the rock and helped to explain zones of no recovery. In addition, timber props within the void were observed. Borehole sonar was performed in the void and provided an indication of room size as well as the presence of timber props within the room. Downhole geophysical logging was performed in the boreholes to measure density, natural gamma, and borehole deviation. The data helped confirm that all the mining was in the Yard Seam and that the overlying Dudley Seam had been eroded in the past over much of the alignment. In summary, the assessment allowed the potential for sinkhole subsidence to be assessed and a mitigation approach developed to allow conditional approval by SA NSW. It also confirmed the presence of mining in the Yard Seam, the depth to the seam and mining conditions, and indicated that subsidence did not appear to have occurred in the past.

Keywords: downhole investigation techniques, drilling, mine subsidence, yard seam

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1882 Factors Associated with Recurrence and Long-Term Survival in Younger and Postmenopausal Women with Breast Cancer

Authors: Sopit Tubtimhin, Chaliya Wamaloon, Anchalee Supattagorn

Abstract:

Background and Significance: Breast cancer is the most frequently diagnosed and leading cause of cancer death among women. This study aims to determine factors potentially predicting recurrence and long-term survival after the first recurrence in surgically treated patients between postmenopausal and younger women. Methods and Analysis: A retrospective cohort study was performed on 498 Thai women with invasive breast cancer, who had undergone mastectomy and been followed-up at Ubon Ratchathani Cancer Hospital, Thailand. We collected based on a systematic chart audit from medical records and pathology reports between January 1, 2002, and December 31, 2011. The last follow-up time point for surviving patients was December 31, 2016. A Cox regression model was used to calculate hazard ratios of recurrence and death. Findings: The median age was 49 (SD ± 9.66) at the time of diagnosis, 47% was post-menopausal women ( ≥ 51years and not experienced any menstrual flow for a minimum of 12 months), and 53 % was younger women ( ˂ 51 years and have menstrual period). Median time from the diagnosis to the last follow-up or death was 10.81 [95% CI = 9.53-12.07] years in younger cases and 8.20 [95% CI = 6.57-9.82] years in postmenopausal cases. The recurrence-free survival (RFS) for younger estimates at 1, 5 and 10 years of 95.0 %, 64.0% and 58.93% respectively, appeared slightly better than the 92.7%, 58.1% and 53.1% for postmenopausal women [HRadj = 1.25, 95% CI = 0.95-1.64]. Regarding overall survival (OS) for younger at 1, 5 and 10 years were 97.7%, 72.7 % and 52.7% respectively, for postmenopausal patients, OS at 1, 5 and 10 years were 95.7%, 70.0% and 44.5 respectively, there were no significant differences in survival [HRadj = 1.23, 95% CI = 0.94 -1.64]. Multivariate analysis identified five risk factors for negatively impacting on survival were triple negative [HR= 2.76, 95% CI = 1.47-5.19], Her2-enriched [HR = 2.59, 95% CI = 1.37-4.91], luminal B [HR = 2.29, 95 % CI=1.35-3.89], not free margin [HR = 1.98, 95%CI=1.00-3.96] and patients who received only adjuvant chemotherapy [HR= 3.75, 95% CI = 2.00-7.04]. Statistically significant risks of overall cancer recurrence were Her2-enriched [HR = 5.20, 95% CI = 2.75-9.80], triple negative [HR = 3.87, 95% CI = 1.98-7.59], luminal B [HR= 2.59, 95% CI = 1.48-4.54,] and patients who received only adjuvant chemotherapy [HR= 2.59, 95% CI = 1.48-5.66]. Discussion and Implications: Outcomes from this studies have shown that postmenopausal women have been associated with increased risk of recurrence and mortality. As the results, it provides useful information for planning the screening and treatment of early-stage breast cancer in the future.

