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383 Exploring the Food Environments and Their Influence on Food Choices of Working Adults
Authors: Deepa Shokeen, Bani Tamber Aeri
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Food environments are believed to play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. The relationship between the food environment and obesity is complex. While there is little research linking food access with obesity as an outcome measure in any age group, with the help of this article we will try to understand the relationship between what we eat and the environmental context in which these food choices are made. Methods: A literature search of studies published between January 2000 and December 2013 was undertaken on computerized medical, social science, health, nutrition and education databases including Google, PubMed etc. Reports of organisations such as World Health Organisation (WHO), Centre for Chronic Disease Control (CCDC) were studied to project the data. Results: Studies show that food environments play a significant role in the obesity epidemic and robust research methods are required to establish which factors or aspects of the food environment are relevant to food choice and to adiposity. Evidence indicates that the food environment may help explain the obesity and cardio-metabolic risk factors among young adults. Conclusion: Cardiovascular disease is the ever growing chronic disease, the incidence of which will increase markedly in the coming decades. Therefore, it is the need of the hour to assess the prevalence of various risk factors that contribute to the incidence of cardiovascular diseases especially in the work environment. Research is required to establish how different environments affect different individuals as individuals interact with the environment on a number of levels. We need to ascertain the impact of selected food and nutrition environments (Information, organization, community, consumer) on food choice and dietary intake of the working adults as it is important to learn how these food environments influence the eating perceptions and health behaviour of the adults.Keywords: food environment, prevalence, cardiovascular disease, India, worksite, risk factors
Procedia PDF Downloads 401382 An Analysis of the Regression Hypothesis from a Shona Broca’s Aphasci Perspective
Authors: Esther Mafunda, Simbarashe Muparangi
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The present paper tests the applicability of the Regression Hypothesis on the pathological language dissolution of a Shona male adult with Broca’s aphasia. It particularly assesses the prediction of the Regression Hypothesis, which states that the process according to which language is forgotten will be the reversal of the process according to which it will be acquired. The main aim of the paper is to find out whether mirror symmetries between L1 acquisition and L1 dissolution of tense in Shona and, if so, what might cause these regression patterns. The paper also sought to highlight the practical contributions that Linguistic theory can make to solving language-related problems. Data was collected from a 46-year-old male adult with Broca’s aphasia who was receiving speech therapy at St Giles Rehabilitation Centre in Harare, Zimbabwe. The primary data elicitation method was experimental, using the probe technique. The TART (Test for Assessing Reference Time) Shona version in the form of sequencing pictures was used to access tense by Broca’s aphasic and 3.5-year-old child. Using the SPSS (Statistical Package for Social Studies) and Excel analysis, it was established that the use of the future tense was impaired in Shona Broca’s aphasic whilst the present and past tense was intact. However, though the past tense was intact in the male adult with Broca’s aphasic, a reference to the remote past was made. The use of the future tense was also found to be difficult for the 3,5-year-old speaking child. No difficulties were encountered in using the present and past tenses. This means that mirror symmetries were found between L1 acquisition and L1 dissolution of tense in Shona. On the basis of the results of this research, it can be concluded that the use of tense in a Shona adult with Broca’s aphasia supports the Regression Hypothesis. The findings of this study are important in terms of speech therapy in the context of Zimbabwe. The study also contributes to Bantu linguistics in general and to Shona linguistics in particular. Further studies could also be done focusing on the rest of the Bantu language varieties in terms of aphasia.Keywords: Broca’s Aphasia, regression hypothesis, Shona, language dissolution
Procedia PDF Downloads 95381 Epidemiological Correlates of Adherence to Anti-Hypertensive Treatment in Primary Health Care Setting of Ludhiana, Punjab
Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal
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Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.Keywords: hypertension, anti-hypertensive, adherence, counselling
Procedia PDF Downloads 90380 Time of Death Determination in Medicolegal Death Investigations
Authors: Michelle Rippy
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Medicolegal death investigation historically is a field that does not receive much research attention or advancement, as all of the subjects are deceased. Public health threats, drug epidemics and contagious diseases are typically recognized in decedents first, with thorough and accurate death investigations able to assist in epidemiology research and prevention programs. One vital component of medicolegal death investigation is determining the decedent’s time of death. An accurate time of death can assist in corroborating alibies, determining sequence of death in multiple casualty circumstances and provide vital facts in civil situations. Popular television portrays an unrealistic forensic ability to provide the exact time of death to the minute for someone found deceased with no witnesses present. The actuality of unattended decedent time of death determination can generally only be narrowed to a 4-6 hour window. In the mid- to late-20th century, liver temperatures were an invasive action taken by death investigators to determine the decedent’s core temperature. The core temperature was programmed into an equation to determine an approximate time of death. Due to many inconsistencies with the placement of the thermometer and other variables, the accuracy of the liver temperatures was dispelled and this once common place action lost scientific support. Currently, medicolegal death investigators utilize three major after death or post-mortem changes at a death scene. Many factors are considered in the subjective determination as to the time of death, including the cooling of the decedent, stiffness of the muscles, release of blood internally, clothing, ambient temperature, disease and recent exercise. Current research is utilizing non-invasive hospital grade tympanic thermometers to measure the temperature in the each of the decedent’s ears. This tool can be used at the scene and in conjunction with scene indicators may provide a more accurate time of death. The research is significant and important to investigations and can provide an area of accuracy to a historically inaccurate area, considerably improving criminal and civil death investigations. The goal of the research is to provide a scientific basis to unwitnessed deaths, instead of the art that the determination currently is. The research is currently in progress with expected termination in December 2018. There are currently 15 completed case studies with vital information including the ambient temperature, decedent height/weight/sex/age, layers of clothing, found position, if medical intervention occurred and if the death was witnessed. This data will be analyzed with the multiple variables studied and available for presentation in January 2019.Keywords: algor mortis, forensic pathology, investigations, medicolegal, time of death, tympanic
