Search results for: integrated groundwater management

Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

Procedia PDF Downloads 155

Authors: Mrunalini Sonne

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Aquaculture uses a variety of broad spectrum antibiotics to manage and prevent a variety of diseases without understanding their mechanisms of action. This has led to water pollution in the modern world. The necessity for alternate control measures against bacterial illnesses in the aquaculture sector is highlighted by issues brought on by antibiotic-resistant bacteria and the dearth of effective control strategies. Bacteriophages (phages) have shown promise as therapeutic agents for the efficient management of bacterial infections in aquaculture. In the current study, a variety of investigations were conducted to determine if utilizing lytic phages to reduce Aeromonas spp. infection in fish aquaculture was appropriate. Motile Aeromonas septicaemia is a fish disease that has caused financial harm to the aquaculture sector. Currently, the production of aquaculture depends significantly on antibiotics, which adds to the worldwide problem of the rise of bacteria that are resistant to medicines and resistance genes. To decrease the usage of antibiotics in aquaculture systems, it is crucial to create efficient antibiotic substitutes. Bacteriophages are capable of acting as a natural antagonist, mostly because of their great specificity, capacity for self-replication, and ability to quickly eradicate dangerous bacteria. There is a need for research that goes beyond just isolating and characterising lytic bacteriophages to examine their morphology, stability, and efficacy in various environmental conditions. Bacteriophage (or phage) therapy is a promising technique to control dangerous microbes in farmed fish. More phage therapy research in aquaculture is required in order to effectively employ phage treatment to lessen infection in fish brought on by Aeromonas.

Keywords: aquaculture, bacteriophages, fish, freshwater

Procedia PDF Downloads 107

Authors: Pei-Fan Mu

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Background: Lung cancer is the most common cancer with the highest mortality rate. Patients with lung cancer under chemotherapy treatment experience life-threatening uncertainty. This study was based on the broaden-and-build theory using intentionality reflection of the body and internalization of positive prioritization strategies to enhance positive emotions of patients with lung cancer. Purpose: The purpose of this study was to use a quasi-experimental research design to examine the effectiveness of the enhancing positive emotion program. Method: Data were collected from a medical center in Taiwan. Fifty-four participants with lung cancer were recruited. Thirty participants were in the experiential group receiving the two weeks program. The content of the program includes awareness and understanding of the symptom experience, co-existing with illness and establishing self-identity, cognitive-emotion adjustment and establishing a new body schema, and symptom management to reach spiritual well-being. Twenty-four participants were in the control group receiving regular nursing care. Baseline, one month later and two months later, programmed measurements of symptoms of distress, positive emotion, and psychological well-being. Results: These two weeks of enhancing the positive emotion program resulted in a significantly improved positive emotion score for the experimental group compared to the control group. The findings of this study indicated that the positive emotion had significant differences between the two groups. There were no differences in symptom distress between the two groups. Discussion: The findings indicated that the enhancing positive emotion program could help patients enhance their life-threatening facing conditions.

Keywords: positive emotion, lung cancer, experimental design, symptom distress

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Authors: Siriraks Khawchaimaha, Sangwian Boonto

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Sport Authority of Thailand (SAT) is the state enterprise, promotes and supports all sports kind both professional and athletes for competitions, and administer under government policy and government officers and therefore, all financial supports whether cash inflows and cash outflows are strictly committed to government budget and limited to the planned projects at least 12 to 16 months ahead of reality, as results of ineffective in sport events, administration and competitions. In order to retain in the sports challenges around the world, SAT need to has its own sports business services model by each stadium, region and athletes’ competencies. Based on the HMK model of Khawchaimaha, S. (2007), this research study is formalized into each 10 regional stadiums to details into the characteristics root of fans, athletes, coaches, equipments and facilities, and stadiums. The research designed is firstly the evaluation of external factors: hardware whereby competition or practice of stadiums, playground, facilities, and equipments. Secondly, to understand the software of the organization structure, staffs and management, administrative model, rules and practices. In addition, budget allocation and budget administration with operating plan and expenditure plan. As results for the third step, issues and limitations which require action plan for further development and support, or to cease that unskilled sports kind. The final step, based on the HMK model and modeling canvas by Alexander O and Yves P (2010) are those of template generating Sports Business Services Model for each 10 SAT’s regional stadiums.

Keywords: HMK model, not for profit organization, sport business model, sport services model

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Authors: Janeth Chepkemoi, Richard Onwonga, Noel Templer, Elkana Kipkoech, Angela Gitau

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Conventional agriculture is one of the leading causes of land degradation, threatening the sustainability of food production. Organic farming promotes practices that have the potential of feeding the world while also promoting ecological health. A study was therefore carried out with the aim of conceptualizing how such farming systems are contributing to ecological health in Trans Nzoia County. 71 farmers were interviewed and data was collected on parameters such as land preparation, agroforestry, soil fertility management, soil and water conservation, and pests and diseases. A soil sample was also collected from each farm for laboratory analysis. Data collected were analyzed using Microsoft Excel and SPSS version 21. Results showed that 66% of the respondents practiced organic farming whereas 34% practiced conventional farming. Intercropping and crop rotations were the most common cropping systems and the most preferred land preparation tools among both organic and conventional farmers were tractors and hand hoes. Organic farms fared better in agroforestry, organic soil amendments, land and water conservation, and soil chemical properties. Pests and disease, however, affected organic farms more than conventional. The average nitrogen (%), K (Cmol/ kg and P (ppm) of organic soils were 0.26, 0.7 and 26.18 respectively, conventional soils were 0.21, 0.66 and 22.85. Soil organic carbon content of organic farms averaged a higher percentage of 2.07% as compared to 1.91 for the conventional. In conclusion, most farmers in Trans Nzoia County had transitioned into ecologically friendly farming practices that improved the quality and health of the soil and therefore promoted its sustainability.

