Search results for: specific assessment
1022 Addressing Supply Chain Data Risk with Data Security Assurance
Authors: Anna Fowler
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When considering assets that may need protection, the mind begins to contemplate homes, cars, and investment funds. In most cases, the protection of those assets can be covered through security systems and insurance. Data is not the first thought that comes to mind that would need protection, even though data is at the core of most supply chain operations. It includes trade secrets, management of personal identifiable information (PII), and consumer data that can be used to enhance the overall experience. Data is considered a critical element of success for supply chains and should be one of the most critical areas to protect. In the supply chain industry, there are two major misconceptions about protecting data: (i) We do not manage or store confidential/personally identifiable information (PII). (ii) Reliance on Third-Party vendor security. These misconceptions can significantly derail organizational efforts to adequately protect data across environments. These statistics can be exciting yet overwhelming at the same time. The first misconception, “We do not manage or store confidential/personally identifiable information (PII)” is dangerous as it implies the organization does not have proper data literacy. Enterprise employees will zero in on the aspect of PII while neglecting trade secret theft and the complete breakdown of information sharing. To circumvent the first bullet point, the second bullet point forges an ideology that “Reliance on Third-Party vendor security” will absolve the company from security risk. Instead, third-party risk has grown over the last two years and is one of the major causes of data security breaches. It is important to understand that a holistic approach should be considered when protecting data which should not involve purchasing a Data Loss Prevention (DLP) tool. A tool is not a solution. To protect supply chain data, start by providing data literacy training to all employees and negotiating the security component of contracts with vendors to highlight data literacy training for individuals/teams that may access company data. It is also important to understand the origin of the data and its movement to include risk identification. Ensure processes effectively incorporate data security principles. Evaluate and select DLP solutions to address specific concerns/use cases in conjunction with data visibility. These approaches are part of a broader solutions framework called Data Security Assurance (DSA). The DSA Framework looks at all of the processes across the supply chain, including their corresponding architecture and workflows, employee data literacy, governance and controls, integration between third and fourth-party vendors, DLP as a solution concept, and policies related to data residency. Within cloud environments, this framework is crucial for the supply chain industry to avoid regulatory implications and third/fourth party risk.Keywords: security by design, data security architecture, cybersecurity framework, data security assurance
Procedia PDF Downloads 891021 E-Waste Generation in Bangladesh: Present and Future Estimation by Material Flow Analysis Method
Authors: Rowshan Mamtaz, Shuvo Ahmed, Imran Noor, Sumaiya Rahman, Prithvi Shams, Fahmida Gulshan
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Last few decades have witnessed a phenomenal rise in the use of electrical and electronic equipment globally in our everyday life. As these items reach the end of their lifecycle, they turn into e-wastes and contribute to the waste stream. Bangladesh, in conformity with the global trend and due to its ongoing rapid growth, is also using electronics-based appliances and equipment at an increasing rate. This has caused a corresponding increase in the generation of e-wastes. Bangladesh is a developing country; its overall waste management system, is not yet efficient, nor is it environmentally sustainable. Most of its solid wastes are disposed of in a crude way at dumping sites. Addition of e-wastes, which often contain toxic heavy metals, into its waste stream has made the situation more difficult and challenging. Assessment of generation of e-wastes is an important step towards addressing the challenges posed by e-wastes, setting targets, and identifying the best practices for their management. Understanding and proper management of e-wastes is a stated item of the Sustainable Development Goals (SDG) campaign, and Bangladesh is committed to fulfilling it. A better understanding and availability of reliable baseline data on e-wastes will help in preventing illegal dumping, promote recycling, and create jobs in the recycling sectors and thus facilitate sustainable e-waste management. With this objective in mind, the present study has attempted to estimate the amount of e-wastes and its future generation trend in Bangladesh. To achieve this, sales data on eight selected electrical and electronic products (TV, Refrigerator, Fan, Mobile phone, Computer, IT equipment, CFL (Compact Fluorescent Lamp) bulbs, and Air Conditioner) have been collected from different sources. Primary and secondary data on the collection, recycling, and disposal of the e-wastes have also been gathered by questionnaire survey, field visits, interviews, and formal and informal meetings with the stakeholders. Material Flow Analysis (MFA) method has been applied, and mathematical models have been developed in the present study to estimate e-waste amounts and their future trends up to the year 2035 for the eight selected electrical and electronic equipment. End of life (EOL) method is adopted in the estimation. Model inputs are products’ annual sale/import data, past and future sales data, and average life span. From the model outputs, it is estimated that the generation of e-wastes in Bangladesh in 2018 is 0.40 million tons and by 2035 the amount will be 4.62 million tons with an average annual growth rate of 20%. Among the eight selected products, the number of e-wastes generated from seven products are increasing whereas only one product, CFL bulb, showed a decreasing trend of waste generation. The average growth rate of e-waste from TV sets is the highest (28%) while those from Fans and IT equipment are the lowest (11%). Field surveys conducted in the e-waste recycling sector also revealed that every year around 0.0133 million tons of e-wastes enter into the recycling business in Bangladesh which may increase in the near future.Keywords: Bangladesh, end of life, e-waste, material flow analysis
Procedia PDF Downloads 1981020 Insect Manure (Frass) as a Complementary Fertilizer to Enhance Soil Mineralization Function: Application to Cranberry and Field Crops
Authors: Joël Passicousset, David Gilbert, Chloé Chervier-Legourd, Emmanuel Caron-Garant, Didier Labarre
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Living soil agriculture tries to reconciliate food production while improving soil health, soil biodiversity, soil fertility and more generally attenuating the inherent environmental drawbacks induced by modern agriculture. Using appropriate organic materials as soil amendments has a role to play in the aim of increasing the soil organic matter, improving soil fertility, sequestering carbon, and diminishing the dependence on both mineral fertilizer and pesticides. Insect farming consists in producing insects that can be used as a rich-in-protein and entomo-based food. Usually, detritivores are chosen, thus they can be fed with food wastes, which contributes to circular economy while producing low-carbon food. This process also produces frass, made of insect feces, exuvial material, and non-digested fibrous material, that have valuable fertilizer and biostimulation properties. But frass, used as a sole fertilizer on a crop may be not completely adequate for plants’ needs. This is why this project considers black soldier fly (termed BSF, one of the three main insect species grown commercially) frass as a complementary fertilizer, both in organic and in conventional contexts. Three kinds of experiments are made to understand the behaviour of fertilizer treatments based on frass incorporation. Lab-scale mineralization experiments suggest that BSF frass alone mineralizes more slowly than chicken manure alone (CM), but at a ratio of 90% CM-10% BSF frass, the mineralization rate of the mixture is higher than both frass and CM individually. For example, in the 7 days following the fertilization with same nitrogen amount introduced among treatments, around 80% of the nitrogen content supplied through 90% CM-10% BSF frass fertilization is present in the soil under mineral forms, compared to roughly 60% for commercial CM fertilization and 45% with BSF-frass. This suggests that BSF frass contains a more recalcitrant form of organic nitrogen than CM, but also that BSF frass has a highly active microbiota that can increase CM mineralization rate. Consequently, when progressive mineralization is needed, pure BSF-frass may be a consistent option from an agronomic aspect whereas, for specific crops that require spikes of readily available nitrogen sources (like cranberry), fast release 90CM-10BSF frass biofertilizer are more appropriate. Field experiments on cranberry suggests that, indeed, 90CM-10BSF frass is a potent candidate for organic cranberry production, as currently, organic growers rely solely on CM, whose mineralization kinetics are known to imperfectly match plant’s needs, which is known to be a major reason that sustains the current yield gap between conventional and organic cranberry sectors.Keywords: soil mineralization, biofertilizer, BSF-frass, chicken manure, soil functions, nitrogen, soil microbiota
Procedia PDF Downloads 701019 Digital Image Correlation Based Mechanical Response Characterization of Thin-Walled Composite Cylindrical Shells
Authors: Sthanu Mahadev, Wen Chan, Melanie Lim
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Anisotropy dominated continuous-fiber composite materials have garnered attention in numerous mechanical and aerospace structural applications. Tailored mechanical properties in advanced composites can exhibit superiority in terms of stiffness-to-weight ratio, strength-to-weight ratio, low-density characteristics, coupled with significant improvements in fatigue resistance as opposed to metal structure counterparts. Extensive research has demonstrated their core potential as more than just mere lightweight substitutes to conventional materials. Prior work done by Mahadev and Chan focused on formulating a modified composite shell theory based prognosis methodology for investigating the structural response of thin-walled circular cylindrical shell type composite configurations under in-plane mechanical loads respectively. The prime motivation to develop this theory stemmed from its capability to generate simple yet accurate closed-form analytical results that can efficiently characterize circular composite shell construction. It showcased the development of a novel mathematical framework to analytically identify the location of the centroid for thin-walled, open cross-section, curved composite shells that were characterized by circumferential arc angle, thickness-to-mean radius ratio, and total laminate thickness. Ply stress variations for curved cylindrical shells were analytically