Search results for: Main Karoo Basin
757 Digital Advance Care Planning and Directives: Early Observations of Adoption Statistics and Responses from an All-Digital Consumer-Driven Approach
Authors: Robert L. Fine, Zhiyong Yang, Christy Spivey, Bonnie Boardman, Maureen Courtney
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Importance: Barriers to traditional advance care planning (ACP) and advance directive (AD) creation have limited the promise of ACP/AD for individuals and families, the healthcare team, and society. Reengineering ACP by using a web-based, consumer-driven process has recently been suggested. We report early experience with such a process. Objective: Begin to analyze the potential of the creation and use of ACP/ADs as generated by a consumer-friendly, digital process by 1) assessing the likelihood that consumers would create ACP/ADs without structured intervention by medical or legal professionals, and 2) analyzing the responses to determine if the plans can help doctors better understand a person’s goals, preferences, and priorities for their medical treatments and the naming of healthcare agents. Design: The authors chose 900 users of MyDirectives.com, a digital ACP/AD tool, solely based on their state of residence in order to achieve proportional representation of all 50 states by population size and then reviewed their responses, summarizing these through descriptive statistics including treatment preferences, demographics, and revision of preferences. Setting: General United States population. Participants: The 900 participants had an average age of 50.8 years (SD = 16.6); 84.3% of the men and 91% of the women were in self-reported good health when signing their ADs. Main measures: Preferences regarding the use of life-sustaining treatments, where to spend final days, consulting a supportive and palliative care team, attempted cardiopulmonary resuscitation (CPR), autopsy, and organ and tissue donation. Results: Nearly 85% of respondents prefer cessation of life-sustaining treatments during their final days whenever those may be, 76% prefer to spend their final days at home or in a hospice facility, and 94% wanted their future doctors to consult a supportive and palliative care team. 70% would accept attempted CPR in certain limited circumstances. Most respondents would want an autopsy under certain conditions, and 62% would like to donate their organs. Conclusions and relevance: Analysis of early experience with an all-digital web-based ACP/AD platform demonstrates that individuals from a wide range of ages and conditions can engage in an interrogatory process about values, goals, preferences, and priorities for their medical treatments by developing advance directives and easily make changes to the AD created. Online creation, storage, and retrieval of advance directives has the potential to remove barriers to ACP/AD and, thus, to further improve patient-centered end-of-life care.Keywords: Advance Care Plan, Advance Decisions, Advance Directives, Consumer; Digital, End of Life Care, Goals, Living Wills, Prefences, Universal Advance Directive, Statements
Procedia PDF Downloads 325756 Three-Dimensional Model of Leisure Activities: Activity, Relationship, and Expertise
Authors: Taekyun Hur, Yoonyoung Kim, Junkyu Lim
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Previous works on leisure activities had been categorizing activities arbitrarily and subjectively while focusing on a single dimension (e.g. active-passive, individual-group). To overcome these problems, this study proposed a Korean leisure activities’ matrix model that considered multidimensional features of leisure activities, which was comprised of 3 main factors and 6 sub factors: (a) Active (physical, mental), (b) Relational (quantity, quality), (c) Expert (entry barrier, possibility of improving). We developed items for measuring the degree of each dimension for every leisure activity. Using the developed Leisure Activities Dimensions (LAD) questionnaire, we investigated the presented dimensions of a total of 78 leisure activities which had been enjoyed by most Koreans recently (e.g. watching movie, taking a walk, watching media). The study sample consisted of 1348 people (726 men, 658 women) ranging in age from teenagers to elderlies in their seventies. This study gathered 60 data for each leisure activity, a total of 4860 data, which were used for statistical analysis. First, this study compared 3-factor model (Activity, Relation, Expertise) fit with 6-factor model (physical activity, mental activity, relational quantity, relational quality, entry barrier, possibility of improving) fit by using confirmatory factor analysis. Based on several goodness-of-fit indicators, the 6-factor model for leisure activities was a better fit for the data. This result indicates that it is adequate to take account of enough dimensions of leisure activities (6-dimensions in our study) to specifically apprehend each leisure attributes. In addition, the 78 leisure activities were cluster-analyzed with the scores calculated based on the 6-factor model, which resulted in 8 leisure activity groups. Cluster 1 (e.g. group sports, group musical activity) and Cluster 5 (e.g. individual sports) had generally higher scores on all dimensions than others, but Cluster 5 had lower relational quantity than Cluster 1. In contrast, Cluster 3 (e.g. SNS, shopping) and Cluster 6 (e.g. playing a lottery, taking a nap) had low scores on a whole, though Cluster 3 showed medium levels of relational quantity and quality. Cluster 2 (e.g. machine operating, handwork/invention) required high expertise and mental activity, but low physical activity. Cluster 4 indicated high mental activity and relational quantity despite low expertise. Cluster 7 (e.g. tour, joining festival) required not only moderate degrees of physical activity and relation, but low expertise. Lastly, Cluster 8 (e.g. meditation, information searching) had the appearance of high mental activity. Even though clusters of our study had a few similarities with preexisting taxonomy of leisure activities, there was clear distinctiveness between them. Unlike the preexisting taxonomy that had been created subjectively, we assorted 78 leisure activities based on objective figures of 6-dimensions. We also could identify that some leisure activities, which used to belong to the same leisure group, were included in different clusters (e.g. filed ball sports, net sports) because of different features. In other words, the results can provide a different perspective on leisure activities research and be helpful for figuring out what various characteristics leisure participants have.Keywords: leisure, dimensional model, activity, relationship, expertise
Procedia PDF Downloads 309755 Perception of Tactile Stimuli in Children with Autism Spectrum Disorder
Authors: Kseniya Gladun
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Tactile stimulation of a dorsal side of the wrist can have a strong impact on our attitude toward physical objects such as pleasant and unpleasant impact. This study explored different aspects of tactile perception to investigate atypical touch sensitivity in children with autism spectrum disorder (ASD). This study included 40 children with ASD and 40 healthy children aged 5 to 9 years. We recorded rsEEG (sampling rate of 250 Hz) during 20 min using EEG amplifier “Encephalan” (Medicom MTD, Taganrog, Russian Federation) with 19 AgCl electrodes placed according to the International 10–20 System. The electrodes placed on the left, and right mastoids served as joint references under unipolar montage. The registration of EEG v19 assignments was carried out: frontal (Fp1-Fp2; F3-F4), temporal anterior (T3-T4), temporal posterior (T5-T6), parietal (P3-P4), occipital (O1-O2). Subjects were passively touched by 4 types of tactile stimuli on the left wrist. Our stimuli were presented with a velocity of about 3–5 cm per sec. The stimuli materials and procedure were chosen for being the most "pleasant," "rough," "prickly" and "recognizable". Type of tactile stimulation: Soft cosmetic brush - "pleasant" , Rough shoe brush - "rough", Wartenberg pin wheel roller - "prickly", and the cognitive tactile stimulation included letters by finger (most of the patient’s name ) "recognizable". To designate the moments of the stimuli onset-offset, we marked the moment when the moment of the touch began and ended; the stimulation was manual, and synchronization was not precise enough for event-related measures. EEG epochs were cleaned from eye movements by ICA-based algorithm in EEGLAB plugin for MatLab 7.11.0 (Mathwork Inc.). Muscle artifacts were cut out by manual data inspection. The response to tactile stimuli was significantly different in the group of children with ASD and healthy children, which was also depended on type of tactile stimuli and the severity of ASD. Amplitude of Alpha rhythm increased in parietal region to response for only pleasant stimulus, for another type of stimulus ("rough," "thorny", "recognizable") distinction of amplitude was not observed. Correlation dimension D2 was higher in healthy children compared to children with ASD (main effect ANOVA). In ASD group D2 was lower for pleasant and unpleasant compared to the background in the right parietal area. Hilbert transform changes in the frequency of the theta rhythm found only for a rough tactile stimulation compared with healthy participants only in the right parietal area. Children with autism spectrum disorders and healthy children were responded to tactile stimulation differently with specific frequency distribution alpha and theta band in the right parietal area. Thus, our data supports the hypothesis that rsEEG may serve as a sensitive index of altered neural activity caused by ASD. Children with autism have difficulty in distinguishing the emotional stimuli ("pleasant," "rough," "prickly" and "recognizable").Keywords: autism, tactile stimulation, Hilbert transform, pediatric electroencephalography
Procedia PDF Downloads 250754 Lessons Learnt from Tutors’ Perspectives on Online Tutorial’s Policies in Open and Distance Education Institution
Authors: Durri Andriani, Irsan Tahar, Lilian Sarah Hiariey
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Every institution has to develop, implement, and control its policies to ensure the effectiveness of the institution. In doing so, all related stakeholders have to be involved to maximize the benefit of the policies and minimize the potential constraints and resistances. Open and distance education (ODE) institution is no different. As an education institution, ODE institution has to focus their attention to fulfilling academic needs of their students through open and distance measures. One of them is quality learning support system. Significant stakeholders in learning support system are tutors since they are the ones who directly communicate with students. Tutors are commonly seen as objects whose main responsibility is limited to implementing policies decided by management in ODE institutions. Nonetheless, tutors’ perceptions of tutorials are believed to influence tutors’ performances in facilitating learning support. It is therefore important to analyze tutors’ perception on various aspects of learning support. This paper presents analysis of tutors’ perceptions on policies of tutoriala in ODE institution using Policy Analysis Framework (PAF) modified by King, Nugent, Russell, and Lacy. Focus of this paper is on on-line tutors, those who provide tutorials via Internet. On-line tutors were chosen to stress the increasingly important used of Internet in ODE system. The research was conducted in Universitas Terbuka (UT), Indonesia. UT is purposely selected because of its large number (1,234) of courses offered and large area coverage (6000 inhabited islands). These posed UT in a unique position where learning support system has, to some extent, to be standardized while at the same time it has to be able to cater the needs of different courses in different places for students with different backgrounds. All 598 listed on-line tutors were sent the research questionnaires. Around 20% of the email addresses could not be reached. Tutors were asked to fill out open-ended questionnaires on their perceptions on definition of on-line tutorial, roles of tutors and students in on-line tutorials, requirement for on-line tutors, learning materials, and student evaluation in on-line tutorial. Data analyzed was gathered from 40 on-line tutors who sent back filled-out questionnaires. Data were analyzed qualitatively using content analysis from all 40 tutors. The results showed that using PAF as entry point in choosing learning support services as area of policy with delivery learning materials as the issue at UT has been able to provide new insights of aspects need to be consider in formulating policies in online tutorial and in learning support services. Involving tutors as source of information could be proven to be productive. In general, tutors had clear understanding about definition of online tutorial, roles of tutors and roles of students, and requirement of tutor. Tutors just need to be more involved in the policy formulation since they could provide data on students and problem faced in online tutorial. However, tutors need an adjustment in student evaluation which according tutors too focus on administrative aspects and subjective.Keywords: distance education, on-line tutorial, tutorial policy, tutors’ perspectives
