Search results for: logistics centers

Authors: Anil Kumar Baral

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The research introduces a ground-breaking approach to waste management, emphasizing innovation, education, and transformation. Using Chandragiri Municipality as a case study, the study advocates a shift from traditional to progressive waste management strategies, contributing an inventive waste framework, sustainability advocacy, and a transformative blueprint. The waste composition analysis highlights Chandragiri's representative profile, leading to a comprehensive plan addressing challenges and recommending a transition to a profitable waste treatment model, supported by relevant statistics. The data-driven approach incorporates the official data of waste Composition from Chandragiri Municipality as secondary data and incorporates the primary data from Chandragiri households, ensuring a nuanced perspective. Discussions on implementation, viability, and environmental preservation underscore the dual benefit of sustainability. The study includes a comparative analysis, monitoring, and evaluation framework, examining international relevance and collaboration, and conducting a social and environmental impact assessment. The results indicate the necessity for creative changes in Chandragiri's waste practices, recommending separate treatment centers in wards level rather than Municipal level, composting machines, and a centralized waste treatment plant. Educational reforms involve revising school curricula and awareness campaigns. The transformation's success hinges on reducing waste size, efficient treatment center operation, and ongoing public literacy. The conclusion summarizes key findings, envisioning a future with sustainable waste management practices deeply embedded in the community fabric.

Keywords: innovate, educate, transform, municipality, method

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Authors: Davie Hope Moyo

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The environment is a combination of two things: resources and hazards. One of the hazards that is a result of environmental changes is the occurrence of flooding. Floods are one of the disasters that are highly feared by people because they have a huge impact on the human population and their environment. In recent years, flooding disasters in the Nsanje district are increasing in both frequency and magnitude. This study aims to understand the root causes of this phenomenon. To understand the causes of flooding, this study focused on the case of TA Ndamera in the Nsanje district, southern Malawi. People in the Nsanje district face disruption in their day-to-day life because of floods that affect their communities. When floods happen, people lose their property, land, livestock, and even lives. The study was carried out in order to have a better understanding of the root causes of floods. The findings of this study may help the government and other development agencies to put in place mitigation measures that will make Nsanje District resilient to the occurrence of future flood hazards. Data was collected from the area of TA Ndamera in order to assess the causes of flooding in the district. Interviews, transect walks, and researcher observation was done to appreciate the topography of the district and evaluate other factors that are making the people become vulnerable to the impacts of flooding in the district. It was found that flooding in the district is mainly caused by heavy rainfall in the upper shire, settlements along river banks, deforestation, and the topography of the district in general. The research study ends by providing recommendation strategies that need to be put in place to increase the resilience of the communities to future flood hazards. The research recommends the development of indigenous knowledge systems to alert people of incoming floods, construction of evacuation centers to ease pressure on schools, savings, and insurance schemes, construction of dykes, desilting rivers, and afforestation.

Keywords: disaster causes, mitigation, safety measures, Nsanje Malawi

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Authors: Wala Abou Saoud, Aymen Amine Assadi, Monia Guiza, Abdelkrim Bouzaza, Wael Aboussaoud, Abdelmottaleb Ouederni, Dominique Wolbert

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Volatile organic compounds (VOCs) constitute one of the most important families of chemicals involved in atmospheric pollution, causing damage to the environment and human health, and need, consequently, to be eliminated. Among the promising technologies, dielectric barrier discharge (DBD) plasma - photocatalysis coupling reveals very interesting prospects in terms of process synergy of compounds mineralization’s, with low energy consumption. In this study, the removal of organic compounds such butyraldehyde (BUTY) and dimethyl disulfide (DMDS) (exhaust gasses from animal quartering centers.) in air mixture using DBD plasma coupled with photocatalysis was tested, in order to determine whether or not synergy effect was present. The removal efficiency of these pollutants, a selectivity of CO₂ and CO, and byproducts formation such as ozone formation were investigated in order to evaluate the performance of the combined process. For this purpose, a series of experiments were carried out in a continuous reactor. Many operating parameters were also investigated such as the specific energy of discharge, the inlet concentration of pollutant and the flowrate. It appears from this study that, the performance of the process has enhanced and a synergetic effect is observed. In fact, we note an enhancement of 10 % on removal efficiency. It is interesting to note that the combined system leads to better CO₂ selectivity than for plasma. Consequently, intermediates by-products have been reduced due to various other species (O•, N, OH•, O₂•-, O₃, NO₂, NOx, etc.). Additionally, the behavior of combining DBD plasma and photocatalysis has shown that the ozone can be easily also decomposed in presence of photocatalyst.

Keywords: combined process, DBD plasma, photocatalysis, pilot scale, synergetic effect, VOCs

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Authors: Shanti Swaroop Gupta, Bibekananda Mohapatra, S. K. Chaturvedi, Anand Bohra

