Search results for: global health
3714 Application of Lean Manufacturing Tools in Hot Asphalt Production
Authors: S. Bayona, J. Nunez, D. Paez, C. Diaz
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The application of Lean manufacturing tools continues to be an effective solution for increasing productivity, reducing costs and eliminating waste in the manufacture of goods and services. This article analyzes the production process of a hot asphalt manufacturing company from an administrative and technical perspective. Three main phases were analyzed, the first phase was related to the determination of the risk priority number of the main operations in asphalt mix production process by an FMEA (Failure Mode Effects Analysis), in the second phase the Value Stream Mapping (VSM) of the production line was performed and in the third phase a SWOT (Strengths, Weaknesses Opportunities, Threats) matrix was constructed. Among the most valued failure modes were the lack training of workers in occupational safety and health issues, the lack of signaling and classification of granulated material, and the overweight of vehicles loaded. The analysis of the results in the three phases agree on the importance of training operational workers, improve communication with external actors in order to minimize delays in material orders and strengthen control suppliers.Keywords: asphalt, lean manufacturing, productivity, process
Procedia PDF Downloads 1173713 Fiber-Optic Sensors for Hydrogen Peroxide Vapor Measurement
Authors: H. Akbari Khorami, P. Wild, N. Djilali
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This paper reports on the response of a fiber-optic sensing probe to small concentrations of hydrogen peroxide (H2O2) vapor at room temperature. H2O2 has extensive applications in industrial and medical environments. Conversely, H2O2 can be a health hazard by itself. For example, H2O2 induces cellular damage in human cells and its presence can be used to diagnose illnesses such as asthma and human breast cancer. Hence, development of reliable H2O2 sensor is of vital importance to detect and measure this species. Ferric ferrocyanide, referred to as Prussian blue (PB), was deposited on the tip of a multimode optical fiber through the single source precursor technique and served as an indicator of H2O2 in a spectroscopic manner. Sensing tests were performed in H2O2-H2O vapor mixtures with different concentrations of H2O2. The results of sensing tests show the sensor is able to detect H2O2 concentrations in the range of 50.6 ppm to 229.5 ppm. Furthermore, the sensor response to H2O2 concentrations is linear in a log-log scale with the adjacent R-square of 0.93. This sensing behavior allows us to detect and quantify the concentration of H2O2 in the vapor phase.Keywords: chemical deposition, fiber-optic sensor, hydrogen peroxide vapor, prussian blue
Procedia PDF Downloads 3593712 Outcome of Obstetric Admission to General Intensive Care over a Period of 3 Years
Authors: Kamel Abdelaziz Mohamed
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Intoduction:Inadequate knowledge about obstetric admission and infrequent dealing with the obstetric patients in ICU results in high mortality and morbidity. Aim of the work:To evaluate the indications, course, severity of illness, and outcome of obstetric patients admitted to the intensive care unit (ICU). Patients and Methods: We collected baseline data and acute physiology and chronic health evaluation II (APACHE II) scores. ICU mortality was the primary outcome. Results: Seventy obstetric patients were admitted to the ICU over 3 years, 36 of these patients (51.4 %) were admitted during the antepartum period. The primary obstetric indication for ICU admission was pregnancy-induced hypertension (22 patients, 31.4%), followed by sepsis (8 patients, 11.4%) as the leading non-obstetric admission. The mean APACHE II score was 19.6. The predicted mortality rate based on the APACHE II score was 22%, however, only 4 maternal deaths (5.7%) were among the obstetric patients admitted to the ICU. Conclusion: Evaluation of obstetric patients by (APACHE II) scores showed higher predicted mortality rate, however the overall mortality was lower. Regular follow up, together with early detection of complications and prompt ICU admission necessitating proper management by specialized team can improve mortality.Keywords: obstetric, complication, postpartum, sepsis
Procedia PDF Downloads 3073711 Powerful Bacteriocins Produced by Bacillus thuringiensis Strains Isolated from Soil at Northern of Algeria
Authors: R. Gounina-Allouane, I. Moussaoui, N. Boukahel
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Bacillus antimicrobial metabolites, especially those of Bacillus thuringiensis (Bt), are of great interest for research because of health risks generated by the excessive use of chemical additives as well as the propagation of resistant microbial strains, caused by the massive treatment with antibiotics. The objective of this study was the selection of Bt strains producing antimicrobial peptides (bacteriocins), and the partial purification of the most powerful bacteriocins, then the determination of their spectra of antimicrobial action. A collection of twenty one Bt strains isolated from soil at Boumerdès (northern of Algeria) was used for screening strains having an antagonistic activity against phylogenetically closed bacteria. Spectra of antagonistic activity of two selected strains was determined against other Bt strains, Gram positive and Gram negative bacterial strains of clinical origin and others from ATCC collection as well as yeasts isolated in human dermatology. Bacteriocins of these two strains were partially purified and their effect on the kinetics of growth of the most sensitive microbial strains was studied. The bacteriocinogenic strains were biochemically characterized and their sensitivity to antibiotics was studied.Keywords: antimicrobial peptides, Bacillus thuringiensis, bacteriocin, partial purification
Procedia PDF Downloads 3583710 Determination of the Presence of Antibiotic Resistance from Vibrio Species in Northern Italy
Authors: Tramuta Clara, Masotti Chiara, Pitti Monica, Adriano Daniela, Battistini Roberta, Serraca Laura, Decastelli Lucia
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Oysters are considered filter organisms, and their raw consumption may increase health risks for consumers: it is often associated with outbreaks of gastroenteritis or enteric illnesses. Most of these foodborne diseases are caused by Vibrio strains, enteric pathogens also involved in the diffusion of genetic determinants of antibiotic resistance and their entrance along the food chain. The European Food Safety Authority (EFSA), during the European Union report on antimicrobial resistance in 2017, focused the attention about the role of food as a possible carrier of antibiotic-resistant bacteria or antibiotic-resistance genes that determine health risks for humans. This study wants to determine antibiotic resistance and antibiotic-resistance genes in Vibrio spp. isolated from Crassostrea gigas oysters collected in the Golfo della Spezia (Liguria, Italy). A total of 47 Vibrio spp. strains were isolated (ISO21872-2:2017) during the summer of 2021 from oysters of Crassostrea gigas. The strains were identified by MALDI-TOF (Bruker, Germany) mass spectrometry and tested for antibiotic