Search results for: emotion management
1099 Investigating Acute and Chronic Pain after Bariatric Surgery
Authors: Patti Kastanias, Wei Wang, Karyn Mackenzie, Sandra Robinson, Susan Wnuk
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Obesity is a worldwide epidemic and is recognized as a chronic disease. Pain in the obese individual is a multidimensional issue. An increase in BMI is positively correlated with pain incidence and severity, especially in central obesity where individuals are twice as likely to have chronic pain. Both obesity and chronic pain are also associated with mood disorders. Pain is worse among obese individuals with depression and anxiety. Bariatric surgery provides patients with an effective solution for long-term weight loss and associated health problems. However, not much is known about acute and chronic pain after bariatric surgery and its contributing factors, including mood disorders. Nurse practitioners (NPs) at one large multidisciplinary bariatric surgery centre led two studies to examine acute and chronic pain and pain management over time after bariatric surgery. The purpose of the initial study was to examine the incidence and severity of acute and chronic pain after bariatric surgery. The aim of the secondary study was to further examine chronic pain, specifically looking at psychological factors that influence severity or incidence of both neuropathic and somatic pain as well as changes in opioid use. The initial study was a prospective, longitudinal study where patients having bariatric surgery at one surgical center were followed up to 6 months postop. Data was collected at 7 time points using validated instruments for pain severity, pain interference, and patient satisfaction. In the second study, subjects were followed longitudinally starting preoperatively and then at 6 months and 1 year postoperatively to capture changes in chronic pain and influencing variables over time. Valid and reliable instruments were utilized for all major study outcomes. In the first study, there was a trend towards decreased acute post-operative pain over time. The incidence and severity of chronic pain was found to be significantly reduced at 6 months post bariatric surgery. Interestingly, interference of chronic pain in daily life such as normal work, mood, and walking ability was significantly improved at 6 months postop however; this was not the case with sleep. Preliminary results of the secondary study indicate that pain severity, pain interference, anxiety and depression are significantly improved at 6 months postoperatively. In addition, preoperative anxiety, depression and emotional regulation were predictive of pain interference, but not pain severity. The results of our regression analyses provide evidence for the impact of pre-existing psychological factors on pain, particularly anxiety in obese populations.Keywords: bariatric surgery, mood disorders, obesity, pain
Procedia PDF Downloads 2911098 Determinants of Probability Weighting and Probability Neglect: An Experimental Study of the Role of Emotions, Risk Perception, and Personality in Flood Insurance Demand
Authors: Peter J. Robinson, W. J. Wouter Botzen
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Individuals often over-weight low probabilities and under-weight moderate to high probabilities, however very low probabilities are either significantly over-weighted or neglected. Little is known about factors affecting probability weighting in Prospect Theory related to emotions specific to risk (anticipatory and anticipated emotions), the threshold of concern, as well as personality traits like locus of control. This study provides these insights by examining factors that influence probability weighting in the context of flood insurance demand in an economic experiment. In particular, we focus on determinants of flood probability neglect to provide recommendations for improved risk management. In addition, results obtained using real incentives and no performance-based payments are compared in the experiment with high experimental outcomes. Based on data collected from 1’041 Dutch homeowners, we find that: flood probability neglect is related to anticipated regret, worry and the threshold of concern. Moreover, locus of control and regret affect probabilistic pessimism. Nevertheless, we do not observe strong evidence that incentives influence flood probability neglect nor probability weighting. The results show that low, moderate and high flood probabilities are under-weighted, which is related to framing in the flooding context and the degree of realism respondents attach to high probability property damages. We suggest several policies to overcome psychological factors related to under-weighting flood probabilities to improve flood preparations. These include policies that promote better risk communication to enhance insurance decisions for individuals with a high threshold of concern, and education and information provision to change the behaviour of internal locus of control types as well as people who see insurance as an investment. Multi-year flood insurance may also prevent short-sighted behaviour of people who have a tendency to regret paying for insurance. Moreover, bundling low-probability/high-impact risks with more immediate risks may achieve an overall covered risk which is less likely to be judged as falling below thresholds of concern. These measures could aid the development of a flood insurance market in the Netherlands for which we find to be demand.Keywords: flood insurance demand, prospect theory, risk perceptions, risk preferences
Procedia PDF Downloads 2641097 Spatial Analysis as a Tool to Assess Risk Management in Peru
Authors: Josué Alfredo Tomas Machaca Fajardo, Jhon Elvis Chahua Janampa, Pedro Rau Lavado
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A flood vulnerability index was developed for the Piura River watershed in northern Peru using Principal Component Analysis (PCA) to assess flood risk. The official methodology to assess risk from natural hazards in Peru was introduced in 1980 and proved effective for aiding complex decision-making. This method relies in part on decision-makers defining subjective correlations between variables to identify high-risk areas. While risk identification and ensuing response activities benefit from a qualitative understanding of influences, this method does not take advantage of the advent of national and international data collection efforts, which can supplement our understanding of risk. Furthermore, this method does not take advantage of broadly applied statistical methods such as PCA, which highlight central indicators of vulnerability. Nowadays, information processing is much faster and allows for more objective decision-making tools, such as PCA. The approach presented here develops a tool to improve the current flood risk assessment in the Peruvian basin. Hence, the spatial analysis of the census and other datasets provides a better understanding of the current land occupation and a basin-wide distribution of services and human populations, a necessary step toward ultimately reducing flood risk in Peru. PCA allows the simplification of a large number of variables into a few factors regarding social, economic, physical and environmental dimensions of vulnerability. There is a correlation between the location of people and the water availability mainly found in rivers. For this reason, a comprehensive vision of the population location around the river basin is necessary to establish flood prevention policies. The grouping of 5x5 km gridded areas allows the spatial analysis of flood risk rather than assessing political divisions of the territory. The index was applied to the Peruvian region of Piura, where several flood events occurred in recent past years, being one of the most affected regions during the ENSO events in Peru. The analysis evidenced inequalities for the access to basic services, such as water, electricity, internet and sewage, between rural and urban areas.Keywords: assess risk, flood risk, indicators of vulnerability, principal component analysis
Procedia PDF Downloads 1761096 Influential Factors Impacting the Utilization of Pain Assessment Tools among Hospitalized Elderly Patients in Taiwan
Authors: Huei Jiun Chen, Hui Mei Huan
