Search results for: economic and environmental impacts
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 14156

Search results for: economic and environmental impacts

3206 Pre and Post Mordant Effect of Alum on Gamma Rays Assisted Cotton Fabric by Using Ipomoea indica Leaves Extract

Authors: Abdul Hafeez, Shahid Adeel, Ayesha Hussain

Abstract:

There are number of plants species in the universe which give the protections from different diseases and give colour for the foods and textiles. The environmental condition of the universe suggested toward the ecofriendly textiles. The aim of the paper is to analyze the influence of pre & post mordanting of alum on radiated cotton fabric with Gamma Radiation of different doses by using Ipomoea indica leaves extract. Alum used as mordant with the concentration of 2, 4, 6, 8 and 10% as pre and post mordanting to observe the effect of light and colour fastness of radiated cotton. 6% of alum concentration in pre mordanting gave good colour strength 117.82 with darker in shade toward the greenish tone and in post mordanting 6% concentration gave good colour strength 102.19. The lab values show that the colour is darker in tone and gave bluish effect. Further results showed that alum gave good light and rubbing fastness on gamma radiated cotton fabric.

Keywords: Ipomoea indica, gamma radiation, alum, light fastness

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3205 A New Social Vulnerability Index for Evaluating Social Vulnerability to Climate Change at the Local Scale

Authors: Cuong V Nguyen, Ralph Horne, John Fien, France Cheong

Abstract:

Social vulnerability to climate change is increasingly being acknowledged, and proposals to measure and manage it are emerging. Building upon this work, this paper proposes an approach to social vulnerability assessment using a new mechanism to aggregate and account for causal relationships among components of a Social Vulnerability Index (SVI). To operationalize this index, the authors propose a means to develop an appropriate primary dataset, through application of a specifically-designed household survey questionnaire. The data collection and analysis, including calibration and calculation of the SVI is demonstrated through application in case study city in central coastal Vietnam. The calculation of SVI at the fine-grained local neighbourhood scale provides high resolution in vulnerability assessment, and also obviates the need for secondary data, which may be unavailable or problematic, particularly at the local scale in developing countries. The SVI household survey is underpinned by the results of a Delphi survey, an in-depth interview and focus group discussions with local environmental professionals and community members. The research reveals inherent limitations of existing SVIs but also indicates the potential for their use in assessing social vulnerability and making decisions associated with responding to climate change at the local scale.

Keywords: climate change, local scale, social vulnerability, social vulnerability index

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3204 Percentile Norms of Heart Rate Variability (HRV) of Indian Sportspersons Withdrawn from Competitive Games and Sports

Authors: Pawan Kumar, Dhananjoy Shaw

Abstract:

Heart rate variability (HRV) is the physiological phenomenon of variation in the time interval between heartbeats and is alterable with fitness, age and different medical conditions including withdrawal/retirement from games/sports. Objectives of the study were to develop (a) percentile norms of heart rate variability (HRV) variables derived from time domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity (b) percentile norms of heart rate variability (HRV) variables derived from frequency domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity. The study was conducted on 430 males. Ages of the sample ranged from 30 to 35 years of same socio-economic status. Date was collected using ECG polygraphs. Data were processed and extracted using frequency domain analysis and time domain analysis. Collected data were computed with percentile from one to hundred. The finding showed that the percentile norms of heart rate variability (HRV) variables derived from time domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity namely, NN50 count (ranged from 1 to 189 score as percentile range). pNN50 count (ranged from .24 to 60.80 score as percentile range). SDNN (ranged from 17.34 to 167.29 score as percentile range). SDSD (ranged from 11.14 to 120.46 score as percentile range). RMMSD (ranged from 11.19 to 120.24 score as percentile range) and SDANN (ranged from 4.02 to 88.75 score as percentile range). The percentile norms of heart rate variability (HRV) variables derived from frequency domain analysis of the Indian sportspersons withdrawn from competitive games/sports pertaining to sympathetic and parasympathetic activity namely Low Frequency (Normalized Power) ranged from 20.68 to 90.49 score as percentile range. High Frequency (Normalized Power) ranged from 14.37 to 81.60 score as percentile range. LF/ HF ratio(ranged from 0.26 to 9.52 score as percentile range). LF (Absolute Power) ranged from 146.79 to 5669.33 score as percentile range. HF (Absolute Power) ranged from 102.85 to 10735.71 score as percentile range and Total Power (Absolute Power) ranged from 471.45 to 25879.23 score as percentile range. Conclusion: The analysis documented percentile norms for time domain analysis and frequency domain analysis for versatile use and evaluation.

Keywords: RMSSD, Percentile, SDANN, HF, LF

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3203 The Effect of Gas Flare on the Health of Schoolchildren in the Niger Delta Area of Nigeria

Authors: Uche Joyce Ogbonda, Yingchun Ji, Paul Coates

Abstract:

The proximity of schools to gas flaring sites and the use of simple ventilation systems in school buildings with currently no regulation or laid down blueprint during design and construction in an environment prone to adverse environmental hazards caused by the continuous exploration of oil in the Niger Delta is worrisome. Although a wide health implication has been associated with inhalation of poor air, its effect on the performance of schoolchildren and staffs is poorly understood. Thus, the aim of this research is to explore from professionals around the region the issues surrounding the provision of clean air indoors even though, most developed and developing world are advancing in newer systems and technologies for clean indoor air. This study adopts both qualitative and quantitative approach using both open-ended and semi- structured interview techniques. This paper finds that indoor air quality is not considered during design, selection, and construction of schools. Analysis showed that rather than consider the health effect associated with the inhalation of ambient air by schoolchildren who spend 80% of their active time in schools due to the use of simple open windows and doors as source of breathable air. Advanced ventilation systems were therefore recommended to ensure supplying clean air for school buildings.