Procedia PDF Downloads 252753 Switchable Lipids: From a Molecular Switch to a pH-Sensitive System for the Drug and Gene Delivery
Authors: Jeanne Leblond, Warren Viricel, Amira Mbarek
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Although several products have reached the market, gene therapeutics are still in their first stages and require optimization. It is possible to improve their lacking efficiency by the use of carefully engineered vectors, able to carry the genetic material through each of the biological barriers they need to cross. In particular, getting inside the cell is a major challenge, because these hydrophilic nucleic acids have to cross the lipid-rich plasmatic and/or endosomal membrane, before being degraded into lysosomes. It takes less than one hour for newly endocytosed liposomes to reach highly acidic lysosomes, meaning that the degradation of the carried gene occurs rapidly, thus limiting the transfection efficiency. We propose to use a new pH-sensitive lipid able to change its conformation upon protonation at endosomal pH values, leading to the disruption of the lipidic bilayer and thus to the fast release of the nucleic acids into the cytosol. It is expected that this new pH-sensitive mechanism promote endosomal escape of the gene, thereby its transfection efficiency. The main challenge of this work was to design a preparation presenting fast-responding lipidic bilayer destabilization properties at endosomal pH 5 while remaining stable at blood pH value and during storage. A series of pH-sensitive lipids able to perform a conformational switch upon acidification were designed and synthesized. Liposomes containing these switchable lipids, as well as co-lipids were prepared and characterized. The liposomes were stable at 4°C and pH 7.4 for several months. Incubation with siRNA led to the full entrapment of nucleic acids as soon as the positive/negative charge ratio was superior to 2. The best liposomal formulation demonstrated a silencing efficiency up to 10% on HeLa cells, very similar to a commercial agent, with a lowest toxicity than the commercial agent. Using flow cytometry and microscopy assays, we demonstrated that drop of pH was required for the transfection efficiency, since bafilomycin blocked the transfection efficiency. Additional evidence was brought by the synthesis of a negative control lipid, which was unable to switch its conformation, and consequently exhibited no transfection ability. Mechanistic studies revealed that the uptake was mediated through endocytosis, by clathrin and caveolae pathways, as reported for previous lipid nanoparticle systems. This potent system was used for the treatment of hypercholesterolemia. The switchable lipids were able to knockdown PCSK9 expression on human hepatocytes (Huh-7). Its efficiency is currently evaluated on in vivo mice model of PCSK9 KO mice. In summary, we designed and optimized a new cationic pH-sensitive lipid for gene delivery. Its transfection efficiency is similar to the best available commercial agent, without the usually associated toxicity. The promising results lead to its use for the treatment of hypercholesterolemia on a mice model. Anticancer applications and pulmonary chronic disease are also currently investigated.Keywords: liposomes, siRNA, pH-sensitive, molecular switch
Procedia PDF Downloads 203752 The Environmental Concerns in Coal Mining, and Utilization in Pakistan
Authors: S. R. H. Baqri, T. Shahina, M. T. Hasan
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Pakistan is facing acute shortage of energy and looking for indigenous resources of the energy mix to meet the short fall. After the discovery of huge coal resources in Thar Desert of Sindh province, focus has shifted to coal power generation. The government of Pakistan has planned power generation of 20000 MW on coal by the year 2025. This target will be achieved by mining and power generation in Thar coal Field and on imported coal in different parts of Pakistan. Total indigenous coal production of around 3.0 million tons is being utilized in brick kilns, cement and sugar industry. Coal-based power generation is only limited to three units of 50 MW near Hyderabad from nearby Lakhra Coal field. The purpose of this presentation is to identify and redressal of issues of coal mining and utilization with reference to environmental hazards. Thar coal resource is estimated at 175 billion tons out of a total resource estimate of 184 billion tons in Pakistan. Coal of Pakistan is of Tertiary age (Palaeocene/Eocene) and classified from lignite to sub-bituminous category. Coal characterization has established three main pollutants such as Sulphur, Carbon dioxide and Methane besides some others associated with coal and rock types. The element Sulphur occurs in organic as well as inorganic forms associated with coals as free sulphur and as pyrite, gypsum, respectively. Carbon dioxide, methane and minerals are mostly associated with fractures, joints local faults, seatearth and roof rocks. The abandoned and working coal mines give kerosene odour due to escape of methane in the atmosphere. While the frozen methane/methane ices in organic matter rich sediments have also been reported from the Makran coastal and offshore areas. The Sulphur escapes into the atmosphere during mining and utilization of coal in industry. The natural erosional processes due to rivers, streams, lakes and coastal waves erode over lying sediments allowing pollutants to escape into air and water. Power plants emissions should be controlled through application of appropriate clean coal technology and need to be regularly monitored. Therefore, the systematic and scientific studies will be required to estimate the quantity of methane, carbon dioxide and sulphur at various sites such as abandoned and working coal mines, exploratory wells for coal, oil and gas. Pressure gauges on gas pipes connecting the coal-bearing horizons will be installed on surface to know the quantity of gas. The quality and quantity of gases will be examined according to the defined intervals of times. This will help to design and recommend the methods and procedures to stop the escape of gases into atmosphere. The element of Sulphur can be removed partially by gravity and chemical methods after grinding and before industrial utilization of coal.Keywords: atmosphere, coal production, energy, pollutants
Procedia PDF Downloads 434751 Trophic Variations in Uptake and Assimilation of Cadmium, Manganese and Zinc: An Estuarine Food-Chain Radiotracer Experiment
Authors: K. O’Mara, T. Cresswell
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Nearly half of the world’s population live near the coast, and as a result, estuaries and coastal bays in populated or industrialized areas often receive metal pollution. Heavy metals have a chemical affinity for sediment particles and can be stored in estuarine sediments and become biologically available under changing conditions. Organisms inhabiting estuaries can be exposed to metals from a variety of sources including metals dissolved in water, bound to sediment or within contaminated prey. Metal uptake and assimilation responses can vary even between species that are biologically similar, making pollution effects difficult to predict. A multi-trophic level experiment representing a common Eastern Australian estuarine food chain was used to study the sources for Cd, Mn and Zn uptake and assimilation in organisms occupying several trophic levels. Sand cockles (Katelysia scalarina), school prawns (Metapenaeus macleayi) and sand whiting (Sillago ciliata) were exposed to radiolabelled seawater, suspended sediment and food. Three pulse-chase trials on filter-feeding sand cockles were performed using radiolabelled phytoplankton (Tetraselmis sp.), benthic microalgae (Entomoneis sp.) and suspended sediment. Benthic microalgae had lower metal uptake than phytoplankton during labelling but higher cockle assimilation efficiencies (Cd = 51%, Mn = 42%, Zn = 63 %) than both phytoplankton (Cd = 21%, Mn = 32%, Zn = 33%) and suspended sediment (except Mn; (Cd = 38%, Mn = 42%, Zn = 53%)). Sand cockles were also sensitive to uptake of Cd, Mn and Zn dissolved in seawater. Uptake of these metals from the dissolved phase was negligible in prawns and fish, with prawns only accumulating metals during moulting, which were then lost with subsequent moulting in the depuration phase. Diet appears to be the main source of metal assimilation in school prawns, with 65%, 54% and 58% assimilation efficiencies from Cd, Mn and Zn respectively. Whiting fed contaminated prawns were able to exclude the majority of the metal activity through egestion, with only 10%, 23% and 11% assimilation efficiencies from Cd, Mn and Zn respectively. The findings of this study support previous studies that find diet to be the dominant accumulation source for higher level trophic organisms. These results show that assimilation efficiencies can vary depending on the source of exposure; sand cockles assimilated more Cd, Mn, and Zn from the benthic diatom than phytoplankton and assimilation was higher in sand whiting fed prawns compared to artificial pellets. The sensitivity of sand cockles to metal uptake and assimilation from a variety of sources poses concerns for metal availability to predators ingesting the clam tissue, including humans. The high tolerance of sand whiting to these metals is reflected in their widespread presence in Eastern Australian estuaries, including contaminated estuaries such as Botany Bay and Port Jackson.Keywords: cadmium, food chain, metal, manganese, trophic, zinc
Procedia PDF Downloads 200750 Controlling Deforestation in the Densely Populated Region of Central Java Province, Banjarnegara District, Indonesia
Authors: Guntur Bagus Pamungkas
