Search results for: risk stratification tool

Authors: Jyoti Singh, Ranju Bansal

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Fighting pain and inflammation is a common problem faced by physicians while dealing with a wide variety of diseases. Since ancient time nonsteroidal anti-inflammatory agents (NSAIDs) and opioids have been the cornerstone of treatment therapy, however, the usefulness of both these classes is limited due to severe side effects. NSAIDs, which are mainly used to treat mild to moderate inflammatory pain, induce gastric irritation and nephrotoxicity whereas opioids show an array of adverse reactions such as respiratory depression, sedation, and constipation. Moreover, repeated administration of these drugs induces tolerance to the analgesic effects and physical dependence. Further discovery of selective COX-2 inhibitors (coxibs) suggested safety without any ulcerogenic side effects; however, long-term use of these drugs resulted in kidney and hepatic toxicity along with an increased risk of secondary cardiovascular effects. The basic approaches towards inflammation and pain treatment are constantly changing, and researchers are continuously trying to develop safer and effective anti-inflammatory drug candidates for the treatment of different inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriasis and multiple sclerosis. Synthetic 3(2H)-pyridazinones constitute an important scaffold for drug discovery. Structure-activity relationship studies on pyridazinones have shown that attachment of a lactam at N-2 of the pyridazinone ring through a methylene spacer results in significantly increased anti-inflammatory and analgesic properties of the derivatives. Further introduction of the heterocyclic ring at lactam nitrogen results in improvement of biological activities. Keeping in mind these SAR studies, a new series of compounds were synthesized as shown in scheme 1 and investigated for anti-inflammatory, analgesic, anti-platelet activities and docking studies. The structures of newly synthesized compounds have been established by various spectroscopic techniques. All the synthesized pyridazinone derivatives exhibited potent anti-inflammatory and analgesic activity. Homoveratryl substituted derivative was found to possess highest anti-inflammatory and analgesic activity displaying 73.60 % inhibition of edema at 40 mg/kg with no ulcerogenic activity when compared to standard drugs indomethacin. Moreover, 2-substituted-4-benzo[d][1,3]dioxole-6-phenylpyridazin-3(2H)-ones derivatives did not produce significant changes in bleeding time and emerged as safe agents. Molecular docking studies also illustrated good binding interactions at the active site of the cyclooxygenase-2 (hCox-2) enzyme.

Keywords: anti-inflammatory, analgesic, pyridazin-3(2H)-one, selective COX-2 inhibitors

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Authors: Nowrozy Jahan, Sharifah Syed Hassan, Daniel Reidpath

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In recent decades, Malaysia has become a dengue hyper-endemic country with the co-circulation of the four-dengue virus (DENV) serotypes. The number of symptomatic dengue cases is maintaining an increasing trend since 1995 and sharply increased in 2014. The four DENV serotypes have been co-circulating since 2000, and this pattern of cyclical dominance of sub-types contributed to the development of frequent major dengue epidemics in Malaysia. Since 2012, different Malaysian state was dominated by different serotypes. The study aims to estimate the burden of asymptomatic dengue in a healthy adult population which may act as a potential source of further symptomatic dengue infection. It also aims to identify the predominant DENV serotypes which are circulating at the community level. A longitudinal prospective community-based study was conducted in the Segamat district of Johor State, southern part of Malaysia where the number of reported dengue cases has steadily increased over the last three years (2013-2015). More specifically, the study was conducted in and around of Kampung Abdullah of Sungai Segamat sub-district which was identified as a hot spot area over the period of 2013-2015. This community-based study has been conducted by Southeast Asia Community Observatory (SEACO), an ISO-certified research platform in collaboration of the Ministry of Health Malaysia and Monash University Malaysia. It was conducted from May 2015 to May 2016. In this study, 277 apparently looking healthy respondents joined who were followed up as a cohort for four times during the one-year study period. Blood was collected to detect the serological marker of dengue at each round of follow-up. Among 277, 184 respondents (66%) joined all four rounds. Half of the study respondents were at the age-group of 45-64 years, slightly more than half of the respondents (59%) were female, and the most (69%) of them were Malay; only 35% lived in urban areas. During the baseline, the study found a very high prevalence of exposure to dengue virus; 89% of the study respondents had serological evidence of previous asymptomatic dengue infection; the majority of them did not know about it as they did not develop any symptom of dengue fever; only 13% knew as they developed symptoms. At the end of the one-year study period, 19% of respondents developed recent secondary dengue infection which was also identified by the serological marker as they did not develop any symptom (asymptomatic cases). The asymptomatic dengue incidence was higher during the rainy season compared to the dry season. All four dengue serotypes were identified in the serum of the infected respondents; among them, DENV-2 was the most prominent. Further genetic analysis is going on to identify the association of HLA-B*46 and HLA-DRB1*08 with dengue resistance. This study provides evidence for the policymakers to be aware of asymptomatic dengue infection, to develop a useful tool for raising awareness about asymptomatic dengue infection among the general population, to monitor the community participation to strengthen the individual and community level dengue prevention and control measures when neither there is vaccine nor particular treatment for dengue.

Keywords: asymptomatic, dengue, health adults, prospective study

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Authors: U. Thisara G. Perera, C. M. Kanchana N. K. Chandrasekara

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Dengue is an epidemic which is spread by Aedes Egyptai and Aedes Albopictus mosquitoes. The cases of dengue show a dramatic growth rate of the epidemic in urban and semi urban areas spatially in tropical and sub-tropical regions of the world. Incidence of dengue has become a prominent reason for hospitalization and deaths in Asian countries, including Sri Lanka. During the last decade the dengue epidemic began to spread from urban to semi-urban and then to rural settings of the country. The highest number of dengue infected patients was recorded in Sri Lanka in the year 2016 and the highest number of patients was identified in Colombo district. Together with the commercial, industrial, and other supporting services, the district suffers from rapid urbanization and high population density. Thus, drainage and waste disposal patterns of the people in this area exert an additional pressure to the environment. The district is situated in the wet zone and thus low lying lands constitute the largest portion of the district. This situation additionally facilitates mosquito breeding sites. Therefore, the purpose of the present study was to assess the spatial and temporal distribution patterns of dengue epidemic in Kolonnawa MOH area (Medical Officer of Health) in the district of Colombo. The study was carried out using 615 recorded dengue cases in Kollonnawa MOH area during the south east monsoon season from May to September 2016. The Moran’s I and Kernel density estimation were used as analytical methods. The analysis of data was accomplished through the integrated use of ArcGIS 10.1 software packages along with Microsoft Excel analytical tool. Field observation was also carried out for verification purposes during the study period. Results of the Moran’s I index indicates that the spatial distribution of dengue cases showed a cluster distribution pattern across the area. Kernel density estimation emphasis that dengue cases are high where the population has gathered, especially in areas comprising housing schemes. Results of the Kernel Density estimation further discloses that hot spots of dengue epidemic are located in the western half of the Kolonnawa MOH area, which is close to the Colombo municipal boundary and there is a significant relationship with high population density and unplanned urban land use practices. Results of the field observation confirm that the drainage systems in these areas function poorly and careless waste disposal methods of the people further encourage mosquito breeding sites. This situation has evolved harmfully from a public health issue to a social problem, which ultimately impacts on the economy and social lives of the country.

