Search results for: program review principles

Authors: Tatiana Butkova, Nikolai Kibrik, Kristina Malsagova, Alexander Izotov, Alexander Stepanov, Anna Kaysheva

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Relevance. The genetic risk of developing schizophrenia is determined by two factors: single nucleotide polymorphisms and gene copy number variations. The search for serological markers for early diagnosis of schizophrenia is driven by the fact that the first five years of the disease are accompanied by significant biological, psychological, and social changes. It is during this period that pathological processes are most amenable to correction. The aim of this study was to analyze single nucleotide polymorphisms (SNPs) that are hypothesized to potentially influence the onset and development of the endogenous process. Materials and Methods It was analyzed 73 single nucleotide polymorphism variants. The study included 48 patients undergoing inpatient treatment at "Psychiatric Clinical Hospital No. 1" in Moscow, comprising 23 females and 25 males. Inclusion criteria: - Patients aged 18 and above. - Diagnosis according to ICD-10: F20.0, F20.2, F20.8, F21.8, F25.1, F25.2. - Voluntary informed consent from patients. Exclusion criteria included: - The presence of concurrent somatic or neurological pathology, neuroinfections, epilepsy, organic central nervous system damage of any etiology, and regular use of medication. - Substance abuse and alcohol dependence. - Women who were pregnant or breastfeeding. Clinical and psychopathological assessment was complemented by psychometric evaluation using the PANSS scale at the beginning and end of treatment. The duration of observation during therapy was 4-6 weeks. Total DNA extraction was performed using QIAamp DNA. Blood samples were processed on Illumina HiScan and genotyped for 652,297 markers on the Infinium Global Chips Screening Array-24v2.0 using the IMPUTE2 program with parameters Ne=20,000 and k=90. Additional filtration was performed based on INFO>0.5 and genotype probability>0.5. Quality control of the obtained DNA was conducted using agarose gel electrophoresis, with each tested sample having a volume of 100 µL. Results. It was observed that several SNPs exhibited gender dependence. We identified groups of single nucleotide polymorphisms with a membership of 80% or more in either the female or male gender. These SNPs included rs2661319, rs2842030, rs4606, rs11868035, rs518147, rs5993883, and rs6269.Another noteworthy finding was the limited combination of SNPs sufficient to manifest clinical symptoms leading to hospitalization. Among all 48 patients, each of whom was analyzed for deviations in 73 SNPs, it was discovered that the combination of involved SNPs in the manifestation of pronounced clinical symptoms of schizophrenia was 19±3 out of 73 possible. In study, the frequency of occurrence of single nucleotide polymorphisms also varied. The most frequently observed SNPs were rs4849127 (in 90% of cases), rs1150226 (86%), rs1414334 (75%), rs10170310 (73%), rs2857657, and rs4436578 (71%). Conclusion. Thus, the results of this study provide additional evidence that these genes may be associated with the development of schizophrenia spectrum disorders. However, it's impossible cannot rule out the hypothesis that these polymorphisms may be in linkage disequilibrium with other functionally significant polymorphisms that may actually be involved in schizophrenia spectrum disorders. It has been shown that missense SNPs by themselves are likely not causative of the disease but are in strong linkage disequilibrium with non-functional SNPs that may indeed contribute to disease predisposition.

Keywords: gene polymorphisms, genotyping, single nucleotide polymorphisms, schizophrenia.

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Authors: Rodriguez Diego, Del Valle Martin, Hargreaves Matias, Riveros Jose Luis

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Nutrient deficiencies due to a diet low in quantitative and qualitative terms, are prevalent throughout the developing world, especially in sub-Saharan Africa. Children and women of childbearing age are especially vulnerable. Limited availability, access and intake of animal foods at home and lack of knowledge about their value in the diet and the role they play in health, contribute to poor diet quality. Poor bioavailability of micronutrients in diets based on foods high in fiber and phytates, the low content of some micronutrients in these foods are further factors to consider. Goats are deeply embedded in almost every Sub-Saharan African rural culture, generally kept for their milk, meat, hair or leather. Goats have played an important role in African social life, especially in food security. Goat meat has good properties for human wellbeing, with a special role in lower income households. It has a high-quality protein (20 protein g/100 meat g) including all essential amino acids, good unsaturated/satured fatty acids relationship, and it is an important B-vitamin source with high micronutrients bioavailability. Mozambique has major food security problems, with poor food access and utilization, undiversified diets, chronic poverty and child malnutrition. Our objective was to design a nutritional intervention based on a dietary diversification, nutritional education, cultural beliefs and local resources, aimed to strengthen food security of children at Barrio Broma village (15°43'58.78"S; 32°46'7.27"E) in Chitima, Mozambique. Two surveys were conducted first of socio-productive local databases and then to 100 rural households about livelihoods, food diversity and anthropometric measurements in children under 5 years. Our results indicate that the main economic activity is goat production, based on a native breed with two deliveries per year in the absence of any management. Adult goats weighted 27.2±10.5 kg and raised a height of 63.5±3.8 cm. Data showed high levels of poverty, with a food diversity score of 2.3 (0-12 points), where only 30% of households consume protein and 13% iron, zinc, and B12 vitamin. The main constraints to food security were poor access to water and low income to buy food. Our dietary intervention was based on improving diet quality by increasing the access to dried goat meat, fresh vegetables, and legumes, and its utilization by a nutritional education program. This proposal was based on local culture and living conditions characterized by the absence of electricity power and drinkable water. The drying process proposed would secure the food maintenance under local conditions guaranteeing food safety for a longer period. Additionally, an ancient local drying technique was rescued and used. Moreover, this kind of dietary intervention would be the most efficient way to improve the infant nutrition by delivering macro and micronutrients on time to these vulnerable populations.

Keywords: child malnutrition, dietary diversification, food security, goat meat

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Authors: Afentoula Mavrodi, Andreas Georgiou, Georgios Tsiotras, Vassilis Aletras

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Placing a monetary value on a quality-adjusted-life-year (QALY) is of utmost importance in economic evaluation. Identifying the population’s preferences is critical in order to understand some of the reasons driving variations in the assigned monetary value. Yet, evidence of the motives behind value assignment to a QALY by the general public is limited. Developing an instrument that would capture the population’s motives could be proven valuable to policy-makers, to guide them in allocating different values to a QALY based on users’ motivations. The aim of this study was to identify the most relevant motives and develop an appropriate instrument to assess them. To design the instrument, we employed: a) the EQ-5D-3L tool to assess participants’ current health status, and b) the Willingness-to-Pay (WTP) approach, within the Contingent Valuation (CV) Method framework, to elicit the monetary value. Advancing the open-ended approach adopted to assess solely protest bidders’ motives; a variety of follow-up item-specific statements were designed (deductive approach), aiming to evaluate motives of both protest bidders and participants willing to pay for the hypothetical treatment under consideration. The initial design of the survey instrument was the outcome of an extensive literature review. This instrument was revised based on 15 semi-structured interviews that took place in September 2018 and a pilot study held during two months (October-November) in 2018. Individuals with different educational, occupational and economical backgrounds and adequate verbal skills were recruited to complete the semi-structured interviews. The follow-up motivation statements of both protest bidders and those willing to pay were revised and rephrased after the semi-structured interviews. In total 4 statements for protest bidders and 3 statements for those willing to pay for the treatment were chosen to be included in the survey tool. Using the CATI (Computer Assisted Telephone Interview) method, a randomly selected sample of 97 persons living in Thessaloniki, Greece, completed the questionnaire on two occasions over a period of 4 weeks. Based on pilot study results, a test-retest reliability assessment was performed using the intra-class correlation coefficient (ICC). All statements formulated for protest bidders showed acceptable reliability (ICC values of 0.84 (95% CI: 0.67, 0.92) and above). Similarly, all statements for those willing to pay for the treatment showed high reliability (ICC values of 0.86 (95% CI: 0.78, 0.91) and above). Overall, the instrument designed in this study was reliable with regards to the item-specific statements assessing participants’ motivation. Validation of the instrument will take place in a future study. For a holistic WTP per QALY instrument, participants’ motivation must be addressed broadly. The instrument developed in this study captured a variety of motives and provided insight with regards to the method through which the latter are evaluated. Last but not least, it extended motive assessment to all study participants and not only protest bidders.