Keywords: air quality, gas flare, health implication, schools, ventilation system

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3202 Income and Factor Analysis of Small Scale Broiler Production in Imo State, Nigeria

Authors: Ubon Asuquo Essien, Okwudili Bismark Ibeagwa, Daberechi Peace Ubabuko

Abstract:

The Broiler Poultry subsector is dominated by small scale production with low aggregate output. The high cost of inputs currently experienced in Nigeria tends to aggravate the situation; hence many broiler farmers struggle to break-even. This study was designed to examine income and input factors in small scale deep liter broiler production in Imo state, Nigeria. Specifically, the study examined; socio-economic characteristics of small scale deep liter broiler producing Poultry farmers; estimate cost and returns of broiler production in the area; analyze input factors in broiler production in the area and examined marketability, age and profitability of the enterprise. A multi-stage sampling technique was adopted in selecting 60 small scale broiler farmers who use deep liter system from 6 communities through the use of structured questionnaire. The socioeconomic characteristics of the broiler farmers and the profitability/ marketability age of the birds were described using descriptive statistical tools such as frequencies, means and percentages. Gross margin analysis was used to analyze the cost and returns to broiler production, while Cobb Douglas production function was employed to analyze input factors in broiler production. The result of the study revealed that the cost of feed (P<0.1), deep liter material (P<0.05) and medication (P<0.05) had a significant positive relationship with the gross return of broiler farmers in the study area, while cost of labour, fuel and day old chicks were not significant. Furthermore, Gross profit margin of the farmers who market their broiler at the 8th week of rearing was 80.7%; and 78.7% and 60.8% for farmers who market at the 10th week and 12th week of rearing, respectively. The business is, therefore, profitable but at varying degree. Government and Development partners should make deliberate efforts to curb the current rise in the prices of poultry feeds, drugs and timber materials used as bedding so as to widen the profit margin and encourage more farmers to go into the business. The farmers equally need more technical assistance from extension agents with regards to timely and profitable marketing.

Keywords: broilers, factor analysis, income, small scale

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3201 Corrosion Interaction Between Steel and Acid Mine Drainage: Use of AI Based on Fuzzy Logic

Authors: Maria Luisa de la Torre, Javier Aroba, Jose Miguel Davila, Aguasanta M. Sarmiento

Abstract:

Steel is one of the most widely used materials in polymetallic sulfide mining installations. One of the main problems suffered by these facilities is the economic losses due to the corrosion of this material, which is accelerated and aggravated by the contact with acid waters generated in these mines when sulfides come into contact with oxygen and water. This generation of acidic water, in turn, is accelerated by the presence of acidophilic bacteria. In order to gain a more detailed understanding of this corrosion process and the interaction between steel and acidic water, a laboratory experiment was carried out in which carbon steel plates were introduced into four different solutions for 27 days: distilled water (BK), which tried to assimilate the effect produced by rain on this material, an acid solution from a mine with a high Fe2+/Fe3+ (PO) content, another acid solution of water from another mine with a high Fe3+/Fe2+ (PH) content and, finally, one that reproduced the acid mine water with a high Fe2+/Fe3+ content but in which there were no bacteria (ST). Every 24 hours, physicochemical parameters were measured, and water samples were taken to carry out an analysis of the dissolved elements. The results of these measurements were processed using an explainable AI model based on fuzzy logic. It could be seen that, in all cases, there was an increase in pH, as well as in the concentrations of Fe and, in particular, Fe(II), as a consequence of the oxidation of the steel plates. Proportionally, the increase in Fe concentration was higher in PO and ST than in PH because Fe precipitates were produced in the latter. The rise of Fe(II) was proportionally much higher in PH, especially in the first hours of exposure, because it started from a lower initial concentration of this ion. Although to a lesser extent than in PH, the greater increase in Fe(II) also occurred faster in PO than in ST, a consequence of the action of the catalytic bacteria. On the other hand, Cu concentrations decreased throughout the experiment (with the exception of distilled water, which initially had no Cu, as a result of an electrochemical process that generates a precipitation of Cu together with Fe hydroxides. This decrease is lower in PH because the high total acidity keeps it in solution for a longer time. With the application of an artificial intelligence tool, it has been possible to evaluate the effects of steel corrosion in mining environments, corroborating and extending what was obtained by means of classical statistics.

Keywords: acid mine drainage, artificial intelligence, carbon steel, corrosion, fuzzy logic

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3200 The Golden Bridge for Better Farmers Life

Authors: Giga Rahmah An-Nafisah, Lailatus Syifa Kamilah

Abstract:

Agriculture today, especially in Indonesia have globally improved. Since the election of the new president, who in the program of work priority the food self-sufficiency. Many ways and attempts have been planned carefully. All this is done to maximize agricultural production for the future. But if we look from another side, there is something missing. Yes! Improvement of life safety of the farmers, useless we fix all agricultural processing systems to maximize agricultural output, but the Hero of agriculture itself it does not change towards a better life. Yes, broker or middleman system agriculture results. Broker system or middleman this is the real problem facing farmers for their welfare. How come? As much as agriculture result, but if farmers were sell into middlemen with very low prices, then there will be no progress for their welfare. Broker system who do the actual middlemen should not happen in the current agricultural system, because the agriculture condition currently being concern, they would still be able to reap a profit as much as possible, no matter how miserable farmers manage the farm and currently face import competition this cannot be avoided anymore. This phenomenon is already visible plain sight all, who see it. Why? Because farmers those who fell victim cannot do anything to change this system. It is true, if only these middlemen who want to receive it for the sale of agricultural products, or arguably the only system that is the bridge realtor economic life of the farmers. The problem is that we should strive for the welfare of the heroes of our food. A golden bridge that could save them that, are the government. Why? Because the government can more easily with the powers to stop this broker system compared to other parties. The government supposed to be a bridge connecting the farmers with consumers or the people themselves. Yes, with improved broker system becomes: buy agricultural produce with highest prices to farmers and selling of agricultural products with lowest price to the consumer or the people themselves. And then the next question about the fate of middlemen? The system indirectly realtor is like system corruption. Why? Because the definition of corruption is an activity that is detrimental to the victim without being noticed by anyone continue to enrich himself and his victim's life miserable. Government may transfer performance of the middlemen into the idea of a new bridge that is done by the government itself. The government could lift them into this new bridge system employs them to remain a distributor of agricultural products themselves, but under the new policy made by the government to keep improving the welfare of farmers. This idea is made is not going to have much effect would improve the welfare of farmers, but most/least this idea will bring around many people for helping conscience farmers to the government, through the daily chatter, as well as celebrity gossip can quickly know too many people.

