Search results for: hospital site suitability

Authors: Muhammad Ghaffar Doggar, Farah

Abstract:

The primary objective of this feasibility study is to conduct a techno-financial assessment for installation of biomass based power plant in Faisalabad division. The study involves identification of best site for power plant followed by an assessment of biomass resource potential in the area and propose power plant of suitable size. The study also entailed comprehensive supply chain analysis to determine biomass fuel pricing, transportation and storage. Further technical and financial analyses have been done for selection of appropriate technology for the power plant and its financial viability, respectively. The assessment of biomass resources and the subsequent technical analysis revealed that 20 MW biomass power plant could be implemented at one of the locations near Faisalabad city i.e. AARI Site, Near Chak Jhumra district Faisalabad, Punjab province. Three options for steam pressure; namely, 70 bar, 90 bar and 100 bar boilers have been considered. Using international experience and prices on power plant technology and local prices on locally available equipment, the study concludes biomass fuel price of around 50 US dollars (USD) per ton when delivered to power plant site. The electricity prices used for feasibility calculations were 0.13 USD per KWh for electricity from a locally financed project and 0.11 USD per KWh for internationally financed power plant. For local financing the most viable choice is the 70 bar solution and with international financing, the most feasible solution is using a 90 bar boiler. Between the two options, the internationally financed 90 bar boiler setup gives better financial results than the locally financed 70 bar boiler project. It has been concluded that 20 MW with 90 bar power plant and internationally financed would have an equity IRR of 23% and a payback period of 7 years. This will be a cheap option for installation of power plants.

Keywords: AARI, Ayub agriculture research institute, biomass - crops residue, KWh - electricity Units, MG - Muhammad Ghaffar

Procedia PDF Downloads 331

Authors: Po-Ching Chou, Wen-Chen Liang, I. Chen Chen, Jong-Hau Hsu, Yuh-Jyh Jong

Abstract:

Background：Cardiopulmonary complications seem to cause high morbidity and mortality in patients with neuromuscular diseases (NMD) but so far there is no domestic data reported in Taiwan. We, therefore attempted to analyze the factors to cause the death in NMD patients from our cohort. Methods：From 1998 to 2013, we retrospectively collected the information of the NMD patients treated and followed up in Kaohsiung Medical University Hospital. Forty-two patients with NMD who expired during these fifteen years were enrolled. The medical records of these patients were reviewed and the causes of death and the associated affecting factors were analyzed. Results：Eighteen patients with NMD (mean age=13.3, SD=12.4) with complete medical record and detailed information were finally included in this study, including spinal muscular atrophy (SMA) (n=9, 7/9: type 1), Duchenne muscular dystrophy (n=6), congenital muscular dystrophy (n=1), carnitine acyl-carnitine translocase (CACT) deficiency (n=1) and spinal muscular atrophy with respiratory distress (SMARD)(n=1). The place of death was in ICU (n=11, 61%), emergency room (n=3, 16.6%) or home (n=4, 22.2%). For SMA type 1 patients, most of them (71.4%, 5/7) died in emergency room or home and the other two expired during an ICU admission. The causes of death included acute respiratory failure due to pneumonia (n=13, 72.2 %), ventilator failure or dislocation (n=2, 11.1%), suffocation/choking (n=2, 11.1%), and heart failure with hypertrophic cardiomyopathy (n=1, 5.55%). Among the 15 patients died of respiratory failure or choking, 73.3% of the patients (n=11) received no ventilator care at home. 80% of the patients (n=12) received no cough assist at home. The patient died of cardiomyopathy received no medications for heart failure until the last admission. Conclusion: Respiratory failure and choking are the leading causes of death in NMD patients. Appropriate respiratory support and airway clearance play the critical role to reduce the mortality.

Keywords: neuromuscular disease, cause of death, tertiary care hospital, medical sciences

Procedia PDF Downloads 524

Authors: Dorsa Pourmojib, Marc J. Boutin

Abstract:

Urban space is used everyday by a diverse range of urban dwellers, each with different expectations. In this space, opportunities and resources are not distributed equitably among urban dwellers, despite the importance of inclusivity. In addition, some marginalized groups may not be considered. These include people with low incomes, immigrants from diverse cultures, various age groups, and those with special needs. To this end, this research aims to enhance social equity in urban space by bridging the gap between social equity and spatial equity in the urban context. This gap in the knowledge base related to urban design may be present for several reasons; lack of studies on relationship between social equity and spatial equity in urban open space, lack of practical design strategies for promoting social equity in urban open space, lack of proper site analysis in terms of context and users of the site both for designing new urban open spaces and developing the existing ones, and lack of researchers that are designers and finally it could be related to priorities of the city’s policies in addressing such issues, since it is time, money and energy consuming. The main objective of this project is addressing the aforementioned gap in the knowledge by exploring the relationship between social equity and spatial equity in urban open space. Answering the main question of this research is a promising step to this end; 'What are the considerations towards providing social equity through the design of urban elements that offer spatial equity?' To answer the main question of this research there are several secondary questions which should be addressed. Such as; how can the characteristics of social equity be translated to spatial equity? What are the diverse user’s needs and which of their needs are not considered in that site? What are the specific elements in the site which should be designed in order to promote social equity? What is the current situation of social and spatial equity in the proposed site? To answer the research questions and achieve the proposed objectives, a three-step methodology has been implemented. Firstly, a comprehensive research framework based on the available literature has been presented. Afterwards, three different urban spaces have been analyzed in terms of specific key research questions as the precedent studies; Naqsh-e Jahan Square (Iran), Superkilen Park (Denmark) and Campo Dei Fiori (Italy). In this regard, a proper gap analysis of the current situation and the proposed situation of these sites has been conducted. Finally, by combining the extracted design considerations from the precedent studies and the literature review, practical design strategies have been introduced as a result of this research. The presented guidelines enable the designers to create socially equitable urban spaces. To conclude, this research proposes a spatial approach to social inclusion and equity in urban space by presenting a practical framework and criteria for translating social equity to spatial equity in urban areas.

Keywords: inclusive urban design, social equity, social inclusion, spatial equity

Procedia PDF Downloads 132

Authors: Lip Vui Tshin

Abstract:

Sabah, one of the thirteen Malaysian states, is located in the northern part of Malaysian Borneo. It is a melting pot of many different cultures and traditions, being home to about 2.9 million people with more than 30 ethic groups. It is also known as one of the twelve mega-diversity sites in the world with its rich living heritage; ethnic makes it ideal for the ecotourism industry. Sabah enjoys a steady flow of eco tourists from domestic and international markets with a gradual increase in the number of visitor arrival each year. Sabah’s ecotourism is categorized by its natural attraction, wildlife and wilderness habitats. This paper sets out to interpret and develop the indicators for success ecotourism sites in Sabah and measures its development stage. The long-term viability of tourism can be assured only when the limitations and favorable opportunities of the overall environment for tourism development are understood and ways to measure changes induced by tourism are identified and applied. This is a literature review of ecotourism site success indicators, and the outcome of this review is the identification of existing clusters and categorization of indicators and charting the way forward to develop a better understanding in ecotourism site success.

Keywords: ecotourism, ecotourism indicators, ecotourism success, Sabah

Procedia PDF Downloads 263

Authors: G. S. Ayyappan, Srinivas Kota, Jaffer R. C. Sheriff, C. Prakash Chandra Joshua

Abstract:

In the present scenario of energy crises, energy conservation in the electrical machines is very important in the industries. In order to conserve energy, one needs to monitor the performance of an induction motor on-site and in-situ. The instruments available for this purpose are very meager and very expensive. This paper deals with the design and development of induction motor performance analyser on-line, on-site, and in-situ. The system measures only few electrical input parameters like input voltage, line current, power factor, frequency, powers, and motor shaft speed. These measured data are coupled to name plate details and compute the operating efficiency of induction motor. This system employs the method of computing motor losses with the help of equivalent circuit parameters. The equivalent circuit parameters of the concerned motor are estimated using the developed algorithm at any load conditions and stored in the system memory. The developed instrument is a reliable, accurate, compact, rugged, and cost-effective one. This portable instrument could be used as a handy tool to study the performance of both slip ring and cage induction motors. During the analysis, the data can be stored in SD Memory card and one can perform various analyses like load vs. efficiency, torque vs. speed characteristics, etc. With the help of the developed instrument, one can operate the motor around its Best Operating Point (BOP). Continuous monitoring of the motor efficiency could lead to Life Cycle Assessment (LCA) of motors. LCA helps in taking decisions on motor replacement or retaining or refurbishment.

Keywords: energy conservation, equivalent circuit parameters, induction motor efficiency, life cycle assessment, motor performance analysis

Procedia PDF Downloads 371

Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman

Abstract:

Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.

Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital

Procedia PDF Downloads 145

Authors: Abdelkader Merah, Kada Hartani

Abstract:

A reference model based control approach for improving behavior following car is proposed in this paper. The reference model is nonlinear and provides dynamic solutions consistent with safety constraints and comfort specifications. a robust fuzzy logic based control strategy is further proposed in this paper. A set of simulation results showing the suitability of the proposed technique for various demanding cenarios is also included in this paper.