Procedia PDF Downloads 118379 Ultra-Sensitive Point-Of-Care Detection of PSA Using an Enzyme- and Equipment-Free Microfluidic Platform
Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang
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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive
Procedia PDF Downloads 110378 Trajectories of Conduct Problems and Cumulative Risk from Early Childhood to Adolescence
Authors: Leslie M. Gutman
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Conduct problems (CP) represent a major dilemma, with wide-ranging and long-lasting individual and societal impacts. Children experience heterogeneous patterns of conduct problems; based on the age of onset, developmental course and related risk factors from around age 3. Early childhood represents a potential window for intervention efforts aimed at changing the trajectory of early starting conduct problems. Using the UK Millennium Cohort Study (n = 17,206 children), this study (a) identifies trajectories of conduct problems from ages 3 to 14 years and (b) assesses the cumulative and interactive effects of individual, family and socioeconomic risk factors from ages 9 months to 14 years. The same factors according to three domains were assessed, including child (i.e., low verbal ability, hyperactivity/inattention, peer problems, emotional problems), family (i.e., single families, parental poor physical and mental health, large family size) and socioeconomic (i.e., low family income, low parental education, unemployment, social housing). A cumulative risk score for the child, family, and socioeconomic domains at each age was calculated. It was then examined how the cumulative risk scores explain variation in the trajectories of conduct problems. Lastly, interactive effects among the different domains of cumulative risk were tested. Using group-based trajectory modeling, four distinct trajectories were found including a ‘low’ problem group and three groups showing childhood-onset conduct problems: ‘school-age onset’; ‘early-onset, desisting’; and ‘early-onset, persisting’. The ‘low’ group (57% of the sample) showed a low probability of conducts problems, close to zero, from 3 to 14 years. The ‘early-onset, desisting’ group (23% of the sample) demonstrated a moderate probability of CP in early childhood, with a decline from 3 to 5 years and a low probability thereafter. The ‘early-onset, persistent’ group (8%) followed a high probability of conduct problems, which declined from 11 years but was close to 70% at 14 years. In the ‘school-age onset’ group, 12% of the sample showed a moderate probability of conduct problems from 3 and 5 years, with a sharp increase by 7 years, increasing to 50% at 14 years. In terms of individual risk, all factors increased the likelihood of being in the childhood-onset groups compared to the ‘low’ group. For cumulative risk, the socioeconomic domain at 9 months and 3 years, the family domain at all ages except 14 years and child domain at all ages were found to differentiate childhood-onset groups from the ‘low’ group. Cumulative risk at 9 months and 3 years did not differentiate between the ‘school-onset’ group and ‘low’ group. Significant interactions were found between the domains for the ‘early-onset, desisting group’ suggesting that low levels of risk in one domain may buffer the effects of high risk in another domain. The implications of these findings for preventive interventions will be highlighted.Keywords: conduct problems, cumulative risk, developmental trajectories, early childhood, adolescence
Procedia PDF Downloads 251377 Oro-Facial Manifestations of Acute Myeloid Leukaemia -A Case Report
Authors: Aamna Tufail, Kajal Kotecha, Iordanis Toursounidis, Ravinder Pabla
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Introduction/Aims: Acute Myeloid Leukaemia (AML) is a part of leukaemic group of hematopoietic disorders with a varying range of presentations, including oro-facial manifestations. Early recognition and management are essential for favourable outcomes. Materials and Methods: We present our experience, clinical presentation, and clinical photographs of a patient with previously undiagnosed AML who presented with oral symptoms to the emergency department of our hospital. An analysis of clinical characteristics, diagnostic investigations, and management modalities was performed. Results/Statistics: A 58-year-old man presented to A&E reporting an 11-day history of right sided facial swelling, acute TMJ symptoms, and oral discomfort. A dentist ruled out acute dental causes one day post onset of symptoms. Initial assessment was anatomically inconsistent and did not reveal a routine oral or maxillofacial etiology. Detailed clinical examination demonstrated fever, generalised pallor, swelling and erythema of right nasolabial region, bilateral masseteric tenderness, intraoral palatal ecchymosis, palatal ulceration, buccal and labial petechiae, cervical lymphadenopathy, and haematoma on dorsum of right hand overlying right 2nd metacarpal joint. Suspecting a systemic medical cause, we requested haematological investigations, which revealed neutropenia, thrombocytopenia, and anaemia. Flow cytometry confirmed CD34 + AML. Oral discomfort was managed symptomatically. The patient was referred to a tertiary care centre for acute haematologic care, where he was treated with IV antibiotics and continuing cycles of chemotherapy. Conclusions/Clinical Relevance: Oro-facial manifestations may be the first clinical sign of AML. Awareness of its features is vital in early diagnosis. In this context, dentists and oral medicine specialists can play an important role in detecting clinical signs of haematological disorders such as AML.Keywords: acute myeloid leukaemia, oral symptoms, ulceration, diagnosis, management
Procedia PDF Downloads 64376 The Integration of Geographical Information Systems and Capacitated Vehicle Routing Problem with Simulated Demand for Humanitarian Logistics in Tsunami-Prone Area: A Case Study of Phuket, Thailand
Authors: Kiatkulchai Jitt-Aer, Graham Wall, Dylan Jones
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As a result of the Indian Ocean tsunami in 2004, logistics applied to disaster relief operations has received great attention in the humanitarian sector. As learned from such disaster, preparing and responding to the aspect of delivering essential items from distribution centres to affected locations are of the importance for relief operations as the nature of disasters is uncertain especially in suffering figures, which are normally proportional to quantity of supplies. Thus, this study proposes a spatial decision support system (SDSS) for humanitarian logistics by integrating Geographical Information Systems (GIS) and the capacitated vehicle routing problem (CVRP). The GIS is utilised for acquiring demands simulated from the tsunami flooding model of the affected area in the first stage, and visualising the simulation solutions in the last stage. While CVRP in this study encompasses designing the relief routes of a set of homogeneous vehicles from a relief centre to a set of geographically distributed evacuation points in which their demands are estimated by using both simulation and randomisation techniques. The CVRP is modeled as a multi-objective optimization problem where both total travelling distance and total transport resources used are minimized, while demand-cost efficiency of each route is maximized in order to determine route priority. As the model is a NP-hard combinatorial optimization problem, the Clarke and Wright Saving heuristics is proposed to solve the problem for the near-optimal solutions. The real-case instances in the coastal area of Phuket, Thailand are studied to perform the SDSS that allows a decision maker to visually analyse the simulation scenarios through different decision factors.Keywords: demand simulation, humanitarian logistics, geographical information systems, relief operations, capacitated vehicle routing problem