susceptibility using a broth microdiluition method (ISO20776-1:2019) using Sensititre EUVSEC plates (Thermo-Fisher Scientific) to obtain the Minimum Inhibitory Concentration (MIC). The strains were tested with PCR-based biomolecular methods, according to previous works, to define the presence of 23 resistance genes of the main classes of antibiotics used in human and veterinary medicine: tet (B), tet (C), tet (D), tet (A), tet (E), tet (G ), tet (K), tet (L), tet (M), tet (O), tet (S) (tetracycline resistance); blaCTX-M, blaTEM, blaOXA, blaSHV (β-lactam resistance); mcr-1 and mcr-2 (colistin resistance); qnrA, qnrB, and qnrS (quinolone resistance); sul1, sul2 and sul3 (sulfonamide resistance). Six different species have been identified: V. alginolyticus 34% (n=16), V. harveyi 28% (n=13), V. fortis 15% (n=7), V. pelagius 8% (n=4), V. parahaemolyticus 11% (n=5) e V. chagasii 4% (n=2). The PCR assays showed the presence of the blaTEM gene on 40% of the strains (n=19). All the other genes were not detected, except for a V. alginolyticus positive for anrS gene. The broth microdiluition method results showed an high level of resistance for ciprofloxacin (62%; n=29), ampicillin (47%; n=22), and colistin (49%; n=23). Furthermore, 32% (n=15) of strains can be considered multiresistant bacteria for the simultaneous presence of resistance for three different antibiotic classes. Susceptibility towards meropenem, azithromycin, gentamicin, ceftazidime, cefotaxime, chloramphenicol, tetracycline and sulphamethoxazole reached 100%. The Vibrio species identified in this study are widespread in marine environments and can cause gastrointerstinal infections after the ingestion of raw fish products and bivalve molluscs. The level of resistance to antibiotics such as ampicillin, ciprofloxacin and colistin can be connected to anthropic factors (industrial, agricultural and domestic wastes) that promote the spread of resistance to these antibiotics. It can be also observed a strong correlation between phenotypic (resistant MIC) and genotypic (positive blaTEM gene) resistance for ampicillin on the same strains, probably due to the transfer of genetic material between bacterial strains. Consumption of raw bivalve molluscs can represent a risk for consumers heath due to the potentially presence of foodborne pathogens, highly resistant to different antibiotics and source of transferable antibiotic-resistant genes.Keywords: vibrio species, blaTEM genes, antimicrobial resistance, PCR
Procedia PDF Downloads 763709 An Alternative and Complementary Medicine Method in Vulnerable Pediatric Cancer Patients: Yoga
Authors: Ç. Erdoğan, T. Turan
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Pediatric cancer patients experience multiple distressing, challenges, physical symptom such as fatigue, pain, sleep disturbance, and balance impairment that continue years after treatment completion. In recent years, yoga is often used in children with cancer to cope with these symptoms. Yoga practice is defined as a unique physical activity that combines physical practice, breath work and mindfulness/meditation. Yoga is an increasingly popular mind-body practice also characterized as a mindfulness mode of exercise. This study aimed to evaluate the impact of yoga intervention of children with cancer. This article planned searching the literature in this field. It has been determined that individualized yoga is feasible and provides benefits for inpatient children, improves health-related quality of life, physical activity levels, physical fitness. After yoga program, children anxiety score decreases significantly. Additionally, individualized yoga is feasible for inpatient children receiving intensive chemotherapy. As a result, yoga is an alternative and complementary medicine that can be safely used in children with cancer.Keywords: cancer treatment, children, nursing, yoga
Procedia PDF Downloads 2243708 Micro-Oculi Facades as a Sustainable Urban Facade
Authors: Ok-Kyun Im, Kyoung Hee Kim
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We live in an era that faces global challenges of climate changes and resource depletion. With the rapid urbanization and growing energy consumption in the built environment, building facades become ever more important in architectural practice and environmental stewardship. Furthermore, building facade undergoes complex dynamics of social, cultural, environmental and technological changes. Kinetic facades have drawn attention of architects, designers, and engineers in the field of adaptable, responsive and interactive architecture since 1980’s. Materials and building technologies have gradually evolved to address the technical implications of kinetic facades. The kinetic façade is becoming an independent system of the building, transforming the design methodology to sustainable building solutions. Accordingly, there is a need for a new design methodology to guide the design of a kinetic façade and evaluate its sustainable performance. The research objectives are two-fold: First, to establish a new design methodology for kinetic facades and second, to develop a micro-oculi façade system and assess its performance using the established design method. The design approach to the micro-oculi facade is comprised of 1) façade geometry optimization and 2) dynamic building energy simulation. The façade geometry optimization utilizes multi-objective optimization process, aiming to balance the quantitative and qualitative performances to address the sustainability of the built environment. The dynamic building energy simulation was carried out using EnergyPlus and Radiance simulation engines with scripted interfaces. The micro-oculi office was compared with an office tower with a glass façade in accordance with ASHRAE 90.1 2013 to understand its energy efficiency. The micro-oculi facade is constructed with an array of circular frames attached to a pair of micro-shades called a micro-oculus. The micro-oculi are encapsulated between two glass panes to protect kinetic mechanisms with longevity. The micro-oculus incorporates rotating gears that transmit the power to adjacent micro-oculi to minimize the number of mechanical parts. The micro-oculus rotates around its center axis with a step size of 15deg depending on the sun’s position while maximizing daylighting potentials and view-outs. A 2 ft by 2ft prototyping was undertaken to identify operational challenges and material implications of the micro-oculi facade. In this research, a systematic design methodology was proposed, that integrates multi-objectives of kinetic façade design criteria and whole building energy performance simulation within a holistic design process. This design methodology is expected to encourage multidisciplinary collaborations between designers and engineers to collaborate issues of the energy efficiency, daylighting performance and user experience during design phases. The preliminary energy simulation indicated that compared to a glass façade, the micro-oculi façade showed energy savings due to its improved thermal properties, daylighting attributes, and dynamic solar performance across the day and seasons. It is expected that the micro oculi façade provides a cost-effective, environmentally-friendly, sustainable, and aesthetically pleasing alternative to glass facades. Recommendations for future studies include lab testing to validate the simulated data of energy and optical properties of the micro-oculi façade. A 1:1 performance mock-up of the micro-oculi façade can suggest in-depth understanding of long-term operability and new development opportunities applicable for urban façade applications.Keywords: energy efficiency, kinetic facades, sustainable architecture, urban facades