Keywords: contingent valuation method, instrument, motives, quality-adjusted life-year, willingness-to-pay

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Authors: Raquel Dafouz Neus Cáceres, Javier Fernandez-Rubio, Belinda Huerta José Luis Rodríguez-Gil, Nicola Mastroianni, Miren López de Alda, Damià Barceló, Yolanda Valcárcel

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The region of Galicia, found in north-western (NW) Spain, is a national and world leader in shellfish, especially mussel production, and recognized for its fishing industry. Few studies have evaluated the presence of emerging contaminants in NW Spain, with those published mainly concerning the continental aquatic environment. The objective of this study was to identify the environmental risk posed by the presence of pharmaceuticals and drugs of abuse in this important coastal region. The presence of sixteen pharmaceuticals (benzodiazepines, anxiolytics, and caffeine), and 19 drugs of abuse (cocainics, amphetamine-like compounds, opiates and opioids, lysergic compounds, and cannabinoids) was assessed in 23 sites located in the Rías (Coastal inlets) of Muros, Arousa, and Pontevedra (NW Spain). Twenty-two of these locations were affected by waste-water treatment plant (WWTP) effluents, and one represented the effluent of one of these WWTPs. Venlafaxine was the pharmaceutical compound detected at higher concentration in the three Rías, with a maximum value of 291 ng/L at the site Porto do Son (Ría de Muros). Total concentration in the three Rías was 819,26 ng/L. Next, citalopram and lorazepam were the most prevalent compounds detected. Metabolite of cocaine benzoylecgonine was the drug of abuse with the highest concentration, measured at 972 ng/L in the Ría of Noia WWTP (no dilution). This compound was also detected at 142 ng/L in the site La Isla de Aros, Ría of Pontevedra. Total concentration for the three Rías was 1210 ng/L. Ephedrine was also detected at high level in the three Rías, with a total concentration of 579,28 ng/L. The results obtained for caffeine show maximum and average concentrations of 857 ng/L Isla de Arosa, Ría de Pontevedra the highest measured in seawater in Spain. A preliminary hazard assessment was carried out by comparing these measured environmental concentrations (MEC) to predicted no-effect concentrations (PNECs) for aquatic organisms. Six out of the 22 seawater samples resulted in a Hazard Quotient (HQ) from chronic exposure higher than 1 with the highest being 17.14, indicating a high probability of adverse effects in the aquatic environment. In addition, the risk was assessed on the basis of persistence, bioaccumulation, and toxicity (PBT). This work was financially supported by the Spanish Ministry of Economy and Competitiveness through the Carlos III Health Institute and the program 'Proyectos de Investigacion en Salud 2015-2017' FIS (PI14/00516), the European Regional Development Fund (ERDF), the Catalan Government (Consolidated Research Groups '2014 SGR 418 - Water and Soil Quality Unit' and 2014 SGR 291 - ICRA), and the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 603437. The poster entitled 'Environmental Risk of Pharmaceuticals, Drugs of Abuse and Stimulant Caffeine in Marine Water: A Case Study in the North-Western of Spain'.

Keywords: drug of abuse, pharmaceuticals, caffeine, environmental risk, seawater

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Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri

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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one year

Keywords: teledermatology, prisoners, reaching, un-reachable

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Authors: Md. Nuru Miah, A. F. M. Akhter Uddin

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Medicinal plants are grown naturally in a tropical environment in Bangladesh and used as drug and therapeutic agents in the health care system. According to Bangladesh Agricultural Research Institute (BARI), there are 722 species of medicinal plants in the country. Of them, 255 plants are utilized by the manufacturers of Ayurvedic and Unani medicines. Medicinal plants like Aloevera, Ashwagonda, shotomul,Tulsi, Vuikumra, Misridana are extensively cultivated in some selected areas as well; where Aloevera scored the highest position in production. In the early 1980, Ayurvedic and Unani companies procured 80 percent of medicinal plants from natural forests, and the rest 20 percent was imported. Now the scenario has changed; 80 percent is imported, and the rest 20 percent is collected from local products(Source: Astudy on sectorbased need assessment of Business promotion council-Herbal products and medicinal plants, page-4). Uttara Development Program Society, a leading Non- Government development organization in Bangladesh, has been implementing a value chain development project under promoting Agricultural commercialization and Enterprises of Pally Karma Sahayak Foundation (PKSF) funded by the International Fund for Agricultural Development (IFAD) in Natore Sadar Upazila from April 2017 to sustainably develop the technological interventions for products and market development. The ultimate goal of the project is to increase income, generate employment and develop this sector as a sustainable business enterprise. Altogether 10,000 farmers (Nursery owners, growers, input supplier, processors, whole sellers, and retailers) are engaged in different activities of the project. The entrepreneurs engaged in medicinal plant cultivation did not know and follow environmental and good agricultural practices. They used to adopt traditional methodology in production and processing. Locally the farmers didn’t have any positive initiative to expand their business as well as developvalue added products. A lot of diversified products could be possible to develop and marketed with the introduction of post-harvest processing technology and market linkage with the local and global buyer. Training is imparted to the nursery owners and herbal growers on production technologies, sowing method, use of organic fertilizers/compost/pesticides, harvesting procedures, and storage facilities. Different types of herbal tea like Rosella, Moringa, Tulshi, and Basak are being produced and packed locally with a good scope of its marketing in different cities of the country. The project has been able to achieve a significant impact in the development of production technologies, but still, there is room for further improvement in processing, packaging, and marketing level. The core intervention of the current project to develop some entrepreneurs for branding, packaging, promotion, and marketing while considering environment friendly practices. The present strategies will strengthen the knowledge and skills of the entrepreneurs for the production and marketing of their products, maintaining worldwide accepted compliance system for easy access to the global market.

Keywords: aloe vera, herbs and shrubs, market, interventions

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Authors: Crysovaladou Kefaloudi, Kassiani Mellou, Eirini Saranti-Papasaranti, Athanasios Koustenis, Chrysoula Botsi, Agapios Terzidis

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Recent migration crisis led to a vast migrant – refugees movement to Greece which created an urgent need for hosting settlements. Taken into account the protection of public health from possible pathogens related to water and food supply as well as waste and sewage accumulation, a 'Living Conditions Recording Form' was created in the context of 'PHILOS' European Program funded by the Asylum Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs, in order to assess a number of environmental sanitation parameters, in refugees – migrants camps in mainland. The assessment will be completed until the end of July. From March to June 2017, mobile unit teams comprised of health inspectors of sub-action 2 of “PHILOS” proceeded with the assessment of living conditions in twenty-two out of thirty-one camps and 'Stata' was used for the statistical analysis of obtained information. Variables were grouped into the following categories: 1) Camp administration, 2) hosted population number, 3) accommodation, 4) heating installations, 5) personal hygiene, 6) sewage collection and disposal, 7) water supply, 8) waste collection and management, 9) pest control, 10) fire safety, 11) food handling and safety. Preliminary analysis of the results showed that camp administration was performed in 90% of the camps by a public authority with the coordination of various NGOs. The median number of hosted population was 222 ranging from 62 to 3200, and the median value of hosted population per accommodation type was 4 in 19 camps. Heating facilities were provided in 86.1% of camps. In 18.2 % of the camps, one personal hygiene facility was available per 6 people ranging in the rest of the camps from 1 per 3 to 1 per 20 hosted refugees-migrants. Waste and sewage collection was performed depending on populations demand in an adequate way in all recorded camps. In 90% of camps, water was supplied through the central water supply system. In 85% of camps quantity and quality of water supply inside camps was regularly monitored for microbial and chemical indices. Pest control was implemented in 86.4% of the camps as well as fire safety measures. Food was supplied by catering companies in 50% of the camps, and the quality and quantity food was monitored at a regular basis. In 77% of camps, food was prepared by the hosted population with the availability of proper storage conditions. Furthermore, in all camps, hosted population was provided with personal hygiene items and health sanitary educational programs were implemented in 77.3% of camps. In conclusion, in the majority of the camps, environmental sanitation parameters were satisfactory. However, waste and sewage accumulation, as well as inadequate pest control measures were recorded in some camps. The obtained data have led to a number of recommendations for the improvement of sanitary conditions, disseminated to all relevant stakeholders. Special emphasis was given to hygiene measures implementation during food handling by migrants – refugees, as well as to waste and sewage accumulation taking in to account the population’s cultural background.

Keywords: environmental sanitation parameters, food borne diseases risk assessment, refugee – migrants camps, water borne diseases risk assessment

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Authors: Signe Svensson, Remy Rey, Anna-Lisa Osvalder, Henrik Artman, Lars Nordström

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The electric power system is undergoing significant changes. Thereby, the operation and control are becoming partly modified, more multifaceted and automated, and thereby supplementary operator skills might be required. This paper discusses developing operational challenges in future power system control rooms, posed by the evolving landscape of sustainable power systems, driven in turn by the shift towards electrification and renewable energy sources. A literature review followed by interviews and a comparison to other related domains with similar characteristics, a descriptive analysis was performed from a human factors perspective. Analysis is meant to identify trends, relationships, and challenges. A power control domain taxonomy includes a temporal domain (planning and real-time operation) and three operational domains within the power system (generation, switching and balancing). Within each operational domain, there are different control actions, either in the planning stage or in the real-time operation, that affect the overall operation of the power system. In addition to the temporal dimension, the control domains are divided in space between a multitude of different actors distributed across many different locations. A control room is a central location where different types of information are monitored and controlled, alarms are responded to, and deviations are handled by the control room operators. The operators’ competencies, teamwork skills, team shift patterns as well as control system designs are all important factors in ensuring efficient and safe electricity grid management. As the power system evolves with sustainable energy technologies, challenges are found. Questions are raised regarding whether the operators’ tacit knowledge, experience and operation skills of today are sufficient to make constructive decisions to solve modified and new control tasks, especially during disturbed operations or abnormalities. Which new skills need to be developed in planning and real-time operation to provide efficient generation and delivery of energy through the system? How should the user interfaces be developed to assist operators in processing the increasing amount of information? Are some skills at risk of being lost when the systems change? How should the physical environment and collaborations between different stakeholders within and outside the control room develop to support operator control? To conclude, the system change will provide many benefits related to electrification and renewable energy sources, but it is important to address the operators’ challenges with increasing complexity. The control tasks will be modified, and additional operator skills are needed to perform efficient and safe operations. Also, the whole human-technology-organization system needs to be considered, including the physical environment, the technical aids and the information systems, the operators’ physical and mental well-being, as well as the social and organizational systems.