Procedia PDF Downloads 248375 Aboriginal Head and Neck Cancer Patients Have Different Patterns of Metastatic Involvement, and Have More Advanced Disease at Diagnosis
Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern
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Introduction: The mortality gap in Aboriginal Head and Neck Cancer is well known, but the reasons for poorer survival are not well established. Aim: We aimed to evaluate the locoregional and metastatic involvement, and stage at diagnosis, in Aboriginal compared with non-Aboriginal patients. Methods: We performed a retrospective cohort analysis of 320 HNC patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by sites, histology, rurality, and age. We collected data on the patient characteristics, tumour features, regions involved, stage at diagnosis, treatment history, and survival and relapse patterns, including sites of metastatic and locoregional involvement. Results: Aboriginal patients had a significantly higher incidence of lung metastases (26.3% versus 13.7%, p=0.009). Aboriginal patients also had a numerically but non-statistically significant higher incidence of thoracic nodal involvement (10% vs 5.8%) and malignant pleural effusions (3.8% vs 2.5%). Aboriginal patients also had a numerically but not statistically significantly higher incidence of adrenal and bony involvement. Interestingly, non-Aboriginal patients had an increased rate of cutaneous (2.1% vs 0%) and liver metastases (4.6% vs 2.5%) compared with Aboriginal patients. In terms of locoregional involvement, Aboriginal patients were more than twice as likely to have contralateral neck involvement (58.8% vs 24.2%, p<0.00001), and 30% more likely to have ipsilateral neck lymph node involvement (78.8% vs 60%, p=0.002) than non-Aboriginal patients. Aboriginal patients had significantly more advanced disease at diagnosis (p=0.008). Aboriginal compared with non-Aboriginal patients were less likely to present with stage I (7.5% vs 22.5%), stage II (11.3% vs 13.8%), or stage III disease (13.8% vs 17.1%), and more likely to present with more advanced stage IVA (42.5% vs 34.6%), stage IVB (15% vs 7.1%), or stage IVC (10% vs 5%) disease (p=0.008). Number of regions of disease involvement was higher in Aboriginal patients (median 3, mean 3.64, range 1-10) compared with non-Aboriginal patients (median 2, mean 2.80, range 1-12). Conclusion: Aboriginal patients had a significantly higher incidence of lung metastases, and significantly more frequent involvement of ipsilateral and contralateral neck lymph nodes. Aboriginal patients also had significantly more advanced disease at presentation with a higher stage at diagnosis. We are performing further analyses to investigate explanations for these findings.Keywords: head and neck cancer, Aboriginal, metastases, locoregional, pattern of relapse, sites of disease
Procedia PDF Downloads 69374 Sizing of Drying Processes to Optimize Conservation of the Nuclear Power Plants on Stationary
Authors: Assabo Mohamed, Bile Mohamed, Ali Farah, Isman Souleiman, Olga Alos Ramos, Marie Cadet
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The life of a nuclear power plant is regularly punctuated by short or long period outages to carry out maintenance operations and/or nuclear fuel reloading. During these stops periods, it is essential to conserve all the secondary circuit equipment to avoid corrosion priming. This kind of circuit is one of the main components of a nuclear reactor. Indeed, the conservation materials on shutdown of a nuclear unit improve circuit performance and reduce the maintenance cost considerably. This study is a part of the optimization of the dry preservation of equipment from the water station of the nuclear reactor. The main objective is to provide tools to guide Electricity Production Nuclear Centre (EPNC) in order to achieve the criteria required by the chemical specifications of conservation materials. A theoretical model of drying exchangers of water station is developed by the software Engineering Equation Solver (EES). It used to size requirements and air quality needed for dry conservation of equipment. This model is based on heat transfer and mass transfer governing the drying operation. A parametric study is conducted to know the influence of aerothermal factor taking part in the drying operation. The results show that the success of dry conservation of equipment of the secondary circuit of nuclear reactor depends strongly on the draining, the quality of drying air and the flow of air injecting in the secondary circuit. Finally, theoretical case study performed on EES highlights the importance of mastering the entire system to balance the air system to provide each exchanger optimum flow depending on its characteristics. From these results, recommendations to nuclear power plants can be formulated to optimize drying practices and achieve good performance in the conservation of material from the water at the stop position.Keywords: dry conservation, optimization, sizing, water station
Procedia PDF Downloads 262373 Assessment of Indoor Air Pollution in Naturally Ventilated Dwellings of Mega-City Kolkata
Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya
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The US Environmental Protection Agency defines indoor air pollution as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. This study attempts to demonstrate the causal relationship between the indoor air pollution and its determining aspects. Detailed indoor air pollution audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavourable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group in the urban area of the metropolitan. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses the relationship between indoor air pollution levels and factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.Keywords: indoor air quality, occupant health, air pollution, architecture, urban environment
Procedia PDF Downloads 107372 Measurement and Simulation of Axial Neutron Flux Distribution in Dry Tube of KAMINI Reactor
Authors: Manish Chand, Subhrojit Bagchi, R. Kumar
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A new dry tube (DT) has been installed in the tank of KAMINI research reactor, Kalpakkam India. This tube will be used for neutron activation analysis of small to large samples and testing of neutron detectors. DT tube is 375 cm height and 7.5 cm in diameter, located 35 cm away from the core centre. The experimental thermal flux at various axial positions inside the tube has been measured by irradiating the flux monitor (¹⁹⁷Au) at 20kW reactor power. The measured activity of ¹⁹⁸Au and the thermal cross section of ¹⁹⁷Au (n,γ) ¹⁹⁸Au reaction were used for experimental thermal flux measurement. The flux inside the tube varies from 10⁹ to 10¹⁰ and maximum flux was (1.02 ± 0.023) x10¹⁰ n cm⁻²s⁻¹ at 36 cm from the bottom of the tube. The Au and Zr foils without and with cadmium cover of 1-mm thickness were irradiated at the maximum flux position in the DT to find out the irradiation specific input parameters like sub-cadmium to epithermal neutron flux ratio (f) and the epithermal neutron flux shape factor (α). The f value was 143 ± 5, indicates about 99.3% thermal neutron component and α value was -0.2886 ± 0.0125, indicates hard epithermal neutron spectrum due to insufficient moderation. The measured flux profile has been validated using theoretical model of KAMINI reactor through Monte Carlo N-Particle Code (MCNP). In MCNP, the complex geometry of the entire reactor is modelled in 3D, ensuring minimum approximations for all the components. Continuous energy cross-section data from ENDF-B/VII.1 as well as S (α, β) thermal neutron scattering functions are considered. The neutron flux has been estimated at the corresponding axial locations of the DT using mesh tally. The thermal flux obtained from the experiment shows good agreement with the theoretically predicted values by MCNP, it was within ± 10%. It can be concluded that this MCNP model can be utilized for calculating other important parameters like neutron spectra, dose rate, etc. and multi elemental analysis can be carried out by irradiating the sample at maximum flux position using measured f and α parameters by k₀-NAA standardization.Keywords: neutron flux, neutron activation analysis, neutron flux shape factor, MCNP, Monte Carlo N-Particle Code
