Search results for: high dose rate brachytherapy
Commenced in January 2007
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Paper Count: 25667

Search results for: high dose rate brachytherapy

15437 Iran’s Sexual and Reproductive Rights Roll-Back: An Overview of Iran’s New Population Policies

Authors: Raha Bahreini

Abstract:

This paper discusses the roll-back of women’s sexual and reproductive rights in the Islamic Republic of Iran, which has come in the wake of a striking shift in the country’s official population policies. Since the late 1980s, Iran has won worldwide praise for its sexual and reproductive health and services, which have contributed to a steady decline in the country’s fertility rate–from 7.0 births per women in 1980 to 5.5 in 1988, 2.8 in 1996 and 1.85 in 2014. This is owed to a significant increase in the voluntary use of modern contraception in both rural and urban areas. In 1976, only 37 per cent of women were using at least one method of contraception; by 2014 this figure had reportedly risen to a high of nearly 79 per cent for married girls and women living in urban areas and 73.78 per cent for those living in rural areas. Such progress may soon be halted. In July 2012, Iran’s Supreme Leader Ayatollah Sayed Ali Khamenei denounced Iran’s family planning policies as an imitation of Western lifestyle. He exhorted the authorities to increase Iran’s population to 150 to 200 million (from around 78.5 million), including by cutting subsidies for contraceptive methods and dismantling the state’s Family and Population Planning Programme. Shortly thereafter, Iran’s Minister of Health and Medical Education announced the scrapping of the budget for the state-funded Family and Population Planning Programme. Iran’s Parliament subsequently introduced two bills; the Comprehensive Population and Exaltation of Family Bill (Bill 315), and the Bill to Increase Fertility Rates and Prevent Population Decline (Bill 446). Bill 446 outlaws voluntary tubectomies, which are believed to be the second most common method of modern contraception in Iran, and blocks access to information about contraception, denying women the opportunity to make informed decisions about the number and spacing of their children. Coupled with the elimination of state funding for Iran’s Family and Population Programme, the move would undoubtedly result in greater numbers of unwanted pregnancies, forcing more women to seek illegal and unsafe abortions. Bill 315 proposes various discriminatory measures in the areas of employment, divorce, and protection from domestic violence in order to promote a culture wherein wifedom and child-bearing is seen as women’s primary duty. The Bill, for example, instructs private and public entities to prioritize, in sequence, men with children, married men without children and married women with children when hiring for certain jobs. It also bans the recruitment of single individuals as family law lawyers, public and private school teachers and members of the academic boards of universities and higher education institutes. The paper discusses the consequences of these initiatives which would, if continued, set the human rights of women and girls in Iran back by decades, leaving them with a future shaped by increased inequality, discrimination, poor health, limited choices and restricted freedoms, in breach of Iran’s international human rights obligations.

Keywords: family planning and reproductive health, gender equality and empowerment of women, human rights, population growth

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15436 Electricity Price Forecasting: A Comparative Analysis with Shallow-ANN and DNN

Authors: Fazıl Gökgöz, Fahrettin Filiz

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Electricity prices have sophisticated features such as high volatility, nonlinearity and high frequency that make forecasting quite difficult. Electricity price has a volatile and non-random character so that, it is possible to identify the patterns based on the historical data. Intelligent decision-making requires accurate price forecasting for market traders, retailers, and generation companies. So far, many shallow-ANN (artificial neural networks) models have been published in the literature and showed adequate forecasting results. During the last years, neural networks with many hidden layers, which are referred to as DNN (deep neural networks) have been using in the machine learning community. The goal of this study is to investigate electricity price forecasting performance of the shallow-ANN and DNN models for the Turkish day-ahead electricity market. The forecasting accuracy of the models has been evaluated with publicly available data from the Turkish day-ahead electricity market. Both shallow-ANN and DNN approach would give successful result in forecasting problems. Historical load, price and weather temperature data are used as the input variables for the models. The data set includes power consumption measurements gathered between January 2016 and December 2017 with one-hour resolution. In this regard, forecasting studies have been carried out comparatively with shallow-ANN and DNN models for Turkish electricity markets in the related time period. The main contribution of this study is the investigation of different shallow-ANN and DNN models in the field of electricity price forecast. All models are compared regarding their MAE (Mean Absolute Error) and MSE (Mean Square) results. DNN models give better forecasting performance compare to shallow-ANN. Best five MAE results for DNN models are 0.346, 0.372, 0.392, 0,402 and 0.409.

Keywords: deep learning, artificial neural networks, energy price forecasting, turkey

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15435 Research and Application of Consultative Committee for Space Data Systems Wireless Communications Standards for Spacecraft

Authors: Cuitao Zhang, Xiongwen He

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According to the new requirements of the future spacecraft, such as networking, modularization and non-cable, this paper studies the CCSDS wireless communications standards, and focuses on the low data-rate wireless communications for spacecraft monitoring and control. The application fields and advantages of wireless communications are analyzed. Wireless communications technology has significant advantages in reducing the weight of the spacecraft, saving time in spacecraft integration, etc. Based on this technology, a scheme for spacecraft data system is put forward. The corresponding block diagram and key wireless interface design of the spacecraft data system are given. The design proposal of the wireless node and information flow of the spacecraft are also analyzed. The results show that the wireless communications scheme is reasonable and feasible. The wireless communications technology can meet the future spacecraft demands in networking, modularization and non-cable.

Keywords: Consultative Committee for Space Data Systems (CCSDS) standards, information flow, non-cable, spacecraft, wireless communications

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15434 Spatial Analysis the Suitability Area for Jatropha curcas L. as an Alternative to Biodiesel in Central Kalimantan, Indonesia

Authors: Rizki Oktariza, Sri Fauza Pratiwi, Hilza Ikhsanti

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Human depends on fossil fuels as the bigger sources of considerable energy in all sectors. Based on that cases, we are needed alternative energy to supplies needed for fuel, one of them by using energy fuel from the biodiesel. The raw materials that can be used for producing the biodiesel energy are Jatropha curcas L. In Indonesia, the availability of land for the development of the Jatropha curcas L which has very appropriate Indonesia reached 14.2 million hectares, with an area of suitable in Kalimantan around 10 million hectares. In Central Kalimantan, as one of the provinces of Kalimantan, has considerable potential planting Jatropha curcas L because of the physical condition and have a largest of the agricultural land. To support the potential of Jatropha curcas L in Central Kalimantan, spatial analysis is needed to find out the appropriate areas for Jatropha curcas L growing land. The suitability of region is influenced by several variables i.e., rainfall, the slope of the land, the surface temperature and the altitude of a region. The compliance of criteria are divided into four criteria: high suitable (S1), moderately suitable (S2), marginally suitable (S3), not suitable (N). The suitability of the region is based on these variables and made an overlay analysis of these variables by using Geographic Information System. Based on this overlay analysis will results a map of the suitability area for planting Jatropha curcas L, which is distribution criteria is high suitable (S1) of 213,245 ha, moderately suitable (S2) of 14,389,353 ha, marginally suitable (S3) 360,357 ha, not suitable (N) 0.020 ha.