Keywords: organic farming, conventional farming, ecological health, soil health

Procedia PDF Downloads 127

Authors: Sikander Nawaz Khan

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Natural disasters like flood, earthquake, cyclone, volcanic eruption and others are causing immense losses to the property and lives every year. Current status and actual loss information of natural hazards can be determined and also prediction for next probable disasters can be made using different remote sensing and mapping technologies. Global Positioning System (GPS) calculates the exact position of damage. It can also communicate with wireless sensor nodes embedded in potentially dangerous places. GPS provide precise and accurate locations and other related information like speed, track, direction and distance of target object to emergency responders. Remote Sensing facilitates to map damages without having physical contact with target area. Now with the addition of more remote sensing satellites and other advancements, early warning system is used very efficiently. Remote sensing is being used both at local and global scale. High Resolution Satellite Imagery (HRSI), airborne remote sensing and space-borne remote sensing is playing vital role in disaster management. Early on Geographic Information System (GIS) was used to collect, arrange, and map the spatial information but now it has capability to analyze spatial data. This analytical ability of GIS is the main cause of its adaption by different emergency services providers like police and ambulance service. Full potential of these so called 3S technologies cannot be used in alone. Integration of GPS and other remote sensing techniques with GIS has pointed new horizons in modeling of earth science activities. Many remote sensing cases including Asian Ocean Tsunami in 2004, Mount Mangart landslides and Pakistan-India earthquake in 2005 are described in this paper.

Keywords: disaster mitigation, GIS, GPS, remote sensing

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Authors: Narges Ebadi, Davod Ahmadi, Hiliary Monteith, Hugo Melgar-Quinonez

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Migration cannot necessarily relieve pressure on water resources in origin communities, and male out-migration can increase the water management burden of women. However, inflows of financial remittances seem to offer possibilities of investing in improving drinking-water access. Therefore, remittances may be an important pathway for migrants to support water security. This paper explores the association between water access and the receipt of remittances in households in sub-Saharan Africa. Data from round 6 of the 'Afrobarometer' surveys in 2016 were used (n= 49,137). Descriptive, bivariate and multivariate statistical analyses were carried out in this study. Regardless of country, findings from descriptive analyses showed that approximately 80% of the respondents never received remittance, and 52% had enough clean water. Only one-fifth of the respondents had piped water supply inside the house (19.9%), and approximately 25% had access to a toilet inside the house. Bivariate analyses revealed that even though receiving remittances was significantly associated with water supply, the strength of association was very weak. However, other factors such as the area of residence (rural vs. urban), cash income frequencies, electricity access, and asset ownership were strongly associated with water access. Results from unadjusted multinomial logistic regression revealed that the probability of having no access to piped water increased among remittance recipients who received financial support at least once a month (OR=1.324) (p < 0.001). In contrast, those not receiving remittances were more likely to regularly have a water access concern (OR=1.294) (p < 0.001), and not have access to a latrine (OR=1.665) (p < 0.001). In conclusion, receiving remittances is significantly related to water access as the strength of odds ratios for socio-demographic factors was stronger.

Keywords: remittances, water access, SSA, migration

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Authors: Beghdadi Chafika, Mrabet Sonia, Heroual Nabila, Ahmed Fouatih Noureddine

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Introduction: Cleft lip and palate are the most common congenital malformations of the orofacial sphere, accounting for one in every 700 births worldwide. They have a multifactorial origin, requiring multidisciplinary intervention from birth to adulthood. In the absence of work in Algeria on this pathology, we undertook a study to describe the epidemiological aspects and determine the risk factors. Methodology: This is a cross-sectional descriptive study from February 2018 to June 2021, including all cleft patients referred to and or followed up for management at the ODF/ CHU d'Oran department. Results: 260 patients were included. Males predominated (sex ratio=1.17). The mean age of the patients was 1.65 ± 2.6 years, most of whom lived in Oran. The mean age of the mothers was 32.5 years, and 37 years for the fathers. More than half of all cases had cleft lip and palate, with a predominance on the left side. Consanguinity was found in 20%. Mothers had more medical history than fathers. Stress, emotional shock, active smoking in the father, low socio-economic status, and vitamin deficiency in the mother were the most common factors. Both dentitions were affected by various dental anomalies, the most frequent of which was a numerical anomaly (31.6%), followed by the delayed eruption (23.1%) with the absence of inclusion and transposition. All functions have been disrupted to varying degrees, depending on the severity of the damage. Because of the anatomical and physiological characteristics of clefts, any disturbance during embryogenesis alters the course of the latter, leading to congenital anomalies. Conclusion: The study enabled us to draw up a profile of cleft lip and palate and to identify certain risk factors to guide the main lines of prevention.