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For sustainable development in India, there is an urgent need to follow the principles of industrial symbiosis in the industrial processes, under which the scraps, wastes, or by‐products of one industry can become the raw materials for another. This will not only help in reducing the dependence on natural resources but also help in gaining economic advantage to the industry. Gypsum is one such area in India, where the linear economy model of by-product gypsum utilization has resulted in unutilized legacy phosphogypsum stock of 64.65 million tonnes (mt) at phosphoric acid plants in 2020-21. In the future, this unutilized gypsum stock will increase further due to the expected generation of Flue Gas Desulphurization (FGD) gypsum in huge quantities from thermal power plants. Therefore, it is essential to transit from the linear to circular economy in Gypsum in India, which will result in huge environmental as well as ecological benefits. Gypsum is required in many sectors like Construction (Cement industry, gypsum boards, glass fiber reinforced gypsum panels, gypsum plaster, fly ash lime bricks, floor screeds, road construction), agriculture, in the manufacture of Plaster of Paris, pottery, ceramic industry, water treatment processes, manufacture of ammonium sulphate, paints, textiles, etc. The challenges faced in areas of quality, policy, logistics, lack of infrastructure, promotion, etc., for complete utilization of by-product gypsum have been discussed. The untapped potential of by-product gypsum utilization in various sectors like the use of gypsum in agriculture for sodic soil reclamation, utilization of legacy stock in cement industry on mission mode, improvement in quality of by-product gypsum by standardization and usage in building materials industry has been identified. Based on the measures required to tackle the various challenges and utilization of the untapped potential of gypsum, a comprehensive action plan for the transition from linear to the circular economy in gypsum in India has been formulated. The strategies and policy measures required to implement the action plan to achieve a circular economy in Gypsum have been recommended for various government departments. It is estimated that the focused implementation of the proposed action plan would result in a significant decrease in unutilized gypsum legacy stock in the next five years and it would cease to exist by 2027-28 if the proposed action plan is effectively implemented.

Keywords: circular economy, FGD gypsum, India, phosphogypsum

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Authors: Yiling Shao, Megan Dai

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This paper attempts to explore whether the cultural infrastructure supported by the Chinese government is still subject to a logic of “strict regulation”.Previous studies have pointed out that the "paternalism" tendency of China's cultural policy always leads to excessive government intervention in cultural development, while Chinese cultural practitioners can only seek cultural autonomy in the cracks of supervision. This can also explain why Chinese cultural policies sometimes have different effects than the official expectations.But this only reflects one aspect of China's cultural policy. In fact, the welfare cultural infrastructure funded by the government seems to highlight the principles of "safeguarding citizens' cultural rights" and "citizens' voluntary" rather than "indoctrination" and "enlightenment", What new features of China's cultural policy are reflected behind this policy orientation that is completely different from the logic of "regulation", which has also become an important issue in this paper. Based on the field survey of a cultural infrastructure (Gao ming District Cultural Center) in Gao ming District, Fo shan City, Guangdong Province, China, for nearly one year, the authors have obtained many text and picture materials.The paper discusses the dual role of cultural centers in China's cultural policy -both as a formal commitment by the state to protect citizens' basic cultural rights and as a social space for citizens to use preferential policies to obtain cultural capital. All in all, the author have conclued three operational logics of the cultural infrastructure currently supported by the Chinese government (at least in developed areas): first, the cultural center has become a versatile cultural space; second, grass-roots cultural cadres can be described as "policy entrepreneurs"; third, ordinary citizens will use the officially supported cultural infrastructure to increase cultural capital. This paper argues that, in comparison to the common “regulatory hand” in the field of cultural industries, in cultural infrastructure supported by state, the authorities and citizens are not in conflict. On the contrary, authorities must adopt a de-regulatory "pleasing" strategy to gain the support of citizens.

Keywords: cultural infrastructure, cultural capital, deregulation, policy entrepreneur

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Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

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Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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Authors: Subramanyam Devarakonda Hanumantharao, Udayendu Prakash Sharma, Mahesh Garg

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Introduction: Gomabai Netralaya a reputed eye hospital is located in Neemuch a small city of Madhya Pradesh, India. The hospital is established in 1992 by Late. G.D Agrawal a renowned educationist, freedom fighter and philanthropist. The eye hospital was established to serve all sections of the society in affordable manner. To provide comprehensive eye care services to the rural poor the hospital started organizing outreach camps since 1994. Purpose: To study the cost effectiveness of outreach eye camps for addressing the sustainability issues of the outreach program. Methods: One year statistics of outreach eye camps were collected from Hospital Management Information System software to analyze the productivity of camps. Income and expenses report was collected from outreach department records to analyze per camp expenses and per patient expenses against the income generated. All current year records were analyzed to have accuracy of information and results. Information was collected in two ways: 1)Actual camp performance records and expenses from book of accounts. 2)Cross verification was done through one to one discussion with outreach staff. Results: Total 17534 outpatients were examined through 52 outreach eye camps. Total 6042 (34% of total outpatients) patients were advised with cataracts and 4651 (77% of advice) operations were performed. The average OPD per camp was 337 and per camp 116 patients was advised for cataract surgery and 89 surgeries were performed per camp. Total 18200 US$ incurred on organizing 52 outreach camps in the radius of 100 k.ms. Considering the total outpatients screened through camps the screening cost per patient was 1.00 US$ and considering the surgical output the per surgery expenses was 4.00 US$. The cost recovery of the total expenses was through Government grant of US$ 16.00 per surgery (that includes surgical grant). All logistics cost of camps and patients transportation cost was taken care by local donors. Conclusion: The present study demonstrates that with people’s participation, successful high volume outreach eye camps can be organized. The cost effectiveness of the outreach camps is totally depended on volume of outpatient’s turn-up at camp site and per camp surgical output. The only solution to sustainability of outreach eye camps is sharing of cost with local donors and increasing productivity.