Keywords: operator, process control, energy system, sustainability, future control room, skill

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Authors: John Lachapelle

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Introduction: Neural stimulation is increasingly targeted toward treatment of back pain, PTSD, Parkinson’s disease, and for sensory perception. Sensory recording during stimulation is important in order to examine neural response to stimulation. Most neural amplifiers (headstages) focus on noise efficiency factor (NEF). Conversely, neural headstages need to handle artifacts from several sources including power lines, movement (EMG), and neural stimulation itself. In this work a layered approach to artifact rejection is used to reduce corruption of the neural ENG signal by 60dBv, resulting in recovery of sensory signals in rats and primates that would previously not be possible. Methods: The approach combines analog techniques to reduce and handle unwanted signal amplitudes. The methods include optimized (1) sensory electrode placement, (2) amplifier configuration, and (3) artifact blanking when necessary. The techniques together are like concentric moats protecting a castle; only the wanted neural signal can penetrate. There are two conditions in which the headstage operates: unwanted artifact < 50mV, linear operation, and artifact > 50mV, fast-settle gain reduction signal limiting (covered in more detail in a separate paper). Unwanted Signals at the headstage input: Consider: (a) EMG signals are by nature < 10mV. (b) 60 Hz power line signals may be > 50mV with poor electrode cable conditions; with careful routing much of the signal is common to both reference and active electrode and rejected in the differential amplifier with <50mV remaining. (c) An unwanted (to the neural recorder) stimulation signal is attenuated from stimulation to sensory electrode. The voltage seen at the sensory electrode can be modeled Φ_m=I_o/4πσr. For a 1 mA stimulation signal, with 1 cm spacing between electrodes, the signal is <20mV at the headstage. Headstage ASIC design: The front end ASIC design is designed to produce < 1% THD at 50mV input; 50 times higher than typical headstage ASICs, with no increase in noise floor. This requires careful balance of amplifier stages in the headstage ASIC, as well as consideration of the electrodes effect on noise. The ASIC is designed to allow extremely small signal extraction on low impedance (< 10kohm) electrodes with configuration of the headstage ASIC noise floor to < 700nV/rt-Hz. Smaller high impedance electrodes (> 100kohm) are typically located closer to neural sources and transduce higher amplitude signals (> 10uV); the ASIC low-power mode conserves power with 2uV/rt-Hz noise. Findings: The enhanced neural processing ASIC has been compared with a commercial neural recording amplifier IC. Chronically implanted primates at MGH demonstrated the presence of commercial neural amplifier saturation as a result of large environmental artifacts. The enhanced artifact suppression headstage ASIC, in the same setup, was able to recover and process the wanted neural signal separately from the suppressed unwanted artifacts. Separately, the enhanced artifact suppression headstage ASIC was able to separate sensory neural signals from unwanted artifacts in mouse-implanted peripheral intrafascicular electrodes. Conclusion: Optimizing headstage ASICs allow observation of neural signals in the presence of large artifacts that will be present in real-life implanted applications, and are targeted toward human implantation in the DARPA HAPTIX program.

Keywords: ASIC, biosensors, biomedical signal processing, biomedical sensors

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Authors: Stavros T. Ponis, George D. Plakas-Koumadorakis, Sotiris P. Gayialis

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Augmented Reality (AR) can be defined as a technology, which takes the capabilities of computer-generated display, sound, text and effects to enhance the user's real-world experience by overlaying virtual objects into the real world. By doing that, AR is capable of providing a vast array of work support tools, which can significantly increase employee productivity, enhance existing job training programs by making them more realistic and in some cases introduce completely new forms of work and task executions. One of the most promising AR industrial applications, as literature shows, is the use of Head Worn, monocular or binocular Displays (HWD) to support logistics and production operations, such as order picking, part assembly and maintenance. This paper presents the initial results of an ongoing research project for the introduction of a dedicated AR-HWD solution to the picking process of a Distribution Center (DC) in Greece operated by a large Telecommunication Service Provider (TSP). In that context, the proposed research aims to determine whether gamification elements should be integrated in the functional requirements of the AR solution, such as providing points for reaching objectives and creating leaderboards and awards (e.g. badges) for general achievements. Up to now, there is a an ambiguity on the impact of gamification in logistics operations since gamification literature mostly focuses on non-industrial organizational contexts such as education and customer/citizen facing applications, such as tourism and health. To the contrary, the gamification efforts described in this study focus in one of the most labor- intensive and workflow dependent logistics processes, i.e. Customer Order Picking (COP). Although introducing AR in COP, undoubtedly, creates significant opportunities for workload reduction and increased process performance the added value of gamification is far from certain. This paper aims to provide insights on the suitability and usefulness of AR-enhanced gamification in the hard and very demanding environment of a logistics center. In doing so, it will utilize a review of the current state-of-the art regarding gamification of production and logistics processes coupled with the results of questionnaire guided interviews with industry experts, i.e. logisticians, warehouse workers (pickers) and AR software developers. The findings of the proposed research aim to contribute towards a better understanding of AR-enhanced gamification, the organizational change it entails and the consequences it potentially has for all implicated entities in the often highly standardized and structured work required in the logistics setting. The interpretation of these findings will support the decision of logisticians regarding the introduction of gamification in their logistics processes by providing them useful insights and guidelines originating from a real life case study of a large DC operating more than 300 retail outlets in Greece.

Keywords: augmented reality, technology acceptance, warehouse management, vision picking, new forms of work, gamification

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Authors: Chandan Kundu, Sankar Bhattacharya

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A significant disadvantage of fossil fuel energy production is the considerable amount of carbon dioxide (CO₂) released, which is one of the contributors to climate change. Apart from environmental concerns, changing fossil fuel prices have pushed society gradually towards renewable energy sources in recent years. Biomass is a plentiful and renewable resource and a source of carbon. Recent years have seen increased research interest in generating fuels and chemicals from biomass. Unlike fossil-based resources, biomass is composed of lignocellulosic material, which does not contribute to the increase in atmospheric CO₂ over a longer term. These considerations contribute to the current move of the chemical industry from non-renewable feedstock to renewable biomass. This presentation focuses on generating bio-oil and two major platform chemicals that can potentially improve the environment. Thermochemical processes such as pyrolysis are considered viable methods for producing bio-oil and biomass-based platform chemicals. Fluidized bed reactors, on the other hand, are known to boost bio-oil yields during pyrolysis due to their superior mixing and heat transfer features, as well as their scalability. This review and the associated experimental work are focused on the thermochemical conversion of biomass to bio-oil and two high-value platform chemicals, Levoglucosenone (LGO) and 5-Chloromethyl furfural (5-CMF), in a fluidized bed reactor. These two active molecules with distinct features can potentially be useful monomers in the chemical and pharmaceutical industries since they are well adapted to the manufacture of biologically active products. This process took several meticulous steps. To begin, the biomass was delignified using a peracetic acid pretreatment to remove lignin. Because of its complicated structure, biomass must be pretreated to remove the lignin, increasing access to the carbohydrate components and converting them to platform chemicals. The biomass was then characterized by Thermogravimetric analysis, Synchrotron-based THz spectroscopy, and in-situ DRIFTS in the laboratory. Based on the results, a continuous-feeding fluidized bed reactor system was constructed to generate platform chemicals from pretreated biomass using hydrogen chloride acid-gas as a catalyst. The procedure also yields biochar, which has a number of potential applications, including soil remediation, wastewater treatment, electrode production, and energy resource utilization. Consequently, this research also includes a preliminary experimental evaluation of the biochar's prospective applications. The biochar obtained was evaluated for its CO₂ and steam reactivity. The outline of the presentation will comprise the following: Biomass pretreatment for effective delignification Mechanistic study of the thermal and thermochemical conversion of biomass Thermochemical conversion of untreated and pretreated biomass in the presence of an acid catalyst to produce LGO and CMF A thermo-catalytic process for the production of LGO and 5-CMF in a continuously-fed fluidized bed reactor and efficient separation of chemicals Use of biochar generated from the platform chemicals production through gasification

