Search results for: emergency unit
2342 Stock Market Development and the Growth of Nigerian Economy
Authors: Godwin Chigozie Okpara, Eugene Iheanacho
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This paper examined the dynamic behavior of stock market development and the growth of Nigerian economy. The variables; market capitalization ratio, turnover ratio and liquidity proxies by the ratio of market capitalization to gross domestic product were sourced and computed from the Nigerian stock exchange fact books and the CBN statistical bulletin of the Central Bank of Nigeria. The variables were tested and found stationary and cointregrated using the augumented Dickey Fuller unit root test and the Johnson cointegration test respectively. The dynamic behavior of the stock market development model was verified using the error correction model. The result shows that about 0.4l percent of the short run deviation is corrected every year and also reveals that market capitalization ratio and market liquidity are positive and significant function of economic growth. In other words market capitalization ratio and liquidity positively and significantly impact economic growth. Market development variables such as turnover ratio and market restriction can exert positive but insignificant impact on the growth of the economy suggesting that securities transaction relative to the size of the securities market are not high enough to significantly engender economic growth in Nigeria. In the light of this, the researchers recommend that the regulatory body as well as the government, should provide a conducive environment capable of encouraging the growth and development of the stock market. This if well articulated will enhance the market turnover and the growth of the economy.Keywords: market capitalization ratio, turnover ratio, liquidity, unit root test, cointegration
Procedia PDF Downloads 3372341 Mapping Thermal Properties Using Resistivity, Lithology and Thermal Conductivity Measurements
Authors: Riccardo Pasquali, Keith Harlin, Mark Muller
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The ShallowTherm project is focussed on developing and applying a methodology for extrapolating relatively sparsely sampled thermal conductivity measurements across Ireland using mapped Litho-Electrical (LE) units. The primary data used consist of electrical resistivities derived from the Geological Survey Ireland Tellus airborne electromagnetic dataset, GIS-based maps of Irish geology, and rock thermal conductivities derived from both the current Irish Ground Thermal Properties (IGTP) database and a new programme of sampling and laboratory measurement. The workflow has been developed across three case-study areas that sample a range of different calcareous, arenaceous, argillaceous, and volcanic lithologies. Statistical analysis of resistivity data from individual geological formations has been assessed and integrated with detailed lithological descriptions to define distinct LE units. Thermal conductivity measurements from core and hand samples have been acquired for every geological formation within each study area. The variability and consistency of thermal conductivity measurements within each LE unit is examined with the aim of defining a characteristic thermal conductivity (or range of thermal conductivities) for each LE unit. Mapping of LE units, coupled with characteristic thermal conductivities, provides a method of defining thermal conductivity properties at a regional scale and facilitating the design of ground source heat pump closed-loop collectors.Keywords: thermal conductivity, ground source heat pumps, resistivity, heat exchange, shallow geothermal, Ireland
Procedia PDF Downloads 1772340 Emergency Treatment of Methanol Poisoning: A Mathematical Approach
Authors: Priyanka Ghosh, Priti Kumar Roy
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Every year a considerable number of people die due to methyl alcohol poisoning, in which most of them die even before proper treatment. This work gives a simple and cheap first aid to those affected individuals by the administration of activated charcoal. In this article, we emphasise on the adsorption capability of activated charcoal for the treatment of poisoning and use an impulsive differential equation to study the effect of activated charcoal during adsorption. We also investigate the effects of various parameters on the adsorption which are incorporated in the model system.Keywords: activated charcoal, adsorption, impulsive differential equation, methanol poisoning
Procedia PDF Downloads 3072339 Day-Case Ketamine Infusions in Patients with Chronic Pancreatitis
Authors: S. M. C. Kelly, M. Goulden
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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis
Procedia PDF Downloads 1352338 Design and Implementation Wireless System by Using Microcontrollers.Application for Drive Acquisition System with Multiple Sensors
Authors: H. Fekhar
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Design and implementation acquisition system using radio frequency (RF) ASK module and micro controllers PIC is proposed in this work. The paper includes hardware and software design. The design tools are divided into two units , namely the sender MCU and receiver.The system was designed to measure temperatures of two furnaces and pressure pneumatic process. The wireless transmitter unit use the 433.95 MHz band directly interfaced to micro controller PIC18F4620. The sender unit consists of temperatures-pressure sensors , conditioning circuits , keypad GLCD display and RF module.Signal conditioner converts the output of the sensors into an electric quantity suitable for operation of the display and recording system.The measurements circuits are connected directly to 10 bits multiplexed A/D converter.The graphic liquid crystal display (GLCD) is used . The receiver (RF) module connected to a second microcontroller ,receive the signal via RF receiver , decode the Address/data and reproduces the original data . The strategy adopted for establishing communication between the sender MCU and receiver uses the specific protocol “Header, Address and data”.The communication protocol dealing with transmission and reception have been successfully implemented . Some experimental results are provided to demonstrate the effectiveness of the proposed wireless system. This embedded system track temperatures – pressure signal reasonably well with a small error.Keywords: microcontrollers, sensors, graphic liquid cristal display, protocol, temperature, pressure
Procedia PDF Downloads 4572337 Resilience Compendium: Strategies to Reduce Communities' Risk to Disasters
Authors: Caroline Spencer, Suzanne Cross, Dudley McArdle, Frank Archer