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Introduction: Pain is an unpleasant experience for hospitalized patients that impacts both their physical and mental well-being. It is important to select appropriate pain assessment tools to ensure effective pain management. Therefore, it is suggested to use Verbal Rating Scale (VRS) instead for better assessment. The Wong-Baker FACES Pain Rating Scale(WBS) is a widely used pain assessment tool in Taiwan to help individuals communicate the intensity of their pain. However, in clinical practice, even when using various assessment tools to evaluate pain, Numeric Rating Scale-11 (NRS-11) is still commonly utilized to quantify the intensity of pain. The correlation between NRS and other pain assessment tools has not been extensively explored in Taiwan. Additionally, the influence of gender and education level on pain assessment among elderly individuals has not been extensively studied in Taiwan. The aim of this study is to investigate the correlation between pain assessment scales (NRS-11, VRS, WBS) in assessing pain intensity among elderly inpatients. The secondary objective of this study is to examine how gender and education level influence pain assessment among individuals, as well as to explore their preferences regarding pain assessment tools. Method: In this study, a questionnaire survey and purposive sampling were employed to recruit participants from a medical center located in central Taiwan. Participants were requested to assess their pain intensity in the past 24 hours using NRS-11, VRS, and WBS. Additionally, the study investigated their preferences for pain assessment tools. Result: A total of 252 participants were included in this study, with a mean age of 71.1 years (SD=6.2). Of these participants, 135 were male (53.6%), and 44.4% had a primary level or below education. Participants were asked to use NRS-11, VRS, and WBS to assess their current, maximum, and minimum pain intensity experienced in the past 24 hours. The findings indicated a significant correlation (p< .01) among all three pain assessment tools. No significant differences were observed in gender across the three pain assessment scales. For severe pain, there were significant differences in self-rated pain scales among the elderly participants with different education levels (F=3.08, p< .01; X²=17.25, X²=17.21, p< .01), but there were no significant differences observed for mild pain. Regarding preferences for pain assessment tools, 158 participants (62.7%) favored VRS, followed by WBS; gender and education level had no influence on their preferences. Conclusion: Most elderly participants prefer using VRS (Verbal Rating Scale) to self-reported their pain. The reason for this preference may be attributed to the verbal nature of VRS, as it is simple and easy to understand. Furthermore, it could be associated with the level of education among the elderly participants. The pain assessment using VRS demonstrated a significant correlation with NRS-11 and WBS, and gender was not found to have any influence on these assessment. Further research is needed to explore the effect of different education levels on self-reported pain intensity among elderly people in Taiwan.Keywords: pain assessment, elderly, gender, education
Procedia PDF Downloads 581095 Management of Meskit (Prosopis juliflora) Tree in Oman: The Case of Using Meskit (Prosopis juliflora) Pods for Feeding Omani Sheep
Authors: S. Al-Khalasi, O. Mahgoub, H. Yaakub
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This study evaluated the use of raw or processed Prosopis juliflora (Meskit) pods as a major ingredient in a formulated ration to provide an alternative non-conventional concentrate for livestock feeding in Oman. Dry Meskit pods were reduced to lengths of 0.5- 1.0 cm to ensure thorough mixing into three diets. Meskit pods were subjected to two types of treatments; roasting and soaking. They were roasted at 150оC for 30 minutes using a locally-made roasting device (40 kg barrel container rotated by electric motor and heated by flame gas cooker). Chopped pods were soaked in tap water for 24 hours and dried for 2 days under the sun with frequent turning. The Meskit-pod-based diets (MPBD) were formulated and pelleted from 500 g/kg ground Meskit pods, 240 g/kg wheat bran, 200 g/kg barley grain, 50 g/kg local dried sardines and 10 g/kg of salt. Twenty four 10 months-old intact Omani male lambs with average body weight of 27.3 kg (± 0.5 kg) were used in a feeding trial for 84 days. They were divided (on body weight basis) and allocated to four diet combination groups. These were: Rhodes grass hay (RGH) plus a general ruminant concentrate (GRC); RGH plus raw Meskit pods (RMP) based concentrate; RGH plus roasted Meskit pods (ROMP) based concentrate; RGH plus soaked Meskit pods (SMP) based concentrate Daily feed intakes and bi-weekly body weights were recorded. MPBD had higher contents of crude protein (CP), acid detergent fibre (ADF) and neutral detergent fibre (NDF) than the GRC. Animals fed various types of MPBD did not show signs of ill health. There was a significant effect of feeding ROMP on the performance of Omani sheep compared to RMP and SMP. The ROMP fed animals had similar performance to those fed the GRC in terms of feed intake, body weight gain and feed conversion ratio (FCR).This study indicated that roasted Meskit pods based diet may be used instead of the commercial concentrate for feeding Omani sheep without adverse effects on performance. It offers a cheap alternative source of protein and energy for feeding Omani sheep. Also, it might help in solving the spread impact of Meskit trees, maintain the ecosystem and helping in preserving the local tree species.Keywords: growth, Meskit, Omani sheep, Prosopis juliflora
Procedia PDF Downloads 4671094 Application of the Building Information Modeling Planning Approach to the Factory Planning
Authors: Peggy Näser
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Factory planning is a systematic, objective-oriented process for planning a factory, structured into a sequence of phases, each of which is dependent on the preceding phase and makes use of particular methods and tools, and extending from the setting of objectives to the start of production. The digital factory, on the other hand, is the generic term for a comprehensive network of digital models, methods, and tools – including simulation and 3D visualisation – integrated by a continuous data management system. Its aim is the holistic planning, evaluation and ongoing improvement of all the main structures, processes and resources of the real factory in conjunction with the product. Digital factory planning has already become established in factory planning. The application of Building Information Modeling has not yet been established in factory planning but has been used predominantly in the planning of public buildings. Furthermore, this concept is limited to the planning of the buildings and does not include the planning of equipment of the factory (machines, technical equipment) and their interfaces to the building. BIM is a cooperative method of working, in which the information and data relevant to its lifecycle are consistently recorded, managed and exchanged in a transparent communication between the involved parties on the basis of digital models of a building. Both approaches, the planning approach of Building Information Modeling and the methodical approach of the Digital Factory, are based on the use of a comprehensive data model. Therefore it is necessary to examine how the approach of Building Information Modeling can be extended in the context of factory planning in such a way that an integration of the equipment planning, as well as the building planning, can take place in a common digital model. For this, a number of different perspectives have to be investigated: the equipment perspective including the tools used to implement a comprehensive digital planning process, the communication perspective between the planners of different fields, the legal perspective, that the legal certainty in each country and the quality perspective, on which the quality criteria are defined and the planning will be evaluated. The individual perspectives are examined and illustrated in the article. An approach model for the integration of factory planning into the BIM approach, in particular for the integrated planning of equipment and buildings and the continuous digital planning is developed. For this purpose, the individual factory planning phases are detailed in the sense of the integration of the BIM approach. A comprehensive software concept is shown on the tool. In addition, the prerequisites required for this integrated planning are presented. With the help of the newly developed approach, a better coordination between equipment and buildings is to be achieved, the continuity of the digital factory planning is improved, the data quality is improved and expensive implementation errors are avoided in the implementation.Keywords: building information modeling, digital factory, digital planning, factory planning
Procedia PDF Downloads 2571093 Factors Determining the Vulnerability to Occupational Health Risk and Safety of Call Center Agents in the Philippines