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As part of a tropical country that is normally rich in forest land areas, Indonesia has always been in the world's spotlight due to its significantly increasing process of deforestation. In one hand, it is related to the mainstay for maintaining the sustainability of the earth's ecosystem functions. On the other hand, they also cover the various potential sources of the global economy. Therefore, it can always be the target of different scale of investors to excessively exploit them. No wonder the emergence of disasters in various characteristics always comes up. In fact, the deforestation phenomenon does not only occur in various forest land areas in the main islands of Indonesia but also includes Java Island, the most densely populated areas in the world. This island only remains the forest land of about 9.8% of the total forest land in Indonesia due to its long history of it, especially in Central Java Province, the most densely populated area in Java. Again, not surprisingly, this province belongs to the area with the highest frequency of disasters because of it, landslides in particular. One of the areas that often experience it is Banjarnegara District, especially in mountainous areas that lies in the range from 1000 to 3000 meters above sea level, where the remains of land forest area can easyly still be found. Even among them still leaves less untouchable tropical rain forest whose area also covers part of a neighboring district, Pekalongan, which is considered to be the rest of the world's little paradise on Earth. The district's landscape is indeed beautiful, especially in the Dieng area, a major tourist destination in Central Java Province after Borobudur Temple. However, annually hazardous always threatens this district due to this landslide disaster. Even, there was a tragic event that was buried with its inhabitants a few decades ago. This research aims to find part of the concept of effective forest management through monitoring the presence of remaining forest areas in this area. The research implemented monitoring of deforestation rates using the Stochastic Cellular Automata-Markov Chain (SCA-MC) method, which serves to provide a spatial simulation of land use and cover changes (LULCC). This geospatial process uses the Landsat-8 OLI image product with Thermal Infra-Red Sensors (TIRS) Band 10 in 2020 and Landsat 5 TM with TIRS Band 6 in 2010. Then it is also integrated with physical and social geography issues using the QGIS 2.18.11 application with the Mollusce Plugin, which serves to clarify and calculate the area of land use and cover, especially in forest areas—using the LULCC method, which calculates the rate of forest area reduction in 2010-2020 in Banjarnegara District. Since the dependence of this area on the use of forest land is quite high, concepts and preventive actions are needed, such as rehabilitation and reforestation of critical lands through providing proper monitoring and targeted forest management to restore its ecosystem in the future.Keywords: deforestation, populous area, LULCC method, proper control and effective forest management
Procedia PDF Downloads 135749 A Feasibility and Implementation Model of Small-Scale Hydropower Development for Rural Electrification in South Africa: Design Chart Development
Authors: Gideon J. Bonthuys, Marco van Dijk, Jay N. Bhagwan
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Small scale hydropower used to play a very important role in the provision of energy to urban and rural areas of South Africa. The national electricity grid, however, expanded and offered cheap, coal generated electricity and a large number of hydropower systems were decommissioned. Unfortunately, large numbers of households and communities will not be connected to the national electricity grid for the foreseeable future due to high cost of transmission and distribution systems to remote communities due to the relatively low electricity demand within rural communities and the allocation of current expenditure on upgrading and constructing of new coal fired power stations. This necessitates the development of feasible alternative power generation technologies. A feasibility and implementation model was developed to assist in designing and financially evaluating small-scale hydropower (SSHP) plants. Several sites were identified using the model. The SSHP plants were designed for the selected sites and the designs for the different selected sites were priced using pricing models (civil, mechanical and electrical aspects). Following feasibility studies done on the designed and priced SSHP plants, a feasibility analysis was done and a design chart developed for future similar potential SSHP plant projects. The methodology followed in conducting the feasibility analysis for other potential sites consisted of developing cost and income/saving formulae, developing net present value (NPV) formulae, Capital Cost Comparison Ratio (CCCR) and levelised cost formulae for SSHP projects for the different types of plant installations. It included setting up a model for the development of a design chart for a SSHP, calculating the NPV, CCCR and levelised cost for the different scenarios within the model by varying different parameters within the developed formulae, setting up the design chart for the different scenarios within the model and analyzing and interpreting results. From the interpretation of the develop design charts for feasible SSHP in can be seen that turbine and distribution line cost are the major influences on the cost and feasibility of SSHP. High head, short transmission line and islanded mini-grid SSHP installations are the most feasible and that the levelised cost of SSHP is high for low power generation sites. The main conclusion from the study is that the levelised cost of SSHP projects indicate that the cost of SSHP for low energy generation is high compared to the levelised cost of grid connected electricity supply; however, the remoteness of SSHP for rural electrification and the cost of infrastructure to connect remote rural communities to the local or national electricity grid provides a low CCCR and renders SSHP for rural electrification feasible on this basis.Keywords: cost, feasibility, rural electrification, small-scale hydropower
Procedia PDF Downloads 223748 Improving Literacy Level Through Digital Books for Deaf and Hard of Hearing Students
Authors: Majed A. Alsalem
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In our contemporary world, literacy is an essential skill that enables students to increase their efficiency in managing the many assignments they receive that require understanding and knowledge of the world around them. In addition, literacy enhances student participation in society improving their ability to learn about the world and interact with others and facilitating the exchange of ideas and sharing of knowledge. Therefore, literacy needs to be studied and understood in its full range of contexts. It should be seen as social and cultural practices with historical, political, and economic implications. This study aims to rebuild and reorganize the instructional designs that have been used for deaf and hard-of-hearing (DHH) students to improve their literacy level. The most critical part of this process is the teachers; therefore, teachers will be the center focus of this study. Teachers’ main job is to increase students’ performance by fostering strategies through collaborative teamwork, higher-order thinking, and effective use of new information technologies. Teachers, as primary leaders in the learning process, should be aware of new strategies, approaches, methods, and frameworks of teaching in order to apply them to their instruction. Literacy from a wider view means acquisition of adequate and relevant reading skills that enable progression in one’s career and lifestyle while keeping up with current and emerging innovations and trends. Moreover, the nature of literacy is changing rapidly. The notion of new literacy changed the traditional meaning of literacy, which is the ability to read and write. New literacy refers to the ability to effectively and critically navigate, evaluate, and create information using a range of digital technologies. The term new literacy has received a lot of attention in the education field over the last few years. New literacy provides multiple ways of engagement, especially to those with disabilities and other diverse learning needs. For example, using a number of online tools in the classroom provides students with disabilities new ways to engage with the content, take in information, and express their understanding of this content. This study will provide teachers with the highest quality of training sessions to meet the needs of DHH students so as to increase their literacy levels. This study will build a platform between regular instructional designs and digital materials that students can interact with. The intervention that will be applied in this study will be to train teachers of DHH to base their instructional designs on the notion of Technology Acceptance Model (TAM) theory. Based on the power analysis that has been done for this study, 98 teachers are needed to be included in this study. This study will choose teachers randomly to increase internal and external validity and to provide a representative sample from the population that this study aims to measure and provide the base for future and further studies. This study is still in process and the initial results are promising by showing how students have engaged with digital books.Keywords: deaf and hard of hearing, digital books, literacy, technology
Procedia PDF Downloads 487747 The Digital Divide: Examining the Use and Access to E-Health Based Technologies by Millennials and Older Adults
Authors: Delana Theiventhiran, Wally J. Bartfay
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Background and Significance: As the Internet is becoming the epitome of modern communications, there are many pragmatic reasons why the digital divide matters in terms of accessing and using E-health based technologies. With the rise of technology usage globally, those in the older adult generation may not be as familiar and comfortable with technology usage and are thus put at a disadvantage compared to other generations such as millennials when examining and using E-health based platforms and technology. Currently, little is known about how older adults and millennials access and use e-health based technologies. Methods: A systemic review of the literature was undertaken employing the following three databases: (i) PubMed, (ii) ERIC, and (iii) CINAHL; employing the search term 'digital divide and generations' to identify potential articles. To extract required data from the studies, a data abstraction tool was created to obtain the following information: (a) author, (b) year of publication, (c) sample size, (d) country of origin, (e) design/methods, (f) major findings/outcomes obtained. Inclusion criteria included publication dates between the years of Jan 2009 to Aug 2018, written in the English language, target populations of older adults aged 65 and above and millennials, and peer reviewed quantitative studies only. Major Findings: PubMed provided 505 potential articles, where 23 of those articles met the inclusion criteria. Specifically, ERIC provided 53 potential articles, where no articles met criteria following data extraction. CINAHL provided 14 potential articles, where eight articles met criteria following data extraction. Conclusion: Practically speaking, identifying how newer E-health based technologies can be integrated into society and identifying why there is a gap with digital technology will help reduce the impact on generations and individuals who are not as familiar with technology and Internet usage. The largest concern of all is how to prepare older adults for new and emerging E-health technologies. Currently, there is a dearth of literature in this area because it is a newer area of research and little is known about it. The benefits and consequences of technology being integrated into daily living are being investigated as a newer area of research. Several of the articles (N=11) indicated that age is one of the larger factors contributing to the digital divide. Similarly, many of the examined articles (N=5) identify that privacy concerns were one of the main deterrents of technology usage for elderly individuals aged 65 and above. The older adult generation feels that privacy is one of the major concerns, especially in regards to how data is collected, used and possibly sold to third party groups by various websites. Additionally, access to technology, the Internet, and infrastructure also plays a large part in the way that individuals are able to receive and use information. Lastly, a change in the way that healthcare is currently used, received and distributed would also help attribute to the change to ensure that no generation is left behind in a technologically advanced society.Keywords: digital divide, e-health, millennials, older adults
Procedia PDF Downloads 171746 Applications of Digital Tools, Satellite Images and Geographic Information Systems in Data Collection of Greenhouses in Guatemala
Authors: Maria A. Castillo H., Andres R. Leandro, Jose F. Bienvenido B.