Keywords: cleft lip and palate, dental anomalies, risk factors, orthodontics

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Authors: Kamel Abd Elaziz Mohamed, Ahmed Yehia Mousa, Ahmed Samir ElSawy, Adel Mohamed Saleem

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Introduction: Critically ill patients frequently require tracheostomy to simplify long term air way management. While tracheostomy indications have remained unchanged, the timing of elective tracheostomy for the ventilated patient has been questioned. Aim of the work: This study was performed to compare the differences between early and late percutaneous dilatational tracheostomy (PDT) regarding, mechanical ventilation duration (MVD), length of ICU stay, length of hospital stay, incidence of ventilator associated pneumonia and hospital outcome. Patients and methods: Forty patients who met the inclusion criteria were randomly divided into early PDT who had the tracheostomy within the first 10 days of mechanical ventilation (MV) and the late PDT who had the tracheostomy after 10 days of MV. On admission, demographic data and Acute Physiology and Chronic ill Health II and GCS were collected. The duration of mechanical ventilation, ICU length of stay (LOS) and hospital LOS were all calculated. Results: Total of 40 patients were randomized to either early PDT (n= 20) or late PDT (n= 20). There were no significant differences between both groups regarding demographic data or the scores: APACHE II (22.75± 7 vs 24.35 ± 8) and GCS (6.10 ±2 vs 7.10 ± 2.71). An early PDT showed fewer complications vs late procedure, however it was insignificant. There were significant differences between the two groups regarding mean (MVD) which was shorter in early PDT than the late PDT group (32.2± 10.5) vs (20.6 ± 13 days; p= 0.004). Mean ICU stay was shorter in early PDT than late PDT (21 .0± 513.4) vs (40.15 ±12.7 days; p 6 0.001). Mean hospital stay was shorter in early PDT than late PDT (34.60± 18.37) vs (55.60± 25.73 days; p=0.005). Patients with early PDT suffered less sepsis and VAP than late PDT, there was no difference regarding the mortality rate between the two groups. Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

Keywords: intensive care unit, early PDT, late PDT, intubation

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Authors: Guanglin Song

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(Objective) Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. (Methods) A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city.(Conclusion) The findings reveal that:1.there exists overall maldistribution and over-concentration of healthcare resources in Study Area, characterized by structural imbalance; 2.the low rate of primary care utilization in Study Area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem; 3.gradual optimization of the healthcare facility layout in Study Area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance.(Prospects) This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. Provide some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: flow of public services, urban networks, healthcare facilities, spatial planning, urban networks

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Authors: Pius Babuna, Xiaohua Yang, Roberto Xavier Supe Tulcan, Bian Dehui, Mohammed Takase, Bismarck Yelfogle Guba, Chuanliang Han, Doris Abra Awudi, Meishui Lia

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Water inequality, water security, and water governance are fundamental parameters that affect the sustainable use of water resources. Through policy formulation and decision-making, water governance determines both water security and water inequality. Largely, where water inequality exists, water security is undermined through unsustainable water use practices that lead to pollution of water resources, conflicts, hoarding of water, and poor sanitation. Incidentally, the interconnectedness of water governance, water inequality, and water security has not been investigated previously. This study modified the Gini coefficient and used a Logistics Growth of Water Resources (LGWR) Model to access water inequality and water security mathematically, and discussed the connected role of water governance. We tested the validity of both models by calculating the actual water inequality and water security of Ghana. We also discussed the implications of water inequality on water security and the overarching role of water governance. The results show that regional water inequality is widespread in some parts. The Volta region showed the highest water inequality (Gini index of 0.58), while the central region showed the lowest (Gini index of 0.15). Water security is moderately sustainable. The use of water resources is currently stress-free. It was estimated to maintain such status until 2132 ± 18, when Ghana will consume half of the current total water resources of 53.2 billion cubic meters. Effectively, water inequality is a threat to water security, results in poverty, under-development heightens tensions in water use, and causes instability. With proper water governance, water inequality can be eliminated through formulating and implementing approaches that engender equal allocation and sustainable use of water resources.

Keywords: water inequality, water security, water governance, Gini coefficient, moran index, water resources management

Procedia PDF Downloads 139

Authors: Sara Hasani

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This research focuses on natural sudden onset disasters characterised as ‘occurring with little or no warning and often cause excessive injuries far surpassing the national response capacities’. Based on the panel analysis of the historic record of 4,252 natural onset disasters between 1980 to 2015, a predictive method was developed to predict the human impact of the disaster (fatality, injured, homeless) with less than 3% of errors. The geographical dispersion of the disasters includes every country where the data were available and cross-examined from various humanitarian sources. The records were then filtered into 4252 records of the disasters where the five predictive variables (disaster type, HDI, DRI, population, and population density) were clearly stated. The procedure was designed based on a combination of pattern recognition techniques and rule-based clustering for prediction and discrimination analysis to validate the results further. The result indicates that there is a relationship between the disaster human impact and the five socio-economic characteristics of the affected country mentioned above. As a result, a framework was put forward, which could predict the disaster’s human impact based on their severity rank in the early hours of disaster strike. The predictions in this model were outlined in two worst and best-case scenarios, which respectively inform the lower range and higher range of the prediction. A necessity to develop the predictive framework can be highlighted by noticing that despite the existing research in literature, a framework for predicting the human impact and estimating the needs at the time of the disaster is yet to be developed. This can further be used to allocate the resources at the response phase of the disaster where the data is scarce.

