Search results for: construction site safety
957 Complete Chloroplast DNA Sequences of Georgian Endemic Polyploid Wheats
Authors: M. Gogniashvili, I. Maisaia, A. Kotorashvili, N. Kotaria, T. Beridze
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Three types of plasmon (A, B and G) is typical for genus Triticum. In polyploid species - Triticum turgidum L. and Triticum aestivum L. plasmon B is detected. In the forthcoming paper, complete nucleotide sequence of chloroplast DNA of 11 representatives of Georgian wheat polyploid species, carrying plasmon B was determined. Sequencing of chloroplast DNA was performed on an Illumina MiSeq platform. Chloroplast DNA molecules were assembled using the SOAPdenovo computer program. All contigs were aligned to the reference chloroplast genome sequence using BLASTN. For detection of SNPs and Indels and phylogeny tree construction computer programs Mafft and Blast were used. Using Triticum aestivum L. subsp. macha (Dekapr. & Menabde) Mackey var. paleocolchicum Dekapr. et Menabde as a reference, 5 SNPs can be identified in chloroplast DNA of Georgian endemic polyploid wheat. The number of noncoding substitutions is 2, coding substitutions - 3. In comparison with reference DNA two - 38 bp and 56 bp inversions were observed in paleocolchicum subspecies. There were six 1 bp indels detected in Georgian polyploid wheats, all of them at microsatellite stretches. The phylogeny tree shows that subspecies macha, carthlicum and paleocolchicum occupy different positions. According to the simplified scheme based on SNP and indel data, the ancestral, female parent of the all studied polyploid wheat is unknown X predecesor, from which four lines were formed. 1 SNP and two inversions (38 bp and 56 bp) caused the formation of subsp. paleocolchicum. Three other lines are macha, durum and carthlicum lines. Macha line is further divided into two sublines (M_1 and M_4). Carthlicum line includes subsp.carthlicum and T.aestivum - C_1 - C_2 - A_1. One of the central question of wheat domestication is which people(s) participated in wheat domestication? It is proposed that the predecessors of Georgian peoples (Proto-Kartvelians) must be placed, on the evidence of archaic lexical and toponymic data, in the mountainous regions of the western and central part of the Little Caucasus (the Transcaucasian foothills) at least 4,000 years ago. One of the possibility to explain the ‘wheat puzzle’ is that Kartvelian speakers brought domesticated wheat species and subspecis from Fertile Crescent further north to South Caucasus.Keywords: chloroplast DNA, sequencing, SNP, triticum
Procedia PDF Downloads 157956 Green Synthesis (Using Environment Friendly Bacteria) of Silver-Nanoparticles and Their Application as Drug Delivery Agents
Authors: Sutapa Mondal Roy, Suban K. Sahoo
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The primary aim of this work is to synthesis silver nanoparticles (AgNPs) through environmentally benign routes to avoid any chemical toxicity related undesired side effects. The nanoparticles were stabilized with drug ciprofloxacin (Cp) and were studied for their effectiveness as drug delivery agent. Targeted drug delivery improves the therapeutic potential of drugs at the diseased site as well as lowers the overall dose and undesired side effects. The small size of nanoparticles greatly facilitates the transport of active agents (drugs) across biological membranes and allows them to pass through the smallest capillaries in the body that are 5-6 μm in diameter, and can minimize possible undesired side effects. AgNPs are non-toxic, inert, stable, and has a high binding capacity and thus can be considered as biomaterials. AgNPs were synthesized from the nutrient broth supernatant after the culture of environment-friendly bacteria Bacillus subtilis. The AgNPs were found to show the surface plasmon resonance (SPR) band at 425 nm. The Cp capped Ag nanoparticles formation was complete within 30 minutes, which was confirmed from absorbance spectroscopy. Physico-chemical nature of the AgNPs-Cp system was confirmed by Dynamic Light Scattering (DLS), Transmission Electron Microscopy (TEM) etc. The AgNPs-Cp system size was found to be in the range of 30-40 nm. To monitor the kinetics of drug release from the surface of nanoparticles, the release of Cp was carried out by careful dialysis keeping AgNPs-Cp system inside the dialysis bag at pH 7.4 over time. The drug release was almost complete after 30 hrs. During the drug delivery process, to understand the AgNPs-Cp system in a better way, the sincere theoretical investigation is been performed employing Density Functional Theory. Electronic charge transfer, electron density, binding energy as well as thermodynamic properties like enthalpy, entropy, Gibbs free energy etc. has been predicted. The electronic and thermodynamic properties, governed by the AgNPs-Cp interactions, indicate that the formation of AgNPs-Cp system is exothermic i.e. thermodynamically favorable process. The binding energy and charge transfer analysis implies the optimum stability of the AgNPs-Cp system. Thus, the synthesized Cp-Ag nanoparticles can be effectively used for biological purposes due to its environmentally benign routes of synthesis procedures, which is clean, biocompatible, non-toxic, safe, cost-effective, sustainable and eco-friendly. The Cp-AgNPs as biomaterials can be successfully used for drug delivery procedures due to slow release of drug from nanoparticles over a considerable period of time. The kinetics of the drug release show that this drug-nanoparticle assembly can be effectively used as potential tools for therapeutic applications. The ease of synthetic procedure, lack of possible chemical toxicity and their biological activity along with excellent application as drug delivery agent will open up vista of using nanoparticles as effective and successful drug delivery agent to be used in modern days.Keywords: silver nanoparticles, ciprofloxacin, density functional theory, drug delivery
Procedia PDF Downloads 390955 The Impact of Building Technologies on Local Identity of Urban Settlements
Authors: Eman Nagi Gowid Selim
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Nowadays, the relevance of places to people has been questioned from different perspectives. This is attributed to the fact that many international concrete blocks were used to create multi-use public spaces in neighborhoods based on the techniques of mass-productions concepts that became one of the most effective ways in building construction, replacing the local and traditional built environment. During the last decades, the world has become increasingly globalized and citizen more mobilized, and thus, ignoring the social and environmental dimensions of the local identity. The main enquiries of the research are “How did building technologies affect urban settlement’s identity?” and “What are the impacts of technologies and globalization on local identities in urban spaces? “From this perspective, the research presents firstly, a historical review that shows how old civilizations enhance their local identities using the newly discovered building materials in each era in different urban settlement and fabrics without losing the identity. The second part of the research highlights the different approaches of building technologies and urban design to present a clear understanding of ways of applying and merging between different methodologies to achieve the most efficient urban space design. The third part aims at analyzing some international and national case studies where the form and structure of particular spaces are vital to identifying the morphological elements of urban settlements and the links existing between them. In addition, it determines how the building materials are used to enrich the vocabulary of the local identity. This part ends with the deduction of the guidelines for the integration of the environmental and social dimensions within the building technologies` approaches to enhance the sustainability of local identities and thus, ending up with redefining "Urban Identity" to guide future research in such cultural areas. Finally, the research uses the comparative methodology for applying the deduced guidelines on a national case study namely “Othman`s Towers” in corniche El Maadi, and then ends up by some results in the form of strategies for future researcher, that identifies how to ensure local identity in urban settlements using new building materials and technologies to achieve social and environmental comfort within the cultural areas.Keywords: building technologies, cultural context, environmental approach, participatory design, social dimension, urban spaces
Procedia PDF Downloads 306954 Biomaterials Solutions to Medical Problems: A Technical Review
Authors: Ashish Thakur