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During the last 20 years, the globalization of economies, population growth, and the increase in the consumption of fresh agricultural products have generated greater demand for ornamentals, flowers, fresh fruits, and vegetables, mainly from tropical areas. This market situation has demanded greater competitiveness and control over production, with more efficient protected agriculture technologies, which provide greater productivity and allow us to guarantee the quality and quantity that is required in a constant and sustainable way. Guatemala, located in the north of Central America, is one of the largest exporters of agricultural products in the region and exports fresh vegetables, flowers, fruits, ornamental plants, and foliage, most of which were grown in greenhouses. Although there are no official agricultural statistics on greenhouse production, several thesis works, and congress reports have presented consistent estimates. A wide range of protection structures and roofing materials are used, from the most basic and simple ones for rain control to highly technical and automated structures connected with remote sensors for monitoring and control of crops. With this breadth of technological models, it is necessary to analyze georeferenced data related to the cultivated area, to the different existing models, and to the covering materials, integrated with altitude, climate, and soil data. The georeferenced registration of the production units, the data collection with digital tools, the use of satellite images, and geographic information systems (GIS) provide reliable tools to elaborate more complete, agile, and dynamic information maps. This study details a methodology proposed for gathering georeferenced data of high protection structures (greenhouses) in Guatemala, structured in four phases: diagnosis of available information, the definition of the geographic frame, selection of satellite images, and integration with an information system geographic (GIS). It especially takes account of the actual lack of complete data in order to obtain a reliable decision-making system; this gap is solved through the proposed methodology. A summary of the results is presented in each phase, and finally, an evaluation with some improvements and tentative recommendations for further research is added. The main contribution of this study is to propose a methodology that allows to reduce the gap of georeferenced data in protected agriculture in this specific area where data is not generally available and to provide data of better quality, traceability, accuracy, and certainty for the strategic agricultural decision öaking, applicable to other crops, production models and similar/neighboring geographic areas.Keywords: greenhouses, protected agriculture, GIS, Guatemala, satellite image, digital tools, precision agriculture
Procedia PDF Downloads 193745 Global Digital Peer-to-Peer (P2P) Lending Platform Empowering Rural India: Determinants of Funding
Authors: Ankur Mehra, M. V. Shivaani
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With increasing digitization, the world is coming closer, not only in terms of informational flow but also in terms of capital flows. And micro-finance institutions (MFIs) have perfectly leveraged this digital world by resorting to the innovative digital social peer-to-peer (P2P) lending platforms, such as, Kiva. These digital P2P platforms bring together micro-borrowers and lenders from across the world. The main objective of this study is to understand the funding preferences of social investors primarily from developed countries (such as US, UK, Australia), lending money to borrowers from rural India at zero interest rates through Kiva. Further, the objective of this study is to increase awareness about such a platform among various MFIs engaged in providing micro-loans to those in need. The sample comprises of India based micro-loan applications posted by various MFIs on Kiva lending platform over the period Sept 2012-March 2016. Out of 7,359 loans, 256 loans failed to get funded by social investors. On an average a micro-loan with 30 days to expiry gets fully funded in 7,593 minutes or 5.27 days. 62% of the loans raised on Kiva are related to livelihood, 32.5% of the loans are for funding basic necessities and balance 5.5% loans are for funding education. 47% of the loan applications have more than one borrower; while, currency exchange risk is on the social lenders for 45% of the loans. Controlling for the loan amount and loan tenure, the analyses suggest that those loan applications where the number of borrowers is more than one have a lower chance of getting funded as compared to the loan applications made by a sole borrower. Such group applications also take more time to get funded. Further, loan application by a solo woman not only has a higher chance of getting funded but as such get funded faster. The results also suggest that those loan applications which are supported by an MFI that has a religious affiliation, not only have a lower chance of getting funded, but also take longer to get funded as compared to the loan applications posted by secular MFIs. The results do not support cross-border currency risk to be a factor in explaining the determinants of loan funding. Finally, analyses suggest that loans raised for the purpose of earning livelihood and education have a higher chance of getting funded and such loans get funded faster as compared to the loans applied for purposes related to basic necessities such a clothing, housing, food, health, and personal use. The results are robust to controls for ‘MFI dummy’ and ‘year dummy’. The key implication from this study is that global social investors tend to develop an emotional connect with single woman borrowers and consequently they get funded faster Hence, MFIs should look for alternative ways for funding loans whose purpose is to meet basic needs; while, more loans related to livelihood and education should be raised via digital platforms.Keywords: P2P lending, social investing, fintech, financial inclusion
Procedia PDF Downloads 140744 Toxic Chemicals from Industries into Pacific Biota. Investigation of Polychlorinated Biphenyls (PCBs), Dioxins (PCDD), Furans (PCDF) and Polybrominated Diphenyls (PBDE No. 47) in Tuna and Shellfish in Kiribati, Solomon Islands and the Fiji Islands
Authors: Waisea Votadroka, Bert Van Bavel
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The most commonly consumed shellfish species produced in the Pacific, shellfish and tuna fish, were investigated for the occurrence of a range of brominated and chlorinated contaminants in order to establish current levels. Polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were analysed in the muscle of tuna species Katsuwonis pelamis, yellow fin tuna, and shellfish species from the Fiji Islands. The investigation of polychlorinated biphenyls (PCBs), furans (PCDFs) and polybrominated diphenylethers (PBDE No.47) in tuna and shellfish in Kiribati, Solomon Islands and Fiji is necessary due to the lack of research data in the Pacific region. The health risks involved in the consumption of marine foods laced with toxic organo-chlorinated and brominated compounds makes in the analyses of these compounds in marine foods important particularly when Pacific communities rely on these resources as their main diet. The samples were homogenized in a motor with anhydrous sodium sulphate in the ratio of 1:3 (muscle) and 1:4-1:5 (roe and butter). The tuna and shellfish samples were homogenized and freeze dried at the sampling location at the Institute of Applied Science, Fiji. All samples were stored in amber glss jars at -18 ° C until extraction at Orebro University. PCDD/Fs, PCBs and pesticides were all analysed using an Autospec Ultina HRGC/HRMS operating at 10,000 resolutions with EI ionization at 35 eV. All the measurements were performed in the selective ion recording mode (SIR), monitoring the two most abundant ions of the molecular cluster (PCDD/Fs and PCBs). Results indicated that the Fiji Composite sample for Batissa violacea range 0.7-238.6 pg/g lipid; Fiji sample composite Anadara antiquate range 1.6 – 808.6 pg/g lipid; Solomon Islands Katsuwonis Pelamis 7.5-3770.7 pg/g lipid; Solomon Islands Yellow Fin tuna 2.1 -778.4 pg/g lipid; Kiribati Katsuwonis Pelamis 4.8-1410 pg/g lipids. The study has demonstrated that these species are good bio-indicators of the presence of these toxic organic pollutants in edible marine foods. Our results suggest that for pesticides levels, p,p-DDE is the most dominant for all the groups and seems to be highest at 565.48 pg/g lipid in composite Batissa violacea from Fiji. For PBDE no.47 in comparing all samples, the composite Batissa violacea from Fiji had the highest level of 118.20 pg/g lipid. Based upon this study, the contamination levels found in the study species were quite lower compared with levels reported in impacted ecosystems around the worldKeywords: polychlorinated biphenyl, polybrominated diphenylethers, pesticides, organoclorinated pesticides, PBDEs
Procedia PDF Downloads 381743 Catalytic Ammonia Decomposition: Cobalt-Molybdenum Molar Ratio Effect on Hydrogen Production
Authors: Elvis Medina, Alejandro Karelovic, Romel Jiménez
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Catalytic ammonia decomposition represents an attractive alternative due to its high H₂ content (17.8% w/w), a product stream free of COₓ, among others; however, challenges need to be addressed for its consolidation as an H₂ chemical storage technology, especially, those focused on the synthesis of efficient bimetallic catalytic systems, as an alternative to the price and scarcity of ruthenium, the most active catalyst reported. In this sense, from the perspective of rational catalyst design, adjusting the main catalytic activity descriptor, a screening of supported catalysts with different compositional settings of cobalt-molybdenum metals is presented to evaluate their effect on the catalytic decomposition rate of ammonia. Subsequently, a kinetic study on the supported monometallic Co and Mo catalysts, as well as on the bimetallic CoMo catalyst with the highest activity is shown. The synthesis of catalysts supported on γ-alumina was carried out using the Charge Enhanced Dry Impregnation (CEDI) method, all with a 5% w/w loading metal. Seeking to maintain uniform dispersion, the catalysts were oxidized and activated (In-situ activation) using a flow of anhydrous air and hydrogen, respectively, under the same conditions: 40 ml min⁻¹ and 5 °C min⁻¹ from room temperature to 600 °C. Catalytic tests were carried out in a fixed-bed reactor, confirming the absence of transport limitations, as well as an Approach to equilibrium (< 1 x 10⁻⁴). The reaction rate on all catalysts was measured between 400 and 500 ºC at 53.09 kPa NH3. The synergy theoretically (DFT) reported for bimetallic catalysts was confirmed experimentally. Specifically, it was observed that the catalyst composed mainly of 75 mol% cobalt proved to be the most active in the experiments, followed by the monometallic cobalt and molybdenum catalysts, in this order of activity as referred to in the literature. A kinetic study was performed at 10.13 – 101.32 kPa NH3 and at four equidistant temperatures between 437 and 475 °C the data were adjusted to an LHHW-type model, which considered the desorption of nitrogen atoms from the active phase surface as the rate determining step (RDS). The regression analysis were carried out under an integral regime, using a minimization algorithm based on SLSQP. The physical meaning of the parameters adjusted in the kinetic model, such as the RDS rate constant (k₅) and the lumped adsorption constant of the quasi-equilibrated steps (α) was confirmed through their Arrhenius and Van't Hoff-type behavior (R² > 0.98), respectively. From an energetic perspective, the activation energy for cobalt, cobalt-molybdenum, and molybdenum was 115.2, 106.8, and 177.5 kJ mol⁻¹, respectively. With this evidence and considering the volcano shape described by the ammonia decomposition rate in relation to the metal composition ratio, the synergistic behavior of the system is clearly observed. However, since characterizations by XRD and TEM were inconclusive, the formation of intermetallic compounds should be still verified using HRTEM-EDS. From this point onwards, our objective is to incorporate parameters into the kinetic expressions that consider both compositional and structural elements and explore how these can maximize or influence H₂ production.Keywords: CEDI, hydrogen carrier, LHHW, RDS