Keywords: disaster management, natural disaster, pattern recognition, prediction

Procedia PDF Downloads 154

Authors: Mehrdad Akbarzadeh, Afsaneh Abrisham

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Introduction: Critical thinking skills are crucial for nurses, particularly those working in neonatal care, where quick and informed decision-making is essential. This study aims to evaluate the effectiveness of critical thinking skills on job performance among neonatal nurses. Methods: A cross-sectional study was conducted with 450 neonatal nurses from a hospital in Mashhad. Participants were assessed using the Critical Thinking Questionnaire (CThQ) to measure their critical thinking abilities across various subscales, including Analyzing, Evaluating, Creating, Remembering, Understanding, and Applying. Additionally, a custom Job Performance Checklist completed by supervising nurses, was used to evaluate job performance across several dimensions. Data were collected and analyzed using SPSS V.23. Correlation analysis was conducted to determine the relationship between critical thinking skills and job performance. Results: The mean age of the nurses was 33.46 ± 14.2 years, with 79.15% being female. The nurses demonstrated high proficiency in critical thinking, with notable scores in the Creating (23.98 ± 4.8), Applying (17.35 ± 3.2), and Evaluating (16.67 ± 3.4) subscales. The results indicate a significant positive correlation between several critical thinking subscales and job performance. The Creating subscale exhibited the strongest correlation (R = 0.79, p < 0.001), followed by Overall CThQ (R = 0.68, p = 0.039) and Evaluating (R = 0.67, p = 0.041). Analyzing (R = 0.45, p = 0.013) and Understanding (R = 0.41, p = 0.015) also showed significant correlations with job performance. Remembering (R = 0.29, p = 0.061) and Applying (R = 0.43, p = 0.057) were not significantly correlated with job performance. Conclusion: The findings indicate that critical thinking skills, especially in creating and evaluating, are strongly associated with job performance in neonatal nurses. Enhancing these skills through targeted training programs could improve job performance, particularly in decision-making and time management. This study underscores the importance of critical thinking in neonatal care and its impact on nursing efficacy and patient outcomes.

Keywords: critical thinking, job performance, neonatal nurses, healthcare quality

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Authors: Jeter Canete, Noreen Joyce Estrella, Yedda Sachi Patrice Madelo

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Zooplankton plays a crucial role in aquatic ecosystems and a number of water parameters involved in it. Despite their relevance, there is inadequate information about zooplankton communities in Sarangani Bay, Sarangani Province: one of the most essential waterbodies in Mindanao. The aim of the present study was to determine the composition, abundance, and diversity of zooplankton as well as to provide more recent data about the physico-chemical characteristics of Sarangani Bay. Zooplankton samples were collected by vertical hauls using a zooplankton net (mouth diameter: 0.5m; mesh size opening: round, 350μm) in three stations in the coastal waters of Alabel, Malapatan, and Maasim during November 2018. A total of 74 species of zooplankton belonging mainly to Kingdom Protozoa, Phylum Arthropoda, Chaetognatha, and Chordata were identified. Results showed a total zooplankton abundance of 1,984,166 ind/m³ with the highest count recorded at Malapatan (717,169 ind/m³) and the lowest at Maasim (624,411 ind/m³). Among 22 zooplankton groups identified, subclass Copepoda was found to be the most dominant (73.10%), followed by Appendicularia (12.18%) and Vertebrata (3.54%). Diversity analysis revealed an even distribution of species and a diverse ecosystem in all stations sampled. Correlation analysis indicated a strong relationship between zooplankton abundance and physico-chemical parameters. Overall, the physico-chemical profile of Sarangani Bay did not differ from the standards set by DENR, and analysis of the zooplankton communities revealed that Sarangani Bay favorably supports marine organisms to flourish. The findings of this study provide useful knowledge on zooplankton communities and can be used to create management strategies to protect the aquatic biodiversity in Sarangani Bay.

Keywords: aquatic biomonitoring, biodiversity, physicochemical analysis, population survey, Sarangani Bay, Sarangani Province, zooplankton

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Authors: Sohail Ahmed, Ke Xing

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This research theoretically explored the evolution mechanism of enterprise technological innovation capability system (ETICS) from the perspective of complex adaptive systems (CAS). Starting from CAS theory, this study proposed an analytical framework for ETICS, its concepts and theory by integrating CAS methodology into the management of technological innovation capability of enterprises and discusses how to use the principles of complexity to analyze the composition, evolution and realization of the technological innovation capabilities in complex dynamic environment. This paper introduces the concept and interaction of multi-agent, the theoretical background of CAS and summarizes the sources of technological innovation, the elements of each subject and the main clusters of adaptive interactions and innovation activities. The concept of multi-agents is applied through the linkages of enterprises, research institutions and government agencies with the leading enterprises in industrial settings. The study was exploratory based on CAS theory. Theoretical model is built by considering technological and innovation literature from foundational to state of the art projects of technological enterprises. On this basis, the theoretical model is developed to measure the evolution mechanism of enterprise technological innovation capability system. This paper concludes that the main characteristics for evolution in technological systems are based on enterprise’s research and development personal, investments in technological processes and innovation resources are responsible for the evolution of enterprise technological innovation performance. The research specifically enriched the application process of technological innovation in institutional networks related to enterprises.

Keywords: complex adaptive system, echo model, enterprise knowledge system, research institutions, multi-agents.