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This technical paper was written in view of focusing the biomaterials and its various applications in modern industries. Author tires to elaborate not only the medical, infect plenty of application in other industries. The scope of the research area covers the wide range of physical, biological and chemical sciences that underpin the design of biomaterials and the clinical disciplines in which they are used. A biomaterial is now defined as a substance that has been engineered to take a form which, alone or as part of a complex system, is used to direct, by control of interactions with components of living systems, the course of any therapeutic or diagnostic procedure. Biomaterials are invariably in contact with living tissues. Thus, interactions between the surface of a synthetic material and biological environment must be well understood. This paper reviews the benefits and challenges associated with surface modification of the metals in biomedical applications. The paper also elaborates how the surface characteristics of metallic biomaterials, such as surface chemistry, topography, surface charge, and wettability, influence the protein adsorption and subsequent cell behavior in terms of adhesion, proliferation, and differentiation at the biomaterial–tissue interface. The chapter also highlights various techniques required for surface modification and coating of metallic biomaterials, including physicochemical and biochemical surface treatments and calcium phosphate and oxide coatings. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials. In addition to this, chapter introduces nanomedicine and the use of both natural and synthetic polymeric biomaterials, focuses on specific current polymeric nanomedicine applications and research, and concludes with the challenges of nanomedicine research. Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. Osteoporosis is a worldwide disease with a very high prevalence in humans older than 50. The main clinical consequences are bone fractures, which often lead to patient disability or even death. A number of commercial biomaterials are currently used to treat osteoporotic bone fractures, but most of these have not been specifically designed for that purpose. Many drug- or cell-loaded biomaterials have been proposed in research laboratories, but very few have received approval for commercial use. Polymeric nanomaterial-based therapeutics plays a key role in the field of medicine in treatment areas such as drug delivery, tissue engineering, cancer, diabetes, and neurodegenerative diseases. Advantages in the use of polymers over other materials for nanomedicine include increased functionality, design flexibility, improved processability, and, in some cases, biocompatibility.Keywords: nanomedicine, tissue, infections, biomaterials
Procedia PDF Downloads 267953 Hydro-Mechanical Characterization of PolyChlorinated Biphenyls Polluted Sediments in Interaction with Geomaterials for Landfilling
Authors: Hadi Chahal, Irini Djeran-Maigre
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This paper focuses on the hydro-mechanical behavior of polychlorinated biphenyl (PCB) polluted sediments when stored in landfills and the interaction between PCBs and geosynthetic clay liners (GCL) with respect to hydraulic performance of the liner and the overall performance and stability of landfills. A European decree, adopted in the French regulation forbids the reintroducing of contaminated dredged sediments containing more than 0,64mg/kg Σ 7 PCBs to rivers. At these concentrations, sediments are considered hazardous and a remediation process must be adopted to prevent the release of PCBs into the environment. Dredging and landfilling polluted sediments is considered an eco-environmental remediation solution. French regulations authorize the storage of PCBs contaminated components with less than 50mg/kg in municipal solid waste facilities. Contaminant migration via leachate may be possible. The interactions between PCBs contaminated sediments and the GCL barrier present in the bottom of a landfill for security confinement are not known. Moreover, the hydro-mechanical behavior of stored sediments may affect the performance and the stability of the landfill. In this article, hydro-mechanical characterization of the polluted sediment is presented. This characterization led to predict the behavior of the sediment at the storage site. Chemical testing showed that the concentration of PCBs in sediment samples is between 1.7 and 2,0 mg/kg. Physical characterization showed that the sediment is organic silty sand soil (%Silt=65, %Sand=27, %OM=8) characterized by a high plasticity index (Ip=37%). Permeability tests using permeameter and filter press showed that sediment permeability is in the order of 10-9 m/s. Compressibility tests showed that the sediment is a very compressible soil with Cc=0,53 and Cα =0,0086. In addition, effects of PCB on the swelling behavior of bentonite were studied and the hydraulic performance of the GCL in interaction with PCBs was examined. Swelling tests showed that PCBs don’t affect the swelling behavior of bentonite. Permeability tests were conducted on a 1.0 m pilot scale experiment, simulating a storage facility. PCBs contaminated sediments were directly placed over a passive barrier containing GCL to study the influence of the direct contact of polluted sediment leachate with the GCL. An automatic water system has been designed to simulate precipitation. Effluent quantity and quality have been examined. The sediment settlements and the water level in the sediment have been monitored. The results showed that desiccation affected the behavior of the sediment in the pilot test and that laboratory tests alone are not sufficient to predict the behavior of the sediment in landfill facility. Furthermore, the concentration of PCB in the sediment leachate was very low ( < 0,013 µg/l) and that the permeability of the GCL was affected by other components present in the sediment leachate. Desiccation and cracks were the main parameters that affected the hydro-mechanical behavior of the sediment in the pilot test. In order to reduce these infects, the polluted sediment should be stored at a water content inferior to its shrinkage limit (w=39%). We also propose to conduct other pilot tests with the maximum concentration of PCBs allowed in municipal solid waste facility of 50 mg/kg.Keywords: geosynthetic clay liners, landfill, polychlorinated biphenyl, polluted dredged materials
Procedia PDF Downloads 126952 Asthma Nurse Specialist Improves the Management of Acute Asthma in a University Teaching Hospital: A Quality Improvement Project
Authors: T. Suleiman, C. Mchugh, H. Ranu
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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.Keywords: asthma, nurse specialist, clinical audit, quality improvement
Procedia PDF Downloads 383951 Non-Steroidal Microtubule Disrupting Analogues Induce Programmed Cell Death in Breast and Lung Cancer Cell Lines
Authors: Marcel Verwey, Anna M. Joubert, Elsie M. Nolte, Wolfgang Dohle, Barry V. L. Potter, Anne E. Theron
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A tetrahydroisoquinolinone (THIQ) core can be used to mimic the A,B-ring of colchicine site-binding microtubule disruptors such as 2-methoxyestradiol in the design of anti-cancer agents. Steroidomimeric microtubule disruptors were synthesized by introducing C'2 and C'3 of the steroidal A-ring to C'6 and C'7 of the THIQ core and by introducing a decorated hydrogen bond acceptor motif projecting from the steroidal D-ring to N'2. For this in vitro study, four non-steroidal THIQ-based analogues were investigated and comparative studies were done between the non-sulphamoylated compound STX 3450 and the sulphamoylated compounds STX 2895, STX 3329 and STX 3451. The objective of this study was to investigate the modes of cell death induced by these four THIQ-based analogues in A549 lung carcinoma epithelial cells and metastatic breast adenocarcinoma MDA-MB-231 cells. Cytotoxicity studies to determine the half maximal growth inhibitory concentrations were done using spectrophotometric quantification via crystal violet staining and lactate dehydrogenase (LDH) assays. Microtubule integrity and morphologic changes of exposed cells were investigated using polarization-optical transmitted light differential interference contrast microscopy, transmission electron microscopy and confocal microscopy. Flow cytometric quantification was used to determine apoptosis induction and the effect that THIQ-based analogues have on cell cycle progression. Signal transduction pathways were elucidated by quantification of the mitochondrial membrane integrity, cytochrome c release and caspase 3, -6 and -8 activation. Induction of autophagic cell death by the THIQ-based analogues was investigated by morphological assessment of fluorescent monodansylcadaverine (MDC) staining of acidic vacuoles and by quantifying aggresome formation via flow cytometry. Results revealed that these non-steroidal microtubule disrupting analogues inhibited 50% of cell growth at nanomolar concentrations. Immunofluorescence microscopy indicated microtubule depolarization and the resultant mitotic arrest was further confirmed through cell cycle analysis. Apoptosis induction via the intrinsic pathway was observed due to depolarization of the mitochondrial membrane, induction of cytochrome c release as well as, caspase 3 activation. Potential involvement of programmed cell death type II was observed due to the presence of acidic vacuoles and aggresome formation. Necrotic cell death did not contribute significantly, indicated by stable LDH levels. This in vitro study revealed the induction of the intrinsic apoptotic pathway as well as possible involvement of autophagy after exposure to these THIQ-based analogues in both MDA-MB-231- and A549 cells. Further investigation of this series of anticancer drugs still needs to be conducted to elucidate the temporal, mechanistic and functional crosstalk mechanisms between the two observed programmed cell deaths pathways.Keywords: apoptosis, autophagy, cancer, microtubule disruptor
Procedia PDF Downloads 255950 An Analytical Systematic Design Approach to Evaluate Ballistic Performance of Armour Grade AA7075 Aluminium Alloy Using Friction Stir Processing
Authors: Lahari Ramya Pa, Sudhakar Ib, Madhu Vc, Madhusudhan Reddy Gd, Srinivasa Rao E.