Authors: Lito M. Amit, Venecio U. Ultra, Young-Woong Song
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The business process outsourcing (BPO) in the Philippines is expanding rapidly attracting more than 2% of total employment. Currently, the BPO industry is confronted with several issues pertaining to sustainable productivity such as meeting the staffing gap, high rate of employees’ turnover and workforce retention, and the occupational health and safety (OHS) of call center agents. We conducted a survey of OHS programs and health concerns among call center agents in the Philippines and determined the sociocultural factors that affect the vulnerability of call center agents to occupational health risks and hazards. The majority of the agents affirmed that OHS are implemented and OHS orientation and emergency procedures were conducted at employment initiations, perceived favorable and convenient working environment except for occasional noise disturbances and acoustic shock, visual, and voice fatigues. Male agents can easily adjust to the demands and changes in their work environment and flexible work schedules than female agents. Female agents have a higher tendency to be pressured and humiliated by low work performance, experience a higher incidence of emotional abuse, psychological abuse, and experience more physical stress than male agents. The majority of the call center agents had a night-shift schedule and regardless of other factors, night shift work brings higher stress to agents. While working in a call center, higher incidence of headaches and insomnia, burnout, suppressed anger, anxiety, and depressions were experienced by female, younger (21-25 years old) and those at night shift than their counterpart. Most common musculoskeletal disorders include body pain in the neck, shoulders and back; and hand and wrist disorders and these are commonly experienced by female and younger workers. About 30% experienced symptoms of cardiovascular and gastrointestinal disorders and weakened immune systems. Overall, these findings have shown the variable vulnerability by a different subpopulation of call center agents and are important in the occupational health risk prevention and management towards a sustainable human resource for BPO industry in the Philippines.Keywords: business process outsourcing industry, health risk of call center agents, socio-cultural determinants, Philippines
Procedia PDF Downloads 4861092 Identification and Management of Septic Arthritis of the Untouched Glenohumeral Joint
Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot
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Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder
Procedia PDF Downloads 4141091 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana
Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei
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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality
Procedia PDF Downloads 671090 Transformation of the Institutionality of International Cooperation in Ecuador from 2007 to 2017: 2017: A Case of State Identity Affirmation through Role Performance
Authors: Natalia Carolina Encalada Castillo
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As part of an intended radical policy change compared to former administrations in Ecuador, the transformation of the institutionality of international cooperation during the period of President Rafael Correa was considered as a key element for the construction of the state of 'Good Living'. This intention led to several regulatory changes in the reception of cooperation for development, and even the departure of some foreign cooperation agencies. Moreover, Ecuador launched the initiative to become a donor of cooperation towards other developing countries through the ‘South-South Cooperation’ approach. All these changes were institutionalized through the Ecuadorian System of International Cooperation as a new framework to establish rules and policies that guarantee a sovereign management of foreign aid. Therefore, this research project has been guided by two questions: What were the factors that motivated the transformation of the institutionality of international cooperation in Ecuador from 2007 to 2017? and, what were the implications of this transformation in terms of the international role of the country? This paper seeks to answer these questions through Role Theory within a Constructivist meta-theoretical perspective, considering that in this case, changes at the institutional level in the field of cooperation, responded not only to material motivations but also to interests built on the basis of a specific state identity. The latter was only possible to affirm through specific roles such as ‘sovereign recipient of cooperation’ as well as ‘donor of international cooperation’. However, the performance of these roles was problematic as they were not easily accepted by the other actors in the international arena or in the domestic level. In terms of methodology, these dynamics are analyzed in a qualitative way mainly through interpretive analysis of the discourse of high-level decision-makers from Ecuador and other cooperation actors. Complementary to this, document-based research of relevant information as well as interviews have been conducted. Finally, it is concluded that even if material factors such as infrastructure needs, trade and investment interests, as well as reinforcement of state control and monitoring of cooperation flows, motivated the institutional transformation of international cooperation in Ecuador; the essential basis of these changes was the search for a new identity for the country to be projected in the international arena. This identity started to be built but continues to be unstable. Therefore, it is important to potentiate the achievements of the new international cooperation policies, and review their weaknesses, so that non-reimbursable cooperation funds received as well as ‘South-South cooperation’ actions, contribute effectively to national objectives.Keywords: Ecuador, international cooperation, Role Theory, state identity
Procedia PDF Downloads 1921089 Biogas Potential of Deinking Sludge from Wastepaper Recycling Industry: Influence of Dewatering Degree and High Calcium Carbonate Content
Authors: Moses Kolade Ogun, Ina Korner
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To improve on the sustainable resource management in the wastepaper recycling industry, studies into the valorization of wastes generated by the industry are necessary. The industry produces different residues, among which is the deinking sludge (DS). The DS is generated from the deinking process and constitutes a major fraction of the residues generated by the European pulp and paper industry. The traditional treatment of DS by incineration is capital intensive due to energy requirement for dewatering and the need for complementary fuel source due to DS low calorific value. This could be replaced by a biotechnological approach. This study, therefore, investigated the biogas potential of different DS streams (different dewatering degrees) and the influence of the high calcium carbonate content of DS on its biogas potential. Dewatered DS (solid fraction) sample from filter press and the filtrate (liquid fraction) were collected from a partner wastepaper recycling company in Germany. The solid fraction and the liquid fraction were mixed in proportion to realize DS with different water content (55–91% fresh mass). Spiked samples of DS using deionized water, cellulose and calcium carbonate were prepared to simulate DS with varying calcium carbonate content (0– 40% dry matter). Seeding sludge was collected from an existing biogas plant treating sewage sludge in Germany. Biogas potential was studied using a 1-liter batch test system under the mesophilic condition and ran for 21 days. Specific biogas potential in the range 133- 230 NL/kg-organic dry matter was observed for DS samples investigated. It was found out that an increase in the liquid fraction leads to an increase in the specific biogas potential and a reduction in the absolute biogas potential (NL-biogas/ fresh mass). By comparing the absolute biogas potential curve and the specific biogas potential curve, an optimal dewatering degree corresponding to a water content of about 70% fresh mass was identified. This degree of dewatering is a compromise when factors such as biogas yield, reactor size, energy required for dewatering and operation cost are considered. No inhibitory influence was observed in the biogas potential of DS due to the reported high calcium carbonate content of DS. This study confirms that DS is a potential bioresource for biogas production. Further optimization such as nitrogen supplementation due to DS high C/N ratio can increase biogas yield.Keywords: biogas, calcium carbonate, deinking sludge, dewatering, water content