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Authors: Konstans Ruseva, Kristina Ivanova, Katerina Todorova, Margarita Gabrashanska, Tzanko Tzanov, Elena Vassileva

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Zwitterionic polymers (ZP) are well-known with their ultralow biofouling. They are successfully competing with poly(ethylene glycols) (PEG), which are considered as the “golden standard” in this respect. These unique properties are attributed to their strong hydration capacity, defined by the dipole-dipole interactions, arising between the ZP pendant groups as well as to the dipoles interaction with water molecules. Beside, ZP are highly resistant to bacterial adhesion thus ensuring an excellent anti-biofilm formation ability. Moreover, ZP are able to respond upon external stimuli such as temperature, pH, salt concentration changes which in combination with their anti-biofouling effect render this type of polymers as materials with a high potential in biomedical applications. The present work is focused on the development of zwitterionic hydrogels for efficient treatment of highly exudating and hard-to-heal chronic wounds. To this purpose, two types of ZP networks with different crosslinking degree were synthesized - polysulfobetaine (PSB) and polycarboxybetaine (PCB) ones. They were characterized in terms of their physico-mechanical properties, e.g. microhardness, swelling ability, smart behaviour. Furthermore, the potential of ZP networks to resist biofilm formation towards Staphylococcus aureus and Escherichia coli was studied. Their ability to reduce the high levels of myeloperoxidase and metalloproteinase, two enzymes that are part of the chronic wounds enviroenment, was revealed. Moreover, the in vitro cytotoxic assessment of PSB and PCB networks along with their in vivo performance in rats was also studied to reveal their high biocompatibility.

Keywords: absorption properties, biocompatibility, enzymatic inhibition activity, wound healing, zwitterionic polymers

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Authors: Choppala Pratheek, Vineet Ahuja

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Background: Crohn's disease (CD) recurrence following surgery is a common challenge, and current detection methods rely on risk factors identified in Western populations. This study aimed to investigate the risk factors and rates of postoperative CD recurrence in a tuberculosis-endemic region like India. Retrospective data was collected from a structured database from a specialty IBD clinic by reviewing case files from January 2005 to December 2021. Inclusion criteria involved CD patients diagnosed based on the ECCO-ESGAR consensus guidelines, who had undergone at least one intestinal resection and had a minimum follow-up period of one year at the IBD clinic. Results: A total of 90 patients were followed up for a median period of 45 months (IQR, 20.75 - 72.00). Out of the 90 patients, 61 received ATT prior to surgery, with a mean delay in diagnosis of 2.5 years, although statistically non-significant (P=0.078). Clinical recurrence occurred in 50% of patients, with the cumulative rate increasing from 13.3% at one year to 40% at three years. Among 63 patients who underwent endoscopy, 65.7% showed evidence of endoscopic recurrence, with the cumulative rate increasing from 31.7% at one year to 55.5% at four years. Smoking was identified as a significant risk factor for early endoscopic recurrence (P=0.001) by Cox regression analysis, but no other risk factors were identified. Initiating post-operative medications prior to clinical recurrence delayed its onset (P=0.004). Subgroup analysis indicated that endoscopic monitoring aided in the early identification of recurrence (P=0.001). The findings contribute to enhancing post-operative CD management strategies in such regions where the disease burden is escalating.

Keywords: crohns, post operative, tuberculosis-endemic, risk factors

Procedia PDF Downloads 67

Authors: Shazia Farooq Mirza

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The purpose of this study was to explore the challenges faced by visually impaired children and their parents in doing homework assignments using Braille. This study had a quantitative approach and it was descriptive in nature. It took place in 6 public and special private schools of Lahore.177 visually impaired children of grades 4-10 and 153 parents of the visually impaired children were the volunteer participants of this study which were selected through a convenient sampling method. A survey method was adopted for the data collection. And for this purpose 2 self-developed validated questionnaires were used as instruments. The instruments were constructed by exploring the factors and sub-factors from the literature review. Thirty students with visual impairment and 30 parents of the students with visual impairment filled the questionnaires as a pilot study, and it ensured the reliability of the instruments. Data were analyzed using a statistical package of social sciences and it was completely interpreted. Findings revealed that the common challenges faced by the students with visual impairment were Physical Stress, Readiness, Braille Knowledge, Braille Skill and Communications. And the major challenges faced by the parents of the students with visual impairment were the Availability of the helping material, the Availability of the reading material, Braille Knowledge, Braille skills, School and family interactions, Behavior management and the Environment and equipment. Conclusions were drawn on the basis of the major findings. Future suggestions are given in light of the conclusions. This study will be beneficial for the children with visual impairment, the parents of the children with visual impairment, the special education teachers and for the policymakers of the special schools.

Keywords: challenges, visually impaired children, homework, parents, braille

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Authors: Widad Kouachi, Nacera Benmouhoub

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Background: Erector spinae plane block (ESP) and thoracic paravertebral block (PVB) are two widely used regional anesthesia techniques in breast cancer surgery. Both techniques aim to improve postoperative pain management and reduce opioid consumption. However, comparative data on their efficacy in oncologic breast surgery remains limited. Objectives: This study aims to compare the efficacy of ESP and PVB in postoperative pain control, patient satisfaction, and opioid consumption in breast cancer surgery. Methods: A randomized, double-blind trial was conducted involving 100 patients undergoing oncologic breast surgery. Patients were randomly assigned to two groups: 50 received ESP, and 50 received PVB. Postoperative pain scores (at rest and during movement), opioid consumption, patient satisfaction, and hospital length of stay were recorded and analyzed. Results: Both ESP and PVB provided effective postoperative analgesia. No significant difference in pain scores was observed between the two groups within the first 24 hours. However, ESP showed a notable advantage in managing chronic postoperative pain at the 6-month follow-up. Opioid consumption was lower in both groups compared to patients without a block. No significant differences in complication rates or hospital stay were noted between the groups. Conclusion: ESP and PVB offer comparable efficacy for immediate postoperative pain control in breast cancer surgery. Nevertheless, ESP may have a superior role in managing long-term pain. Further research is needed to explore the mechanisms behind the observed differences in chronic pain outcomes.