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Selection of suitable armor materials for defense applications is very crucial with respect to increasing mobility of the systems as well as maintaining safety. Therefore, determining the material with the lowest possible areal density that resists the predefined threat successfully is required in armor design studies. A number of light metal and alloys are come in to forefront especially to substitute the armour grade steels. AA5083 aluminium alloy which fit in to the military standards imposed by USA army is foremost nonferrous alloy to consider for possible replacement of steel to increase the mobility of armour vehicles and enhance fuel economy. Growing need of AA5083 aluminium alloy paves a way to develop supplement aluminium alloys maintaining the military standards. It has been witnessed that AA 2xxx aluminium alloy, AA6xxx aluminium alloy and AA7xxx aluminium alloy are the potential material to supplement AA5083 aluminium alloy. Among those cited aluminium series alloys AA7xxx aluminium alloy (heat treatable) possesses high strength and can compete with armour grade steels. Earlier investigations revealed that layering of AA7xxx aluminium alloy can prevent spalling of rear portion of armour during ballistic impacts. Hence, present investigation deals with fabrication of hard layer (made of boron carbide) i.e. layer on AA 7075 aluminium alloy using friction stir processing with an intention of blunting the projectile in the initial impact and backing tough portion(AA7xxx aluminium alloy) to dissipate residual kinetic energy. An analytical approach has been adopted to unfold the ballistic performance of projectile. Penetration of projectile inside the armour has been resolved by considering by strain energy model analysis. Perforation shearing areas i.e. interface of projectile and armour is taken in to account for evaluation of penetration inside the armour. Fabricated surface composites (targets) were tested as per the military standard (JIS.0108.01) in a ballistic testing tunnel at Defence Metallurgical Research Laboratory (DMRL), Hyderabad in standardized testing conditions. Analytical results were well validated with experimental obtained one.Keywords: AA7075 aluminium alloy, friction stir processing, boron carbide, ballistic performance, target
Procedia PDF Downloads 334949 A Design Research Methodology for Light and Stretchable Electrical Thermal Warm-Up Sportswear to Enhance the Performance of Athletes against Harsh Environment
Authors: Chenxiao Yang, Li Li
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In this decade, the sportswear market rapidly expanded while numerous sports brands are conducting fierce competitions to hold their market shares and trying to act as a leader in professional competition sports areas to set the trends. Thus, various advancing sports equipment is being deeply explored to improving athletes’ performance in fierce competitions. Although there is plenty protective equipment such as cuff, running legging, etc., on the market, there is still blank in the field of sportswear during prerace warm-up this important time gap, especially for those competitions host in cold environment. Because there is always time gaps between warm-up and race due to event logistics or unexpected weather factors. Athletes will be exposed to chilly condition for an unpredictable long period of time. As a consequence, the effects of warm-up will be negated, and the competition performance will be degraded. However, reviewing the current market, there is none effective sports equipment provided to help athletes against this harsh environment or the rare existing products are so blocky or heavy to restrict the actions. An ideal thermal-protective sportswear should be light, flexible, comfort and aesthetic at the same time. Therefore, this design research adopted the textile circular knitting methodology to integrate soft silver-coated conductive yarns (ab. SCCYs), elastic nylon yarn and polyester yarn to develop the proposed electrical, thermal sportswear, with the strengths aforementioned. Meanwhile, the relationship between heating performance, stretch load, and energy consumption were investigated. Further, a simulation model was established to ensure providing sufficient warm and flexibility at lower energy cost and with an optimized production, parameter determined. The proposed circular knitting technology and simulation model can be directly applied to instruct prototype developments to cater different target consumers’ needs and ensure prototypes’’ safety. On the other hand, high R&D investment and time consumption can be saved. Further, two prototypes: a kneecap and an elbow guard, were developed to facilitate the transformation of research technology into an industrial application and to give a hint on the blur future blueprint.Keywords: cold environment, silver-coated conductive yarn, electrical thermal textile, stretchable
Procedia PDF Downloads 269948 Seismic Impact and Design on Buried Pipelines
Authors: T. Schmitt, J. Rosin, C. Butenweg
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Seismic design of buried pipeline systems for energy and water supply is not only important for plant and operational safety, but in particular for the maintenance of supply infrastructure after an earthquake. Past earthquakes have shown the vulnerability of pipeline systems. After the Kobe earthquake in Japan in 1995 for instance, in some regions the water supply was interrupted for almost two months. The present paper shows special issues of the seismic wave impacts on buried pipelines, describes calculation methods, proposes approaches and gives calculation examples. Buried pipelines are exposed to different effects of seismic impacts. This paper regards the effects of transient displacement differences and resulting tensions within the pipeline due to the wave propagation of the earthquake. Other effects are permanent displacements due to fault rupture displacements at the surface, soil liquefaction, landslides and seismic soil compaction. The presented model can also be used to calculate fault rupture induced displacements. Based on a three-dimensional Finite Element Model parameter studies are performed to show the influence of several parameters such as incoming wave angle, wave velocity, soil depth and selected displacement time histories. In the computer model, the interaction between the pipeline and the surrounding soil is modeled with non-linear soil springs. A propagating wave is simulated affecting the pipeline punctually independently in time and space. The resulting stresses mainly are caused by displacement differences of neighboring pipeline segments and by soil-structure interaction. The calculation examples focus on pipeline bends as the most critical parts. Special attention is given to the calculation of long-distance heat pipeline systems. Here, in regular distances expansion bends are arranged to ensure movements of the pipeline due to high temperature. Such expansion bends are usually designed with small bending radii, which in the event of an earthquake lead to high bending stresses at the cross-section of the pipeline. Therefore, Karman's elasticity factors, as well as the stress intensity factors for curved pipe sections, must be taken into account. The seismic verification of the pipeline for wave propagation in the soil can be achieved by observing normative strain criteria. Finally, an interpretation of the results and recommendations are given taking into account the most critical parameters.Keywords: buried pipeline, earthquake, seismic impact, transient displacement
Procedia PDF Downloads 189947 Common Health Problems of Filipino Overseas Household Service Workers: Implications for Wellness
Authors: Veronica Ramirez
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For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.Keywords: health, household service worker, overseas, wellness
Procedia PDF Downloads 261946 The Use of Five Times Sit-To-Stand Test in Ambulatory People with Spinal Cord Injury When Tested with or without Hands
Authors: Lalita Khuna, Sugalya Amatachaya, Pipatana Amatachaya, Thiwabhorn Thaweewannakij, Pattra Wattanapan