Keywords: broker system, farmers live, government, agricultural economics

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3199 An Assessment of Potentials, Challenges, and Opportunities of Ethiopian Cultural Centers for Tourism Product Development

Authors: Berie Abebe Getahun

Abstract:

The tourism sector has been identified by the Ethiopian government as one of the priority economic sectors and planned to make Ethiopia among the top five African destinations by 2020. It is obvious international tourism demand for Ethiopia lags behind other African countries like South Africa, Egypt, Morocco, Tanzania, and Kenya. Meanwhile, the number of international tourists’ arrival to Ethiopia increases continuously. The main purpose of this study was to find out potentials, challenges, and opportunities of Ethiopian Cultural Center for tourism product development. Therefore, an attempt has been made to identify potentials over which tourism product development can be enhanced, and opportunities that promote tourism product development in Ethiopia. To achieve this objective, data have been collected by using observation, interview and focus group discussion with selected informants working the ministry of tourism and culture. The collected data has been analyzed by transcribing materials, and by using thematic analysis method based on the research objective. Likewise, the analyzed data has been discussed in the context of prevailing literature. As revealed in finding, Ethiopian cultural center has untapped potential for tourism product development that includes: meetings, incentives, conferences, events, availability of concerned stakeholders and demand of visitors. On the other hand, lack of awareness about tourism product development, financial constraints, skilled manpower, absence of tour guiding service and interpretation of heritages have been identified as the major challenges that hindering tourism product development in the cultural center. Moreover, the growth of domestic tourism, distinctive presence and rich culture of Ethiopia, and policy of Ethiopia that promotes the growth and preservation of indigenous cultures are deemed important opportunities for tourism product development in the country. And lastly, conducting a research based on tourism product development, reviewing the existing marketing and promotion strategies, training manpower, working harmoniously with the concerned stakeholders, and a careful examination of opportunities present in order to best utilize resources were implications drawn for future intervention.

Keywords: challenges and opportunities of tourism, Ethiopian tourism potential, tourism product, tourism product development

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3198 Study on the Relative Factors of Introducing Table Vinegar in Reducing Urinary Tract Infection in Patients with Long-Term Indwelling Catheter

Authors: Yu-Ju Hsieh, Lin-Hung Lin, Wen-Hui Chang

Abstract:

This study was designed as an interventional research and intended to validate whether the introduction of drinking vinegar every day can reduce and even prevent urinary tract infection in Taiwan home stayed disabilities who using indwelling catheter. The data was collected from the subjects who have received home care case at northern Taiwan, according to the questionnaire and a medical records retroactive methodology, the subjects were informed and consent to drink 15ml of table vinegar in a daily diet, and through routine urine testing and culture study. Home care nurses would assist collecting urine at the point of before and after a meal from total 35 studied subjects per month, and total collected 4 times for testing. The results showed that when the average age of study subjects was 65.46 years and catheter indwelling time was 15 years, drinking table vinegar could inhibit the activity of E. coli O157: H7 and reduce its breeding. Before drinking table vinegar daily, the subjects’ urine pH value was 7.0-8.0, and the average was 7.5, and the urine PH value dropped to 6.5 after drinking table vinegar for a month. There were two purple urine cases whose urine were changed from purple to normal color after two weeks of drinking, and the protein and bacteria values of urine gradually improved. Urine smell unpleasant before attending to this study, and the symptom improved significantly only after 1 week, and the urine smell returned to normal ammonia and became clean after 1 month later. None of these subjects received treatment in a hospital due to urinary tract infection, and there were no signs of bleeding in all cases during this study. The subjects of this study are chronic patients with a long-term bedridden catheterization; drinking cranberry juice is an economic burden for them, and also highly prohibited for diabetes patients. By adapting to use cheaper table vinegar to acidified urine and improve its smell and ease Purple Urine Syndrome, to furthermore, proven urinary tract infection, it can also to reduce the financial burden on families, the cost of social resources and the rate of re-admission.

Keywords: table vinegar, urinary tract infection, disability patients, long-term indwelling catheter

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3197 Biodegradation of Chlorpyrifos in Real Wastewater by Acromobacter xylosoxidans SRK5 Immobilized in Calcium Alginate

Authors: Saira Khalid, Imran Hashmi

Abstract:

Agrochemical industries produce huge amount of wastewater containing pesticides and other harmful residues. Environmental regulations make it compulsory to bring pesticides to a minimum level before releasing wastewater from industrial units.The present study was designed with the objective to investigate biodegradation of CP in real wastewater using bacterial cells immobilized in calcium alginate. Bacterial strain identified as Acromobacter xylosoxidans SRK5 (KT013092) using 16S rRNA nucleotide sequence analysis was used. SRK5 was immobilized in calcium alginate to make calcium alginate microspheres (CAMs). Real wastewater from industry having 50 mg L⁻¹ of CP was inoculated with free cells or CAMs and incubated for 96 h at 37˚C. CP removal efficiency with CAMs was 98% after 72 h of incubation, and no lag phase was observed. With free cells, 12h of lag phase was observed. After 96 h of incubation 87% of CP removal was observed when inoculated with free cells. No adsorption was observed on vacant CAMs. Phytotoxicity assay demonstrated considerable loss in toxicity. Almost complete COD removal was achieved at 96 h with CAMs. Study suggests the use of immobilized cells of SRK5 for bioaugmentation of industrial wastewater for CP degradation instead of free cells.

Keywords: biodegradation, chlorpyrifos, immobilization, wastewater

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3196 Spatially Distributed Rainfall Prediction Based on Automated Kriging for Landslide Early Warning Systems

Authors: Ekrem Canli, Thomas Glade

Abstract:

The precise prediction of rainfall in space and time is a key element to most landslide early warning systems. Unfortunately, the spatial variability of rainfall in many early warning applications is often disregarded. A common simplification is to use uniformly distributed rainfall to characterize aerial rainfall intensity. With spatially differentiated rainfall information, real-time comparison with rainfall thresholds or the implementation in process-based approaches might form the basis for improved landslide warnings. This study suggests an automated workflow from the hourly, web-based collection of rain gauge data to the generation of spatially differentiated rainfall predictions based on kriging. Because the application of kriging is usually a labor intensive task, a simplified and consequently automated variogram modeling procedure was applied to up-to-date rainfall data. The entire workflow was carried out purely with open source technology. Validation results, albeit promising, pointed out the challenges that are involved in pure distance based, automated geostatistical interpolation techniques for ever-changing environmental phenomena over short temporal and spatial extent.