Keywords: reference model, longitudinal control, fuzzy logic, design of car

Procedia PDF Downloads 419

Authors: Renu Gupta, Ashim K. Pramanik

Abstract:

We report the evolution of structure and magnetic properties in perovskite ruthenates Sr1-xPrxRuO3 (x = 0.0 and 0.1). Our main expectations, to induce the structural modification and change the Ru charge state by Pr doping at Sr site. By the Pr doping on Sr site retains orthorhombic structure while we find a minor change in structural parameters. The SrRuO3 have itinerant type of ferromagnetism with ordering temperature ~160 K. By Pr doping, the magnetic moment decrease and ZFC show three distinct peaks (three transition temperature; TM1, TM2 and TM3). Further analysis of magnetization of both samples, at high temperature follow modified CWL and Pr doping gives Curie temperature ~ 129 K which is close to TM2. Above TM2 to TM3, the inverse susceptibility shows upward deviation from CW behavior, indicating the existence AFM like clustered in this regime. The low-temperature isothermal magnetization M (H) shows moment decreases by Pr doping. The Arrott plot gives spontaneous magnetization (Ms) which also decreases by Pr doping. The evolution of Rhodes-Wohlfarth ratio increases which suggests the FM in this system evolves toward the itinerant type by Pr doping.

Keywords: itinerant ferromagnet, Perovskite structure, Ruthenates, Rhodes-Wohlfarth ratio

Procedia PDF Downloads 347

Authors: Yiu K. C. Jacky, Tang S. K. Eric, W. Y. Tsang, C. Y. Li, C. K. Leung

Abstract:

Objectives : (1) To enhance the competence of nurses on using IPMOE for drug administration; (2) To ensure the transition on implementation of IPMOE in safer and smooth way hospital-wide. Methodology: (1) Well-structured Governance: To make provision for IPMOE implementation, multidisciplinary governance structure at Corporate and Local levels are well established. (2) Staff Engagement: A series of staff engagement events were conducted including Staff Forum, IPMOE Hospital Visit, Kick-off Ceremony and establishment of IPMOE Webpage for familiarizing the forthcoming implementation with frontline staff. (3) Well-organized training program: from Workshop to Workplace Two different IPMOE training programs were tailor-made which aimed at introducing the core features of administration module. Fifty-five identical training classes and six train-the-trainer workshops were organized at 2-3Q 2015. Lending Scheme on IPMOE hardware for hands-on practicing was launched and further extended the training from workshop to workplace. (4) Standard Guidelines and Workflow: the related workflow and guidelines are developed which facilitates users to acquire the competence towards IPMOE and fully familiarize with the standardized contingency plan. (5) Facilities and Equipment: The installations of IPMOE hardware were promptly arranged for rollout. Besides, IPMOE training venue was well-established for staff training. (6) Risk Management Strategy: UCH Medication Safety Forum is organized in December 2015 for sharing “Tricks & Tips” on IPMOE which further disseminate at webpage for arousal of medication safety. Hospital-wide annual audit on drug administration was planned to figure out the compliance and deliberate the rooms for improvement. Results: Through the comprehensive training plan, over 1,000 UCH nurses attended the training program with positive feedback. They agreed that their competence on using IPMOE was enhanced. By the end of November 2015, 28 wards (over 1,000 Inpatient-bed) involving departments of M&G, SUR, O&T and O&G have been successfully rolled out IPMOE in 5-month. A smooth and safe transition of implementation of IPMOE was achieved. Eventually, we all get prepared for embedding IPMOE into daily nursing and work altogether for medication safety at UCH.

Keywords: drug administration, inpatient medication order entry system, medication safety, nursing informatics

Procedia PDF Downloads 328

Authors: Jeffrey Siphiwe Mkhize

Abstract:

Twelve years of schooling for most South African children, particularly those children from disadvantaged past, are confronted with numerous and diverse challenges. These challenges range from infrastructural limitations, language of teaching, poor resources and varying family backgrounds. Likewise, schools are categorized to signify schools’ geographic location, poverty lines, societal class and type of students that the school are likely to enroll. Such categorization perpetuates particular lines of identities that are indirectly reinforced by the same system that seeks to redress. South African universities prefer point systems to determine students’ suitability to gain access to their programmes. Once students are admitted based on the qualifying points there is an assumed equity in the manner in which they receive tuition. They are assumed as equal; noting the widened access to South African universities as means to redress past inequalities. Given the challenges, inequalities, it is necessary to view higher education as a site for knowledge construction that is accessible to all students. Epistemological access is key to all students irrespective of their socio-economic status. This paper seeks to contribute to the discourse of student engagement using lecturer-student relationship as a lens to understand this phenomenon. Data were generated using South African Survey of Student Engagement, focus group interviews, semi-structured one-on-one-interviews as well as document analysis. The focus was on students registered for the first year of a Bachelor of Education degree as well as lecturers that teach high risk modules in this qualification at the same level. The findings suggest that lecturers are challenged by overcrowded classrooms and over-enrolled modules; this challenge hampers their good intentions to become more efficient and innovative in their teaching. Students lack confidence in approaching lecturers for assistance. Collaborative learning has stronger results and students believe in self-support to deal with their challenges based on their individual strengths. Collaborative learning is key to student academic performance.