examined under the application of centric tensile and bending loading. This work presents a cost-effective, small-platform experimental methodology by taking advantage of the full-field measurement capability of digital image correlation (DIC) for an accurate assessment of key mechanical parameters such as in-plane mechanical stresses and strains, centroid location etc. Mechanical property measurement of advanced composite materials can become challenging due to their anisotropy and complex failure mechanisms. Full-field displacement measurements are well suited for characterizing the mechanical properties of composite materials because of the complexity of their deformation. This work encompasses the fabrication of a set of curved cylindrical shell coupons, the design and development of a novel test-fixture design and an innovative experimental methodology that demonstrates the capability to very accurately predict the location of centroid in such curved composite cylindrical strips via employing a DIC based strain measurement technique. Error percentage difference between experimental centroid measurements and previously estimated analytical centroid results are observed to be in good agreement. The developed analytical modified-shell theory provides the capability to understand the fundamental behavior of thin-walled cylindrical shells and offers the potential to generate novel avenues to understand the physics of such structures at a laminate level.Keywords: anisotropy, composites, curved cylindrical shells, digital image correlation
Procedia PDF Downloads 3161018 A Text in Movement in the Totonac Flyers’ Dance: A Performance-Linguistic Theory
Authors: Luisa Villani
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The proposal aims to express concerns about the connection between mind, body, society, and environment in the Flyers’ dance, a very well-known rotatory dance in Mexico, to create meanings and to make the apprehension of the world possible. The interaction among the brain, mind, body, and environment, and the intersubjective relation among them, means the world creates and recreates a social interaction. The purpose of this methodology, based on the embodied cognition theory, which was named “A Performance-Embodied Theory” is to find the principles and patterns that organize the culture and the rules of the apprehension of the environment by Totonac people while the dance is being performed. The analysis started by questioning how anthropologists can interpret how Totonacs transform their unconscious knowledge into conscious knowledge and how the scheme formation of imagination and their collective imagery is understood in the context of public-facing rituals, such as Flyers’ dance. The problem is that most of the time, researchers interpret elements in a separate way and not as a complex ritual dancing whole, which is the original contribution of this study. This theory, which accepts the fact that people are body-mind agents, wants to interpret the dance as a whole, where the different elements are joined to an integral interpretation. To understand incorporation, data was recollected in prolonged periods of fieldwork, with participant observation and linguistic and extralinguistic data analysis. Laban’s notation for the description and analysis of gestures and movements in the space was first used, but it was later transformed and gone beyond this method, which is still a linear and compositional one. Performance in a ritual is the actualization of a potential complex of meanings or cognitive domains among many others in a culture: one potential dimension becomes probable and then real because of the activation of specific meanings in a context. It can only be thought what language permits thinking, and the lexicon that is used depends on the individual culture. Only some parts of this knowledge can be activated at once, and these parts of knowledge are connected. Only in this way, the world can be understood. It can be recognized that as languages geometrize the physical world thanks to the body, also ritual does. In conclusion, the ritual behaves as an embodied grammar or a text in movement, which, depending on the ritual phases and the words and sentences pronounced in the ritual, activates bits of encyclopedic knowledge that people have about the world. Gestures are not given by the performer but emerge from the intentional perception in which gestures are “understood” by the audio-spectator in an inter-corporeal way. The impact of this study regards the possibility not only to disseminate knowledge effectively but also to generate a balance between different parts of the world where knowledge is shared, rather than being received by academic institutions alone. This knowledge can be exchanged, so indigenous communities and academies could be together as part of the activation and the sharing of this knowledge with the world.Keywords: dance, flyers, performance, embodied, cognition
Procedia PDF Downloads 581017 Mapping the Urban Catalytic Trajectory for 'Convention and Exhibition' Projects: A Case of India International Convention and Expo Centre, New Delhi
Authors: Bhavana Gulaty, Arshia Chaudhri