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Objectives: The evolution of the Victorian Compendium of Community-Based Resilience Building Case Studies and its capacity to help communities implement activities that encourage adaptation to disaster risk reduction and promote community resilience in rural and urban locations provide this paper's objectives. Background: Between 2012 and 2019, community groups presented at the Monash University Disaster Resilience Initiative (MUDRI) 'Advancing Community Resilience Annual Forums', provided opportunities for communities to impart local resilience activities, how to solve challenges and share unforeseen learning and be considered for inclusion in the Compendium. A key tenet of the Compendium encourages compiling and sharing of grass-roots resilience building activities to help communities before, during, and after unexpected emergencies. The online Compendium provides free access for anyone wanting to help communities build expertise, reduce program duplication, and save valuable community resources. Identifying case study features across the emergency phases and analyzing critical success factors helps communities understand what worked and what did not work to achieve success and avoid known barriers. International exemplars inform the Compendium, which represents an Australian first and enhances Victorian community resilience initiatives. Emergency Management Victoria provided seed funding for the Compendium. MUDRI matched this support and continues to fund the project. A joint Steering Committee with broad-based user input and Human ethics approval guides its continued growth. Methods: A thematic analysis of the Compendium identified case study features, including critical success factors. Results: The Compendium comprises 38 case studies, representing all eight Victorian regions. Case studies addressed emergency phases, before (29), during (7), and after (17) events. Case studies addressed all hazards (23), bushfires (11), heat (2), fire safety (1), and house fires (1). Twenty case studies used a framework. Thirty received funding, of which nine received less than $20,000 and five received more than $100,000. Twenty-nine addressed a whole of community perspective. Case studies revealed unique and valuable learning in diverse settings. Critical success factors included strong governance; board support, leadership, and trust; partnerships; commitment, adaptability, and stamina; community-led initiatives. Other success factors included a paid facilitator and local government support; external funding, and celebrating success. Anecdotally, we are aware that community groups reference Compendium and that its value adds to community resilience planning. Discussion: The Compendium offers an innovative contribution to resilience research and practice. It augments the seven resilience characteristics to strengthen and encourage communities as outlined in the Statewide Community Resilience Framework for Emergency Management; brings together people from across sectors to deliver distinct, yet connected actions to strengthen resilience as a part of the Rockefeller funded Resilient Melbourne Strategy, and supports communities and economies to be resilient when a shock occurs as identified in the recently published Australian National Disaster Risk Reduction Framework. Each case study offers learning about connecting with community and how to increase their resilience to disaster risks and to keep their community safe from unexpected emergencies. Conclusion: The Compendium enables diverse communities to adopt or adapt proven resilience activities, thereby preserving valuable community resources and offers the opportunity to extend to a national or international Compendium.Keywords: case study, community, compendium, disaster risk reduction, resilience
Procedia PDF Downloads 1202336 Some Inequalities Related with Starlike Log-Harmonic Mappings
Authors: Melike Aydoğan, Dürdane Öztürk
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Let H(D) be the linear space of all analytic functions defined on the open unit disc. A log-harmonic mappings is a solution of the nonlinear elliptic partial differential equation where w(z) ∈ H(D) is second dilatation such that |w(z)| < 1 for all z ∈ D. The aim of this paper is to define some inequalities of starlike logharmonic functions of order α(0 ≤ α ≤ 1).Keywords: starlike log-harmonic functions, univalent functions, distortion theorem
Procedia PDF Downloads 5202335 Disabilities in Railways: Proposed Changes to the Design of Railway Compartments for the Inclusion of Differently Abled Persons
Authors: Bathmajaa Muralisankar
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As much as railway station infrastructure designs and ticket-booking norms have been changed to facilitate use by differently abled persons, the railway train compartments themselves have not been made user-friendly for differently abled persons. Owing to safety concerns, dependency on others for their travel, and fear of isolation, differently abled people do not prefer travelling by train. Rather than including a dedicated compartment open only to the differently abled, including the latter with others in the normal compartment (with the proposed modifications discussed here) will make them feel secure and make for an enhanced travel experience for them. This approach also represents the most practical way to include a particular category of people in the mainstream society. Lowering the height of the compartment doors and providing a wider entrance with a ramp will provide easy entry for those using wheelchairs. As well, removing the first two alternate rows and the first two side seats will not only widen the passage and increase seating space but also improve wheelchair turning radius. This will help them travel without having to depend on others. Seating arrangements may be done to accommodate their family members near them instead of isolating the differently abled in a separate compartment. According to present ticket-booking regulations of the Indian Railways, three to four disabled persons may travel without their family or one to two along with their family, and the numbers may be added or reduced. To help visually challenged and hearing-impaired persons, in addition to the provision of special instruments, railings, and textured footpaths and flooring, the seat numbers above the seats may be set in metal or plastic as an outward projection so the visually impaired can touch and feel the numbers. Braille boards may be included at the entrance to the compartment along with seat numbers in the aforementioned projected manner. These seat numbers may be designed as buttons, which when pressed results in an announcement of the seat number in the applicable local language as well as English. Emergency buttons, rather than emergency chains, within the easy reach of disabled passengers will also help them.Keywords: dependency, differently abled, inclusion, mainstream society
Procedia PDF Downloads 2532334 Pattern of External Injuries Sustained during Bomb Blast Attacks in Karachi, Pakistan from 2000 to 2007
Authors: Arif Anwar Surani, Salman Ali, Asif Surani, Sohaib Zahid, Akbar Shoukat Ali, Zeeshan-Ul-Hassan Usmani, Joseph Varon, Salim Surani