Keywords: biomass, pretreatment, pyrolysis, levoglucosenone

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Authors: Anju Vaidya

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Sanitation is concerned with proper disposal of human excreta, waste water and promotion of hygiene. Lack of sanitation impacts our environment affecting our finance, schooling, health, and thus exacerbating poverty, discrimination and exclusion of the marginalized group. Sanitation can be a route and one of the most important factor to reach the goals of all Millennium Development goals. This study aims at exploring what are the rights to sanitation of the people, how it is enacted and what challenges are being faced while implementing the right to sanitation in South-Asian countries (India, Nepal, Pakistan, Bangladesh, Srilanka) at government, non-government and international level. This study also aims at finding how right sanitation is interlinked with children rights. The available reports submitted by government and civil society organizations working in South-Asian countries from the website of the Office of High Commissioner for Human Rights that were submitted under International covenant on economic, social and cultural rights and Convention on rights of the child have been selected and analyzed. The study uses Literature review to analyze these UN documents submitted from 2000 to 2015 in the context of South-Asian countries. Preliminary insight reveals that sanitation is recognized as one of the important factor to attain adequate standard of living. It has been found that inadequate sanitation has been a major factor that affects all aspects of life and one of its devastating impacts is increased child mortality. Many efforts have been made at national and international level in South-Asian countries to improve the state of sanitation and sanitation services. Various approaches such as Community led Total Sanitation, School led Total Sanitation, establishing Open Defecation free zone, water supply services and other sanitation and hygiene awareness programs are being launched. Despite different efforts and programs being implemented, sanitation and hygiene practices and behavior change remains to be a big challenge. Disparity in access and imbalance between urban and rural services and geographical regions, inadequate financing, clear policy framework and fragile functionality are some of the significant challenges faced while implementing these programs. Children are one of the most vulnerable group that are affected to a large extent. The study brings into light varied approaches that are being made and challenges that are being faced by government, non-government and civil society organizations while implementing the programs and strategies related to sanitation. It also highlights the relation of sanitation as a human right with child rights. This can help the stakeholders and policymakers better understand that improving sanitation situation is a process that requires learning, planning and behavior change and achieving sanitation coverage targets and motivating behavior change requires additional tools based on participation, non-discrimination and process approaches for planning and feedback.

Keywords: challenges, child rights, open defecation, sanitation as a human right

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Authors: Jane E. Hill

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Sexual, physical, or emotional abuses are behaviors used by one person in a relationship or within a family unit to control the other person. Physical abuse can consist of, but not limited to hitting, pushing, and shoving. Sexual abuse is unwanted or forced sexual activity on a person without their consent. Abusive behaviors include intimidation, manipulation, humiliation, isolation, frightening, terrorizing, coercing, threatening, blaming, hurting, injuring, or wounding another individual. Although emotional, psychological and financial abuses are not criminal behaviors, they are forms of abuse and can leave emotional scars on their victim. The purpose of this literature review research was to examine characteristics of female offenders, past abuse, and pathways to offending. The question that guided this research: does past abuse influence recidivism? The theoretical foundation used was relational theory by Jean Baker Miller. One common feature of female offenders is abuse (sexual, physical, or verbal). Abuse can cause mental illnesses and substance abuse. The abuse does not directly affect the women's recidivism. However, results indicated the psychological and maladaptive behaviors as a result of the abuse did contribute to indirect pathways to continue offending. The female offenders’ symptoms of ongoing depression, anxiety, and engaging in substance abuse (self medicating) did lead to the women's incarceration. Using the childhood victimization model as the treatment approach for women's mental illness and substance abuse disorders that were a result from history of child abuse have shown success. With that in mind, if issues surrounding early victimization are not addressed, then the women offenders may not recover from their mental illness or addiction and are at a higher risk of reoffending. However, if the women are not emotionally ready to engage in the treatment process, then it should not be forced onto them because it may cause harm (targeting prior traumatic experiences). Social capital is family support and sources that assist in helping the individual with education, employment opportunities that can lead to success. Human capital refers to internal knowledge, skills, and capacities that help the individual act in new and appropriate ways. The lack of human and social capital is common among female offenders, which leads to extreme poverty and economic marginalization, more often in frequent numbers than men. In addition, the changes in welfare reform have exacerbated women’s difficulties in gaining adequate-paying jobs to support themselves and their children that have contributed to female offenders reoffending. With that in mind, one way to lower the risk factor of female offenders from reoffending is to provide them with educational and vocational training, enhance their self-efficacy, and teach them appropriate coping skills and life skills. Furthermore, it is important to strengthen family bonds and support. Having a supportive family relationship was a statistically significant protective factor for women offenders.

Keywords: characteristics, childhood victimization model, female offenders, treatment

Procedia PDF Downloads 111

Authors: Marita Pigłowska, Beata Kurc, Maciej Galiński

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The application of carbon materials in the branches of the electrochemical industry shows an increasing tendency each year due to the many interesting properties they possess. These are, among others, a well-developed specific surface, porosity, high sorption capacity, good adsorption properties, low bulk density, electrical conductivity and chemical resistance. All these properties allow for their effective use, among others in supercapacitors, which can store electric charges of the order of 100 F due to carbon electrodes constituting the capacitor plates. Coals (including expanded graphite, carbon black, graphite carbon fibers, activated carbon) are commonly used in electrochemical methods of removing oil derivatives from water after tanker disasters, e.g. phenols and their derivatives by their electrochemical anodic oxidation. Phenol can occupy practically the entire surface of carbon material and leave the water clean of hydrophobic impurities. Regeneration of such electrodes is also not complicated, it is carried out by electrochemical methods consisting in unblocking the pores and reducing resistances, and thus their reactivation for subsequent adsorption processes. Graphite is commonly used as an anode material in lithium-ion cells, while due to the limited capacity it offers (372 mAh g-1), new solutions are sought that meet both capacitive, efficiency and economic criteria. Increasingly, biodegradable materials, green materials, biomass, waste (including agricultural waste) are used in order to reuse them and reduce greenhouse effects and, above all, to meet the biodegradability criterion necessary for the production of lithium-ion cells as chemical power sources. The most common of these materials are cellulose, starch, wheat, rice, and corn waste, e.g. from agricultural, paper and pharmaceutical production. Such products are subjected to appropriate treatments depending on the desired application (including chemical, thermal, electrochemical). Starch is a biodegradable polysaccharide that consists of polymeric units such as amylose and amylopectin that build an ordered (linear) and amorphous (branched) structure of the polymer. Carbon is also used as a catalyst. Elemental carbon has become available in many nano-structured forms representing the hybridization combinations found in the primary carbon allotropes, and the materials can be enriched with a large number of surface functional groups. There are many examples of catalytic applications of coal in the literature, but the development of this field has been hampered by the lack of a conceptual approach combining structure and function and a lack of understanding of material synthesis. In the context of catalytic applications, the integrity of carbon environmental management properties and parameters such as metal conductivity range and bond sequence management should be characterized. Such data, along with surface and textured information, can form the basis for the provision of network support services.

Keywords: carbon materials, catalysis, BET, capacitors, lithium ion cell

Procedia PDF Downloads 172

Authors: Sadi Ali, Yaser Kishawi

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As part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely covers the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is to find non-conventional water resource from treated wastewater to irrigate 1500 hectares and serves over 100,000 inhabitants. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & 9 infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, phase A is functioning since Apr 2009. Since Apr 2009, a monitoring plan is conducted to monitor the infiltration rate (I.R.) of the 9 basins. Nearly 23 million m3 of partially treated wastewater were infiltrated up to Jun 2014. It is important to maintain an acceptable rate to allow the basins to handle the coming quantities (currently 10,000 m3 are pumped an infiltrated daily). The methodology applied was to review and analysis the collected data including the I.R.s, the WW quality and the drying-wetting schedule of the basins. One of the main findings is the relation between the Total Suspended Solids (TSS) at BLWWTP and the I.R. at the basins. Since April 2009, the basins scored an average I.R. of about 2.5 m/day. Since then the records showed a decreasing pattern of the average rate until it reached the lower value of 0.42 m/day in Jun 2013. This was accompanied with an increase of TSS (mg/L) concentration at the source reaching above 200 mg/L. The reducing of TSS concentration directly improved the I.R. (by cleaning the WW source ponds at Biet Lahia WWTP site). This was reflected in an improvement in I.R. in last 6 months from 0.42 m/day to 0.66 m/day then to nearly 1.0 m/day as the average of the last 3 months of 2013. The wetting-drying scheme of the basins was observed (3 days wetting and 7 days drying) besides the rainfall rates. Despite the difficulty to apply this scheme accurately a control of flow to each basin was applied to improve the I.R. The drying-wetting system affected the I.R. of individual basins, thus affected the overall system rate which was recorded and assessed. Also the ploughing activities at the infiltration basins as well were recommended at certain times to retain a certain infiltration level. This breaks the confined clogging layer which prevents the infiltration. It is recommended to maintain proper quality of WW infiltrated to ensure an acceptable performance of IBs. The continual maintenance of settling ponds at BLWWTP, continual ploughing of basins and applying soil treatment techniques at the IBs will improve the I.R.s. When the new WWTP functions a high standard effluent quality (TSS 20mg, BOD 20 mg/l, and TN 15 mg/l) will be infiltrated, thus will enhance I.R.s of IBs due to lower organic load.