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The five times sit-to-stand test (FTSST) has been widely used to quantify lower extremity motor strength (LEMS), dynamic balance ability, and risk of falls in many individuals. Recently, it has been used in ambulatory patients with spinal cord injury (SCI) but variously using with or without hands according to patients’ ability. This difference might affect the validity of the test in these individuals. Thus, this study assessed the concurrent validity of the FTSST in ambulatory individuals with SCI, separately for those who could complete the test with or without hands using LEMS and standard functional measures as gold standards. Moreover, the data of the tests from those who completed the FTSST with and without hands were compared. A total of 56 ambulatory participants with SCI who could complete sit-to-stand with or without hands were assessed for the time to complete the FTSST according to their ability. Then they were assessed for their LEMS scores and functional abilities, including the 10-meter walk test (10MWT), the walking index for spinal cord injury II (WISCI II), the timed up and go test (TUGT), and the 6-minute walk test (6MWT). The Mann-Whitney U test was used to compare the different findings between the participants who performed the FTSST with and without hands. The Spearman rank correlation coefficient (ρ) was applied to analyze the levels of correlation between the FTSST and standard tests (LEMS scores and functional measures). There were significant differences in the data between the participants who performed the test with and without hands (p < 0.01). The time to complete the FTSST of the participants who performed the test without hands showed moderate to strong correlation with total LEMS scores and all functional measures (ρ = -0.71 to 0.69, p < 0.001). On the contrary, the FTSST data of those who performed the test with hands were significantly correlated only with the 10MWT, TUGT, and 6MWT (ρ = -0.47 to 0.57, p < 0.01). The present findings confirm the concurrent validity of the FTSST when performed without hands for LEMS and functional mobility necessary for the ability of independence and safety of ambulatory individuals with SCI. However, the test using hands distort the ability of the outcomes to reflect LEMS and WISCI II that reflect lower limb functions. By contrast, the 10MWT, TUGT, and 6MWT allowed upper limb contribution in the tests. Therefore, outcomes of these tests showed a significant correlation to the outcomes of FTSST when assessed using hands. Consequently, the use of FTSST with or without hands needs to consider the clinical application of the outcomes, i.e., to reflect lower limb functions or mobility of the patients.Keywords: mobility, lower limb muscle strength, clinical test, rehabilitation
Procedia PDF Downloads 157945 Is Brain Death Reversal Possible in Near Future: Intrathecal Sodium Nitroprusside (SNP) Superfusion in Brain Death Patients=The 10,000 Fold Effect
Authors: Vinod Kumar Tewari, Mazhar Husain, Hari Kishan Das Gupta
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Background: Primary or secondary brain death is also accompanied with vasospasm of the perforators other than tissue disruption & further exaggerates the anoxic damage, in the form of neuropraxia. In normal conditions the excitatory impulse propagates as anterograde neurotransmission (ANT) and at the level of synapse, glutamate activates NMDA receptors on postsynaptic membrane. Nitric oxide (NO) is produced by Nitric oxide Synthetase (NOS) in postsynaptic dendride or cell body and travels backwards across a chemical synapse to bind to the axon terminal of a presynaptic neuron for regulation of ANT this process is called as the retrograde neurotransmission (RNT). Thus the primary function of NO is RNT and the purpose of RNT is regulation of chemical neurotransmission at synapse. For this reason, RNT allows neural circuits to create feedback loops. The haem is the ligand binding site of NO receptor (sGC) at presynaptic membrane. The affinity of haem exhibits > 10,000-fold excess for NO than Oxygen (THE 10,000 FOLD EFFECT). In pathological conditions ANT, normal synaptic activity including RNT is absent. NO donors like sodium nitroprusside (SNP) releases NO by activating NOS at the level of postsynaptic area. NO now travels backwards across a chemical synapse to bind to the haem of NO receptor at axon terminal of a presynaptic neuron as in normal condition. NO now acts as impulse generator (at presynaptic membrane) thus bypasses the normal ANT. Also the arteriolar perforators are having Nitric Oxide Synthetase (NOS) at the adventitial side (outer border) on which sodium nitroprusside (SNP) acts; causing release of Nitric Oxide (NO) which vasodilates the perforators causing gush of blood in brain’s tissue and reversal of brain death. Objective: In brain death cases we only think for various transplantations but this study being a pilot study reverses some criteria of brain death by vasodilating the arteriolar perforators. To study the effect of intrathecal sodium nitroprusside (IT SNP) in cases of brain death in which: 1. Retrograde transmission = assessed by the hyperacute timings of reversal 2. The arteriolar perforator vasodilatation caused by NO and the maintenance of reversal of brain death reversal. Methods: 35 year old male, who became brain death after head injury and has not shown any signs of improvement after every maneuver for 6 hours, a single superfusion done by SNP via transoptic canal route for quadrigeminal cistern and cisternal puncture for IV ventricular with SNP done. Results: He showed spontaneous respiration (7 bouts) with TCD studies showing start of pulsations of various branches of common carotid arteries. Conclusions: In future we can give this SNP via transoptic canal route and in IV ventricle before declaring the body to be utilized for transplantations or dead or in broader way we can say that in near future it is possible to revert back from brain death or we have to modify our criterion.Keywords: brain death, intrathecal sodium nitroprusside, TCD studies, perforators, vasodilatations, retrograde transmission, 10, 000 fold effect
Procedia PDF Downloads 406944 Influencing Factors on Stability of Shale with Silt Layers at Slopes
Authors: A. K. M. Badrul Alam, Yoshiaki Fujii, Nahid Hasan Dipu, Shakil Ahmed Razo
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Shale rock masses often include silt layers, impacting slope stability in construction and mining. Analyzing their interaction is crucial for long-term stability. This study used an elasto-plastic model, incorporating the stress transfer method and Coulomb's criterion. It computed stress distribution, assessed failure potential, and identified vulnerable regions. A shale rock mass ranging from 14.75 to 16.75 meter thick, with silt layers varying from 0.36 to 0.5 meter thick, was considered in the model. It examined four silt layer conditions: horizontal (SilHL), vertical (SilVL), in-facing (SilIN), and out-facing slope (SilOUT). Mechanical parameters like uniaxial compressive strength (UCS), tensile strength (TS), Young’s modulus (E), Poisson’s ratio, and density were adjusted for varied scenarios: UCS (0.5 to 5 MPa), and E (6 to 60 MPa), keeping UCS/TS = 5 for all the conditions. In the elasto-plastic analysis, the overall decrease of 20%, 40%, 60%, 80%, and 90% was considered. For SilHL:(i) Same E, UCS, and TS for silt layer and shale: strength decrease led to shear, tension then shear; noticeable failure at 60% decrease, significant at 80%, collapse at 90%, (ii) Lower E for silt layer, same strength as shale: no significant differences, (iii) Lower E and UCS, silt layer strength 1/10: No significant differences. For SilVL: (i) Same E, UCS, and TS for silt layer and shale: Similar effects as SilHL, (ii) Lower E for silt layer, same strength as shale: Slip occurred, (iii) Lower E and UCS, silt layer strength 1/10: Bitension failure also observed with larger slip. Toppling failure was observed for lower E cases. For SilIN: (i) Same E, UCS, and TS for silt layer and shale: Effects similar to SilHL, (ii) Lower E for silt layer, same strength as shale: Slip occurred, (iii) Lower E and UCS, silt layer strength 1/10: Tension failure also observed with larger slip. Toppling failure was observed as SilVL. For SilOUT: (i) Same E, UCS, and TS for silt layer and shale: Similar to SilHL with tension failure, (ii) Lower E for silt layer, same strength as shale: No significant differences; failure diverged, (iii) Lower E and UCS, silt layer strength 1/10: Bitension failure also observed with larger slip; failure diverged.Keywords: shale rock masses, silt layers, slope stability, elasto-plastic model, temporal degradation
Procedia PDF Downloads 60943 Achieving Product Robustness through Variation Simulation: An Industrial Case Study
Authors: Narendra Akhadkar, Philippe Delcambre