Keywords: camps, outreach, productivity, sustainable

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: G. Dottavio, M. F. Andrade, F. Renard, V. Cheutet, A.-L. Ladier, S. Vercraene, P. Hoang, S. Briet, R. Dachicourt, Y. Baizet

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An important number of technological equipment and high-skilled workers over long periods of time have to be mobilized during nuclear decommissioning processes. The related operations generate complex flows of waste and high inventory levels, associated to information flows of heterogeneous types. Taking into account that more than 10 decommissioning operations are on-going in France and about 50 are expected toward 2025: A big challenge is addressed today. The management of decommissioning and dismantling of nuclear installations represents an important part of the nuclear-based energy lifecycle, since it has an environmental impact as well as an important influence on the electricity cost and therefore the price for end-users. Bringing new technologies and new solutions into decommissioning methodologies is thus mandatory to improve the quality, cost and delay efficiency of these operations. The purpose of our project is to improve decommissioning management efficiency by developing a decision-support framework dedicated to plan nuclear facility decommissioning operations and to optimize waste evacuation by means of a logistic approach. The target is to create an easy-to-handle tool capable of i) predicting waste flows and proposing the best decommissioning logistics scenario and ii) managing information during all the steps of the process and following the progress: planning, resources, delays, authorizations, saturation zones, waste volume, etc. In this article we present our results from waste nuclear flows simulation during decommissioning process, including discrete-event simulation supported by FLEXSIM 3-D software. This approach was successfully tested and our works confirms its ability to improve this type of industrial process by identifying the critical points of the chain and optimizing it by identifying improvement actions. This type of simulation, executed before the start of the process operations on the basis of a first conception, allow ‘what-if’ process evaluation and help to ensure quality of the process in an uncertain context. The simulation of nuclear waste flows before evacuation from the site will help reducing the cost and duration of the decommissioning process by optimizing the planning and the use of resources, transitional storage and expensive radioactive waste containers. Additional benefits are expected for the governance system of the waste evacuation since it will enable a shared responsibility of the waste flows.

Keywords: nuclear decommissioning, logistical optimization, decision-support framework, waste management

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Authors: Vaishakh Medikeri

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Lightning, the marvelous, spectacular and the awesome truth of nature is one of the greatest energy sources left unharnessed since ages. A single lightning bolt of lightning contains energy of about 15 billion joules. This huge amount of energy cannot be harnessed completely but partially. This paper proposes to harness the energy from lightning strikes. Throughout the globe the frequency of lightning is 40-50 flashes per second, totally 1.4 billion flashes per year; all of these flashes carrying an average energy of about 15 billion joules each. When a lightning bolt strikes the ground, tremendous amounts of energy is transferred to earth which propagates in the form of concentric circular energy waves. These waves have a frequency of about 7.83Hz. Harvesting the lightning bolt directly seems impossible, but harvesting the energy waves produced by the lightning is pretty easier. This can be done using a tricoil energy harnesser which is a new device which I have invented. We know that lightning bolt seeks the path which has minimum resistance down to the earth. For this we can make a lightning rod about 100 meters high. Now the lightning rod is attached to the tricoil energy harnesser. The tricoil energy harnesser contains three coils whose centers are collinear and all the coils are parallel to the ground. The first coil has one of its ends connected to the lightning rod and the other end grounded. There is a secondary coil wound on the first coil with one of its end grounded and the other end pointing to the ground and left unconnected and placed a little bit above the ground so that this end of the coil produces more intense currents, hence producing intense energy waves. The first coil produces very high magnetic fields and induces them in the second and third coils. Along with the magnetic fields induced by the first coil, the energy waves which are currents also flow through the second and the third coils. The second and the third coils are connected to a generator which in turn is connected to a capacitor which stores the electrical energy. The first coil is placed in the middle of the second and the third coil. The stored energy can be used for transmission of electricity. This new technique of harnessing the lightning strikes would be most efficient in places with more probability of the lightning strikes. Since we are using a lightning rod sufficiently long, the probability of cloud to ground strikes is increased. If the proposed apparatus is implemented, it would be a great source of pure and clean energy.

Keywords: generator, lightning rod, tricoil energy harnesser, harvesting energy

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Authors: Juan C. Reyes, Linnette Rodríguez, Héctor Villanueva, Jorge Vázquez, Ivonne Rivera

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On July 2020, a private non-profit community health center (HealthProMed) that serves people without a medical insurance plan or with limited resources in one of the most populated areas in San Juan, Puerto Rico, implemented a COVID-19 case investigation and contact-tracing surveillance system. Nursing personnel at the health center completed a computerized case investigation form that was translated, adapted, and modified from CDC’s Patient Under Investigation (PUI) Form. Between July 13, 2020, and March 17, 2022, a total of 9,233 SARS-CoV-2 tests were conducted at the health center, 16.9% of which were classified as confirmed cases (positive molecular test) and 27.7% as probable cases (positive serologic test). Most of the confirmed cases were females (60.0%), under 20 years old (29.1%), and living in their homes (59.1%). In the 14 days before the onset of symptoms, 26.3% of confirmed cases reported going to the supermarket, 22.4% had contact with a known COVID-19 case, and 20.7% went to work. The symptoms most commonly reported were sore throat (33.4%), runny nose (33.3%), cough (24.9%), and headache (23.2%). The most common preexisting medical conditions among confirmed cases were hypertension (19.3%), chronic lung disease including asthma, emphysema, COPD (13.3%), and diabetes mellitus (12.8). Multiple logistic regression analysis revealed that patients who used alcohol frequently during the last two weeks (OR=1.43; 95%CI: 1.15-1.77), those who were in contact with a positive case (OR=1.58; 95%CI: 1.33-1.88) and those who were obese (OR=1.82; 95%CI: 1.24-2.69) were significantly more likely to be a confirmed case after controlling for sociodemographic variables. Implementing a case investigation and contact-tracing component at community health centers can be of great value in the prevention and control of COVID-19 at the community level and could be used in future outbreaks.