Keywords: pain assessment, brest surgery, bpv block, ESP block

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Authors: Sonu Khanal, Mandira Shrestha

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Snow and Glaciers are the largest dependable reserved sources of water for the river system originating from the Himalayas so an accurate estimate of the volume of water contained in the snowpack and the rate of release of water from snow and glaciers are, therefore, needed for efficient management of the water resources. This research assess the fusion of energy exchanges between the snowpack, air above and soil below according to mass and energy balance which makes it apposite than the models using simple temperature index for the snow and glacier melt computation. UEBGrid a Distributed energy based model is used to calculate the melt which is then routed by Geo-SFM. The model robustness is maintained by incorporating the albedo generated from the Landsat-7 ETM images on a seasonal basis for the year 2002-2003 and substrate map derived from TM. The Substrate file includes predominantly the 4 major thematic layers viz Snow, clean ice, Glaciers and Barren land. This approach makes use of CPC RFE-2 and MERRA gridded data sets as the source of precipitation and climatic variables. The subsequent model run for the year between 2002-2008 shows a total annual melt of 17.15 meter is generate from the Marshyangdi Basin of which 71% is contributed by the glaciers , 18% by the rain and rest being from the snow melt. The albedo file is decisive in governing the melt dynamics as 30% increase in the generated surface albedo results in the 10% decrease in the simulated discharge. The melt routed with the land cover and soil variables using Geo-SFM shows Nash-Sutcliffe Efficiency of 0.60 with observed discharge for the study period.

Keywords: Glacier, Glacier melt, Snowmelt, Energy balance

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Authors: Thomas Trouton, Sebastian Tanner, Manvir Sandher

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The use of simulation in undergraduate and postgraduate medical curricula is ever-growing, is a useful addition to the traditional apprenticeship model of learning within medical education, and better prepares graduates for the team-based approach to healthcare seen in real-life clinical practice. As a learning tool, however, undergraduate medical students often have little understanding of the theory behind the use of medical simulation and have little experience in planning and delivering their own simulated teaching sessions. We designed and implemented a student-selected component (SSC) as part of the undergraduate medical curriculum at the University of Buckingham Medical School to introduce students to the concepts behind the use of medical simulation in education and allow them to plan and deliver their own simulated medical scenario to their peers. The SSC took place over a 2-week period in the 3rd year of the undergraduate course. There was a mix of lectures, seminars and interactive group work sessions, as well as hands-on experience in the simulation suite, to introduce key concepts related to medical simulation, including technical considerations in simulation, human factors, debriefing and troubleshooting scenarios. We evaluated the success of our SSC using “Net Promotor Scores” (NPS) to assess students’ confidence in planning and facilitating a simulation-based teaching session, as well as leading a debrief session. In all three domains, we showed an increase in the confidence of the students. We also showed an increase in confidence in the management of common medical emergencies as a result of the SSC. Overall, the students who chose our SSC had the opportunity to learn new skills in medical education, with a particular focus on the use of simulation-based teaching, and feedback highlighted that a number of students would take these skills forward in their own practice. We demonstrated an increase in confidence in several domains related to the use of medical simulation in education and have hopefully inspired a new generation of medical educators.

Keywords: simulation, SSC, teaching, medical students

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Authors: Valmir Baloshi, Fran Gjoka, Nehat Çollaku, Elvin Toromani

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As a sediment production mechanism, soil erosion is the main environmental threat to the Bovilla watershed, including the decline of water quality of the Bovilla reservoir that provides drinking water to Tirana city (the capital of Albania). Therefore, an experiment with 25 erosion plots for soil erosion monitoring has been set up since June 2017. The aim was to determine the soil loss on plot and watershed scale in Bovilla watershed (Tirana region) for implementation of soil and water protection measures or payments for ecosystem services (PES) programs. The results of erosion monitoring for the period June 2017 - May 2018 showed that the highest values of surface runoff were noted in bare land of 38829.91 liters on slope of 74% and the lowest values in forest land of 12840.6 liters on slope of 64% while the highest values of soil loss were found in bare land of 595.15 t/ha on slope of 62% and lowest values in forest land of 18.99 t/ha on slope of 64%. These values are much higher than the average rate of soil loss in the European Union (2.46 ton/ha/year). In the same sloping class, the soil loss was reduced from orchard or bare land to the forest land, and in the same category of land use, the soil loss increased with increasing land slope. It is necessary to conduct chemical analyses of sediments to determine the amount of chemical elements leached out of the soil and end up in the reservoir of Bovilla. It is concluded that PES programs should be implemented for rehabilitation of sub-watersheds Ranxe, Vilez and Zall-Bastar of the Bovilla watershed with valuable conservation practices.

