Search results for: clinical samples

Authors: Robert H. Bradley, Robert F. Corwyn

Abstract:

There is abundant research showing that socio-economic status is implicated in parenting. However, additional factors such as family context, parent personality, parenting history and child behavior also help determine how parents enact the role of caregiver. Each of these factors not only helps determine how a parent will act in a given situation, but each can serve to moderate the influence of the other factors. Personality has long been studied as a factor that influences parental behavior, but it has almost never been considered as a moderator of family contextual factors. For this study, relations between three maternal personality characteristics (agreeableness, extraversion, neuroticism) and four aspects of parenting (harshness, sensitivity, stimulation, learning materials) were examined when children were 6 months, 36 months, and 54 months old and again at 5th grade. Relations between these three aspects of personality and the overall home environment were also examined. A key concern was whether maternal personality characteristics moderated relations between household income and the four aspects of parenting and between household income and the overall home environment. The data for this study were taken from the NICHD Study of Early Child Care and Youth Development (NICHD SECCYD). The total sample consisted of 1364 families living in ten different sites in the United States. However, the samples analyzed included only those with complete data on all four parenting outcomes (i.e., sensitivity, harshness, stimulation, and provision of learning materials), income, maternal education and all three measures of personality (i.e., agreeableness, neuroticism, extraversion) at each age examined. Results from hierarchical regression analysis showed that mothers high in agreeableness were more likely to demonstrate sensitivity and stimulation as well as provide more learning materials to their children but were less likely to manifest harshness. Maternal agreeableness also consistently moderated the effects of low income on parental behavior. Mothers high in extraversion were more likely to provide stimulation and learning materials, with extraversion serving as a moderator of low income on both. By contrast, mothers high in neuroticism were less likely to demonstrate positive aspects of parenting and more likely to manifest negative aspects (e.g., harshness). Neuroticism also served to moderate the influence of low income on parenting, especially for stimulation and learning materials. The most consistent effects of parent personality were on the overall home environment, with significant main and interaction effects observed in 11 of the 12 models tested. These findings suggest that it may behoove professional who work with parents living in adverse circumstances to consider parental personality in helping to better target prevention or intervention efforts aimed at supporting parental efforts to act in ways that benefit children.

Keywords: home environment, household income, learning materials, personality, sensitivity, stimulation

Procedia PDF Downloads 190

Authors: Rajeev Ravindran, Amit K. Jaiswal

Abstract:

Waste from the food-processing industry is produced in large amount and contains high levels of lignocellulose. Due to continuous accumulation throughout the year in large quantities, it creates a major environmental problem worldwide. The chemical composition of these wastes (up to 75% of its composition is contributed by polysaccharide) makes it inexpensive raw material for the production of value-added products such as biofuel, bio-solvents, nanocrystalline cellulose and enzymes. In order to use lignocellulose as the raw material for the microbial fermentation, the substrate is subjected to enzymatic treatment, which leads to the release of reducing sugars such as glucose and xylose. However, the inherent properties of lignocellulose such as presence of lignin, pectin, acetyl groups and the presence of crystalline cellulose contribute to recalcitrance. This leads to poor sugar yields upon enzymatic hydrolysis of lignocellulose. A pre-treatment method is generally applied before enzymatic treatment of lignocellulose that essentially removes recalcitrant components in biomass through structural breakdown. Present study is carried out to find out the best pre-treatment method for the maximum liberation of reducing sugars from spent coffee waste (SPW). SPW was subjected to a range of physical, chemical and physico-chemical pre-treatment followed by a sequential, combinatorial pre-treatment strategy is also applied on to attain maximum sugar yield by combining two or more pre-treatments. All the pre-treated samples were analysed for total reducing sugar followed by identification and quantification of individual sugar by HPLC coupled with RI detector. Besides, generation of any inhibitory compounds such furfural, hydroxymethyl furfural (HMF) which can hinder microbial growth and enzyme activity is also monitored. Results showed that ultrasound treatment (31.06 mg/L) proved to be the best pre-treatment method based on total reducing content followed by dilute acid hydrolysis (10.03 mg/L) while galactose was found to be the major monosaccharide present in the pre-treated SPW. Finally, the results obtained from the study were used to design a sequential lignocellulose pre-treatment protocol to decrease the formation of enzyme inhibitors and increase sugar yield on enzymatic hydrolysis by employing cellulase-hemicellulase consortium. Sequential, combinatorial treatment was found better in terms of total reducing yield and low content of the inhibitory compounds formation, which could be due to the fact that this mode of pre-treatment combines several mild treatment methods rather than formulating a single one. It eliminates the need for a detoxification step and potential application in the valorisation of lignocellulosic food waste.

Keywords: lignocellulose, enzymatic hydrolysis, pre-treatment, ultrasound

Procedia PDF Downloads 345

Authors: Mridula Devi

Abstract:

Trafficking of women is a slur on human dignity and a shameful act to human civilization and development. Trafficking of women is one of worst brazen abuses which violate the women’s human rights. In India, more particularly in Assam, human trafficking and infringement of human rights of individual includes mainly the women and girl child of the State. Trafficking in North East region of India, more particularly in Assam occurs in two different ways – one is the internal trafficking of women and girl child from conflict affected rural areas of Assam for domestic work and prostitution. Secondly, there is trafficking of women to other south-East Asiatic countries like Bangladesh, Bhutan, Bangkok, Myanmar (Burma) for various purposes such as drug trafficking, labor, bar girl and prostitution.Historically, trafficking in human beings is associated with slavery and bonded or forced labor. Since the period of Roman Civilization, there was the practice of traffic in persons in the form of slave trade among the nations. With the rise of new imperialism, slavery had become an integral part of the colonial system of European Countries. With time, it almost became synonymous with prostitution or commercial sexual exploitation. Finally, the United Nation adopted the Convention for the Suppression of the Traffic in Persons and of the Prostitution of others, 1949 by the G.A.Res.No.-317(iv). The Convention totally denounces the traffic in persons for the purpose of prostitution. However, it is important to note that, now a days trafficking is not confined to commercial sexual exploitation of women and children alone. It has myriad forms and the number of victims has been steadily on the rise over the past few decades. In Assam, it takes place through and for marriage, sexual exploitation, begging, organ trading, militancy conflicts, drug padding and smuggling, labour, adoption, entertainment, and sports. In this paper, empirical methodology has been used. The study is based on primary and secondary sources. Data’s are collected from different books, publications, newspaper, journals etc. For empirical analysis, some random samples are collected and systematized for better result. India suffers from the ignominy of being one of the biggest hubs of women trafficking in the world. Over the years, Assam: the north east part of India has been bearing the brunt of the rapidly rising evil of trafficking of women which threaten the life, dignity and human rights of women. Though different laws are adopted at international and national level to restore trafficking, still the menace of trafficking of women in Assam is not decreased, rather it increased. This causes a serious violation of women’s human right in Assam. Human trafficking or women’s trafficking is a serious crime against society. To curb this in Assam it is required to take some effective and dedicated measure at state level as well as national and international level.

Keywords: Assam, human trafficking, sexual exploitation, India

Procedia PDF Downloads 500

Authors: Laura Roe

Abstract:

This study draws on twelve months of ethnographic fieldwork conducted in 2017 with heroin and poly-substance users in Scotland and explores experiences of time and temporality as factors in continuing drug use. The research largely took place over the year in which drug-related deaths in Scotland reached a record high, and were statistically recorded as the highest in Europe. This qualitative research is therefore significant in understanding both evolving patterns of drug use and the experiential lifeworlds of those who use heroin and other substances in high doses. Methodologies included participant observation, structured and semi-structured interviews, and unstructured conversations with twenty-two regular participants. The fieldwork was conducted in two needle exchanges, a community recovery group and in the community. The initial aim of the study was to assess evolving patterns of drug preferences in order to explore a clinical and user-reported rise in the use of novel psychoactive substances (NPS), which are typically considered to be highly potent, synthetic substances, often available at a low cost. It was found, however, that while most research participants had experimented with NPS with varying intensity, those who used every day regularly consumed heroin, methadone, and alcohol with benzodiazepines such as diazepam or anticonvulsants such as gabapentin. The research found that many participants deliberately pursued the non-fatal effects of overdose, aiming to induce states of dissociation, detachment and uneven consciousness, and did so by both mixing substances and experimenting with novel modes of consumption. Temporality was significant in the decision to consume cocktails of substances, as users described wishing to sever themselves from time; entering into states of ‘non-time’ and insensibility through specific modes of intoxication. Time and temporality similarly impacted other aspects of addicted life. Periods of attempted abstinence witnessed a slowing of time’s passage that was tied to affective states of boredom and melancholy, in addition to a disruptive return of distressing and difficult memories. Abject past memories frequently dominated and disrupted the present, which otherwise could be highly immersive due to the time and energy-consuming nature of seeking drugs while in financial difficulty. There was furthermore a discordance between individual user temporalities and the strict time-based regimes of recovery services and institutional bodies, and the study aims to highlight the impact of such a disjuncture on the efficacy of treatment programs. Many participants had difficulty in adhering to set appointments or temporal frameworks due to their specific temporal situatedness. Overall, exploring increasing tendencies of heroin users in Scotland towards poly-substance use, this study draws on experiences and perceptions of time, analysing how temporality comes to bear on the ways drugs are sought and consumed, and how recovery is imagined and enacted. The study attempts to outline the experiential, intimate and subjective worlds of heroin and poly-substance users while explicating the structural and historical factors that shape them.