Keywords: kriging, landslide early warning system, spatial rainfall prediction, variogram modelling, web scraping

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3195 The Environmental Effects of Amalgam Tooth Fillings

Authors: Abdulsalam I. Rafida, Abdulhmid M. Alkout, Abdultif M. Alroba

Abstract:

This study investigates the heavy metal content in the saliva of persons with amalgam tooth fillings. For this purpose, samples of saliva have been collected based on two factors i.e. the number of amalgam fillings in the mouth (one, two or three fillings), and the time factor i.e. the time since the fillings have been in place (less than a year and more than a year). Samples of saliva have also been collected from persons with no amalgam tooth fillings for control. The samples that have been collected so far, have been examined for the basic heavy metal content featuring amalgam, which include mercury (Hg) and silver (Ag). However, all the above mentioned elements have been detected in the samples of saliva of the persons with amalgam tooth fillings, though with varying amounts depending on the number of fillings. Thus, for persons with only one filling the average quantities were found to be 0.00061 ppm and 0.033 ppm for Hg and Ag respectively. On the other hand for persons with two fillings the average quantities were found to be 0.0012 ppm and 0.029 ppm for each of the two elements respectively. However, in order to understand the chemical reactions associated with amalgam tooth fillings in the mouth, the material have been treated outside the mouth using some nutrient media. Those media included drinking water, fizzy drinks and hot tea. All three media have been found to contain the three elements after amalgam treatment. Yet, the fizzy drink medium was found to contain the highest levels of those elements.

Keywords: amalgam, mercury, silver, fizzy drinks, media

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3194 Moderation Role of Effects of Forms of Upward versus Downward Counterfactual Reasoning on Gambling Cognition and Decision of Nigerians

Authors: Larry O. Awo, George N. Duru

Abstract:

There is growing public and mental health concerns over the availability of gambling platforms and shops in Nigeria and the high level of youth involvement in gambling. Early theorizing maintained that gambling involvement driven by the quest for resource gains. However, evidences show that the economic model of gambling tend to explain the involvement of the gambling business owners (sport lottery operators: SLOs) as most gamblers lose more than they win. This loss, according to the law of effect, ought to discourage decisions to gamble. However, the quest to recover loses has often initiated and prolonged gambling sessions. Therefore, the need to investigate mental contemplations (such as counterfactual reasoning (upward versus downward) of what “would, should, or could” have been, and feeling of the illusion of control; IOC) over gambling outcome as risk or protective factors in gambling decisions became pertinent. The present study sought to understand the differential contributions and conditional effects of upward versus downward counterfactual reasoning as pathways through which the association between IOC and gambling decision of Nigerian youths (N = 120, mean age = 18.05, SD = 3.81) could be explained. The study adopted a randomized group design, and data were obtained by means of stimulus material (the Gambling Episode; GE) and self-report measures of IOC and Gambling Decision. One-way analysis of variance (ANOVA) result showed that participants in the upward counterfactual reasoning group (M = 22.08) differed from their colleagues in the downward counterfactual reasoning group (M = 17.33) on the decision to gamble, and this difference was significant [F(1,112) = 23, P < .01]. HAYES PROCESS macro moderation analysis results showed that 1) IOC and upward counterfactual reasoning were positively associated with the decision to gamble (B = 14.21, t = 6.10, p < .01 and B = 7.22, t = 2.07, p < .01), 3) upward counterfactual reasoning did not moderate the association between IOC and gambling decision (p > .05), and 4) downward counterfactual reasoning negatively moderated the association between IOC and gambling decision (B = 07, t = 2.18, p < .05) such that the association was strong at a low level of downward counterfactual, but wane at high levels of downward counterfactual reasoning. The implication of these findings are that IOC and upward counterfactual reasoning were risk factors and promote gambling behavior, while downward counterfactual reasoning protects individuals from gambling activities. Thus, it is concluded that downward counterfactual reasoning strategies should be included in gambling therapy and treatment packages as it could diminish feelings of both IOC and negative feelings of missed positive outcomes and the urge to gamble.

Keywords: counterfactual reasoning, gambling cognition, gambling decision, nigeria, youths

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3193 Heavy Metal Contamination in Soils: Detection and Assessment Using Machine Learning Algorithms Based on Hyperspectral Images

Authors: Reem El Chakik

Abstract:

The levels of heavy metals in agricultural lands in Lebanon have been witnessing a noticeable increase in the past few years, due to increased anthropogenic pollution sources. Heavy metals pose a serious threat to the environment for being non-biodegradable and persistent, accumulating thus to dangerous levels in the soil. Besides the traditional laboratory and chemical analysis methods, Hyperspectral Imaging (HSI) has proven its efficiency in the rapid detection of HMs contamination. In Lebanon, a continuous environmental monitoring, including the monitoring of levels of HMs in agricultural soils, is lacking. This is due in part to the high cost of analysis. Hence, this proposed research aims at defining the current national status of HMs contamination in agricultural soil, and to evaluate the effectiveness of using HSI in the detection of HM in contaminated agricultural fields. To achieve the two main objectives of this study, soil samples were collected from different areas throughout the country and were analyzed for HMs using Atomic Absorption Spectrophotometry (AAS). The results were compared to those obtained from the HSI technique that was applied using Hyspex SWIR-384 camera. The results showed that the Lebanese agricultural soils contain high contamination levels of Zn, and that the more clayey the soil is, the lower reflectance it has.

Keywords: agricultural soils in Lebanon, atomic absorption spectrophotometer, hyperspectral imaging., heavy metals contamination

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3192 Evaluation of the Efficacy and Tolerance of Gabapentin in the Treatment of Neuropathic Pain

Authors: A. Ibovi Mouondayi, S. Zaher, R. Assadi, K. Erraoui, S. Sboul, J. Daoudim, S. Bousselham, K. Nassar, S. Janani

Abstract:

INTRODUCTION: Neuropathic pain (NP) caused by damage to the somatosensory nervous system has a significant impact on quality of life and is associated with a high economic burden on the individual and society. The treatment of neuropathic pain consists of the use of a wide range of therapeutic agents, including gabapentin, which is used in the treatment of neuropathic pain. OBJECTIF: The objective of this study was to evaluate the efficacy and tolerance of gabapentin in the treatment of neuropathic pain. MATERIAL AND METHOD: This is a monocentric, cross-sectional, descriptive, retrospective study conducted in our department over a period of 19 months from October 2020 to April 2022. The missing parameters were collected during phone calls of the patients concerned. The diagnostic tool adopted was the DN4 questionnaire in the dialectal Arabic version. The impact of NP was assessed by the visual analog scale (VAS) on pain, sleep, and function. The impact of PN on mood was assessed by the "Hospital anxiety, and depression scale HAD" score in the validated Arabic version. The exclusion criteria were patients followed up for depression and other psychiatric pathologies. RESULTS: A total of 67 patients' data were collected. The average age was 64 years (+/- 15 years), with extremes ranging from 26 years to 94 years. 58 women and 9 men with an M/F sex ratio of 0.15. Cervical radiculopathy was found in 21% of this population, and lumbosacral radiculopathy in 61%. Gabapentin was introduced in doses ranging from 300 to 1800 mg per day with an average dose of 864 mg (+/- 346) per day for an average duration of 12.6 months. Before treatment, 93% of patients had a non-restorative sleep quality (VAS>3). 54% of patients had a pain VAS greater than 5. The function was normal in only 9% of patients. The mean anxiety score was 3.25 (standard deviation: 2.70), and the mean HAD depression score was 3.79 (standard deviation: 1.79). After treatment, all patients had improved the quality of their sleep (p<0.0001). A significant difference was noted in pain VAS, function, as well as anxiety and depression, and HAD score. Gabapentin was stopped for side effects (dizziness and drowsiness) and/or unsatisfactory response. CONCLUSION: Our data demonstrate a favorable effect of gabapentin on the management of neuropathic pain with a significant difference before and after treatment on the quality of life of patients associated with an acceptable tolerance profile.

Keywords: neuropathic pain, chronic pain, treatment, gabapentin

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3191 Identification of Bioactive Substances of Opuntia ficus-indica By-Products

Authors: N. Chougui, R. Larbat

Abstract:

The first economic importance of Opuntia ficus-indica relies on the production of edible fruits. This food transformation generates a large amount of by-products (seeds and peels) in addition to cladodes produced by the plant. Several studies showed the richness of these products with bioactive substances like phenolics that have potential applications. Indeed, phenolics have been associated with protection against oxidation and several biological activities responsible of different pathologies. Consequently, there has been a growing interest in identifying natural antioxidants from plants. This study falls within the framework of the industrial exploitation of by-products of the plant. The study aims to investigate the metabolic profile of three by-products (cladodes, peel seeds) regarding total phenolic content by liquid chromatography coupled to mass spectrometry approach (LC-MSn). The byproducts were first washed, crushed and stored at negative temperature. The total phenolic compounds were then extracted by aqueous-ethanolic solvent in order to be quantified and characterized by LC-MS. According to the results obtained, the peel extract was the richest in phenolic compounds (1512.58 mg GAE/100 g DM) followed by the cladode extract (629.23 GAE/100 g DM) and finally by the seed extract (88.82 GAE/100 g DM) which is mainly used for its oil. The LC-MS analysis revealed diversity in phenolics in the three extracts and allowed the identification of hydroxybenzoic acids, hydroxycinnamic acids and flavonoids. The highest complexity was observed in the seed phenolic composition; more than twenty compounds were detected that belong to acids esters among which three feruloyl sucrose isomers. Sixteen compounds belonging to hydroxybenzoic acids, hydroxycinnamic acids and flavonoids were identified in the peel extract, whereas, only nine compounds were found in the cladode extract. It is interesting to highlight that the phenolic composition of the cladode extract was closer to that of the peel exact. However, from a quantitative viewpoint, the peel extract presented the highest amounts. Piscidic and eucomic acids were the two most concentrated molecules, corresponding to 271.3 and 121.6 mg GAE/ 100g DM respectively. The identified compounds were known to have high antioxidant and antiradical potential with the ability to inhibit lipid peroxidation and to exhibit a wide range of biological and therapeutic properties. The findings highlight the importance of using the Opuntia ficus-indica by-products.

Keywords: characterization, LC-MSn analysis, Opuntia ficus-indica, phenolics

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3190 Recognizing and Prioritizing Effective Factors on Productivity of Human Resources Through Using Technique for Order of Preference by Similarity to Ideal Solution Method

Authors: Amirmehdi Dokhanchi, Babak Ziyae

Abstract:

Studying and prioritizing effective factors on productivity of human resources through TOPSIS method is the main aim of the present research study. For this reason, while reviewing concepts existing in productivity, effective factors were studied. Managers, supervisors, staff and personnel of Tabriz Tractor Manufacturing Company are considered subject of this study. Of total individuals, 160 of them were selected through the application of random sampling method as 'subject'. Two questionnaires were used for collecting data in this study. The factors, which had the highest effect on productivity, were recognized through the application of software packages. TOPSIS method was used for prioritizing recognized factors. For this reason, the second questionnaire was put available to statistics sample for studying effect of each of factors towards predetermined indicators. Therefore, decision-making matrix was obtained. The result of prioritizing factors shows that existence of accurate organizational strategy, high level of occupational skill, application of partnership and contribution system, on-the-job-training services, high quality of occupational life, dissemination of appropriate organizational culture, encouraging to creativity and innovation, and environmental factors are prioritized respectively.

Keywords: productivity of human resources, productivity indicators, TOPSIS, prioritizing factors

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3189 Study and Melanocyte Adrenocorticotropic Effects on Sugar Metabolism and Immune Response in Rabbits Oryctolagus cuniculus

Authors: A. Bouaouiche, M. S. Boulakoud

Abstract:

The functioning of the pineal gland, the transducer body of environmental information to the neuroendocrine system is subject to a circadian rhythm. Melatonin is the main neuro-hormone expressing this operation. It is synthesized in the pinealocytes after conversion serotonin via N-acetyl-transferase enzyme, itself subject to a photoperiodic modulation (activation dark inhibition by light). Some authors have suggested that melatonin is involved in diabetic disease and found that it could have a diabetogenic effect. To this study the effect of this hormone on glucose metabolism has long been subject to controversy. Agreeing in effect and hyperinsulinemic hypoglycemic effect. In order to illustrate the level of interaction of melatonin with neuro-immune- corticotropin axis and its impact on carbohydrate metabolism, we studied the impact homeostatic (glucose) through the solicitation of two control systems (gland pineal and corticotropin axis). We then found that melatonin could have an indirect influence on insulin control (glucose metabolism) to the levels of the growth hormone axis (somatostatin) and adrenocorticotropic (corticotropin). In addition, we have suggested that melatonin might limit the hyperglycemic action of corticosteroids by direct action at peripheral level.