Keywords: ANOVA, Bovilla, land cover, slope, soil loss, watershed management

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Authors: Javier Carroquino, Nieves García-Casarejos, Pilar Gargallo

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Climate change, depletion of non-renewable resources in the current energies, pollution from them, the greater ecological awareness of the population, are factors that suggest the change of energy sources in business. The agri-food industry is a growth sector, concerned about product innovation, process and with a clear awareness of what climate change may mean for it. This sector is supposed to have a high receptivity to the implementation of clean energy, as this favors not only the environment but also the essence of its business. This work, through surveys, aims to know the willingness of Spanish wineries to implement renewable energies in their vineyards, as well as the limitations they perceive for their implementation. This questionnaire allows the characterization of the sector in terms of its geographical typologies, their activity levels, their perception of environmental issues, the degree of implementation of measures to mitigate climate change and improve energy efficiency, and its uses and energy consumption. The analysis of data proves that the penetration of renewable energies is still at low levels, being the most used energies, solar thermal, photovoltaic and biomass. The initial investment seems to be at the origin of the lack of implantation of this type of energy in the wineries, and not so much the costs of operations and maintenance. The environmental management of the wineries is still at an embryonic stage within the company's organization chart, because these services are either outsourced or, if technicians are available, they are not exclusively dedicated to these tasks. However, there is a strong environmental awareness, as evidenced by the number of climate change mitigation and energy efficiency measures already adopted. The gap between high awareness and low achievement is probably due to the lack of knowledge about how to do it or the perception of a high cost.

Keywords: survey, renewable energy, winery, Spanish case

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Authors: Gebremedhin Kiros, Amba Shetty, Lakshman Nandagiri

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Soil erosion is a major threat to the sustainability of land and water resources in the catchment and there is a need to identify critical areas of erosion so that suitable conservation measures may be adopted. The present study was taken up to understand the temporal and spatial distribution of soil erosion and daily sediment yield in Geba catchment (5137 km2) located in the Northern Highlands of Ethiopia. Soil and Water Assessment Tool (SWAT) was applied to the Geba catchment using data pertaining to rainfall, climate, soils, topography and land use/land cover (LU/LC) for the historical period 2000-2013. LU/LC distribution in the catchment was characterized using LANDSAT satellite imagery and the GIS-based ArcSWAT version of the model. The model was calibrated and validated using sediment concentration measurements made at the catchment outlet. The catchment was divided into 13 sub-basins and based on estimated soil erosion, these were prioritized on the basis of susceptibility to soil erosion. Model results indicated that the average sediment yield estimated of the catchment was 12.23 tons/ha/yr. The generated soil loss map indicated that a large portion of the catchment has high erosion rates resulting in significantly large sediment yield at the outlet. Steep and unstable terrain, the occurrence of highly erodible soils and low vegetation cover appeared to favor high soil erosion. Results obtained from this study prove useful in adopting in targeted soil and water conservation measures and promote sustainable management of natural resources in the Geba and similar catchments in the region.

Keywords: Ethiopia, Geba catchment, MUSLE, sediment yield, SWAT Model

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Authors: T. Hopkin, S. Lu, P. Rogers, M. Sexton

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Housing Associations (HAs) contribute circa 20% of the UK’s housing supply. HAs are however under increasing pressure as a result of funding cuts and rent reductions. Due to the increased pressure, a number of processes are currently being reviewed by HAs, especially how they manage and learn from defects. Learning from defects is considered a useful approach to achieving defect reduction within the UK housebuilding industry. This paper contributes to our understanding of how HAs learn from defects by undertaking an initial round table discussion with key HA stakeholders as part of an ongoing collaborative research project with the National House Building Council (NHBC) to better understand how house builders and HAs learn from defects to reduce their prevalence. The initial discussion shows that defect information runs through a number of groups, both internal and external of a HA during both the defects management process and organizational learning (OL) process. Furthermore, HAs are reliant on capturing and recording defect data as the foundation for the OL process. During the OL process defect data analysis is the primary enabler to recognizing a need for a change to organizational routines. When a need for change has been recognized, new options are typically pursued to design out defects via updates to a HAs Employer’s Requirements. Proposed solutions are selected by a review board and committed to organizational routine. After implementing a change, both structured and unstructured feedback is sought to establish the change’s success. The findings from the HA discussion demonstrates that OL can achieve defect reduction within the house building sector in the UK. The paper concludes by outlining a potential ‘learning from defects model’ for the housebuilding industry as well as describing future work.

Keywords: defects, new homes, housing association, organizational learning

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Authors: Balakrishna Valluru, Ruth Suckling

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A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

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Authors: Keerthie Dissanayake, Chandrika Jayasinghe, Priyani Wanigasekara, Jayampathy Dissanayake, Ajith Sominanda