Procedia PDF Downloads 2573707 Assessment of Prevalent Diseases Caused by Mining Activities in the Northern Part of Mindanao Island, Philippines
Authors: Odinah Cuartero-Enteria, Kyla Rita Mercado, Jason Salamanes, Aian Pecasales, Sherwin Sabado
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The northern part of Mindanao Island, Philippines has sizable reserve of mineral resources. Years ago, mining activities have been flourishing which resulted to both local economic gain but with environmental concerns. This study investigates the prevalent diseases by mining activities in these areas. The study was done using the secondary data gathered from the Rural Health Units (RHU) of the selected areas. The study further determined the prevalent diseases that existed in the three areas from years 2005, 2010 and 2015 indicating before the mining activities and when mining activities are present. The results show that areas which are far from mining activities have fewer cases of patients suffering from air-borne diseases. The top ten most common diseases such as pneumonia, tuberculosis, influenza, upper respiratory tract infection (URTI) and skin diseases were caused by air-borne due to air pollution. Hence, the places where mining activities are present contribute to the prevalent diseases. Thus, addressing the air pollution caused by mining activities is very important.Keywords: Philippines, Mindanao Island, mining activities, pollution, prevalent diseases
Procedia PDF Downloads 4733706 Improved Anatomy Teaching by the 3D Slicer Platform
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 2413705 The Effect of Progressive Muscle Relaxation and Sleep Hygiene Education to Change Sleep Quality Index Scores of Patient with Breast Cancer
Authors: Ika Wulansari, Yati Afiyanti, Indang Trihandini
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Sleeping disorder experienced by patients with breast cancer can affect the physical, mental, health, and well-being. This study examines the effect of progressive muscle relaxation training and sleep hygiene education to change sleep quality scores of the patient with breast cancer. The study design using quasi-experiment with pre-post test within the control group, involving 62 breast cancer patients using consecutive sampling method in Jakarta. Statistical test results with independent t-test showed a significant difference in score of sleep quality between in intervention group and the control group (6,66±3,815; 9,30±3,334, p-value = 0,005). Progressive muscle relaxation exercise and sleep hygiene education proven to be affective to change the patients sleeping quality, so that it can be an alternative therapeutic option to overcome sleeping disorders.Keywords: sleeping disorders, breast cancer, progressive muscle relaxation, sleep hygiene education
Procedia PDF Downloads 3153704 Tensile and Direct Shear Responses of Basalt-Fibre Reinforced Composite Using Alkali Activate Binder
Authors: S. Candamano, A. Iorfida, L. Pagnotta, F. Crea
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Basalt fabric reinforced cementitious composites (FRCM) have attracted great attention because they result in being effective in structural strengthening and eco-efficient. In this study, authors investigate their mechanical behavior when an alkali-activated binder, with tuned properties and containing high amounts of industrial by-products, such as ground granulated blast furnace slag, is used. Reinforcement is made up of a balanced, coated bidirectional fabric made out of basalt fibres and stainless steel micro-wire, with a mesh size of 8x8 mm and an equivalent design thickness equal to 0.064 mm. Mortars mixes have been prepared by maintaining constant the water/(reactive powders) and sand/(reactive powders) ratios at 0.53 and 2.7 respectively. Tensile tests were carried out on composite specimens of nominal dimensions equal to 500 mm x 50 mm x 10 mm, with 6 embedded rovings in the loading direction. Direct shear tests (DST), aimed to the stress-transfer mechanism and failure modes of basalt-FRCM composites, were carried out on brickwork substrate using an externally bonded basalt-FRCM composite strip 10 mm thick, 50 mm wide and a bonded length of 300 mm. Mortars exhibit, after 28 days of curing, a compressive strength of 32 MPa and a flexural strength of 5.5 MPa. Main hydration product is a poorly crystalline CASH gel. The constitutive behavior of the composite has been identified by means of direct tensile tests, with response curves showing a tri-linear behavior. The first linear phase represents the uncracked (I) stage, the second (II) is identified by crack development and the third (III) corresponds to cracked stage, completely developed up to failure. All specimens exhibit a crack pattern throughout the gauge length and failure occurred as a result of sequential tensile failure of the fibre bundles, after reaching the ultimate tensile strength. The behavior is mainly governed by cracks development (II) and widening (III) up to failure. The main average values related to the stages are σI= 173 MPa and εI= 0.026% that are the stress and strain of the transition point between stages I and II, corresponding to the first mortar cracking; σu = 456 MPa and εu= 2.20% that are the ultimate tensile strength and strain, respectively. The tensile modulus of elasticity in stage III is EIII= 41 GPa. All single-lap shear test specimens failed due to composite debonding. It occurred at the internal fabric-to-matrix interface, and it was the result of fracture of the matrix between the fibre bundles. For all specimens, transversal cracks were visible on the external surface of the composite and involved only the external matrix layer. This cracking appears when the interfacial shear stresses increase and slippage of the fabric at the internal matrix layer interface occurs. Since the external matrix layer is bonded to the reinforcement fabric, it translates with the slipped fabric. Average peak load around 945 N, peak stress around 308 MPa, and global slip around 6 mm were measured. The preliminary test results allow affirming that Alkali Activated Binders can be considered a potentially valid alternative to traditional mortars in designing FRCM composites.Keywords: alkali activated binders, basalt-FRCM composites, direct shear tests, structural strengthening
Procedia PDF Downloads 1233703 The Role of Quality Management Tools and Knowledge Sharing in Improving the Level of Academic Staff: An Empirical Investigation of the Jordanian Universities
Authors: Tasneem Alfalah, Salsabeel Alfalah, Jannat Alfalah