Keywords: Dengue epidemic, health hazards, Kernel density, Moran’s I, Sri Lanka

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Authors: Jenn Gallup, Onur Kocaoz, Onder Islek

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In their pursuit of postsecondary transitions, individuals with disabilities tend to experience, academic, behavioral, and emotional challenges to a greater extent than their typically developing peers. These challenges result in lower rates of graduation, employment, independent living, and participation in college than their peers without disabilities. The lack of friendships and support systems has had a negative impact on those with a disability transitioning to postsecondary settings to include, employment, independent living, and university settings. Establishing friendships and support systems early on is an indicator of potential success and persistence in postsecondary education, employment, and independent living for typically developing college students. It is evident that a deficit in friendships and supports is a key deficit also for individuals with disabilities. To address the specific needs of this group, a mentor program was developed for a transition program held at the university for youth aged 18-21. Pre-service teachers enrolled in the special education program engaged with youth in the transition program in a variety of activities on campus. The mentorship program had two purposes: to assist young adults with disabilities who were transitioning to a workforce setting to help increase social skills, self-advocacy, supports and friendships, and confidence; and to give their peers without disabilities who were enrolled in a secondary special education course as a pre-service teacher the experience of interacting with and forming friendships with peers who had a disability for the purposes of career development. Additionally, according to researchers mobile technology has created a virtual world of equality and opportunity for a large segment of the population that was once marginalized due to physical and cognitive impairments. All of the participants had access to smart phones; therefore, technology was explored during this study to determine if it could be used as a compensatory tool to allow the young adults with disabilities to do things that otherwise would have been difficult because of their disabilities. Additionally, all participants were asked to incorporate technology such as smart phones to communicate beyond the activities, collaborate using virtual platform games which would support and promote social skills, soft-skills, socialization, and relationships. The findings of this study confirmed that a peer mentorship program that harnessed the power of technology supported outcomes specific to young adults with and without disabilities. Mobile technology and virtual game-based platforms, were identified as a significant contributor to personal, academic, and career growth for both groups. The technology encouraged friendships, provided an avenue for rich social interactions, and increased soft-skills. Results will be shared along with the development of the program and potential implications to the field.

Keywords: career outcomes, mentorship, soft-skills, technology, transition

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Authors: Rozelle Labuschagne, Ronel Roos

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Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

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Authors: Baye Berihun Getahun, Mulugeta Atnaf Tiruneh, Richard G. F. Visser

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Resource-poor farmers practice low-input farming systems, and yet, most breeding programs give less attention to this huge farming system, which serves as a source of food and income for several people in developing countries. The high-input conventional breeding system appears to have failed to adequately meet the needs and requirements of 'difficult' environments operating under this system. Moreover, the unavailability of resources for crop production is getting for their peaks, the environment is maltreated by excessive use of agrochemicals, crop productivity reaches its plateau stage, particularly in the developed nations, the world population is increasing, and food shortage sustained to persist for poor societies. In various parts of the world, genetic gain at the farmers' level remains low which could be associated with low adoption of crop varieties, which have been developed under high input systems. Farmers usually use their local varieties and apply minimum inputs as a risk-avoiding and cost-minimizing strategy. This evidence indicates that the conventional high-input plant breeding system has failed to feed the world population, and the world is moving further away from the United Nations' goals of ending hunger, food insecurity, and malnutrition. In this review, we discussed the rationality of focused breeding programs for low-input farming systems and, the technical aspect of crop breeding that accommodates future food needs and its significance for developing countries in the decreasing scenario of resources required for crop production. To this end, the application of exotic introgression techniques like polyploidization, pan-genomics, comparative genomics, and De novo domestication as a pre-breeding technique has been discussed in the review to exploit the untapped genetic diversity of the crop wild relatives (CWRs). Desired recombinants developed at the pre-breeding stage are exploited through appropriate breeding approaches such as evolutionary plant breeding (EPB), rhizosphere-related traits breeding, and participatory plant breeding approaches. Populations advanced through evolutionary breeding like composite cross populations (CCPs) and rhizosphere-associated traits breeding approach that provides opportunities for improving abiotic and biotic soil stress, nutrient acquisition capacity, and crop microbe interaction in improved varieties have been reviewed. Overall, we conclude that low input farming system is a huge farming system that requires distinctive breeding approaches, and the exotic pre-breeding introgression techniques and the appropriate breeding approaches which deploy the skills and knowledge of both breeders and farmers are vital to develop heterogeneous landrace populations, which are effective for farmers practicing low input farming across the world.

Keywords: low input farming, evolutionary plant breeding, composite cross population, participatory plant breeding

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Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

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Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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Authors: Brayan S. Pabón, R. Ricardo Moreno, Edith Gonzalez

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Inside the wide Colombian natural fiber set is the banana stem leaf, known as Calceta de Plátano, which is a material present in several regions of the country and is a fiber extracted from the pseudo stem of the banana plant (Musa paradisiaca) as a regular maintenance process. Colombia had a production of 2.8 million tons in 2007 and 2008 corresponding to 8.2% of the international production, number that is growing. This material was selected to be studied because it is not being used by farmers due to it being perceived as a waste from the banana harvest and a propagation pest agent inside the planting. In addition, the Calceta does not have industrial applications in Colombia since there is not enough concrete knowledge that informs us about the properties of the material and the possible applications it could have. Based on this situation the industrial design is used as a link between the properties of the material and the need to transform it into industrial products for the market. Therefore, the project identifies potential design attributes that the banana stem leaf can have for product development. The methodology was divided into 2 main chapters: Methodology for the material recognition: -Data Collection, inquiring the craftsmen experience and bibliography. -Knowledge in practice, with controlled experiments and validation tests. -Creation of design attributes and material profile according to the knowledge developed. Moreover, the Design methodology: -Application fields selection, exploring the use of the attributes and the relation with product functions. -Evaluating the possible fields and selection of the optimum application. -Design Process with sketching, ideation, and product development. Different protocols were elaborated to qualitatively determine some material properties of the Calceta, and if they could be designated as design attributes. Once defined, performed and analyzed the validation protocols, 25 design attributes were identified and classified into 4 attribute categories (Environmental, Functional, Aesthetics and Technical) forming the material profile. Then, 15 application fields were defined based on the relation between functions of product and the use of the Calceta attributes. Those fields were evaluated to measure how much are being used the functional attributes. After fields evaluation, a final field was defined , influenced by traditional use of the fiber for packing food. As final result, two products were designed for this application field. The first one is the Multiple Container, which works to contain small or large-thin pieces of food, like potatoes chips or small sausages; it allows the consumption of food with sauces or dressings. The second is the Chorizo container, specifically designed for this food due to the long shape and the consumption mode. Natural fiber research allows the generation of a solider and a more complete knowledge about natural fibers. In addition, the research is a way to strengthen the identity through the investigation of the proper and autochthonous, allowing the use of national resources in a sustainable and creative way. Using divergent thinking and the design as a tool, this investigation can achieve advances in the natural fiber handling.

Keywords: banana stem leaf, Calceta de Plátano, design attributes, natural fibers, product design

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Authors: Rafael Sousa Santos, Clara Pimena Do Vale, Barbara Bogoni, Poul Henning Kirkegaard

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The representative component, a determining aspect of the architect's training, has been marked by an exponential and unprecedented development. However, the multiplication of possibilities has also multiplied uncertainties about architectural design teaching, and by extension, about the very principles of architectural education. In this paper, it is intended to present the results of a research developed on the following problem: the relation between the forms of representation and the architectural design teaching-learning processes. The research had as its object the educational model of two schools – the Politecnico di Milano (POLIMI) and the Faculty of Architecture of the University of Porto (FAUP) – and was led by three main objectives: to characterize the educational model followed in both schools focused on the representative component and its role; to interpret the relation between forms of representation and the architectural design teaching-learning processes; to consider their possibilities of valorisation. Methodologically, the research was conducted according to a qualitative embedded multiple-case study design. The object – i.e., the educational model – was approached in both POLIMI and FAUP cases considering its Context and three embedded unities of analysis: the educational Purposes, Principles, and Practices. In order to guide the procedures of data collection and analysis, a Matrix for the Characterization (MCC) was developed. As a methodological tool, the MCC allowed to relate the three embedded unities of analysis with the three main sources of evidence where the object manifests itself: the professors, expressing how the model is assumed; the architectural design classes, expressing how the model is achieved; and the students, expressing how the model is acquired. The main research methods used were the naturalistic and participatory observation, in-person-interview and documentary and bibliographic review. The results reveal the importance of the representative component in the educational model of both cases, despite the differences in its role. In POLIMI's model, representation is particularly relevant in the teaching of architectural design, while in FAUP’s model, it plays a transversal role – according to an idea of 'general training through hand drawing'. In fact, the difference between models relative to representation can be partially understood by the level of importance that each gives to hand drawing. Regarding the teaching of architectural design, the two cases are distinguished in the relation with the representative component: while in POLIMI the forms of representation serve essentially an instrumental purpose, in FAUP they tend to be considered also for their methodological dimension. It seems that the possibilities for valuing these models reside precisely in the relation between forms of representation and architectural design teaching. It is expected that the knowledge base developed in this research may have three main contributions: to contribute to the maintenance of the educational model of POLIMI and FAUP; through the precise description of the methodological procedures, to contribute by transferability to similar studies; through the critical and objective framework of the problem underlying the forms of representation and its relation with architectural design teaching, to contribute to the broader discussion concerning the contemporary challenges on architectural education.