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Objective: Terrorism and suicidal bomb blast attacks are commonplace in Karachi, Pakistan. During the years 2000 to 2007, there were over 60 bomb explosions resulting in more than 1500 casualties. These explosions produce a wide variety of external injuries. We undertook this study to evaluate pattern of external injury produced after bomb blast attacks and to compare injury profile resulting from explosions in open versus semi-confined blast environments. Method: A retrospective, cross-sectional, study was conducted to review injuries sustained after bomb blast attacks in Karachi, Pakistan, from January 2000 to October 2007. Emergency medical records and medico legal certificates of patients presented to three major public sector hospitals of Karachi were evaluated using self-design proforma. Results: Data of 481 victims meet inclusion criteria and were incorporated for final analysis. Of these, 63.6% were injured in open spaces and 36.4% were injured in semi-confined blast environments. Lacerations were commonly encountered as external injury (47.7%) followed by penetrating wounds (15.3%). Lower and upper extremities were most commonly affected (38.6% and 19% respectively). Open and semi-confined blast environments produced a specific injury pattern and profile (p=<0.001). Conclusions: Bomb blast attacks in Karachi produce an external injury pattern consistent with other studies, with exception of an increased frequency in penetrating wounds. Semi-confined blast environments were associated with severe injuries. Further studies are required to better classify injuries and their severity based on standardized scoring systems. Effective emergency response systems must be designed to cope with mass causalities following bomb explosions.Keywords: bomb blast attacks, injury pattern, external injury, open space, semi-confined space, blast environment
Procedia PDF Downloads 3962333 Smart Help at the Workplace for Persons with Disabilities (SHW-PWD)
Authors: Ghassan Kbar, Shady Aly, Ibrahim Alsharawy, Akshay Bhatia, Nur Alhasan, Ronaldo Enriquez
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The Smart Help for persons with disability (PWD) is a part of the project SMARTDISABLE which aims to develop relevant solution for PWD that target to provide an adequate workplace environment for them. It would support PWD needs smartly through smart help to allow them access to relevant information and communicate with other effectively and flexibly, and smart editor that assist them in their daily work. It will assist PWD in knowledge processing and creation as well as being able to be productive at the work place. The technical work of the project involves design of a technological scenario for the Ambient Intelligence (AmI) - based assistive technologies at the workplace consisting of an integrated universal smart solution that suits many different impairment conditions and will be designed to empower the Physically disabled persons (PDP) with the capability to access and effectively utilize the ICTs in order to execute knowledge rich working tasks with minimum efforts and with sufficient comfort level. The proposed technology solution for PWD will support voice recognition along with normal keyboard and mouse to control the smart help and smart editor with dynamic auto display interface that satisfies the requirements for different PWD group. In addition, a smart help will provide intelligent intervention based on the behavior of PWD to guide them and warn them about possible misbehavior. PWD can communicate with others using Voice over IP controlled by voice recognition. Moreover, Auto Emergency Help Response would be supported to assist PWD in case of emergency. This proposed technology solution intended to make PWD very effective at the work environment and flexible using voice to conduct their tasks at the work environment. The proposed solution aims to provide favorable outcomes that assist PWD at the work place, with the opportunity to participate in PWD assistive technology innovation market which is still small and rapidly growing as well as upgrading their quality of life to become similar to the normal people at the workplace. Finally, the proposed smart help solution is applicable in all workplace setting, including offices, manufacturing, hospital, etc.Keywords: ambient intelligence, ICT, persons with disability PWD, smart application, SHW
Procedia PDF Downloads 4212332 The Key Role of a Bystander Improving the Effectiveness of Cardiopulmonary Resuscitation Performed in Extra-Urban Areas
Authors: Leszek Szpakowski, Daniel Celiński, Sławomir Pilip, Grzegorz Michalak
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The aim of the study was to analyse the usefulness of the 'E-rescuer' pilot project planned to be implemented in a chosen area of Eastern Poland in the cases of suspected sudden cardiac arrests in the extra-urban areas. Inventing an application allowing to dispatch simultaneously both Medical Emergency Teams and the E-rescuer to the place of the accident is the crucial assumption of the mentioned pilot project. The E-rescuer is defined to be the trained person able to take effective basic life support and to use automated external defibrillator. Having logged in using a smartphone, the E-rescuer's readiness is reported online to provide cardiopulmonary resuscitation exactly at the given location. Due to the accurately defined location of the E-rescuer, his arrival time is possible to be precisely fixed, and the substantive support through the displayed algorithms is capable of being provided as well. Having analysed the medical records in the years 2015-2016, cardiopulmonary resuscitation was considered to be effective when an early indication of circulation was provided, and the patient was taken to hospital. In the mentioned term, there were 2.291 cases of a sudden cardiac arrest. Cardiopulmonary resuscitation was taken in 621 patients in total including 205 people in the urban area and 416 in the extra-urban areas. The effectiveness of cardiopulmonary resuscitation in the extra-urban areas was much lower (33,8%) than in the urban (50,7%). The average ambulance arrival time was respectively longer in the extra-urban areas, and it was 12,3 minutes while in the urban area 3,3 minutes. There was no significant difference in the average age of studied patients - 62,5 and 64,8 years old. However, the average ambulance arrival time was 7,6 minutes for effective resuscitations and 10,5 minutes for ineffective ones. Hence, the ambulance arrival time is a crucial factor influencing on the effectiveness of cardiopulmonary resuscitation, especially in the extra-urban areas where it is much longer than in the urban. The key role of trained E-rescuers being nearby taking basic life support before the ambulance arrival can effectively support Emergency Medical Services System in Poland.Keywords: basic life support, bystander, effectiveness, resuscitation
Procedia PDF Downloads 2012331 The Application and Relevance of Costing Techniques in Service-Oriented Business Organizations a Review of the Activity-Based Costing (ABC) Technique
Authors: Udeh Nneka Evelyn