Keywords: geographic information system, Jatropha curcas L., overlay, the suitable area

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15433 Correlation Analysis of Reactivity in the Oxidation of Para and Meta-Substituted Benzyl Alcohols by Benzimidazolium Dichromate in Non-Aqueous Media: A Kinetic and Mechanistic Aspects

Authors: Seema Kothari, Dinesh Panday

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An observed correlation of the reaction rates with the changes in the nature of substituent present on one of the reactants often reveals the nature of transition state. Selective oxidation of organic compounds under non-aqueous media is an important transformation in synthetic organic chemistry. Inorganic chromates and dichromates being drastic oxidant and are generally insoluble in most organic solvents, a number of different chromium (VI) derivatives have been synthesized. Benzimidazolium dichromate (BIDC) is one of the recently reported Cr(VI) reagents which is neither hygroscopic nor light sensitive being, therefore, much stable. Not many reports on the kinetics of the oxidations by BIDC are seemed to be available in the literature. In the present investigation, the kinetics and mechanism of benzyl alcohol (BA) and a number of para- and meta-substituted benzyl alcohols by benzimidazolium dichromate (BIDC), in dimethyl sulphoxide, is reported. The reactions were followed spectrophotometrically at 364 nm by monitoring the decrease in [BIDC] for up to 85-90% reaction, the temperature being constant. The observed oxidation product is the corresponding benzaldehyde. The reactions were of first order with respect to each the alcohol and BIDC. The reactions are catalyzed by proton, and the dependence is of the form: kobs = a + b[H+]. The reactions thus follow both, an acid-dependent and acid-independent paths. The oxidation of [1,1 2H2]benzyl alcohol exhibited the presence of a substantial kinetic isotope effect ( kH/kD = 6.20 at 298 K ). This indicated the cleavage of a α-C-H bond in the rate-determining step. An analysis of the temperature dependence of the deuterium isotope effect showed that the loss of hydrogen proceeds through a concerted cyclic process. The rate of oxidation of BA was determined in 19 organic solvents. An analysis of the solvent effect by Swain’s equation indicated that though both the anion and cation-solvating powers of the solvent contribute to the observed solvent effect, the role of cation-solvation is major. The rates of the para and meta compounds, at 298 K, failed to exhibit a significant correlation in terms of Hammett or Brown's substituent constants. The rates were then subjected to analyses in terms of dual substituent parameter (DSP) equations. The rates of oxidation of the para-substituted benzyl alcohols show an excellent correlation with Taft's σI and σRBA values. However, the rates for the meta-substituted benzyl alcohols show an excellent correlation with σI and σR0. The polar reaction constants are negative indicating an electron-deficient transition state. Hence the overall mechanism is proposed to involve the formation of a chromate ester in a fast pre-equilibrium and then a decomposition of the ester in a subsequent slow step via a cyclic concerted symmetrical transition state, involving hydride-ion transfer, leading to the product. The first order dependence on alcohol may be accounted in terms of the small value of the formation constant of the ester intermediate. An another reaction mechanism accounting the acid-catalysis involve the formation of a protonated BIDC prior to formation of an ester intermediate which subsequently decomposes in a slow step leading to the product.

Keywords: benzimidazolium dichromate, benzyl alcohols, correlation analysis, kinetics, oxidation

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15432 Causes of Road Crashes Among Students Attending Schools in Huye District and Kigali City

Authors: Ami Nkumbuye

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Background: Every year 1.3 million people die due to Road crashes, according to the Global status report. Road crashes remain the greatest killer aged between 15-29 years. Young people are paying an unacceptable price for their own safer mobility. 23,498 students attending class daily from home crossing the roads of 3 districts Kigali and Southern province is showing a similar trend with 40320 cross road daily. As most of them don't have any idea about the safety, they should have when they are crossing roads and traffic rules and signs as well. Despite the high number of mortality related to road crashes in Rwanda, we don't have any approved calendar to teach young people road safety as the most affected age group. Objective: The objective of this study was to identify the causes of road crashes and the outcome of victims after being involved in road crashes over a period of two years, from January 2020 to December 2021, in Huye district and Kigali City. Methods: A retrospective descriptive study with open questions and then data analysis, students were identified from 15 schools in Kigali City and Southern Province and through the Local Action Project supported by Global Youth Coalition for Road Safety and Youth for Road Safety (YOURS), students asked about the cause of road crashes through open and closed question and data analyzed. Result: There were 354 students from 15 schools: 198 males and 156 females. Their age ranged from 10 to 25 years. The commonest cause of road crashes among students attending schools daily was: high speed, lack of education on safe behavior on the road, drinking and driving, and poor road infrastructures, with 47%, 32%, 13% and 8 %, respectively. The hospital admission after road crashes for the victims was 32.3%. In most scenes where road crashes occur, students report that they didn't see any person who could provide post-crash care until the ambulance came, in some cases, resulted in bad outcomes for the victims after road crashes. Conclusion: This study revealed that high speed and lack of education n road safety are the major cause of road crashes among young people in Rwanda. If local Non-Governmental Organization and Decision makers work on these issues like never before, we can see a decrease in road crash among young people and adult as well. We would like to give a recommendation to two institutions: the first is the Rwanda National Police Traffic department to set 30km/m as the maximum speed limit in City and near schools. The second is for the Ministry of Education to put Road Safety and Post Crash Care curricula in both Primary and Secondary schools.