Keywords: soil aquifer treatment, recovery and reuse scheme, infiltration basins, North Gaza

Procedia PDF Downloads 246

Authors: B. Garfolo, L. Kelpsh, R. Roak, R. Kuck

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Often, student ratings of instructors play a significant role in the career path of an instructor in higher education. So then, how does a student view the effectiveness of instructor teaching? This question has been address by literally thousands of studies found in the literature. Yet, why does this question still persist? A literature review reveals that while it is true that student evaluations of instructors can be biased, there is still a considerable amount of work that needs to be done in understanding why. As student evaluations of instructors can be used in a variety of settings (formative or summative) it is critical to understand the nature of the bias. The authors believe that not only is some bias possible in student evaluations, it should be expected for the simple reason that a student evaluation is a human activity and as such, relies upon perception and interpersonal judgment. As such, student ratings are affected by the same factors that can potentially affect any rater’s judgment, such as stereotypes based on gender, culture, race, etc. Previous study findings suggest that student evaluations of teacher effectiveness differ between male and female raters. However, even though studies have shown that instructor gender does play an important role in influencing student ratings, the exact nature and extent of that role remains the subject of debate. Researchers, in their attempt to define good teaching, have looked for differences in student evaluations based on a variety of characteristics such as course type, class size, ability level of the student and grading practices in addition to instructor and student characteristics (gender, age, etc.) with inconsistent results. If a student evaluation represents more than an instructor’s teaching ability, for example, a physical characteristic such as gender, then this information must be taken into account if the evaluation is to have meaning with respect to instructor assessment. While the authors concede that it is difficult or nearly impossible to separate gender from student perception of teaching practices in person, it is, however, possible to shield an instructor’s gender identity with respect to an online teaching experience. The online teaching modality presents itself as a unique opportunity to experiment directly with gender identity. The analysis of the differences of online behavior of individuals when they perceive that they are interacting with a male or female could provide a wealth of data on how gender influences student perceptions of teaching effectiveness. Given the importance of the role student ratings play in hiring, retention, promotion, tenure, and salary deliberations in academic careers, this question warrants further attention as it is important to be aware of possible bias in student evaluations if they are to be used at all with respect to any academic considerations. For experimental purposes, the author’s constructed and online class where each instructors operate under two different gender identities. In this study, each instructor taught multiple sections of the same class using both a male identity and a female identity. The study examined student evaluations of teaching based on certain student and instructor characteristics in order to determine if and where male and female students might differ in their ratings of instructors based on instructor gender. Additionally, the authors examined if there are differences between undergraduate and graduate students' ratings with respect to the experimental criteria.

Keywords: gender bias, ethics, student evaluations, student perceptions, online instruction

Procedia PDF Downloads 265

Authors: María-Luisa Pinto-Salamanca, Wilson-Javier Pérez-Holguín

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Reconstruction of contact forces is a fundamental technique for analyzing the properties of a touched object and is essential for regulating the grip force in slip control loops. This is based on the processing of the distribution, intensity, and direction of the forces during the capture of the sensors. Currently, efficient hardware alternatives have been used more frequently in different fields of application, allowing the implementation of computationally complex algorithms, as is the case with tactile signal processing. The use of hardware for smart tactile sensing systems is a research area that promises to improve the processing time and portability requirements of applications such as artificial skin and robotics, among others. The literature review shows that hardware implementations are present today in almost all stages of smart tactile detection systems except in the force reconstruction process, a stage in which they have been less applied. This work presents a hardware implementation of a model-driven reported in the literature for the contact force reconstruction of flat and rigid tactile sensor arrays from normal stress data. From the analysis of a software implementation of such a model, this implementation proposes the parallelization of tasks that facilitate the execution of matrix operations and a two-dimensional optimization function to obtain a vector force by each taxel in the array. This work seeks to take advantage of the parallel hardware characteristics of Field Programmable Gate Arrays, FPGAs, and the possibility of applying appropriate techniques for algorithms parallelization using as a guide the rules of generalization, efficiency, and scalability in the tactile decoding process and considering the low latency, low power consumption, and real-time execution as the main parameters of design. The results show a maximum estimation error of 32% in the tangential forces and 22% in the normal forces with respect to the simulation by the Finite Element Modeling (FEM) technique of Hertzian and non-Hertzian contact events, over sensor arrays of 10×10 taxels of different sizes. The hardware implementation was carried out on an MPSoC XCZU9EG-2FFVB1156 platform of Xilinx® that allows the reconstruction of force vectors following a scalable approach, from the information captured by means of tactile sensor arrays composed of up to 48 × 48 taxels that use various transduction technologies. The proposed implementation demonstrates a reduction in estimation time of x / 180 compared to software implementations. Despite the relatively high values of the estimation errors, the information provided by this implementation on the tangential and normal tractions and the triaxial reconstruction of forces allows to adequately reconstruct the tactile properties of the touched object, which are similar to those obtained in the software implementation and in the two FEM simulations taken as reference. Although errors could be reduced, the proposed implementation is useful for decoding contact forces for portable tactile sensing systems, thus helping to expand electronic skin applications in robotic and biomedical contexts.

Keywords: contact forces reconstruction, forces estimation, tactile sensor array, hardware implementation

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Authors: Ahmedou Moulaye Idriss, Yahya Tfeil

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Medical imaging technology has become an indispensable tool in many branches of the biomedical, health area, and research and is vitally important for the training of professionals in these fields. It is not only about the tools, technologies, and knowledge provided but also about the community that this training project proposes. In order to be able to raise the level of anatomy teaching in the medical school of Nouakchott in Mauritania, it is necessary and even urgent to facilitate access to modern technology for African countries. The role of technology as a key driver of justifiable development has long been recognized. Anatomy is an essential discipline for the training of medical students; it is a key element for the training of medical specialists. The quality and results of the work of a young surgeon depend on his better knowledge of anatomical structures. The teaching of anatomy is difficult as the discipline is being neglected by medical students in many academic institutions. However, anatomy remains a vital part of any medical education program. When anatomy is presented in various planes medical students approve of difficulties in understanding. They do not increase their ability to visualize and mentally manipulate 3D structures. They are sometimes not able to correctly identify neighbouring or associated structures. This is the case when they have to make the identification of structures related to the caudate lobe when the liver is moved to different positions. In recent decades, some modern educational tools using digital sources tend to replace old methods. One of the main reasons for this change is the lack of cadavers in laboratories with poorly qualified staff. The emergence of increasingly sophisticated mathematical models, image processing, and visualization tools in biomedical imaging research have enabled sophisticated three-dimensional (3D) representations of anatomical structures. In this paper, we report our current experience in the Faculty of Medicine in Nouakchott Mauritania. One of our main aims is to create a local learning community in the fields of anatomy. The main technological platform used in this project is called 3D Slicer. 3D Slicer platform is an open-source application available for free for viewing, analysis, and interaction with biomedical imaging data. Using the 3D Slicer platform, we created from real medical images anatomical atlases of parts of the human body, including head, thorax, abdomen, liver, and pelvis, upper and lower limbs. Data were collected from several local hospitals and also from the website. We used MRI and CT-Scan imaging data from children and adults. Many different anatomy atlases exist, both in print and digital forms. Anatomy Atlas displays three-dimensional anatomical models, image cross-sections of labelled structures and source radiological imaging, and a text-based hierarchy of structures. Open and free online anatomical atlases developed by our anatomy laboratory team will be available to our students. This will allow pedagogical autonomy and remedy the shortcomings by responding more fully to the objectives of sustainable local development of quality education and good health at the national level. To make this work a reality, our team produced several atlases available in our faculty in the form of research projects.

Keywords: anatomy, education, medical imaging, three dimensional

Procedia PDF Downloads 238

Authors: Natalia Hordynska, Magdalena Szechynska-Hebda, Miroslaw Sobczak, Elzbieta Rozanska, Joanna Troczynska, Zofia Banaszak, Maria Wedzony

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Albinism is a common problem encountered in wheat and triticale breeding programs, which require in vitro culture steps e.g. generation of doubled haploids via androgenesis process. Genetic factor is a major determinant of albinism, however, environmental conditions such as temperature and media composition influence the frequency of albino plant formation. Cold incubation of wheat and triticale spikes induced a switch from gametophytic to sporophytic development. Further, androgenic structures formed from anthers of the genotypes susceptible to androgenesis or treated with cold stress, had a pool of structurally primitive plastids, with small starch granules or swollen thylakoids. High temperature was a factor inducing andro-genesis of wheat and triticale, but at the same time, it was a factor favoring the formation of albino plants. In genotypes susceptible to albinism or after heat stress conditions, cells formed from anthers were vacuolated, and plastids were eliminated. Partial or complete loss of chlorophyll pigments and incomplete differentiation of chloroplast membranes result in formation of tissues or whole plant unable to perform photosynthesis. Indeed, susceptibility to the andro-genesis process was associated with an increase of total concentration of photosynthetic pigments in anthers, spikes and regenerated plants. The proper balance of the synthesis of various pigments, was the starting point for their proper incorporation into photosynthetic membranes. In contrast, genotypes resistant to the androgenesis process and those treated with heat, contained 100 times lower content of photosynthetic pigments. In particular, the synthesis of violaxanthin, zeaxanthin, lutein and chlorophyll b was limited. Furthermore, deregulation of starch and lipids synthesis, which led to the formation of very complex starch granules and an increased number of oleosomes, respectively, correlated with the reduction of the efficiency of androgenesis. The content of other sugars varied depending on the genotype and the type of stress. The highest content of various sugars was found for genotypes susceptible to andro-genesis, and highly reduced for genotypes resistant to androgenesis. The most important sugars seem to be glucose and fructose. They are involved in sugar sensing and signaling pathways, which affect the expression of various genes and regulate plant development. Sucrose, on the other hand, seems to have minor effect at each stage of the androgenesis. The sugar metabolism was related to metabolic activity of microspores. The genotypes susceptible to androgenesis process had much faster mitochondrium- and chloroplast-dependent energy conversion and higher heat production by tissues. Thus, the effectiveness of metabolic processes, their balance and the flexibility under the stress was a factor determining the direction of microspore development, and in the later stages of the androgenesis process, a factor supporting the induction of androgenic structures, chloroplast formation and the regeneration of green plants. The work was financed by Ministry of Agriculture and Rural Development within Program: ‘Biological Progress in Plant Production’, project no HOR.hn.802.15.2018.