Procedia PDF Downloads 163371 An Occupational Health Risk Assessment for Exposure to Benzene, Toluene, Ethylbenzene and Xylenes: A Case Study of Informal Traders in a Metro Centre (Taxi Rank) in South Africa
Authors: Makhosazana Dubazana
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Many South Africans commuters use minibus taxis daily and are connected to the informal transport network through metro centres informally known as Taxi Ranks. Taxi ranks form part of an economic nexus for many informal traders, connecting them to commuters, their prime clientele. They work along designated areas along the periphery of the taxi rank and in between taxi lanes. Informal traders are therefore at risk of adverse health effects associated with the inhalation of exhaust fumes from minibus taxis. Of the exhaust emissions, benzene, toluene, ethylbenzene and xylenes (BTEX) have high toxicity. Purpose: The purpose of this study was to conduct a Human Health Risk Assessment for informal traders, looking at their exposure to BTEX compounds. Methods: The study was conducted in a subsection of a taxi rank which is representative of the entire taxi rank. This subsection has a daily average of 400 minibus taxi moving through it and an average of 60 informal traders working in it. In the health risk assessment, a questionnaire was conducted to understand the occupational behaviour of the informal traders. This was used to deduce the exposure scenarios and sampling locations. Three sampling campaigns were run for an average of 10 hours each covering the average working hours of traders. A gas chronographer was used for collecting continues ambient air samples at 15 min intervals. Results: Over the three sampling days, the average concentrations were, 8.46ppb, 0.63 ppb, 1.27ppb and 1.0ppb for benzene, toluene, ethylbenzene, and xylene respectively. The average cancer risk is 9.46E-03. In several cases, they were incidences of unacceptable risk for the cumulative exposure of all four BTEX compounds. Conclusion: This study adds to the body of knowledge on the Human Health Risk effects of urban BTEX pollution, furthermore focusing on the impact of urban BTEX on high risk personal such as informal traders, in Southern Africa.Keywords: human health risk assessment, informal traders, occupational risk, urban BTEX
Procedia PDF Downloads 232370 Ultrasound as an Aid to Predict the Onset of Leaking in Dengue Haemorrhagic Fever: Experience of a Dengue Treatment Facility in South Asia
Authors: Hasn Perera, Is Almeida, Hnk Perera, Mzf Mohammed, Ade Silva, H. Wijesinghe, Ajal Fernando
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Introduction: Dengue is a major Public Health burden of two clinical entities, Dengue Fever & Dengue Haemorrhagic Fever (DHF). The vast majority of dengue deaths occur in DHF patients, where the diagnosis hinges on the presence of fluid leakage. Limited Ultrasound Scans (USS) of chest and abdomen are used widely at Centre for Clinical Management of Dengue & Dengue Haemorrhagic Fever (CCMDDHF), as the primary method for detecting fluid leaking in DHF. This study analyses the relationship between haematological and USS findings at the onset of leaking and to further determine the usefulness of ultrasound in diagnosing DHF. Methods: A prospective analysis of 80 serologically confirmed dengue patients initially admitted to a General Medical and Paediatric wards who were subsequently transferred to the CCMDDHF from March to September 2017 were analysed. In addition to repeated blood counts and capillary haematocrits’, serial USS were done to detect the onset fluid leaking by three competent and experienced doctors at CCMDDHF. Results: 80 patients (male: female: 38:42) with a mean age of 20 years (SD ±16.8, range 3-74) were evaluated. Dropping of platelet counts below 100,000 and haematocrit rise towards 20% started 4±1.3 day of fever with a mean platelet value of 69x103(range17-98x103). Gallbladder wall thickening was the commonest (98.7%) USS finding followed by fluid in hepato-renal pouch (95%), pelvic fluid (58.7%), right-sided pleural effusion (35%), bilateral effusions (7.5%). USS evidence of plasma leakage was detected in 11.25 %( n=9) of DHF cases from 1 day before significant haematocrit rise was noted. 35 (43.7%) patients with lowering platelets and haematocrit rise showed no objective evidence of plasma leaking on ultrasound scan. Conclusion: This outbreak underscores the importance of USS as a useful, sensitive and cost-effective tool for early diagnosis of suspected DHF cases, facilitating the tracking of progress of leaking and management of epidemics.Keywords: dengue, ultrasound, plasma leaking, South Asia
Procedia PDF Downloads 234369 Brachypodium: A Model Genus to Study Grass Genome Organisation at the Cytomolecular Level
Authors: R. Hasterok, A. Betekhtin, N. Borowska, A. Braszewska-Zalewska, E. Breda, K. Chwialkowska, R. Gorkiewicz, D. Idziak, J. Kwasniewska, M. Kwasniewski, D. Siwinska, A. Wiszynska, E. Wolny
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In contrast to animals, the organisation of plant genomes at the cytomolecular level is still relatively poorly studied and understood. However, the Brachypodium genus in general and B. distachyon in particular represent exceptionally good model systems for such study. This is due not only to their highly desirable ‘model’ biological features, such as small nuclear genome, low chromosome number and complex phylogenetic relations, but also to the rapidly and continuously growing repertoire of experimental tools, such as large collections of accessions, WGS information, large insert (BAC) libraries of genomic DNA, etc. Advanced cytomolecular techniques, such as fluorescence in situ hybridisation (FISH) with evermore sophisticated probes, empowered by cutting-edge microscope and digital image acquisition and processing systems, offer unprecedented insight into chromatin organisation at various phases of the cell cycle. A good example is chromosome painting which uses pools of chromosome-specific BAC clones, and enables the tracking of individual chromosomes not only during cell division but also during interphase. This presentation outlines the present status of molecular cytogenetic analyses of plant genome structure, dynamics and evolution using B. distachyon and some of its relatives. The current projects focus on important scientific questions, such as: What mechanisms shape the karyotypes? Is the distribution of individual chromosomes within an interphase nucleus determined? Are there hot spots of structural rearrangement in Brachypodium chromosomes? Which epigenetic processes play a crucial role in B. distachyon embryo development and selective silencing of rRNA genes in Brachypodium allopolyploids? The authors acknowledge financial support from the Polish National Science Centre (grants no. 2012/04/A/NZ3/00572 and 2011/01/B/NZ3/00177)Keywords: Brachypodium, B. distachyon, chromosome, FISH, molecular cytogenetics, nucleus, plant genome organisation