Procedia PDF Downloads 54742 Numerical Investigation of the Boundary Conditions at Liquid-Liquid Interfaces in the Presence of Surfactants
Authors: Bamikole J. Adeyemi, Prashant Jadhawar, Lateef Akanji
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Liquid-liquid interfacial flow is an important process that has applications across many spheres. One such applications are residual oil mobilization, where crude oil and low salinity water are emulsified due to lowered interfacial tension under the condition of low shear rates. The amphiphilic components (asphaltenes and resins) in crude oil are considered to assemble at the interface between the two immiscible liquids. To justify emulsification, drag and snap-off suppression as the main effects of low salinity water, mobilization of residual oil is visualized as thickening and slip of the wetting phase at the brine/crude oil interface which results in the squeezing and drag of the non-wetting phase to the pressure sinks. Meanwhile, defining the boundary conditions for such a system can be very challenging since the interfacial dynamics do not only depend on interfacial tension but also the flow rate. Hence, understanding the flow boundary condition at the brine/crude oil interface is an important step towards defining the influence of low salinity water composition on residual oil mobilization. This work presents a numerical evaluation of three slip boundary conditions that may apply at liquid-liquid interfaces. A mathematical model was developed to describe the evolution of a viscoelastic interfacial thin liquid film. The base model is developed by the asymptotic expansion of the full Navier-Stokes equations for fluid motion due to gradients of surface tension. This model was upscaled to describe the dynamics of the film surface deformation. Subsequently, Jeffrey’s model was integrated into the formulations to account for viscoelastic stress within a long wave approximation of the Navier-Stokes equations. To study the fluid response to a prescribed disturbance, a linear stability analysis (LSA) was performed. The dispersion relation and the corresponding characteristic equation for the growth rate were obtained. Three slip (slip, 1; locking, -1; and no-slip, 0) boundary conditions were examined using the resulted characteristic equation. Also, the dynamics of the evolved interfacial thin liquid film were numerically evaluated by considering the influence of the boundary conditions. The linear stability analysis shows that the boundary conditions of such systems are greatly impacted by the presence of amphiphilic molecules when three different values of interfacial tension were tested. The results for slip and locking conditions are consistent with the fundamental solution representation of the diffusion equation where there is film decay. The interfacial films at both boundary conditions respond to exposure time in a similar manner with increasing growth rate which resulted in the formation of more droplets with time. Contrarily, no-slip boundary condition yielded an unbounded growth and it is not affected by interfacial tension.Keywords: boundary conditions, liquid-liquid interfaces, low salinity water, residual oil mobilization
Procedia PDF Downloads 126741 Navigate the Labyrinth of Leadership: Leaders’ Experiences in Saudi Higher Education
Authors: Laila Albughayl
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The purpose of this qualitative case study was to explore Saudi females’ leadership journeys as they navigate the labyrinth of leadership in higher education. To gain a better understanding of how these leaders overcame challenges and accessed support as they progressed through the labyrinth to top positions in Saudi higher education. The significance of this research derived from the premise that leaders need to acquire essential leadership competencies such as knowledge, skills, and practices to effectively lead through economic transformation, growing globalism, and rapidly developing technology in an increasingly diverse world. In addition, understanding Saudi women’s challenges in the labyrinth will encourage policymakers to improve the situation under which these women work. The metaphor ‘labyrinth’ for Eagly and Carli (2007) encapsulates the winding paths, dead ends, and maze-like pathways that are full of challenges and supports that women traverse to access and maintain leadership positions was used. In this study, ‘labyrinth’ was used as the conceptual framework to explore women leaders’ challenges and opportunities in leadership in Saudi higher education. A proposed model for efficient navigation of the labyrinth of leadership was used. This model focused on knowledge, skills, and behaviours (KSB) as the analytical framework for examining responses to the research questions. This research was conducted using an interpretivist qualitative approach. A case study was the methodology used. Semi-structured interviews were the main data collection method. Purposive sampling was used to select ten Saudi leaders in three public universities. In coding, the 6-step framework of thematic analysis for Braun and Clarke was used to identify, analyze, and report themes within the data. NVivo software was also used as a tool to assist with managing and organizing the data. The resultant findings showed that the challenges identified by participants in navigating the labyrinth of leadership in Saudi higher education replicated some of those identified in the literature. The onset findings also revealed that the organizational barriers in Saudi higher education came as the top hindrance to women’s advancement in the labyrinth of leadership, followed by societal barriers. The findings also showed that women’s paths in the labyrinth of leadership in higher education were still convoluted and tedious compared to their male counterparts. In addition, the findings revealed that Saudi women leaders use significant strategies to access leadership posts and effectively navigate the labyrinth; this was not indicated in the literature. In addition, the resultant findings revealed that there are keys that assisted Saudi female leaders in effectively navigating the labyrinth of leadership. For example, the findings indicated that spirituality (religion) was a powerful key that enabled Saudi women leaders to pursue and persist in their leadership paths. Based on participants' experiences, a compass for effective navigation of the labyrinth of leadership in higher education was created for current and aspirant Saudi women leaders to follow. Finally, the findings had several significant implications for practice, policy, theory, and future research.Keywords: women, leadership, labyrinth, higher education
Procedia PDF Downloads 82740 Facilitating Social Connections with Neurodivergent Adolescents: An Exploratory Study of Youth Experiences in a Social Group Based on Dungeons and Dragons
Authors: Jonathon Smith, Alba Agostino
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Autism, also referred to as autism spectrum disorder (ASD), is commonly associated with difficulties in social and communication skills. Other characteristics common to autistic individuals include repetitive behaviours, difficulties adhering to routine, as well as paying attention. Recent findings indicate that autism is the fastest-growing neurodevelopmental disorder in North America, yet programming aimed at improving the quality of autistic individual’s real-world social interactions is limited. Although there are social skills programs for autistic youth, participation appears to improve social knowledge, but that knowledge does not improve social competence or transfer to the participant’s daily social interactions. Peers are less likely to interact with autistic people based thin slice judgements, meaning that even when an autistic youth has successfully completed a social skills program, they most likely will still be rejected by peers and not have a social group to participate in. Recently, many researchers are exploring therapeutic interventions using Dungeon and Dragons (D&D) for conditions such as social anxiety, loneliness, and identity exploration. D&D is a table-top role-playing game (TTRPG) based on social play experience where the players must communicate, plan, negotiate, and compromise with other players to achieve a shared goal. The game encourages players to assume the role of their character and act out their play within the rules of the game with the guidance of the games dungeon master. The popularity Dungeons and Dragons has increased at a rapid rate, and many suggest that there social-emotional benefits of joining and participating in these types of gaming experiences, however this is an under researched topic and studies examining the benefits of such games is lacking in the field. The main purpose of this exploratory study is to examine the autistic youth’s experiences of participating in a D&D club. Participants of this study were four high functioning autistic youth between the ages of 14-18 (average age – 16) enrolled in a D&D Club that was specifically designed for neurodiverse youth. The youth participation with the club ranged from 4 months to 8 months. All participants completed a 30–40-minute semi-structured interview where they were able to express their perceptions as participants of the D&D club. Preliminary findings suggest that the game provided a place for the youth to engage in authentic social interactions. Additionally, preliminary results suggest that the youth report being in a positive space with other neurodivergent youth created an atmosphere where they felt confident and could connect with others. The findings from this study will aid clinicians, researchers, and educators in developing programming aimed at improving social interactions and connections for autistic youth.Keywords: autism, social connection, dungeons and dragons, neurodivergent affirming space
Procedia PDF Downloads 25739 Effect of Compaction Method on the Mechanical and Anisotropic Properties of Asphalt Mixtures