Procedia PDF Downloads 1601088 Efficacy of Different Soil-Applied Fungicides to Manage Phytophthora Root Rot of Chili (Solanum annum) in Pakistan
Authors: Kiran Nawaz, Ahmad Ali Shahid, Sehrish Iftikhar, Waheed Anwar, Muhammad Nasir Subhani
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Chili (Solanum annum L.) attacks by many fungal pathogens, including members of Oomycetes which are responsible for root rot in different chili growing areas of the world. Oomycetes pathogens cause economic losses in different regions of the Pakistan. Most of the plant tissues, including roots, crowns, fruit, and leaves, are vulnerable to Phytophthora capsici. It is very difficult to manage the Phytophthora root rot of chili as many commercial varieties are tremendously vulnerable to P. capsici. The causal agent of the disease was isolated on corn meal agar (CMA) and identified on a morphological basis by using available taxonomic keys. The pathogen was also confirmed on the molecular basis through internal transcribed spacer region and with other molecular markers.The Blastn results showed 100% homology with already reported sequences of P. capsici in NCBI database. Most of the farmers have conventionally relied on foliar fungicide applications to control Phytophthora root rot in spite of their incomplete effectiveness. In this study, in vitro plate assay, seed soaking and foliar applications of 6 fungicides were evaluated against root rot of chili. In vitro assay revealed that significant inhibition of linear growth was obtained with Triflumizole at 7.0%, followed by Thiophanate methyl (8.9%), Etridiazole (6.0%), Propamocarb (5.9%) and 7.5% with Mefenoxam and Iprodione for P. capsici. The promising treatments of in vitro plate bioassay were evaluated in pot experiments under controlled conditions in the greenhouse. All fungicides were applied after at 6-day intervals. Results of pot experiment showed that all treatments considerably inhibited the percentage of P. capsici root rot incidence. In addition, application of seed soaking with all six fungicides combined with the foliar spray of the same components showed the significant reduction in root rot incidence. The combine treatments of all fungicides as in vitro bioassay, seed soaking followed by foliar spray is considered non-harmful control methods which have advantages and limitation. Hence, these applications proved effective and harmless for the management of soil-borne plant pathogens.Keywords: blastn, bioassay, corn meal agar(CMA), oomycetes
Procedia PDF Downloads 2301087 Rethinking the Value of Pancreatic Cyst CEA Levels from Endoscopic Ultrasound Fine-Needle Aspiration (EUS-FNA): A Longitudinal Analysis
Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen
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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike
Procedia PDF Downloads 1321086 Prayer Therapy in a Case of Acute Myeloid Leukemia: The Good, the Bad and the Ugly
Authors: Rubai M. Ochieng
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Cancer, which accounts for 7 percent of deaths per year in Kenya, is the third highest cause of death after infectious and cardiovascular diseases. Awareness Campaigns have tended to focus on leading cancers including breast and cervical for women as well as prostrate and Esophageal for men. Consequently, less common cancers such as Acute Myeloid Leukemia (AML) are rarely properly understood by the general population and a section of the medical fraternity. Diagnoses of AML in patients who may not have heard about it sometimes results in shock, denial and confusion not just to the diagnosed, but also to their family and friends. The diagnosed and caregivers are bound to receive a lot of contradicting information about prognosis, care and treatment of AML. This information, which often comes from diverse sources including doctors, friends, internet and social media platforms, causes further confusion and panic. The situation is handled differently by different people. Religious people sometimes resort to prayer. This paper, written from the perspective of a care giver, is based on data collected from a case of Acute Myeloid Leukemia diagnosed in a 32 year old male who lost his life within six weeks of diagnosis. The sample constitutes of 16 people who participated in prayers. Out of this total, 5 were males including the diagnosed and 11 were females. All the 16 were Christians of protestant orientation including Anglicans, Quakers and Church of God members. Data was collected by the researcher herself through participant of observation. Findings discuss how the 16 participants prayed individually at different times, together in an overnight prayer meeting and every morning through a group social media platform. They shared songs and words of encouragement from the bible. The group prayed for healing, peace and strength to the diagnosed and family, financial breakthrough and doctors’ work and decisions, among other challenges that came with the situation. The paper reveals the immense benefits of prayer to the diagnosed and his close relatives and friends. They include acceptance of the condition and a positive attitude in handling the challenges that arose from the disease and treatment processes. The challenges arising from the prayer approach of handling the situation are also discussed. The paper concludes that prayer as therapy goes a long way in cancer management.Keywords: acute myeloid leukemia, Kenya, participant observation, prayer
Procedia PDF Downloads 1551085 Laboratory Diagnostic Testing of Peste des Petits Ruminants in Georgia
Authors: Nino G. Vepkhvadze, Tea Enukidze
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Every year the number of countries around the world face the risk of the spread of infectious diseases that bring significant ecological and social-economic damage. Hence, the importance of food product safety is emphasized that is the issue of interest for many countries. To solve them, it’s necessary to conduct preventive measures against the diseases, have accurate diagnostic results, leadership, and management. The Peste des petits ruminants (PPR) disease is caused by a morbillivirus closely related to the rinderpest virus. PPR is a transboundary disease as it emerges and evolves, considered as one of the top most damaging animal diseases. The disease imposed a serious threat to sheep-breeding when the farms of sheep, goats are significantly growing within the country. In January 2016, PPR was detected in Georgia. Up to present the origin of the virus, the age relationship of affected ruminants and the distribution of PPRV in Georgia remains unclear. Due to the nature of PPR, and breeding practices in the country, reemerging of the disease in Georgia is highly likely. The purpose of the studies is to provide laboratories with efficient tools allowing the early detection of PPR emergence and re-emergences. This study is being accomplished under the Biological Threat Reduction Program project with the support of the Defense Threat Reduction Agency (DTRA). The purpose of the studies is to investigate the samples and identify areas at high risk of the disease. Georgia has a high density of small ruminant herds bred as free-ranging, close to international borders. Kakheti region, Eastern Georgia, will be considered as area of high priority for PPR surveillance. For this reason, in 2019, in Kakheti region investigated n=484 sheep and goat serum and blood samples from the same animals, utilized serology and molecular biology methods. All samples were negative by RT-PCR, and n=6 sheep samples were seropositive by ELISA-Ab. Future efforts will be concentrated in areas where the risk of PPR might be high such as international bordering regions of Georgia. For diagnostics, it is important to integrate the PPRV knowledge with epidemiological data. Based on these diagnostics, the relevant agencies will be able to control the disease surveillance.Keywords: animal disease, especially dangerous pathogen, laboratory diagnostics, virus
Procedia PDF Downloads 1101084 Impact of Short-Term Drought on Vegetation Health Condition in the Kingdom of Saudi Arabia Using Space Data
Authors: E. Ghoneim, C. Narron, I. Iqbal, I. Hassan, E. Hammam