Keywords: addiction, poly-substance use, temporality, timelessness

Procedia PDF Downloads 100

Authors: Patrick Louie Robles, Jerry Suls, Ciaran Friel, Mark Butler, Samantha Gordon, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

Abstract:

Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence finds increasing physical activity is positively associated with health benefits. Behavior change techniques (BCTs) have demonstrated some effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a personalized trials (N-of-1) design, delivered virtually, to evaluate the efficacy of using five BCTs in increasing low-intensity physical activity (by 2,000 steps of walking per day) in adults aged 45-75 years old. The 5 BCTs described in habit formation theory are goal setting, action planning, rehearsal, rehearsal in a consistent context, and self-monitoring. The study recruited health system employees in the target age range who had no mobility restrictions and expressed interest in increasing their daily activity by a minimum of 2,000 steps per day at least five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. Participants then engaged remotely with a clinical research coordinator to establish a “walking plan” that included a time and day interval (e.g., between 7am -8am on Monday-Friday), a location for the walk (e.g., park), and how much time the plan would need to achieve a minimum of 2,000 steps over their baseline average step count (20 minutes). All elements of the walking plan were required to remain consistent throughout the study. In the 10-week intervention phase of the study, participants received all five BCTs in a single, time-sensitive text message. The text message was delivered 30 minutes prior to the established walk time and signaled participants to begin walking when the context (i.e., day of the week, time of day) they pre-selected is encountered. Participants were asked to log both the start and conclusion of their activity session by pressing a button on the Fitbit tracker. Within 30 minutes of the planned conclusion of the activity session, participants received a text message with a link to a secure survey. Here, they noted whether they engaged in the BCTs when prompted and completed an automaticity survey to identify how “automatic” their walking behavior had become. At the end of their trial, participants received a personalized summary of their step data over time, helping them learn more about their responses to the five BCTs. Whether the use of these 5 ‘habit formation’ BCTs in combination elicits a change in physical activity behavior among older adults will be reported. This study will inform the feasibility of a virtually-delivered N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

Procedia PDF Downloads 119

Authors: Momita Das, Sofia Banu, Jibon Kotoky

Abstract:

Environmental contamination of natural resources with persistent organic pollutants is of great world-wide apprehension. Polycyclic aromatic hydrocarbons (PAHs) are among the organic pollutants, released due to various anthropogenic activities. Due to their toxic, carcinogenic and mutagenic properties, PAHs are of environmental and human concern. Presently, bioremediation has evolved as the most promising biotechnology for cleanup of such contaminants because of its economical and less cost effectiveness. In the present study, distribution of 16 USEPA priority PAHs was determined in the soil samples collected from fifteen different sites of Guwahati City, the Gateway of the North East Region of India. The total concentrations of 16 PAHs (Σ16 PAHs) ranged from 42.7-742.3 µg/g. Higher concentration of total PAHs was found more in the Industrial areas compared to all the sites (742.3 µg/g and 628 µg/g). It is noted that among all the PAHs, Naphthalene, Acenaphthylene, Anthracene, Fluoranthene, Chrysene and Benzo(a)Pyrene were the most available and contain the higher concentration of all the PAHs. Since microbial activity has been deemed the most influential and significant cause of PAH removal; further, twenty-three bacteria were isolated from the most contaminated sites using the enrichment process. These strains were acclimatized to utilize naphthalene and anthracene, each at 100 µg/g concentration as sole carbon source. Among them, one Gram-positive strain (JMG-01) was selected, and biodegradation ability and initial catabolic genes of PAHs degradation were investigated. Based on 16S rDNA analysis, the isolate was identified as Bacillus cereus strain JMG-01. Topographic images obtained using Scanning Electron Microscope (SEM) and Atomic Force Microscope (AFM) at scheduled time intervals of 7, 14 and 21 days, determined the variation in cell morphology during the period of degradation. AFM and SEM micrograph of biomass showed high filamentous growth leading to aggregation of cells in the form of biofilm with reference to the incubation period. The percentage degradation analysis using gas chromatography and mass analyses (GC-MS) suggested that more than 95% of the PAHs degraded when the concentration was at 500 µg/g. Naphthalene, naphthalene-2-methy, benzaldehyde-4-propyl, 1, 2, benzene di-carboxylic acid and benzene acetic acid were the major metabolites produced after degradation. Moreover, PCR experiments with specific primers for catabolic genes, ndo B and Cat A suggested that JMG-01 possess genes for PAHs degradation. Thus, the study concludes that Bacillus cereus strain JMG-01 has efficient biodegrading ability and can trigger the clean-up of PAHs contaminated soil.

Keywords: AFM, Bacillus cereus strain JMG-01, degradation, polycyclic aromatic hydrocarbon, SEM

Procedia PDF Downloads 244

Authors: Jia Wang, Wanting Zhang, Yutong Xv, Zihan Guo, Weiguang Ma

Abstract:

Background: Before becoming qualified nurses, newly graduated nurses(NGNs) must experience a painful transition period, even transition shocks. Transition shocks are public health issues. To address the transition issue of NGNs, many programs or interventions have been developed and implemented. However, there are no studies to understand and assess the transition state of newly graduated nurses from work to life, from external abilities to internal emotions. Aims: Assess the transition status of newly graduated nurses in China. Identify the factors influencing the transition status of newly graduated nurses. Methods: The multi-center cross-sectional study design was adopted. From May 2022 to June 2023, 1261 newly graduated nurse in hospitals were surveyed online with the the Demographic Questionnaire and Transition Status Scale for Newly Graduated Nurses. SPSS 26.0 were used for data input and statistical analysis. Statistic description were adopted to evaluate the demographic characteristics and transition status of NGNs. Independent-samples T-test, Analysis of Variance and Multiple regression analysis was used to explore the influencing factors of transition status. Results: The total average score of Transition Status Scale for Newly Graduated Nurses was 4.00（SD = 0.61）. Among the various dimensions of Transition Status, the highest dimension was competence for nursing work, while the lowest dimension was balance between work and life. The results showed factors influencing the transition status of NGNs include taught by senior nurses, night shift status, internship department, attribute of working hospital, province of work and residence, educational background, reasons for choosing nursing, types of hospital, and monthly income. Conclusion: At present, the transition status score of new nurses in China is relatively high, and NGNs are more likely to agree with their own transition status, especially the dimension of competence for nursing work. However, they have a poor level of excess in terms of life-work balance. Nursing managers should reasonably arrange the working hours of NGNs, promote their work-life balance, increase the salary and reward mechanism of NGNs, arrange experienced nursing mentors to teach, optimize the level of hospitals, provide suitable positions for NGNs with different educational backgrounds, pay attention to the culture shock of NGNs from other provinces, etc. Optimize human resource management by intervening in these factors that affect the transition of new nurses and promote a better transition of new nurses.