Keywords: collaborative learning, consultations, student engagement, student performance

Procedia PDF Downloads 101

Authors: Yoshitaka Ooya, Daishuke Furuya, Manabu Nemoto

Abstract:

Some countries such as Canada and Australia have mandatory bicycle helmet laws for all citizens and age groups. As of 2008 Japan has also adopted a helmet law but it is restricted to people 13 years old and under. People over 13 years of age are not required to wear helmets in Japan. Currently, the rate that people 0-13 years old actually wear helmets is low. In 2013 a number of patients came to Saitama University Hospital International Medical Center for treatment due to bicycle-related trauma. The total number of patients was 89 (55 male and 34 female). The average age of the patients was 40.9 years old (eldest; 83 y/o, median; 40 y/o, youngest; 1 y/o with a standard deviation ± 2.8). 54 of these patients (61%) experienced head trauma as well as some experiencing multiple injuries associated with their accident. 13 patients were wearing helmets, 50 patients were not wearing helmets and it is unknown if the remaining 26 patients were wearing helmets. This information was acquired from the patient`s medical charts. Only one patient who was wearing a helmet had a severe head injury, and this patient also experienced other multiple injuries. 17 patients who were not wearing helmets had severe head injuries and out of the 17, two had multiple injuries. The mechanism for injury varied. 12 patients were injured in an accident with a vehicle, only one of which was wearing a helmet. This patient also had multiple injuries. Of the other 11 patients, two had multiple injuries. The remaining patient`s injuries were caused by other accidents (3; fell over while riding, 2; crashed into an inanimate object, 1; collided with a motorcycle). The ladder of which had a severe head injury. All of these patients had light energy accidents and were all over 13 years of age. In Japan it is not mandatory for people over the age of 13 years to wear a bicycle helmet. Research shows that light energy accidents were mostly present in people over the age of 13, to which the law does not require the wearing of helmets. It is important that all people in all age groups be required to wear helmets when operating a bicycle to reduce the rate of light energy severe head injuries.

Keywords: bicycle helmet, head trauma, hospital, traumatic situation

Procedia PDF Downloads 352

Authors: Henni Mansour Abdelwaheb

Abstract:

This study discusses the design of a bounded position/force feedback controller developed to ensure position and force tracking for bilateral teleoperation arms operating with variable delay, and actuator saturation. Also, an adaptive robust Radial Basis Function (RBF) neural network is used to estimate the environment torque. The parameters of the environment torque are then sent from the slave site to the master site as a non-power signal to avoid passivity problems. Moreover, a nonlinear function is applied to each controller term as a smooth saturation function, providing a bounded control signal and preserving the system’s actuators. Lastly, the Lyapunov approach demonstrates the global stability of the controlled system, and numerical experiment results further confirm the validity of the presented strategy.

Keywords: teleoperation manipulators system, time-varying delay, actuator saturation, adaptive robust rbf neural network approximation, uncertainties

Procedia PDF Downloads 67

Authors: Abdulmalik Altuwayjiri, Milad Pirhadi, Sina Taghvaee, Constantinos Sioutas

Abstract:

A significant portion of PM₂.₅ mass concentration is carbonaceous matter (CM), which majorly exists in the form of organic carbon (OC). Ambient OC originates from a multitude of sources and plays an important role in global climate effects, visibility degradation, and human health. In this study, positive matrix factorization (PMF) was utilized to identify and quantify the long-term contribution of PM₂.₅ sources to total OC mass concentration in central Los Angeles (CELA) and Riverside (i.e., receptor site), using the chemical speciation network (CSN) database between 2005 and 2015, a period during which several state and local regulations on tailpipe emissions were implemented in the area. Our PMF resolved five different factors, including tailpipe emissions, non-tailpipe emissions, biomass burning, secondary organic aerosol (SOA), and local industrial activities for both sampling sites. The contribution of vehicular exhaust emissions to the OC mass concentrations significantly decreased from 3.5 µg/m³ in 2005 to 1.5 µg/m³ in 2015 (by about 58%) at CELA, and from 3.3 µg/m³ in 2005 to 1.2 µg/m³ in 2015 (by nearly 62%) at Riverside. Additionally, SOA contribution to the total OC mass, showing higher levels at the receptor site, increased from 23% in 2005 to 33% and 29% in 2010 and 2015, respectively, in Riverside, whereas the corresponding contribution at the CELA site was 16%, 21% and 19% during the same period. The biomass burning maintained an almost constant relative contribution over the whole period. Moreover, while the adopted regulations and policies were very effective at reducing the contribution of tailpipe emissions, they have led to an overall increase in the fractional contributions of non-tailpipe emissions to total OC in CELA (about 14%, 28%, and 28% in 2005, 2010 and 2015, respectively) and Riverside (22%, 27% and 26% in 2005, 2010 and 2015), underscoring the necessity to develop equally effective mitigation policies targeting non-tailpipe PM emissions.