Keywords: community health center, Puerto Rico, risk factors, SARS-CoV-2

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Authors: Iman Shabanzadeh

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In terms of its geopolitical position, Iran has been one of the main centers of migration movements in the world in recent decades. However, the policy makers' lack of preparation in completing the cycle of social integration of these immigrants, especially the second and third generation, has caused these people to always be prone to leave the country and immigrate to developed and industrialized countries. In this research, the issue of integration of immigrants in Iran from the perspective of four indicators, "Identity Documents", "Access to Banking Services", "Access to Health and Treatment Services" and "Obtaining a Driver's License" will be analyzed. The research method is descriptive-analytical. To collect information, library and document sources in the field of laws and regulations related to immigrants' rights in Iran, semi-structured interviews with experts have been used. The investigations of this study show that none of the residence documents of immigrants in Iran guarantee the full enjoyment of basic citizenship rights for them. In fact, the function of many of these identity documents, such as the census card, educational support card, etc., is only to prevent crossing the border, and none of them guarantee the basic rights of citizenship. Therefore, for many immigrants, the difference between legality and illegality is only in the risk of crossing the border, and this has led to the spread of the habit of illegal presence for them. Despite this, it seems that there is no clear and coherent policy framework around the issue of foreign immigrants in the country. This policy incoherence can be clearly seen in the diversity and plurality of identity and legal documents of the citizens present in the country and the policy maker's lack of planning to integrate and organize the identity of this huge group. Examining the differences and socioeconomic inequalities between immigrants and the native Iranian population shows that immigrants have been poorly integrated into the structures of Iranian society from an economic and social point of view.

Keywords: immigrants, social integration, citizen services, structural inequality

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Authors: Abebe Tibebu

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This study investigates the quality of training factors in Ethiopian Technical and Vocational Education and Training (TVET) colleges and their impact on declining enrollment rates. Employing a descriptive survey design, both quantitative and qualitative data were collected from diverse stakeholders, including Grade 12 graduates, current TVET trainees, trainers, college deans, community members, high school directors, teachers, and officials from TVET government agencies. The sample included 20 TVET centers from various Ethiopian regions. Secondary data were obtained from college and government documents, while primary data were gathered through questionnaires, interviews, focus group discussions, and observations. Analysis was conducted using descriptive statistics with SPSS, capturing response frequencies and percentages. The study's findings highlight several key factors affecting TVET enrollment: limited infrastructure capacity, insufficient trainer competency, misaligned curriculum, low-quality training delivery particularly in cooperative training implementation and industry partnership and low success rates on Certification of Competency (CoC) exams. Many TVET institutions lack qualified trainers, adequate machinery, and timely provision of materials for practical skills training. Based on these findings, the study recommends enhanced infrastructure investment, professional development for trainers, curriculum adjustments to better align with industry needs, and standardized assessment practices. Addressing these areas through collaborative efforts with government bodies and industry stakeholders is essential to improving the quality and appeal of Ethiopian TVET programs, ultimately strengthening enrollment and outcomes.

Keywords: TVET, quality factors, enrollment, potentially enrolled

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Authors: Emeshaw Damtew Zebene, Edom Seife, Hagos Tesfay, Gurja Belay

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Background: cancer incidence and mortality has grown rapidly throughout the world. Aging of the population, urbanization, physical inactivity, economic growth followed by smoking and drinking contributed a lot for the increased incidence of cancer all over the globe. Objective: the aim of this study was to assess a one-year trend of cancer patients who underwent curative/radical radiotherapy at radiotherapy center, Tikur Anbessa specialized hospital, Ethiopia. Methodology: We performed a prospective descriptive study of cancer patients treated with LINAC at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia, from April 2021- March 2022. A standardized questionnaire was used to collect sociodemographic and clinical characteristics of the patients. Descriptive statistics and chi-square results were generated using SPSS version 24. The level of significance was obtained at 0.05. Results: Sixty-four (64) curative/radical patients-44 females and 20 males were analyzed. Majority, 27(42.2%), of the patients age range from 45 to 64, and 45(70%) of them were urban residents where a group of higher gynecologic cancer was observed.78% of the patients were with locally advanced cancer, and 54(84.4%) of them had no awareness about cancer. Generally, head & neck cancer were found the most prevalent cancer 20(31.3%), and the leading cause of cancer among women was cervical cancer 17(38.6%), where about half 7(15.9%) of them were HIV positive. Conclusion: Our finding revealed that most of curative/radical patients presented at a locally advanced stage of the disease. Hence, maintaining the already available teletherapy machines and installing additional radiotherapy centers may help in treating the patients at the early stage of the disease. Since almost all of our study participants did not have information about cancer, awareness raising mechanisms should be done. Additionally, understanding differences in cancer incidence between urban and rural is important. Key words: Cancer, Curative/radical, Radiotherapy, Tikur Anbessa Specialized Hospital

Keywords: cancer, curative/radical, radiotherapy, tkur anbessa specialized hospital