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The quality of higher education as a service is fundamental to a country’s development because universities prepare the professionals who will work as managers in companies and manage public and private resources and care for the health and education of new generations. Knowledge sharing involves the interaction of all activities between individuals. Thus, the higher education institutions are aiming to improve and assist their academics in generating new ideas by encouraging them to work as a team, to simplify the exchange of the new knowledge and to further improve the learning process and achieving institutional aims. Moreover, the sources of competitive advantage in universities derive from intellectual capital and innovations in which innovation comes through knowledge sharing. Using quality tools is to define the exact requirements needed to create the concept of knowledge sharing and what are the barriers to achieve this in universities. The purpose of this research is critically evaluating the role of using quality tools to facilitate the concept of knowledge sharing and improve the academic staff level in the Jordanian universities.Keywords: higher education, knowledge sharing, quality, management tools
Procedia PDF Downloads 4633702 Patient Reported Experience of in-Patient Orthognathic Care in an NHS Hospital, in Comparison to a Private Hospital
Authors: R. Litt, A. Kana, K. House
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The primary aim of this patient-related experience questionnaire was to gain a better understanding of our patients' experience as inpatients when they undergo orthognathic surgery. The secondary aim of this study was to identify ways in which we can improve the orthognathic inpatient experience and to share this with other units. All patients who received orthognathic surgery at an NHS hospital - Bristol Royal Infirmary, England, over the course of 6 months were asked to complete a questionnaire regarding their care. This data was then analysed and compared to the same questionnaire given to patients treated in a private hospital where orthognathic surgery was completed. All treatment was completed by the same surgeon. The design of the questions took into account NICE (National Institute for Health and Care Excellence) guidance on improving the experience of patient care. Particularly taking into account patients' essential requirements of care, for example, assessing and managing pain, ensuring adequate and appropriate nutrition, and ensuring the patients' personal needs are regularly reviewed and addressed. Overall the patient-related experience after orthognathic surgery was comparable in both the NHS and private hospitals. However, the questionnaire highlighted aspects of inpatient care after orthognathic surgery that can easily be improved in order to provide our patients with the best possible care.Keywords: orthognathic surgery, patient feedback, jaw surgery, inpatient experience
Procedia PDF Downloads 1493701 Eco Scale: A Tool for Assessing the Greenness of Pharmaceuticals Analysis
Authors: Heba M. Mohamed
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Owing to scientific and public concern about health and environment and seeking for a better quality of life; “Green”, “Environmentally” and “Eco” friendly practices have been presented and implemented in different research areas. Subsequently, researchers’ attention is drawn in the direction of greening the analytical methodologies and taking the Green Analytical Chemistry principles (GAC) into consideration. It is of high importance to appraise the environmental impact of each of the implemented green approaches. Compared to the other traditional green metrics (E-factor, Atom economy and the process profile), the eco scale is the optimum choice to assess the environmental impact of the analytical procedures used for pharmaceuticals analysis. For analytical methodologies, Eco-Scale is calculated by allotting penalty points to any factor of the used analytical procedure which disagree and not match with the model green analysis, where the perfect green analysis has its Eco-Scale value of 100. In this work, calculation and comparison of the Eco-Scale for some of the reported green analytical methods was done, to accentuate their greening potentials. Where the different scores can reveal how green the method is, compared to the ideal value. The study emphasizes that greenness measurement is not only about the waste quantity determination but also dictates a holistic scheme, considering all factors.Keywords: eco scale, green analysis, environmentally friendly, pharmaceuticals analysis
Procedia PDF Downloads 4383700 Tensile and Bond Characterization of Basalt-Fabric Reinforced Alkali Activated Matrix
Authors: S. Candamano, A. Iorfida, F. Crea, A. Macario
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Recently, basalt fabric reinforced cementitious composites (FRCM) have attracted great attention because they result to be effective in structural strengthening and cost/environment efficient. In this study, authors investigate their mechanical behavior when an inorganic matrix, belonging to the family of alkali-activated binders, is used. In particular, the matrix has been designed to contain high amounts of industrial by-products and waste, such as Ground Granulated Blast Furnace Slag (GGBFS) and Fly Ash. Fresh state properties, such as workability, mechanical properties and shrinkage behavior of the matrix have been measured, while microstructures and reaction products were analyzed by Scanning Electron Microscopy and X-Ray Diffractometry. Reinforcement is made up of a balanced, coated bidirectional fabric made out of basalt fibres and stainless steel micro-wire, with a mesh size of 8x8 mm and an equivalent design thickness equal to 0.064 mm. Mortars mixes have been prepared by maintaining constant the water/(reactive powders) and sand/(reactive powders) ratios at 0.53 and 2.7 respectively. An appropriate experimental campaign based on direct tensile tests on composite specimens and single-lap shear bond test on brickwork substrate has been thus carried out to investigate their mechanical behavior under tension, the stress-transfer mechanism and failure modes. Tensile tests were carried out on composite specimens of nominal dimensions equal to 500 mm x 50 mm x 10 mm, with 6 embedded rovings in the loading direction. Direct shear tests (DST) were carried out on brickwork substrate using an externally bonded basalt-FRCM composite strip 10 mm thick, 50 mm wide and a bonded length of 300 mm. Mortars exhibit, after 28 days of curing, an average compressive strength of 32 MPa and flexural strength of 5.5 MPa. Main hydration product is a poorly crystalline aluminium-modified calcium silicate hydrate (C-A-S-H) gel. The constitutive behavior of the composite has been identified by means of direct tensile tests, with response curves showing a tri-linear behavior. Test results indicate that the behavior is mainly governed by cracks development (II) and widening (III) up to failure. The ultimate tensile strength and strain were respectively σᵤ = 456 MPa and ɛᵤ= 2.20%. The tensile modulus of elasticity in stage III was EIII= 41 GPa. All single-lap shear test specimens failed due to composite debonding. It occurred at the internal fabric-to-matrix interface, and it was the result of a fracture of the matrix between the fibre bundles. For all specimens, transversal cracks were visible on the external surface of the composite and involved only the external matrix layer. This cracking appears when the interfacial shear stresses increase and slippage of the fabric at the internal matrix layer interface occurs. Since the external matrix layer is bonded to the reinforcement fabric, it translates with the slipped fabric. Average peak load around 945 N, peak stress around 308 MPa and global slip around 6 mm were measured. The preliminary test results allow affirming that Alkali-Activated Materials can be considered a potentially valid alternative to traditional mortars in designing FRCM composites.Keywords: Alkali-activated binders, Basalt-FRCM composites, direct shear tests, structural strengthening