Keywords: PM₂.₅, organic carbon, Los Angeles megacity, PMF, source apportionment, non-tailpipe emissions

Procedia PDF Downloads 190

Authors: Luksanaporn Krungkraipetch

Abstract:

Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

Procedia PDF Downloads 59

Authors: A. Kavita Murugkar, B. Anurag Kashyap

Abstract:

With the Rights for Persons with Disabilities Act (RPWD Act) 2016, the Indian government has made it mandatory for all establishments, including Heritage Sites, to be accessible for People with Disabilities. However, recent access audit surveys done under the Accessible India Campaign by Ministry of Culture indicate that there are very few accessibility measures provided in the Heritage sites for people with disabilities. Though there are some measures for the mobility impaired, surveys brought out that there are almost no provisions for people with vision impairment (PwVI) in heritage sites thus depriving them of a reasonable physical & intellectual access that facilitates an enjoyable experience and enriching interpretation of the Heritage Site. There is a growing need to develop multisensory interpretative tools that can help the PwVI in perceiving heritage sites in the absence of vision. The purpose of this research was to examine the usability of an audio-tactile model as a haptic and sound-based strategy for augmenting the perception and experience of PwVI in a heritage site. The first phase of the project was a multi-stage phenomenological experimental study with visually impaired users to investigate the design parameters for developing an audio-tactile model for PwVI. The findings from this phase included user preferences related to the physical design of the model such as the size, scale, materials, details, etc., and the information that it will carry such as braille, audio output, tactile text, etc. This was followed by the second phase in which a working prototype of an audio-tactile model is designed and developed for a heritage site based on the findings from the first phase of the study. A nationally listed heritage site from the author’s city was selected for making the model. The model was lastly tested by visually impaired users for final refinements and validation. The prototype developed empowers People with Vision Impairment to navigate independently in heritage sites. Such a model if installed in every heritage site, can serve as a technological guide for the Person with Vision Impairment, giving information of the architecture, details, planning & scale of the buildings, the entrances, location of important features, lifts, staircases, and available, accessible facilities. The model was constructed using 3D modeling and digital printing technology. Though designed for the Indian context, this assistive technology for the blind can be explored for wider applications across the globe. Such an accessible solution can change the otherwise “incomplete’’ perception of the disabled visitor, in this case, a visually impaired visitor and augment the quality of their experience in heritage sites.

Keywords: accessibility, architectural perception, audio tactile model , inclusive heritage, multi-sensory perception, visual impairment, visitor experience

Procedia PDF Downloads 100

Authors: Seyed Abolhasan Naeini, Saeideh Mohammadi

Abstract:

Rapid urban development leads to the construction of urban tunnels for transport. Passage of tunnels under the surface structures and utilities prompted the changes in the site conditions and hence alteration of the dynamic response of surface structures. Therefore, in this study, the effect of the interaction of tunnel-superstructure on the site response is investigated numerically. For this purpose, Fast Lagrangian Analysis of Continua (FLAC 2D) is used, and stratification and properties of soil layers are selected based on the line No 7 of Tehran subway. The superstructure is modeled both as an equivalent surcharge and the actual structure, and the results are compared. A comparison of the results shows that consideration of structure geometry is necessary for dynamic analysis and it leads to the changes in displacements and accelerations. Consequently, the geometry of the superstructure should be modeled completely instead of the application of an equivalent load. The effect of tunnel diameter and depth on the settlement of superstructures is also studied. Results show that when the tunnel depth and diameter grow, the settlements increase considerably.

Keywords: tunnel, FLAC2D, settlement, dynamic analysis

Procedia PDF Downloads 123

Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

Abstract:

In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

Procedia PDF Downloads 444

Authors: Arditya Nugraha, Herry Gunawan, Agung P. Widodo

Abstract:

The various possible strategies to find hydrocarbon are explored within a wide ranging of efforts. It started to identify petroleum concept in the basin. The main objectives of this paper are to integrate and develop information, knowledge, and evaluation from Indonesia’s sedimentary basins system in terms of their suitability for exploration activity and estimate the hydrocarbon potential available. The system which compiled data information and knowledge and comprised exploration and production data of all basins in Indonesia called as Basin Professor which stands for Basin Professional and Processor. Basin Professor is a website application using Geography Information System which consists of all information about basin montage, basin summary, petroleum system, stratigraphy, development play, risk factor, exploration history, working area, regional cross section, well correlation, prospect & lead inventory and infrastructure spatial. From 82 identified sedimentary basins, North Sumatra, Central Sumatra, South Sumatera, East Java, Kutai, and Tarakan basins are respectively positioned of the Indonesia’ s mature basin and the most productive basin. The Eastern of Indonesia also have many hydrocarbon potential and discovered several fields in Papua and East Abadi. Basin Professor compiled the well data in all of the basin in Indonesia from mature basin to frontier basin. Well known geological data, subsurface mapping, prospect and lead, resources and established infrastructures are the main factors make these basins have higher suitability beside another potential basin. The hydrocarbon potential resulted from this paper based on the degree of geological data, petroleum, and economic evaluation. Basin Professor has provided by a calculator tool in lead and prospect for estimate the hydrocarbon reserves, recoverable in place and geological risk. Furthermore, the calculator also defines the preliminary economic evaluation such as investment, POT IRR and infrastructures in each basin. From this Basin Professor, petroleum companies are able to estimate that Indonesia has a huge potential of hydrocarbon oil and gas reservoirs and still interesting for hydrocarbon exploration and production activity.