Keywords: road safety, post-crash care, young people, students

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15431 Potency of Minapolitan Area Development to Enhance Gross Domestic Product and Prosperty in Indonesia

Authors: Shobrina Silmi Qori Tarlita, Fariz Kukuh Harwinda

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Indonesia has 81.000 kilometers coastal line and 70% water surface which is known as the country who has a huge potential in fisheries sector and also which is able to support more than 50 % of Gross Domestic Product. But according to Department of Marine and Fisheries data, fisheries sector supported only 20% of Total GDP in 1998. Not only that, the highest decline in fisheries sector income occured in 2009. Those conditions occur, because of some factors contributed to the lack of integrated working platform for the fisheries and marine management in some areas which have a high productivity to increase the economical profit every year for the country, especially Indonesia, besides the labor requirement for every company, whether a big company or smaller one, depends on the natural condition that makes a lot of people become unemployed if the weather condition or any other conditions dealing with the natural condition is bad for creating fisheries and marine management, especially in aquaculture and fish – captured operation. Not only those, a lot of fishermen, especially in Indonesia, mostly make their job profession as an additional job or side job to fulfill their own needs, although they are averagely poor. Another major problem are the lack of the sustainable developmental program to stabilize the productivity of fisheries and marine natural source, like protecting the environment for fish nursery ground and migration channel, that makes the low productivity of fisheries and marine natural resource, even though the growth of the society in Indonesia has increased for years and needs more food resource to comply the high demand nutrition for living. The development of Minapolitan Area is one of the alternative solution to build a better place for aqua-culturist as well as the fishermen which focusing on systemic and business effort for fisheries and marine management. Minapolitan is kind of integration area which gathers and integrates the ones who is focusing their effort and business in fisheries sector, so that Minapolitan is capable of triggering the fishery activity on the area which using Minapolitan management intensively. From those things, finally, Minapolitan is expected to reinforce the sustainable development through increasing the productivity of fish – capturing operation as well as aquaculture, and it is also expected that Minapolitan will be able to increase GDP, the earning for a lot of people and also will be able to bring prosperity around the world. From those backgrounds, this paper will explain more about the Minapolitan Area and the design of reinforcing the Minapolitan Area by zonation in the Fishery and Marine exploitation area with high productivity as well as low productivity. Hopefully, this solution will be able to answer the economical and social issue for declining food resource, especially fishery and marine resource.

Keywords: Minapolitan, fisheries, economy, Indonesia

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15430 Korean Smart Cities: Strategic Foci, Characteristics and Effects

Authors: Sang Ho Lee, Yountaik Leem

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This paper reviews Korean cases of smart cities through the analysis framework of strategic foci, characteristics and effects. Firstly, national strategies including c(cyber), e(electronic), u(ubiquitous) and s(smart) Korea strategies were considered from strategic angles. Secondly, the characteristics of smart cities in Korea were looked through the smart cities examples such as Seoul, Busan, Songdo and Sejong cities etc. from the views on the by STIM (Service, Technology, Infrastructure and Management) analysis. Finally, the effects of smart cities on socio-economies were investigated from industrial perspective using the input-output model and structural path analysis. Korean smart city strategies revealed that there were different kinds of strategic foci. c-Korea strategy focused on information and communications network building and user IT literacy. e-Korea strategy encouraged e-government and e-business through utilizing high-speed information and communications network. u-Korea strategy made ubiquitous service as well as integrated information and communication operations center. s-Korea strategy is propelling 4th industrial platform. Smart cities in Korea showed their own features and trends such as eco-intelligence, high efficiency and low cost oriented IoT, citizen sensored city, big data city. Smart city progress made new production chains fostering ICTs (Information Communication Technologies) and knowledge intermediate inputs to industries.

Keywords: Korean smart cities, Korean smart city strategies, STIM, smart service, infrastructure, technologies, management, effect of smart city

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15429 Effect of Linear Thermal Gradient on Steady-State Creep Behavior of Isotropic Rotating Disc

Authors: Minto Rattan, Tania Bose, Neeraj Chamoli

Abstract:

The present paper investigates the effect of linear thermal gradient on the steady-state creep behavior of rotating isotropic disc using threshold stress based Sherby’s creep law. The composite discs made of aluminum matrix reinforced with silicon carbide particulate has been taken for analysis. The stress and strain rate distributions have been calculated for discs rotating at linear thermal gradation using von Mises’ yield criterion. The material parameters have been estimated by regression fit of the available experimental data. The results are displayed and compared graphically in designer friendly format for the above said temperature profile with the disc operating under uniform temperature profile. It is observed that radial and tangential stresses show minor variation and the strain rates vary significantly in the presence of thermal gradation as compared to disc having uniform temperature.

Keywords: creep, isotropic, steady-state, thermal gradient

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15428 Sustainable Urban Growth of Neighborhoods: A Case Study of Alryad-Khartoum

Authors: Zuhal Eltayeb Awad

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Alryad neighborhood is located in Khartoum town– the administrative center of the Capital of Sudan. The neighborhood is one of the high-income residential areas with villa type development of low-density. It was planned and developed in 1972 with large plots (600-875m²), wide crossing roads and balanced environment. Recently the area transformed into more compact urban form of high density, mixed-use integrated development with more intensive use of land; multi-storied apartments. The most important socio-economic process in the neighborhood has been the commercialization and deinitialization of the area in connect with the displacement of the residential function. This transformation affected the quality of the neighborhood and the inter-related features of the built environment. A case study approach was chosen to gather the necessary qualitative and quantitative data. A detailed survey on existing development pattern was carried out over the whole area of Alryad. Data on the built and social environment of the neighborhoods were collected through observations, interviews and secondary data sources. The paper reflected a theoretical and empirical interest in the particular characteristics of compact neighborhood with high density, and mixed land uses and their effect on social wellbeing of the residents all in the context of the sustainable development. The research problem is focused on the challenges of transformation that associated with compact neighborhood that created multiple urban problems, e.g., stress of essential services (water supply, electricity, and drainage), congestion of streets and demand for parking. The main objective of the study is to analyze the transformation of this area from residential use to commercial and administrative use. The study analyzed the current situation of the neighborhood compared to the five principles of sustainable neighborhood prepared by UN Habitat. The study found that the neighborhood is experienced changes that occur to inner-city residential areas and the process of change of the neighborhood was originated by external forces due to the declining economic situation of the whole country. It is evident that non-residential uses have taken place uncontrolled, unregulated and haphazardly that led to damage the residential environment and deficiency in infrastructure. The quality of urban life and in particular on levels of privacy was reduced, the neighborhood changed gradually to be a central business district that provides services to the whole Khartoum town. The change of house type may be attributed to a demand-led housing market and absence of policy. The results showed that Alryad is not fully sustainable and self-contained, street network characteristics and mixed land-uses development are compatible with the principles of sustainability. The area of streets represents 27.4% of the total area of the neighborhood. Residential density is 4,620 people/ km², that is lower than the recommendations, and the limited block land-use specialization is higher than 10% of the blocks. Most inhabitants have a high income so that there is no social mix in the neighborhood. The study recommended revision of the current zoning regulations in order to control and regulate undesirable development in the neighborhood and provide new solutions which allow promoting the neighborhood sustainable development.