Keywords: androgenesis, chloroplast, metabolism, temperature stress

Procedia PDF Downloads 259

Authors: Mehari Teshome, Lara Agostini, Anna Nosella

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The current knowledge-based economy extends intellectual property rights (IPRs) legal research themes into a more strategic and organizational perspectives. From the diverse types of IPRs, patents are the strongest and well-known form of legal protection that influences commercial success and market value. Indeed, from our pilot survey, we understood that firms are less likely to manage their patents and actively used it as a tool for achieving competitive advantage rather they invest resource and efforts for patent application. To this regard, the literature also confirms that insights into how firms manage their patents from a holistic, strategic perspective, and how the portfolio value of patents can be optimized are scarce. Though patent management is an important business tool and there exist few scales to measure some dimensions of patent management, at the best of our knowledge, no systematic attempt has been made to develop a valid and comprehensive measure of it. Considering this theoretical and practical point of view, the aim of this article is twofold: to develop a framework for patent management encompassing all relevant dimensions with their respective constructs and measurement items, and to validate the measurement using survey data from practitioners. Methodology: We used six-step methodological approach (i.e., specify the domain of construct, item generation, scale purification, internal consistency assessment, scale validation, and replication). Accordingly, we carried out a systematic review of 182 articles on patent management, from ISI Web of Science. For each article, we mapped relevant constructs, their definition, and associated features, as well as items used to measure these constructs, when provided. This theoretical analysis was complemented by interviews with experts in patent management to get feedbacks that are more practical on how patent management is carried out in firms. Afterwards, we carried out a questionnaire survey to purify our scales and statistical validation. Findings: The analysis allowed us to design a framework for patent management, identifying its core dimensions (i.e., generation, portfolio-management, exploitation and enforcement, intelligence) and support dimensions (i.e., strategy and organization). Moreover, we identified the relevant activities for each dimension, as well as the most suitable items to measure them. For example, the core dimension generation includes constructs as: state-of-the-art analysis, freedom-to-operate analysis, patent watching, securing freedom-to-operate, patent potential and patent-geographical-scope. Originality and the Study Contribution: This study represents a first step towards the development of sound scales to measure patent management with an overarching approach, thus laying the basis for developing a recognized landmark within the research area of patent management. Practical Implications: The new scale can be used to assess the level of sophistication of the patent management of a company and compare it with other firms in the industry to evaluate their ability to manage the different activities involved in patent management. In addition, the framework resulting from this analysis can be used as a guide that supports managers to improve patent management in firms.

Keywords: patent, management, scale, development, intellectual property rights (IPRs)

Procedia PDF Downloads 144

Authors: Hari K. Adhikari, Keshab Sharma, K. C. Apil

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The Gorkha Nepal earthquake of moment magnitude (Mw) 7.8 hit the central region of Nepal on April 25, 2015; with the epicenter about 77 km northwest of Kathmandu Valley. This paper aims to explore challenges of reconstruction in the rural earthquake-stricken areas of Nepal. The Gorkha earthquake on April 25, 2015, has significantly affected the livelihood of people and overall economy in Nepal, causing severe damage and destruction in central Nepal including nation’s capital. A larger part of the earthquake affected area is difficult to access with rugged terrain and scattered settlements, which posed unique challenges and efforts on a massive scale reconstruction and rehabilitation. 800 thousand buildings were affected leaving 8 million people homeless. Challenge of reconstruction of optimum 800 thousand houses is arduous for Nepal in the background of its turmoil political scenario and weak governance. With significant actors involved in the reconstruction process, no appreciable relief has reached to the ground, which is reflected over the frustration of affected people. The 2015 Gorkha earthquake is one of most devastating disasters in the modern history of Nepal. Best of our knowledge, there is no comprehensive study on reconstruction after disasters in modern Nepal, which integrates the necessary information to deal with challenges and opportunities of reconstructions. The study was conducted using qualitative content analysis method. Thirty engineers and ten social mobilizes working for reconstruction and more than hundreds local social workers, local party leaders, and earthquake victims were selected arbitrarily. Information was collected through semi-structured interviews and open-ended questions, focus group discussions, and field notes, with no previous assumption. Author also reviewed literature and document reviews covering academic and practitioner studies on challenges of reconstruction after earthquake in developing countries such as 2001 Gujarat earthquake, 2005 Kashmir earthquake, 2003 Bam earthquake and 2010 Haiti earthquake; which have very similar building typologies, economic, political, geographical, and geological conditions with Nepal. Secondary data was collected from reports, action plans, and reflection papers of governmental entities, non-governmental organizations, private sector businesses, and the online news. This study concludes that inaccessibility, absence of local government, weak governance, weak infrastructures, lack of preparedness, knowledge gap and manpower shortage, etc. are the key challenges of the reconstruction after 2015 earthquake in Nepal. After scrutinizing different challenges and issues, study counsels that good governance, integrated information, addressing technical issues, public participation along with short term and long term strategies to tackle with technical issues are some crucial factors for timely and quality reconstruction in context of Nepal. Sample collected for this study is relatively small sample size and may not be fully representative of the stakeholders involved in reconstruction. However, the key findings of this study are ones that need to be recognized by academics, governments, and implementation agencies, and considered in the implementation of post-disaster reconstruction program in developing countries.

Keywords: Gorkha earthquake, reconstruction, challenges, policy

Procedia PDF Downloads 407

Authors: Alex J. Summers, Jasmine P. Devadhasan, Douglas Montgomery, Brittany Fischer, Jian Gu, Frederic Zenhausern

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Immunoassays have been utilized for several applications, including the detection of pathogens. Our laboratory is in the development of a tier 1 biothreat panel utilizing Vertical Flow Assay (VFA) technology for simultaneous detection of pathogens and toxins. One method of manufacturing VFA membranes is with non-contact piezoelectric dispensing, which provides advantages, such as low-volume and rapid dispensing without compromising the structural integrity of antibody or substrate. Challenges of this processinclude premature discontinuation of dispensing and misaligned spotting. Preliminary data revealed the Yp 11C7 mAb (11C7)reagent to exhibit a large angle of failure during printing which may have contributed to variable printing outputs. A Design of Experiment (DOE) was executed using this reagent to investigate the effects of hydrostatic pressure and reagent concentration on microarray printing outputs. A Nano-plotter 2.1 (GeSIM, Germany) was used for printing antibody reagents ontonitrocellulose membrane sheets in a clean room environment. A spotting plan was executed using Spot-Front-End software to dispense volumes of 11C7 reagent (20-50 droplets; 1.5-5 mg/mL) in a 6-test spot array at 50 target membrane locations. Hydrostatic pressure was controlled by raising the Pressure Compensation Vessel (PCV) above or lowering it below our current working level. It was hypothesized that raising or lowering the PCV 6 inches would be sufficient to cause either liquid accumulation at the tip or discontinue droplet formation. After aspirating 11C7 reagent, we tested this hypothesis under stroboscope.75% of the effective raised PCV height and of our hypothesized lowered PCV height were used. Humidity (55%) was maintained using an Airwin BO-CT1 humidifier. The number and quality of membranes was assessed after staining printed membranes with dye. The droplet angle of failure was recorded before and after printing to determine a “stroboscope score” for each run. The DOE set was analyzed using JMP software. Hydrostatic pressure and reagent concentration had a significant effect on the number of membranes output. As hydrostatic pressure was increased by raising the PCV 3.75 inches or decreased by lowering the PCV -4.5 inches, membrane output decreased. However, with the hydrostatic pressure closest to equilibrium, our current working level, membrane output, reached the 50-membrane target. As the reagent concentration increased from 1.5 to 5 mg/mL, the membrane output also increased. Reagent concentration likely effected the number of membrane output due to the associated dispensing volume needed to saturate the membranes. However, only hydrostatic pressure had a significant effect on stroboscope score, which could be due to discontinuation of dispensing, and thus the stroboscope check could not find a droplet to record. Our JMP predictive model had a high degree of agreement with our observed results. The JMP model predicted that dispensing the highest concentration of 11C7 at our current PCV working level would yield the highest number of quality membranes, which correlated with our results. Acknowledgements: This work was supported by the Chemical Biological Technologies Directorate (Contract # HDTRA1-16-C-0026) and the Advanced Technology International (Contract # MCDC-18-04-09-002) from the Department of Defense Chemical and Biological Defense program through the Defense Threat Reduction Agency (DTRA).