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Authors: Chiou-Fang Liou

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Cancer has been one of the most life-threaten diseases worldwide for 30+ years. The influences of cancer illness include symptoms from cancer itself along with its treatments. The quality of life among patients diagnosed with cancer during cancer treatments has been conceptualized within four domains: Functional Well-Being, Social Well-Being, Physical Well-Being, and Emotional Well-Being. Patients with cancer often need to make adjustments to face all the challenges. The middle-range theory of Resourcefulness and Quality of life has been applied to explore factors contributing to cancer patients’ needs. Resourcefulness is defined as sets of skills that can be learned and consisted of Person and Social Resourcefulness. Empirical evidence also supported a possible relationship between Resourcefulness and Quality of Life. However, little is known about the extent to which the two concepts are related to each other. This study, therefore, applied a multivariate technique, Canonical Correlation Analysis, to identify the relationship between the two sets of variables with multi-dimensional measures, the Resourcefulness and Quality of Life in Cancer patients receiving treatments. After IRB approval, this multi-centered study took place at two medical centers in the Central Region of Taiwan. Sample A total of 186 patients with various cancer diagnoses and either receiving radiation therapy or chemotherapy consented to and answered questionnaires. The Import findings of the Generalized F test identified two typical sets with several linear relations and explained a total of 79.1% of the total variance. The first typical set found Personal Resourcefulness negatively related to Social Well-being, Functional being, Emotional Well-being, and Physical, in that order. The second typical set found Social Resourcefulness negatively related to Functional Well-being and Physical-being yet positively related to Social Well-being and Emotional Well-being. Discussion and Conclusion, The results of this presented study supported the statistically significant relationship between two sets of variables that are consistent with the theory. In addition, the results are considerably important in cancer patients receiving cancer treatments.

Keywords: cancer, canonical correlation analysis, quality of life, resourcefulness

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Authors: Aneesh Mathew, Arunab K. S., Atul Kumar Sharma

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The uncontrolled rise in population has led to unplanned, swift, and unsustainable urban expansion, causing detrimental environmental impacts on both local and global ecosystems. This research delves into a comprehensive examination of the Urban Heat Island (UHI) phenomenon in Bengaluru and Hyderabad, India. It centers on the spatial and temporal distribution of UHI and its correlation with air pollutants. Conducted across summer and winter seasons from 2001 to 2021 in Bangalore and Hyderabad, this study discovered that UHI intensity varies seasonally, peaking in summer and decreasing in winter. The annual maximum UHI intensities range between 4.65 °C to 6.69 °C in Bengaluru and 5.74 °C to 6.82 °C in Hyderabad. Bengaluru particularly experiences notable fluctuations in average UHI intensity. Introducing the Urban Thermal Field Variance Index (UTFVI), the study indicates a consistent strong UHI effect in both cities, significantly impacting living conditions. Moreover, hotspot analysis demonstrates a rising trend in UHI-affected areas over the years in Bengaluru and Hyderabad. This research underscores the connection between air pollutant concentrations and land surface temperature (LST), highlighting the necessity of comprehending UHI dynamics for urban environmental management and public health. It contributes to a deeper understanding of UHI patterns in swiftly urbanizing areas, providing insights into the intricate relationship between urbanization, climate, and air quality. These findings serve as crucial guidance for policymakers, urban planners, and researchers, facilitating the development of innovative, sustainable strategies to mitigate the adverse impacts of uncontrolled expansion while promoting the well-being of local communities and the global environment.

Keywords: urban heat island effect, land surface temperature, air pollution, urban thermal field variance index

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Authors: Perpetual Onyejelem, Kenichi Matsui

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Solid waste management has recently posed urgent challenges to environmental sustainability and public health in emerging Sub-Saharan urban centers. This paper examines solid waste management in Port Harcourt, the rapidly growing city in Nigeria, with a focus on current solid waste management practices and its health implications. To do so we analyzed past academic papers and official documents. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and its four-stage inclusion/exclusion criteria were utilized as part of a systematic literature review technique to identify papers related to solid waste management practices (Scopus and Google Scholar). In terms of policy documents, we focused on information about the implementation between 2014 and 2023. We found that the Rivers State Waste Management Policy and the National Policy on Solid Waste Management were the two most important documents to understand Port Harcourt’s practices. Past studies, however, highlighted that residents continued to dump waste in drainages as they were largely unaware of the policies that encourage them to sort waste. The studies tend to blame the city of its lack of political commitment to monitoring waste sites. Another study highlighted inefficient waste collection practices, the absence of community participation and poor resident awareness of 3R practices. Government documents and past studies tend to agree that an increase in disorderly waste management practices and the emergence of vector-borne diseases (e.g., malaria, lassa fever, cholera) co-incided in Port Harcourt. This led to increased spending for healthcare for locals, particularly low-income households. This study concludes by making some remedial recommendations.

Keywords: health effects, solid waste management practices, environmental pollution, Port Harcourt

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Authors: Snezana Lazic, Zarko Gacevic, Mark Holmes, Ekaterina Chernysheva, Marcus Müller, Peter Veit, Frank Bertram, Juergen Christen, Yasuhiko Arakawa, Enrique Calleja

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The study reports how the pencil-like morphology of a homoepitaxially grown GaN nanowire can be exploited for the fabrication of a thin conformal InGaN nanoshell, hosting nonpolar, semipolar and polar single photon sources (SPSs). All three SPS types exhibit narrow emission lines (FWHM~0.35 - 2 meV) and high degrees of linear optical polarization (P > 70%) in the low-temperature micro-photoluminescence (µ-PL) experiments and are characterized by a pronounced antibunching in the photon correlation measurements (gcorrected(2)(0) < 0.3). The quantum-dot-like exciton localization centers induced by compositional fluctuations within the InGaN nanoshell are identified as the driving mechanism for the single photon emission. As confirmed by the low-temperature transmission electron microscopy combined with cathodoluminescence (TEM-CL) study, the crystal region (i.e. non-polar m-, semi-polar r- and polar c-facets) hosting the single photon emitters strongly affects their emission wavelength, which ranges from ultra-violet for the non-polar to visible for the polar SPSs. The photon emission lifetime is also found to be facet-dependent and varies from sub-nanosecond time scales for the non- and semi-polar SPSs to a few nanoseconds for the polar ones. These differences are mainly attributed to facet-dependent indium content and electric field distribution across the hosting InGaN nanoshell. The hereby reported pencil-like InGaN nanoshell is the first single nanostructure able to host all three types of single photon emitters and is thus a promising building block for tunable quantum light devices integrated into future photonic and optoelectronic circuits.