Keywords: basin summary, petroleum system, resources, economic evaluation

Procedia PDF Downloads 278

Authors: Jaehyun Choi, Hyunjung Kim, Namho Kim

Abstract:

Earthwork is one of the critical civil construction operations that require large-quantities of resources due to its intensive dependency upon construction equipment. Therefore, efficient construction equipment management can highly contribute to productivity improvements and cost savings. Earthwork operation utilizes various combinations of construction equipment in order to meet project requirements such as time and cost. Identification of site condition and construction methods should be performed in advance in order to develop a proper execution plan. The factors to be considered include capacity of equipment assigned, the method of construction, the size of the site, and the surrounding condition. In addition, optimal combination of various construction equipment should be selected. However, in real world practice, equipment utilization plan is performed based on experience and intuition of management. The researchers evaluated the efficiency of various alternatives of construction equipment combinations by utilizing the process simulation model, validated the model from a case study project, and presented a methodology to find optimized plan among alternatives.

Keywords: earthwork operation, construction equipment, process simulation, optimization

Procedia PDF Downloads 417

Authors: Hamed K. Esfahani, Bithin Datta

Abstract:

Transport of reactive chemical contaminant species in groundwater aquifers is a complex and highly non-linear physical and geochemical process especially for real life scenarios. Simulating this transport process involves solving complex nonlinear equations and generally requires huge computational time for a given aquifer study area. Development of optimal remediation strategies in aquifers may require repeated solution of such complex numerical simulation models. To overcome this computational limitation and improve the computational feasibility of large number of repeated simulations, Genetic Programming based trained surrogate models are developed to approximately simulate such complex transport processes. Transport process of acid mine drainage, a hazardous pollutant is first simulated using a numerical simulated model: HYDROGEOCHEM 5.0 for a contaminated aquifer in a historic mine site. Simulation model solution results for an illustrative contaminated aquifer site is then approximated by training and testing a Genetic Programming (GP) based surrogate model. Performance evaluation of the ensemble GP models as surrogate models for the reactive species transport in groundwater demonstrates the feasibility of its use and the associated computational advantages. The results show the efficiency and feasibility of using ensemble GP surrogate models as approximate simulators of complex hydrogeologic and geochemical processes in a contaminated groundwater aquifer incorporating uncertainties in historic mine site.

Keywords: geochemical transport simulation, acid mine drainage, surrogate models, ensemble genetic programming, contaminated aquifers, mine sites

Procedia PDF Downloads 265

Authors: Chernet Mulugeta, Girma Seyoum, Yeshineh Demrew, Kehabtimer Shiferaw

Abstract:

Background: Obstetric fistula (OF) is a serious medical condition that includes an abnormal opening between the vagina and bladder (vesico-vaginal fistula) or the vagina and rectum (recto-vaginal fistula). It is usually caused by prolonged obstructed labour. Despite its serious health and psychosocial consequences, there is a paucity of evidence regarding the time it takes to heal from OF. Objective: The aim of this study was to assess the time to cure from obstetric fistula and its predictors among women admitted to Addis Ababa Hamlin Fistula Hospital, Addis Ababa, Ethiopia. Methodology: An institution-based retrospective cohort study was conducted from January 2015 to December 2020 among a randomly selected 434 women with OF in Addis Ababa Hamlin Fistula Hospital. Data was collected using a structured checklist adapted from a similar study. The open data kit (ODK) collected data was exported and analyzed by using STATA (14.2). Kaplan Meir was used to compare the recovery time from OF. To identify the predictors of OF, a Cox regression model was fitted, and an adjusted hazard ratio with a 95% confidence interval was used to estimate the strength of the associations. Results: The average time to recover from obstetric fistula was 3.95 (95% CI: 3.0-4.6) weeks. About ¾ of the women [72.8% (95% CI - 0.65-1.2)] were physically cured of obstetric fistula. Having secondary education and above [AHR=3.52; 95% CI (1.98, 6.25)] compared to no formal education, having a live birth [AHR=1.64; 95% CI (1.22, 2.21)], having an intact bladder [AHR=2.47; 95% CI (1.1, 5.54)] compared to totally destructed, and having a grade 1 fistula [AHR=1.98; 95% CI (1.19, 3.31)] compared to grade 3 were the significant predictors of shorter time to cure from an obstetric fistula. Conclusion and recommendation: Overall, the proportion of women with OF who were not being cured was unacceptably high. The time it takes for them to recover from the fistula was also extended. It connotes us to work on the identified predictors to improve the time to recovery from OF.