Keywords: newly graduated nurse, transition, humanistic car, nursing management, nursing practice education

Procedia PDF Downloads 53

Authors: Mariia Karizhenskaia, Tanvi Nandani, Ali Tafazoli Moghadam

Abstract:

Hospice palliative care (HPC) is one of the most complicated philosophies of care in which physical, social/cultural, and spiritual aspects of human life are intermingled with an undeniably significant role in every aspect. Among these dimensions of care, culture possesses an outstanding position in the process and goal determination of HPC. This study shows the importance of cultural elements in the establishment of effective and optimized structures of HPC in the Canadian healthcare environment. Our systematic search included Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 1998 to 2023 to identify recent national literature connecting culture and palliative care delivery. The most frequently presented feature among the articles is the role of culture in the efficiency of the HPC. It has been shown frequently that including the culturespecific parameters of each nation in this system of care is vital for its success. On the other hand, ignorance about the exclusive cultural trends in a specific location has been accompanied by significant failure rates. Accordingly, implementing a culture-wise adaptable approach is mandatory for multicultural societies. The following outcome of research studies in this field underscores the importance of culture-oriented education for healthcare staff. Thus, all the practitioners involved in HPC will recognize the importance of traditions, religions, and social habits for processing the care requirements. Cultural competency training is a telling sample of the establishment of this strategy in health care that has come to the aid of HPC in recent years. Another complexity of the culturized HPC nowadays is the long-standing issue of racialization. Systematic and subconscious deprivation of minorities has always been an adversity of advanced levels of care. The last part of the constellation of our research outcomes is comprised of the ethical considerations of culturally driven HPC. This part is the most sophisticated aspect of our topic because almost all the analyses, arguments, and justifications are subjective. While there was no standard measure for ethical elements in clinical studies with palliative interventions, many research teams endorsed applying ethical principles for all the involved patients. Notably, interpretations and projections of ethics differ in varying cultural backgrounds. Therefore, healthcare providers should always be aware of the most respectable methodologies of HPC on a case-by-case basis. Cultural training programs have been utilized as one of the main tactics to improve the ability of healthcare providers to address the cultural needs and preferences of diverse patients and families. In this way, most of the involved health care practitioners will be equipped with cultural competence. Considerations for ethical and racial specifications of the clients of this service will boost the effectiveness and fruitfulness of the HPC. Canadian society is a colorful compilation of multiple nationalities; accordingly, healthcare clients are diverse, and this divergence is also translated into HPC patients. This fact justifies the importance of studying all the cultural aspects of HPC to provide optimal care on this enormous land.

Keywords: cultural competence, end-of-life care, hospice, palliative care

Procedia PDF Downloads 55

Authors: Aisha Siddiqa

Abstract:

The knowledge of pragmatic practices in a particular language is considered key to effective communication. Unlike one’s native language where this knowledge is acquired spontaneously, more conscious attention is required to learn second language pragmatics. Traditional foreign language (FL) classrooms generally focus on the acquisition of vocabulary and lexico-grammatical structures, neglecting pragmatic functions that are essential for effective communication in the multilingual networks of the modern world. In terms of effective communication, of particular importance is knowledge of what is perceived as polite or impolite in a certain language, an aspect of pragmatics which is not perceived as obligatory but is nonetheless indispensable for successful intercultural communication and integration. While learning a second language, the acquisition of politeness assumes more prominence as the politeness norms and practices vary according to language and culture. Therefore, along with focusing on the ‘use’ of politeness strategies, it is crucial to examine the ‘acquisition’ and the ‘acquisitional development’ of politeness strategies by second language learners, particularly, by lower proficiency leaners as the norms of politeness are usually focused in lower levels. Hence, there is an obvious need for a study that not only investigates the acquisition of pragmatics by young FL learners using innovative multiple methods; but also identifies the potential causes of the gaps in their development. The present research employs a cross sectional design to explore the acquisition of politeness by young English as a foreign language learners (EFL) in France; at three levels of secondary school learning. The methodology involves two phases. In the first phase a cartoon oral production task (COPT) is used to elicit samples of requests from young EFL learners in French schools. These data are then supplemented by a) role plays, b) an analysis of textbooks, and c) video recordings of classroom activities. This mixed method approach allows us to explore the repertoire of politeness strategies the learners possess and delve deeper into the opportunities available to learners in classrooms to learn politeness strategies in requests. The paper will provide the results of the analysis of COPT data for 250 learners at three different stages of English as foreign language development. Data analysis is based on categorization of requests developed in CCSARP project. The preliminary analysis of the COPT data shows that there is substantial evidence of pragmalinguistic development across all levels but the developmental process seems to gain momentum in the second half of the secondary school period as compared to the early period at school. However, there is very little evidence of sociopragmatic development. The study aims to document the current classroom practices in France by looking at the development of young EFL learner’s politeness strategies across three levels of secondary schools.

Keywords: acquisition, English, France, interlanguage pragmatics, politeness

Procedia PDF Downloads 400

Authors: V. Samulionis, J. Banys, A. Sánchez-Ferrer

Abstract:

Inorganic nanoparticles are used for fabrication of various composites based on polymer materials because they exhibit a good homogeneity and solubility of the composite material. Multifunctional materials based on composites of a polymer containing inorganic nanotubes are expected to have a great impact on industrial applications in the future. An emerging family of such composites are polyurea elastomers with inorganic MoS2 nanotubes or MoSI nanowires. Polyurea elastomers are a new kind of materials with higher performance than polyurethanes. The improvement of mechanical, chemical and thermal properties is due to the presence of hydrogen bonds between the urea motives which can be erased at high temperature softening the elastomeric network. Such materials are the combination of amorphous polymers above glass transition and crosslinkers which keep the chains into a single macromolecule. Polyurea exhibits a phase separated structure with rigid urea domains (hard domains) embedded in a matrix of flexible polymer chains (soft domains). The elastic properties of polyurea can be tuned over a broad range by varying the molecular weight of the components, the relative amount of hard and soft domains, and concentration of nanoparticles. Ultrasonic methods as non-destructive techniques can be used for elastomer composites characterization. In this manner, we have studied the temperature dependencies of the longitudinal ultrasonic velocity and ultrasonic attenuation of these new polyurea elastomers and composites with inorganic nanoparticles. It was shown that in these polyurea elastomers large ultrasonic attenuation peak and corresponding velocity dispersion exists at 10 MHz frequency below room temperature and this behaviour is related to glass transition Tg of the soft segments in the polymer matrix. The relaxation parameters and Tg depend on the segmental molecular weight of the polymer chains between crosslinking points, the nature of the crosslinkers in the network and content of MoS2 nanotubes or MoSI nanowires. The increase of ultrasonic velocity in composites modified by nanoparticles has been observed, showing the reinforcement of the elastomer. In semicrystalline polyurea elastomer matrices, above glass transition, the first order phase transition from quasi-crystalline to the amorphous state has been observed. In this case, the sharp ultrasonic velocity and attenuation anomalies were observed near the transition temperature TC. Ultrasonic attenuation maximum related to glass transition was reduced in quasicrystalline polyureas indicating less influence of soft domains below TC. The first order phase transition in semicrystalline polyurea elastomer samples has large temperature hysteresis (> 10 K). The impact of inorganic MoS2 nanotubes resulted in the decrease of the first order phase transition temperature in semicrystalline composites.

Keywords: inorganic nanotubes, polyurea elastomer composites, ultrasonic velocity, ultrasonic attenuation

Procedia PDF Downloads 284

Authors: Huey-Yeu Yan, Ching-Ying Lee, Hung-Ru Lin

Abstract:

Background: Physical assessment is a vital clinical nursing competence. The gap between conventional teaching method and the way e-generation students’ preferred could be bridged owing to the support of Internet technology, i.e. interacting with online media to manage learning works. Nursing instructors in the wake of new learning pattern of the e-generation students are challenged to actively adjust and make teaching contents and methods more versatile. Objective: The objective of this research is to explore the effects on teaching and learning with live webcast-assisted on a specific topic, Physical Assessment technique, on a designated group of young nursing majors. It’s hoped that, with a way of nursing instructing, more versatile learning resources may be provided to facilitate self-directed learning. Design: This research adopts a cross-sectional descriptive survey. The instructor demonstrated physical assessment techniques and operation procedures via live webcast broadcasted online to all students. It increased both the off-time interaction between teacher and students concerning teaching materials. Methods: A convenient sampling was used to recruit a total of 52 nursing-majors at a certain university. The nursing majors took two-hour classes of Physical Assessment per week for 18 weeks (36 hrs. in total). The instruction covered four units with live webcasting and then conducted an online anonymous survey of learning outcomes by questionnaire. The research instrument was the online questionnaire, covering three major domains—online media used, learning outcome evaluation and evaluation result. The data analysis was conducted via IBM SPSS Statistics Version 2.0. The descriptive statistics was undertaken to describe the analysis of basic data and learning outcomes. Statistical methods such as descriptive statistics, t-test, ANOVA, and Pearson’s correlation were employed in verification. Results: Results indicated the following five major findings. (1) learning motivation, about four fifth of the participants agreed the online instruction resources are very helpful in improving learning motivation and raising the learning interest. (2) learning needs, about four fifth of participants agreed it was helpful to plan self-directed practice after the instruction, and meet their needs of repetitive learning and/or practice at their leisure time. (3) learning effectiveness, about two third agreed it was helpful to reduce pre-exam anxiety, and improve their test scores. (4) course objects, about three fourth agreed that it was helpful to achieve the goal of ‘executing the complete Physical Assessment procedures with proper skills’. (5) finally, learning reflection, about all of participants agreed this experience of online instructing, learning, and practicing is beneficial to them, they recommend instructor to share with other nursing majors, and they will recommend it to fellow students too. Conclusions: Live webcasting is a low-cost, convenient, efficient and interactive resource to facilitate nursing majors’ motivation of learning, need of self-directed learning and practice, outcome of learning. When live webcasting is integrated into nursing teaching, it provides an opportunity of self-directed learning to promote learning effectiveness, as such to fulfill the teaching objective.

Keywords: innovative teaching, learning effectiveness, live webcasting, physical assessment technique

Procedia PDF Downloads 111

Authors: Esther Friedlander, Philip Friedlander

Abstract:

The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.

Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC

Procedia PDF Downloads 50

Authors: Mahshid Arabi

Abstract:

In recent years, remarkable advancements in the fields of artificial intelligence and machine learning have led to the development of facial recognition technologies. These technologies are now employed in a wide range of applications, including security, surveillance, healthcare, and education. In the field of education, the identification of university entrance exam candidates has been one of the fundamental challenges. Traditional methods such as using ID cards and handwritten signatures are not only inefficient and prone to fraud but also susceptible to errors. In this context, utilizing advanced technologies like facial recognition can be an effective and efficient solution to increase the accuracy and reliability of identity verification in entrance exams. This article examines the use of FaceMatch software for recognizing the faces of university entrance exam candidates in Iran. The main objective of this research is to evaluate the efficiency and accuracy of FaceMatch software in identifying university entrance exam candidates to prevent fraud and ensure the authenticity of individuals' identities. Additionally, this research investigates the advantages and challenges of using this technology in Iran's educational systems. This research was conducted using an experimental method and random sampling. In this study, 1000 university entrance exam candidates in Iran were selected as samples. The facial images of these candidates were processed and analyzed using FaceMatch software. The software's accuracy and efficiency were evaluated using various metrics, including accuracy rate, error rate, and processing time. The research results indicated that FaceMatch software could accurately identify candidates with a precision of 98.5%. The software's error rate was less than 1.5%, demonstrating its high efficiency in facial recognition. Additionally, the average processing time for each candidate's image was less than 2 seconds, indicating the software's high efficiency. Statistical evaluation of the results using precise statistical tests, including analysis of variance (ANOVA) and t-test, showed that the observed differences were significant, and the software's accuracy in identity verification is high. The findings of this research suggest that FaceMatch software can be effectively used as a tool for identifying university entrance exam candidates in Iran. This technology not only enhances security and prevents fraud but also simplifies and streamlines the exam administration process. However, challenges such as preserving candidates' privacy and the costs of implementation must also be considered. The use of facial recognition technology with FaceMatch software in Iran's educational systems can be an effective solution for preventing fraud and ensuring the authenticity of university entrance exam candidates' identities. Given the promising results of this research, it is recommended that this technology be more widely implemented and utilized in the country's educational systems.

Keywords: facial recognition, FaceMatch software, Iran, university entrance exam

Procedia PDF Downloads 20

Authors: Abubakar Bello Usman, Alhassan Muhammad Gani, Kolo Ibrahim

Abstract:

The use of botanical raw materials to produce pharmaceuticals, herbal remedies, teas, spirits, cosmetics, sweets, dietary supplements, special industrial compounds and crude materials constitute an important global resource in terms of healthcare and economy. In Nigeria and other developing countries, the indigenous knowledge on the uses of plants lies with the older generation and the traditional healers. However, these custodians are decreasing in number due to death and other unforeseen occurrences. An Ethno-botanical survey was carried out to obtain information on the ethno medical values of wide range of plants used by the people of Gombe State, North-Eastern Nigeria, in the practice of healing and cure of typhoid (enteric) fever. Oral interviews were conducted so as to consider those with low literacy level who are involved in the practice of traditional medicine and thirty four (34) informants availed themselves for the interview and were consulted. All relevant information obtained from the respondents was recorded. A recent and valid nomenclature, along with local names, family names, part of the plant(s) used, methods of preparation and administration and fifty four (54) plant species belonging to 27 families as well as 7 unidentified species that are commonly used by the people of the state in ethnomedical treatment of the ailment were tabulated. Those interviewed included traditional practitioners, local herb sellers, traditional rulers, hunters, farmers and patients. Specific questions were asked and information supplied by informants was promptly documented. Results showed that the people of Gombe State are knowledgeable on herbal medicine in the treatment of diseases and ailments. Furthermore, the aqueous leaf extracts of Senna siamea, the plant species with the highest PPK (percentage of people who have knowledge about the use of a species for treating typhoid fever) in this ethnobotanical survey, was tested for its activity against clinical isolates of Salmonella typhi using the agar well diffusion method. The aqueous extracts showed some activity (zones of inhibition 11, 9, 7.5, 3.5, 1.3 mm) at 2000, 1800, 1600, 1400, 1200 µg/ml concentrations respectively. Preliminary phytochemical studies of the aqueous leaf extracts of the plant revealed the presence of secondary metabolites such as alkaloids, saponins, tannins, flavonoids and cardiac glycosides. Though a large number of traditionally used plants for the treatment of enteric fever were identified, further scientific validation of the traditional claims of anti-typhoid properties is imperative. This would establish their candidature for any possible future research for active principles and the possible development of new cheaper and more effective anti-typhoid drugs, as well as in the conservation of this rich diversity of medicinal plants.

Keywords: antimicrobial activities, ethnobotany, gombe state, north-eastern Nigeria, phytochemical screening, senna siamea, typhoid fever

Procedia PDF Downloads 312

Authors: Teruya Goto, Hokuto Chiba, Tatsuhiro Takahashi

Abstract:

Carbon fiber reinforced thermoplastic resin using short carbon fiber has been produced by melt mixing and the improvement of mechanical properties has been frequently reported up to now. One of the most frequently reported enhancement has been seen in carbon fiber / polypropylene (PP) composites by adding small amount of maleic anhydride grafted polypropylene (MA-g-PP) into PP matrix. However, the further enhancement of tensile strength and tensile modules has been expected for lightning the composite more. Our present research aims to improve the mechanical property by using a highly reactive monolayer polymer, which can react with both COOH of carbon fiber surface and maleic anhydride of MA-g-PP in the matrix, on carbon fiber for PP/CF composite. It has been known that oxazoline has much higher reactivity with COOH without catalysts, compared with amine group and alcohol OH group. However, oxazoline group has not been used for the interface. To achieve the purpose, poly-2-vinyl-2-oxazoline (Pvozo), having highly reactivity with COOH and maleic anhydride, has been originally synthesized through radical polymerization using 2-vinyl-2-oxazoline as a monomer, resulting in the Mw around 140,000. Monolayer Pvozo chemically reacted on CF was prepared in 1-methoxy-2-propanol solution of Pvozo by heating at 100oC for 3 hours. After this solution treatment, unreacted Pvozo was completely washed out by methanol, resulting the uniform formation of the monolayer Pvozo on CF. Monolayer Pvozo coated CF was melt mixed by with PP and a small amount of MA-g-PP for the preparation of the composite samples using a batch type melt mixer. With performing the tensile strength tests of the composites, the tensile strength of CF/MA-g-PP/PP showed 40% increase, compared to that of CF/PP. While, that of Pvozo coated CF/MA-g-PP/PP exhibited 80% increase, compared to that of CF/PP. To get deeper insight of the dramatic increase, the weight percentage of chemically grafted polymer based on CF was evaluated by dissolving and removing the matrix polymer by xylene using by thermos gravimetric analysis (TGA). The chemically grafted remained polymer was found to be 0.69wt% in CF/PP, 0.98wt% in CF/MA-g-PP/PP, 1.51wt% in Pvozo coated CF/MA-g-PP/PP, suggesting that monolayer Pvozo contributed to the increase of the grafted polymer amount. In addition, the very strong adhesion by Pvozo was confirmed by observing the fractured cross-sectional surface of the composite by scanning electron micrograph (SEM). As a conclusion, the effectiveness of a highly reactive monolayer Pvozo on CF for the enhancement of the mechanical properties of CF/PP composite was demonstrated, which can be interpreted by the clear evidence of the increase of the grafting polymer on CF.