Keywords: pinéal gland, melatonin, neuro-immuno-corticotrop, metabolism

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3188 Stochastic Prioritization of Dependent Actuarial Risks: Preferences among Prospects

Authors: Ezgi Nevruz, Kasirga Yildirak, Ashis SenGupta

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Comparing or ranking risks is the main motivating factor behind the human trait of making choices. Cumulative prospect theory (CPT) is a preference theory approach that evaluates perception and bias in decision making under risk and uncertainty. We aim to investigate the aggregate claims of different risk classes in terms of their comparability and amenability to ordering when the impact of risk perception is considered. For this aim, we prioritize the aggregate claims taken as actuarial risks by using various stochastic ordering relations. In order to prioritize actuarial risks, we use stochastic relations such as stochastic dominance and stop-loss dominance that are proposed in the frame of partial order theory. We take into account the dependency of the individual claims exposed to similar environmental risks. At first, we modify the zero-utility premium principle in order to obtain a solution for the stop-loss premium under CPT. Then, we propose a stochastic stop-loss dominance of the aggregate claims and find a relation between the stop-loss dominance and the first-order stochastic dominance under the dependence assumption by using properties of the familiar as well as some emerging multivariate claim distributions.

Keywords: cumulative prospect theory, partial order theory, risk perception, stochastic dominance, stop-loss dominance

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3187 Indoor Emissions Produced by Kerosene Heating, Determining Its Formation Potential of Secondary Particulate Matter and Transport

Authors: J. M. Muñoz, Y. Vasquez, P. Oyola, M. Rubio

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All emissions of contaminants inside of homes, offices, school and another enclosure closer that affect the health of those who inhabit or use them are cataloged how indoor pollution. The importance of this study is because individuals spend most of their time in indoors ambient. The main indoor pollutants are oxides of nitrogen (NOₓ), sulfur dioxide (SO₂), carbon monoxide (CO) and particulate matter (PM). Combustion heaters are an important source of pollution indoors. It will be measured: NOₓ, SO₂, CO, PM₂,₅ y PM₁₀ continuous and discreet form at indoor and outdoor of two households with different heating energy; kerosene and electricity (control home) respectively, in addition to environmental parameters such as temperature. With the values obtained in the 'control home' it will be possible estimate the contaminants transport from outside to inside of the household and later the contribution generated by kerosene heating. Transporting the emissions from burning kerosene to a photochemical chamber coupled to a continuous and discreet measuring system of contaminants it will be evaluated the oxidation of the emissions and formation of secondary particulate matter. It will be expected watch a contaminants transport from outside to inside of the household and the kerosene emissions present a high potential of formation secondary particulate matter.

Keywords: heating, indoor pollution, kerosene, secondary particulate matter

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3186 New Trends in Pakistani Cinema: Muslim Women, Cinematic Struggle and the Global World

Authors: Sana Zia

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One of the most important questions for research on Muslim women's representation is the relationship between Islam and women’s situation in Islamic countries. In this context, certain questions can be raised like is it possible to analyze women’s situation in Islamic countries like Pakistan? Or what is the relationship between Islam and patriarchy? So this paper will examine all these questions by analysing Muslim women's representation in Pakistani Cinema. It is also significant to note that despite political and religious constraints in Muslim countries, in particular, Pakistan, women have not only been part of the film industry for long, but they also have chosen films as their feminist tool to question and expose the effects of patriarchy, religious fundamentalism, and gender-specific socio-cultural oppression. The religious-cultural ethos that could include gender-specific restrictions and limitations on their creative expression as Muslim women in an Islamic society. A new wave of Pakistani cinema is pivoting around strong Muslim female characters and opened up a new thought about Islamic women.Their contributions and success through this medium emphasized the need to investigate the significance and effectiveness of contemporary cinema as a tool of resistance and cross-cultural communication in a Muslim society. So this research can also provide a better understanding about Islam that needs to be modernized and reclaimed from the clutches of fundamentalism and extremism. This paper thus investigates the interrelation of women's representation and Pakistani cinema by analysing two films ‘Bol: To speak up’ and ‘Dukhter: Daughter’. The feminist analysis of these films not only helps to understand the new trends and dimensions in representation of Muslim women in Pakistani cinema, but this also helps to raise awareness globally regarding the depiction of Muslim women. So to foreground the above mentioned discussion, the films under study helps to evaluate their significance, the role they play towards activism, resistance, and global awareness in terms of what could be termed as a Muslim woman. The paper thus provides a valuable insight that how and why Islam is being used as a mechanism to merge social, political and economic factors to define the rights and conditions of Pakistani Muslim women and highlight the cinematic struggle of the film maker’s which by using films as an awareness tool are going to highlight the problems and issues of Muslim women in the global world.

Keywords: Muslim women, Pakistani cinema, patriarchy, religious fundamentalism

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3185 Analysis of the Effect of Food Veils on the Preservation of Button and Oyster Mushrooms, Case Study: Zein Corn Coating

Authors: Mohamad Javad Shakouri, Hamid Tavakkolipour, Mahdis Jamshidi Tehranian

Abstract:

The inclination toward using food coatings is increasing daily, due to containing natural elements and not producing environmental pollution. Food coatings are uniform and thin layers of natural substances that cover the food product and act as a barrier against moisture, oxygen, and substances dissolved in food. Using food coatings on fruits and vegetables can delay water dissipation, losing aroma, decolorization, and improve the appearance of the product, and in general, preserve and protect the quality of fresh produce. When fruits and vegetables grow, they are equipped with a natural shield, called cuticle– a layer of wax. Washing the products, after harvest, the cuticle – this protective coating – is removed. In order to replace the cuticle, we can use an edible protective coating. This coating delays dehydration and deterioration and hence increases the life of the product while keeping its moisture. In this study, it was concluded that using food coatings, such as corn zein, carrageenan, and starch can have a substantial effect on the quantitative and qualitative preservation of food products, such as fruits, vegetables, and mushrooms.