Keywords: time to recovery, obstetric fistula, predictors, Ethiopia

Procedia PDF Downloads 71

Authors: Douglas Arthur, Oluwayemisi Ekor, Ernest Obese, Andrew Kissi Agyei, Elvis Ofori Ameyaw

Abstract:

bjective: Pain negatively impacts every aspect of health, and patients with pain disorders create enormous demands on healthcare systems globally, costing economies up to $635 billion annually. The study was therefore conducted at the Cape Coast Teaching Hospital (CCTH), the only Tertiary Hospital in the Central Region of Ghana and was designed to assess pain disorders in patients between 18 and 90 years attending Urology Clinic. Methods: The study employed a descriptive cross-sectional design, and 149 subjects (16-24, 25-34, 35-44, 45-54, 55-64, 65-90 years) were conveniently selected. The McGill Pain Questionnaire (MPQ), a multidimensional instrument that assesses several aspects of pain by the use of words (descriptors) that the patient chooses to express his/her pain, was used as the primary instrument for data collection. A patient profile form (PPF) was also designed to document the demographics and history of patients. Results: The prevalence of pain disorders was higher among females compared to males. The univariate and multivariate analysis showed that females were more likely to experience pain while being married correlated with a lower likelihood of pain. Again, the 45-54 age group exhibited the highest prevalence of pain disorders. Results from the MPQ showed that half of the patients experienced pain on a daily basis, 15.91% had experienced pain for 3-6 months and 37% experienced pain for more than one year. Pain intensity was described by 25% of the subjects as excruciating for their worst pain experience, followed by 21% for the distressing experience. The most frequently reported area of pain was the abdominal region (22.72%). The co-administration of NSAIDs and opioid compounds was provided for 17.46% of the patients with chronic pain. Conclusion: The treatment interventions improved the pain and associated symptoms such as nausea, improved daily activities and ability to sleep. However, attention and resources should be devoted to 45-54 age group.

Keywords: pain, opioids, distressing, excruciating

Procedia PDF Downloads 17

Authors: Mohamed Bekheit Gad Khaleil

Abstract:

The Maadi was a civilization .It is considered one of the oldest civilizations in the world and an area of prehistoric times, especially the civilization (Nakada 1&2 ) It contains the oldest stone house in the history. Many excavations have been done in this area. This report was prepared under my supervision and in cooperation with the German institute .The stone building was redocumented, photographed and drawn once again . The stone building has been built carefully. The measurements for this building are (8m x 4m).and the depth of this building is 2m underground and an entrance located at the eastern part of the northern wall and it has three huge pits in the middle of the building seem to have contained wooden posts, most probably to support the roof. The use of the building is unclear. Circular impressions in front of the north wall and in the south-eastern part of the floor indicate that much of it was a storehouse for numerous vessels such as unique feature may have not only served for private domestic purposes. Before starting work in any site, instruction must be followed :- 1-Gather as much information about this place as possible . (Historical background - previous excavations - maps - pictures) 2-Writing, recording, describing and documenting 3- Draw a map of the site showing the place’s division system (trenches) 4- Safe ( Workers & The Place )

Keywords: photographing, excavations, documentation, registration

Procedia PDF Downloads 28

Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

Abstract:

Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

Procedia PDF Downloads 333

Authors: Michael Adebayo, Saheed Lawal

Abstract:

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

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

Procedia PDF Downloads 75

Authors: Warda Jabeen, Romaisa Shamim Khan, Osama Shakeel, Ahmed Faraz Bhatti, Raza Hussain

Abstract:

Background: The worldwide incidence of cutaneous melanoma (CM) has been on the rise over the past few decades. Primary prevention and early treatment remain the focus of management to reduce the burden of disease. This entails identification of risk factors to prompt early diagnosis. In Pakistan, there is a scarcity of clinico-pathological data relating to cutaneous malignant melanoma. Objective: The purpose of this study was to analyze the epidemiological and clinical characteristics of patients presenting with cutaneous malignant melanoma in Pakistan, and to compare the results with other studies. Method: Shaukat Khanum Memorial Cancer Hospital and Research Centre is currently the only dedicated cancer hospital in the country, accepting patients from all over Pakistan. Majority of the patients, however, belong to the northern half of the country. From the recorded data of the hospital, all cutaneous melanoma cases were identified and evaluated. Results: Between 1997 and 2017, a total of 169 cutaneous melanoma patients were registered at Shaukat Khanum. Mean age was 47.5 years. The highest incidence of melanoma was seen in the age group 40-59 years (n=69, 40.8%). Most commonly reported clinical subtype was unspecified melanoma (n=154, 91%). Amongst those in which T stage was reported, the most frequently observed T-stage at presentation was T4 (n=23, 13.6%). With regards to body distribution, in our study CM was seen most commonly in the lower limb including the hip. The yearly incidence of melanoma has increased/remained stable from 2007 to 2017. Conclusion: cutaneous malignant melanoma is a fairly common disease in Pakistan. Patients tend to present at a more advanced stage as compared to patients in developed countries. Identification of risk factors and tumor characteristics is therefore of paramount importance to deal with these patients.