Keywords: architectural design teaching, architectural education, educational models, forms of representation

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Authors: Celestine Odigwe, Epoke Lincoln, Rhoda-Dara Ephraim

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Background; Immunization against the childhood killer diseases is the cardinal strategy for the prevention of these diseases all over the world in under five children, these diseases include; Tuberculosis, Measles, Polio, Tetanus, Diphthria, Pertusis, Yellow Fever, Hepatitis B, Haemophilus Influenza type B. 6.9 million children die before their fifth birthday , 80% of the worlds death in children under 5 years occur in 25 countries most in Africa and Asia and 2 million children can be saved each year with routine immunization Therefore failure to achieve total immunization coverage puts several children at risk. Aim; The aim of the study was to ascertain the prevalence, Investigate the various reasons and causes why several under five children in a suburb of calabar municipal county fail to get the required immunizations as at and when due and possibly the consequences, so that efforts can be re-directed towards the solution of the problems so identified. Methods; the study was a community based cross sectional study. The respondents were the mothers/guardians of the sampled children who were all aged 0-59 months. To be eligible for recruitment into the study, the parent or guardian was required to give an informed consent, reside within the Calabar South County with his/her children aged 0-59 months. We calculated our sample size using the Leslie-Kish formula and we used a two-staged sampling method, first to ballot for the wards to be involved and then to select four of the most populated ones in the wards chosen. Data collection was by interviewer administered structured questionnaire (Appendix I), Data collected was entered and analyzed using Statistical Package for the Social Sciences (SPSS) Version 20. Percentages were calculated and represented using charts and tables Results; The number of children sampled was 159. We found that 150 were fully immunized and 9 were not, the prevalence of missed opportunity was 32% from the study. The reasons for missed opportunities were varied, ranging from false contraindications, logistical problems resulting in very poor access roads to health facilities and poor organization of health centers together with negative health worker attitudes. Some of the consequences of these missed opportunities were increased susceptibility to vaccine preventable diseases, resurgence of the above diseases and increased morbidity and mortality of children aged less than 5 years. Conclusion; We found that ignorance on the part of both parents/guardians and health care staff together with infrastructural inadequacies in the county such as- roads, poor electric power supply for storage of vaccines were hugely responsible for most missed opportunities for immunization. The details of these and suggestions for improvement and the way forward are discussed.

Keywords: missed opportunity, immunization, under five, Calabar south

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Authors: Seung Ah Lee, Sunghyun Cho, Kyong Mee Chung

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Rapid population aging became a worldwide demographic phenomenon due to rising life expectancy and declining fertility rates. Considering the current increasing rate of population aging, it is assumed that Korean society enters into a ‘super-aged’ society in 10 years, in which people aged 65 years or older account for more than 20% of entire population. In line with this trend, ICT services aimed to help elderly people to improve the quality of life have been suggested. However, existing ICT services mainly focus on supporting health or nursing care and are somewhat limited to meet a variety of specialized needs and challenges of this population. It is pointed out that the majority of services have been driven by technology-push policies. Given that the usage of ICT services greatly vary on individuals’ socio-economic status (SES), physical and psychosocial needs, this study systematically categorized elderly population into sub-groups and identified their needs and characteristics related to ICT usage in detail. First, three assessment criteria (demographic variables including SES, cognitive functioning level, and emotional functioning level) were identified based on previous literature, experts’ opinions, and focus group interview. Second, survey questions for needs assessment were developed based on the criteria and administered to 600 respondents from a national probability sample. The questionnaire consisted of 67 items concerning demographic information, experience on ICT services and information technology (IT) devices, quality of life and cognitive functioning, etc. As the result of survey, age (60s, 70s, 80s), education level (college graduates or more, middle and high school, less than primary school) and cognitive functioning level (above the cut-off, below the cut-off) were considered the most relevant factors for categorization and 18 sub-groups were identified. Finally, 18 sub-groups were clustered into 3 groups according to following similarities; computer usage rate, difficulties in using ICT, and familiarity with current or previous job. Group 1 (‘active users’) included those who with high cognitive function and educational level in their 60s and 70s. They showed favorable and familiar attitudes toward ICT services and used the services for ‘joyful life’, ‘intelligent living’ and ‘relationship management’. Group 2 (‘potential users’), ranged from age of 60s to 80s with high level of cognitive function and mostly middle to high school graduates, reported some difficulties in using ICT and their expectations were lower than in group 1 despite they were similar to group 1 in areas of needs. Group 3 (‘limited users’) consisted of people with the lowest education level or cognitive function, and 90% of group reported difficulties in using ICT. However, group 3 did not differ from group 2 regarding the level of expectation for ICT services and their main purpose of using ICT was ‘safe living’. This study developed a systematic needs assessment tool and identified three sub-groups of elderly ICT users based on multi-criteria. It is implied that current cognitive function plays an important role in using ICT and determining needs among the elderly population. Implications and limitations were further discussed.

Keywords: elderly population, ICT, needs assessment, population aging

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Authors: Mia Bahar, Özlem Bozkurt

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Obsessive-compulsive disorder (OCD) is a typical, persistent, and long-lasting mental health condition in which a person experiences uncontrollable, recurrent thoughts (or "obsessions") and/or activities (or "compulsions") that they feel compelled to engage in repeatedly. Obsessive-compulsive disorder is both underdiagnosed and undertreated. It frequently manifests in a variety of medical settings and is persistent, expensive, and burdensome. Obsessive-compulsive neurosis was long believed to be a condition that offered valuable insight into the inner workings of the unconscious mind. Obsessive-compulsive disorder is now recognized as a prime example of a neuropsychiatric condition susceptible to particular pharmacotherapeutic and psychotherapy therapies and mediated by pathology in particular neural circuits. An obsessive-compulsive disorder which is called OCD, usually has two components, one cognitive and the other behavioral, although either can occur alone. Obsessions are often repetitive and intrusive thoughts that invade consciousness. These obsessions are incredibly hard to control or dismiss. People who have OCD often engage in rituals to reduce anxiety associated with intrusive thoughts. Once the ritual is formed, the person may feel extreme relief and be free from anxiety until the thoughts of contamination intrude once again. These thoughts are strengthened through a manifestation of negative reinforcement because they allow the person to avoid anxiety and obscurity. These thoughts are described as autogenous, meaning they most likely come from nowhere. These unwelcome thoughts are related to actions which we can describe as Thought Action Fusion. The thought becomes equated with an action, such as if they refuse to perform the ritual, something bad might happen, and so people perform the ritual to escape the intrusive thought. In almost all cases of OCD, the person's life gets extremely disturbed by compulsions and obsessions. Studies show OCD is an estimated 1.1% prevalence, making it a challenging issue with high co-morbidities with other issues like depressive episodes, panic disorders, and specific phobias. The first to reveal brain anomalies in OCD were numerous CT investigations, although the results were inconsistent. A few studies have focused on the orbitofrontal cortex (OFC), anterior cingulate gyrus (AC), and thalamus, structures also implicated in the pathophysiology of OCD by functional neuroimaging studies, but few have found consistent results. However, some studies have found abnormalities in the basal ganglion. There have also been some discussions that OCD might be genetic. OCD has been linked to families in studies of family aggregation, and findings from twin studies show that this relationship is somewhat influenced by genetic variables. Some Research has shown that OCD is a heritable, polygenic condition that can result from de novo harmful mutations as well as common and unusual variants. Numerous studies have also presented solid evidence in favor of a significant additive genetic component to OCD risk, with distinct OCD symptom dimensions showing both common and individual genetic risks.