Keywords: compact neighborhood, land uses, mixed use, residential area, transformation

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15427 Classification for Obstructive Sleep Apnea Syndrome Based on Random Forest

Authors: Cheng-Yu Tsai, Wen-Te Liu, Shin-Mei Hsu, Yin-Tzu Lin, Chi Wu

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Background: Obstructive Sleep apnea syndrome (OSAS) is a common respiratory disorder during sleep. In addition, Body parameters were identified high predictive importance for OSAS severity. However, the effects of body parameters on OSAS severity remain unclear. Objective: In this study, the objective is to establish a prediction model for OSAS by using body parameters and investigate the effects of body parameters in OSAS. Methodologies: Severity was quantified as the polysomnography and the mean hourly number of greater than 3% dips in oxygen saturation during examination in a hospital in New Taipei City (Taiwan). Four levels of OSAS severity were classified by the apnea and hypopnea index (AHI) with American Academy of Sleep Medicine (AASM) guideline. Body parameters, including neck circumference, waist size, and body mass index (BMI) were obtained from questionnaire. Next, dividing the collecting subjects into two groups: training and testing groups. The training group was used to establish the random forest (RF) to predicting, and test group was used to evaluated the accuracy of classification. Results: There were 3330 subjects recruited in this study, whom had been done polysomnography for evaluating severity for OSAS. A RF of 1000 trees achieved correctly classified 79.94 % of test cases. When further evaluated on the test cohort, RF showed the waist and BMI as the high import factors in OSAS. Conclusion It is possible to provide patient with prescreening by body parameters which can pre-evaluate the health risks.

Keywords: apnea and hypopnea index, Body parameters, obstructive sleep apnea syndrome, Random Forest

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15426 The Determination of Stress Experienced by Nursing Undergraduate Students during Their Education

Authors: Gülden Küçükakça, Şefika Dilek Güven, Rahşan Kolutek, Seçil Taylan

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Objective: Nursing students face with stress factors affecting academic performance and quality of life as from first moments of their educational life. Stress causes health problems in students such as physical, psycho-social, and behavioral disorders and might damage formation of professional identity by decreasing efficiency of education. In addition to determination of stress experienced by nursing students during their education, it was aimed to help review theoretical and clinical education settings for bringing stress of nursing students into positive level and to raise awareness of educators concerning their own professional behaviors. Methods: The study was conducted with 315 students studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in the academic year of 2015-2016 and agreed to participate in the study. “Personal Information Form” prepared by the researchers upon the literature review and “Nursing Education Stress Scale (NESS)” were used in this study. Data were assessed with analysis of variance and correlation analysis. Results: Mean NESS Scale score of the nursing students was estimated to be 66.46±16.08 points. Conclusions: As a result of this study, stress level experienced by nursing undergraduate students during their education was determined to be high. In accordance with this result, it can be recommended to determine sources of stress experienced by nursing undergraduate students during their education and to develop approaches to eliminate these stress sources.

Keywords: stress, nursing education, nursing student, nursing education stress

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15425 Talent Management, Employee Competency, and Organizational Performance

Authors: Sunyoung Park

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Context: Talent management is a strategic approach that has received considerable attention in recent years to improve employee competency and organizational performance in many organizations. The implementation of talent management involves identifying objectives and positions within the organization, developing a pool of high-potential employees, and establishing appropriate HR functions to promote high employee and organizational performance. This study aims to investigate the relationship between talent management, HR functions, employee competency, and organizational performance in the South Korean context. Research Aim: The main objective of this study is to investigate the structural relationships among talent management, human resources (HR) functions, employee competency, and organizational performance. Methodology: To achieve the research aim, this study used a quantitative research method. Specifically, a total of 1,478 responses were analyzed using structural equation modeling based on data obtained from the Human Capital Corporate Panel (HCCP) survey in South Korea. Findings: The study revealed that talent management has a positive influence on HR functions and employee competency. Additionally, HR functions directly affect employee competency and organizational performance. Employee competency was found to be related to organizational performance. Moreover, talent management and HR functions indirectly affect organizational performance through employee competency. Theoretical Importance: This study provides empirical evidence of the relationship between talent management, HR functions, employee competency, and organizational performance in the South Korean context. The findings suggest that organizations should focus on developing appropriate talent management and HR functions to improve employee competency, which, in turn, will lead to better organizational performance. Moreover, the study contributes to the existing literature by emphasizing the importance of the relationship between talent management and HR functions in improving organizational performance.

Keywords: employee competency, HR functions, organizational performance, talent management

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15424 Flexible Mixed Model Assembly Line Design: A Strategy to Respond for Demand Uncertainty at Automotive Part Manufacturer in Indonesia

Authors: T. Yuri, M. Zagloel, Inaki M. Hakim, Tegu Bintang Nugraha

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In an era of customer centricity, automotive parts manufacturer in Indonesia must be able to keep up with the uncertainty and fluctuation of consumer demand. Flexible Manufacturing System (FMS) is a strategy to react to predicted and unpredicted changes of demand in automotive industry. This research is about flexible mixed model assembly line design through Value Stream Mapping (VSM) and Line Balancing in mixed model assembly line prior to simulation. It uses value stream mapping to identify and reduce waste while finding the best position to add or reduce manpower. Line balancing is conducted to minimize or maximize production rate while increasing assembly line productivity and efficiency. Results of this research is a recommendation of standard work combination for specifics demand scenario which can enhance assembly line efficiency and productivity.