Procedia PDF Downloads 351368 Automated, Short Cycle Production of Polymer Composite Applications with Special Regards to the Complexity and Recyclability of Composite Elements
Authors: Peter Pomlenyi, Orsolya Semperger, Gergely Hegedus
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The purpose of the project is to develop a complex composite component with visible class ‘A’ surface. It is going to integrate more functions, including continuous fiber reinforcement, foam core, injection molded ribs, and metal inserts. Therefore we are going to produce recyclable structural composite part from thermoplastic polymer in serial production with short cycle time for automotive applications. Our design of the process line is determined by the principles of Industry 4.0. Accordingly, our goal is to map in details the properties of the final product including the mechanical properties in order to replace metal elements used in automotive industry, with special regard to the effect of each manufacturing process step on the afore mentioned properties. Period of the project is 3 years, which lasts from the 1st of December 2016 to the 30th November 2019. There are four consortium members in the R&D project evopro systems engineering Ltd., Department of Polymer Engineering of the Budapest University of Technology and Economics, Research Centre for Natural Sciences of Hungarian Academy of Sciences and eCon Engineering Ltd. One of the most important result that we can obtain short cycle time (up to 2-3 min) with in-situ polymerization method, which is an innovation in the field of thermoplastic composite production. Because of the mentioned method, our fully automated production line is able to manufacture complex thermoplastic composite parts and satisfies the short cycle time required by the automotive industry. In addition to the innovative technology, we are able to design, analyze complex composite parts with finite element method, and validate our results. We are continuously collecting all the information, knowledge and experience to improve our technology and obtain even more accurate results with respect to the quality and complexity of the composite parts, the cycle time of the production, and the design and analyzing method of the composite parts.Keywords: T-RTM technology, composite, automotive, class A surface
Procedia PDF Downloads 139367 Investigating Constructions and Operation of Internal Combustion Engine Water Pumps
Authors: Michał Gęca, Konrad Pietrykowski, Grzegorz Barański
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The water pump in the compression-ignition internal combustion engine transports a hot coolant along a system of ducts from the engine block to the radiator where coolant temperature is lowered. This part needs to maintain a constant volumetric flow rate. Its power should be regulated to avoid a significant drop in pressure if a coolant flow decreases. The internal combustion engine cooling system uses centrifugal pumps for suction. The paper investigates 4 constructions of engine pumps. The pumps are from diesel engine of a maximum power of 75 kW. Each of them has a different rotor shape, diameter and width. The test stand was created and the geometry inside the all 4 engine blocks was mapped. For a given pump speed on the inverter of the electric engine motor, the valve position was changed and volumetric flow rate, pressure, and power were recorded. Pump speed was regulated from 1200 RPM to 7000 RPM every 300 RPM. The volumetric flow rates and pressure drops for the pump speeds and efficiencies were specified. Accordingly, the operations of each pump were mapped. Our research was to select a pump for the aircraft compression-ignition engine. There was calculated a pressure drop at a given flow on the block and radiator of the designed aircraft engine. The water pump should be lightweight and have a low power demand. This fact shall affect the shape of a rotor and bearings. The pump volumetric flow rate was assumed as 3 kg/s (previous AVL BOOST research model) where the temperature difference was 5°C between the inlet (90°C) and outlet (95°C). Increasing pump speed above the boundary flow power defined by pressure and volumetric flow rate does not increase it but pump efficiency decreases. The maximum total pump efficiency (PCC) is 45-50%. When the pump is driven by low speeds with a 90% closed valve, its overall efficiency drops to 15-20%. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.Keywords: aircraft engine, diesel engine, flow, water pump
Procedia PDF Downloads 252366 Vulnerability Assessment of Groundwater Quality Deterioration Using PMWIN Model
Authors: A. Shakoor, M. Arshad
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The utilization of groundwater resources in irrigation has significantly increased during the last two decades due to constrained canal water supplies. More than 70% of the farmers in the Punjab, Pakistan, depend directly or indirectly on groundwater to meet their crop water demands and hence, an unchecked paradigm shift has resulted in aquifer depletion and deterioration. Therefore, a comprehensive research was carried at central Punjab-Pakistan, regarding spatiotemporal variation in groundwater level and quality. Processing MODFLOW for window (PMWIN) and MT3D (solute transport model) models were used for existing and future prediction of groundwater level and quality till 2030. The comprehensive data set of aquifer lithology, canal network, groundwater level, groundwater salinity, evapotranspiration, groundwater abstraction, recharge etc. were used in PMWIN model development. The model was thus, successfully calibrated and validated with respect to groundwater level for the periods of 2003 to 2007 and 2008 to 2012, respectively. The coefficient of determination (R2) and model efficiency (MEF) for calibration and validation period were calculated as 0.89 and 0.98, respectively, which argued a high level of correlation between the calculated and measured data. For solute transport model (MT3D), the values of advection and dispersion parameters were used. The model used for future scenario up to 2030, by assuming that there would be no uncertain change in climate and groundwater abstraction rate would increase gradually. The model predicted results revealed that the groundwater would decline from 0.0131 to 1.68m/year during 2013 to 2030 and the maximum decline would be on the lower side of the study area, where infrastructure of canal system is very less. This lowering of groundwater level might cause an increase in the tubewell installation and pumping cost. Similarly, the predicted total dissolved solids (TDS) of the groundwater would increase from 6.88 to 69.88mg/L/year during 2013 to 2030 and the maximum increase would be on lower side. It was found that in 2030, the good quality would reduce by 21.4%, while marginal and hazardous quality water increased by 19.28 and 2%, respectively. It was found from the simulated results that the salinity of the study area had increased due to the intrusion of salts. The deterioration of groundwater quality would cause soil salinity and ultimately the reduction in crop productivity. It was concluded from the predicted results of groundwater model that the groundwater deteriorated with the depth of water table i.e. TDS increased with declining groundwater level. It is recommended that agronomic and engineering practices i.e. land leveling, rainwater harvesting, skimming well, ASR (Aquifer Storage and Recovery Wells) etc. should be integrated to meliorate management of groundwater for higher crop production in salt affected soils.Keywords: groundwater quality, groundwater management, PMWIN, MT3D model
Procedia PDF Downloads 378365 Linking the Built Environment, Activities and Well-Being: Examining the Stories among Older Adults during Ageing-in-Place
Authors: Wenquan Gan, Peiyu Zhao, Xinyu Zhao