Keywords: compulsions, obsessions, neuropsychiatric, genetic

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Authors: Muzaffar Shaikh, Shoaib Shaikh, Mark Moyou, Gaby Hawat

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This paper presents the use of Analytic Hierarchy Process (AHP) in evaluating the site selection of a new plant by a corporation. Due to intense competition at a global level, multinational corporations are continuously striving to minimize production and shipping costs of their products. One key factor that plays significant role in cost minimization is where the production plant is located. In the U.S. for example, labor and land costs continue to be very high while they are much cheaper in countries such as India, China, Indonesia, etc. This is why many multinational U.S. corporations (e.g. General Electric, Caterpillar Inc., Ford, General Motors, etc.), have shifted their manufacturing plants outside. The continued expansion of the Internet and its availability along with technological advances in computer hardware and software all around the globe have facilitated U.S. corporations to expand abroad as they seek to reduce production cost. In particular, management of multinational corporations is constantly engaged in concentrating on countries at a broad level, or cities within specific countries where certain or all parts of their end products or the end products themselves can be manufactured cheaper than in the U.S. AHP is based on preference ratings of a specific decision maker who can be the Chief Operating Officer of a company or his/her designated data analytics engineer. It serves as a tool to first evaluate the plant site selection criteria and second, alternate plant sites themselves against these criteria in a systematic manner. Examples of site selection criteria are: Transportation Modes, Taxes, Energy Modes, Labor Force Availability, Labor Rates, Raw Material Availability, Political Stability, Land Costs, etc. As a necessary first step under AHP, evaluation criteria and alternate plant site countries are identified. Depending upon the fidelity of analysis, specific cities within a country can also be chosen as alternative facility locations. AHP experience in this type of analysis indicates that the initial analysis can be performed at the Country-level. Once a specific country is chosen via AHP, secondary analyses can be performed by selecting specific cities or counties within a country. AHP analysis is usually based on preferred ratings of a decision-maker (e.g., 1 to 5, 1 to 7, or 1 to 9, etc., where 1 means least preferred and a 5 means most preferred). The decision-maker assigns preferred ratings first, criterion vs. criterion and creates a Criteria Matrix. Next, he/she assigns preference ratings by alternative vs. alternative against each criterion. Once this data is collected, AHP is applied to first get the rank-ordering of criteria. Next, rank-ordering of alternatives is done against each criterion resulting in an Alternative Matrix. Finally, overall rank ordering of alternative facility locations is obtained by matrix multiplication of Alternative Matrix and Criteria Matrix. The most practical aspect of AHP is the ‘what if’ analysis that the decision-maker can conduct after the initial results to provide valuable sensitivity information of specific criteria to other criteria and alternatives.

Keywords: analytic hierarchy process, multinational corporations, plant site selection, preference ratings

Procedia PDF Downloads 275

Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

Procedia PDF Downloads 117

Authors: André Jesus, Yanjie Zhu, Irwanda Laory

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Structural health monitoring is one of the most promising technologies concerning aversion of structural risk and economic savings. Analysts often have to deal with a considerable variety of uncertainties that arise during a monitoring process. Namely the widespread application of numerical models (model-based) is accompanied by a widespread concern about quantifying the uncertainties prevailing in their use. Some of these uncertainties are related with the deterministic nature of the model (code uncertainty) others with the variability of its inputs (parameter uncertainty) and the discrepancy between a model/experiment (systematic uncertainty). The actual process always exhibits a random behaviour (observation error) even when conditions are set identically (residual variation). Bayesian inference assumes that parameters of a model are random variables with an associated PDF, which can be inferred from experimental data. However in many Bayesian methods the determination of systematic uncertainty can be problematic. In this work systematic uncertainty is associated with a discrepancy function. The numerical model and discrepancy function are approximated by Gaussian processes (surrogate model). Finally, to avoid the computational burden of a fully Bayesian approach the parameters that characterise the Gaussian processes were estimated in a four stage process (modular Bayesian approach). The proposed methodology has been successfully applied on fields such as geoscience, biomedics, particle physics but never on the SHM context. This approach considerably reduces the computational burden; although the extent of the considered uncertainties is lower (second order effects are neglected). To successfully identify the considered uncertainties this formulation was extended to consider multiple responses. The efficiency of the algorithm has been tested on a small scale aluminium bridge structure, subjected to a thermal expansion due to infrared heaters. Comparison of its performance with responses measured at different points of the structure and associated degrees of identifiability is also carried out. A numerical FEM model of the structure was developed and the stiffness from its supports is considered as a parameter to calibrate. Results show that the modular Bayesian approach performed best when responses of the same type had the lowest spatial correlation. Based on previous literature, using different types of responses (strain, acceleration, and displacement) should also improve the identifiability problem. Uncertainties due to parametric variability, observation error, residual variability, code variability and systematic uncertainty were all recovered. For this example the algorithm performance was stable and considerably quicker than Bayesian methods that account for the full extent of uncertainties. Future research with real-life examples is required to fully access the advantages and limitations of the proposed methodology.

Keywords: bayesian, calibration, numerical model, system identification, systematic uncertainty, Gaussian process

Procedia PDF Downloads 315

Authors: Anna Citterbergova

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This study explores the safeguards and guarantees to children’s personal data protection under the current EU and US legislative framework, namely the GDPR (2018) and COPPA (2000). Considering that children are online for the majority of their free time, one cannot overlook the negative side effects that may be associated with online participation, which may put children’s wellbeing and their fundamental rights at risk. The question of whether the current relevant legislative framework in relation to the responsibilities of the internet service providers (ISPs) are adequate safeguards and guarantees to children’s personal data protection has been an evolving debate both in the US and in the EU. From a children’s rights perspective, processors of personal data have certain obligations that must meet the international human rights principles (e. g. the CRC, ECHR), which require taking into account the best interest of the child. Accordingly, the need to protect children’s privacy online remains strong and relevant with the expansion of the number and importance of social media platforms to human life. At the same time, the landscape of the internet is rapidly evolving, and commercial interests are taking a more targeted approach in seeking children’s data. Therefore, it is essential to constantly evaluate the ongoing and evolving newly adopted market policies of ISPs that may misuse the gap in the current letter of the law. Previous studies in the field have already pointed out that both GDPR and COPPA may theoretically not be sufficient in protecting children’s personal data. With the focus on social media platforms, this study uses the doctrinal-descriptive method to identifiy the mechanisms enshrined in the GDPR and COPPA designed to protect children’s personal data. In its second part, the study includes a data gathering phase by the national data protection authorities responsible for monitoring and supervision of the GDPR in relation to children’s personal data protection who monitor the enforcement of the data protection rules throughout the European Union an contribute to their consistent application. These gathered primary source of data will later be used to outline the series of benefits and challenges to children’s persona lata protection faced by these institutes and the analysis that aims to suggest if and/or how to hold ISPs accountable while striking a fair balance between the commercial rights and the right to protection of the personal data of children. The preliminary results can be divided into two categories. First, conclusions in the doctrinal-descriptive part of the study. Second, specific cases and situations from the practice of national data protection authorities. While for the first part, concrete conclusions can already be presented, the second part is currently still in the data gathering phase. The result of this research is a comprehensive analysis on the safeguards and guarantees to children’s personal data protection under the current EU and US legislative framework, based on doctrinal-descriptive approach and original empirical data.