Authors: Mai Sirhan, Arieh Sidess
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Asphaltic mixture is a heterogeneous material composed of three main components: aggregates; bitumen and air voids. The professional experience and scientific literature categorize asphaltic mixture as a viscoelastic material, whose behavior is determined by temperature and loading rate. Properties characterization of the asphaltic mixture used under the service conditions is done by compacting and testing cylindric asphalt samples in the laboratory. These samples must resemble in a high degree internal structure of the mixture achieved in service, and the mechanical characteristics of the compacted asphalt layer in the pavement. The laboratory samples are usually compacted in temperatures between 140 and 160 degrees Celsius. In this temperature range, the asphalt has a low degree of strength. The laboratory samples are compacted using the dynamic or vibrational compaction methods. In the compaction process, the aggregates tend to align themselves in certain directions that lead to anisotropic behavior of the asphaltic mixture. This issue has been studied in the Strategic Highway Research Program (SHRP) research, that recommended using the gyratory compactor based on the assumption that this method is the best in mimicking the compaction in the service. In Israel, the Netivei Israel company is considering adopting the Gyratory Method as a replacement for the Marshall method used today. Therefore, the compatibility of the Gyratory Method for the use with Israeli asphaltic mixtures should be investigated. In this research, we aimed to examine the impact of the compaction method used on the mechanical characteristics of the asphaltic mixtures and to evaluate the degree of anisotropy in relation to the compaction method. In order to carry out this research, samples have been compacted in the vibratory and gyratory compactors. These samples were cylindrically cored both vertically (compaction wise) and horizontally (perpendicular to compaction direction). These models were tested under dynamic modulus and permanent deformation tests. The comparable results of the tests proved that: (1) specimens compacted by the vibratory compactor had higher dynamic modulus values than the specimens compacted by the gyratory compactor (2) both vibratory and gyratory compacted specimens had anisotropic behavior, especially in high temperatures. Also, the degree of anisotropy is higher in specimens compacted by the gyratory method. (3) Specimens compacted by the vibratory method that were cored vertically had the highest resistance to rutting. On the other hand, specimens compacted by the vibratory method that were cored horizontally had the lowest resistance to rutting. Additionally (4) these differences between the different types of specimens rise mainly due to the different internal arrangement of aggregates resulting from the compaction method. (5) Based on the initial prediction of the performance of the flexible pavement containing an asphalt layer having characteristics based on the results achieved in this research. It can be concluded that there is a significant impact of the compaction method and the degree of anisotropy on the strains that develop in the pavement, and the resistance of the pavement to fatigue and rutting defects.Keywords: anisotropy, asphalt compaction, dynamic modulus, gyratory compactor, mechanical properties, permanent deformation, vibratory compactor
Procedia PDF Downloads 117738 Using the Clinical Decision Support Platform, Dem DX, to Assess the ‘Urgent Community Care Team’s Notes Regarding Clinical Assessment, Management, and Healthcare Outcomes
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Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation
Procedia PDF Downloads 163737 Dys-Regulation of Immune and Inflammatory Response in in vitro Fertilization Implantation Failure Patients under Ovarian Stimulation
Authors: Amruta D. S. Pathare, Indira Hinduja, Kusum Zaveri
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Implantation failure (IF) even after the good-quality embryo transfer (ET) in the physiologically normal endometrium is the main obstacle in in vitro fertilization (IVF). Various microarray studies have been performed worldwide to elucidate the genes requisite for endometrial receptivity. These studies have included the population based on different phases of menstrual cycle during natural cycle and stimulated cycle in normal fertile women. Additionally, the literature is also available in recurrent implantation failure patients versus oocyte donors in natural cycle. However, for the first time, we aim to study the genomics of endometrial receptivity in IF patients under controlled ovarian stimulation (COS) during which ET is generally practised in IVF. Endometrial gene expression profiling in IF patients (n=10) and oocyte donors (n=8) were compared during window of implantation under COS by whole genome microarray (using Illumina platform). Enrichment analysis of microarray data was performed to determine dys-regulated biological functions and pathways using Database for Annotation, Visualization and Integrated Discovery, v6.8 (DAVID). The enrichment mapping was performed with the help of Cytoscape software. Microarray results were validated by real-time PCR. Localization of genes related to immune response (Progestagen-Associated Endometrial Protein (PAEP), Leukaemia Inhibitory Factor (LIF), Interleukin-6 Signal Transducer (IL6ST) was detected by immunohistochemistry. The study revealed 418 genes downregulated and 519 genes upregulated in IF patients compared to healthy fertile controls. The gene ontology, pathway analysis and enrichment mapping revealed significant downregulation in activation and regulation of immune and inflammation response in IF patients under COS. The lower expression of Progestagen Associated Endometrial Protein (PAEP), Leukemia Inhibitory Factor (LIF) and Interleukin 6 Signal Transducer (IL6ST) in cases compared to controls by real time and immunohistochemistry suggests the functional importance of these genes. The study was proved useful to uncover the probable reason of implantation failure being imbalance of immune and inflammatory regulation in our group of subjects. Based on the present study findings, a panel of significant dysregulated genes related to immune and inflammatory pathways needs to be further substantiated in larger cohort in natural as well as stimulated cycle. Upon which these genes could be screened in IF patients during window of implantation (WOI) before going for embryo transfer or any other immunological treatment. This would help to estimate the regulation of specific immune response during WOI in a patient. The appropriate treatment of either activation of immune response or suppression of immune response can be then attempted in IF patients to enhance the receptivity of endometrium.Keywords: endometrial receptivity, immune and inflammatory response, gene expression microarray, window of implantation
Procedia PDF Downloads 153736 Diversity and Use of Agroforestry Yards of Family Farmers of Ponte Alta – Gama, Federal District, Brazil
Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Martins
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The home gardens areas are production systems, which are located near the homes and are quite common in the tropics. They consist of agricultural and forest species and may also involve the raising of small animals to produce food for subsistence as well as income generation, with a special focus on the conservation of biodiversity. Home gardens are diverse Agroforestry systems with multiple uses, among many, food security, income aid, traditional medicine. The work was carried out on rural properties of the family farmers of the Ponte Alta Rural Nucleus, Gama Administrative Region, in the city of Brasília, Federal District- Brazil. The present research is characterized methodologically as a quantitative, exploratory and descriptive nature. The instruments used in this research were: bibliographic survey and semi-structured questionnaire. The data collection was performed through the application of a semi-structured questionnaire, containing questions that referred to the perception and behavior of the interviewed producer on the subject under analysis. In each question, the respondent explained his knowledge about sustainability, agroecological practices, environmental legislation, conservation methods, forest and medicinal species, ago social and socioeconomic characteristics, use and purpose of agroforestry and technical assistance. The sample represented 55.62% of the universe of the study. We interviewed 99 people aged 18-83 years, with a mean age of 49 years. The low level of education, coupled with the lack of training and guidance for small family farmers in the Ponte Alta Rural Nucleus, is one of the limitations to the development of practices oriented towards sustainable and agroecological agriculture in the nucleus. It is observed that 50.5% of the interviewed people landed with agroforestry yards less than 20 years ago, and only 16.17% of them are older than 35 years. In identifying agriculture as the main activity of most of the rural properties studied, attention is drawn to the cultivation of medicinal plants, fruits and crops as the most extracted products. However, it is verified that the crops in the backyards have the exclusive purpose of family consumption, which could be complemented with the marketing of the surplus, as well as with the aggregation of value to the cultivated products. Initiatives such as this may contribute to the increase in family income and to the motivation and value of the crop in agroecological gardens. We conclude that home gardens of Ponte Alta are highly diverse thus contributing to local biodiversity conservation of are managed by women to ensure food security and allows income generation. The tradition of existing knowledge on the use and management of the diversity of resources used in agroforestry yards is of paramount importance for the development of sustainable alternative practices.Keywords: agriculture, agroforestry system, rural development, sustainability
Procedia PDF Downloads 140735 Exploring Disengaging and Engaging Behavior of Doctoral Students
Authors: Salome Schulze