Procedia PDF Downloads 1293699 The Roots of Amazonia’s Droughts and Floods: Complex Interactions of Pacific and Atlantic Sea-Surface Temperatures
Authors: Rosimeire Araújo Silva, Philip Martin Fearnside
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Extreme droughts and floods in the Amazon have serious consequences for natural ecosystems and the human population in the region. The frequency of these events has increased in recent years, and projections of climate change predict greater frequency and intensity of these events. Understanding the links between these extreme events and different patterns of sea surface temperature in the Atlantic and Pacific Oceans is essential, both to improve the modeling of climate change and its consequences and to support efforts of adaptation in the region. The relationship between sea temperatures and events in the Amazon is much more complex than is usually assumed in climatic models. Warming and cooling of different parts of the oceans, as well as the interaction between simultaneous temperature changes in different parts of each ocean and between the two oceans, have specific consequences for the Amazon, with effects on precipitation that vary in different parts of the region. Simplistic generalities, such as the association between El Niño events and droughts in the Amazon, do not capture this complexity. We investigated the variability of Sea Surface Temperature (SST) in the Tropical Pacific Ocean during the period 1950-2022, using Empirical Orthogonal Functions (FOE), spectral analysis coherence and wavelet phase. The two were identified as the main modes of variability, which explain about 53,9% and 13,3%, respectively, of the total variance of the data. The spectral and coherence analysis and wavelets phase showed that the first selected mode represents the warming in the central part of the Pacific Ocean (the “Central El Niño”), while the second mode represents warming in the eastern part of the Pacific (the “Eastern El Niño The effects of the 1982-1983 and 1976-1977 El Niño events in the Amazon, although both events were characterized by an increase in sea surface temperatures in the Equatorial Pacific, the impact on rainfall in the Amazon was distinct. In the rainy season, from December to March, the sub-basins of the Japurá, Jutaí, Jatapu, Tapajós, Trombetas and Xingu rivers were the regions that showed the greatest reductions in rainfall associated with El Niño Central (1982-1983), while the sub-basins of the Javari, Purus, Negro and Madeira rivers had the most pronounced reductions in the year of Eastern El Niño (1976-1977). In the transition to the dry season, in April, the greatest reductions were associated with the Eastern El Niño year for the majority of the study region, with the exception only of the sub-basins of the Madeira, Trombetas and Xingu rivers, which had their associated reductions to Central El Niño. In the dry season from July to September, the sub-basins of the Japurá Jutaí Jatapu Javari Trombetas and Madeira rivers were the rivers that showed the greatest reductions in rainfall associated with El Niño Central, while the sub-basins of the Tapajós Purus Negro and Xingu rivers had the most pronounced reductions. In the Eastern El Niño year this season. In this way, it is possible to conclude that the Central (Eastern) El Niño controlled the reductions in soil moisture in the dry (rainy) season for all sub-basins shown in this study. Extreme drought events associated with these meteorological phenomena can lead to a significant increase in the occurrence of forest fires. These fires have a devastating impact on Amazonian vegetation, resulting in the irreparable loss of biodiversity and the release of large amounts of carbon stored in the forest, contributing to the increase in the greenhouse effect and global climate change.Keywords: sea surface temperature, variability, climate, Amazon
Procedia PDF Downloads 633698 HPLC-UV Screening of Legal (Caffeine and Yohimbine) and Illegal (Ephedrine and Sibutramine) Substances from Weight Loss Dietary Supplements for Athletes
Authors: Amelia Tero-Vescan, Camil-Eugen Vari, Laura Ciulea, Cristina Filip, Silvia Imre
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A HPLC –UV method for the identification of ephedrine (EPH), sibutramine (SB), yohimbine (Y) and caffeine (CF) was developed. Separation was performed on a Kromasil 100-RP8, 150 mm x 4.6 mm, 5 mm column equipped with a precolumn Kromasil RP 8. Mobile phase was a gradient of 80-35 % sodium dihydrogen phosphate pH=5 with NH4OH and acetonitrile over 15 minutes time of analysis. Based on the responses of 113 athletes about dietary supplements (DS) consumed for "fat burning" and weight loss which have a legal status in Romania, 28 supplements have been selected and investigated for their content in CF, Y, legal substances, and SB, EPH (prohibited substances in DS). The method allows quantitative determination of the four substances in a short analysis time and with minimum cost. The presence of SB and EPH in the analyzed DS was not detected while the content in CF and Y considering the dosage recommended by the manufacturer does not affect the health of the consumers. DS labeling (plant extracts with CF and Y content) allows manufacturers to avoid declaring correct and exact amounts per pharmaceutical form (pure CF or equivalent and Y, respectively).Keywords: dietary supplements, sibutramine, ephedrine, yohimbine, caffeine, HPLC
Procedia PDF Downloads 4423697 A Foucauldian Analysis of Postcolonial Hybridity in a Kuwaiti Novel
Authors: Annette Louise Dupont
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Background and Introduction: Broadly defined, hybridity is a condition of racial and cultural ‘cross-pollination’ which arises as a result of contact between colonized and colonizer. It remains a highly contested concept in postcolonial studies as it is implicitly underpinned by colonial notions of ‘racial purity.’ While some postcolonial scholars argue that individuals exercise significant agency in the construction of their hybrid subjectivities, others underscore associated experiences of exclusion, marginalization, and alienation. Kuwait and the Philippines are among the most disparate of contemporary postcolonial states. While oil resources transformed the former British Mandate of Kuwait into one of the world’s richest countries, enduring poverty in the former US colony of the Philippines drives a global diaspora which produces multiple Filipino hybridities. Although more Filipinos work in the Arabian Gulf than in any other region of the world, scholarly and literary accounts of their experiences of hybridization in this region are relatively scarce when compared to those set in North America, Australia, Asia, and Europe. Study Aims and Significance: This paper aims to address this existing lacuna by investigating hybridity and other postcolonial themes in a novel by a Kuwaiti author which vividly portrays the lives of immigrants and citizens in Kuwait and which gives a rare voice and insight into the struggles of an Arab-Filipino and European-Filipina. Specifically, this paper explores the relationships between colonial discourses of ‘black’ and ‘white’ and postcolonial discourses pertaining to ‘brown’ Filipinos and ‘brown’ Arabs, in order to assess their impacts on the protagonists’ hybrid subjectivities. Methodology: Foucault’s notions of discourse not only provide a conceptual basis for analyzing the colonial ideology of Orientalism, but his theories related to the social exclusion of the ‘mad’ also elucidate the mechanisms by which power can operate to marginalize, alienate and subjectify the Other, therefore a Foucauldian lens is applied to the analysis of postcolonial themes and hybrid subjectivities portrayed in the novel. Findings: The study finds that Kuwaiti and Filipino discursive practices mirror those of former white colonialists and colonized black laborers and that these discursive practices combine with a former British colonial system of foreign labor sponsorship to create a form of governmentality in Kuwait which is based on exclusion and control. The novel’s rich social description and the reflections of the key protagonist and narrator suggest that such fiction has a significant role to play in highlighting the historical and cultural specificities of experiences of postcolonial hybridity in under-researched geographic, economic, social, and political settings. Whereas hybridity can appear abstract in scholarly accounts, the significance of literary accounts in which the lived experiences of hybrid protagonists are anchored to specific historical periods, places and discourses, is that contextual particularities are neither obscured nor dehistoricized. Conclusions: The application of Foucauldian theorizations of discourse, disciplinary, and biopower to the analysis of this Kuwaiti literary text serves to extend an understanding of the effects of contextually-specific discourses on hybrid Filipino subjectivities, as well as a knowledge of prevailing social dynamics in a little-researched postcolonial Arabian Gulf state.Keywords: Filipino, Foucault, hybridity, Kuwait
Procedia PDF Downloads 1283696 Are SMS Reminders an Precursor to Outpatient Show-Ups?
Authors: Shankar M. Bakkannavar, Smitha Nayak, Vinod C. Nayak, Ravi Bagali
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Attendance rate for hospital outpatient appointments plays a pivotal role in operational efficiency of a hospital. Strategic interventions like ‘reminder systems’ prior to the scheduled appointment has proved to be an effective strategy for outpatient appointment ‘show-ups’. This study is designed with an objective to assess the effectiveness of SMS reminders as an intervention to enhance the effectiveness of hospital outpatient attendance. Method: The survey was conducted at Columbia Asia Hosiptal, Bangalore. We surveyed 60 patients who had a scheduled outpatient appointment in Department of General Medicine, Department of Obstetrics and Gynecology and the Orthopedics department, as these departments had a heavy patient flow and had higher contributions to the top line of the hospital. Results: Majority (64%) of the patients preferred to be sent an SMS reminder on the outpatient appointment schedule. 37 (61%) respondents stated that the ideally, reminders could be effective only if they are sent 24-48 hours prior to the appointment schedule. 41(68%) respondents were of the opinion that a minimum of two reminders would be necessary to ensure patients show up for the appointment. 1% level of significance. It also observed that there is strong association between age and preference on mode of reminder (P=0.002).Keywords: reminder systems, appointment show-ups, SMS reminders, health Information
Procedia PDF Downloads 3543695 Potential Impacts of Invasive House Crows (Corvus splendens) Bird Species in Ismailia Governorate, Egypt: Ecology, Control and Risk Management
Authors: Atef Mohamed Kamel Ahmed
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House crows (Corvus splendens) have become well-established in Ismailia Governorate, Egypt, where they pose several and serious impacts on native biodiversity, ecosystems and humans health. However, there is a lack of literature on the status and effects of invasive birds in Egypt. Over the past 10 years in Ismailia, House crow have increased at a rate approaching (60000 birds)15% per annum; if this were allowed to continue, the population now 10909 birds and will exceed more by 2013, probably accompanied by an increase in geographical distribution in all Suez canal regions and an exacerbation of the problems caused. Population control is recommended, involving improvements in urban hygiene and the capture of adult crows using stupefying baits. Suitable baits and stupefacient doses were identified and these should be used annually, just before the breeding season. Control should be accompanied by studies of relevant aspects of the biology of house crows in Ismailia Governorate.Keywords: environmental impact t, non-native invasive species, House crow birds, risk management, Ismailia-Egypt
Procedia PDF Downloads 4723694 Towards the Ideal Life: Quantitative Study on the Impact of Social Enterprises towards Their Employees
Authors: Joseph Daniel Lumain
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The Philippine business sector has witnessed the emergence of a new category that distinguishes itself from the common framework that most enterprises utilize as this new emerging player incorporates social needs as part of its mission and goals. Various literature has manifested the relevance of social enterprises as an instrument towards poverty alleviation, as it concretely increases the capabilities of individuals. This study aims to identify whether or not social enterprises creates an impact towards their employees by positively influencing their respective perceptions on their capabilities on income, health and education. Utilizing Amartya Sen’s Capabilities Framework, this study is grounded on the relationships between social enterprises and increased capabilities, and increased capabilities and developing towards living a life they truly desire. The data gathered was analyzed quantitatively, supplemented by qualitative interviews with one to two employees from the social enterprise itself. Focusing on three social enterprises found within GKonomics, or the platform of Gawad Kalinga for social enterprise development, this purposive study was able to show that employees’ perceptions on their employment positively influenced their perceptions on their capabilities, and that this result affected their improvement towards living a life they desire.Keywords: social enterprise, Amartya Sen, capabilities framework, Gawad Kalinga
Procedia PDF Downloads 4433693 Effect of Whole-Body Vibration Training on Self-Reported Physical Disability in Employees with Chronic Low-Back Pain: A Randomized Controlled Trial
Authors: Tobias Stephan Kaeding, Rebecca Schwarz, Momme Kück, Lothar Stein