Keywords: GaN nanowire, InGaN nanoshell, linear polarization, nonpolar, semipolar, polar quantum dots, single-photon sources

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Authors: Jaydip De

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Urban parks are open places, green fields and riverside gardens usually maintained by public or private authorities, or eventually by both jointly; and utilized for a multidimensional purpose by the citizens. These parks are indeed the lung of urban centers. In urban socio-environmental setup, parks are the nucleus of social integration, community building, and physical development. In contemporary cities, these green places seem to perform as the panacea of congested, complex and stressful urban life. The alarmingly increasing urban population and the resultant congestion of high-rises are making life wearisome in neo-liberal cities. This has made the citizen always quest for open space and fresh air. In such a circumstance, the mere existence of parks is not capable of satisfying the growing aspirations. Therefore in this endeavour, a structured attempt is so made to empirically identify the utility, visitors’ satisfaction, and future needs through the cases of two urban parks of Kolkata Metropolitan Area, India. This study is principally based upon primary information collected through visitors’ perception survey conducted at the Chinsurah ground and Chandernagore strand. The correlation between different utility categories is identified and analyzed systematically. At the same time, indices like Weighted Satisfaction Score (WSS), Facility wise Satisfaction Index (FSI), Urban Park Satisfaction Index (UPSI) and Urban Park Necessity Index (UPNI) are advocated to quantify the visitors’ satisfaction and future necessities. It is explored that the most important utilities are passive in nature. Simultaneously, satisfaction levels of visitors are average, and their requirements are centred on the daily needs of the next generation, i.e., the children. Further, considering the visitors’ opinion planning measures are promulgated for holistic development of urban parks to revitalize sustainability of citified life.

Keywords: citified life, future needs, visitors’ satisfaction, urban parks, utility

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Authors: Noreen Pulte

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Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

Procedia PDF Downloads 95

Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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Authors: Adam J. Carinci

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Background: The opioid epidemic is the most pressing healthcare crisis of our time. There is increasing recognition that opioids have limited long-term efficacy and are associated with hyperalgesia, addiction, and increased morbidity and mortality. Therefore, alternative strategies to combat chronic pain are paramount. We initiated a multicenter retrospective case series to review the efficacy of DRG stimulation in facilitating opioid tapering, opioid discontinuation and as a viable alternative to chronic opioid therapy. Purpose: The dorsal root ganglion (DRG) plays a key role in the development and maintenance of pain. Recent innovations in neuromodulation, specifically, dorsal root ganglion stimulation, offers an effective alternative to opioids in the treatment of chronic pain. This retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy. Procedure: This small multicenter retrospective case series provides preliminary evidence that DRG stimulation facilitates opioid weaning, opioid tapering and is a viable option to opioid therapy in the treatment of chronic pain. A retrospective analysis was completed. Visual analog scale pain scores and pain medication usage were collected at the baseline visit and after four weeks, 3 months and 6 months of treatment. Ten consecutive patients across two study centers were included. The pain was rated 7.38 at baseline and decreased to 1.50 at the 4-week follow-up, a reduction of 79.5%. All patients significantly decreased their opioid pain medication use with an average > 30% reduction in morphine equivalents and four were able to discontinue their medications entirely. Conclusion: This Retrospective case series demonstrates preliminary evidence that DRG stimulation facilitates opioid tapering, opioid discontinuation and presents a viable alternative to chronic opioid therapy.

Keywords: dorsal root ganglion, neuromodulation, opioid sparing, stimulation

Procedia PDF Downloads 114

Authors: Odenigbo Veronica Ngozi, Ukwuaba Loretta Chika, Ukamaka Eze

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This study delved into youth’s empowerment pathway to unlocking entrepreneurial skills and employability in Enugu state, Nigeria. The purpose of the study is to ascertain the effect of youth joblessness in Enugu State. Two research questions guided the study, and two null hypotheses, which were formulated and tested at a 0.05 level of significance, were used for the analysis. A descriptive survey research design was employed for the study. The population for the study consisted of 103 male and female youths in Enugu state, who were randomly sampled among youths as respondents. A structured questionnaire which was developed by researchers and titled ‘Youth Empowerment a Pathway to Unlocking Entrepreneurial Skills and Employability (YEPUESEQ)’, was used to elicit information from the respondents. The instrument was validated by three experts, one from the Department of Measurement and Evaluation and two from the Department of Continuing Education and Development Studies, all from Enugu State University of Science and Technology, Agbani (ESUT). Cronbach Alpha reliability estimate was used to determine the internal consistency of the instrument with a reliability index of 0.74, indicating that the instrument is highly reliable and suitable to elicit information from the respondent. Data collected were analyzed using mean and standard deviation to answer the two research questions, while the null hypotheses were tested at 0.05 level of significance using a t-test. The findings of the study indicated that when the youths are jobless, they tend to join bad gangs in as much as they can get money, but when they are empowered, they tend towards supporting themselves, the community, and the nation as a whole in bringing in human, economic and social development to society. Based on the findings, the researchers recommended, among others, that the government should establish skill acquisition centers while the youths can enroll for a particular skill of their choice with good facilities, infrastructures and qualified facilitators.