Keywords: immunoassay, microarray, design of experiment, piezoelectric dispensing

Procedia PDF Downloads 181

Authors: Rodríguez Sánchez Carla, Sancho-Esper Franco, Guillen-Davo Marina

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Tourism is one of the most important sectors worldwide since it is an important economic engine for today's society. It is also one of the sectors that most negatively affect the environment in terms of CO₂ emissions due to this expansion. In light of this, airlines are developing Voluntary Carbon Offset (VCO). There is important evidence focused on analyzing the features of these VCO programs and their efficacy in reducing CO₂ emissions, and findings are mixed without a clear consensus. Different research approaches have centered on analyzing factors and consequences of VCO programs, such as economic modelling based on panel data, survey research based on traveler responses or experimental research analyzing customer decisions in a simulated context. This study belongs to the latter group because it tries to understand how different characteristics of an online ticket purchase website affect the willingness of a traveler to choose a sustainable one. The proposed behavioral model is based on several theories, such as the nudge theory, the dual processing ELM and the cognitive dissonance theory. This randomized experiment aims at overcoming previous studies based on self-reported measures that mainly study sustainable behavioral intention rather than actual decision-making. It also complements traditional self-reported independent variables by gathering objective information from an eye-tracking device. This experiment analyzes the influence of two characteristics of the online purchase website: i) the type of information regarding flight CO₂ emissions (quantitative vs. qualitative) and the comparison framework related to the sustainable purchase decision (negative: alternative with more emissions than the average flight of the route vs. positive: alternative with less emissions than the average flight of the route), therefore it is a 2x2 experiment with four alternative scenarios. A pretest was run before the actual experiment to refine the experiment features and to check the manipulations. Afterward, a different sample of students answered the pre-test questionnaire aimed at recruiting the cases and measuring several pre-stimulus measures. One week later, students came to the neurolab at the University setting to be part of the experiment, made their decision regarding online purchases and answered the post-test survey. A final sample of 21 students was gathered. The committee of ethics of the institution approved the experiment. The results show that qualitative information generates more sustainable decisions (less contaminant alternative) than quantitative information. Moreover, evidence shows that subjects are more willing to choose the sustainable decision to be more ecological (comparison of the average with the less contaminant alternative) rather than to be less contaminant (comparison of the average with the more contaminant alternative). There are also interesting differences in the information processing variables from the eye tracker. Both the total time to make the choice and the specific times by area of interest (AOI) differ depending on the assigned scenario. These results allow for a better understanding of the factors that condition the decision of a traveler to be part of a VCO program and provide useful information for airline managers to promote these programs to reduce environmental impact.

Keywords: voluntary carbon offset, airline, online purchase, carbon emission, sustainability, randomized experiment

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Authors: Yelda Yenel, Orkut Acele

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In a media-saturated world, celebrities have become ubiquitous figures, encountered both in public spaces and within the privacy of our homes, seamlessly integrating into daily life. From Alexander the Great to contemporary media personalities, the image of celebrity has persisted throughout history, manifesting in various forms and contexts. Over time, as the relationship between society and the market evolved, so too did the roles and behaviors of celebrities. These transformations offer insights into the cultural climate, revealing shifts in habits and worldviews. In Türkiye, the emergence of private television channels brought an influx of celebrities into everyday life, making them a pervasive part of daily routines. To understand modern celebrity culture, it is essential to examine the ideological functions of media within political, economic, and social contexts. Within this framework, celebrities serve as both reflections and creators of cultural values and, at times, act as intermediaries, offering insights into the society of their era. Starting its broadcasting life in 1992 with religious films and religious conversation, Türkiye Newspaper, Radio, Television channel (TGRT) later changed its appearance, slogan, and the celebrities it featured in response to the political atmosphere. Celebrities played a critical role in transforming from the existing slogan 'Peace has come to the screen' to 'Watch and see what will happen”. Celebrities hold significant roles in society, and their images are produced and circulated by various actors, including media organizations and public relations teams. Understanding these dynamics is crucial for analyzing their influence and impact. This study aims to explore Turkish society in the 1990s, focusing on TGRT and its visual and discursive characteristics regarding celebrity figures such as Seda Sayan. The first section examines the historical development of celebrity culture and its transformations, guided by the conceptual framework of celebrity studies. The complex and interconnected image of celebrity, as introduced by post-structuralist approaches, plays a fundamental role in making sense of existing relationships. This section traces the existence and functions of celebrities from antiquity to the present day. The second section explores the economic, social, and cultural contexts of 1990s Türkiye, focusing on the media landscape and visibility that became prominent in the neoliberal era following the 1980s. This section also discusses the political factors underlying TGRT's transformation, such as the 1997 military memorandum. The third section analyzes TGRT as a case study, focusing on its significance as an Islamic television channel and the shifts in its public image, categorized into two distinct periods. The channel’s programming, which aligned with Islamic teachings, and the celebrities who featured prominently during these periods became the public face of both TGRT and the broader society. In particular, the transition to a more 'secular' format during TGRT's second phase is analyzed, focusing on changes in celebrity attire and program formats. This study reveals that celebrities are used as indicators of ideology, benefiting from this instrumentalization by enhancing their own fame and reflecting the prevailing cultural hegemony in society.

Keywords: celebrity culture, media, neoliberalism, TGRT

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Authors: Marlon Gallo, Eduardo Miguel, Laura Oca, Eneko Gonzalez, Unai Iraola

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The heat generation of an energy storage system is an essential topic when designing a battery pack and its cooling system. Heat generation estimation is used together with thermal models to predict battery temperature in operation and adapt the design of the battery pack and the cooling system to these thermal needs guaranteeing its safety and correct operation. In the present work, a comparison between the use of a heat flux sensor (HFS) for indirect measurement of heat losses in a cell and the widely used and simplified version of Bernardi’s equation for estimation is presented. First, a Li-ion cell is thermally characterized with an HFS to measure the thermal parameters that are used in a first-order lumped thermal model. These parameters are the equivalent thermal capacity and the thermal equivalent resistance of a single Li-ion cell. Static (when no current is flowing through the cell) and dynamic (making current flow through the cell) tests are conducted in which HFS is used to measure heat between the cell and the ambient, so thermal capacity and resistances respectively can be calculated. An experimental platform records current, voltage, ambient temperature, surface temperature, and HFS output voltage. Second, an equivalent circuit model is built in a Matlab-Simulink environment. This allows the comparison between the generated heat predicted by Bernardi’s equation and the HFS measurements. Data post-processing is required to extrapolate the heat generation from the HFS measurements, as the sensor records the heat released to the ambient and not the one generated within the cell. Finally, the cell temperature evolution is estimated with the lumped thermal model (using both HFS and Bernardi’s equation total heat generation) and compared towards experimental temperature data (measured with a T-type thermocouple). At the end of this work, a critical review of the results obtained and the possible mismatch reasons are reported. The results show that indirectly measuring the heat generation with HFS gives a more precise estimation than Bernardi’s simplified equation. On the one hand, when using Bernardi’s simplified equation, estimated heat generation differs from cell temperature measurements during charges at high current rates. Additionally, for low capacity cells where a small change in capacity has a great influence on the terminal voltage, the estimated heat generation shows high dependency on the State of Charge (SoC) estimation, and therefore open circuit voltage calculation (as it is SoC dependent). On the other hand, with indirect measuring the heat generation with HFS, the resulting error is a maximum of 0.28ºC in the temperature prediction, in contrast with 1.38ºC with Bernardi’s simplified equation. This illustrates the limitations of Bernardi’s simplified equation for applications where precise heat monitoring is required. For higher current rates, Bernardi’s equation estimates more heat generation and consequently, a higher predicted temperature. Bernardi´s equation accounts for no losses after cutting the charging or discharging current. However, HFS measurement shows that after cutting the current the cell continues generating heat for some time, increasing the error of Bernardi´s equation.