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The shortcoming of traditional costing system in terms of validity, accuracy, consistency, and Relevance increased the need for modern management accounting system. Activity –Based Costing (ABC) can be used as a modern tool for planning, Control and decision making for management. Past studies on ABC system have focused on manufacturing firms thereby making the studies on service firms scanty to some extent. This paper reviewed the application and relevance of activity-based costing technique in service oriented business organizations by employing a qualitative research method which relied heavily on literature review of past and current relevant articles focusing on ABC. Findings suggest that ABC is not only appropriate for use in a manufacturing environment; it is also most appropriate for service organizations such as financial institutions, the healthcare industry and government organization. In fact, some banking and financial institutions have been applying the concept for years under other names. One of them is unit costing, which is used to calculate the cost of banking services by determining the cost and consumption of each unit of output of functions required to deliver the service. ABC in very basic terms may provide very good payback for businesses. Some of the benefits that relate directly to the financial services industry are: identification the most profitable customers: more accurate product and service pricing: increase product profitability: Well organized process costs.Keywords: business, costing, organizations, planning, techniques
Procedia PDF Downloads 2392330 The Impact of Developing an Educational Unit in the Light of Twenty-First Century Skills in Developing Language Skills for Non-Arabic Speakers: A Proposed Program for Application to Students of Educational Series in Regular Schools
Authors: Erfan Abdeldaim Mohamed Ahmed Abdalla
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The era of the knowledge explosion in which we live requires us to develop educational curricula quantitatively and qualitatively to adapt to the twenty-first-century skills of critical thinking, problem-solving, communication, cooperation, creativity, and innovation. The process of developing the curriculum is as significant as building it; in fact, the development of curricula may be more difficult than building them. And curriculum development includes analyzing needs, setting goals, designing the content and educational materials, creating language programs, developing teachers, applying for programmes in schools, monitoring and feedback, and then evaluating the language programme resulting from these processes. When we look back at the history of language teaching during the twentieth century, we find that developing the delivery method is the most crucial aspect of change in language teaching doctrines. The concept of delivery method in teaching is a systematic set of teaching practices based on a specific theory of language acquisition. This is a key consideration, as the process of development must include all the curriculum elements in its comprehensive sense: linguistically and non-linguistically. The various Arabic curricula provide the student with a set of units, each unit consisting of a set of linguistic elements. These elements are often not logically arranged, and more importantly, they neglect essential points and highlight other less important ones. Moreover, the educational curricula entail a great deal of monotony in the presentation of content, which makes it hard for the teacher to select adequate content; so that the teacher often navigates among diverse references to prepare a lesson and hardly finds the suitable one. Similarly, the student often gets bored when learning the Arabic language and fails to fulfill considerable progress in it. Therefore, the problem is not related to the lack of curricula, but the problem is the development of the curriculum with all its linguistic and non-linguistic elements in accordance with contemporary challenges and standards for teaching foreign languages. The Arabic library suffers from a lack of references for curriculum development. In this paper, the researcher investigates the elements of development, such as the teacher, content, methods, objectives, evaluation, and activities. Hence, a set of general guidelines in the field of educational development were reached. The paper highlights the need to identify weaknesses in educational curricula, decide the twenty-first-century skills that must be employed in Arabic education curricula, and the employment of foreign language teaching standards in current Arabic Curricula. The researcher assumes that the series of teaching Arabic to speakers of other languages in regular schools do not address the skills of the twenty-first century, which is what the researcher tries to apply in the proposed unit. The experimental method is the method of this study. It is based on two groups: experimental and control. The development of an educational unit will help build suitable educational series for students of the Arabic language in regular schools, in which twenty-first-century skills and standards for teaching foreign languages will be addressed and be more useful and attractive to students.Keywords: curriculum, development, Arabic language, non-native, skills
Procedia PDF Downloads 842329 Improving the Technology of Assembly by Use of Computer Calculations
Authors: Mariya V. Yanyukina, Michael A. Bolotov
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Assembling accuracy is the degree of accordance between the actual values of the parameters obtained during assembly, and the values specified in the assembly drawings and technical specifications. However, the assembling accuracy depends not only on the quality of the production process but also on the correctness of the assembly process. Therefore, preliminary calculations of assembly stages are carried out to verify the correspondence of real geometric parameters to their acceptable values. In the aviation industry, most calculations involve interacting dimensional chains. This greatly complicates the task. Solving such problems requires a special approach. The purpose of this article is to carry out the problem of improving the technology of assembly of aviation units by use of computer calculations. One of the actual examples of the assembly unit, in which there is an interacting dimensional chain, is the turbine wheel of gas turbine engine. Dimensional chain of turbine wheel is formed by geometric parameters of disk and set of blades. The interaction of the dimensional chain consists in the formation of two chains. The first chain is formed by the dimensions that determine the location of the grooves for the installation of the blades, and the dimensions of the blade roots. The second dimensional chain is formed by the dimensions of the airfoil shroud platform. The interaction of the dimensional chain of the turbine wheel is the interdependence of the first and second chains by means of power circuits formed by a plurality of middle parts of the turbine blades. The timeliness of the calculation of the dimensional chain of the turbine wheel is the need to improve the technology of assembly of