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Introduction: The goal of this randomized and controlled study is to examine whether whole-body vibration (WBV) training is able to reduce self-reported physical disability in office employees with chronic low-back pain. Materials and methods: 41 subjects (68.3% female/mean age 45.5 ± 9.1 years/mean BMI 26.6 ± 5.2) were randomly allocated to an intervention group (INT (n= 21)) or a control group (CON (n=20). The INT participated in WBV training 2.5 times per week for 3 months. The primary outcome was the change in the Roland and Morris disability questionnaire (RMQ) score over the study period. In addition, secondary outcomes included changes in the Oswestry Disability Index (ODI). Results: The compliance with the intervention in the INT reached a mean of 81.1% ± 31.2% with no long-lasting unwanted side effects. We found significant positive effects of 3 months of WBV training in the INT compared to the CON regarding the RMQ (p=0.027) and the ODI (p=0.002). Conclusions: WBV training seems to be an effective, safe and suitable intervention for the reduction of the self-reported physical disability in seated working employees with chronic low-back pain.Keywords: back pain, exercise, occupational health management, vibration training
Procedia PDF Downloads 2993692 Case Report: Treatment Resistant Schizophrenia in an Immigrant Adolescent
Authors: Omaymah Al-Otoom, Rajesh Mehta
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Introduction: Migration is an established risk factor in the development of schizophrenia and other forms of psychosis. The exposure to different social adversities, including social isolation, discrimination, and economic stress, is thought to contribute to elevated rates of psychosis in immigrants and their children. We present a case of resistant schizophrenia in an immigrant adolescent. Case: The patient is a 15-year-old male immigrant. In October 2021, the patient was admitted for irritability, suicidal ideations, and hallucinations. He was treated with Fluoxetine 10 mg daily for irritability. In November 2021, he presented with similar manifestations. Fluoxetine was discontinued, and Risperidone 1 mg at bedtime was started for psychotic symptoms. In March 2022, he presented with commanding auditory hallucinations (voices telling him that people were going to kill his father). Risperidone was gradually increased to 2.5 mg twice daily for hallucinations. The outpatient provider discontinued Risperidone and started Olanzapine 7.5 mg and Lurasidone 40 mg daily. In August 2022, he presented with worsening paranoia due to medication non-adherence. The patient had limited improvement on medications. In October 2022, the patient presented to the ED for visual hallucinations and aggression towards the family. His medications were Olanzapine 10 mg daily, Lurasidone 60 mg daily, and Haloperidol 2.5 mg twice daily. In the ED, he received multiple as-needed medications and was placed in seclusion for his aggressive behavior. The patient showed a positive response to a higher dose of Olanzapine and decreased dose of Lurasidone. The patient was discharged home in stable condition. Two days after discharge, he was brought for bizarre behavior, visual hallucinations, and homicidal ideations at school. Due to concerns for potential antipsychotic side effects and poor response, Lurasidone and Olanzapine were discontinued, and he was discharged home on Haloperidol 5 mg in the morning and 15 mg in the evening. Clozapine treatment was recommended on an outpatient basis. He has no family history of psychotic disorders. He has no history of substance use. A medical workup was done, the electroencephalogram was normal, and the urine toxicology was negative. Discussion: Our patient was on three antipsychotics at some point with no improvement in his psychotic symptoms, which qualifies as treatment-resistant schizophrenia (TRP). It is well recognized that migrants are at higher risk of different psychiatric disorders, including posttraumatic stress disorder, affective disorders, schizophrenia, and psychosis. This is thought to be related to higher exposure to traumatic life events compared to the general population. In addition, migrants are more likely to experience poverty, separation from family members, and discrimination which could contribute to mental health issues. In one study, they found that people who migrated before the age of 18 had twice the risk of psychotic disorders compared to the native-born population. It is unclear whether migration increases the risk of treatment resistance. In a Canadian study, neither ethnicity nor migrant status was associated with treatment resistance; however, this study was limited by its small sample size. There is a need to implement psychiatric prevention strategies and outreach programs through research to mitigate the risk of mental health disorders among immigrants.Keywords: psychosis, immigrant, adolescent, treatment resistant schizophrenia
Procedia PDF Downloads 1163691 Urban Flood Resilience Comprehensive Assessment of "720" Rainstorm in Zhengzhou Based on Multiple Factors
Authors: Meiyan Gao, Zongmin Wang, Haibo Yang, Qiuhua Liang
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Under the background of global climate change and rapid development of modern urbanization, the frequency of climate disasters such as extreme precipitation in cities around the world is gradually increasing. In this paper, Hi-PIMS model is used to simulate the "720" flood in Zhengzhou, and the continuous stages of flood resilience are determined with the urban flood stages are divided. The flood resilience curve under the influence of multiple factors were determined and the urban flood toughness was evaluated by combining the results of resilience curves. The flood resilience of urban unit grid was evaluated based on economy, population, road network, hospital distribution and land use type. Firstly, the rainfall data of meteorological stations near Zhengzhou and the remote sensing rainfall data from July 17 to 22, 2021 were collected. The Kriging interpolation method was used to expand the rainfall data of Zhengzhou. According to the rainfall data, the flood process generated by four rainfall events in Zhengzhou was reproduced. Based on the results of the inundation range and inundation depth in different areas, the flood process was divided into four stages: absorption, resistance, overload and recovery based on the once in 50 years rainfall standard. At the same time, based on the levels of slope, GDP, population, hospital affected area, land use type, road network density and other aspects, the resilience curve was applied to evaluate the urban flood resilience of different regional units, and the difference of flood process of different precipitation in "720" rainstorm in Zhengzhou was analyzed. Faced with more than 1,000 years of rainstorm, most areas are quickly entering the stage of overload. The influence levels of factors in different areas are different, some areas with ramps or higher terrain have better resilience, and restore normal social order faster, that is, the recovery stage needs shorter time. Some low-lying areas or special terrain, such as tunnels, will enter the overload stage faster in the case of heavy rainfall. As a result, high levels of flood protection, water level warning systems and faster emergency response are needed in areas with low resilience and high risk. The building density of built-up area, population of densely populated area and road network density all have a certain negative impact on urban flood resistance, and the positive impact of slope on flood resilience is also very obvious. While hospitals can have positive effects on medical treatment, they also have negative effects such as population density and asset density when they encounter floods. The result of a separate comparison of the unit grid of hospitals shows that the resilience of hospitals in the distribution range is low when they encounter floods. Therefore, in addition to improving the flood resistance capacity of cities, through reasonable planning can also increase the flood response capacity of cities. Changes in these influencing factors can further improve urban flood resilience, such as raise design standards and the temporary water storage area when floods occur, train the response speed of emergency personnel and adjust emergency support equipment.Keywords: urban flood resilience, resilience assessment, hydrodynamic model, resilience curve