Keywords: personal data of children, personal data protection, GDPR, COPPA, ISPs, social media

Procedia PDF Downloads 76

Authors: Tony R. Walker, N. Devin MacAskill, Andrew Thalhiemer

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Sydney Harbour, Nova Scotia, Canada has long been subject to effluent and atmospheric inputs of contaminants, including thousands of tons of PAHs from a large coking and steel plant which operated in Sydney for nearly a century. Contaminants comprised of coal tar residues which were discharged from coking ovens into a small tidal tributary, which became known as the Sydney Tar Ponds (STPs), and subsequently discharged into Sydney Harbour. An Environmental Impact Statement concluded that mobilization of contaminated sediments posed unacceptable ecological risks, therefore immobilizing contaminants in the STPs using solidification and stabilization was identified as a primary source control remediation option to mitigate against continued transport of contaminated sediments from the STPs into Sydney Harbour. Recent developments in contaminant mass flux techniques focus on understanding “mobile” vs. “immobile” contaminants at remediation sites. Forensic source evaluations are also increasingly used for understanding origins of PAH contaminants in soils or sediments. Flux and forensic source evaluation-informed remediation decision-making uses this information to develop remediation end point goals aimed at reducing off-site exposure and managing potential ecological risk. This study included reviews of previous flux studies, calculating current mass flux estimates and a forensic assessment using PAH fingerprint techniques, during remediation of one of Canada’s most polluted sites at the STPs. Historically, the STPs was thought to be the major source of PAH contamination in Sydney Harbour with estimated discharges of nearly 800 kg/year of PAHs. However, during three years of remediation monitoring only 17-97 kg/year of PAHs were discharged from the STPs, which was also corroborated by an independent PAH flux study during the first year of remediation which estimated 119 kg/year. The estimated mass efflux of PAHs from the STPs during remediation was in stark contrast to ~2000 kg loading thought necessary to cause a short term increase in harbour sediment PAH concentrations. These mass flux estimates during remediation were also between three to eight times lower than PAHs discharged from the STPs a decade prior to remediation, when at the same time, government studies demonstrated on-going reduction in PAH concentrations in harbour sediments. Flux results were also corroborated using forensic source evaluations using PAH fingerprint techniques which found a common source of PAHs for urban soils, marine and aquatic sediments in and around Sydney. Coal combustion (from historical coking) and coal dust transshipment (from current coal transshipment facilities), are likely the principal source of PAHs in these media and not migration of PAH laden sediments from the STPs during a large scale remediation project.

Keywords: contaminated sediment, mass flux, forensic source evaluations, remediation

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Authors: Minjung Maing, Sibei Liu

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This research discusses the results of a study of window opening behavior of large housing developments in the high-density megacity of Hong Kong. The methods used for the study involved field observations using photo documentation of the four cardinal elevations (north, south-east, and west) of two large housing developments in a very dense urban area of approx. 46,000 persons per square meter within the city of Hong Kong. The targeted housing developments (A and B) are large public housing with a population of about 13,000 in each development of lower income. However, the mean income level in development A is about 40% higher than development B and home ownership is 60% in development A and 0% in development B. Mapping of the surrounding amenities and layout of the developments were also studied to understand the available activities to the residents. The photo documentation of the elevations was taken from November 2016 to February 2018 to gather a full spectrum of different seasons and both in the morning and afternoon (am/pm) times. From the photograph, the window opening behavior was measured by counting the amount of windows opened as a percentage of all the windows on that façade. For each date of survey data collected, weather data was recorded from weather stations located in the same region to collect temperature, humidity and wind speed. To further understand the behavior, simulation studies of microclimate conditions of the housing development was conducted using the software ENVI-met, a widely used simulation tool by researchers studying urban climate. Four major conclusions can be drawn from the data analysis and simulation results. Firstly, there is little change in the amount of window opening during the different seasons within a temperature range of 10 to 35 degrees Celsius. This means that people who tend to open their windows have consistent window opening behavior throughout the year and high tolerance of indoor thermal conditions. Secondly, for all four elevations the lower-income development B opened more windows (almost two times more units) than higher-income development A meaning window opening behavior had strong correlations with income level. Thirdly, there is a lack of correlation between outdoor horizontal wind speed and window opening behavior, as the changes of wind speed do not seem to affect the action of opening windows in most conditions. Similar to the low correlation between horizontal wind speed and window opening percentage, it is found that vertical wind speed also cannot explain the window opening behavior of occupants. Fourthly, there is a slightly higher average of window opening on the south elevation than the north elevation, which may be due to the south elevation being well shaded from high angle sun during the summer and allowing heat into units from lower angle sun during the winter season. These findings are important to providing insight into how to better design urban environments and indoor thermal environments for a liveable high density city.

Keywords: high-density housing, subtropical climate, urban behavior, window opening

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Authors: Dereje Regasa

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The global food system is at a crossroads, which requires prompt action to minimize the effects of the crises. Agroecology is gaining prominence due to its contributions to sustainable food systems. To support efforts in mitigating the crises, the Food and Agriculture Organization (FAO) established alternative approaches for sustainable agri-food systems. Agroecological elements and principles were developed to guide and support measures that countries need to achieve the Sustainable Development Goals (SDGs). The SDGs require the systemic integration of practices for a smart intensification or adaptation of traditional or industrial agriculture. As one of the countries working towards SDGs, the agricultural practices in Ethiopia need to be guided by these agroecological elements and principles. Aiming at the identification of challenging aspects of a sustainable agri-food system and the characterization of an enabling environment for agroecology, as well as exploring to what extent the existing policies and strategies support the agroecological transition process, five policy and strategy documents were reviewed. These documents are the Rural Development Policy and Strategy, the Environment Policy, the Biodiversity Policy, and the Soil Strategy of the Ministry of Agriculture (MoA). Using the Agroecology Criteria Tool (ACT), the contents were reviewed, focusing on agroecological requirements and the inclusion of sustainable practices. ACT is designed to support a self-assessment of elements supporting agroecology. For each element, binary values were assigned based on the inclusion of the minimum requirements index and then validated through discussion with the document owners. The results showed that the documents were well below the requirements for an agroecological transition of the agri-food system. The Rural Development Policy and Strategy only suffice to 83% in Human and Social Value. It does not support the transition concerning the other elements. The Biodiversity Policy and Soil Strategy suffice regarding the inclusion of Co-creation and Sharing of knowledge (100%), while the remaining elements were not considered sufficiently. In contrast, the Environment Policy supports the transition with three elements accounting for 100%. These are Resilience, Recycling, and Human and Social Care. However, when the four documents were combined, elements such as Synergies, Diversity, Efficiency, Human and Social value, Responsible governance, and Co-creation and Sharing of knowledge were identified as fully supportive (100%). This showed that the policies and strategies complemented one another to a certain extent. However, the evaluation results call for improvements concerning elements like Culture and food traditions, Circular and solidarity economy, Resilience, Recycling, and Regulation and balance since the majority of the elements were not sufficiently observed. Consequently, guidance for the smart intensification of local practices is needed, as well as traditional knowledge enriched with advanced technologies. Ethiopian agricultural and environmental policies and strategies should provide sufficient support and guidance for the intensification of sustainable practices and should provide a framework for an agroecological transition towards a sustainable agri-food system.

Keywords: agroecology, diversity, recycling, sustainable food system, transition

Procedia PDF Downloads 69

Authors: Francesca Marsili

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The reliability assessment of existing structures with probabilistic methods is becoming an increasingly important and frequent engineering task. However probabilistic reliability methods are based on an exhaustive knowledge of the stochastic modeling of the variables involved in the assessment; at the moment standards for the modeling of variables are absent, representing an obstacle to the dissemination of probabilistic methods. The framework according to probability distribution functions (PDFs) are established is represented by the Bayesian statistics, which uses Bayes Theorem: a prior PDF for the considered parameter is established based on information derived from the design stage and qualitative judgments based on the engineer past experience; then, the prior model is updated with the results of investigation carried out on the considered structure, such as material testing, determination of action and structural properties. The application of Bayesian statistics arises two different kind of problems: 1. The results of the updating depend on the engineer previous experience; 2. The updating of the prior PDF can be performed only if the structure has been tested, and quantitative data that can be statistically manipulated have been collected; performing tests is always an expensive and time consuming operation; furthermore, if the considered structure is an ancient building, destructive tests could compromise its cultural value and therefore should be avoided. In order to solve those problems, an interesting research path is represented by investigating Artificial Intelligence (AI) techniques that can be useful for the automation of the modeling of variables and for the updating of material parameters without performing destructive tests. Among the others, one that raises particular attention in relation to the object of this study is constituted by Case-Based Reasoning (CBR). In this application, cases will be represented by existing buildings where material tests have already been carried out and an updated PDFs for the material mechanical parameters has been computed through a Bayesian analysis. Then each case will be composed by a qualitative description of the material under assessment and the posterior PDFs that describe its material properties. The problem that will be solved is the definition of PDFs for material parameters involved in the reliability assessment of the considered structure. A CBR system represent a good candi¬date in automating the modelling of variables because: 1. Engineers already draw an estimation of the material properties based on the experience collected during the assessment of similar structures, or based on similar cases collected in literature or in data-bases; 2. Material tests carried out on structure can be easily collected from laboratory database or from literature; 3. The system will provide the user of a reliable probabilistic description of the variables involved in the assessment that will also serve as a tool in support of the engineer’s qualitative judgments. Automated modeling of variables can help in spreading probabilistic reliability assessment of existing buildings in the common engineering practice, and target at the best intervention and further tests on the structure; CBR represents a technique which may help to achieve this.