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The delay of students in completing their dissertations is a worldwide problem. At the University of South Africa where this research was done, only about a third of the students complete their studies within the required period of time. This study explored the reasons why the students interrupted their studies, and why they resumed their research at a later stage. If this knowledge could be utilised to improve the throughput of doctoral students, it could have significant economic benefits for institutions of higher education while at the same time enhancing their academic prestige. To inform the investigation, attention was given to key theories concerning the learning of doctoral students, namely the situated learning theory, the social capital theory and the self-regulated learning theory, based on the social cognitive theory of learning. Ten students in the faculty of Education were purposefully selected on the grounds of their poor progress, or of having been in the system for too long. The collection of the data was in accordance with a Finnish study, since the two studies had the same aims, namely to investigate student engagement and disengagement. Graphic elicitation interviews, based on visualisations were considered appropriate to collect the data. This method could stimulate the reflection and recall of the participants’ ‘stories’ with very little input from the interviewer. The interviewees were requested to visualise, on paper, their journeys as doctoral students from the time when they first registered. They were to indicate the significant events that occurred and which facilitated their engagement or disengagement. In the interviews that followed, they were requested to elaborate on these motivating or challenging events by explaining when and why they occurred, and what prompted them to resume their studies. The interviews were tape-recorded and transcribed verbatim. Information-rich data were obtained containing visual metaphors. The data indicated that when the students suffered a period of disengagement, it was sometimes related to a lack of self-regulated learning, in particular, a lack of autonomy, and the inability to manage their time effectively. When the students felt isolated from the academic community of practice disengagement also occurred. This included poor guidance by their supervisors, which accordingly deprived them of significant social capital. The study also revealed that situational factors at home or at work were often the main reasons for the students’ procrastinating behaviour. The students, however, remained in the system. They were motivated towards a renewed engagement with their studies if they were self-regulated learners, and if they felt a connectedness with the academic community of practice because of positive relationships with their supervisors and of participation in the activities of the community (e.g., in workshops or conferences). In support of their learning, networking with significant others who were sources of information provided the students with the necessary social capital. Generally, institutions of higher education cannot address the students’ personal issues directly, but they can deal with key institutional factors in order to improve the throughput of doctoral students. It is also suggested that graphic elicitation interviews be used more often in social research that investigates the learning and development of the students.Keywords: doctoral students, engaging and disengaging experiences, graphic elicitation interviews, student procrastination
Procedia PDF Downloads 193734 Effect of Phenolic Acids on Human Saliva: Evaluation by Diffusion and Precipitation Assays on Cellulose Membranes
Authors: E. Obreque-Slier, F. Orellana-Rodríguez, R. López-Solís
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Phenolic compounds are secondary metabolites present in some foods, such as wine. Polyphenols comprise two main groups: flavonoids (anthocyanins, flavanols, and flavonols) and non-flavonoids (stilbenes and phenolic acids). Phenolic acids are low molecular weight non flavonoid compounds that are usually grouped into benzoic (gallic, vanillinic and protocatechuic acids) and cinnamic acids (ferulic, p-coumaric and caffeic acids). Likewise, tannic acid is an important polyphenol constituted mainly by gallic acid. Phenolic compounds are responsible for important properties in foods and drinks, such as color, aroma, bitterness, and astringency. Astringency is a drying, roughing, and sometimes puckering sensation that is experienced on the various oral surfaces during or immediately after tasting foods. Astringency perception has been associated with interactions between flavanols present in some foods and salivary proteins. Despite the quantitative relevance of phenolic acids in food and beverages, there is no information about its effect on salivary proteins and consequently on the sensation of astringency. The objective of this study was assessed the interaction of several phenolic acids (gallic, vanillinic, protocatechuic, ferulic, p-coumaric and caffeic acids) with saliva. Tannic acid was used as control. Thus, solutions of each phenolic acids (5 mg/mL) were mixed with human saliva (1:1 v/v). After incubation for 5 min at room temperature, 15-μL aliquots of the mixtures were dotted on a cellulose membrane and allowed to diffuse. The dry membrane was fixed in 50 g/L trichloroacetic acid, rinsed in 800 mL/L ethanol and stained for protein with Coomassie blue for 20 min, destained with several rinses of 73 g/L acetic acid and dried under a heat lamp. Both diffusion area and stain intensity of the protein spots were semiqualitative estimates for protein-tannin interaction (diffusion test). The rest of the whole saliva-phenol solution mixtures of the diffusion assay were centrifuged and fifteen-μL aliquots of each supernatant were dotted on a cellulose membrane, allowed to diffuse and processed for protein staining, as indicated above. In this latter assay, reduced protein staining was taken as indicative of protein precipitation (precipitation test). The diffusion of the salivary protein was restricted by the presence of each phenolic acids (anti-diffusive effect), while tannic acid did not alter diffusion of the salivary protein. By contrast, phenolic acids did not provoke precipitation of the salivary protein, while tannic acid produced precipitation of salivary proteins. In addition, binary mixtures (mixtures of two components) of various phenolic acids with gallic acid provoked a restriction of saliva. Similar effect was observed by the corresponding individual phenolic acids. Contrary, binary mixtures of phenolic acid with tannic acid, as well tannic acid alone, did not affect the diffusion of the saliva but they provoked an evident precipitation. In summary, phenolic acids showed a relevant interaction with the salivary proteins, thus suggesting that these wine compounds can also contribute to the sensation of astringency.Keywords: astringency, polyphenols, tannins, tannin-protein interaction
Procedia PDF Downloads 245733 Abuse against Elderly Widows in India and Selected States: An Exploration
Authors: Rasmita Mishra, Chander Shekher
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Background: Population ageing is an inevitable outcome of demographic transition. Due to increased life expectancy, the old age population in India and worldwide has increased, and it will continue to grow more alarmingly in the near future. There are redundant austerity that has been bestowed upon the widows, thus, the life of widows is never been easy in India. The loss of spouse along with other disadvantaged socioeconomic intermediaries like illiteracy and poverty often make the life of widows more difficult to live. Methodology: Ethical statement: The study used secondary data available in the public domain for its wider use in social research. Thus, there was no requirement of ethical consent in the present study. Data source: Building a Knowledge Base on Population Aging in India (BKPAI), 2011 dataset is used to fulfill the objectives of this study. It was carried out in seven states – Himachal Pradesh, Kerala, Maharashtra, Odisha, Punjab, Tamil Nadu, and West Bengal – having a higher percentage of the population in the age group 60 years and above compared to the national average. Statistical analysis: Descriptive and inferential statistics were used to understand the level of elderly widows and incidence of abuse against them in India and selected states. Bivariate and Trivariate analysis were carried out to check the pattern of abuse by selected covariates. Chi-Square test is used to verify the significance of the association. Further, Discriminant Analysis (DA) is carried out to understand which factor can separate out group of neglect and non-neglect elderly. Result: With the addition of 27 million from 2001 to 2011, the total elderly population in India is more than 100 million. Elderly females aged 60+ were more widows than their counterpart elderly males. This pattern was observed across selected states and at national level. At national level, more than one tenth (12 percent) of elderly experienced abuse in their lifetime. Incidence of abuse against elderly widows within family was considerably higher than the outside the family. This pattern was observed across the selected place and abuse in the study. In discriminant analysis, the significant difference between neglected and non-neglected elderly on each of the independent variables was examined using group mean and ANOVA. Discussion: The study is the first of its kind to assess the incidence of abuse against elderly widows using large-scale survey data. Another novelty of this study is that it has assessed for those states in India whereby the proportion of elderly is higher than the national average. Place and perpetrators involved in the abuse against elderly widows certainly envisaged the safeness in the present living arrangement of elderly widows. Conclusion: Due to the increasing life expectancy it is expected that the number of elderly will increase much faster than before. As biologically women live longer than men, there will be more women elderly than men. With respect to the living arrangement, after the demise of the spouse, elderly widows are more likely to live with their children who emerged as the main perpetrator of abuse.Keywords: elderly abuse, emotional abuse physical abuse, material abuse, psychological abuse, quality of life
Procedia PDF Downloads 425732 Reducing the Computational Cost of a Two-way Coupling CFD-FEA Model via a Multi-scale Approach for Fire Determination
Authors: Daniel Martin Fellows, Sean P. Walton, Jennifer Thompson, Oubay Hassan, Kevin Tinkham, Ella Quigley
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Structural integrity for cladding products is a key performance parameter, especially concerning fire performance. Cladding products such as PIR-based sandwich panels are tested rigorously, in line with industrial standards. Physical fire tests are necessary to ensure the customer's safety but can give little information about critical behaviours that can help develop new materials. Numerical modelling is a tool that can help investigate a fire's behaviour further by replicating the fire test. However, fire is an interdisciplinary problem as it is a chemical reaction that behaves fluidly and impacts structural integrity. An analysis using Computational Fluid Dynamics (CFD) and Finite Element Analysis (FEA) is needed to capture all aspects of a fire performance test. One method is a two-way coupling analysis that imports the updated changes in thermal data, due to the fire's behaviour, to the FEA solver in a series of iterations. In light of our recent work with Tata Steel U.K using a two-way coupling methodology to determine the fire performance, it has been shown that a program called FDS-2-Abaqus can make predictions of a BS 476 -22 furnace test with a degree of accuracy. The test demonstrated the fire performance of Tata Steel U.K Trisomet product, a Polyisocyanurate (PIR) based sandwich panel used for cladding. Previous works demonstrated the limitations of the current version of the program, the main limitation being the computational cost of modelling three Trisomet panels, totalling an area of 9 . The computational cost increases substantially, with the intention to scale up to an LPS 1181-1 test, which includes a total panel surface area of 200 .The FDS-2-Abaqus program is developed further within this paper to overcome this obstacle and better accommodate Tata Steel U.K PIR sandwich panels. The new developments aim to reduce the computational cost and error margin compared to experimental data. One avenue explored is a multi-scale approach in the form of Reduced Order Modeling (ROM). The approach allows the user to include refined details of the sandwich panels, such as the overlapping joints, without a computationally costly mesh size.Comparative studies will be made between the new implementations and the previous study completed using the original FDS-2-ABAQUS program. Validation of the study will come from physical experiments in line with governing body standards such as BS 476 -22 and LPS 1181-1. The physical experimental data includes the panels' gas and surface temperatures and mechanical deformation. Conclusions are drawn, noting the new implementations' impact factors and discussing the reasonability for scaling up further to a whole warehouse.Keywords: fire testing, numerical coupling, sandwich panels, thermo fluids