Keywords: breast cancer, menopause status, recurrence-free survival, overall survival

Procedia PDF Downloads 160
1881 A Qualitative Study Exploring Factors Influencing the Uptake of and Engagement with Health and Wellbeing Smartphone Apps

Authors: D. Szinay, O. Perski, A. Jones, T. Chadborn, J. Brown, F. Naughton

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Background: The uptake of health and wellbeing smartphone apps is largely influenced by popularity indicators (e.g., rankings), rather than evidence-based content. Rapid disengagement is common. This study aims to explore how and why potential users 1) select and 2) engage with such apps, and 3) how increased engagement could be promoted. Methods: Semi-structured interviews and a think-aloud approach were used to allow participants to verbalise their thoughts whilst searching for a health or wellbeing app online, followed by a guided search in the UK National Health Service (NHS) 'Apps Library' and Public Health England’s (PHE) 'One You' website. Recruitment took place between June and August 2019. Adults interested in using an app for behaviour change were recruited through social media. Data were analysed using the framework approach. The analysis is both inductive and deductive, with the coding framework being informed by the Theoretical Domains Framework. The results are further mapped onto the COM-B (Capability, Opportunity, Motivation - Behaviour) model. The study protocol is registered on the Open Science Framework (https://osf.io/jrkd3/). Results: The following targets were identified as playing a key role in increasing the uptake of and engagement with health and wellbeing apps: 1) psychological capability (e.g., reduced cognitive load); 2) physical opportunity (e.g., low financial cost); 3) social opportunity (e.g., embedded social media); 4) automatic motivation (e.g., positive feedback). Participants believed that the promotion of evidence-based apps on NHS-related websites could be enhanced through active promotion on social media, adverts on the internet, and in general practitioner practices. Future Implications: These results can inform the development of interventions aiming to promote the uptake of and engagement with evidence-based health and wellbeing apps, a priority within the UK NHS Long Term Plan ('digital first'). The targets identified across the COM-B domains could help organisations that provide platforms for such apps to increase impact through better selection of apps.

Keywords: behaviour change, COM-B model, digital health, mhealth

Procedia PDF Downloads 156
1880 The Relationship of Weight Regain with Biochemical and Psychological Factors in Non Postmenopausal Women

Authors: Farzad Shidfar, Najmeh Rostami, Ziaodin Mazhari, Fatemeh Hosseini Baharanchi

Abstract:

Background and Aim: The rate of failure to maintain a reduced weight has been increased. By definition, people who regain about one-third to two-thirds of their lost weight after one year from the end of the dietary treatment and return all the lost weight after 5 years it is called weight regain. This study was performed to find the causes of weight regain and its relationship with biochemical and psychological factors. Materials and Methods: This cross-sectional study was performed by reviewing the files of people who followed the dietary treatment in 1397-1398.seventy-three persons was in the weight regain group, and seventy-three people were in the weight maintenance group. Psychological factors such as depression, anxiety, quality of life, physical activity, and dietary frequency were assessed through a questionnaire, and biochemical factors such as serum insulin and fasting blood sugar were measured. The mean basal energy in the weight regain group was significantly higher than the weight maintenance group (p = 0.004). There was no significant difference between the two groups in terms of food intake and inflammatory index of food. There was no significant difference between the two groups in terms of food intake and inflammatory index of food. Mean serum insulin concentration (p = 0.023), mean fasting blood sugar (p = 0.04) and insulin resistance (p = 0.013) in the weight regain group were higher than the weight maintenance group. The weight maintenance group showed higher insulin sensitivity than the weight regain group (p = 0.005). There was no significant difference between the two groups in terms of psychological indicators. Conclusion: The only body mass index after one year from the end of the treatment period, insulin sensitivity, serum insulin concentration, fasting blood sugar, insulin resistance, selenium intake, and basal energy expenditure Specific and significant with weight regain. However, the significance of insulin resistance, basal energy expenditure, and body mass index after one year from the end of the treatment period was higher than other variables in the weight regain group.

Keywords: body weight maintenance, weight regain, insulin resistance, insulin sensitivity

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1879 Development of Biosensor Chip for Detection of Specific Antibodies to HSV-1

Authors: Zatovska T. V., Nesterova N. V., Baranova G. V., Zagorodnya S. D.