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In power protection and control products, assembly process variations due to the individual parts manufactured from single or multi-cavity tooling is a major problem. The dimensional and geometrical variations on the individual parts, in the form of manufacturing tolerances and assembly tolerances, are sources of clearance in the kinematic joints, polarization effect in the joints, and tolerance stack-up. All these variations adversely affect the quality of product, functionality, cost, and time-to-market. Variation simulation analysis may be used in the early product design stage to predict such uncertainties. Usually, variations exist in both manufacturing processes and materials. In the tolerance analysis, the effect of the dimensional and geometrical variations of the individual parts on the functional characteristics (conditions) of the final assembled products are studied. A functional characteristic of the product may be affected by a set of interrelated dimensions (functional parameters) that usually form a geometrical closure in a 3D chain. In power protection and control products, the prerequisite is: when a fault occurs in the electrical network, the product must respond quickly to react and break the circuit to clear the fault. Usually, the response time is in milliseconds. Any failure in clearing the fault may result in severe damage to the equipment or network, and human safety is at stake. In this article, we have investigated two important functional characteristics that are associated with the robust performance of the product. It is demonstrated that the experimental data obtained at the Schneider Electric Laboratory prove the very good prediction capabilities of the variation simulation performed using CETOL (tolerance analysis software) in an industrial context. Especially, this study allows design engineers to better understand the critical parts in the product that needs to be manufactured with good, capable tolerances. On the contrary, some parts are not critical for the functional characteristics (conditions) of the product and may lead to some reduction of the manufacturing cost, ensuring robust performance. The capable tolerancing is one of the most important aspects in product and manufacturing process design. In the case of miniature circuit breaker (MCB), the product's quality and its robustness are mainly impacted by two aspects: (1) allocation of design tolerances between the components of a mechanical assembly and (2) manufacturing tolerances in the intermediate machining steps of component fabrication.Keywords: geometrical variation, product robustness, tolerance analysis, variation simulation
Procedia PDF Downloads 168942 Optimizing Stormwater Sampling Design for Estimation of Pollutant Loads
Authors: Raja Umer Sajjad, Chang Hee Lee
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Stormwater runoff is the leading contributor to pollution of receiving waters. In response, an efficient stormwater monitoring program is required to quantify and eventually reduce stormwater pollution. The overall goals of stormwater monitoring programs primarily include the identification of high-risk dischargers and the development of total maximum daily loads (TMDLs). The challenge in developing better monitoring program is to reduce the variability in flux estimates due to sampling errors; however, the success of monitoring program mainly depends on the accuracy of the estimates. Apart from sampling errors, manpower and budgetary constraints also influence the quality of the estimates. This study attempted to develop optimum stormwater monitoring design considering both cost and the quality of the estimated pollutants flux. Three years stormwater monitoring data (2012 – 2014) from a mix land use located within Geumhak watershed South Korea was evaluated. The regional climate is humid and precipitation is usually well distributed through the year. The investigation of a large number of water quality parameters is time-consuming and resource intensive. In order to identify a suite of easy-to-measure parameters to act as a surrogate, Principal Component Analysis (PCA) was applied. Means, standard deviations, coefficient of variation (CV) and other simple statistics were performed using multivariate statistical analysis software SPSS 22.0. The implication of sampling time on monitoring results, number of samples required during the storm event and impact of seasonal first flush were also identified. Based on the observations derived from the PCA biplot and the correlation matrix, total suspended solids (TSS) was identified as a potential surrogate for turbidity, total phosphorus and for heavy metals like lead, chromium, and copper whereas, Chemical Oxygen Demand (COD) was identified as surrogate for organic matter. The CV among different monitored water quality parameters were found higher (ranged from 3.8 to 15.5). It suggests that use of grab sampling design to estimate the mass emission rates in the study area can lead to errors due to large variability. TSS discharge load calculation error was found only 2 % with two different sample size approaches; i.e. 17 samples per storm event and equally distributed 6 samples per storm event. Both seasonal first flush and event first flush phenomena for most water quality parameters were observed in the study area. Samples taken at the initial stage of storm event generally overestimate the mass emissions; however, it was found that collecting a grab sample after initial hour of storm event more closely approximates the mean concentration of the event. It was concluded that site and regional climate specific interventions can be made to optimize the stormwater monitoring program in order to make it more effective and economical.Keywords: first flush, pollutant load, stormwater monitoring, surrogate parameters
Procedia PDF Downloads 244941 DNA Nano Wires: A Charge Transfer Approach
Authors: S. Behnia, S. Fathizadeh, A. Akhshani
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In the recent decades, DNA has increasingly interested in the potential technological applications that not directly related to the coding for functional proteins that is the expressed in form of genetic information. One of the most interesting applications of DNA is related to the construction of nanostructures of high complexity, design of functional nanostructures in nanoelectronical devices, nanosensors and nanocercuits. In this field, DNA is of fundamental interest to the development of DNA-based molecular technologies, as it possesses ideal structural and molecular recognition properties for use in self-assembling nanodevices with a definite molecular architecture. Also, the robust, one-dimensional flexible structure of DNA can be used to design electronic devices, serving as a wire, transistor switch, or rectifier depending on its electronic properties. In order to understand the mechanism of the charge transport along DNA sequences, numerous studies have been carried out. In this regard, conductivity properties of DNA molecule could be investigated in a simple, but chemically specific approach that is intimately related to the Su-Schrieffer-Heeger (SSH) model. In SSH model, the non-diagonal matrix element dependence on intersite displacements is considered. In this approach, the coupling between the charge and lattice deformation is along the helix. This model is a tight-binding linear nanoscale chain established to describe conductivity phenomena in doped polyethylene. It is based on the assumption of a classical harmonic interaction between sites, which is linearly coupled to a tight-binding Hamiltonian. In this work, the Hamiltonian and corresponding motion equations are nonlinear and have high sensitivity to initial conditions. Then, we have tried to move toward the nonlinear dynamics and phase space analysis. Nonlinear dynamics and chaos theory, regardless of any approximation, could open new horizons to understand the conductivity mechanism in DNA. For a detailed study, we have tried to study the current flowing in DNA and investigated the characteristic I-V diagram. As a result, It is shown that there are the (quasi-) ohmic areas in I-V diagram. On the other hand, the regions with a negative differential resistance (NDR) are detectable in diagram.Keywords: DNA conductivity, Landauer resistance, negative dierential resistance, Chaos theory, mean Lyapunov exponent
Procedia PDF Downloads 427940 Enhancing Wayfinding and User Experience in Hospital Environments: A Study of University Medical Centre Ljubljana
Authors: Nastja Utrosa, Matevz Juvancic