Keywords: CFRTP, interface, oxazoline, polymer graft, mechanical property

Procedia PDF Downloads 183

Authors: Kailash Chandra, Devanshu Gupta

Abstract:

The Himalayan Mountains of India fall under two biogeographic zones Trans Himalaya (TH) and Himalaya and seven biotic provinces (TH-Ladakh Mountains, TH-Tibetan Plateau, TH-Sikkim, North-West Himalaya, West Himalaya, Central Himalaya, and East Himalaya). Because of the extreme environment and altitudinal variations, unique physiography, varied ecological conditions, and different vegetations, the Himalaya exhibit a rich assemblage of life, both flora, and fauna, further subjected to the impacts of climate change. To the authors’ best knowledge, there is no comprehensive account except for sporadic faunal investigations, to assess or interpret the insect diversity and their biogeographic distribution in Indian Himalaya (IH), one of the biodiversity hotspots. Therefore, in this paper, a compelling review of the extensive knowledge of insect diversity of IH is presented for the first time to the best of our knowledge. The inventory of the known insect species of IH was compiled from the exploration cum faunal-study data ready with the zoological survey of India, Kolkata as well as from the information published in the scientific literature till date. The species were listed with their valid names with their distribution in seven biotic provinces of IH. The insect fauna of IH represents about 38% of the identified insect diversity of India. The interpretation of data provided significant information in detecting possible gap areas in the taxonomic representation of different insect orders. Archaeognatha, Zygentoma, Ephemeroptera, Phasmida, Embioptera, Psocoptera, Phthiraptera, Strepsiptera, Megaloptera, Raphidioptera, Siphonaptera, and Mecoptera need revisions, and it is required to collect more samples from remote areas of the region. Scope for finding new taxa even in the most diverse orders, Coleoptera, Lepidoptera, Hymenoptera, Diptera, and Hemiptera cannot be overlooked. Exploration of cold deserts of Trans Himalaya and East Himalaya (Arunachal Pradesh) may result in a good number of new species from these regions. The most notable data was that many of the species recorded from Himalaya are still known from their type localities only, so there is an urgency to revisit and resurvey those collection localities for the evaluation of the status of those species. It is also required to assess and monitor the impact of climate change on the diversity of insects inhabiting in the fragile Himalayan ecosystem. DNA barcoding especially pests and biological control agents to solve the problems of identification in species complexes is also the need of the hour. In a nutshell, it can be concluded that the inventory of insects of this region is extensive but is far from final as every year hundreds of new species are described.

Keywords: catalog, climate change, diversity, DNA barcoding

Procedia PDF Downloads 190

Authors: Agata Chudzicka-Czupała, Nadiya Hapon, Liudmyla Karamushka, Marta żywiołek-Szeja

Abstract:

Objectives: The study is about the determinants of coping with stress connected with volunteer activity for Russo-Ukrainian war 2022 refugees. We examined the mental health reactions, chosen psychological traits, and motivational functions of volunteers working in Poland and Ukraine in relation to their coping with stress styles. The study was financed with funds from the Foundation for Polish Science in the framework of the FOR UKRAINE Programme. Material and Method: The study was conducted in 2022. The study was a quantitative, questionnaire-based survey. Data was collected through an online survey. The volunteers were asked to assess their propensity to use different styles of coping with stress connected with their activity for Russo-Ukrainian war refugees using The Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE) questionnaire. Depression, anxiety, and stress were measured using the Depression, Anxiety, and Stress (DASS)-21 item scale. Chosen psychological traits, psychological capital and hardiness, were assessed by The Psychological Capital Questionnaire and The Norwegian Revised Scale of Hardiness (DRS-15R). Then The Volunteer Function Inventory (VFI) was used. The significance of differences between the variable means of the samples was tested by the Student's t-test. We used multivariate linear regression to identify factors associated with coping with stress styles separately for each national sample. Results: The sample consisted of 720 volunteers helping war refugees (in Poland, 435 people, and 285 in Ukraine). The results of the regression analysis indicate variables that are significant predictors of the propensity to use particular styles of coping with stress (problem-focused style, emotion-focused style and avoidant coping). These include levels of depression and stress, individual psychological characteristics and motivational functions, different for Polish and Ukrainians. Ukrainian volunteers are significantly more likely to use all three coping with stress styles than Polish ones. The results also prove significant differences in the severity of anxiety, stress and depression, the selected psychological traits and motivational functions studied, which led volunteers to participate in activities for war refugees. Conclusions: The results show that depression and stress severity, as well as psychological capital and hardiness, and motivational factors are connected with coping with stress behavior. The results indicate the need for increased attention to the well-being of volunteers acting under stressful conditions. They also prove the necessity of guiding the selection of people for specific types of volu

Keywords: anxiety, coping with stress styles, depression, hardiness, mental health, motivational functions, psychological capital, resilience, stress, war, volunteer, civil society

Procedia PDF Downloads 49

Authors: Léa Chawki, Émilie Cappe

Abstract:

Context: Nowadays, supporting parents of children with autism spectrum disorder (ASD) and helping them adjust to their child’s condition represents a core clinical and scientific necessity and is encouraged by the French National Strategy for Autism (2018). In France, ASD remains a challenging condition, causing distress, segregation and social stigma to concerned family members concerned by this handicap. The literature highlights that neurodevelopmental disorders in children, such as ASD, influence parental well-being. This impact could be different according to parents’ culture and the child’s particular disorder manifestation, such as developmental coordination disorder (DCC), for instance. Objectives: This present study aims to explore parental stress, anxiety and depressive symptoms, as well as the quality of life in parents of children with ASD or DCD, as well as the explicit individual, psychosocial and cultural factors of parental well-being. Methods: Participants will be recruited through diagnostic centers, child and specialized adolescent units, and organizations representing families with ASD and DCD. Our sample will include five groups of 150 parents: four groups of parents having children with ASD – one living in France, one in the US, one in Canada and the other in Lebanon – and one group of French parents of children with DCD. Self-evaluation measures will be filled directly by parents in order to measure parental stress, anxiety and depressive symptoms, quality of life, coping and emotional regulation strategies, internalized stigma, perceived social support, the child’s problem behaviors severity, as well as motor coordination deficits in children with ASD and DCD. A sociodemographic questionnaire will help collect additional useful data regarding participants and their children. Individual and semi-structured research interviews will be conducted to complete quantitative data by further exploring participants’ distinct experiences related to parenting a child with a neurodevelopmental disorder. An interview grid, specially designed for the needs of this study, will strengthen the comparison between the experiences of parents of children with ASD with those of parents of children with DCD. It will also help investigate cultural differences regarding parent support policies in the context of raising a child with ASD. Moreover, interviews will help clarify the link between certain research variables (behavioral differences between ASD and DCD, family leisure activities, family and children’s extracurricular life, etc.) and parental well-being. Research perspectives: Results of this study will provide a more holistic understanding of the roles of individual, psychosocial and cultural variables related to parental well-being. Thus, this study will help direct the implementation of support services offered to families of children with neurodevelopmental disorders (ASD and DCD). Also, the implications of this study are essential in order to guide families through changes related to public policies assisting neurodevelopmental disorders and other disabilities. The between-group comparison (ASD and DCD) is also expected to help clarify the origins of all the different challenges encountered by those families. Hence, it will be interesting to investigate whether complications perceived by parents are more likely to arise from child-symptom severity, or from the lack of support obtained from health and educational systems.