Keywords: reliability assessment of existing buildings, Bayesian analysis, case-based reasoning, historical structures

Procedia PDF Downloads 324

Authors: Flavia Oliveira de A. M. Cruz, Edison Tostes Faria, Paula Elaine D. Reis

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When the breast is submitted to radiation therapy (RT), the most common effects are pain, skin changes, mobility restrictions, local sensory alteration, and fatigue. These effects, if not managed properly, may reduce the quality of life of cancer patients and may lead to the treatment discontinuation. Therefore, promoting knowledge and guidelines for symptom management remain a high priority for patients and a challenge for health professionals, due to the need to handle side effects in a population with a life-threatening disease. Printed materials are important strategies for supporting educative activities since they help the individual to assimilate and understand the amount of information transmitted. Nurses' behavior can be systematized through the use of an educative manual, which may be effective in promoting information regarding the treatment, self-care and how to control the effects of RT at home. In view of the importance of guaranteeing the validity of the material before its use, the objective of this research was to validate the content and appearance of an educative manual for breast cancer patients undergoing RT. The Theory of Psychometrics was used for the validation process in this descriptive methodological research. A minimum agreement rate (AR) of 80% was considered to guarantee the validity of the material. The data were collected from October to December 2017, by means of two assessments tools, constructed in the form of a Likert scale, with five levels of understanding. These instruments addressed different aspects of the evaluation, in view of two different groups of participants; 17 experts in the theme area of the educative manual, and 12 women that received RT previously to treat breast cancer. The manual was titled 'Orientation Manual: radiation therapy in breast', and was focused on breast cancer patients attended at the Department of Oncology of the Brasília University Hospital (UNACON/HUB). The research project was submitted to the Research Ethics Committee at the School of Health Sciences of the University of Brasília (CAAE: 24592213.1.0000.0030). Only two items of the assessment tool for the experts, one related to the manual's ability to promote behavioral and attitude changes and the other related to the extent of its use for other health services, obtained AR < 80% and were reformulated based on the participants' suggestions and in the literature. All other items were considered appropriate and/or complete appropriate in the three blocks proposed for the experts: objectives - 89%, structure and form - 93%, and relevance - 93%; and good and/or very good in the five blocks of analysis proposed for patients: objectives - 100%, organization - 100%, writing style - 100%, appearance - 100%, and motivation. The appearance and content validation of the educative manual proposed were attended to. The educative manual was considered relevant and pertinent and may contribute to the understanding of the therapeutic process by breast cancer patients during RT, as well as support clinical practice through the nursing consultation.

Keywords: oncology nursing, nursing care, validation studies, educational technology

Procedia PDF Downloads 109

Authors: Langhit Kurar, Loren Charles

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Introduction: In light of recent BOAST 12 (August 2016) published guidance on management of ankle fractures, the project aimed to highlight key discrepancies throughout the care trajectory from admission to point of discharge at a district general hospital. Wide breadth of data covering three key domains: accident and emergency, radiology, and orthopaedic surgery were subsequently stratified and recommendations on note documentation, and outpatient follow up were made. Methods: A retrospective twelve month audit was conducted reviewing results of ankle fracture management in 37 patients. Inclusion criterion involved all patients seen at Darent Valley Hospital (DVH) emergency department with radiographic evidence of an ankle fracture. Exclusion criterion involved all patients managed solely by nursing staff or having sustained purely ligamentous injury. Medical notes, including discharge summaries and the PACS online radiographic tool were used for data extraction. Results: Cross-examination of the A & E domain revealed limited awareness of the BOAST 12 recent publication including requirements to document skin integrity and neurovascular assessment. This had direct implications as this would have changed the surgical plan for acutely compromised patients. The majority of results obtained from the radiographic domain were satisfactory with appropriate X-rays taken in over 95% of cases. However, due to time pressures within A & E, patients were often left without a post manipulation XRAY in a backslab. Poorly reduced fractures were subsequently left for a long period resulting in swollen ankles and a time-dependent lag to surgical intervention. This had knocked on implications for prolonged inpatient stay resulting in hospital-acquired co-morbidity including pressure sores. Discussion: The audit has highlighted several areas of improvement throughout the disease trajectory from review in the emergency department to follow up as an outpatient. This has prompted the creation of an algorithm to ensure patients with significant fractures presenting to the emergency department are seen promptly and treatment expedited as per recent guidance. This includes timing for X-rays taken in A & E. Re-audit has shown significant improvement in both documentation at time of presentation and appropriate follow-up strategies. Within the orthopedic domain, we are in the process of creating an ankle fracture pathway to ensure imaging and weight bearing status are made clear to the consulting clinicians in an outpatient setting. Significance/Clinical Relevance: As a result of the ankle fracture algorithm we have adapted the BOAST 12 guidance to shape an intrinsic pathway to not only improve patient management within the emergency department but also create a standardised format for follow up.

Keywords: ankle, fracture, BOAST, radiology

Procedia PDF Downloads 163

Authors: Naziema Begum Jappie

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Leadership and entrepreneurship in higher education have become critical components in navigating the evolving landscape of academia in the 21st century. This abstract explores the multifaceted relationship between leadership and entrepreneurship within the realm of higher education, emphasizing their roles in fostering innovation and sustainability. Higher education institutions, often characterized as slow-moving and resistant to change, are facing unprecedented challenges. Globalization, rapid technological advancements, changing student demographics, and financial constraints necessitate a reimagining of traditional models. Leadership in higher education must embrace entrepreneurial thinking to effectively address these challenges. Entrepreneurship in higher education involves cultivating a culture of innovation, risk-taking, and adaptability. Visionary leaders who promote entrepreneurship within their institutions empower faculty and staff to think creatively, seek new opportunities, and engage with external partners. These entrepreneurial efforts lead to the development of novel programs, research initiatives, and sustainable revenue streams. Innovation in curriculum and pedagogy is a central aspect of leadership and entrepreneurship in higher education. Forward-thinking leaders encourage faculty to experiment with teaching methods and technology, fostering a dynamic learning environment that prepares students for an ever-changing job market. Entrepreneurial leadership also facilitates the creation of interdisciplinary programs that address emerging fields and societal challenges. Collaboration is key to entrepreneurship in higher education. Leaders must establish partnerships with industry, government, and non-profit organizations to enhance research opportunities, secure funding, and provide real-world experiences for students. Entrepreneurial leaders leverage their institutions' resources to build networks that extend beyond campus boundaries, strengthening their positions in the global knowledge economy. Financial sustainability is a pressing concern for higher education institutions. Entrepreneurial leadership involves diversifying revenue streams through innovative fundraising campaigns, partnerships, and alternative educational models. Leaders who embrace entrepreneurship are better equipped to navigate budget constraints and ensure the long-term viability of their institutions. In conclusion, leadership and entrepreneurship are intertwined elements essential to the continued relevance and success of higher education institutions. Visionary leaders who champion entrepreneurship foster innovation, enhance the student experience, and secure the financial future of their institutions. As academia continues to evolve, leadership and entrepreneurship will remain indispensable tools in shaping the future of higher education. This abstract underscores the importance of these concepts and their potential to drive positive change within the higher education landscape.