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The routine use of Disease Activity Score-28 (DAS28) to assess the disease activity in rheumatoid arthritis (RA) is limited due to its dependency on laboratory investigations and the complex calculations involved. In contrast, the clinical disease activity index (CDAI) is simple to calculate, which makes the "treat to target" strategy for the management of RA more practical. We aimed to assess the validity of CDAI compared to DAS28 in RA patients in Sri Lanka. A total of 103 newly diagnosed RA patients were recruited, and their disease activity was calculated using DAS 28 and CDAI during the first visit to the clinic (0 months) and re-assessed at 4 and 9 months of the follow-up visits. The validity of the CDAI, compared to DAS 28, was evaluated. Patients had a female preponderance (6:1) and a short symptom duration (mean = 6.33 months). The construct validity of CDAI, as assessed by Cronbach's α test, was 0.868. Convergent validity was assessed by correlation and Kappa statistics. Strong positive correlations were observed between CDAI and DAS 28 at the baseline (0 months), 4, and 9 months of evaluation (Spearman's r = 0.9357, 0.9354, 0.9106, respectively). Moderate-good inter-rater agreements between the DAS-28 and CDAI were observed (Weighted kappa of 0.660, 0.519, and 0.741 at 0, 4, and 9 months respectively). Discriminant validity, as assessed by ROC curves at 0, 4th, and 9th months of the evaluation, showed the area under the curve (AUC) of 0.958, 0.985, and 0.914, respectively. The suggested cut-off points for different CDAI disease activity categories according to ROC curves were ≤ 2 (Remission), >2 to ≤ 5 (low), >5 to ≤ 18 (moderate), > 18 (high). These findings indicate that the CDAI has good concordance with DAS 28 in assessing the disease activity in RA patients in this study sample.

Keywords: rheumatoid arthritis, CDAI, disease activity, Sri Lanka, validation

Procedia PDF Downloads 155

Authors: Samaneh Arasteh

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Neighbourhood satisfaction and safety are the two main components of urban life and have a substantial impact on residents’ quality of life. The relationship between these two components, especially in areas surrounding our individual private dwellings, is highly influential on many social, economic, and wellbeing activities that may benefit neighbourhood residents. Neighbourhood and urban design – which are liable to be affected by the perceived quality of local public spaces – are likely to be significant factors influencing broader residents’ feelings of safety. With this in mind, this study reviews recent normative literature on how these design processes have influenced neighbourhood satisfaction including perceived safety with a focus on different aspects of public spaces including planning, management, and design in a mix-tenure neighbourhood. Following the study aim, Riverwood in Sydney’s southwest was chosen as a case study to gain a detailed understanding of the context by engaging with community members, residents, non-government organisations, and experts. Moreover, archival studies on neighbourhood satisfaction and safety, expert interviews, and resident questionnaires are presented to shed light on the relationship between neighbourhood satisfaction and perception of safety. The study argues that for the safer neighbourhood in urban areas, social-cultural factors need to be aligned toward strengthening physical factors and since making the environments safer, it is important to understand practical and achievable mechanisms which are required to improve existing estates. Findings show that increasing the clarity of community social and physical environmental involvements can promote residents’ feelings of safety and following neighbourhood satisfaction.

Keywords: neighbourhood satisfaction, public space, Riverwood, urban safety

Procedia PDF Downloads 182

Authors: Kalangi Rodrigo

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The term Neuroecology elucidates the study of customizable variation in cognition and the brain. Subject marked the birth since 1980s, when researches began to apply methods of comparative evolutionary biology to cognitive processes and the underlying neural mechanisms of cognition. In Archaeology and Anthropology, we observe behaviors such as social learning skills, innovative feeding and foraging, tool use and social manipulation to determine the cognitive processes of ancient mankind. Depending on the brainstem size was used as a control variable, and phylogeny was controlled using independent contrasts. Both disciplines need to enriched with comparative literature and neurological experimental, behavioral studies among tribal peoples as well as primate groups which will lead the research to a potential end. Neuroecology examines the relations between ecological selection pressure and mankind or sex differences in cognition and the brain. The goal of neuroecology is to understand how natural law acts on perception and its neural apparatus. Furthermore, neuroecology will eventually lead both principal disciplines to Ethology, where human behaviors and social management studies from a biological perspective. It can be either ethnoarchaeological or prehistoric. Archaeology should adopt general approach of neuroecology, phylogenetic comparative methods can be used in the field, and new findings on the cognitive mechanisms and brain structures involved mating systems, social organization, communication and foraging. The contribution of neuroecology to archaeology and anthropology is the information it provides on the selective pressures that have influenced the evolution of cognition and brain structure of the mankind. It will shed a new light to the path of evolutionary studies including behavioral ecology, primate archaeology and cognitive archaeology.

Keywords: Neuroecology, Archaeology, Brain Evolution, Cognitive Archaeology

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Authors: Irakli Manvelidze, Genadi Iashvili, Giga Phartenadze, Giorgi Katamadze

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Establishment of electronic governance in the region is facing serious problems. Organizational, technical, social and methodological problems have been identified after the research. These problems currently create serious barriers and prevent the development of effective e-governance. Lack of human resources, difference in program targets of the centre and the region, lack of citizens’ awareness about the project of electronic governance are other issues that should be mentioned. In spite of positive changes the overall situation concerning development of modern information-communication technologies in Adjara is not satisfactory. The information systems in the region can be described as transforming in a democratic way which needs serious reforms. Current situation shows that unsystematic, uncoordinated actions were made which overall represents more chaotic rather than coordinated systematic process. Therefore, a strategic document ‘Adjarian Electronic Government’ should be created which will ensure systematic development of electronic governance in the region. The implementation of the strategy of ‘Adjarian Electronic Government’ should be based on not only conceptual and instrumental but also legal basics. A legal normative basis should be created which will include formation of electronic government’s instrumental basis as well as creation of united regional system of electronic document management. Meanwhile types of documents which would be used in inter institutional relations should be defined under a legal norm. Creation of regional united system of e-filing will regulate regional public institutions, relations between local self-government and public organizations as well as it will ensure coordinated work of all regional public institutions.

Keywords: e-government, information society, public administration, reforming state governance, public institutions

Procedia PDF Downloads 283