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The scarcity of water is becoming a more prominent threat, especially in areas that are already arid in nature. Although the Kingdom of Saudi Arabia (KSA) is an arid country, its southwestern region offers a high variety of botanical landscapes, many of which are wooded forests, while the eastern and northern regions offer large areas of groundwater irrigated farmlands. At present, some parts of KSA, including forests and farmlands, have witnessed protracted and severe drought due to change in rainfall pattern as a result of global climate change. Such prolonged drought that last for several consecutive years is expected to cause deterioration of forested and pastured lands as well as cause crop failure in the KSA (e.g., wheat yield). An analysis to determine vegetation drought vulnerability and severity during the growing season (September-April) over a fourteen year period (2000-2014) in KSA was conducted using MODIS Terra imagery. The Vegetation Condition Index (VCI), derived from the Normalized Difference Vegetation Index (NDVI), and the Temperature Condition Index (TCI), derived from the Land Surface Temperature (LST) data was extracted from MODIS Terra Images. The VCI and TCI were then combined to compute the Vegetation Health Index (VHI). The VHI revealed the overall vegetation health for the area under investigation. A preliminary outcome of the modeled VHI over KSA, using averaged monthly vegetation data over a 14-year period, revealed that the vegetation health condition is deteriorating over time in both naturally vegetated areas and irrigated farmlands. The derived drought map for KSA indicates that both extreme and severe drought occurrences have considerably increased over the same study period. Moreover, based on the cumulative average of drought frequency in each governorate of KSA it was determined that Makkah and Jizan governorates to the east and southwest, witness the most frequency of extreme drought, whereas Tabuk to the northwest, exhibits the less extreme drought frequency. Areas where drought is extreme or severe would most likely have negative influences on agriculture, ecosystems, tourism, and even human welfare. With the drought risk map the kingdom could make informed land management decisions including were to continue with agricultural endeavors and protect forested areas and even where to develop new settlements.Keywords: drought, vegetation health condition, TCI, Saudi Arabia
Procedia PDF Downloads 3751083 A Systematic Review: Prevalence and Risk Factors of Low Back Pain among Waste Collection Workers
Authors: Benedicta Asante, Brenna Bath, Olugbenga Adebayo, Catherine Trask
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Background: Waste Collection Workers’ (WCWs) activities contribute greatly to the recycling sector and are an important component of the waste management industry. As the recycling sector evolves, reports of injuries and fatal accidents in the industry demand notice particularly common and debilitating musculoskeletal disorders such as low back pain (LBP). WCWs are likely exposed to diverse work-related hazards that could contribute to LBP. However, to our knowledge there has never been a systematic review or other synthesis of LBP findings within this workforce. The aim of this systematic review was to determine the prevalence and risk factors of LBP among WCWs. Method: A comprehensive search was conducted in Ovid Medline, EMBASE, and Global Health e-publications with search term categories ‘low back pain’ and ‘waste collection workers’. Articles were screened at title, abstract, and full-text stages by two reviewers. Data were extracted on study design, sampling strategy, socio-demographic, geographical region, and exposure definition, definition of LBP, risk factors, response rate, statistical techniques, and LBP prevalence. Risk of bias (ROB) was assessed based on Hoy Damien’s ROB scale. Results: The search of three databases generated 79 studies. Thirty-two studies met the study inclusion criteria for both title and abstract; thirteen full-text articles met the study criteria at the full-text stage. Seven articles (54%) reported prevalence within 12 months of LBP between 42-82% among WCW. The major risk factors for LBP among WCW included: awkward posture; lifting; pulling; pushing; repetitive motions; work duration; and physical loads. Summary data and syntheses of findings was presented in trend-lines and tables to establish the several prevalence periods based on age and region distribution. Public health implications: LBP is a major occupational hazard among WCWs. In light of these risks and future growth in this industry, further research should focus on more detail ergonomic exposure assessment and LBP prevention efforts.Keywords: low back pain, scavenger, waste collection workers, waste pickers
Procedia PDF Downloads 3151082 Advancing Circular Economy Principles: Integrating AI Technology in Street Sanitation for Sustainable Urban Development
Authors: Xukai Fu
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The concept of circular economy is interdisciplinary, intersecting environmental engineering, information technology, business, and social science domains. Over the course of its 15-year tenure in the sanitation industry, Jinkai has concentrated its efforts in the past five years on integrating artificial intelligence (AI) technology with street sanitation apparatus and systems. This endeavor has led to the development of various innovations, including the Intelligent Identification Sweeper Truck (Intelligent Waste Recognition and Energy-saving Control System), the Intelligent Identification Water Truck (Intelligent Flushing Control System), the intelligent food waste treatment machine, and the Intelligent City Road Sanitation Surveillance Platform. This study will commence with an examination of prevalent global challenges, elucidating how Jinkai effectively addresses each within the framework of circular economy principles. Utilizing a review and analysis of pertinent environmental management data, we will elucidate Jinkai's strategic approach. Following this, we will investigate how Jinkai utilizes the advantages of circular economy principles to guide the design of street sanitation machinery, with a focus on digitalization integration. Moreover, we will scrutinize Jinkai's sustainable practices throughout the invention and operation phases of street sanitation machinery, aligning with the triple bottom line theory. Finally, we will delve into the significance and enduring impact of corporate social responsibility (CSR) and environmental, social, and governance (ESG) initiatives. Special emphasis will be placed on Jinkai's contributions to community stakeholders, with a particular emphasis on human rights. Despite the widespread adoption of circular economy principles across various industries, achieving a harmonious equilibrium between environmental justice and social justice remains a formidable task. Jinkai acknowledges that the mere development of energy-saving technologies is insufficient for authentic circular economy implementation; rather, they serve as instrumental tools. To earnestly promote and embody circular economy principles, companies must consistently prioritize the UN Sustainable Development Goals and adapt their technologies to address the evolving exigencies of our world.Keywords: circular economy, core principles, benefits, the tripple bottom line, CSR, ESG, social justice, human rights, Jinkai
Procedia PDF Downloads 341081 Influence of Farnesol on Growth and Development of Dysdercus koenigii
Authors: Shailendra Kumar, Kamal Kumar Gupta
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Dysdercus koenigii is an economically important pest of cotton worldwide. The pest damages the crop by sucking sap, staining lint, reducing the oil content of the seeds and deteriorating the quality of cotton. Plant possesses a plethora of secondary metabolites which are used as defense mechanism against herbivores. One of the important categories of such chemicals is insect growth regulators and the intermediates in their biosynthesis. Farnesol belongs to sesquiterpenoid. It is an intermediate in Juvenile hormone biosynthetic pathway in insects has been widely reported in the variety of plants. This chemical can disrupt the normal metabolic function and therefore, affects various life processes of the insects. Present study tested the efficacy of farnesol against Dysdercus koenigii. 2μl of 5% (100µg) and 10% (200µg) of the farnesol was applied topically on the dorsum of thoracic region of the newly emerged fifth instar nymphs of Dysdercus. The treated insects were observed daily for their survival, weight gain, and developmental anomalies for a period of ten days. The results indicated that treatment with 200µg farnesol decreased survival of the insects to 70% after 24h of exposure. At lower doses, no significant decrease in the survival was observed. However, the surviving nymphs showed alteration in growth, development, and metamorphosis. The weight gain in the treated nymphs showed deviation from control. The treated nymphs showed an increase in mortality during subsequent days and increase in the nymphal duration. The number of nymphs undergoing metamorphosis decreased to 46% and 88% in the treatments with the dose of 200µg and 100µg respectively. Severe developmental anomalies were also observed in the treated nymphs. The treated nymphs moulted into supernumerary nymphs, adultoids, adults with exuviae attached and adults with wing deformities. On treatment with 200µg; 26% adultoid, 4% adults with exuviae attached and 12% adults with wing deformed were produced. Treatment with 100µg resulted in production of 34% adultoid, 26% adults with deformed wing and 4% adults with exuviae attached. Many of the treated nymphs did not metamorphose into adults, remained in nymphal stage and died. Our results indicated potential application plant-derived secondary metabolites like farnesol in the management of Dysdercus population.Keywords: development, Dysdercus koenigii, farnesol, survival