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Under the background of the rapid development of China’s ageing population, ageing-in-place has become a primary strategy to cope with this problem promoted by the Chinese government. However, most older adults currently living in old residential communities are insufficient to support their ageing-in-place. Therefore, exploring how to retrofit existing communities towards ageing-friendly standards to support older adults is essential for healthy ageing. To better cope with this issue, this study aims to shed light on the inter-relationship among the built environment, daily activities, and well-being of older adults in urban China. Using mixed research methods including GPS tracking, structured observation, and in-depth interview to examine: (a) what specific places or facilities are most commonly used by the elderly in the ageing-in-place process; (b) what specific built environment characteristics attract older adults in these frequently used places; (c) how has the use of these spaces impacted the well-being of older adults. Specifically, structured observation and GPS are used to record and map the older residents’ behaviour and movement in Suzhou, China, a city with a highly aged population and suitable as a research case. Subsequently, a follow-up interview is conducted to explore what impact of activities and the built environment on their well-being. Results showed that for the elderly with good functional ability, the facilities promoted by the Chinese government to support ageing-in-place, such as community nursing homes for the aged, day-care centre, and activity centres for the aged, are rarely used by older adults. Additionally, older adults have their preferred activities and built environment characteristics that contribute to their well-being. Our findings indicate that a complex interrelationship between the built environment and activities can influence the well-being of the elderly. Further investigations are needed to understand how to support healthy ageing-in-place, especially in addition to providing permanent elder-ly-care facilities, but to attend to the design interventions that can enhance these particularly built environment characteristics to facilitate a healthy lifestyle in later life.Keywords: older adults, built environment, spatial behavior, community activity, healthy ageing
Procedia PDF Downloads 107364 Comparing Trastuzumab-Related Cardiotoxicity between Elderly and Younger Patients with Breast Cancer: A Prospective Cohort Study
Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky
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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity
Procedia PDF Downloads 205363 Outcomes of the Gastrocnemius Flap Performed by Orthopaedic Surgeons in Salvage Revision Knee Arthroplasty: A Retrospective Study at a Tertiary Orthopaedic Centre
Authors: Amirul Adlan, Robert McCulloch, Scott Evans, Michael Parry, Jonathan Stevenson, Lee Jeys
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Background and Objectives: The gastrocnemius myofascial flap is used to manage soft-tissue defects over the anterior aspect of the knee in the context of a patient presenting with a sinus and periprosthetic joint infection (PJI) or extensor mechanism failure. The aim of this study was twofold: firstly, to evaluate the outcomes of gastrocnemius flaps performed by appropriately trained orthopaedic surgeons in the context of PJI and, secondly, to evaluate the infection-free survival of this patient group. Methods: We retrospectively reviewed 30 patients who underwent gastrocnemius flap reconstruction during staged revision total knee arthroplasty for prosthetic joint infection (PJI). All flaps were performed by an orthopaedic surgeon with orthoplastics training. Patients had a mean age of 68.9 years (range 50–84) and were followed up for a mean of 50.4 months (range 2–128 months). A total of 29 patients (97 %) were categorized into Musculoskeletal Infection Society (MSIS) local extremity grade 3 (greater than two compromising factors), and 52 % of PJIs were polymicrobial. The primary outcome measure was flap failure, and the secondary outcome measure was a recurrent infection. Results: Flap survival was 100% with no failures or early returns to theatre for flap problems such as necrosis or haematoma. Overall infection-free survival during the study period was 48% (13 of 27 infected cases). Using limb salvage as the outcome, 77% (23 of 30 patients) retained the limb. Infection recurrence occurred in 48% (10 patients) in the type B3 cohort and 67% (4 patients) in the type C3 cohort (p = 0.65). Conclusion: The surgical technique for a gastrocnemius myofascial flap is reliable and reproducible when performed by appropriately trained orthopaedic surgeons, even in high-risk groups. However, the risks of recurrent infection and amputation remain high within our series due to poor host and extremity factors.Keywords: gastrocnemius flap, limb salvage, revision arthroplasty, outcomes
Procedia PDF Downloads 111362 A Brief Trauma Treatment Program for Survivors of Trauma: A Single-Case Design
Authors: Duane Booysen, Ashraf Kagee
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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.Keywords: psychological interventions, public mental health, traumatic stress, single-case design
Procedia PDF Downloads 155361 Physical Activity and Mental Health: A Cross-Sectional Investigation into the Relationship of Specific Physical Activity Domains and Mental Well-Being
Authors: Katja Siefken, Astrid Junge
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Background: Research indicates that physical activity (PA) protects us from developing mental disorders. The knowledge regarding optimal domain, intensity, type, context, and amount of PA promotion for the prevention of mental disorders is sparse and incoherent. The objective of this study is to determine the relationship between PA domains and mental well-being, and whether associations vary by domain, amount, context, intensity, and type of PA. Methods: 310 individuals (age: 25 yrs., SD 7; 73% female) completed a questionnaire on personal patterns of their PA behaviour (IPQA) and their mental health (Centre of Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder (GAD-7) scale, the subjective physical well-being (FEW-16)). Linear and multiple regression were used for analysis. Findings: Individuals who met the PA recommendation (N=269) reported higher scores on subjective physical well-being than those who did not meet the PA recommendations (N=41). Whilst vigorous intensity PA predicts subjective well-being (β = .122, p = .028), it also correlates with depression. The more vigorously physically active a person is, the higher the depression score (β = .127, p = .026). The strongest impact of PA on mental well-being can be seen in the transport domain. A positive linear correlation on subjective physical well-being (β =.175, p = .002), and a negative linear correlation for anxiety (β =-.142, p = .011) and depression (β = -.164, p = .004) was found. Multiple regression analysis indicates similar results: Time spent in active transport on the bicycle significantly lowers anxiety and depression scores and enhances subjective physical well-being. The more time a participant spends using the bicycle for transport, the lower the depression (β = -.143, p = .013) and anxiety scores (β = -.111,p = .050). Conclusions: Meeting the PA recommendations enhances subjective physical well-being. Active transport has a substantial impact on mental well-being. Findings have implications for policymakers, employers, public health experts and civil society. A stronger focus on the promotion and protection of health through active transport is recommended. Inter-sectoral exchange, outside the health sector, is required. Health systems must engage other sectors in adopting policies that maximize possible health gains.Keywords: active transport, mental well-being, health promotion, psychological disorders