Keywords: lithium-ion battery, heat flux sensor, heat generation, thermal characterization

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Authors: Juan A. Arzate, Funda C. Ertem, M. Nicolas Cruz-Bournazou, Peter Neubauer, Stefan Junne

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— One of the biggest challenges the world faces today is global warming that is caused by greenhouse gases (GHGs) coming from the combustion of fossil fuels for energy generation. In order to mitigate climate change, the European Union has committed to reducing GHG emissions to 80–95% below the level of the 1990s by the year 2050. Renewable technologies are vital to diminish energy-related GHG emissions. Since water and biomass are limited resources, the largest contributions to renewable energy (RE) systems will have to come from wind and solar power. Nevertheless, high proportions of fluctuating RE will present a number of challenges, especially regarding the need to balance the variable energy demand with the weather dependent fluctuation of energy supply. Therefore, biogas plants in this content would play an important role, since they are easily adaptable. Feedstock availability varies locally or seasonally; however there is a lack of knowledge in how biogas plants should be operated in a stable manner by local feedstock. This problem may be prevented through suitable control strategies. Such strategies require the development of convenient mathematical models, which fairly describe the main processes. Modelling allows us to predict the system behavior of biogas plants when different feedstocks are used with different loading rates. Life cycle assessment (LCA) is a technique for analyzing several sides from evolution of a product till its disposal in an environmental point of view. It is highly recommend to use as a decision making tool. In order to achieve suitable strategies, the combination of a flexible energy generation provided by biogas plants, a secure production process and the maximization of the environmental benefits can be obtained by the combination of process modelling and LCA approaches. For this reason, this study focuses on the biogas plant which flexibly generates required energy from the co-digestion of maize, grass and cattle manure, while emitting the lowest amount of GHG´s. To achieve this goal AMOCO model was combined with LCA. The program was structured in Matlab to simulate any biogas process based on the AMOCO model and combined with the equations necessary to obtain climate change, acidification and eutrophication potentials of the whole production system based on ReCiPe midpoint v.1.06 methodology. Developed simulation was optimized based on real data from operating biogas plants and existing literature research. The results prove that AMOCO model can successfully imitate the system behavior of biogas plants and the necessary time required for the process to adapt in order to generate demanded energy from available feedstock. Combination with LCA approach provided opportunity to keep the resulting emissions from operation at the lowest possible level. This would allow for a prediction of the process, when the feedstock utilization supports the establishment of closed material circles within a smart bio-production grid – under the constraint of minimal drawbacks for the environment and maximal sustainability.

Keywords: AMOCO model, GHG emissions, life cycle assessment, modelling

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Authors: Zahra Mohajer, Afsaneh Soltani

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Doping is a major issue in competitive sports and is favored by vast groups of athletes. The feeling of being higher-ranking than others and gaining fame has caused many athletes to misuse drugs. The definition of doping is to use prohibited substances and/or methods that help physical or mental performances or both. Doping counts as the illegal use of chemical substances or drugs, excessive amounts of physiological substances to increase the performance at or out of competition or even the use of inappropriate medications to treat an injury to gain the ability to participate in a competition. The International Olympic Committee (IOC) and World Anti-Doping Agency (WADA) have forbidden these substances to ensure fair and equal competition and also the health of the competitors. As of 2004 WADA has published an international list of illegal substances used for doping, which is updated annually. In the process of the Genome Project scientists have gained the ability to treat numerous diseases by gene therapy, which may result in bodily performance increase and therefore a potential opportunity to misuse by some athletes. Gene doping is defined as the non-therapeutic direct and indirect genetic modifications using genetic materials that can improve the performances in sports events. Biosynthetic drugs are a form of indirect genetic engineering. The method can be performed in three ways such as injecting the DNA directly into the muscle, inserting the genetically engineered cells, or transferring the DNA using a virus as a vector. Erythropoietin is a hormone majorly released by the kidney and in small amounts by the liver. Its function is to stimulate the erythropoiesis and therefore the more production of red blood cells (RBC) which causes an increase in Hemoglobin (Hb). During this process, the oxygen delivery to muscles will increase, which will improve athletic performance and postpone exhaustion. There are ways to increase the oxygen transferred to muscles such as blood transfusion, stimulating the production of red blood cells by using Erythropoietin (EPO), and also using allosteric effectors of Hemoglobin. EPO can either be injected as a protein or can be inserted into the cells as the gene which encodes EPO. Adeno-associated viruses have been employed to deliver the EPO gene to the cells. Employing the genes that naturally exist in the human body such as the EPO gene can reduce the risk of detecting gene doping. The first research about blood doping was conducted in 1947. The study has shown that an increase in hematocrit (HCT) up to 55% following homologous transfusion makes it more unchallenging for the body to perform the exercise at the altitude. Thereafter athletes’ attraction to blood infusion escalated. Also, a study has demonstrated that by reinfusing their own blood 4 weeks after being drawn, three men have shown a rise in Hb level which improved the oxygen uptake, and a delay in exhaustion. The list of performance-enhancing drugs is published by WADA annually and includes the following drugs: anabolic agents, hormones, Beta-2 agonists, Beta-blockers, Diuretics, Stimulants, narcotics, cannabinoids, and corticosteroids.

Keywords: doping, PEDs, sports, WADA

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Authors: Khan Farhan Rafat, Riaz Ahmed

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Renowned offshore organizations are drifting towards collaborative exertion to win and implement international projects for business gains. However, devoid of financial constraints, with the availability of skilled professionals, and despite improved project management practices through state-of-the-art tools and techniques, project delays have become a norm these days. This situation calls for exploring the factor(s) affecting the bonding between project management performance and project success. In the context of the well-known 3M’s of project management (that is, manpower, machinery, and materials), machinery and materials are dependent upon manpower. Because the body of knowledge inveterate on the influence of national culture on men, hence, the realization of the impact on the link between project management performance and project success need to be investigated in detail to arrive at the possible cause(s) of project delays. This research initiative was, therefore, undertaken to fill the research gap. The unit of analysis for the proposed research excretion was the individuals who had worked on skyscraper construction projects. In reverent studies, project management is best described using construction examples. It is due to this reason that the project oriented city of Dubai was chosen to reconnoiter on causes of project delays. A structured questionnaire survey was disseminated online with the courtesy of the Project Management Institute local chapter to carry out the cross-sectional study. The Construction Industry Institute, Austin, of the United States of America along with 23 high-rise builders in Dubai were also contacted by email requesting for their contribution to the study and providing them with the online link to the survey questionnaire. The reliability of the instrument was warranted using Cronbach’s alpha coefficient of 0.70. The appropriateness of sampling adequacy and homogeneity in variance was ensured by keeping Kaiser–Meyer–Olkin (KMO) and Bartlett’s test of sphericity in the range ≥ 0.60 and < 0.05, respectively. Factor analysis was used to verify construct validity. During exploratory factor analysis, all items were loaded using a threshold of 0.4. Four hundred and seventeen respondents, including members from top management, project managers, and project staff, contributed to the study. The link between project management performance and project success was significant at 0.01 level (2-tailed), and 0.05 level (2-tailed) for Pearson’s correlation. Before initiating the moderator analysis test for linearity, multicollinearity, outliers, leverage points and influential cases, test for homoscedasticity and normality were carried out which are prerequisites for conducting moderator review. The moderator analysis, using a macro named PROCESS, was performed to verify the hypothesis that national culture has an influence on the said link. The empirical findings, when compared with Hofstede's results, showed high power distance as the cause of construction project delays in Dubai. The research outcome calls for the project sponsors and top management to reshape their project management strategy and allow for low power distance between management and project personnel for timely completion of projects.

Keywords: causes of construction project delays, construction industry, construction management, power distance

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Authors: Noura Al Akkari, Aurélie Foucquier, Sylvain Lespinats

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Load monitoring is a management process for energy consumption towards energy savings and energy efficiency. Non Intrusive Load Monitoring (NILM) is one method of load monitoring used for disaggregation purposes. NILM is a technique for identifying individual appliances based on the analysis of the whole residence data retrieved from the main power meter of the house. Our NILM framework starts with data acquisition, followed by data preprocessing, then event detection, feature extraction, then general appliance modeling and identification at the final stage. The event detection stage is a core component of NILM process since event detection techniques lead to the extraction of appliance features. Appliance features are required for the accurate identification of the household devices. In this research work, we aim at developing a new event detection methodology with accurate load disaggregation to extract appliance features. Time-domain features extracted are used for tuning general appliance models for appliance identification and classification steps. We use unsupervised algorithms such as Dynamic Time Warping (DTW). The proposed method relies on detecting areas of operation of each residential appliance based on the power demand. Then, detecting the time at which each selected appliance changes its states. In order to fit with practical existing smart meters capabilities, we work on low sampling data with a frequency of (1/60) Hz. The data is simulated on Load Profile Generator software (LPG), which was not previously taken into consideration for NILM purposes in the literature. LPG is a numerical software that uses behaviour simulation of people inside the house to generate residential energy consumption data. The proposed event detection method targets low consumption loads that are difficult to detect. Also, it facilitates the extraction of specific features used for general appliance modeling. In addition to this, the identification process includes unsupervised techniques such as DTW. To our best knowledge, there exist few unsupervised techniques employed with low sampling data in comparison to the many supervised techniques used for such cases. We extract a power interval at which falls the operation of the selected appliance along with a time vector for the values delimiting the state transitions of the appliance. After this, appliance signatures are formed from extracted power, geometrical and statistical features. Afterwards, those formed signatures are used to tune general model types for appliances identification using unsupervised algorithms. This method is evaluated using both simulated data on LPG and real-time Reference Energy Disaggregation Dataset (REDD). For that, we compute performance metrics using confusion matrix based metrics, considering accuracy, precision, recall and error-rate. The performance analysis of our methodology is then compared with other detection techniques previously used in the literature review, such as detection techniques based on statistical variations and abrupt changes (Variance Sliding Window and Cumulative Sum).

Keywords: electrical disaggregation, DTW, general appliance modeling, event detection

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

Procedia PDF Downloads 97