this unit. The task at hand contains geometric and mathematical components; therefore, its solution can be implemented following the algorithm: 1) research and analysis of production errors by geometric parameters; 2) development of a parametric model in the CAD system; 3) creation of set of CAD-models of details taking into account actual or generalized distributions of errors of geometrical parameters; 4) calculation model in the CAE-system, loading of various combinations of models of parts; 5) the accumulation of statistics and analysis. The main task is to pre-simulate the assembly process by calculating the interacting dimensional chains. The article describes the approach to the solution from the point of view of mathematical statistics, implemented in the software package Matlab. Within the framework of the study, there are data on the measurement of the components of the turbine wheel-blades and disks, as a result of which it is expected that the assembly process of the unit will be optimized by solving dimensional chains.Keywords: accuracy, assembly, interacting dimension chains, turbine
Procedia PDF Downloads 3722328 Approaching In vivo Dosimetry for Kilovoltage X-Ray Radiotherapy
Authors: Rodolfo Alfonso, David Alonso, Albin Garcia, Jose Luis Alonso
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Recently a new kilovoltage radiotherapy unit model Xstrahl 200 - donated to the INOR´s Department of Radiotherapy (DR-INOR) in the framework of a IAEA's technical cooperation project- has been commissioned. This unit is able to treat shallow and low deep laying lesions, as it provides 8 discrete beam qualities, from 40 to 200 kV. As part of the patient-specific quality assurance program established at DR-INOR for external beam radiotherapy, it has been recommended to implement in vivo dose measurements (IVD), as they allow effectively discovering eventual errors or failures in the radiotherapy process. For that purpose a radio-photoluminescence (RPL) dosimetry system, model XXX, -also donated to DR-INOR by the same IAEA project- has been studied and commissioned. Main dosimetric parameters of the RPL system, such as reproducibility, linearity, and filed size influence were assessed. In a similar way, the response of radiochromic EBT3 type film was investigated for purposes of IVD. Both systems were calibrated in terms of entrance surface dose. Results of the dosimetric commissioning of RPL and EBT3 for IVD, and their pre-clinical implementation through end-to-end test cases are presented. The RPL dosimetry seems more recommendable for hyper-fractionated schemes with larger fields and curved patient contours, as those in chest wall irradiations, where the use of more than one dosimeter could be required. The radiochromic system involves smaller corrections with field size, but it sensibility is lower; hence it is more adequate for hypo-fractionated treatments with smaller fields.Keywords: glass dosimetry, in vivo dosimetry, kilovotage radiotherapy, radiochromic dosimetry
Procedia PDF Downloads 3942327 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 3872326 Use of Chlorophyll Meters to Assess In-Season Wheat Nitrogen Fertilizer Requirements in the Southern San Joaquin Valley
Authors: Brian Marsh
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Nitrogen fertilizer is the most used and often the most mismanaged nutrient input. Nitrogen management has tremendous implications on crop productivity, quality and environmental stewardship. Sufficient nitrogen is needed to optimum yield and quality. Soil and in-season plant tissue testing for nitrogen status are a time consuming and expensive process. Real time sensing of plant nitrogen status can be a useful tool in managing nitrogen inputs. The objectives of this project were to assess the reliability of remotely sensed non-destructive plant nitrogen measurements compared to wet chemistry data from sampled plant tissue, develop in-season nitrogen recommendations based on remotely sensed data for improved nitrogen use efficiency and assess the potential for determining yield and quality from remotely sensed data. Very good correlations were observed between early-season remotely sensed crop nitrogen status and plant nitrogen concentrations and subsequent in-season fertilizer recommendations. The transmittance/absorbance type meters gave the most accurate readings. Early in-season fertilizer recommendation would be to apply 40 kg nitrogen per hectare plus 16 kg nitrogen per hectare for each unit difference measured with the SPAD meter between the crop and reference area or 25 kg plus 13 kg per hectare for each unit difference measured with the CCM 200. Once the crop was sufficiently fertilized meter readings became inconclusive and were of no benefit for determining nitrogen status, silage yield and quality and grain yield and protein.Keywords: wheat, nitrogen fertilization, chlorophyll meter
Procedia PDF Downloads 3912325 Algorithms of ABS-Plastic Extrusion
Authors: Dmitrii Starikov, Evgeny Rybakov, Denis Zhuravlev
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Plastic for 3D printing is very necessary material part for printers. But plastic production is technological process, which implies application of different control algorithms. Possible algorithms of providing set diameter of plastic fiber are proposed and described in the article. Results of research were proved by existing unit of filament production.Keywords: ABS-plastic, automation, control system, extruder, filament, PID-algorithm
Procedia PDF Downloads 4002324 Modelling Heat Transfer Characteristics in the Pasteurization Process of Medium Long Necked Bottled Beers
Authors: S. K. Fasogbon, O. E. Oguegbu
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Pasteurization is one of the most important steps in the preservation of beer products, which improves its shelf life by inactivating almost all the spoilage organisms present in it. However, there is no gain saying the fact that it is always difficult to determine the slowest heating zone, the temperature profile and pasteurization units inside bottled beer during pasteurization, hence there had been significant experimental and ANSYS fluent approaches on the problem. This work now developed Computational fluid dynamics model using COMSOL Multiphysics. The model was simulated to determine the slowest heating zone, temperature profile and pasteurization units inside the bottled beer during the pasteurization process. The results of the simulation were compared with the existing data in the literature. The results showed that, the location and size of the slowest heating zone is dependent on the time-temperature combination of each zone. The results also showed that the temperature profile of the bottled beer was found to be affected by the natural convection resulting from variation in density during pasteurization process and that the pasteurization unit increases with time subject to the temperature reached by the beer. Although the results of this work agreed with literatures in the aspects of slowest heating zone and temperature profiles, the results of pasteurization unit however did not agree. It was suspected that this must have been greatly affected by the bottle geometry, specific heat capacity and density of the beer in question. The work concludes that for effective pasteurization to be achieved, there is a need to optimize the spray water temperature and the time spent by the bottled product in each of the pasteurization zones.Keywords: modeling, heat transfer, temperature profile, pasteurization process, bottled beer