Procedia PDF Downloads 3471080 The Silent Tuberculosis: A Case Study to Highlight Awareness of a Global Health Disease and Difficulties in Diagnosis
Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das
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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge
Procedia PDF Downloads 1831079 Smart Construction Sites in KSA: Challenges and Prospects
Authors: Ahmad Mohammad Sharqi, Mohamed Hechmi El Ouni, Saleh Alsulamy
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Due to the emerging technologies revolution worldwide, the need to exploit and employ innovative technologies for other functions and purposes in different aspects has become a remarkable matter. Saudi Arabia is considered one of the most powerful economic countries in the world, where the construction sector participates effectively in its economy. Thus, the construction sector in KSA should convoy the rapid digital revolution and transformation and implement smart devices on sites. A Smart Construction Site (SCS) includes smart devices, artificial intelligence, the internet of things, augmented reality, building information modeling, geographical information systems, and cloud information. This paper aims to study the level of implementation of SCS in KSA, analyze the obstacles and challenges of adopting SCS and find out critical success factors for its implementation. A survey of close-ended questions (scale and multi-choices) has been conducted on professionals in the construction sector of Saudi Arabia. A total number of twenty-nine questions has been prepared for respondents. Twenty-four scale questions were established, and those questions were categorized into several themes: quality, scheduling, cost, occupational safety and health, technologies and applications, and general perception. Consequently, the 5-point Likert scale tool (very low to very high) was adopted for this survey. In addition, five close-ended questions with multi-choice types have also been prepared; these questions have been derived from a previous study implemented in the United Kingdom (UK) and the Dominic Republic (DR), these questions have been rearranged and organized to fit the structured survey in order to place the Kingdom of Saudi Arabia in comparison with the United Kingdom (UK) as well as the Dominican Republic (DR). A total number of one hundred respondents have participated in this survey from all regions of the Kingdom of Saudi Arabia: southern, central, western, eastern, and northern regions. The drivers, obstacles, and success factors for implementing smart devices and technologies in KSA’s construction sector have been investigated and analyzed. Besides, it has been concluded that KSA is on the right path toward adopting smart construction sites with attractive results comparable to and even better than the UK in some factors.Keywords: artificial intelligence, construction projects management, internet of things, smart construction sites, smart devices
Procedia PDF Downloads 1441078 Energy Efficiency Line Guides for School Buildings in Florence in a Postgraduate Master Course
Authors: Lucia Ceccherini Nelli, Alessandra Donato
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The ABITA Master course of the University of Florence offered by the Department of Architecture covers nearly all the energy-relevant issues that can arise in public and private companies and sectors. The main purpose of the Master course, active since 2003, is to analyse the energy consumption of building technologies, components, and structures at the conceptual design stage, so it could be very helpful, for designers, when making decisions related to the selection of the most suitable design alternatives and for the materials choice that will be used in an energy-efficient building. The training course provides a solid basis for increasing the knowledge and skills of energy managers and is developed with an emphasis on practical experiences related to the knowledge through case studies, measurements, and verification of energy-efficient solutions in buildings, in the industry and in the cities. The main objectives are: i)To raise the professional standards of those engaged in energy auditing, ii) To improve the practice of energy auditors by encouraging energy auditing professionals in a continuing education program of professional development, iii) Implement in the use of instrumentations for the typical measurements, iv) To propose an integrated methodology that links energy analysis tools with green building certification systems. This methodology will be applied at the early design stage of a project’s life. The final output of the practical training is to achieve an elevated professionalism in the study of environmental design and Energy management in buildings. The results are the redaction of line guides instruction for the energy refurbishment of Public schools in Florence. The school heritage of the Municipality of Florence requires interventions for the control of energy performance, as old construction buildings are often made without taking into account the necessary envelope performance. For this reason, every year, the Master's course aims to study groups of public schools to enable the Municipality to carry out energy redevelopment interventions on the existing building heritage. The future challenges of the education and training program are related to follow-up activities, the development of interactive tools and the curriculum's customization to meet the constantly growing needs of energy experts from industry.Keywords: expert in energy, energy auditing, public buildings, thermal analysis
Procedia PDF Downloads 1811077 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study
Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor
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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan
Procedia PDF Downloads 501076 Nursing Education in Estonia During the Years of Occupation: Paternalism and Ideology
Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits
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Background data. In 1940–1941 and 1945–1991 Estonia was occupied by Soviet Union. Paternalism was a common principle in Soviet social policy, including health care. The Soviet government, not the individuals themselves, decided on achieving a person’s quality of life. With the help of Soviet ideology, the work culture of nurses was constructed and the education system was also reshaped according to the ideology. The “new period of awakening” was initiated under Gorbachev’s perestroika and glasnost (1985–1991), leading to democratization. Aim. The qualitative study aimed to analyze nursing education in Soviet Estonia in the conditions of paternalistic orientation and ideological pressure. Method. The research was conducted in 2021 and 2023. Senior nurses (aged 69–87) who had worked for at least 20 years during the Soviet era were surveyed. Thematic interviews were conducted in written form and orally (13 interviewees), followed by a focus group interview (8 interviewees). A thematic content analysis was performed. Results. Nursing is part of society’s culture and in this sense, in - terviews with nurses provide us with critical information about the functioning of society and cultural identity at a given time. During the Soviet era the training of nurses occured within vocational training institutions. The curricula underwent a shift towards a Soviet-oriented approach. A significant portion of lessons were dedicated to imparting knowledge on the principles and tenets of Communist-Marxist ideology. Therefore, practical subjects and nursing theory were frequently allocated limited space. A paternalistic orientation prevailed in health care: just as the state regulated how to cure, spread hygiene, and healthy lifestyles propaganda, training was also determined by the management of the institution, thereby limiting the person´s autonomy to decide what kind of training was needed. The research is of significant value in the context of the history of nursing, as it helps to understand the difficulties and complexity of the development of nursing on the timeline. The Soviet era still affects Estonian society today and will continue to do so in the future. The same type of developments occurred in other post-Soviet countries.Keywords: Estonian SSR, nursing education, paternalism, senior nurse, Soviet ideology