Keywords: entrepreneurship, higher education, innovation, leadership

Procedia PDF Downloads 51

Authors: Sherin Ahmed El-Badry Sadek

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In this research, it is scientifically examined what contribution the professionalization of teachers can make to the development of a future-oriented vocational education and training system in Egypt. For this purpose, a needs assessment of the Egyptian vocational training system with the central actors and prevailing structures forms the foundation of the study, which theoretically underpinned with the attempt to resolve to some extent the tension between Luhmann's systems theory approach and the actor-centered theory of professional teacher competence. The vocational education system, in particular, must be adaptable and flexible due to the rapidly changing qualification requirements. In view of the pace of technological progress and the associated market changes, vocational training is no longer to be understood only as an educational tool aimed at those who achieve poorer academic performance or are not motivated to take up a degree. Rather, it is to be understood as a cornerstone for the development of society, and international experience shows that it is the core of lifelong learning. But to what extent have the education systems been able to react to these changes in their political, social, and technological systems? And how effective and sustainable are these changes actually? The vocational training system, in particular, has a particular impact on other social systems, which is why the appropriate parameters with the greatest leverage must be identified and adapted. Even if systems and structures are highly relevant, teachers must not hide behind them and must instead strive to develop further and to constantly learn. Despite numerous initiatives and programs to reform vocational training in Egypt, including the EU-funded Technical and Vocational Education and Training (TVET) reform phase I and phase II, the fit of the skilled workers to the needs of the labor market is still insufficient. Surveys show that the majority of employers are very dissatisfied with the graduates that the vocational training system produces. The data was collected through guideline-based interviews with experts from the education system and relevant neighboring systems, which allowed me to reconstruct central in-depth structures, as well as patterns of action and interpretation, in order to subsequently feed these into a matrix of recommendations for action. These recommendations are addressed to different decision-makers and stakeholders and are intended to serve as an impetus for the sustainable improvement of the Egyptian vocational training system. The research findings have shown that education, and in particular vocational training, is a political field that is characterized by a high degree of complexity and which is embedded in a barely manageable, highly branched landscape of structures and actors. At the same time, the vocational training system is not only determined by endogenous factors but also increasingly shaped by the dynamics of the environment and the neighboring social subsystems, with a mutual dependency relationship becoming apparent. These interactions must be taken into account in all decisions, even if prioritization of measures and thus a clear sequence and process orientation are of great urgency.

Keywords: competence orientation, educational policies, education systems, expert interviews, globalization, organizational development, professionalization, systems theory, teacher training, TVET system, vocational training

Procedia PDF Downloads 130

Authors: Morgan Johansson, Joosef Leppanen, Mathias Flansbjer, Fabio Lozano, Josef Makdesi

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Concrete is commonly used for protective structures and how impact loading affects different types of concrete structures is an important issue. Often the knowledge gained from static loading is also used in the design of impulse loaded structures. A large plastic deformation capacity is essential to obtain a large energy absorption in an impulse loaded structure. However, the structural response of an impact loaded concrete beam may be very different compared to a statically loaded beam. Consequently, the plastic deformation capacity and failure modes of the concrete structure can be different when subjected to dynamic loads; and hence it is not sure that the observations obtained from static loading are also valid for dynamic loading. The aim of this paper is to investigate the residual plastic deformation capacity in reinforced concrete beams subjected to drop weight impact tests. A test-series consisting of 18 simply supported beams (0.1 x 0.1 x 1.18 m, ρs = 0.7%) with a span length of 1.0 m and subjected to a point load in the beam mid-point, was carried out. 2x6 beams were first subjected to drop weight impact tests, and thereafter statically tested until failure. The drop in weight had a mass of 10 kg and was dropped from 2.5 m or 5.0 m. During the impact tests, a high-speed camera was used with 5 000 fps and for the static tests, a camera was used with 0.5 fps. Digital image correlation (DIC) analyses were conducted and from these the velocities of the beam and the drop weight, as well as the deformations and crack propagation of the beam, were effectively measured. Additionally, for the static tests, the applied load and midspan deformation were measured. The load-deformation relations for the beams subjected to an impact load were compared with 6 reference beams that were subjected to static loading only. The crack pattern obtained were compared using DIC, and it was concluded that the resulting crack formation depended much on the test method used. For the static tests, only bending cracks occurred. For the impact loaded beams, though, distinctive diagonal shear cracks also formed below the zone of impact and less wide shear cracks were observed in the region half-way to the support. Furthermore, due to wave propagation effects, bending cracks developed in the upper part of the beam during initial loading. The results showed that the plastic deformation capacity increased for beams subjected to drop weight impact tests from a high drop height of 5.0 m. For beams subjected to an impact from a low drop height of 2.5 m, though, the plastic deformation capacity was in the same order of magnitude as for the statically loaded reference beams. The beams tested were designed to fail due to bending when subjected to a static load. However, for the impact tested beams, one beam exhibited a shear failure at a significantly reduced load level when it was tested statically; indicating that there might be a risk of reduced residual load capacity for impact loaded structures.

Keywords: digital image correlation (DIC), drop weight impact, experiments, plastic deformation capacity, reinforced concrete

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Authors: Virginia Venturini, Elisabet Walker, Aylen Carrasco-Millan

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Latin America stands at the front of climate change impacts, with forecasts projecting accelerated temperature and sea level rises compared to the global average. These changes are set to trigger a cascade of effects, including coastal retreat, intensified droughts in some nations, and heightened flood risks in others. In Argentina, wildfires historically affected forests, but since 2004, wetland fires have emerged as a pressing concern. By 2021, the wetlands of the Paraná River faced a dangerous situation. In fact, during the year 2021, a high-risk scenario was naturally formed in the wetlands of the Paraná River, in Argentina. Very low water levels in the rivers, and excessive standing dead plant material (fuel), triggered most of the fires recorded in the vast wetland region of the Paraná during 2020-2021. During 2008 fire events devastated nearly 15% of the Paraná Delta, and by late 2021 new fires burned more than 300,000 ha of these same wetlands. Therefore, the goal of this work is to explore remote sensing tools to monitor environmental conditions and the severity of prescribed burns in the Paraná River wetlands. Thus, two prescribed burning experiments were carried out in the study area (31°40’ 05’’ S, 60° 34’ 40’’ W) during September 2023. The first experiment was carried out on Sept. 13th, in a plot of 0.5 ha which dominant vegetation were Echinochloa sp., and Thalia, while the second trial was done on Sept 29th in a plot of 0.7 ha, next to the first burned parcel; here the dominant vegetation species were Echinochloa sp. and Solanum glaucophyllum. Field campaigns were conducted between September 8th and November 8th to assess the severity of the prescribed burns. Flight surveys were conducted utilizing a DJI® Inspire II drone equipped with a Sentera® NDVI camera. Then, burn severity was quantified by analyzing images captured by the Sentera camera along with data from the Sentinel 2 satellite mission. This involved subtracting the NDVI images obtained before and after the burn experiments. The results from both data sources demonstrate a highly heterogeneous impact of fire within the patch. Mean severity values obtained with drone NDVI images of the first experience were about 0.16 and 0.18 with Sentinel images. For the second experiment, mean values obtained with the drone were approximately 0.17 and 0.16 with Sentinel images. Thus, most of the pixels showed low fire severity and only a few pixels presented moderated burn severity, based on the wildfire scale. The undisturbed plots maintained consistent mean NDVI values throughout the experiments. Moreover, the severity assessment of each experiment revealed that the vegetation was not completely dry, despite experiencing extreme drought conditions.

Keywords: prescribed-burn, severity, NDVI, wetlands

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Authors: Odenigbo Veronica Ngozi, Lorreta Chika Ukwuaba

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This study focuses on how the strengthening adult literacy program can help accelerate transformative strategies to end female genital mutilation (FGM) in Nigeria, specifically in Nsukka Local Government Area. The research delves into the definition of FGM, adult literacy programs, and how to achieve ending FGM to attain Sustainable Development Goals (SDGs) in 2030. It further discusses the practice of FGM in Nigeria and emphasizes the statement of the problem. The main aim of the study is to investigate how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs in 2030. The researchers utilized a survey research design to conduct the study in Nsukka L.G.A. The population was composed of 26 facilitators and adult learners in five adult learning centers in the area. The entire population was used as a sample, and structured questionnaires were employed to elicit information. The items on the questionnaire were face-validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation while the hypothesis was tested at 0.05 level of degree of significance using a t-test. The findings show that through adult literacy program acceleration of transformative strategies, the practices of FGM can be ended. Strengthening adult literacy programs is a good channel to end or stop FGM through the knowledge and skill acquired from the learning centers. The theoretical importance of the study lies in the fact that it highlights the role of adult literacy programs in accelerating transformative strategies to combat harmful cultural practices such as FGM. It further supports the importance of education and knowledge in achieving sustainable development goals by 2030. Structured questionnaires were distributed to an entire population of 26 facilitators and adult learners in five adult learning centers in Nsukka L.G.A. The questionnaire items were face–validated by three experts, and the reliability of the instrument was verified using Cronbach Alpha Reliability Technique. The research questions were analyzed using means and standard deviation, while the hypothesis was tested using a t-test at 0.05 level of degree of significance. The study addressed the question of how strengthening adult literacy programs can help accelerate transformative strategies to end FGM in Nigeria and achieve SDGs by 2030. In conclusion, the study found that adult literacy is a good tool to end FGM in Nigeria. The recommendations were that government, non-governmental organizations (NGOs), Community-based organizations (CBOs), and individuals should support the funding and establishment of adult literacy centers in communities so as to reach every illiterate parent or individual and acquire the knowledge and skill needed to understand the negative effect of FGM in the life of a girl child.