Keywords: Autism spectrum disorder, cross-cultural, cross-disorder, developmental coordination delay, well-being

Procedia PDF Downloads 75

Authors: Aya Tanaka, Mariko Era, Manami Masuda, Yui Okuno, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita

Abstract:

Objectives— Fungi and bacteria are present in a wide range of natural environments. They are breed in the foods such as vegetables and fruit, causing corruption and deterioration of these foods in some cases. Furthermore, some species of fungi and bacteria are known to cause food intoxication or allergic reactions in some individuals. To prevent fungal and bacterial contamination, various fungicides and bactericidal have been developed that inhibit fungal and bacterial growth. Fungicides and bactericides must show high antifungal and antibacterial activity, sustainable activity, and a high degree of safety. Therefore, we focused on the fatty acid salt which is the main component of soap. We focused on especially C10K and C12K. This study aimed to find the effectiveness of the fatty acid salt as antimicrobial agents for food safety. Materials and Methods— Cladosporium cladosporioides NBRC 30314, Penicillium pinophilum NBRC 6345, Aspergillus oryzae (Akita Konno store), Rhizopus oryzae NBRC 4716, Fusarium oxysporum NBRC 31631, Escherichia coli NBRC 3972, Bacillus subtilis NBRC 3335, Staphylococcus aureus NBRC 12732, Pseudomonas aenuginosa NBRC 13275 and Serratia marcescens NBRC 102204 were chosen as tested fungi and bacteria. Hartmannella vermiformis NBRC 50599 and Acanthamoeba castellanii NBRC 30010 were chosen as tested amoeba. Nine fatty acid salts including potassium caprate (C10K) and laurate (C12K) at 350 mM and pH 10.5 were used as antifungal activity. The spore suspension of each fungus (3.0×10⁴ spores/mL) or the bacterial suspension (3.0×10⁵ or 3.0×10⁶ or 3.0×10⁷ CFU/mL) was mixed with each of the fatty acid salts (final concentration of 175 mM). Samples were counted at 0, 10, 60, and 180 min by plating (100 µL) on potato dextrose agar or nutrient agar. Fungal and bacterial colonies were counted after incubation for 1 or 2 days at 30 °C. Results— C10K was antifungal activity of 4 log-unit incubated time for 10 min against fungi other than A. oryzae. C12K was antifungal activity of 4 log-unit incubated time for 10 min against fungi other than P. pinophilum and A. oryzae. C10K and C12K did not show high anti-yeast activity. C10K was antibacterial activity of 6 or 7 log-unit incubated time for 10 min against bacteria other than B. subtilis. C12K was antibacterial activity of 5 to 7 log-unit incubated time for 10 min against bacteria other than S. marcescens. C12K was anti-amoeba activity of 4 log-unit incubated time for 10 min against H. vermiformis. These results suggest C10K and C12K have potential in the field of food safety.

Keywords: food safety, microbes, antimicrobial, fatty acid salts

Procedia PDF Downloads 467

Authors: Perizat Aitmaganbet, Kerbez Kimatova, Gulmira Umarova

Abstract:

As a result of medical check-up conducted in the framework of this research study an evaluation of the health status of the population living in the oil-producing regions, namely Sarkul and Kenkiyak villages in Aktobe was examined. With the help of the Spearman correlation, the connection between the level of hazard chemical elements in the atmosphere and the health of population living in the regions of oil and gas industry was estimated. Background & Objective. The oil and gas resource-extraction industries play an important role in improving the economic conditions of the Republic of Kazakhstan, especially for the oil-producing administrative regions. However, environmental problems may adversely affect the health of people living in that area. Thus, the aim of the study is to evaluate the exposure to negative environmental factors of the adult population living in Sarkul and Kenkiyak villages, the oil and gas producing areas in the Aktobe region. Methods. After conducting medical check-up among the population of Sarkul and Kenkiyak villages. A single cross-sectional study was conducted. The population consisted of randomly sampled 372 adults (181 males and 191 females). Also, atmospheric air probes were taken to measure the level of hazardous chemical elements in the air. The nonparametric method of the Spearman correlation analysis was performed between the mean concentration of substances exceeding the Maximum Permissible Concentration and the classes of newly diagnosed diseases. Selection and analysis of air samples were carried out according to the developed research protocol; the qualitative-quantitative analysis was carried out on the Gas analyzer HANK-4 apparatus. Findings. The medical examination of the population identified the following diseases: the first two dominant were diseases of the circulatory and digestive systems, in the 3rd place - diseases of the genitourinary system, and the nervous system and diseases of the ear and mastoid process were on the fourth and fifth places. Moreover, significant pollution of atmospheric air by carbon monoxide (MPC-5,0 mg/m3), benzapyrene (MPC-1mg/m3), dust (MPC-0,5 mg/m3) and phenol (МРС-0,035mg/m3) were identified in places. Correlation dependencies between these pollutants of air and the diseases of the population were established, as a result of diseases of the circulatory system (r = 0,7), ear and mastoid process (r = 0,7), nervous system (r = 0,6) and digestive organs(r = 0,6 ); between the concentration of carbon monoxide and diseases of the circulatory system (r = 0.6), the digestive system(r = 0.6), the genitourinary system (r = 0.6) and the musculoskeletal system; between nitric oxide and diseases of the digestive system (r = 0,7) and the circulatory system (r = 0,6); between benzopyrene and diseases of the digestive system (r = 0,6), the genitourinary system (r = 0,6) and the nervous system (r = 0,4). Conclusion. The positive correlation was found between air pollution and the health of the population living in Sarkul and Kenkiyak villages. To enhance the reliability of the results we are going to continue this study further.

Keywords: atmospheric air, chemical substances, oil and gas, public health

Procedia PDF Downloads 93

Authors: Gokulan Vethanayakam, Daniel Aston

Abstract:

Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

Procedia PDF Downloads 53

Authors: S. B. R. Slagmulder

Abstract:

Monitoring inspiratory effort and dynamic lung stress in patients on pressure support ventilation in the ICU is important for protecting against self inflicted lung injury (P-SILI) and diaphragm dysfunction. Strategies to address the detrimental effects of respiratory drive and effort can lead to improved patient outcomes. Two non-invasive estimation methods, occlusion pressure (Pocc) and P0.1, have been proposed for achieving lung and diaphragm protective ventilation. However, their relationship and interpretation in neuro ICU patients is not well understood. P0.1 is the airway pressure measured during a 100-millisecond occlusion of the inspiratory port. It reflects the neural drive from the respiratory centers to the diaphragm and respiratory muscles, indicating the patient's respiratory drive during the initiation of each breath. Occlusion pressure, measured during a brief inspiratory pause against a closed airway, provides information about the inspiratory muscles' strength and the system's total resistance and compliance. Research Objective: Understanding the relationship between Pocc and P0.1 in brain-injured patients can provide insights into the interpretation of these values in pressure support ventilation. This knowledge can contribute to determining extubation readiness and optimizing ventilation strategies to improve patient outcomes. The central goal is to asses a study protocol for determining the relationship between Pocc and P0.1 in brain-injured patients on pressure support ventilation and their ability to predict successful extubation. Additionally, comparing these values between brain-damaged and non-brain-damaged patients may provide valuable insights. Key Areas of Inquiry: 1. How do Pocc and P0.1 values correlate within brain injury patients undergoing pressure support ventilation? 2. To what extent can Pocc and P0.1 values serve as predictive indicators for successful extubation in patients with brain injuries? 3. What differentiates the Pocc and P0.1 values between patients with brain injuries and those without? Methodology: P0.1 and occlusion pressures are standard measurements for pressure support ventilation patients, taken by attending doctors as per protocol. We utilize electronic patient records for existing data. Unpaired T-test will be conducted to compare P0.1 and Pocc values between both study groups. Associations between P0.1 and Pocc and other study variables, such as extubation, will be explored with simple regression and correlation analysis. Depending on how the data evolve, subgroup analysis will be performed for patients with and without extubation failure. Results: While it is anticipated that neuro patients may exhibit high respiratory drive, the linkage between such elevation, quantified by P0.1, and successful extubation remains unknown The analysis will focus on determining the ability of these values to predict successful extubation and their potential impact on ventilation strategies. Conclusion: Further research is pending to fully understand the potential of these indices and their impact on mechanical ventilation in different patient populations and clinical scenarios. Understanding these relationships can aid in determining extubation readiness and tailoring ventilation strategies to improve patient outcomes in this specific patient population. Additionally, it is vital to account for the influence of sedatives, neurological scores, and BMI on respiratory drive and occlusion pressures to ensure a comprehensive analysis.