Procedia PDF Downloads 403690 Acute Toxicity of Atrazine Herbicide on Caspian Kutum, Rutilus frisii kutum larvae
Authors: Zahra Khoshnood, Reza Khoshnood
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Pesticides and drugs used in agriculture and veterinary medicine may end up in aquatic environments and bio-accumulate in the food chain, thus causing serious problems for fauna and human health. For determination of the toxic effects of atrazine herbicide on Caspian kutum, Rutilus frisii kutum larvae, the 96-h LC50 of atrazine was measured for newly hatched larvae as 18.53 ppm. Toxicity of atrazine herbicide on Caspian kutum larvae was investigated using concentrations: 9.25 ppm, 4.62 ppm and 2.31 ppm for 7 days. Comparison of the length, weight and condition factor showed that no significant differences between atrazine exposed and control groups. The concentration of Na+, K+, Ca2+, Mg2+, and Cl- in whole body of larvae in control and atrazine exposure groups were measured and the results showed that concentrations of all these ions is higher in atrazine exposure group than control group. It is obvious from this study that atrazine negatively affects osmoregulation process and changes ion compositions of the body even at sub-lethal concentration and acute exposure but have no effects on growth parameters of the body.Keywords: atrazine, caspian kutum, acute toxicity, body ions, lc50
Procedia PDF Downloads 2973689 Traumatic Brain Injury Neurosurgical Care Continuum Delays in Mulago Hospital in Kampala Uganda
Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund
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Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury
Procedia PDF Downloads 2203688 The Safe Introduction of Tocilizumab for the Treatment of SARS-CoV-2 Pneumonia at an East London District General Hospital
Authors: Andrew Read, Alice Parry, Kate Woods
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Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoingKeywords: education, patient safety , SARS-CoV-2, Tocilizumab
Procedia PDF Downloads 1753687 Analyzing Success Factors of Canadian Play-Based Intervention Programs for Children with Different Abilities: A Comparative Study
Authors: Shuaa A. Mutawally, Budor H. Saigh, Ebtehal A. Mutawally
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This study aims to analyze and compare the success factors of play-based intervention programs for children with different abilities in Canada. Children with disabilities often face limited participation in play and physical activities, leading to increased health risks. Understanding the specific features of these interventions that contribute to positive outcomes is crucial to promoting holistic development in these children. A comparative case study approach was used, selecting three similar successful intervention programs through purposive sampling. Data were collected through interviews and program documents, with 40 participants purposively chosen. Thematic analysis was conducted to identify key themes, including Quality Program, Meeting the Needs of Participants, and Lessons Learned from Experts and Practitioners. These programs play a vital role in addressing the gap in community programming for children with different abilities. The results of this study contribute to the generalization of success factors derived from best practices in play-based intervention programs for children with different abilities.Keywords: children with different abilities, physical activity, play, play-based intervention programs
Procedia PDF Downloads 743686 Indigenous Storytelling: Transformation for Health, Emotions and Spirituality
Authors: Annabelle Nelson
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This literature review documents indigenous storytelling as it functions to help humans face adversity and find emotional strength by aligning with nature. Archetypes in stories can transform the inner world from a Jungian perspective. Joseph Campbell’s hero-heroine cycle depicts the structure of stories to include a call to adventure, tests, helpers, and a return as the transformed person can help him or herself and even help their communities. By showcasing certain character traits, such as bravery or perseverance or humility, stories give maps for humans to face adversity. The main characters or archetypes in stories, as Carl Jung posited, provide a vehicle that can open consciousness if a listener identifies with the character. As documented in the review, this has many benefits. First, it can open consciousness to the collective unconscious for insight and intuitive clarity, as well as healing and release emotional trauma. The resultant spacious quality of consciousness allows the spiritual self to present insights to conscious awareness. Research in applied youth development programs demonstrates the utility of storytelling to prompt healthy choices and transform difficult life experience into success.Keywords: archetypes, learning, storytelling, transformation
Procedia PDF Downloads 1883685 Bio-Efficacy of Vermiwash and Leaf Extracts against Mealy Bug, Paracoccus marginatus Hemiptera: Pseudococcidae
Authors: Radha Rajamma, Susheela Palanisamy
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The use of chemical fertilizers and pesticides has posed a serious threat to the environment, cause disturbance to the soil ecosystem, pollute the water causing serious health problems. The indigenous practices such as herbal spray, phyto-alternatives, etc. offer harmless alternatives in integrated pest management. The use of plant materials has become an integral part of insect pest management because of their cheap and non-toxic nature. Hence an investigation has been made to determine the bio-efficacy of vermiwash and two leaf extracts, Azadirachta indica and Vitex negundo against mealy bug, Paracoccus marginatus. The results on the effect of vermitechnologies on the activity of mealy bug indicated the effectiveness of vermiwash foliar application in suppressing the pest activity. Accumulative mortality of mealy bug increased gradually with the increase of exposure intervals. The combined treatment of vermiwash with Azadirachta indica reported the highest mortality percentage of 96% followed by the individual treatment of leaf extracts. Hence vermiwash was proved to be the most effective in enhancing the potency of mealy bug and decreased LC50 of the target insect.Keywords: Azadirachta indica, Paracoccus marginatus, vermiwash, Vitex negundo
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