Abstract:

In recent years, biosensor technologies based on the phenomenon of surface plasmon resonance (SPR) are becoming increasingly used in biology and medicine. Their application facilitates exploration in real time progress of binding of biomolecules and identification of agents that specifically interact with biologically active substances immobilized on the biosensor surface (biochips). Special attention is paid to the use of Biosensor analysis in determining the antibody-antigen interaction in the diagnostics of diseases caused by viruses and bacteria. According to WHO, the diseases that are caused by the herpes simplex virus (HSV), take second place (15.8%) after influenza as a cause of death from viral infections. Current diagnostics of HSV infection include PCR and ELISA assays. The latter allows determination the degree of immune response to viral infection and respective stages of its progress. In this regard, the searches for new and available diagnostic methods are very important. This work was aimed to develop Biosensor chip for detection of specific antibodies to HSV-1 in the human blood serum. The proteins of HSV1 (strain US) were used as antigens. The viral particles were accumulated in cell culture MDBK and purified by differential centrifugation in cesium chloride density gradient. Analysis of the HSV1 proteins was performed by polyacrylamide gel electrophoresis and ELISA. The protein concentration was measured using De Novix DS-11 spectrophotometer. The device for detection of antigen-antibody interactions was an optoelectronic two-channel spectrometer ‘Plasmon-6’, using the SPR phenomenon in the Krechman optical configuration. It was developed at the Lashkarev Institute of Semiconductor Physics of NASU. The used carrier was a glass plate covered with 45 nm gold film. Screening of human blood serums was performed using the test system ‘HSV-1 IgG ELISA’ (GenWay, USA). Development of Biosensor chip included optimization of conditions of viral antigen sorption and analysis steps. For immobilization of viral proteins 0.2% solution of Dextran 17, 200 (Sigma, USA) was used. Sorption of antigen took place at 4-8°C within 18-24 hours. After washing of chip, three times with citrate buffer (pH 5,0) 1% solution of BSA was applied to block the sites not occupied by viral antigen. It was found direct dependence between the amount of immobilized HSV1 antigen and SPR response. Using obtained biochips, panels of 25 positive and 10 negative for the content of antibodies to HSV-1 human sera were analyzed. The average value of SPR response was 185 a.s. for negative sera and from 312 to. 1264 a.s. for positive sera. It was shown that SPR data were agreed with ELISA results in 96% of samples proving the great potential of SPR in such researches. It was investigated the possibility of biochip regeneration and it was shown that application of 10 mM NaOH solution leads to rupture of intermolecular bonds. This allows reuse the chip several times. Thus, in this study biosensor chip for detection of specific antibodies to HSV1 was successfully developed expanding a range of diagnostic methods for this pathogen.

Keywords: biochip, herpes virus, SPR

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1878 Constructivism and Situational Analysis as Background for Researching Complex Phenomena: Example of Inclusion

Authors: Radim Sip, Denisa Denglerova

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It’s impossible to capture complex phenomena, such as inclusion, with reductionism. The most common form of reductionism is the objectivist approach, where processes and relationships are reduced to entities and clearly outlined phases, with a consequent search for relationships between them. Constructivism as a paradigm and situational analysis as a methodological research portfolio represent a way to avoid the dominant objectivist approach. They work with a situation, i.e. with the essential blending of actors and their environment. Primary transactions are taking place between actors and their surroundings. Researchers create constructs based on their need to solve a problem. Concepts therefore do not describe reality, but rather a complex of real needs in relation to the available options how such needs can be met. For examination of a complex problem, corresponding methodological tools and overall design of the research are necessary. Using an original research on inclusion in the Czech Republic as an example, this contribution demonstrates that inclusion is not a substance easily described, but rather a relationship field changing its forms in response to its actors’ behaviour and current circumstances. Inclusion consists of dynamic relationship between an ideal, real circumstances and ways to achieve such ideal under the given circumstances. Such achievement has many shapes and thus cannot be captured by description of objects. It can be expressed in relationships in the situation defined by time and space. Situational analysis offers tools to examine such phenomena. It understands a situation as a complex of dynamically changing aspects and prefers relationships and positions in the given situation over a clear and final definition of actors, entities, etc. Situational analysis assumes creation of constructs as a tool for solving a problem at hand. It emphasizes the meanings that arise in the process of coordinating human actions, and the discourses through which these meanings are negotiated. Finally, it offers “cartographic tools” (situational maps, socials worlds / arenas maps, positional maps) that are able to capture the complexity in other than linear-analytical ways. This approach allows for inclusion to be described as a complex of phenomena taking place with a certain historical preference, a complex that can be overlooked if analyzed with a more traditional approach.