Procedia PDF Downloads 320360 Negotiating Strangeness: Narratives of Forced Return Migration and the Construction of Identities
Authors: Cheryl-Ann Sarita Boodram
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Historically, the movement of people has been the subject of socio-political and economic regulatory policies which congeal to regulate human mobility and establish geopolitical and spatial identities and borderlands. As migratory practices evolved, so too has the problematization associated with movement, migration and citizenship. The emerging trends have led to active development of immigration technology governing human mobility and the naming of migratory practices. One such named phenomenon is ‘deportation’ or the forced removal of individuals from their adopted country. Deportation, has gained much attention within the human mobility landscape in the past twenty years following the September 2001 terrorist attack on the World Trade Centre in New York. In a reactionary move, several metropolitan countries, including Canada and the United Kingdom enacted or reviewed immigration laws which further enabled the removal of foreign born criminals to the land of their birth in the global south. Existing studies fall short of understanding the multiple textures of the forced returned migration experiences and the social injustices resulting from deportation displacement. This study brings together indigenous research methodologies through the use of participatory action research and social work with returned migrants in Trinidad and Tobago to uncover the experiences of displacement of deported nationals. The study explores the experiences of negotiating life as a ‘stranger’ and how return has influenced the construction of identities of returned nationals. Findings from this study reveal that deportation has led to inequalities and facilitated ‘othering’ of this group within their own country of birth. The study further highlighted that deportation leads to circuits of dispossession, and perpetuates inequalities. This study provides original insights into the way returned migrants negotiate, map and embody ‘strangeness’ and manage their return to a soil they consider unfamiliar and alien.Keywords: stranger, alien geographies, displacement, deportation, negotiating strangeness, identity, otherness, alien landscapes
Procedia PDF Downloads 505359 Day-Case Ketamine Infusions in Patients with Chronic Pancreatitis
Authors: S. M. C. Kelly, M. Goulden
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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis
Procedia PDF Downloads 136358 Pracademia in Irish Higher Education: The Only Solution to Contemporary Regulation in Professional Social Care Practice
Authors: Aoife Prendergast
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The synergy between theory and practice can be considered elusive, the touchstone for the development of successful undergraduate programmes particularly in allied health professions such as social care. A 'pracademic' is a person who spans both the somewhat ethereal world of academia as a scholar and the pragmatic world of practice. This paper examines the concept of 'pracademia' in relation to the role of the social care practitioner and continuing professional development. It also assists in the understanding of the synergy between social care professionals and higher education. A consideration of the identity and position in terms of approach to regulation is explored as well as an acknowledgement of the strengths and opportunities for sharing power in hierarchical positions. The world of practice serves as the centre point of the academic compass for most professional programs. Just as schools of engineering and law are disciplined by the marketplace, which seeks well-trained students, so our social care programmes must perennially find ways to address the fast changing needs of practitioners, whether they be government, not-for-profit organizations, consulting firms or contractors. We may not expect such traditional academic disciplines as history, sociology, or political science to cater to the needs of external audiences or practitioners— indeed, these disciplines' insulation from public concerns and issues is considered a strength by some. This paper aims to explore the integration of academic teaching and research with the communities of practice in social care. This appears to be a fundamental aspiration of the social care profession. While building and integrating an important body of academic theory and concepts from a variety of disciplines, social care as a field has embraced a professional orientation by seeking to be relevant to practitioners at various levels. While teaching theory, social care programmes, and faculty are often acutely aware that their academic content and credibility, in part, rest on a deep connection with practitioners. While theory can be self-contained, the impact of our research and teaching arguably finds its most compelling and highest audience when it addresses the agenda items and concerns of practitioners.Keywords: social care, pracademia, supervision, practice education
Procedia PDF Downloads 162357 Characterising Rates of Renal Dysfunction and Sarcoidosis in Patients with Elevated Serum Angiotensin-Converting Enzyme
Authors: Fergal Fouhy, Alan O’Keeffe, Sean Costelloe, Michael Clarkson
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Background: Sarcoidosis is a systemic, non-infectious disease of unknown aetiology, characterized by non-caseating granulomatous inflammation. The lung is most often affected (90%); however, the condition can affect all organs, including the kidneys. There is limited evidence describing the incidence and characteristics of renal involvement in sarcoidosis. Serum angiotensin-converting enzyme (ACE) is a recognised biomarker used in the diagnosis and monitoring of sarcoidosis. Methods: A single-centre, retrospective cohort study of patients presenting to Cork University Hospital (CUH) in 2015 with first-time elevations of serum ACE was performed. This included an initial database review of ACE and other biochemistry results, followed by a medical chart review to confirm the presence or absence of sarcoidosis and management thereof. Acute kidney injury (AKI) was staged using the AKIN criteria, and chronic kidney disease (CKD) was staged using the KDIGO criteria. Follow-up was assessed over five years tracking serum creatinine, serum calcium, and estimated glomerular filtration rates (eGFR). Results: 119 patients were identified as having a first raised serum ACE in 2015. Seventy-nine male patients and forty female patients were identified. The mean age of patients identified was 47 years old. 11% had CKD at baseline. 18% developed an AKI at least once within the next five years. A further 6% developed CKD during this time period. 13% developed hypercalcemia. The patients within the lowest quartile of serums ACE had an incidence of sarcoidosis of 5%. None of this group developed hypercalcemia, 23% developed AKI, and 7% developed CKD. Of the patients with a serum ACE in the highest quartile, almost all had documented diagnoses of sarcoidosis with an incidence of 96%. 3% of this group developed hypercalcemia, 13% AKI and 3% developed CKD. Conclusions: There was an unexpectedly high incidence of AKI in patients who had a raised serum ACE. Not all patients with a raised serum ACE had a confirmed diagnosis of sarcoidosis. There does not appear to be a relationship between increased serum ACE levels and increased incidence of hypercalcaemia, AKI, and CKD. Ideally, all patients should have biopsy-proven sarcoidosis. This is an initial study that should be replicated with larger numbers and including multiple centres.Keywords: sarcoidosis, acute kidney injury, chronic kidney disease, hypercalcemia