Keywords: automotive industry, demand uncertainty, flexible assembly system, line balancing, value stream mapping

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15423 Cross Ventilation in Waterfront Urban Canyons: The Case Study of Alexandria

Authors: Bakr Gomaa

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Cross ventilation is an important and practical mean to achieve thermal comfort and conserve energy. This is especially true in the breezy waterfront settings. However, due to a number of factors, cross ventilation in buildings is usually studied by using oversimplified scenarios. It is then reasonable to study the impact of complex set of factors on the accuracy of predicting air flow rate because of wind driven cross ventilation. The objective of this paper is to provide architects with the tools necessary to achieve natural ventilation for cooling purposes in a waterfront urban canyon context. Also, urban canyons have not received much attention in terms of their impact on cross ventilation, and while we know how the wind flows between buildings in different urban canyon settings, the effect of the parallel-to-the-wind urban canyon on cross ventilation in buildings remains unclear. For this, we use detailed weather data, boundary layer correction factor, and CFD simulations to study the pressure patterns that form on the canyons surfaces in the case study of Alexandria. We found that the simplified numerical methods of calculating the cross ventilation in buildings can lead to inaccurate design decisions.

Keywords: cross ventilation, Alexandria, CFD, urban canyon

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15422 Hypothesis of a Holistic Treatment of Cancer: Crab Method

Authors: Devasis Ghosh

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The main hindrance to total cure of cancer is a) the failure to control continued production of cancer cells, b) its sustenance and c) its metastasis. This review study has tried to address this issue of total cancer cure in a more innovative way. A 10-pronged “CRAB METHOD”, a novel holistic scientific approach of Cancer treatment has been hypothesized in this paper. Apart from available Chemotherapy, Radiotherapy and Oncosurgery, (which shall not be discussed here), seven other points of interference and treatment has been suggested, i.e. 1. Efficient stress management. 2. Dampening of ATF3 expression. 3. Selective inhibition of Platelet Activity. 4. Modulation of serotonin production, metabolism and 5HT receptor antagonism. 5. Auxin, its anti-proliferative potential and its modulation. 6. Melatonin supplementation because of its oncostatic properties. 7. HDAC Inhibitors especially valproic acid use due to its apoptotic role in many cancers. If all the above stated seven steps are thoroughly taken care of at the time of initial diagnosis of cancer along with the available treatment modalities of Chemotherapy, Radiotherapy and Oncosurgery, then perhaps, the morbidity and mortality rate of cancer may be greatly reduced.

Keywords: ATF3 dampening, auxin modulation, cancer, platelet activation, serotonin, stress, valproic acid

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15421 Factors Affecting in Soil Analysis Technique Adopted by the Southern Region Farmers, Syria

Authors: Moammar Dayoub

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The study aimed to know the reality of farmers and determine the extent of adoption of the recommendations of the fertilizer and the difficulties and problems they face. The study was conducted on a random sample of farmers consist of 95 farmers who had analysed their field soil in scientific research centres in agricultural southern region through the form specially prepared for this purpose, the results showed that the rate of adoption of the fertilizer recommendations whole amounted to an average of 36.9% in the southern region, The degree of adoption was 34.7% in the region. The results showed that 41% of farmers did not implement the recommendations because of the non-convenient analysis, and 34% due to neglect, and 15% due to the weather and an environment, while 10% of them for lack of manure in the suitable time. The study also revealed that Independent factors affecting the continuing adoption of soil analysis are: farms experience, sampling method in farmer’s schools, irrigated area, and personal knowledge of farmers in analysing the soil. Also, show that the application of fertilizer recommendations led to increased production by 15-20%, this analysis emphasizes the importance of soil analysis and adherence to the recommendations of the research centres.

Keywords: adoption, recommendations of the fertilizer, soil analysis, southern region

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15420 The Global Relationship between the Prevalence of Diabetes Mellitus and Incidence of Tuberculosis: 2000-2012

Authors: Alaa Badawi, Suzan Sayegh, Mohamed Sallam, Eman Sadoun, Mohamed Al-Thani, Muhammad W. Alam, Paul Arora

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Background: The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has increased over the past decade with DM prevalence increasing in countries already afflicted with a high burden of TB. The coexistence of the two conditions presents a serious threat to global public health. Objective: The present study examines the global relationship between the prevalence of DM and the incidence of TB to evaluate their coexistence worldwide and their contribution to one another. Methods: This is an ecological longitudinal study covering the period between years 2000 to 2012. We utilized data from the WHO and World Bank sources and International Diabetes Federation to estimate prevalence of DM (%) and the incidence of TB (per 100,000). Measures of central tendency and dispersion as well as the harmonic mean and linear regression were used for different WHO regions. The association between DM prevalence and TB incidence was examined by quartile of DM prevalence. Results: The worldwide average (±S.D.) prevalence of DM within the study period was 6.6±3.8% whereas TB incidence was 135.0±190.5 per 100,000. DM prevalence was highest in the Eastern Mediterranean (8.3±4.1) and West Pacific (8.2±5.6) regions and lowest in the Africa (3.5±2.6). TB incidence was highest in Africa (313.1±275.9 per 100,000) and South-East Asia (216.7±124.9) and lowest in the European (46.5±68.6) and American (47.2±52.9) regions. Only countries with high DM prevalence (>7.6%) showed a significant positive association with TB incidence (r=0.17, p=0.013). Conclusion: A positive association between DM and TB may exist in some – but not all – world regions, a dual burden that necessitates identifying the nature of this coexistence to assist in developing public health approaches that curb their rising burden.

Keywords: diabetes mellitus, tuberculosis, disease burden, global association

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15419 Wetting Characterization of High Aspect Ratio Nanostructures by Gigahertz Acoustic Reflectometry

Authors: C. Virgilio, J. Carlier, P. Campistron, M. Toubal, P. Garnier, L. Broussous, V. Thomy, B. Nongaillard

Abstract:

Wetting efficiency of microstructures or nanostructures patterned on Si wafers is a real challenge in integrated circuits manufacturing. In fact, bad or non-uniform wetting during wet processes limits chemical reactions and can lead to non-complete etching or cleaning inside the patterns and device defectivity. This issue is more and more important with the transistors size shrinkage and concerns mainly high aspect ratio structures. Deep Trench Isolation (DTI) structures enabling pixels’ isolation in imaging devices are subject to this phenomenon. While low-frequency acoustic reflectometry principle is a well-known method for Non Destructive Test applications, we have recently shown that it is also well suited for nanostructures wetting characterization in a higher frequency range. In this paper, we present a high-frequency acoustic reflectometry characterization of DTI wetting through a confrontation of both experimental and modeling results. The acoustic method proposed is based on the evaluation of the reflection of a longitudinal acoustic wave generated by a 100 µm diameter ZnO piezoelectric transducer sputtered on the silicon wafer backside using MEMS technologies. The transducers have been fabricated to work at 5 GHz corresponding to a wavelength of 1.7 µm in silicon. The DTI studied structures, manufactured on the wafer frontside, are crossing trenches of 200 nm wide and 4 µm deep (aspect ratio of 20) etched into a Si wafer frontside. In that case, the acoustic signal reflection occurs at the bottom and at the top of the DTI enabling its characterization by monitoring the electrical reflection coefficient of the transducer. A Finite Difference Time Domain (FDTD) model has been developed to predict the behavior of the emitted wave. The model shows that the separation of the reflected echoes (top and bottom of the DTI) from different acoustic modes is possible at 5 Ghz. A good correspondence between experimental and theoretical signals is observed. The model enables the identification of the different acoustic modes. The evaluation of DTI wetting is then performed by focusing on the first reflected echo obtained through the reflection at Si bottom interface, where wetting efficiency is crucial. The reflection coefficient is measured with different water / ethanol mixtures (tunable surface tension) deposited on the wafer frontside. Two cases are studied: with and without PFTS hydrophobic treatment. In the untreated surface case, acoustic reflection coefficient values with water show that liquid imbibition is partial. In the treated surface case, the acoustic reflection is total with water (no liquid in DTI). The impalement of the liquid occurs for a specific surface tension but it is still partial for pure ethanol. DTI bottom shape and local pattern collapse of the trenches can explain these incomplete wetting phenomena. This high-frequency acoustic method sensitivity coupled with a FDTD propagative model thus enables the local determination of the wetting state of a liquid on real structures. Partial wetting states for non-hydrophobic surfaces or low surface tension liquids are then detectable with this method.

Keywords: wetting, acoustic reflectometry, gigahertz, semiconductor

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15418 Processing and Modeling of High-Resolution Geophysical Data for Archaeological Prospection, Nuri Area, Northern Sudan

Authors: M. Ibrahim Ali, M. El Dawi, M. A. Mohamed Ali

Abstract:

In this study, the use of magnetic gradient survey, and the geoelectrical ground methods used together to explore archaeological features in Nuri’s pyramids area. Research methods used and the procedures and methodologies have taken full right during the study. The magnetic survey method was used to search for archaeological features using (Geoscan Fluxgate Gradiometer (FM36)). The study area was divided into a number of squares (networks) exactly equal (20 * 20 meters). These squares were collected at the end of the study to give a major network for each region. Networks also divided to take the sample using nets typically equal to (0.25 * 0.50 meter), in order to give a more specific archaeological features with some small bipolar anomalies that caused by buildings built from fired bricks. This definition is important to monitor many of the archaeological features such as rooms and others. This main network gives us an integrated map displayed for easy presentation, and it also allows for all the operations required using (Geoscan Geoplot software). The parallel traverse is the main way to take readings of the magnetic survey, to get out the high-quality data. The study area is very rich in old buildings that vary from small to very large. According to the proportion of the sand dunes and the loose soil, most of these buildings are not visible from the surface. Because of the proportion of the sandy dry soil, there is no connection between the ground surface and the electrodes. We tried to get electrical readings by adding salty water to the soil, but, unfortunately, we failed to confirm the magnetic readings with electrical readings as previously planned.

Keywords: archaeological features, independent grids, magnetic gradient, Nuri pyramid

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15417 Modern Well Logs Technology to Improve Geological Model for Libyan Deep Sand Stone Reservoir

Authors: Tarek S. Duzan, Fisal Ben Ammer, Mohamed Sula

Abstract:

In some places within Sirt Basin-Libya, it has been noticed that seismic data below pre-upper cretaceous unconformity (PUK) is hopeless to resolve the large-scale structural features and is unable to fully determine reservoir delineation. Seismic artifacts (multiples) are observed in the reservoir zone (Nubian Formation) below PUK, which complicate the process of seismic interpretation. The nature of the unconformity and the structures below are still ambiguous and not fully understood which generates a significant gap in characterizing the geometry of the reservoir, the uncertainty accompanied with lack of reliable seismic data creates difficulties in building a robust geological model. High resolution dipmeter is highly useful in steeply dipping zones. This paper uses FMl and OBMl borehole images (dipmeter) to analyze the structures below the PUK unconformity from two wells drilled recently in the North Gialo field (a mature reservoir). In addition, borehole images introduce new evidences that the PUK unconformity is angular and the bedding planes within the Nubian formation (below PUK) are significantly titled. Structural dips extracted from high resolution borehole images are used to construct a new geological model by the utilization of latest software technology. Therefore, it is important to use the advance well logs technology such as FMI-HD for any future drilling and up-date the existing model in order to minimize the structural uncertainty.

Keywords: FMI (formation micro imager), OBMI (oil base mud imager), UBI (ultra sonic borehole imager), nub sandstone reservoir in North gialo

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15416 Transient/Steady Natural Convective Flow of Reactive Viscous Fluid in Vertical Porous Pipe

Authors: Ahmad K. Samaila, Basant K. Jha

Abstract:

This paper presents the effects of suction/injection of transient/steady natural convection flow of reactive viscous fluid in a vertical porous pipe. The mathematical model capturing the time dependent flow of viscous reactive fluid is solved using implicit finite difference method while the corresponding steady state model is solved using regular perturbation technique. Results of analytical and numerical solutions are reported for various parametric conditions to illustrate special features of the solutions. The coefficient of skin friction and rate of heat transfer are obtained and illustrated graphically. The numerical solution is shown to be in excellent agreement with the closed form analytical solution. It is interesting to note that time required to reach steady state is higher in case of injection in comparison to suction.