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Hospital buildings are complex public environments characterized by intricate functional arrangements and architectural layouts. Effective wayfinding is essential for patients, visitors, students, and staff. However, spatial orientation planning is often overlooked until after construction. While these environments meet functional needs, they frequently neglect the psychological aspects of user experience. This study investigates wayfinding within complex urban healthcare environments, focusing on the influences of spatial design, spatial cognition, and user experience. The inherent complexity of these environments, with extensive spatial dimensions and dispersed buildings, exacerbates the problem. Gradual expansions and additions contribute to disorientation and navigational difficulties for users. Effective route guidance in urban healthcare settings has become increasingly crucial. However, research on the environmental elements that influence wayfinding in such environments remains limited. To address this gap, we conducted a study at the University Medical Centre Ljubljana (UMCL), Slovenia's largest university hospital. Using a questionnaire, we assessed how individuals' perceptions and use of outdoor hospital spaces with a diverse sample (n=179). We evaluated the area’s usability by analyzing visit frequency, stops, modes of arrival, and parking patterns and examined the visitors' age distribution. Additionally, we investigated spatial aids and the use of color as an orientation element at three specific locations within the medical center. Our study explored the impact of color on entrance selection and the effectiveness of warm versus cool colors for wayfinding. Our findings highlight the significance of graphic adjustments in shaping perceptions of hospital outdoor spaces. Most participants preferred visually organized entrances, underscoring the importance of effective visual communication. Implementing these adaptations can substantially enhance the user experience, reducing stress and increasing satisfaction in hospital environments.Keywords: hospital layout design, healthcare facilities, wayfinding, navigational aids, spatial orientation, color, signage
Procedia PDF Downloads 51939 A Dynamic Curriculum as a Platform for Continuous Competence Development
Authors: Niina Jallinoja, Anu Moisio
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Focus on adult learning is vital to overcome economic challenges as well as to respond to the demand for new competencies and sustained productivity in the digitalized world economy. Employees of all ages must be able to carry on continuous professional development to remain competitive in the labor market. According to EU policies, countries should offer more flexible opportunities for adult learners who study online and in so-called ‘second chance’ qualification programmes. Traditionally, adult education in Finland has comprised of not only liberal adult education but also the government funding to study for Bachelor, Master's, and Ph.D. degrees in Finnish Universities and Universities of Applied Sciences (UAS). From the beginning of 2021, public funding is allocated not only to degrees but also to courses to achieve new competencies for adult learners in Finland. Consequently, there will be degree students (often younger of age) and adult learners studying in the same evening, online and blended courses. The question is thus: How are combined studies meeting the different needs of degree students and adult learners? Haaga-Helia University of Applied Sciences (UAS), located in the metropolitan area of Finland, is taking up the challenge of continuous learning for adult learners. Haaga-Helia has been reforming the bachelor level education and respective shorter courses from 2019 in the biggest project in its history. By the end of 2023, Haaga-Helia will have a flexible, modular curriculum for the bachelor's degrees of hospitality management, business administration, business information technology, journalism and sports management. Building on the shared key competencies, degree students will have the possibility to build individual study paths more flexibly, thanks to the new modular structure of the curriculum. They will be able to choose courses across all degrees, and thus, build their own unique competence combinations. All modules can also be offered as separate courses or learning paths to non-degree students, both publicly funded and as commercial services for employers. Consequently, there will be shared course implementations for degree studies and adult learners with various competence requirements. The newly designed courses are piloted in parallel of the designing of the curriculum in Haaga-Helia during 2020 and 2021. Semi-structured online surveys are composed among the participants for the key competence courses. The focus of the research is to understand how students in the bachelor programme and adult learners from Open UAE perceive the learning experience in such a diverse learning group. A comparison is also executed between learning methods of in-site teaching, online implementation, blended learning and virtual self-learning courses to understand how the pedagogy is meeting the learning objectives of these two different groups. The new flexible curricula and the study modules are to be designed to fill the most important competence gaps that exist in the Finnish labor markets. The new curriculum will be dynamic and constantly evolving over time according to the future competence needs in the labor market. This type of approach requires constant dialogue between Haaga-Helia and workplaces during and after designing of the shared curriculum.Keywords: ccompetence development, continuous learning, curriculum, higher education
Procedia PDF Downloads 130938 Epidemiology of Healthcare-Associated Infections among Hematology/Oncology Patients: Results of a Prospective Incidence Survey in a Tunisian University Hospital
Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour
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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence
Procedia PDF Downloads 395937 Lean Implementation in a Nurse Practitioner Led Pediatric Primary Care Clinic: A Case Study
Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller
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Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.Keywords: ambulatory care, lean, pediatric primary care, system efficiency
Procedia PDF Downloads 304936 Advancing Healthcare Excellence in China: Crafting a Strategic Operational Evaluation Index System for Chinese Hospital Departments amid Payment Reform Initiatives
Authors: Jing Jiang, Yuguang Gao, Yang Yu
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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients
Procedia PDF Downloads 69935 Characterization of Polymorphic Forms of Rifaximin
Authors: Ana Carolina Kogawa, Selma Gutierrez Antonio, Hérida Regina Nunes Salgado
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Rifaximin is an oral antimicrobial, gut - selective and not systemic with adverse effects compared to placebo. It is used for the treatment of hepatic encephalopathy, travelers diarrhea, irritable bowel syndrome, Clostridium difficile, ulcerative colitis and acute diarrhea. The crystalline form present in the rifaximin with minimal systemic absorption is α, being the amorphous form significantly different. Regulators are increasingly attention to polymorphisms. Polymorphs can change the form by altering the drug characteristics compromising the effectiveness and safety of the finished product. International Conference on Harmonization issued the ICH Guidance Q6A, which aim to improve the control of polymorphism in new and existing pharmaceuticals. The objective of this study was to obtain polymorphic forms of rifaximin employing recrystallization processes and characterize them by thermal analysis (thermogravimetry - TG and differential scanning calorimetry - DSC), X-ray diffraction, scanning electron microscopy and solubility test. Six polymorphic forms of rifaximin, designated I to VI were obtained by the crystallization process by evaporation of the solvent. The profiles of the TG curves obtained from polymorphic forms of rifaximin are similar to rifaximin and each other, however, the DTG are different, indicating different thermal behaviors. Melting temperature values of all the polymorphic forms were greater to that shown by the rifaximin, indicating the higher thermal stability of the obtained forms. The comparison of the diffractograms of the polymorphic forms of rifaximin with rifaximin α, β and γ constant in patent indicate that forms III, V and VI are formed by mixing polymorph β and α and form III is formed by polymorph β. The polymorphic form I is formed by polymorph β, but with a significant amount of amorphous material. Already, the polymorphic form II consists of polymorph γ, amorphous. In scanning electron microscope is possible to observe the heterogeneity of morphological characteristics of crystals of polymorphic forms among themselves and with rifaximin. The solubility of forms I and II was greater than the solubility of rifaximin, already, forms III, IV and V presented lower solubility than of rifaximin. Similarly, the bioavailability of the amorphous form of rifaximin is considered significantly higher than the form α, the polymorphic forms obtained in this work can not guarantee the excellent tolerability of the reference medicine. Therefore, studies like these are extremely important and they point to the need for greater requirements by the regulatory agencies competent about polymorphs analysis of the raw materials used in the manufacture of medicines marketed globally. These analyzes are not required in the majority of official compendia. Partnerships between industries, research centers and universities would be a viable way to consolidate researches in this area and contribute to improving the quality of solid drugs.Keywords: electronic microscopy, polymorphism, rifaximin, solubility, X-ray diffraction