Procedia PDF Downloads 103356 Numerical Analysis of Heat Transfer in Water Channels of the Opposed-Piston Diesel Engine
Authors: Michal Bialy, Marcin Szlachetka, Mateusz Paszko
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This paper discusses the CFD results of heat transfer in water channels in the engine body. The research engine was a newly designed Diesel combustion engine. The engine has three cylinders with three pairs of opposed pistons inside. The engine will be able to generate 100 kW mechanical power at a crankshaft speed of 3,800-4,000 rpm. The water channels are in the engine body along the axis of the three cylinders. These channels are around the three combustion chambers. The water channels transfer combustion heat that occurs the cylinders to the external radiator. This CFD research was based on the ANSYS Fluent software and aimed to optimize the geometry of the water channels. These channels should have a maximum flow of heat from the combustion chamber or the external radiator. Based on the parallel simulation research, the boundary and initial conditions enabled us to specify average values of key parameters for our numerical analysis. Our simulation used the average momentum equations and turbulence model k-epsilon double equation. There was also used a real k-epsilon model with a function of a standard wall. The turbulence intensity factor was 10%. The working fluid mass flow rate was calculated for a single typical value, specified in line with the research into the flow rate of automotive engine cooling pumps used in engines of similar power. The research uses a series of geometric models which differ, for instance, in the shape of the cross-section of the channel along the axis of the cylinder. The results are presented as colourful distribution maps of temperature, speed fields and heat flow through the cylinder walls. Due to limitations of space, our paper presents the results on the most representative geometric model only. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A. and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.Keywords: Ansys fluent, combustion engine, computational fluid dynamics CFD, cooling system
Procedia PDF Downloads 219355 Unsupervised Detection of Burned Area from Remote Sensing Images Using Spatial Correlation and Fuzzy Clustering
Authors: Tauqir A. Moughal, Fusheng Yu, Abeer Mazher
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Land-cover and land-use change information are important because of their practical uses in various applications, including deforestation, damage assessment, disasters monitoring, urban expansion, planning, and land management. Therefore, developing change detection methods for remote sensing images is an important ongoing research agenda. However, detection of change through optical remote sensing images is not a trivial task due to many factors including the vagueness between the boundaries of changed and unchanged regions and spatial dependence of the pixels to its neighborhood. In this paper, we propose a binary change detection technique for bi-temporal optical remote sensing images. As in most of the optical remote sensing images, the transition between the two clusters (change and no change) is overlapping and the existing methods are incapable of providing the accurate cluster boundaries. In this regard, a methodology has been proposed which uses the fuzzy c-means clustering to tackle the problem of vagueness in the changed and unchanged class by formulating the soft boundaries between them. Furthermore, in order to exploit the neighborhood information of the pixels, the input patterns are generated corresponding to each pixel from bi-temporal images using 3×3, 5×5 and 7×7 window. The between images and within image spatial dependence of the pixels to its neighborhood is quantified by using Pearson product moment correlation and Moran’s I statistics, respectively. The proposed technique consists of two phases. At first, between images and within image spatial correlation is calculated to utilize the information that the pixels at different locations may not be independent. Second, fuzzy c-means technique is used to produce two clusters from input feature by not only taking care of vagueness between the changed and unchanged class but also by exploiting the spatial correlation of the pixels. To show the effectiveness of the proposed technique, experiments are conducted on multispectral and bi-temporal remote sensing images. A subset (2100×1212 pixels) of a pan-sharpened, bi-temporal Landsat 5 thematic mapper optical image of Los Angeles, California, is used in this study which shows a long period of the forest fire continued from July until October 2009. Early forest fire and later forest fire optical remote sensing images were acquired on July 5, 2009 and October 25, 2009, respectively. The proposed technique is used to detect the fire (which causes change on earth’s surface) and compared with the existing K-means clustering technique. Experimental results showed that proposed technique performs better than the already existing technique. The proposed technique can be easily extendable for optical hyperspectral images and is suitable for many practical applications.Keywords: burned area, change detection, correlation, fuzzy clustering, optical remote sensing
Procedia PDF Downloads 169354 High Culture or Low Culture: The Propagation and Popularization of the Classic of Poetry in Modern China
Authors: Fang Tang
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A major Confucian masterpiece and the earliest-known poetry anthology (composed approximately 1046-771 BCE), The Classic of Poetry, reflects different cultures in ancient China. It is regarded as a Chinese classic and one of the world’s most significant written works, an essential part of our global cultural heritage. This paper explores how the ancient Chinese classic became transformed into part of popular culture, found in folk songs circulated in Fangxian county, a mountainous location in Hubei province in central mainland China. It is the hometown of one of the most well-known authors of The Classic of Poetry, whose name is Yin Jifu. Local villagers process, refine, and recreate these poems into popular folk songs, which have been handed down from generation to generation. The folk songs based on The Classic of Poetry vividly reflect local customs, life styles, and various cultural activities. After thousands of years of singing these traditional songs, the region has become an important area to maintain part of Chinese cultural heritages; here, the original high culture is converted into a popular culture that is absorbed into people’s daily life. Based on a year’s field research and many interviews with local singers, this paper explores the ways in which locals have transformed the contents of The Classic of Poetry. It examines how today these popular folk songs become part of much-treasured culture heritage, illustrating the transformation of traditional high culture into popular culture. The paper argues that the modern adaptations of the traditional poems of The Classic of Poetry combine both oral and written cultural heritage and reflects the interaction between ancient Chinese official literature and folk literature. The paper also explores the reasons why the folk songs of The Classic of Poetry are so popular in the area, including the influences of its author Yin Jifu, the impact of ancient diasporic culture from the political centre to remote rural areas, and the interactions of local cultures (famous as Chu culture) and Chinese mainstream cultural policies.Keywords: high/low culture, The Classic of Poetry, the functions of media, cultural policy
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