Keywords: porous pipe, reactive viscous fluid, transient natural-convective flow, analytical solution

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15415 Phenolic Content and Antioxidant Potential of Selected Nigerian Herbs and Spices: A Justification for Consumption and Use in the Food Industry

Authors: Amarachi Delight Onyemachi, Gregory Ikechukwu Onwuka

Abstract:

The growing consumer trend for natural ingredients, functional foods with health benefits and the perceived risk of carcinogenesis associated with synthetic antioxidants have forced food manufacturers to look for alternatives for producing healthy and safe food. Herbs and spices are cheap, natural and harmless sources of antioxidants which can delay and prevent lipid oxidation of food products and also confer its unique organoleptic properties and health benefits to food products. The Nigerian climate has been proven to be conducive for the production of spices and herbs and is blessed bountifully with a wide range of them. Five selected Nigerian herbs and spices Piper guieense, Xylopia aethopica, Gongronema latifolium and Ocimum gratissimum were evaluated for their ability to act as radical scavengers. The spices were extracted with 80% ethanol and evaluated using total phenolic capacity (TPC), DPPH (1,1-diph diphenyl-2-picrylhydrazyl radical) ABTS (2,2’azinobis-(3-ethylbenzthiazoline-6-sulfonic acid)), total antioxidant capacity (TAC), reducing power (RP) assays. The TPC ranged from 5.33 µg GAE/mg (in Gongronema latifolium) to 15.55 µg GAE/mg (in Ocimum gratissimum). The DPPH and ABTS scavenging activity of the extracts ranged from 0.23-0.36 IC50 mg/ml and 2.32-7.25 Trolox equivalent % respectively. The TAC and RP of the extract ranged from 6.73-10.64 µg AAE/mg and 3.52-10.19 µg AAE/mg. The result of percentage yield of the extract ranged from as low as 9.94% in Gongronema latifolium and to as high as 23.85% in Xylopia aethopica. A very strong positive relationship existed between the total antioxidant capacity and total phenolic content of the tested herbs and spices (R2=0.96). All of the extracts exhibited different extent of strong antioxidant activity, high antioxidant activity was found in Ocimum gratissimum and Gongronema latifolium with the least. However, Gongronema latifolium possessed the highest total antioxidant capacity. These data confirm the appreciable antioxidant potentials and high phenolic content of Nigerian herbs and spices, thereby providing justification for their use in dishes and functional foods, prevention of cellular damage caused by free radicals and use as natural antioxidants in the food industry for prevention of lipid oxidation in food products. However, to utilize these natural antioxidants in food products, further analysis and studies of their behaviour in food systems at varying temperature, pH conditions and ionic concentrations should be carried out to displace the use of synthetic antioxidants like BHT and BHA.

Keywords: Antioxidant, free radicals, herbs, phenolic, spices

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15414 The Relationship between Rhythmic Complexity and Listening Engagement as a Proxy for Perceptual Interest

Authors: Noah R. Fram

Abstract:

Although it has been confirmed by multiple studies, the inverted-U relationship between stimulus complexity and preference (liking) remains contentious. Research aimed at substantiating the model are largely reliant upon anecdotal self-assessments of subjects and basic measures of complexity, leaving potential confounds unresolved. This study attempts to address the topic by assessing listening time as a behavioral correlate of liking (with the assumption that engagement prolongs listening time) and by looking for latent factors underlying several measures of rhythmic complexity. Participants listened to groups of rhythms, stopping each one when they started to lose interest and were asked to rate each rhythm in each group in terms of interest, complexity, and preference. Subjects were not informed that the time spent listening to each rhythm was the primary measure of interest. The hypothesis that listening time does demonstrate the same inverted-U relationship with complexity as verbal reports of liking was confirmed using a variety of metrics for rhythmic complexity, including meter-dependent measures of syncopation and meter-independent measures of entropy.

Keywords: complexity, entropy, rhythm, syncopation

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15413 Parametric Optimization of Wire Electric Discharge Machining (WEDM) for Aluminium Metal Matrix Composites

Authors: G. Rajyalakhmi, C. Karthik, Gerson Desouza, Rimmie Duraisamy

Abstract:

In this present work, metal matrix composites with combination of aluminium with (Sic/Al2O3) were fabricated using stir casting technique. The objective of the present work is to optimize the process parameters of Wire Electric Discharge Machining (WEDM) composites. Pulse ON Time, Pulse OFF Time, wire feed and sensitivity are considered as input process parameters with responses Material Removal Rate (MRR), Surface Roughness (SR) for optimization of WEDM process. Taguchi L18 Orthogonal Array (OA) is used for experimentation. Grey Relational Analysis (GRA) is coupled with Taguchi technique for multiple process parameters optimization. ANOVA (Analysis of Variance) is used for finding the impact of process parameters individually. Finally confirmation experiments were carried out to validate the predicted results.

Keywords: parametric optimization, particulate reinforced metal matrix composites, Taguchi-grey relational analysis, WEDM

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15412 Magnetic Silica Nanoparticles as Viable Support for the Immobilization of Oxidative Enzymes

Authors: Y. Moldes-Diz, M. Gamallo, G. Eibes, C. Vazquez-Vazquez, G. Feijoo, J. M. Lema, M. T. Moreira

Abstract:

Laccases (benzenediol oxygen oxidoreductases, EC 1.10.3.2) are excellent biocatalysts for biotechnological and environmental applications because of their high activity, selectivity, and specificity. Specifically, these characteristics allow them to perform the oxidation of recalcitrant compounds with simple requirements for the catalysis (presence of molecular oxygen). Nevertheless, the low stability under unfavorable conditions (pH, inactivating agents or temperature) and high production costs still limits their use for practical applications. Immobilization of enzymes has proven particularly valuable to avoid some of the aforementioned drawbacks. Magnetic nanoparticles (MNPs) have received increasing attention as carriers for enzyme immobilization since they can potentially provide an easy recovery of the biocatalyst from the reaction medium under an external magnetic field. In the present work, silica-coated magnetic nanoparticles (Fe3O4@SiO2) were prepared, characterized and used for laccase immobilization by covalent binding. The synthesis of Fe3O4@SiO2 was performed in a two-step procedure: co-precipitation and reverse microemulsion. The influence of immobilization conditions: concentrations of the functionalization agent (3-aminopropyl-triethoxy-silane) and the cross-linker (glutaraldehyde) as well as the influence of pH, T or inactivating agents were evaluated. In general, immobilized laccase showed superior stability compared to that of free enzyme. The reusability of the biocatalyst was demonstrated in successive batch reactions, where enzyme activity was maintained above 65% after 8 cycles of oxidation of the substrate 2,2'-azinobis-(3-ethylbenzothiazoline-6-sulfonate).