Procedia PDF Downloads 672934 Resourcing for Post-Disaster Housing Reconstruction: The Case of Cyclone Sidr and Aila in Bangladesh
Authors: Zahidul Islam
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This study investigates the effectiveness of resourcing in post-disaster housing reconstruction with reference to Cyclones Sidr and Aila in Bangladesh. Through evaluating three key theories- Build Back Better approach, Balance Scorecard approach and Dynamic Competency theories, the synthesis of literature, and empirical fieldwork, this research develops a dynamic theoretical framework that moves the trajectory of post-disaster housing reconstruction towards the reconstruction of more resilient houses. The ultimate goal of any post-disaster housing reconstruction project is to provide quality houses and to achieve high levels of satisfaction for beneficiaries. However, post-disaster reconstruction projects often fail in their stated objectives; only 10-20% housing needs are met, with most houses constructed on a temporary rather than permanent basis. A number of scholars have argued that access to resources can significantly increase the capacity and capability of disaster victims to rebuild their lives, including the construction of new homes. This study draws on structured interviews of 285 villagers affected by cyclones to investigate the effectiveness of resourcing in rebuilding houses after Cyclone Sidr in 2007 and Cyclone Aila in 2009. Furthermore, semi-structured interviews were conducted with 20 key stakeholders in UNDP, Oxfam, government officials, and national and international NGOs. The results of this study show that recovery rate of cyclone resilient houses that can withstand cyclone is very low and majority of the population are still vulnerable. Furthermore, hierarchical regression of survey data and thematic analyses of qualitative data indicate that access to resources, level of education, quality of building materials and income generating activities of the respondents are critical for effective post-disaster recovery. Conversely, resource availability, lack of coordination among participant organisations, corruption and lack of access to appropriate land constituted significant obstacles to livelihood recovery. Finally, this study makes significant theoretical contributions to theories of post-disaster recovery by introducing new variables and measures for evaluating the quality and effectiveness of post-disaster housing.Keywords: disaster, resourcing, housing, resilience
Procedia PDF Downloads 149933 Lumbar Punctures: Re-Audit of Procedure Documentation Following the Introduction of a Standardised Procedure Checklist
Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer
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Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation
Procedia PDF Downloads 114932 Sonication as a Versatile Tool for Photocatalysts’ Synthesis and Intensification of Flow Photocatalytic Processes Within the Lignocellulose Valorization Concept
Authors: J. C. Colmenares, M. Paszkiewicz-Gawron, D. Lomot, S. R. Pradhan, A. Qayyum
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This work is a report of recent selected experiments of photocatalysis intensification using flow microphotoreactors (fabricated by an ultrasound-based technique) for photocatalytic selective oxidation of benzyl alcohol (BnOH) to benzaldehyde (PhCHO) (in the frame of the concept of lignin valorization), and the proof of concept of intensifying a flow selective photocatalytic oxidation process by acoustic cavitation. The synthesized photocatalysts were characterized by using different techniques such as UV-Vis diffuse reflectance spectroscopy, X-ray diffraction, nitrogen sorption, thermal gravimetric analysis, and transmission electron microscopy. More specifically, the work will be on: a Design and development of metal-containing TiO₂ coated microflow reactor for photocatalytic partial oxidation of benzyl alcohol: The current work introduces an efficient ultrasound-based metal (Fe, Cu, Co)-containing TiO₂ deposition on the inner walls of a perfluoroalkoxy alkanes (PFA) microtube under mild conditions. The experiments were carried out using commercial TiO₂ and sol-gel synthesized TiO₂. The rough surface formed during sonication is the site for the deposition of these nanoparticles in the inner walls of the microtube. The photocatalytic activities of these semiconductor coated fluoropolymer based microreactors were evaluated for the selective oxidation of BnOH to PhCHO in the liquid flow phase. The analysis of the results showed that various features/parameters are crucial, and by tuning them, it is feasible to improve the conversion of benzyl alcohol and benzaldehyde selectivity. Among all the metal-containing TiO₂ samples, the 0.5 at% Fe/TiO₂ (both, iron and titanium, as cheap, safe, and abundant metals) photocatalyst exhibited the highest BnOH conversion under visible light (515 nm) in a microflow system. This could be explained by the higher crystallite size, high porosity, and flake-like morphology. b. Designing/fabricating photocatalysts by a sonochemical approach and testing them in the appropriate flow sonophotoreactor towards sustainable selective oxidation of key organic model compounds of lignin: Ultrasonication (US)-assitedprecipitaion and US-assitedhydrosolvothermal methods were used for the synthesis of metal-oxide-based and metal-free-carbon-based photocatalysts, respectively. Additionally, we report selected experiments of intensification of a flow photocatalytic selective oxidation through the use of ultrasonic waves. The effort of our research is focused on the utilization of flow sonophotocatalysis for the selective transformation of lignin-based model molecules by nanostructured metal oxides (e.g., TiO₂), and metal-free carbocatalysts. A plethora of parameters that affects the acoustic cavitation phenomena, and as a result the potential of sonication were investigated (e.g. ultrasound frequency and power). Various important photocatalytic parameters such as the wavelength and intensity of the irradiated light, photocatalyst loading, type of solvent, mixture of solvents, and solution pH were also optimized.Keywords: heterogeneous photo-catalysis, metal-free carbonaceous materials, selective redox flow sonophotocatalysis, titanium dioxide
Procedia PDF Downloads 105931 Assessment of Environmental Mercury Contamination from an Old Mercury Processing Plant 'Thor Chemicals' in Cato Ridge, KwaZulu-Natal, South Africa
Authors: Yohana Fessehazion
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Mercury is a prominent example of a heavy metal contaminant in the environment, and it has been extensively investigated for its potential health risk in humans and other organisms. In South Africa, massive mercury contamination happened in1980s when the England-based mercury reclamation processing plant relocated to Cato Ridge, KwaZulu-Natal Province, and discharged mercury waste into the Mngceweni River. This mercury waste discharge resulted in high mercury concentration that exceeded the acceptable levels in Mngceweni River, Umgeni River, and human hair of the nearby villagers. This environmental issue raised the alarm, and over the years, several environmental assessments were reported the dire environmental crises resulting from the Thor Chemicals (now known as Metallica Chemicals) and urged the immediate removal of the around 3,000 tons of mercury waste stored in the factory storage facility over two decades. Recently theft of some containers with the toxic substance from the Thor Chemicals warehouse and the subsequent fire that ravaged the facility furtherly put the factory on the spot escalating the urgency of left behind deadly mercury waste removal. This project aims to investigate the mercury contamination leaking from an old Thor Chemicals mercury processing plant. The focus will be on sediments, water, terrestrial plants, and aquatic weeds such as the prominent water hyacinth weeds in the nearby water systems of Mngceweni River, Umgeni River, and Inanda Dam as a bio-indicator and phytoremediator for mercury pollution. Samples will be collected in spring around October when the condition is favourable for microbial activity to methylate mercury incorporated in sediments and blooming season for some aquatic weeds, particularly water hyacinth. Samples of soil, sediment, water, terrestrial plant, and aquatic weed will be collected per sample site from the point of source (Thor Chemicals), Mngceweni River, Umgeni River, and the Inanda Dam. One-way analysis of variance (ANOVA) tests will be conducted to determine any significant differences in the Hg concentration among all sampling sites, followed by Least Significant Difference post hoc test to determine if mercury contamination varies with the gradient distance from the source point of pollution. The flow injection atomic spectrometry (FIAS) analysis will also be used to compare the mercury sequestration between the different plant tissues (roots and stems). The principal component analysis is also envisaged for use to determine the relationship between the source of mercury pollution and any of the sampling points (Umgeni and Mngceweni Rivers and the Inanda Dam). All the Hg values will be expressed in µg/L or µg/g in order to compare the result with the previous studies and regulatory standards. Sediments are expected to have relatively higher levels of Hg compared to the soils, and aquatic macrophytes, water hyacinth weeds are expected to accumulate a higher concentration of mercury than terrestrial plants and crops.Keywords: mercury, phytoremediation, Thor chemicals, water hyacinth