Procedia PDF Downloads 591075 Effect of Packing Ratio on Fire Spread across Discrete Fuel Beds: An Experimental Analysis
Authors: Qianqian He, Naian Liu, Xiaodong Xie, Linhe Zhang, Yang Zhang, Weidong Yan
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In the wild, the vegetation layer with exceptionally complex fuel composition and heterogeneous spatial distribution strongly affects the rate of fire spread (ROS) and fire intensity. Clarifying the influence of fuel bed structure on fire spread behavior is of great significance to wildland fire management and prediction. The packing ratio is one of the key physical parameters describing the property of the fuel bed. There is a threshold value of the packing ratio for ROS, but little is known about the controlling mechanism. In this study, to address this deficiency, a series of fire spread experiments were performed across a discrete fuel bed composed of some regularly arranged laser-cut cardboards, with constant wind speed and different packing ratios (0.0125-0.0375). The experiment aims to explore the relative importance of the internal and surface heat transfer with packing ratio. The dependence of the measured ROS on the packing ratio was almost consistent with the previous researches. The data of the radiative and total heat fluxes show that the internal heat transfer and surface heat transfer are both enhanced with increasing packing ratio (referred to as ‘Stage 1’). The trend agrees well with the variation of the flame length. The results extracted from the video show that the flame length markedly increases with increasing packing ratio in Stage 1. Combustion intensity is suggested to be increased, which, in turn, enhances the heat radiation. The heat flux data shows that the surface heat transfer appears to be more important than the internal heat transfer (fuel preheating inside the fuel bed) in Stage 1. On the contrary, the internal heat transfer dominates the fuel preheating mechanism when the packing ratio further increases (referred to as ‘Stage 2’) because the surface heat flux keeps almost stable with the packing ratio in Stage 2. As for the heat convection, the flow velocity was measured using Pitot tubes both inside and on the upper surface of the fuel bed during the fire spread. Based on the gas velocity distribution ahead of the flame front, it is found that the airflow inside the fuel bed is restricted in Stage 2, which can reduce the internal heat convection in theory. However, the analysis indicates not the influence of inside flow on convection and combustion, but the decreased internal radiation of per unit fuel is responsible for the decrease of ROS.Keywords: discrete fuel bed, fire spread, packing ratio, wildfire
Procedia PDF Downloads 1311074 Investigating the Indoor Air Quality of the Respiratory Care Wards
Authors: Yu-Wen Lin, Chin-Sheng Tang, Wan-Yi Chen
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Various biological specimens, drugs, and chemicals exist in the hospital. The medical staffs and hypersensitive inpatients expose might expose to multiple hazards while they work or stay in the hospital. Therefore, the indoor air quality (IAQ) of the hospital should be paid more attention. Respiratory care wards (RCW) are responsible for caring the patients who cannot spontaneously breathe without the ventilators. The patients in RCW are easy to be infected. Compared to the bacteria concentrations of other hospital units, RCW came with higher values in other studies. This research monitored the IAQ of the RCW and checked the compliances of the indoor air quality standards of Taiwan Indoor Air Quality Act. Meanwhile, the influential factors of IAQ and the impacts of ventilator modules, with humidifier or with filter, were investigated. The IAQ of two five-bed wards and one nurse station of a RCW in a regional hospital were monitored. The monitoring was proceeded for 16 hours or 24 hours during the sampling days with a sampling frequency of 20 minutes per hour. The monitoring was performed for two days in a row and the AIQ of the RCW were measured for eight days in total. The concentrations of carbon dioxide (CO₂), carbon monoxide (CO), particulate matter (PM), nitrogen oxide (NOₓ), total volatile organic compounds (TVOCs), relative humidity (RH) and temperature were measured by direct reading instruments. The bioaerosol samples were taken hourly. The hourly air change rate (ACH) was calculated by measuring the air ventilation volume. Human activities were recorded during the sampling period. The linear mixed model (LMM) was applied to illustrate the impact factors of IAQ. The concentrations of CO, CO₂, PM, bacterial and fungi exceeded the Taiwan IAQ standards. The major factors affecting the concentrations of CO, PM₁ and PM₂.₅ were location and the number of inpatients. The significant factors to alter the CO₂ and TVOC concentrations were location and the numbers of in-and-out staff and inpatients. The number of in-and-out staff and the level of activity affected the PM₁₀ concentrations statistically. The level of activity and the numbers of in-and-out staff and inpatients are the significant factors in changing the bacteria and fungi concentrations. Different models of the patients’ ventilators did not affect the IAQ significantly. The results of LMM can be utilized to predict the pollutant concentrations under various environmental conditions. The results of this study would be a valuable reference for air quality management of RCW.Keywords: respiratory care ward, indoor air quality, linear mixed model, bioaerosol
Procedia PDF Downloads 961073 Vegetation Assessment Under the Influence of Environmental Variables; A Case Study from the Yakhtangay Hill of Himalayan Range, Pakistan
Authors: Hameed Ullah, Shujaul Mulk Khan, Zahid Ullah, Zeeshan Ahmad Sadia Jahangir, Abdullah, Amin Ur Rahman, Muhammad Suliman, Dost Muhammad
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The interrelationship between vegetation and abiotic variables inside an ecosystem is one of the main jobs of plant scientists. This study was designed to investigate the vegetation structure and species diversity along with the environmental variables in the Yakhtangay hill district Shangla of the Himalayan Mountain series Pakistan by using multivariate statistical analysis. Quadrat’s method was used and a total of 171 Quadrats were laid down 57 for Tree, Shrubs and Herbs, respectively, to analyze the phytosociological attributes of the vegetation. The vegetation of the selected area was classified into different Life and leaf-forms according to Raunkiaer classification, while PCORD software version 5 was used to classify the vegetation into different plants communities by Two-way indicator species Analysis (TWINSPAN). The CANOCCO version 4.5 was used for DCA and CCA analysis to find out variation directories of vegetation with different environmental variables. A total of 114 plants species belonging to 45 different families was investigated inside the area. The Rosaceae (12 species) was the dominant family followed by Poaceae (10 species) and then Asteraceae (7 species). Monocots were more dominant than Dicots and Angiosperms were more dominant than Gymnosperms. Among the life forms the Hemicryptophytes and Nanophanerophytes were dominant, followed by Therophytes, while among the leaf forms Microphylls were dominant, followed by Leptophylls. It is concluded that among the edaphic factors such as soil pH, the concentration of soil organic matter, Calcium Carbonates concentration in soil, soil EC, soil TDS, and physiographic factors such as Altitude and slope are affecting the structure of vegetation, species composition and species diversity at the significant level with p-value ≤0.05. The Vegetation of the selected area was classified into four major plants communities and the indicator species for each community was recorded. Classification of plants into 4 different communities based upon edaphic gradients favors the individualistic hypothesis. Indicator Species Analysis (ISA) shows the indicators of the study area are mostly indicators to the Himalayan or moist temperate ecosystem, furthermore, these indicators could be considered for micro-habitat conservation and respective ecosystem management plans.Keywords: species richness, edaphic gradients, canonical correspondence analysis (CCA), TWCA