Keywords: brain damage, diaphragm dysfunction, occlusion pressure, p0.1, respiratory drive

Procedia PDF Downloads 48

Authors: Sabrina Servot, Annick St-Amand, Michel Rousseau, Valerie Simard, Evelyne Touchette

Abstract:

Child maltreatment has a profound impact on children’s development. In its victims, internalizing and externalizing problems are highly prevalent, and sleep problems are common. Furthermore, the environment they live in is often disorganized, lacking routine and consistency. In non-maltreated children, several studies documented the important role of sleep regulation and sleep ecology. A poor sleep ecology (e.g., lack of sleep hygiene and bedtime routine, inappropriate sleeping location) may lead to sleep regulation problems (e.g., short sleep duration, nocturnal awakenings), and sleep regulation problems may increase the risk of behavior problems. Therefore, this scoping review aims to map evidence about sleep ecology and sleep regulation and the associations between sleep ecology, sleep regulation, and behavior problems in maltreated preschoolers. Literature from 1993 was searched in PsycInfo, Pubmed, Medline, Eric, and Proquest Dissertations and Theses. Articles and thesis were comprehensively reviewed based upon inclusion/exclusion criteria: 1) it concerns maltreated children aged 1-5 years, and 2) it addresses at least one of the following: sleep ecology, sleep regulation, and/or their associations with behavior problems in maltreated preschoolers. From the 650 studies screened, nine of them were included. Data were charted according to study characteristics, nature of variable documented, measures, analyses performed, and results of each study, then synthesized in a narrative summary. The main results show all included articles were quantitative. Foster children samples were used in four studies, children experienced different types of maltreatment in six studies, while one was specifically about sexually abused children. Regarding sleep ecology, only one study describing maltreated preschoolers’ sleep ecology was found, while seven studies documented sleep regulation. Among these seven studies, 17 different sleep variables (e.g., parasomnia, dyssomnia, total 24-h sleep duration) were used, each study documenting from one to nine of them. Actigraphic measures were employed in three studies, the others used parent-reported questionnaires or sleep diaries. Maltreated children’s sleep was described and/or compared to non-maltreated children’s sleep, or an intervention group, showing mild differences. As for associations between sleep regulation and behavior problems, five studies investigated it and performed correlational or linear regression analyses between sleep and behavior problems, revealing some significant associations. No study was found about associations between sleep ecology and sleep regulation, between sleep ecology and behavior problems, or between these three variables. In conclusion, literature about sleep ecology, sleep regulation, and their associations with behavior problems are far more scarce in maltreated preschoolers than in non-maltreated ones. At present, there is especially a paucity of research about sleep ecology and the association between sleep ecology and sleep regulation in maltreated preschoolers, while studies on non-maltreated children showed sleep ecology plays a major role in sleep regulation. In addition, as sleep regulation is measured in many different ways among the studies, it is difficult to compare their findings. Finally, it seems necessary that research fill these gaps, as recommendations could be made to clinicians working with maltreated preschoolers regarding the use of sleep ecology and sleep regulation as intervention tools.

Keywords: maltreated preschoolers, sleep ecology, sleep regulation, behavior problems

Procedia PDF Downloads 125

Authors: Elaine Yee Sing Wong, Jonine Jancey, Andy H. Lee, Anthony P. James

Abstract:

Singapore has a rapidly aging population, where the majority of older women aged 50 years and above, are physically inactive and have unhealthy dietary habits, placing them at ‘high risk’ of non-communicable diseases. Given the multiplicity of less than optimal dietary habits and high levels of physical inactivity among Singaporean women, it is imperative to develop appropriate lifestyle interventions at recreational centres to enhance both their physical and nutritional knowledge, as well as provide them with the opportunity to develop skills to support behaviour change. To the best of our knowledge, this proposed study is the first physical activity and nutrition cluster randomised controlled trial conducted in Singapore for older women. Findings from this study may provide insights and recommendations for policy makers and key stakeholders to create new healthy living, recreational centres with supportive environments. This 6-month community-based cluster randomised controlled trial will involve the implementation and evaluation of physical activity and nutrition program for community dwelling Singaporean women, who currently attend recreational centres to promote social leisure activities in their local neighbourhood. The intervention will include dietary education and counselling sessions, physical activity classes, and telephone contact by certified fitness instructors and qualified nutritionists. Social Cognitive Theory with Motivational Interviewing will inform the development of strategies to support health behaviour change. Sixty recreational centres located in Singapore will be randomly selected from five major geographical districts and randomly allocated to the intervention (n=30) or control (n=30) cluster. A sample of 600 (intervention n=300; control n=300) women aged 50 years and above will then be recruited from these recreational centres. The control clusters will only undergo pre and post data collection and will not receive the intervention. It is hypothesised that by the end of the intervention, the intervention group participants (n = 300) compared to the control group (n = 300), will show significant improvements in the following variables: lipid profile, body mass index, physical activity and dietary behaviour, anthropometry, mental and physical health. Data collection will be examined and compared via the Statistical Package for the Social Science version 23. Descriptive and summary statistics will be used to quantify participants’ characteristics and outcome variables. Multi-variable mixed regression analyses will be used to confirm the effects of the proposed health intervention, taking into account the repeated measures and the clustering of the observations. The research protocol was approved by the Curtin University Human Research Ethics Committee (approval number: HRE2016-0366). The study has been registered with the Australian and New Zealand Clinical Trial Registry (12617001022358).

Keywords: community based, healthy aging, intervention, nutrition, older women, physical activity

Procedia PDF Downloads 152

Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

Abstract:

Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

Procedia PDF Downloads 57

Authors: Sakeena Naikwadi, K. Jagaluraiah Sannapapamma

Abstract:

Vetiveria zizanioides is an aromatic grass and traditionally been used in aromatherapy and ayurvedic medicine. Vetiver root is multi-functional biopolymer and has highly aromatic, antimicrobial, UV blocking, antioxidant properties suitable for textile finishing. The vetiver root (Gulabi) powder of different concentration (2, 4, 6,8 percent) were extracted by aqueous and solvent methods subjected to bioassay for antimicrobial efficiency and GCMS spectral analysis. The organic cotton fabric was finished with vetiver root extract (8 percent) by exhaust and pad dry cure methods. The finished fabric was assessed for functional properties viz., UV protective factor, antimicrobial efficiency and aroma intensity. The results revealed that Ethanol extraction showed a greater zone of inhibition compared to aqueous extract in root powder. Among the concentrations, 8 percent root extract in ethanol showed a greater zone of inhibition against gram-positive organism S. aureus and gram-negative organism E. coli. The major compounds present in vetiver root extracts were diethyl pathalate with greater percentage (87.73 %) followed by 7- Isopropyl dimethyl carboxylic acid (4.05 %), 2-butanone 4-trimethyle cyclohexen (1.21 %), phenanthrene carboxylic acid (1.03 %), naphthalene pentanoic acid (0.99 %), 1-phenanthrene carboxylic acid and 1 cyclohexenone 2-methyl oxobuty (0.89 %). The sample finished by pad dry cure method exhibited better UV protection even after 10th wash as compared to exhaust method. Vetiver extract treated samples exhibited maximum zone of inhibition against S. aureus than the E. coli organism. The vetiver root extract treated organic cotton fabric through pad dry cure method possessed good antimicrobial activity against S. aureus and E. coli even after 20th washes compared to vetiver root extract treated by exhaust method. The olfactory analysis was carried out by 30 panels of members and opined that vetiver root extract treated fabric has very good and pleasant aroma with better tactile properties that provide cooling, soothing effect and enhances the mood of the wearer. Vetiver root extract finished organic cotton fabric possessed aroma, antimicrobial and UV properties which are aptly suitable for medical and healthcare textiles viz., wound dressing, bandage gauze, surgical cloths, baby diapers and sanitary napkins. It can be used as after finishing agent for variegated garments and made-ups and can be replaced with commercial after finishing agents.