Keywords: youth, empowerment, entrepreneurial skill, employability skill

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Authors: Cody Stolle, Mojdeh Asadollahipajouh, Khaleb Pafford, Jada Iwuoha, Samantha White, Becky Mueller

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Battery-electric vehicles (BEVs) are growing in sales and popularity in the United States as an alternative to traditional internal combustion engine vehicles (ICEVs). BEVs are generally heavier than corresponding models of ICEVs, with large battery packs located beneath the vehicle floorpan, a “skateboard” chassis, and have front and rear crush space available in the trunk and “frunk” or front trunk. The geometrical and frame differences between the vehicles may lead to incompatibilities with gasoline vehicles during vehicle-to-vehicle crashes as well as run-off-road crashes with roadside barriers, which were designed to handle lighter ICEVs with higher centers-of-mass and with dedicated structural chasses. Crash data were collected from 10 states spanning a five-year period between 2017 and 2021. Vehicle Identification Number (VIN) codes were processed with the National Highway Traffic Safety Administration (NHTSA) VIN decoder to extract BEV models from ICEV models. Crashes were filtered to isolate only vehicles produced between 2010 and 2021, and the crash circumstances (weather, time of day, maximum injury) were compared between BEVs and ICEVs. In Washington, 436,613 crashes were identified, which satisfied the selection criteria, and 3,371 of these crashes (0.77%) involved a BEV. The number of crashes which noted a fire were comparable between BEVs and ICEVs of similar model years (0.3% and 0.33%, respectively), and no differences were discernable for the time of day, weather conditions, road geometry, or other prevailing factors (e.g., run-off-road). However, crashes involving BEVs rose rapidly; 31% of all BEV crashes occurred in just 2021. Results indicate that BEVs are performing comparably to ICEVs, and events surrounding BEV crashes are statistically indistinguishable from ICEV crashes.

Keywords: battery-electric vehicles, transportation safety, infrastructure crashworthiness, run-off-road crashes, ev crash data analysis

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Authors: Ayman M. Mansour, Bilal Hawashin, Hesham Alsalem

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Faster delivery of laboratory test results is one of the most noticeable signs of good laboratory service and is often used as a key performance indicator of laboratory performance. Despite the availability of technology, the delivery time of clinical laboratory test results continues to be a cause of customer dissatisfaction which makes patients feel frustrated and they became careless to get their laboratory test results. The Medical Clinical Laboratory test results are highly sensitive and could harm patients especially with the severe case if they deliver in wrong time. Such results affect the treatment done by physicians if arrived at correct time efforts should, therefore, be made to ensure faster delivery of lab test results by utilizing new trusted, Robust and fast system. In this paper, we proposed a distributed Multi-Agent System to enhance and faster the process of laboratory test results delivery using SMS. The developed system relies on SMS messages because of the wide availability of GSM network comparing to the other network. The software provides the capability of knowledge sharing between different units and different laboratory medical centers. The system was built using java programming. To implement the proposed system we had many possible techniques. One of these is to use the peer-to-peer (P2P) model, where all the peers are treated equally and the service is distributed among all the peers of the network. However, for the pure P2P model, it is difficult to maintain the coherence of the network, discover new peers and ensure security. Also, security is a quite important issue since each node is allowed to join the network without any control mechanism. We thus take the hybrid P2P model, a model between the Client/Server model and the pure P2P model using GSM technology through SMS messages. This model satisfies our need. A GUI has been developed to provide the laboratory staff with the simple and easy way to interact with the system. This system provides quick response rate and the decision is faster than the manual methods. This will save patients life.

Keywords: multi-agent system, delivery process, GSM technology, clinical laboratory results

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Authors: Sara Cumming, Julianne DiSanto, Leah Burton

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Homelessness in Canada is a persistent problem. It has been widely argued that the best tactic for eradicating homelessness is to approach social issues from a Housing First perspective—an approach that centers on quickly moving people into permanent and independent housing and then providing them additional support and services as needed. It is recognized that life skills training is both necessary and an effective way to reduce cyclical homelessness; however, there is a scarcity of research on effective ways to teach life skills; this problem was exacerbated in a pandemic context, where in-person delivery was severely restricted or no longer possible. Very little attention has been paid to the diverse cultural needs of clients in a multicultural context and the need to foster cultural knowledge/awareness in individuals to successfully contribute to the cultural safety of communities. This research attempts to fill these gaps in the literature and in practice by employing a community-engaged research (CER) approach. Academic, government, funders, front-line staff, and clients at 15 not-for-profits from across the Greater Toronto Area in Ontario, Canada, collaborated to co-create a virtual, client-centric, equity, diversity, and inclusion (EDI) informed life skill learning management system. We employed a triangulation methodology for this research. An environmental scan was conducted for best practices. Two separate Creative Problem Solving Sessions were held with over 100 front-line workers, managers, and executive directors who work with homeless populations. Quantitative and open-ended surveys were completed by over 200 individuals with experience with homelessness. All sections of this research aimed to discover the areas of skills that individuals need to maintain housing and to ascertain what a more client-driven EDI approach to life skills training should include. This research will showcase which life skills are deemed essential for homeless and precariously housed individuals.