Keywords: epidemiology of cutaneous malignant melanoma, cutaneous malignant melanoma, Pakistan, skin cancer

Procedia PDF Downloads 128

Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

Abstract:

Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

Procedia PDF Downloads 63

Authors: M. A. Hasan, M. R. Islam, R. A. Tarefder

Abstract:

This study investigates how the site specific traffic data differs from the Mechanistic Empirical Pavement Design Software default values. Two Weigh-in-Motion (WIM) stations were installed in Interstate-40 (I-40) and Interstate-25 (I-25) to developed site specific data. A computer program named WIM Data Analysis Software (WIMDAS) was developed using Microsoft C-Sharp (.Net) for quality checking and processing of raw WIM data. A complete year data from November 2013 to October 2014 was analyzed using the developed WIM Data Analysis Program. After that, the vehicle class distribution, directional distribution, lane distribution, monthly adjustment factor, hourly distribution, axle load spectra, average number of axle per vehicle, axle spacing, lateral wander distribution, and wheelbase distribution were calculated. Then a comparative study was done between measured data and AASHTOWare default values. It was found that the measured general traffic inputs for I-40 and I-25 significantly differ from the default values.

Keywords: AASHTOWare, traffic, weigh-in-motion, axle load distribution

Procedia PDF Downloads 332

Authors: A. Tamimi, S. Greatrex-White, A. Narayanasamy

Abstract:

Background: Spirituality has been increasingly acknowledged in the nursing literature as an important element of holistic patient care. To date there have been numerous studies investigating the meaning of spirituality in Western cultures. Spirituality in Middle Eastern countries however remains under-researched. We will present a study which aimed to address this gap. Aim: The study aimed to explore how spirituality manifests in the lives of Jordanian End Stage Renal Failure (ESRF) patients. Methodology and Method: A hermeneutic phenomenological approach was adopted informed by the philosophy of Martin Heidegger. Participants (n=27) were recruited from four different dialysis units: in a public hospital, a private hospital, an educational hospital and a refugee’s hospital in Jordan. Data was collected through in-depth unstructured interviews. Data Analysis: Analysis was guided by the tenets of hermeneutic phenomenology namely: gaining immediate sense of what was said both during and after each interview, transcribing data verbatim, translating interviews into the English language, intensive reading and re-reading, seeking meaning units by line to line coding, developing situated structures (how spirituality was manifest in each text), developing a general structure from the individual situated structures (how the phenomenon ‘spirituality’ comes into being). Findings: Three major themes emerged from analysis: Religion, Relationships and Desperation. We will argue that a ‘secular’ concept of spirituality had no meaning for the participants in the study. Spirituality is fundamentally part of religion and vice versa. Discussion: The findings may have consequences for the use of spirituality in multi-cultural settings in Western countries. Additionally, findings highlighted an important emphasis on the practice of spirituality, often underestimated in previous literature for Arab-Muslim Jordanian patients. Conclusion: The study findings contribute to the existing gap in knowledge regarding how Arab-Muslim Jordanian ESRF patients experience spirituality during their illness. It provides valuable insights into the importance of spirituality for this patient group and suggests how nurses, educators and policy makers might help address ESRF patients’ spiritual needs and provide appropriate spiritual care. We suggest the findings may have relevance beyond the Jordanian context in educating nurses’ on the importance of appreciating the religious dimension of spirituality.

Keywords: spirituality, nursing, muslim, Jordan

Procedia PDF Downloads 440

Authors: Maryum Nawaz

Abstract:

Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional study was done. Place and Duration: The study was conducted in Pediatric Ophthalmology, Hayatabad Medical Complex, Peshawar. Materials and Methods: The sample size was 146 keeping 41.45%5 proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%) and was not present in 90 (61.6%) of patients. There was no association of gender, age, parent refractive errors, or early usage of electric equipment with the refractive errors. Conclusion: There is a high prevalence of refractive errors in a patient with strabismus. There is no association of age, gender, parent refractive errors, or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.

Keywords: strabismus, refractive error, myopia, hypermetropia, astigmatism

Procedia PDF Downloads 138