Procedia PDF Downloads 77731 Molecular Dynamics Simulation Study of the Influence of Potassium Salts on the Adsorption and Surface Hydration Inhibition Performance of Hexane, 1,6 - Diamine Clay Mineral Inhibitor onto Sodium Montmorillonite
Authors: Justine Kiiza, Xu Jiafang
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The world’s demand for energy is increasing rapidly due to population growth and a reduction in shallow conventional oil and gas reservoirs, resorting to deeper and mostly unconventional reserves like shale oil and gas. Most shale formations contain a large amount of expansive sodium montmorillonite (Na-Mnt), due to high water adsorption, hydration, and when the drilling fluid filtrate enters the formation with high Mnt content, the wellbore wall can be unstable due to hydration and swelling, resulting to shrinkage, sticking, balling, time wasting etc., and well collapse in extreme cases causing complex downhole accidents and high well costs. Recently, polyamines like 1, 6 – hexane diamine (HEDA) have been used as typical drilling fluid shale inhibitors to minimize and/or cab clay mineral swelling and maintain the wellbore stability. However, their application is limited to shallow drilling due to their sensitivity to elevated temperature and pressure. Inorganic potassium salts i.e., KCl, have long been applied for restriction of shale formation hydration expansion in deep wells, but their use is limited due to toxicity. Understanding the adsorption behaviour of HEDA on Na-Mnt surfaces in present of organo-salts, organic K-salts e.g., HCO₂K - main component of organo-salt drilling fluid, is of great significance in explaining the inhibitory performance of polyamine inhibitors. Molecular dynamic simulations (MD) were applied to investigate the influence of HCO₂K and KCl on the adsorption mechanism of HEDA on the Na-Mnt surface. Simulation results showed that adsorption configurations of HEDA are mainly by terminal amine groups with a flat-lying alkyl hydrophobic chain. Its interaction with the clay surface decreased the H-bond number between H₂O-clay and neutralized the negative charge of the Mnt surface, thus weakening the surface hydration ability of Na-Mnt. The introduction of HCO₂K greatly improved inhibition ability, coordination of interlayer ions with H₂O as they were replaced by K+, and H₂O-HCOO- coordination reduced H₂O-Mnt interactions, mobility and transport capability of H₂O molecules were more decreased. While KCl showed little ability and also caused more hydration with time, HCO₂K can be used as an alternative for offshore drilling instead of toxic KCl, with a maximum concentration noted in this study as 1.65 wt%. This study provides a theoretical elucidation for the inhibition mechanism and adsorption characteristics of HEDA inhibitor on Na-Mnt surfaces in the presence of K+-salts and may provide more insight into the evaluation, selection, and molecular design of new clay-swelling high-performance WBDF systems used in oil and gas complex offshore drilling well sections.Keywords: shale, hydration, inhibition, polyamines, organo-salts, simulation
Procedia PDF Downloads 46730 Evaluation of the Boiling Liquid Expanding Vapor Explosion Thermal Effects in Hassi R'Mel Gas Processing Plant Using Fire Dynamics Simulator
Authors: Brady Manescau, Ilyas Sellami, Khaled Chetehouna, Charles De Izarra, Rachid Nait-Said, Fati Zidani
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During a fire in an oil and gas refinery, several thermal accidents can occur and cause serious damage to people and environment. Among these accidents, the BLEVE (Boiling Liquid Expanding Vapor Explosion) is most observed and remains a major concern for risk decision-makers. It corresponds to a violent vaporization of explosive nature following the rupture of a vessel containing a liquid at a temperature significantly higher than its normal boiling point at atmospheric pressure. Their effects on the environment generally appear in three ways: blast overpressure, radiation from the fireball if the liquid involved is flammable and fragment hazards. In order to estimate the potential damage that would be caused by such an explosion, risk decision-makers often use quantitative risk analysis (QRA). This analysis is a rigorous and advanced approach that requires a reliable data in order to obtain a good estimate and control of risks. However, in most cases, the data used in QRA are obtained from the empirical correlations. These empirical correlations generally overestimate BLEVE effects because they are based on simplifications and do not take into account real parameters like the geometry effect. Considering that these risk analyses are based on an assessment of BLEVE effects on human life and plant equipment, more precise and reliable data should be provided. From this point of view, the CFD modeling of BLEVE effects appears as a solution to the empirical law limitations. In this context, the main objective is to develop a numerical tool in order to predict BLEVE thermal effects using the CFD code FDS version 6. Simulations are carried out with a mesh size of 1 m. The fireball source is modeled as a vertical release of hot fuel in a short time. The modeling of fireball dynamics is based on a single step combustion using an EDC model coupled with the default LES turbulence model. Fireball characteristics (diameter, height, heat flux and lifetime) issued from the large scale BAM experiment are used to demonstrate the ability of FDS to simulate the various steps of the BLEVE phenomenon from ignition up to total burnout. The influence of release parameters such as the injection rate and the radiative fraction on the fireball heat flux is also presented. Predictions are very encouraging and show good agreement in comparison with BAM experiment data. In addition, a numerical study is carried out on an operational propane accumulator in an Algerian gas processing plant of SONATRACH company located in the Hassi R’Mel Gas Field (the largest gas field in Algeria).Keywords: BLEVE effects, CFD, FDS, fireball, LES, QRA
Procedia PDF Downloads 184729 Negative Changes in Sexual Behavior of Pregnant Women
Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro
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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.Keywords: obstetric nursing, pregnant women, sexual behavior, women's health
Procedia PDF Downloads 319728 Cognitive Deficits and Association with Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder in 22q11.2 Deletion Syndrome
Authors: Sinead Morrison, Ann Swillen, Therese Van Amelsvoort, Samuel Chawner, Elfi Vergaelen, Michael Owen, Marianne Van Den Bree
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22q11.2 Deletion Syndrome (22q11.2DS) is caused by the deletion of approximately 60 genes on chromosome 22 and is associated with high rates of neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorders (ASD). The presentation of these disorders in 22q11.2DS is reported to be comparable to idiopathic forms and therefore presents a valuable model for understanding mechanisms of neurodevelopmental disorders. Cognitive deficits are thought to be a core feature of neurodevelopmental disorders, and possibly manifest in behavioural and emotional problems. There have been mixed findings in 22q11.2DS on whether the presence of ADHD or ASD is associated with greater cognitive deficits. Furthermore, the influence of developmental stage has never been taken into account. The aim was therefore to examine whether the presence of ADHD or ASD was associated with cognitive deficits in childhood and/or adolescence in 22q11.2DS. We conducted the largest study to date of this kind in 22q11.2DS. The same battery of tasks measuring processing speed, attention and spatial working memory were completed by 135 participants with 22q11.2DS. Wechsler IQ tests were completed, yielding Full Scale (FSIQ), Verbal (VIQ) and Performance IQ (PIQ). Age-standardised difference scores were produced for each participant. Developmental stages were defined as children (6-10 years) and adolescents (10-18 years). ADHD diagnosis was ascertained from a semi-structured interview with a parent. ASD status was ascertained from a questionnaire completed by a parent. Interaction and main effects of cognitive performance of those with or without a diagnosis of ADHD or ASD in childhood or adolescence were conducted with 2x2 ANOVA. Significant interactions were followed up with t-tests of simple effects. Adolescents with ASD displayed greater deficits in all measures (processing speed, p = 0.022; sustained attention, p = 0.016; working memory, p = 0.006) than adolescents without ASD; there was no difference between children with and without ASD. There were no significant differences on IQ measures. Both children and adolescents with ADHD displayed greater deficits on sustained attention (p = 0.002) than those without ADHD. There were no significant differences on any other measures for ADHD. Magnitude of cognitive deficit in individuals with 22q11.2DS varied by cognitive domain, developmental stage and presence of neurodevelopmental disorder. Adolescents with 22q11.2DS and ASD showed greater deficits on all measures, which suggests there may be a sensitive period in childhood to acquire these domains, or reflect increasing social and academic demands in adolescence. The finding of poorer sustained attention in children and adolescents with ADHD supports previous research and suggests a specific deficit which can be separated from processing speed and working memory. This research provides unique insights into the association of ASD and ADHD with cognitive deficits in a group at high genomic risk of neurodevelopmental disorders.Keywords: 22q11.2 deletion syndrome, attention deficit hyperactivity disorder, autism spectrum disorder, cognitive development
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