Keywords: homelessness, Housing First, life skills, community engaged research

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Authors: Yang Ye, Hongfei Qiu, Yaqi Li

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The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.

Keywords: driverless, urban public space, construction strategy, urban design

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Authors: Aarthi Sridhar, Henri Gavin, Karah Kelly

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Rolling Isolation Systems (RISs) are simple and effective means to mitigate earthquake hazards to equipment in critical and precious facilities, such as hospitals, network collocation facilities, supercomputer centers, and museums. The RIS works by isolating components acceleration the inertial forces felt by the subsystem. The RIS consists of two platforms with counter-facing concave surfaces (dishes) in each corner. Steel balls lie inside the dishes and allow the relative motion between the top and bottom platform. Formerly, a mathematical model for the dynamics of RISs was developed using Lagrange’s equations (LE) and experimentally validated. A new mathematical model was developed using Gauss’s Principle of Least Constraint (GPLC) and verified by comparing impulse response trajectories of the GPLC model and the LE model in terms of the peak displacements and accelerations of the top platform. Mathematical models for the RIS are tedious to derive because of the non-holonomic rolling constraints imposed on the system. However, using Gauss’s Principle of Least constraint to find the equations of motion removes some of the obscurity and yields a system that can be easily extended. Though the GPLC model requires more state variables, the equations of motion are far simpler. The non-holonomic constraint is enforced in terms of accelerations and therefore requires additional constraint stabilization methods in order to avoid the possibility that numerical integration methods can cause the system to go unstable. The GPLC model allows the incorporation of more physical aspects related to the RIS, such as contribution of the vertical velocity of the platform to the kinetic energy and the mass of the balls. This mathematical model for the RIS is a tool to predict the motion of the isolation platform. The ability to statistically quantify the expected responses of the RIS is critical in the implementation of earthquake hazard mitigation.

Keywords: earthquake hazard mitigation, earthquake isolation, Gauss’s Principle of Least Constraint, nonlinear dynamics, rolling isolation system

Procedia PDF Downloads 250

Authors: Sali Chinsathit, Haruthai Kaenla

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Organic agriculture has become a major policy theme for agricultural development in Thailand since October 2005. Organic farming is enlisted as an important national agenda, to promote safe food and national export, and many government authorities have initiated projects and activities centered on organic farming promotion. Currently, Thailand has the market share of about 32 million US$ a year by exporting organic products of rice, vegetables, tea, fruits and a few medicinal herbs. There is high potential in organic crop production as there is the tropical environment promoting crop growth and leader farmer in organic farming. However, organic sector is relatively small (0.2%) comparing with conventional agricultural area, since there are many factors affecting farmers’ adoption and success in organic farming. The objective of this project was to get the organic production technology for at least 3 organic crops. The treatment and method were complied with Thai Organic Standard, and were mainly concerned on increase plant biodiversity and soil improvement by using organic fertilizer and bio-extract from fish, egg, plant and fruits. The bio-logical control, plant-extracts, and cultural practices were used to control insect pests and diseases of 3 crops including mangosteen (Garcinia mangostana L.), longkong (Aglaia dookoo Griff.) and banana (Musa (AA group)). The experiments were carried out at research centers of Department of Agriculture and farmers’ farms in Rayong and Chanthaburi provinces from 2009 to 2013. We found that both locations, plant biodiversity by intercropping mangosteen or longkong with banana and soil improvement with composts and bio-extract from fish could increased yield and farmers’ income by 6,835 US$/ha/year. Farmers got knowledge from these technologies to produce organic crops. The organic products were sold both in domestic and international countries. The organic production technologies were also environmental friendly and could be used as an alternative way for farmers in Thailand.

Keywords: banana, longkong, mangosteen, organic farming

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Authors: Kunal K. S., Shwetashri K. R., Keerthan G., Ajinkya R.

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Background: Normal pressure hydrocephalus is a condition caused by abnormal accumulation of cerebrospinal fluid (CSF) within the brain resulting in enlarged cerebral ventricles due to a disruption of CSF formation, absorption, or flow. Over the course of time, ventriculoperitoneal shunt under general anesthesia has become a standard of care. Yet only a finite number of centers have started the inclusion of regional anesthesia techniques for the such patient cohort. Stem Case: We report a case of a 75-year-old male with underlying aortic sclerosis and cardiomyopathy who presented with complaints of confusion, forgetfulness, and difficulty in walking. Neuro-imaging studies revealed disproportionally enlarged subarachnoid space hydrocephalus (DESH). The baseline blood pressure was 116/67 mmHg with a heart rate of 106 beats/min and SpO2 of 96% on room air. The patient underwent smooth induction followed by sonographically guided superficial cervical plexus block and transverse abdominis plane block. Intraoperative pain indices were monitored with Analgesia nociceptive index monitor (ANI, MdolorisTM) and surgical plethysmographic index (SPI, GE Healthcare, Helsinki, FinlandTM). These remained stable during the application of the block and the entire surgical duration. No significant hemodynamic response was observed during the tunneling of the skin by the surgeon. The patient underwent a smooth recovery and emergence. Conclusion: Our decision to incorporate peripheral nerve blockade in conjunction with general anesthesia resulted in opioid-sparing anesthesia and decreased post-operative analgesic requirement by the patient. This blockade was successful in suppressing intraoperative stress responses. Our patient recovered adequately and underwent an uncomplicated post-operative stay.

Keywords: desh, NPH, VP shunt, cervical plexus block, transversus abdominis plane block

Procedia PDF Downloads 80