Keywords: silica-coated magnetic nanoparticles, laccase, immobilization, regeneration

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15411 Effect of Fiber Orientation on the Mechanical Properties of Fabricated Plate Using Basalt Fiber

Authors: Sharmili Routray, Kishor Chandra Biswal

Abstract:

The use of corrosion resistant fiber reinforced polymer (FRP) reinforcement is beneficial in structures particularly those exposed to deicing salts, and/or located in highly corrosive environment. Generally Glass, Carbon and Aramid fibers are used for the strengthening purpose of the structures. Due to the necessities of low weight and high strength materials, it is required to find out the suitable substitute with low cost. Recent developments in fiber production technology allow the strengthening of structures using Basalt fiber which is made from basalt rock. Basalt fiber has good range of thermal performance, high tensile strength, resistance to acids, good electro‐magnetic properties, inert nature, resistance to corrosion, radiation and UV light, vibration and impact loading. This investigation focuses on the effect of fibre content and fiber orientation of basalt fibre on mechanical properties of the fabricated composites. Specimen prepared with unidirectional Basalt fabric as reinforcing materials and epoxy resin as a matrix in polymer composite. In this investigation different fiber orientation are taken and the fabrication is done by hand lay-up process. The variation of the properties with the increasing number of plies of fiber in the composites is also studied. Specimens are subjected to tensile strength test and the failure of the composite is examined with the help of INSTRON universal testing Machine (SATEC) of 600 kN capacities. The average tensile strength and modulus of elasticity of BFRP plates are determined from the test Program.

Keywords: BFRP, fabrication, Fiber Reinforced Polymer (FRP), strengthening

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15410 Tolerance of Colonoscopy: Questioning Its Utility in the Elderly

Authors: Faizan Rathore, Naveed Sultan, Humphrey O. Connor

Abstract:

This study was carried out from Jan '12-Dec'12 to assess current practice in Kerry General Hospital against the age-related indicators for colonoscopies. A total of 1474 colonoscopies were performed,1177(79.9%) were diagnostic and 297 (20.1%) were therapeutic, patients were divided into 4 age groups under 75, 75-80, 81-85, 86+. The trend analysis revealed an increase in diagnostic colonoscopies and decrease in therapeutic colonoscopies with age. 664(45.04%) of colonoscopies were reported normal which made up the majority of the total diagnoses, 1330 (90.2%) of colonoscopies occurred without any complications. Main complications were patient discomfort being the highest, present in 112(7.6%) of patients, and lowest being urticaria around the IV site present in 1 (0.1%) of the cases. Patient discomfort was higher in younger patients as evidenced by 98 cases aged <75 , followed by 11 cases aged 75-80, 2 cases aged 81-85 and 1 case aged >86. Highest percentage of poor tolerance was found in 14 (1.1%) of total patients <75, 1 (0.8%) of total patients aged 75-80, 1(1.7%) of total patients in age group 81-85 and none (0%) in age group >86. We have established the safety of colonoscopy, low rate of complications and a better tolerance in the elderly from this study, however, its utility, especially in the presence of other comorbidities in elderly is questionable.

Keywords: colonoscopy, elderly patients, utility, tolerance

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15409 Concept Mapping to Reach Consensus on an Antibiotic Smart Use Strategy Model to Promote and Support Appropriate Antibiotic Prescribing in a Hospital, Thailand

Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa

Abstract:

Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.

Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams

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15408 Emergency Department Utilisation of Older People Presenting to Four Emergency Departments

Authors: M. Fry, L. Fitzpatrick, Julie Considine, R. Z. Shaban, Kate Curtis

Abstract:

Introduction: The vast majority of older Australians lives independently and are self-managing at home, despite a growing number living with a chronic illness that requires health intervention. Evidence shows that between 50% and 80% of people presenting to the emergency department (ED) are in pain. Australian EDs manage 7.2 million attendances every year and 1.4 million of these are people aged 65 years or more. Research shows that 28% of ED patients aged 65 years or more have Cognitive impairment (CI) associated with dementia, delirium and neurological conditions. Background: Traditional ED service delivery may not be suitable for older people who present with multiple, complex and ongoing illnesses. Likewise, ED clinical staff often perceive that their role should be focused more on immediate and potential lifethreatening illness and conditions which are episodic in nature. Therefore, the needs of older people and their family/carers may not be adequately addressed in the context of an ED presentation. Aim: We aimed to explore the utilisation and characteristics of older people presenting to four metropolitan EDs. Method: The findings being presented are part of a program of research exploring pain management practices for older persons with long bone fractures. The study was conducted across four metropolitan emergency departments of older patients (65years and over) and involved a 12-month randomised medical record audit (n=255). Results: ED presentations across four ED sites in 2012 numbered 168021, with 44778 (26.6%) patients aged 65 and over. Of the 44778 patients, the average age was 79.1 years (SD 8.54). There were more females 23932 (53.5%). The majority (26925: 85.0%) of older persons self-referred to the ED and lived independently. The majority arrived by ambulance (n=18553: 41.4%) and were allocated triage category was 3 (n=19,507:43.65%) or Triage category 4 at (n=15,389: 34.43%). The top five triage symptom presentations involved pain (n=8088; 18.25%), dyspnoea (n=4735; 10.7%), falls (n=4032; 9.1%), other (n=3984; 9.0%), cardiac (n=2987; 6.7%). The top five system based diagnostic presentations involved musculoskeletal (n=8902; 20.1%), cardiac (n=6704:15.0%), respiratory (n=4933; 11.0%), neurological (n=4909; 11.0%), gastroenterology (n=4321; 9.7%). On review of one tertiary hospital database the vital signs on average at time triage: Systolic Blood Pressure 143.6mmHg. Heart Rate 83.4 beats/minute; Respiratory Rate 18.5 breaths/ minute; Oxygen saturation 97.0% and Tympanic temperature 36.7 and Blood Glucose Level 7.4mmols/litre. The majority presented with a Glasgow Coma Score of 14 or higher. On average the older person stayed in the ED 4:56 (SD 3:28minutes).The average time to be seen was 39 minutes (SD 48 minutes). The majority of older persons were admitted (n=27562: 61.5%), did not wait for treatment (n= 8879: 0.02%) discharged home (n=16256: 36.0%). Conclusion: The vast majority of older persons are living independently, although many require admission on arrival to the ED. Many arrived in pain and with musculoskeletal injuries and or conditions. New models of care need to be considered, which may better support self-management and independent living of the older person and the National Emergency Access Targets.

Keywords: chronic, older person, aged care, emergency department

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