Keywords: antimicrobial, olfactory analysis, UV protection factor, vetiver root extract

Procedia PDF Downloads 205

Authors: I. Nanako, Mariko Era, Hiroshi Morita

Abstract:

Objectives: Japanese uses TATAMI rather than flooring at home. Igusa ( Juncus effuses var. decipiens ), which is commonly known in the forms of TATAMI. Juncus spp. grow at a relatively high humidity area (Japan, China and Southeast Asia ). Yatsushiro region in the southern part of Kumamoto prefecture is major produing area of Igusa. Igusa found to have honeycomb structure and was also shown to have the ability to control humidity. And Igusa has been used as a medicinal herb for diuretic and antiphlogistic agent. In previous study, we investigated antimicrobial effects of Igusa, and showed high antimicrobial activity against food poisoning bacteria. Therefore, the food trays blended Igusa can be kept clean by antimicrobial activity of Igusa. We focus on ‘Igusa foam materials’. In this study, we investigated the antibacterial and antifungal activity of Igusa, and new application to foam materials for food industry. Materials and method: We used Igusa foam materials (3 × 3 × 3 cm) as a sample. We set about fifteen types of samples combined with a commercial antibacterial agent A, a commercial antibacterial agent B, potassium laurate (C12K) and a commercial antifungal agent C, a commercial antifungal agent D and a commercial antifungal agent E. We selected four bacteria strains (Escherichia coli NBRC 3972, Staphylococus aureus NBRC 12732, Salmonella typhimurium NBRC 13245, Bacillus subtilis NBRC 3335 ) and three fungus strains (Penicillium pinophilum NBRC 6345, Cladosporium cladosporioides NBRC 30314, Aspergillus oryzae NBRC 5238 ). The fungus was cultured at 30 °C on Igusa foam materials after inoculation of the fungus for fourteen days. The bacteria was cultured at 30 °C on Igusa foam materials after inoculation of the bacteria for three days. And the Igusa foam materials were washed with 10 mL normal saline after three days. The normal saline washed Igusa foam materials plated the NA medium. After, It was cultured at 30 °C and used colony counting method. Result and Conclusion: The fifteen types of sample of Igusa foam materials had antifungal activity against C. cladosporioides, A. oryzae and P. pinophilum for fourteen days. The four types of sample contained potassium laurate and antibacterial agent A, sample contained antibacterial agent B and antifungal agent D, sample contained A and antifungal agent E, sample contained B and E had antibacterial activity against B. subtilis. The three types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E had antibacterial activity against S. typhimurium. The five types of sample contained potassium laurate and A, sample contained B and D, sample contained A and E, sample contained B and E, sample contained B and antifungal agent C had antibacterial activity against E. coli and S. aureus. These results indicate that Igusa of Igusa foam materials had high antifungal activity. In addition, Igusa foam materials combined with a commercial antibacterial agent had antibacterial activity. In the future, we consider that use of Igusa foam materials may be spread from food industry.

Keywords: antibacterial, antifungal, foam materials, Igusa

Procedia PDF Downloads 217

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

Abstract:

Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

Procedia PDF Downloads 105

Authors: Hana Al-Baghaoi, Kumar Shiva Gubbiyappa, Mayuren Candasamy, Kiruthiga Perumal Vijayaraman

Abstract:

Acne is a chronic inflammatory disease of the sebaceous glands characterized by areas of skin with seborrhea, comedones, papules, pustules, nodules, and possibly scarring. Propionibacterium acnes (P. acnes), plays a key role in the pathogenesis of acne. Their colonization and proliferation trigger the host’s inflammatory response leading to the production of pro-inflammatory cytokines such as interleukin-8 (IL-8) and tumour necrosis factor-α (TNF-α). The usage of honey and natural compounds to treat skin ailments has strong support in the current trend of drug discovery. The present study was carried out evaluate antimicrobial and anti-inflammatory potential of Doani Sidr honey and its fractions against P. acnes and to screen madecassoside alone and in combination with fractions of honey. The broth dilution method was used to assess the antibacterial activity. Also, ultra structural changes in cell morphology were studied before and after exposure to Sidr honey using transmission electron microscopy (TEM). The three non-toxic concentrations of the samples were investigated for suppression of cytokines IL 8 and TNF α by testing the cell supernatants in the co-culture of the human peripheral blood mononuclear cells (hPBMCs) heat killed P. acnes using enzyme immunoassay kits (ELISA). Results obtained was evaluated by statistical analysis using Graph Pad Prism 5 software. The Doani Sidr honey and polysaccharide fractions were able to inhibit the growth of P. acnes with a noteworthy minimum inhibitory concentration (MIC) value of 18% (w/v) and 29% (w/v), respectively. The proximity of MIC and MBC values indicates that Doani Sidr honey had bactericidal effect against P. acnes which is confirmed by TEM analysis. TEM images of P. acnes after treatment with Doani Sidr honey showed completely physical membrane damage and lysis of cells; whereas non honey treated cells (control) did not show any damage. In addition, Doani Sidr honey and its fractions significantly inhibited (> 90%) of secretion of pro-inflammatory cytokines like TNF α and IL 8 by hPBMCs pretreated with heat-killed P. acnes. However, no significant inhibition was detected for madecassoside at its highest concentration tested. Our results suggested that Doani Sidr honey possesses both antimicrobial and anti-inflammatory effects against P. acnes and can possibly be used as therapeutic agents for acne. Furthermore, polysaccharide fraction derived from Doani Sidr honey showed potent inhibitory effect toward P. acnes. Hence, we hypothesize that fraction prepared from Sidr honey might be contributing to the antimicrobial and anti-inflammatory activity. Therefore, this polysaccharide fraction of Doani Sidr honey needs to be further explored and characterized for various phytochemicals which are contributing to antimicrobial and anti-inflammatory properties.

Keywords: Doani sidr honey, Propionibacterium acnes, IL-8, TNF alpha

Procedia PDF Downloads 374

Authors: Grigoria Athanasaki, Veerarajan Vimala, A. M. Kannan, Louis Cindrella

Abstract:

Energy usage has been increased throughout the years, leading to severe environmental impacts. Since the majority of the energy is currently produced from fossil fuels, there is a global need for clean energy solutions. Proton Exchange Membrane Fuel Cells (PEMFCs) offer a very promising solution for transportation applications because of their solid configuration and low temperature operations, which allows them to start quickly. One of the main components of PEMFCs is the Gas Diffusion Layer (GDL), which manages water and gas transport and shows direct influence on the fuel cell performance. In this work, a novel dual-layer GDL with gradient porosity was prepared, using polyethylene glycol (PEG) as pore former, to improve the gas diffusion and water management in the system. The microporous layer (MPL) of the fabricated GDL consists of carbon powder PUREBLACK, sodium dodecyl sulfate as a surfactant, 34% wt. PTFE and the gradient porosity was created by applying one layer using 30% wt. PEG on the carbon substrate, followed by a second layer without using any pore former. The total carbon loading of the microporous layer is ~ 3 mg.cm-2. For the assembly of the catalyst layer, Nafion membrane (Ion Power, Nafion Membrane NR211) and Pt/C electrocatalyst (46.1% wt.) were used. The catalyst ink was deposited on the membrane via microspraying technique. The Pt loading is ~ 0.4 mg.cm-2, and the active area is 5 cm2. The sample was ex-situ characterized via wetting angle measurement, Scanning Electron Microscopy (SEM), and Pore Size Distribution (PSD) to evaluate its characteristics. Furthermore, for the performance evaluation in-situ characterization via Fuel Cell Testing using H2/O2 and H2/air as reactants, under 50, 60, 80, and 100% relative humidity (RH), took place. The results were compared to a single layer GDL, fabricated with the same carbon powder and loading as the dual layer GDL, and a commercially available GDL with MPL (AvCarb2120). The findings reveal high hydrophobic properties of the microporous layer of the GDL for both PUREBLACK based samples, while the commercial GDL demonstrates hydrophilic behavior. The dual layer GDL shows high and stable fuel cell performance under all the RH conditions, whereas the single layer manifests a drop in performance at high RH in both oxygen and air, caused by catalyst flooding. The commercial GDL shows very low and unstable performance, possibly because of its hydrophilic character and thinner microporous layer. In conclusion, the dual layer GDL with PEG appears to have improved gas diffusion and water management in the fuel cell system. Due to its increasing porosity from the catalyst layer to the carbon substrate, it allows easier access of the reactant gases from the flow channels to the catalyst layer, and more efficient water removal from the catalyst layer, leading to higher performance and stability.

Keywords: gas diffusion layer, microporous layer, proton exchange membrane fuel cells, relative humidity

Procedia PDF Downloads 107