Keywords: food coating, corn zein, button and oyster mushrooms, ascorbic and citric acids

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3184 Advancing UAV Operations with Hybrid Mobile Network and LoRa Communications

Authors: Annika J. Meyer, Tom Piechotta

Abstract:

Unmanned Aerial Vehicles (UAVs) have increasingly become vital tools in various applications, including surveillance, search and rescue, and environmental monitoring. One common approach to ensure redundant communication systems when flying beyond visual line of sight is for UAVs to employ multiple mobile data modems by different providers. Although widely adopted, this approach suffers from several drawbacks, such as high costs, added weight and potential increases in signal interference. In light of these challenges, this paper proposes a communication framework intermeshing mobile networks and LoRa (Long Range) technology—a low-power, long-range communication protocol. LoRaWAN (Long Range Wide Area Network) is commonly used in Internet of Things applications, relying on stationary gateways and Internet connectivity. This paper, however, utilizes the underlying LoRa protocol, taking advantage of the protocol’s low power and long-range capabilities while ensuring efficiency and reliability. Conducted in collaboration with the Potsdam Fire Department, the implementation of mobile network technology in combination with the LoRa protocol in small UAVs (take-off weight < 0.4 kg), specifically designed for search and rescue and area monitoring missions, is explored. This research aims to test the viability of LoRa as an additional redundant communication system during UAV flights as well as its intermeshing with the primary, mobile network-based controller. The methodology focuses on direct UAV-to-UAV and UAV-to-ground communications, employing different spreading factors optimized for specific operational scenarios—short-range for UAV-to-UAV interactions and long-range for UAV-to-ground commands. This explored use case also dramatically reduces one of the major drawbacks of LoRa communication systems, as a line of sight between the modules is necessary for reliable data transfer. Something that UAVs are uniquely suited to provide, especially when deployed as a swarm. Additionally, swarm deployment may enable UAVs that have lost contact with their primary network to reestablish their connection through another, better-situated UAV. The experimental setup involves multiple phases of testing, starting with controlled environments to assess basic communication capabilities and gradually advancing to complex scenarios involving multiple UAVs. Such a staged approach allows for meticulous adjustment of parameters and optimization of the communication protocols to ensure reliability and effectiveness. Furthermore, due to the close partnership with the Fire Department, the real-world applicability of the communication system is assured. The expected outcomes of this paper include a detailed analysis of LoRa's performance as a communication tool for UAVs, focusing on aspects such as signal integrity, range, and reliability under different environmental conditions. Additionally, the paper seeks to demonstrate the cost-effectiveness and operational efficiency of using a single type of communication technology that reduces UAV payload and power consumption. By shifting from traditional cellular network communications to a more robust and versatile cellular and LoRa-based system, this research has the potential to significantly enhance UAV capabilities, especially in critical applications where reliability is paramount. The success of this paper could pave the way for broader adoption of LoRa in UAV communications, setting a new standard for UAV operational communication frameworks.

Keywords: LoRa communication protocol, mobile network communication, UAV communication systems, search and rescue operations

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3183 Health Monitoring of Primates in a Conservation Unit in Brazil

Authors: Elisângela de Albuquerque Sobreira Borovoski, Ricardo Willian Borovoski

Abstract:

Microbiological infections acquired by animals pose a risk to public health. In public health, monitoring the health of primates is linked to the risk of transmission of zoonoses through scratches, bites and contact with biological samples. The project was approved by the Ethics Committee on the Use of Animals Protocol No. 170/2019. It was authorized by ICMBio Protocol No. 52117-1. The study was carried out in the period 2019-2022 in the municipality of Anápolis. Iron and galvanized wire traps were used and the animals were anesthetized with 4.4mg/kg zolethyl intramuscularly and saliva was collected through swabs. Fifty-three capuchin monkeys were captured from the Onofre Quinan Environmental Park in Anápolis-Goiás for health monitoring purposes. In the laboratory, the samples were deposited on the agar surface and seeded by exhaustion to obtain isolated colonies. These colonies were analyzed according to morphocolonial characteristics. Morphometric characterization and biochemical tests for bacterial identification were performed. A total of 861 bacterial samples were isolated, nine of which were strict anaerobic bacteria of the genus Peptostreptococcus. Previous and constant knowledge of the prevalence of pathogenic agents in biological samples is essential to be prepared to act in pandemic situations.

Keywords: Brazil, microbiology, monkeys, public health

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3182 Web Map Service for Fragmentary Rockfall Inventory

Authors: M. Amparo Nunez-Andres, Nieves Lantada

Abstract:

One of the most harmful geological risks is rockfalls. They cause both economic lost, damaged in buildings and infrastructures, and personal ones. Therefore, in order to estimate the risk of the exposed elements, it is necessary to know the mechanism of this kind of events, since the characteristics of the rock walls, to the propagation of fragments generated by the initial detached rock mass. In the framework of the research RockModels project, several inventories of rockfalls were carried out along the northeast of the Spanish peninsula and the Mallorca island. These inventories have general information about the events, although the important fact is that they contained detailed information about fragmentation. Specifically, the IBSD (Insitu Block Size Distribution) is obtained by photogrammetry from drone or TLS (Terrestrial Laser Scanner) and the RBSD (Rock Block Size Distribution) from the volume of the fragment in the deposit measured by hand. In order to share all this information with other scientists, engineers, members of civil protection, and stakeholders, it is necessary a platform accessible from the internet and following interoperable standards. In all the process, open-software have been used: PostGIS 2.1., Geoserver, and OpenLayers library. In the first step, a spatial database was implemented to manage all the information. We have used the data specifications of INSPIRE for natural risks adding specific and detailed data about fragmentation distribution. The next step was to develop a WMS with Geoserver. A previous phase was the creation of several views in PostGIS to show the information at different scales of visualization and with different degrees of detail. In the first view, the sites are identified with a point, and basic information about the rockfall event is facilitated. In the next level of zoom, at medium scale, the convex hull of the rockfall appears with its real shape and the source of the event and fragments are represented by symbols. The queries at this level offer a major detail about the movement. Eventually, the third level shows all elements: deposit, source, and blocks, in their real size, if it is possible, and in their real localization. The last task was the publication of all information in a web mapping site (www.rockdb.upc.edu) with data classified by levels using libraries in JavaScript as OpenLayers.