Procedia PDF Downloads 2022323 Determination of the Stability of Haloperidol Tablets and Phenytoin Capsules Stored in the Inpatient Dispensary System (Swisslog) by the Respective HPLC and Raman Spectroscopy Assay
Authors: Carol Yue-En Ong, Angelina Hui-Min Tan, Quan Liu, Paul Chi-Lui Ho
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A public general hospital in Singapore has recently implemented an automated unit-dose machine in their inpatient dispensary, Swisslog, with the objective of reducing human error and improving patient safety. However, a concern in stability arises as tablets are removed from their original packaging (bottled loose tablets/capsules) and are repackaged into individual, clear plastic wrappers as unit doses in the system. Drugs that are light-sensitive and hygroscopic would be more susceptible to degradation as the wrapper does not offer full protection. Hence, this study was carried out to study the stability of haloperidol tablets and phenytoin capsules that are light-sensitive and hygroscopic respectively. Validated HPLC-UV assays were first established for quantification of these two compounds. The medications involved were put in the Swisslog and sampled every week for one month. The collected data was analysed and showed no degradation over time. This study also explored an alternative approach for drug stability determination-Raman spectroscopy. The advantage of Raman spectroscopy is its high time efficiency and non-destructive nature. The results suggest that drug degradation can indeed be detected using Raman microscopy, but further research is needed to establish this approach for quantification or qualification of compounds. NanoRam®, a portable Raman spectrocope was also used alongside Raman microscopy but was unsuccessful in detecting degradation in this study.Keywords: drug stability, haloperidol, HPLC, phenytoin, raman spectroscopy, Swisslog
Procedia PDF Downloads 3462322 A Case Study on the Condition Monitoring of a Critical Machine in a Tyre Manufacturing Plant
Authors: Ramachandra C. G., Amarnath. M., Prashanth Pai M., Nagesh S. N.
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The machine's performance level drops down over a period of time due to the wear and tear of its components. The early detection of an emergent fault becomes very vital in order to obtain uninterrupted production in a plant. Maintenance is an activity that helps to keep the machine's performance at an anticipated level, thereby ensuring the availability of the machine to perform its intended function. At present, a number of modern maintenance techniques are available, such as preventive maintenance, predictive maintenance, condition-based maintenance, total productive maintenance, etc. Condition-based maintenance or condition monitoring is one such modern maintenance technique in which the machine's condition or health is checked by the measurement of certain parameters such as sound level, temperature, velocity, displacement, vibration, etc. It can recognize most of the factors restraining the usefulness and efficacy of the total manufacturing unit. This research work is conducted on a Batch Mill in a tire production unit located in the Southern Karnataka region. The health of the mill is assessed using amplitude of vibration as a parameter of measurement. Most commonly, the vibration level is assessed using various points on the machine bearing. The normal or standard level is fixed using reference materials such as manuals or catalogs supplied by the manufacturers and also by referring vibration standards. The Rio-Vibro meter is placed in different locations on the batch-off mill to record the vibration data. The data collected are analyzed to identify the malfunctioning components in the batch off the mill, and corrective measures are suggested.Keywords: availability, displacement, vibration, rio-vibro, condition monitoring
Procedia PDF Downloads 892321 Considerations upon Structural Health Monitoring of Small to Medium Wind Turbines
Authors: Nicolae Constantin, Ştefan Sorohan
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The small and medium wind turbines are running in quite different conditions as compared to the big ones. Consequently, they need also a different approach concerning the structural health monitoring (SHM) issues. There are four main differences between the above mentioned categories: (i) significantly smaller dimensions, (ii) considerably higher rotation speed, (iii) generally small distance between the turbine and the energy consumer and (iv) monitoring assumed in many situations by the owner. In such conditions, nondestructive inspections (NDI) have to be made as much as possible with affordable, yet effective techniques, requiring portable and accessible equipment. Additionally, the turbines and accessories should be easy to mount, dispose and repair. As the materials used for such unit can be metals, composites and combined, the technologies should be adapted accordingly. An example in which the two materials co-exist is the situation in which the damaged metallic skin of a blade is repaired with a composite patch. The paper presents the inspection of the bonding state of the patch, using portable ultrasonic equipment, able to put in place the Lamb wave method, which proves efficient in global and local inspections as well. The equipment is relatively easy to handle and can be borrowed from specialized laboratories or used by a community of small wind turbine users, upon the case. This evaluation is the first in a row, aimed to evaluate efficiency of NDI performed with rather accessible, less sophisticated equipment and related inspection techniques, having field inspection capabilities. The main goal is to extend such inspection procedures to other components of the wind power unit, such as the support tower, water storage tanks, etc.Keywords: structural health monitoring, small wind turbines, non-destructive inspection, field inspection capabilities
Procedia PDF Downloads 3372320 An Audit of Local Guidance Compliance For Stereotactic Core Biopsy For DCIS In The Breast Screening Programme
Authors: Aisling Eves, Andrew Pieri, Ross McLean, Nerys Forester