Procedia PDF Downloads 1411072 Rare Internal Organ Trauma in Adolescent Athletes: Insights from a Pancreatic Injury Case Study
Authors: Muhandiram Rallage Ruvini Nisansala Yatigammana, Anuruddhika Kumudu Kumari Rajakaruna Jayathilaka
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Sports injuries are common among teenagers and children engaged in organized sports. While most sports injuries are typical, some rare occurrences involve conditions such as eye, dental, cervical, and rare internal organ injuries, such as pancreatic injuries. These injuries, especially traumatic pancreatitis, require prompt attention due to their potential for severe and sometimes fatal complications. This case revolves around a real accident involving a 12-year-old girl, Piyumi, who suffered a face-to-face collision during netball practice, resulting in severe abdominal pain. After a medical examination, she was diagnosed with a rare pancreatic injury, uncommon in children compared to adults. In Piyumi’s case, she had a grade 3 pancreatic injury and underwent non-surgical management, successfully healing her wound without surgery. The study attempts to fill empirical and population gaps, addressing a rarely discussed injury experienced by a 12-year-old female netball player. The paper will also provide an in-depth understanding of pancreatic injury, which is a rare sports injury. The study’s main objective was to investigate the incidence and characteristics of pancreatic injury, particularly focusing on pancreatic trauma, among children and adolescents engaged in high-impact sports, such as netball. This research adopted a case study strategy, employing interviews as the primary data collection method. Interviews were conducted with Piyumi, her parents, and the two specialist doctors directly involved in her treatment, providing firsthand accounts and insights. By examining the case, the paper arrives at three main conclusions. Firstly, pancreatic damage is uncommon, especially in the sports world, and proper diagnosis is essential to avoiding health concerns, particularly for minors. Secondly, CT (Computed Tomography) was useful in locating the injury, as injuries can be diagnosed very well with Computed Tomography (CT) images. Finally, and most importantly, pancreatic injuries are infrequent, but trauma can still occur, particularly in high-impact sports or accidents involving extreme force or falls. These injuries should be accurately diagnosed and treated promptly.Keywords: child athlete, pancreatic injury, rare sports injuries, sportswoman
Procedia PDF Downloads 621071 Efficacy of Opicapone and Levodopa with Different Levodopa Daily Doses in Parkinson’s Disease Patients with Early Motor Fluctuations: Findings from the Korean ADOPTION Study
Authors: Jee-Young Lee, Joaquim J. Ferreira, Hyeo-il Ma, José-Francisco Rocha, Beomseok Jeon
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The effective management of wearing-off is a key driver of medication changes for patients with Parkinson’s disease (PD) treated with levodopa (L-DOPA). While L-DOPA is well tolerated and efficacious, its clinical utility over time is often limited by the development of complications such as dyskinesia. Still, common first-line option includes adjusting the daily L-DOPA dose followed by adjunctive therapies usually counting for the L-DOPA equivalent daily dose (LEDD). The LEDD conversion formulae are a tool used to compare the equivalence of anti-PD medications. The aim of this work is to compare the effects of opicapone (OPC) 50 mg, a catechol-O-methyltransferase (COMT) inhibitor, and an additional 100 mg dose of L-DOPA in reducing the off time in PD patients with early motor fluctuations receiving different daily L-DOPA doses. OPC was found to be well tolerated and efficacious in advanced PD population. This work utilized patients' home diary data from a 4-week Phase 2 pharmacokinetics clinical study. The Korean ADOPTION study randomized (1:1) patients with PD and early motor fluctuations treated with up to 600 mg of L-DOPA given 3–4 times daily. The main endpoint was change from baseline in off time in the subgroup of patients receiving 300–400 mg/day L-DOPA at baseline plus OPC 50 mg and in the subgroup receiving >300 mg/day L-DOPA at baseline plus an additional dose of L-DOPA 100 mg. Of the 86 patients included in this subgroup analysis, 39 received OPC 50 mg and 47 L-DOPA 100 mg. At baseline, both L-DOPA total daily dose and LEDD were lower in the L-DOPA 300–400 mg/day plus OPC 50 mg group than in the L-DOPA >300 mg/day plus L-DOPA 100 mg. However, at Week 4, LEDD was similar between the two groups. The mean (±standard error) reduction in off time was approximately three-fold greater for the OPC 50 mg than for the L-DOPA 100 mg group, being -63.0 (14.6) minutes for patients treated with L-DOPA 300–400 mg/day plus OPC 50 mg, and -22.1 (9.3) minutes for those receiving L-DOPA >300 mg/day plus L-DOPA 100 mg. In conclusion, despite similar LEDD, OPC demonstrated a significantly greater reduction in off time when compared to an additional 100 mg L-DOPA dose. The effect of OPC appears to be LEDD independent, suggesting that caution should be exercised when employing LEDD to guide treatment decisions as this does not take into account the timing of each dose, onset, duration of therapeutic effect and individual responsiveness. Additionally, OPC could be used for keeping the L-DOPA dose as low as possible for as long as possible to avoid the development of motor complications which are a significant source of disability.Keywords: opicapone, levodopa, pharmacokinetics, off-time
Procedia PDF Downloads 571070 The AU Culture Platform Approach to Measure the Impact of Cultural Participation on Individuals
Authors: Sendy Ghirardi, Pau Rausell Köster
Abstract:
The European Commission increasingly pushes cultural policies towards social outcomes and local and regional authorities also call for culture-driven strategies for local development and prosperity and therefore, the measurement of cultural participation becomes increasingly more significant for evidence-based policy-making processes. Cultural participation involves various kinds of social and economic spillovers that combine social and economic objectives of value creation, including social sustainability and respect for human values. Traditionally, from the economic perspective, cultural consumption is measured by the value of financial transactions in purchasing, subscribing to, or renting cultural equipment and content, addressing the market value of cultural products and services. The main sources of data are the household spending survey and merchandise trade survey, among others. However, what characterizes the cultural consumption is that it is linked with the hedonistic and affective dimension rather than the utilitarian one. In fact, nowadays, more and more attention is being paid to the social and psychological dimensions of culture. The aim of this work is to present a comprehensive approach to measure the impacts of cultural participation and cultural users’ behaviour, combining both socio-psychological and economic approaches. The model combines contingent evaluation techniques with the individual characteristic and perception analysis of the cultural experiences to evaluate the cognitive, aesthetic, emotive and social impacts of cultural participation. To investigate the comprehensive approach to measure the impact of the cultural events on individuals, the research has been designed on the basis of prior theoretical development. A deep literature methodology has been done to develop the theoretical model applied to the web platform to measure the impacts of cultural experience on individuals. The developed framework aims to become a democratic tool for evaluating the services that cultural or policy institutions can adopt through the use of an interacting platform that produces big data benefiting academia, cultural management and policies. The Au Culture is a prototype based on an application that can be used on mobile phones or any other digital platform. The development of the AU Culture Platform has been funded by the Valencian Innovation Agency (Government of the Region of Valencia) and it is part of the Horizon 2020 project MESOC.Keywords: comprehensive approach, cultural participation, economic dimension, socio-psychological dimension
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