Keywords: constructivism, situational analysis, objective realism, reductionism, inclusion

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1877 Multi-Criteria Decision Making Network Optimization for Green Supply Chains

Authors: Bandar A. Alkhayyal

Abstract:

Modern supply chains are typically linear, transforming virgin raw materials into products for end consumers, who then discard them after use to landfills or incinerators. Nowadays, there are major efforts underway to create a circular economy to reduce non-renewable resource use and waste. One important aspect of these efforts is the development of Green Supply Chain (GSC) systems which enables a reverse flow of used products from consumers back to manufacturers, where they can be refurbished or remanufactured, to both economic and environmental benefit. This paper develops novel multi-objective optimization models to inform GSC system design at multiple levels: (1) strategic planning of facility location and transportation logistics; (2) tactical planning of optimal pricing; and (3) policy planning to account for potential valuation of GSC emissions. First, physical linear programming was applied to evaluate GSC facility placement by determining the quantities of end-of-life products for transport from candidate collection centers to remanufacturing facilities while satisfying cost and capacity criteria. Second, disassembly and remanufacturing processes have received little attention in industrial engineering and process cost modeling literature. The increasing scale of remanufacturing operations, worth nearly $50 billion annually in the United States alone, have made GSC pricing an important subject of research. A non-linear physical programming model for optimization of pricing policy for remanufactured products that maximizes total profit and minimizes product recovery costs were examined and solved. Finally, a deterministic equilibrium model was used to determine the effects of internalizing a cost of GSC greenhouse gas (GHG) emissions into optimization models. Changes in optimal facility use, transportation logistics, and pricing/profit margins were all investigated against a variable cost of carbon, using case study system created based on actual data from sites in the Boston area. As carbon costs increase, the optimal GSC system undergoes several distinct shifts in topology as it seeks new cost-minimal configurations. A comprehensive study of quantitative evaluation and performance of the model has been done using orthogonal arrays. Results were compared to top-down estimates from economic input-output life cycle assessment (EIO-LCA) models, to contrast remanufacturing GHG emission quantities with those from original equipment manufacturing operations. Introducing a carbon cost of $40/t CO2e increases modeled remanufacturing costs by 2.7% but also increases original equipment costs by 2.3%. The assembled work advances the theoretical modeling of optimal GSC systems and presents a rare case study of remanufactured appliances.

Keywords: circular economy, extended producer responsibility, greenhouse gas emissions, industrial ecology, low carbon logistics, green supply chains

Procedia PDF Downloads 158
1876 Hydrogeological Appraisal of Karacahisar Coal Field (Western Turkey): Impacts of Mining on Groundwater Resources Utilized for Water Supply

Authors: Sukran Acikel, Mehmet Ekmekci, Otgonbayar Namkhai

Abstract:

Lignite coal fields in western Turkey generally occurs in tensional Neogene basins bordered by major faults. Karacahisar coal field in Mugla province of western Turkey is a large Neogene basin filled with alternation of silisic and calcerous layers. The basement of the basin is composed of mainly karstified carbonate rocks of Mesozoic and schists of Paleozoic age. The basement rocks are exposed at highlands surrounding the basin. The basin fill deposits forms shallow, low yield and local aquifers whereas karstic carbonate rock masses forms the major aquifer in the region. The karstic aquifer discharges through a spring zone issuing at intersection of two major faults. Municipal water demand in Bodrum city, a touristic attraction area is almost totally supplied by boreholes tapping the karstic aquifer. A well field has been constructed on the eastern edge of the coal basin, which forms a ridge separating two Neogene basins. A major concern was raised about the plausible impact of mining activities on groundwater system in general and on water supply well field in particular. The hydrogeological studies carried out in the area revealed that the coal seam is located below the groundwater level. Mining operations will be affected by groundwater inflow to the pits, which will require dewatering measures. Dewatering activities in mine sites have two-sided effects: a) lowers the groundwater level at and around the pit for a safe and effective mining operation, b) continuous dewatering causes expansion of cone of depression to reach a spring, stream and/or well being utilized by local people, capturing their water. Plausible effect of mining operations on the flow of the spring zone was another issue of concern. Therefore, a detailed representative hydrogeological conceptual model of the site was developed on the basis of available data and field work. According to the hydrogeological conceptual model, dewatering of Neogene layers will not hydraulically affect the water supply wells, however, the ultimate perimeter of the open pit will expand to intersect the well field. According to the conceptual model, the coal seam is separated from the bottom by a thick impervious clay layer sitting on the carbonate basement. Therefore, the hydrostratigraphy does not allow a hydraulic interaction between the mine pit and the karstic carbonate rock aquifer. However, the structural setting in the basin suggests that deep faults intersecting the basement and the Neogene sequence will most probably carry the deep groundwater up to a level above the bottom of the pit. This will require taking necessary measure to lower the piezometric level of the carbonate rock aquifer along the faults. Dewatering the carbonate rock aquifer will reduce the flow to the spring zone. All findings were put together to recommend a strategy for safe and effective mining operation.