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Background: The breast unit local guideline recommends that 12 cores should be used in a stereotactic-guided biopsy to diagnose DCIS. Twelve cores are regarded to provide good diagnostic value without removing more breast tissue than necessary. This study aimed to determine compliance with guidelines and investigated how the number of cores impacted upon the re-excision rate and size discrepancies. Methods: This single-centre retrospective cohort study of 72 consecutive breast screened patients with <15mm DCIS on radiological report underwent stereotactic-guided core biopsy and subsequent surgical excision. Clinical, radiological, and histological data were collected over 5 years, and ASCO guidelines for margin involvement of <2mm was used to guide the need for re-excision. Results: Forty-six (63.9%) patients had <12 cores taken, and 26 (36.1%) patients had ≥12 cores taken. Only six (8.3%) patients had 12 cores taken in their stereotactic biopsy. Incomplete surgical excision was seen in 17 patients overall (23.6%), and of these patients, twelve (70.6%) had fewer than 12 cores taken (p=0.55 for the difference between groups). Mammogram and biopsy underestimated the size of the DCIS in this subgroup by a median of 15mm (range: 6-135mm). Re-excision was required in 9 patients (12.5%), and five patients (6.9%) were found to have invasive ductal carcinoma on excision (80% had <12 cores, p=0.43). Discussion: There is poor compliance with the breast unit local guidelines and higher rates of re-excision in patients who did not have ≥12 cores taken. Taking ≥12 cores resulted in fewer missed invasive cancers lower incomplete excision and re-excision rates.Keywords: stereotactic core biopsy, DCIS, breast screening, Re-excision rates, core biopsy
Procedia PDF Downloads 1262319 Geochemical and Geostructural Characteristics of the Groundwater System and the Role of Faults in Groundwater Movement at the Hammamet Basin, Tebessa Area (Northeast of Algeria)
Authors: iklass hamaili, Fehdi Chemseddine
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Morphostructural, hydrogeological and hydrochemical approaches were applied in this study to characterize the groundwater system of Hammamet Plain, Eastern part of Algeria and its potential for exploitation. The analysis of the fractures in several Mountains forming the natural boundaries of Hammamet plain, with faults of markedly different sizes and joints measured at 21 stations, demonstrate the presence of two principal directions of fractures (NNW-SSE and NNE-SSW). From a hydrogeological standpoint, these two mountains constitute a unit limited by faults-oriented ENE-WSW, NNW-SSE and NNE-SSW. Specifically, fractures of the latter two directions influence the compartmentalization and the hydrogeological functioning of this unit. According to the degree of fracturing and/or karstification, two basic types of aquiferous behavior have been distinguished: fissured aquifer (Essen Mountain and Troubia Mountain), and porous aquifer (Hammamet basin). After sampling and measurement operations, the quantity of chemical components was determined. Thus, the study of the hydrochemical characteristics of this groundwater shows on Piper’s diagram that the majority of them are mainly HCO₃- and Ca₂+ water types. The ionic speciation and mineral dissolution/precipitation were calculated by PHREEQC package software. The chemical composition of the water is influenced by the dissolution and/or precipitation processes during the water-rock interaction and by the cationic exchange reactions between groundwater and alluvial sediments. The high content of CO₂ in the water samples suggests that they circulate in a geochemical opened system.Keywords: aquifer, hydrogeology, hydrochemistry, Hammamet, Tebessa, Algeria
Procedia PDF Downloads 162318 Establishing Sequence Stratigraphic Framework and Hydrocarbon Potential of the Late Cretaceous Strata: A Case Study from Central Indus Basin, Pakistan
Authors: Bilal Wadood, Suleman Khan, Sajjad Ahmed
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The Late Cretaceous strata (Mughal Kot Formation) exposed in Central Indus Basin, Pakistan is evaluated for establishing sequence stratigraphic framework and potential of hydrocarbon accumulation. The petrographic studies and SEM analysis were carried out to infer the hydrocarbon potential of the rock unit. The petrographic details disclosed 4 microfacies including Pelagic Mudstone, OrbitoidalWackestone, Quartz Arenite, and Quartz Wacke. The lowermost part of the rock unit consists of OrbitoidalWackestone which shows deposition in the middle shelf environment. The Quartz Arenite and Quartz Wacke suggest deposition on the deep slope settings while the Pelagic Mudstone microfacies point toward deposition in the distal deep marine settings. Based on the facies stacking patterns and cyclicity in the chronostratigraphic context, the strata is divided into two 3rd order cycles. One complete sequence i.e Transgressive system tract (TST), Highstand system tract (HST) and Lowstand system tract (LST) are again replaced by another Transgressive system tract and Highstant system tract with no markers of sequence boundary. The LST sands are sandwiched between TST and HST shales but no potential porosity/permeability values have been determined. Microfacies and SEM studies revealed very fewer chances for hydrocarbon accumulation and overall reservoir potential is characterized as low.Keywords: cycle, deposition, microfacies, reservoir
Procedia PDF Downloads 1492317 A Distributed Smart Battery Management System – sBMS, for Stationary Energy Storage Applications
Authors: António J. Gano, Carmen Rangel
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Currently, electric energy storage systems for stationary applications have known an increasing interest, namely with the integration of local renewable energy power sources into energy communities. Li-ion batteries are considered the leading electric storage devices to achieve this integration, and Battery Management Systems (BMS) are decisive for their control and optimum performance. In this work, the advancement of a smart BMS (sBMS) prototype with a modular distributed topology is described. The system, still under development, has a distributed architecture with modular characteristics to operate with different battery pack topologies and charge capacities, integrating adaptive algorithms for functional state real-time monitoring and management of multicellular Li-ion batteries, and is intended for application in the context of a local energy community fed by renewable energy sources. This sBMS system includes different developed hardware units: (1) Cell monitoring units (CMUs) for interfacing with each individual cell or module monitoring within the battery pack; (2) Battery monitoring and switching unit (BMU) for global battery pack monitoring, thermal control and functional operating state switching; (3) Main management and local control unit (MCU) for local sBMS’s management and control, also serving as a communications gateway to external systems and devices. This architecture is fully expandable to battery packs with a large number of cells, or modules, interconnected in series, as the several units have local data acquisition and processing capabilities, communicating over a standard CAN bus and will be able to operate almost autonomously. The CMU units are intended to be used with Li-ion cells but can be used with other cell chemistries, with output voltages within the 2.5 to 5 V range. The different unit’s characteristics and specifications