Procedia PDF Downloads 226930 Submicron Laser-Induced Dot, Ripple and Wrinkle Structures and Their Applications
Authors: P. Slepicka, N. Slepickova Kasalkova, I. Michaljanicova, O. Nedela, Z. Kolska, V. Svorcik
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Polymers exposed to laser or plasma treatment or modified with different wet methods which enable the introduction of nanoparticles or biologically active species, such as amino-acids, may find many applications both as biocompatible or anti-bacterial materials or on the contrary, can be applied for a decrease in the number of cells on the treated surface which opens application in single cell units. For the experiments, two types of materials were chosen, a representative of non-biodegradable polymers, polyethersulphone (PES) and polyhydroxybutyrate (PHB) as biodegradable material. Exposure of solid substrate to laser well below the ablation threshold can lead to formation of various surface structures. The ripples have a period roughly comparable to the wavelength of the incident laser radiation, and their dimensions depend on many factors, such as chemical composition of the polymer substrate, laser wavelength and the angle of incidence. On the contrary, biopolymers may significantly change their surface roughness and thus influence cell compatibility. The focus was on the surface treatment of PES and PHB by pulse excimer KrF laser with wavelength of 248 nm. The changes of physicochemical properties, surface morphology, surface chemistry and ablation of exposed polymers were studied both for PES and PHB. Several analytical methods involving atomic force microscopy, gravimetry, scanning electron microscopy and others were used for the analysis of the treated surface. It was found that the combination of certain input parameters leads not only to the formation of optimal narrow pattern, but to the combination of a ripple and a wrinkle-like structure, which could be an optimal candidate for cell attachment. The interaction of different types of cells and their interactions with the laser exposed surface were studied. It was found that laser treatment contributes as a major factor for wettability/contact angle change. The combination of optimal laser energy and pulse number was used for the construction of a surface with an anti-cellular response. Due to the simple laser treatment, we were able to prepare a biopolymer surface with higher roughness and thus significantly influence the area of growth of different types of cells (U-2 OS cells).Keywords: cell response, excimer laser, polymer treatment, periodic pattern, surface morphology
Procedia PDF Downloads 240929 Turn-Taking and Leading Roles in Early Cognition: Interaction of Social Cognition and Language in Development
Authors: Zsuzsanna Schnell, Francesca Ervas
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Background: Our study aims to clarify how language fosters further cognitive development and how we eventually arrive at the complex human specific skill of pragmatic competence and reveal what levels of mentalization and theory of mind are in place before language. Method: Our experimental pragmatic investigation maps the interaction of mentalization and pragmatic competence. We map the different levels of mentalization that empower different levels of pragmatic meaning construction and evaluate the results with statistical analysis (MannWhitney and ANOVA). Analyzing the comprehension of literal and non-compositional (figurative) utterances, we apply linguistic trials, among them metaphor-, irony-, irony with surface cue-, humor- and the recognition of maxim infringements trial in neurotypical (NT) preschoolers with a coherent and comparative methodology. Results: The findings reveal the relationship and direction of interaction between Language and theory of mind. On the one hand social-cognitive skills enhance, facilitate and provide a basis for language acquisition, and in return linguistic structures (DeVilliers 2000, 2007) provide a framework for further development of mentalizing skills. Conclusions: Findings confirm that this scaffolding becomes a mutually supportive system where language and social cognition develops in interaction. Certain stages in ToM development serve as a precursor of understanding grammatically complex sentences, like embedded phrases which mirror embedded mental states; which, in turn, facilitates the development of pragmatic competence, thus, the social use of language, integrating social, cognitive, linguistic and psychological factors in discourse. Future implications: Our investigation functions as a differential-diagnostic measure, with typically developing results thus serve as a baseline in further empirical research for atypical cases. This enables the study of populations where language and ToM development is disturbed, reveals how language and ToM are acquired and interact, and gives an insight into what this has to do with clinical symptoms. This in turn can reveal the causal link to the syndrome at hand, which can set directions for therapeutic development and training.Keywords: theory of mind, language development, mentalization, language philosophy, experimental pragmatics
Procedia PDF Downloads 36928 Housing Price Dynamics: Comparative Study of 1980-1999 and the New Millenium
Authors: Janne Engblom, Elias Oikarinen
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The understanding of housing price dynamics is of importance to a great number of agents: to portfolio investors, banks, real estate brokers and construction companies as well as to policy makers and households. A panel dataset is one that follows a given sample of individuals over time, and thus provides multiple observations on each individual in the sample. Panel data models include a variety of fixed and random effects models which form a wide range of linear models. A special case of panel data models is dynamic in nature. A complication regarding a dynamic panel data model that includes the lagged dependent variable is endogeneity bias of estimates. Several approaches have been developed to account for this problem. In this paper, the panel models were estimated using the Common Correlated Effects estimator (CCE) of dynamic panel data which also accounts for cross-sectional dependence which is caused by common structures of the economy. In presence of cross-sectional dependence standard OLS gives biased estimates. In this study, U.S housing price dynamics were examined empirically using the dynamic CCE estimator with first-difference of housing price as the dependent and first-differences of per capita income, interest rate, housing stock and lagged price together with deviation of housing prices from their long-run equilibrium level as independents. These deviations were also estimated from the data. The aim of the analysis was to provide estimates with comparisons of estimates between 1980-1999 and 2000-2012. Based on data of 50 U.S cities over 1980-2012 differences of short-run housing price dynamics estimates were mostly significant when two time periods were compared. Significance tests of differences were provided by the model containing interaction terms of independents and time dummy variable. Residual analysis showed very low cross-sectional correlation of the model residuals compared with the standard OLS approach. This means a good fit of CCE estimator model. Estimates of the dynamic panel data model were in line with the theory of housing price dynamics. Results also suggest that dynamics of a housing market is evolving over time.Keywords: dynamic model, panel data, cross-sectional dependence, interaction model
Procedia PDF Downloads 254