Keywords: conceptual model, dewatering, groundwater, mining operation

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1875 Research on the Conservation Strategy of Territorial Landscape Based on Characteristics: The Case of Fujian, China

Authors: Tingting Huang, Sha Li, Geoffrey Griffiths, Martin Lukac, Jianning Zhu

Abstract:

Territorial landscapes have experienced a gradual loss of their typical characteristics during long-term human activities. In order to protect the integrity of regional landscapes, it is necessary to characterize, evaluate and protect them in a graded manner. The study takes Fujian, China, as an example and classifies the landscape characters of the site at the regional scale, middle scale, and detailed scale. A multi-scale approach combining parametric and holistic approaches is used to classify and partition the landscape character types (LCTs) and landscape character areas (LCAs) at different scales, and a multi-element landscape assessment approach is adopted to explore the conservation strategies of the landscape character. Firstly, multiple fields and multiple elements of geography, nature and humanities were selected as the basis of assessment according to the scales. Secondly, the study takes a parametric approach to the classification and partitioning of landscape character, Principal Component Analysis, and two-stage cluster analysis (K-means and GMM) in MATLAB software to obtain LCTs, combines with Canny Operator Edge Detection Algorithm to obtain landscape character contours and corrects LCTs and LCAs by field survey and manual identification methods. Finally, the study adopts the Landscape Sensitivity Assessment method to perform landscape character conservation analysis and formulates five strategies for different LCAs: conservation, enhancement, restoration, creation, and combination. This multi-scale identification approach can efficiently integrate multiple types of landscape character elements, reduce the difficulty of broad-scale operations in the process of landscape character conservation, and provide a basis for landscape character conservation strategies. Based on the natural background and the restoration of regional characteristics, the results of landscape character assessment are scientific and objective and can provide a strong reference in regional and national scale territorial spatial planning.

Keywords: parameterization, multi-scale, landscape character identify, landscape character assessment

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1874 Framework for Explicit Social Justice Nursing Education and Practice: A Constructivist Grounded Theory Research

Authors: Victor Abu

Abstract:

Background: Social justice ideals are considered as the foundation of nursing practice. These ideals are not always clearly integrated into nursing professional standards or curricula. This hinders concerted global nursing agendas for becoming aware of social injustice or engaging in action for social justice to improve the health of individuals and groups. Aim and objectives: The aim was to create an educational framework for empowering nursing students for social justice awareness and action. This purpose was attained by understanding the meaning of social justice, the effect of social injustice, the visibility of social justice learning, and ways of integrating social justice in nursing education and practice. Methods: Critical interpretive methodologies and constructivist grounded theory research designs guided the processes of recruiting nursing students (n = 11) and nurse educators (n = 11) at a London nursing university to participate in interviews and focus groups, which were analysed by coding systems. Findings: Firstly, social justice was described as ethical practices that enable individuals and groups to have good access to health resources. Secondly, social injustice was understood as unfair practices that caused minimal access to resources, social deprivation, and poor health. Thirdly, social justice learning was considered to be invisible in nursing education due to a lack of explicit modules, educator knowledge, and organisational support. Lastly, explicit modules, educating educators, and attracting leaders’ support were suggested as approaches for the visible integration of social justice in nursing education and practice. Discussion: This research proposes approaches for nursing awareness and action for the development of critical active nurse-learner, critical conscious nurse-educator, and servant nurse leader. The framework on Awareness for Social Justice Action (ASJA) created in this research is an approach for empowering nursing students for social justice practices. Conclusion: This research contributes to and advocates for greater nursing scholarship to raise the spotlight on social justice in the profession.

Keywords: social justice, nursing practice, nursing education, nursing curriculum, social justice awareness, social justice action, constructivist grounded theory

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