are described, including the different implemented hardware solutions. The developed hardware supports both passive and active methods for charge equalization, considered fundamental functionalities for optimizing the performance and the useful lifetime of a Li-ion battery package. The functional characteristics of the different units of this sBMS system, including different process variables data acquisition using a flexible set of sensors, can support the development of custom algorithms for estimating the parameters defining the functional states of the battery pack (State-of-Charge, State-of-Health, etc.) as well as different charge equalizing strategies and algorithms. This sBMS system is intended to interface with other systems and devices using standard communication protocols, like those used by the Internet of Things. In the future, this sBMS architecture can evolve to a fully decentralized topology, with all the units using Wi-Fi protocols and integrating a mesh network, making unnecessary the MCU unit. The status of the work in progress is reported, leading to conclusions on the system already executed, considering the implemented hardware solution, not only as fully functional advanced and configurable battery management system but also as a platform for developing custom algorithms and optimizing strategies to achieve better performance of electric energy stationary storage devices.Keywords: Li-ion battery, smart BMS, stationary electric storage, distributed BMS
Procedia PDF Downloads 992316 Creativity and Innovation in a Military Unit of South America: Decision Making Process, Socio-Emotional Climate, Shared Flow and Leadership
Authors: S. da Costa, D. Páez, E. Martínez, A. Torres, M. Beramendi, D. Hermosilla, M. Muratori
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This study examined the association between creative performance, organizational climate and leadership, affectivity, shared flow, and group decision making. The sample consisted of 315 cadets of a military academic unit of South America. Satisfaction with the decision-making process during a creative task was associated with the usefulness and effectiveness of the ideas generated by the teams with a weighted average correlation of r = .18. Organizational emotional climate, positive and innovation leadership were associated with this group decision-making process r = .25, with shared flow, r = .29 and with positive affect felt during the performance of the creative task, r = .12. In a sequential mediational analysis positive organizational leadership styles were significantly associated with decision-making process and trough cohesion with utility and efficacy of the solution of a creative task. Satisfactory decision-making was related to shared flow during the creative task at collective or group level, and positive affect with flow at individual level.This study examined the association between creative performance, organizational climate and leadership, affectivity, shared flow, and group decision making. The sample consisted of 315 cadets of a military academic unit of South America. Satisfaction with the decision-making process during a creative task was associated with the usefulness and effectiveness of the ideas generated by the teams with a weighted average correlation of r = .18. Organizational emotional climate, positive and innovation leadership were associated with this group decision-making process r = .25, with shared flow, r = .29 and with positive affect felt during the performance of the creative task, r = .12. In a sequential mediational analysis positive organizational leadership styles were significantly associated with decision-making process and trough cohesion with utility and efficacy of the solution of a creative task. Satisfactory decision-making was related to shared flow during the creative task at collective or group level, and positive affect with flow at individual level.Keywords: creativity, innovation, military, organization, teams
Procedia PDF Downloads 1222315 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education
Authors: Lauren G. Coggins
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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.Keywords: education, healthcare-associated infections, infection, nursing, prevention
Procedia PDF Downloads 1162314 Resilient Design Solutions for Megathermal Climates of the Global South
Authors: Bobuchi Ken-Opurum
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The impacts of climate change on urban settlements is growing. In the global south, communities are even more vulnerable and suffer there is an increased vulnerability from due to climate change disasters such as flooding and high temperatures. This is primarily due to high intensity rainfall, low-lying coasts, inadequate infrastructure, and limited resources. According to the Emergency Events Database, floods were the leading cause of disaster -based deaths in the global south between 2006 and 2015. This includes deaths from heat stress related health outcomes. Adapting to climate vulnerabilities is paramount in reducing the significant redevelopment costs from climate disasters. Governments and urban planners provide top-down approaches such as evacuation, and disaster and emergency communication. While they address infrastructure and public services, they are not always able to address the immediate and critical day to day needs of poor and vulnerable populations. There is growing evidence that some bottom-up strategies and grassroots initiatives of self-build housing such as in urban informal settlements are successful in coping and adapting to hydroclimatic impacts. However, these research findings are not consolidated and the evaluation of the resilience outcomes of the bottom-up strategies are limited. Using self-build housing as a model for sustainable and resilient urban planning, this research aimed to consolidate the flood and heat stress resilient design solutions, analyze the effectiveness of these solutions, and develop guidelines and methods for adopting these design solutions into mainstream housing in megathermal climates. The methodological approach comprised of analyses of over 40 ethnographic based peer reviewed literature, white papers, and reports between the years 2000 and 2019 to identify coping strategies and grassroots initiatives that have been applied by occupants and communities of the global south. The results of the research provide a consolidated source and prioritized list of the best bottom-up strategies for communities in megathermal climates to improve the lives of people in some of the most vulnerable places in the world.Keywords: resilient, design, megathermal, climate change
Procedia PDF Downloads 1242313 Prescription of Lubricating Eye Drops in the Emergency Eye Department: A Quality Improvement Project
Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley
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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.Keywords: lubrication, dry eye disease, guideline, prescription
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