Keywords: adult literacy, female genital mutilation, learning centers, SDGs, strengthening

Procedia PDF Downloads 51

Authors: Avi Shrivastava

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Our world continues to grapple with a lot of social issues. Economic growth and scientific advancements have not completely eradicated poverty, homelessness, discrimination and bias, gender inequality, health issues, mental illness, addiction, and other social issues. So, how do we improve the human condition in a world driven by advanced technology? The answer is simple: we will have to leverage technology to address some of the most important social challenges of the day. AI, or artificial intelligence, has emerged as a critical tool in the battle against issues that deprive marginalized and disadvantaged groups of the right to enjoy benefits that a society offers. Social work professionals can transform their lives by harnessing it. The lack of reliable data is one of the reasons why a lot of social work projects fail. Social work professionals continue to rely on expensive and time-consuming primary data collection methods, such as observation, surveys, questionnaires, and interviews, instead of tapping into AI-based technology to generate useful, real-time data and necessary insights. By leveraging AI’s data-mining ability, we can gain a deeper understanding of how to solve complex social problems and change lives of people. We can do the right work for the right people and at the right time. For example, AI can enable social work professionals to focus their humanitarian efforts on some of the world’s poorest regions, where there is extreme poverty. An interdisciplinary team of Stanford scientists, Marshall Burke, Stefano Ermon, David Lobell, Michael Xie, and Neal Jean, used AI to spot global poverty zones – identifying such zones is a key step in the fight against poverty. The scientists combined daytime and nighttime satellite imagery with machine learning algorithms to predict poverty in Nigeria, Uganda, Tanzania, Rwanda, and Malawi. In an article published by Stanford News, Stanford researchers use dark of night and machine learning, Ermon explained that they provided the machine-learning system, an application of AI, with the high-resolution satellite images and asked it to predict poverty in the African region. “The system essentially learned how to solve the problem by comparing those two sets of images [daytime and nighttime].” This is one example of how AI can be used by social work professionals to reach regions that need their aid the most. It can also help identify sources of inequality and conflict, which could reduce inequalities, according to Nature’s study, titled The role of artificial intelligence in achieving the Sustainable Development Goals, published in 2020. The report also notes that AI can help achieve 79 percent of the United Nation’s (UN) Sustainable Development Goals (SDG). AI is impacting our everyday lives in multiple amazing ways, yet some people do not know much about it. If someone is not familiar with this technology, they may be reluctant to use it to solve social issues. So, before we talk more about the use of AI to accomplish social work objectives, let’s put the spotlight on how AI and social work can complement each other.

Keywords: social work, artificial intelligence, AI based social work, machine learning, technology

Procedia PDF Downloads 86

Authors: Raheel Shakoor Siddiqui, Shahbaz Malik, Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, Livio DiMascio

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Background: elderly traumatic hip fracture patients frequently present to trauma services globally. Rising low energy falls amongst an osteoporotic aging population is the commonest cause for injury. Hip fractures in this population are a major cause for severe pain, morbidity and mortality. The term hip fracture is interchangeable with neck of femur fracture, fractured neck of femur or proximal femur fracture. Hip fracture pain management protocols and guidelines suggest conventional analgesia, nerve block and opioid based treatment as rescue analgesia. There is a current global opioid crisis with overuse, abuse and dependence. Adverse opioid related complications in vulnerable elderly patients further adds to morbidity and mortality. Systematic reviews in literature have evidenced superiority of multimodal analgesia in osteoarthritic primary joint replacements compared to opioids however, this has not yet been conducted for elderly traumatic hip fracture patients. Aims: The primary aim of this systematic review is to provide standardised evidence following Cochrane and PRISMA guidance in determining advantages of perioperative multimodal analgesia over conventional opioid based treatments in elderly traumatic hip fractures. Methods: 5 databases were searched from January 2000-2023 which identified 8 randomised controlled trials and 446 total participants. These trials met defined PICOS eligibility criteria of patient mean age ≥ 65 years presenting with a unilateral traumatic fractured neck of femur for operative intervention. Analgesic intervention with perioperative multimodal analgesia has been compared to conventional opioid based analgesia. Outcomes of interest include, primarily, the change in postoperative opioid consumption within a 0-30 postoperative period and secondarily, the change in postoperative adverse events and complications. A qualitative synthesis has been performed due to clinical heterogenicity and variance amongst trials. Results: GRADE evidence of moderate quality supports perioperative multimodal analgesia leads to a reduction in postoperative opioid consumption however, low quality evidence supports a reduction of adverse effects and complications. Conclusion: Perioperative multimodal analgesia whether used preoperative, intraoperative and/or postoperative leads to a reduction in postoperative opioid consumption for elderly traumatic hip fracture patients. This review recommends the use of perioperative multimodal analgesia as part of hip fracture pain protocols however, caution and clinical judgement should be used as the risk of adverse effects may not be lower.

Keywords: trauma, orthopaedics, hip, fracture, neck of femur fracture, analgesia, multimodal analgesia, opioid

Procedia PDF Downloads 82

Authors: Jongtae Rhee, Sangkwon Han, Seungbin Ji, Junhyeong Park, Byeonghun Kim, Taekyung Kim, Byeonghyeon Jeon, Jiwoo Yang

Abstract:

The shared kitchen is a concept that transfers the value of the sharing economy to the kitchen. It is a type of kitchen equipped with cooking facilities that allows multiple companies or chefs to share time and space and use it jointly. These shared kitchens provide economic benefits and convenience, such as reduced investment costs and rent, but also increase the risk of safety management, such as cross-contamination of food ingredients. Therefore, to manage the safety of food ingredients and finished products in a shared kitchen where several entities jointly use the kitchen and handle various types of food ingredients, it is critical to manage followings: the freshness of food ingredients, user hygiene and safety and cross-contamination of cooking equipment and facilities. In this study, it propose a machine learning-based system for hygiene safety and cross-contamination management, which are highly difficult to manage. User clothing management and user access management, which are most relevant to the hygiene and safety of shared kitchens, are solved through machine learning-based methodology, and cutting board usage management, which is most relevant to cross-contamination management, is implemented as an integrated safety management system based on artificial intelligence. First, to prevent cross-contamination of food ingredients, we use images collected through a real-time camera to determine whether the food ingredients match a given cutting board based on a real-time object detection model, YOLO v7. To manage the hygiene of user clothing, we use a camera-based facial recognition model to recognize the user, and real-time object detection model to determine whether a sanitary hat and mask are worn. In addition, to manage access for users qualified to enter the shared kitchen, we utilize machine learning based signature recognition module. By comparing the pairwise distance between the contract signature and the signature at the time of entrance to the shared kitchen, access permission is determined through a pre-trained signature verification model. These machine learning-based safety management tasks are integrated into a single information system, and each result is managed in an integrated database. Through this, users are warned of safety dangers through the tablet PC installed in the shared kitchen, and managers can track the cause of the sanitary and safety accidents. As a result of system integration analysis, real-time safety management services can be continuously provided by artificial intelligence, and machine learning-based methodologies are used for integrated safety management of shared kitchens that allows dynamic contracts among various users. By solving this problem, we were able to secure the feasibility and safety of the shared kitchen business.

Keywords: artificial intelligence, food safety, information system, safety management, shared kitchen

Procedia PDF Downloads 49