Keywords: geological risk, web mapping, WMS, rockfalls

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3181 Shedding Light on Colorism: Exploring Stereotypes, Influential Factors, and Consequences in African American Communities

Authors: India Sanders, Jeffrey Sherman

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Colorism has been a persistent and ingrained issue in the history of the United States, with far-reaching consequences that continue to affect various aspects of daily life, institutional policies, public spaces, economic structures, and social norms. This complex problem has had a particularly profound impact on the African-American community, shaping how they are perceived and treated within society at large. The prevalence of negative stereotypes surrounding African Americans can lead to severe repercussions such as discrimination and mental health disparities. The effects of such biases can also materialize in diverse forms, impacting the well-being and livelihoods of individuals within this community. Current research has examined how people from different racial groups perceive different skin tones of Black people, looking at the cognitive processes that manifest through categorization and stereotypes. Additionally, studies observed consequences related to colorism and how it directly affects those with darker versus lighter skin tones. However, not much research has been conducted on the influence of stereotypes associated with various skin tones. In the present study, it is hypothesized that participants in Group A will rate positive stereotypes associated with lighter skin tones significantly higher than positive stereotypes associated with darker skin tones. It is also hypothesized that participants in Group B will rate negative stereotypes associated with darker skin tones significantly higher than negative stereotypes associated with lighter skin tones. For this study, a quantitative study on stereotypes of skin tone representation within the African-American community will be conducted. Participants will rate the accuracy of various visual representations within mass media of African Americans with light skin tones and dark skin tones using a Likert scale. Participants will also be provided a questionnaire further examining the perception of stereotypes and how this affects their interactions with African Americans with lighter versus darker skin tones. The purpose of this study is to investigate the impact of skin tone portrayals on African Americans, including associated stereotypes and societal perceptions. It is expected that participants will more likely associate negative stereotypes with African Americans who have darker skin tones, as this is a common and reinforced viewpoint in the cultural and social system.

Keywords: colorism, discrimination, racism, stereotype

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3180 The Contribution of Diet and Lifestyle Factors in the Prevalence of Irritable Bowel Syndrome

Authors: Alexander Dao, Oscar Wambuguh

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Irritable Bowel Syndrome (IBS) is a heterogeneous functional bowel disease that is characterized by chronic visceral abdominal pain and abnormal bowel function and habits. Its multifactorial pathophysiology and mechanisms are still largely a mystery to the contemporary biomedical community, although there are many hypotheses to try to explain IBS’s presumed physiological, psychosocial, genetic, and environmental etiologies. IBS’s symptomatic presentation is varied and divided into four major subtypes: IBS-C, IBS-D, IBS-M, and IBS-U. Given its diverse presentation and unclear mechanisms, diagnosis is done through a combination of positive identification utilizing the “Rome IV Irritable Bowel Syndrome Criteria'' (Rome IV) diagnostic criteria while also excluding other potential conditions with similar symptoms. Treatment of IBS is focused on the management of symptoms using an assortment of pharmaceuticals, lifestyle changes, and dietary changes, with future potential in microbial treatment and psychotherapy as other therapy methods. Its chronic, heterogeneous nature and disruptive gastrointestinal (GI) symptoms are negatively impactful on patients’ daily lives, health systems, and society. However, with a better understanding of the gaps in knowledge and technological advances in IBS’s pathophysiology, management, and treatment options, there is optimism for the millions of people worldwide who are suffering from the debilitating effects of IBS.

Keywords: irritable bowel syndrome, lifestyle, diet, functional gastrointestinal disorder

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3179 Encoding the Design of the Memorial Park and the Family Network as the Icon of 9/11 in Amy Waldman's the Submission

Authors: Masami Usui

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After 9/11, the American literary scene was confronted with new perspectives that enabled both writers and readers to recognize the hidden aspects of their political, economic, legal, social, and cultural phenomena. There appeared an argument over new and challenging multicultural aspects after 9/11 and this argument is presented by a tension of space related to 9/11. In Amy Waldman’s the Submission (2011), designing both the memorial park and the family network has a significant meaning in establishing the progress of understanding from multiple perspectives. The most intriguing and controversial topic of racism is reflected in the Submission, where one young architect’s blind entry to the competition for the memorial of Ground Zero is nominated, yet he is confronted with strong objections and hostility as soon as he turns out to be a Muslim named Mohammad Khan. This ‘Khan’ issue, immediately enlarged into a social controversial issue on American soil, causes repeated acts of hostility to Muslim women by ignorant citizens all over America. His idea of the park is to design a new concept of tracing the cultural background of the open space. Against his will, his name is identified as the ‘ingredient’ of the networking of the resistant community with his supporters: on the other hand, the post 9/11 hysteria and victimization is presented in such family associations as the Angry Family Members and Grieving Family Members. These rapidly expanding networks, whether political or not, constructed by the internet, embody the contemporary societal connection and representation. The contemporary quest for the significance of human relationships is recognized as a quest for global peace. Designing both the memorial park and the communication networks strengthens a process of facing the shared conflicts and healing the survivors’ trauma. The tension between the idea and networking of the Garden for the memorial site and the collapse of Ground Zero signifies the double mission of the site: to establish the space to ease the wounded and to remember the catastrophe. Reading the design of these icons of 9/11 in the Submission means that decoding the myth of globalization and its representations in this century.

Keywords: American literature, cultural studies, globalization, literature of catastrophe

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3178 Risk Reduction of Household Refuse, a Case Study of Shagari Low-Cost, Mubi North (LGA) Adamawa State, Nigeria

Authors: Maryam Tijjani Kolo

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Lack of refuse dumping points has made the residents of Shagari low-cost well armed with some health and environmental related hazards. These studies investigate the effect of household refuse on the resident of Shagari low-cost. A well structured questionnaire was administered to elicit views of the respondent in the study area through adopting cluster sampling method. A total of 100 questionnaires were selected and divided into 50, each to both sections of the study area. Interview was conducted to each household head. Data obtained were analyzed using simple parentages to determine the major hazard in the area. Result showed that majority of the household are civil servant and traders, earning reasonable monthly income. 68% of the respondent has experienced the effect of living close to waste dumping areas, which include unpleasant smell and polluted smoke when refuse is burnt, which causes eye and respiratory induction, human injury from broken bottles or sharp objects as well as water, insect and air borne diseases. Hence, the need to urgently address these menace before it overwhelms the capacities of the community becomes paramount. Thus, the community should be given more enlightenment and refuse dumping sites should be created by the local government area.

Keywords: household, refuse, refuse dumping points, Shagari low-cost

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3177 Impact of Clinical Pharmacist Intervention in Improving Drug Related Problems in Patients with Chronic Kidney Disease

Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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