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Great civic projects contribute integrally to a city, and every city undergoes a recurring cycle of urban transformations and regeneration by their insertion. The M.I.C.E. (Meetings, Incentives, Convention and Exhibitions) industry is the forbearer of one category of such catalytic civic projects. Through a specific focus on M.I.C.E. destinations, this paper illustrates the multifarious dimensions that urban catalysts impact the city on S.P.U.R. (Seed. Profile. Urbane. Reflections), the theoretical framework of this paper aims to unearth these dimensions in the realm of the COEX (Convention & Exhibition) biosphere. The ‘COEX Biosphere’ is the filter of such catalysts being ecosystems unto themselves. Like a ripple in water, the impact of these strategic interventions focusing on art, culture, trade, and promotion expands right from the trigger; the immediate context to the region and subsequently impacts the global scale. These ripples are known to bring about significant economic, social, and political and network changes. The COEX inventory in the Asian context has one such prominent addition; the proposed India International Convention and Exhibition Centre (IICC) at New Delhi. It is envisioned to be the largest facility in Asia currently and would position India on the global M.I.C.E map. With the first phase of the project scheduled to open for use in the end of 2019, this flagship project of the Government of India is projected to cater to a peak daily footfall of 3,20,000 visitors and estimated to generate 5,00,000 jobs. While the economic benefits are yet to manifest in real time and ‘Good design is good business’ holds true, for the urban transformation to be meaningful, the benefits have to go beyond just a balance sheet for the city’s exchequer. This aspect has been found relatively unexplored in research on these developments. The methodology for investigation will comprise of two steps. The first will be establishing an inventory of the global success stories and associated benefits of COEX projects over the past decade. The rationale for capping the timeframe is the significant paradigm shift that has been observed in their recent conceptualization; for instance ‘Innovation Districts’ conceptualised in the city of Albuquerque that converges into the global economy. The second step would entail a comparative benchmarking of the projected transformations by IICC through a toolkit of parameters. This is posited to yield a matrix that can form the test bed for mapping the catalytic trajectory for projects in the pipeline globally. As a ready reckoner, it purports to be a catalyst to substantiate decision making in the planning stage itself for future projects in similar contexts.Keywords: catalysts, COEX, M.I.C.E., urban transformations
Procedia PDF Downloads 1581016 Fabrication of High-Aspect Ratio Vertical Silicon Nanowire Electrode Arrays for Brain-Machine Interfaces
Authors: Su Yin Chiam, Zhipeng Ding, Guang Yang, Danny Jian Hang Tng, Peiyi Song, Geok Ing Ng, Ken-Tye Yong, Qing Xin Zhang
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Brain-machine interfaces (BMI) is a ground rich of exploration opportunities where manipulation of neural activity are used for interconnect with myriad form of external devices. These research and intensive development were evolved into various areas from medical field, gaming and entertainment industry till safety and security field. The technology were extended for neurological disorders therapy such as obsessive compulsive disorder and Parkinson’s disease by introducing current pulses to specific region of the brain. Nonetheless, the work to develop a real-time observing, recording and altering of neural signal brain-machine interfaces system will require a significant amount of effort to overcome the obstacles in improving this system without delay in response. To date, feature size of interface devices and the density of the electrode population remain as a limitation in achieving seamless performance on BMI. Currently, the size of the BMI devices is ranging from 10 to 100 microns in terms of electrodes’ diameters. Henceforth, to accommodate the single cell level precise monitoring, smaller and denser Nano-scaled nanowire electrode arrays are vital in fabrication. In this paper, we would like to showcase the fabrication of high aspect ratio of vertical silicon nanowire electrodes arrays using microelectromechanical system (MEMS) method. Nanofabrication of the nanowire electrodes involves in deep reactive ion etching, thermal oxide thinning, electron-beam lithography patterning, sputtering of metal targets and bottom anti-reflection coating (BARC) etch. Metallization on the nanowire electrode tip is a prominent process to optimize the nanowire electrical conductivity and this step remains a challenge during fabrication. Metal electrodes were lithographically defined and yet these metal contacts outline a size scale that is larger than nanometer-scale building blocks hence further limiting potential advantages. Therefore, we present an integrated contact solution that overcomes this size constraint through self-aligned Nickel silicidation process on the tip of vertical silicon nanowire electrodes. A 4 x 4 array of vertical silicon nanowires electrodes with the diameter of 290nm and height of 3µm has been successfully fabricated.Keywords: brain-machine interfaces, microelectromechanical systems (MEMS), nanowire, nickel silicide
Procedia PDF Downloads 4351015 Exploration of the Psychological Aspect of Empowerment of Marginalized Women Working in the Unorganized Sector of Metropolis City
Authors: Sharmistha Chanda, Anindita Chaudhuri
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This exploratory study highlights the psychological aspects of women's empowerment to find the importance of the psychological dimension of empowerment, such as; meaning, competence, self-determination, impact, and assumption, especially in the weaker marginalized section of women. A large proportion of rural, suburban, and urban poor survive by working in unorganized sectors of metropolitan cities. Relative Poverty and lack of employment in rural areas and small towns drive many people to the metropolitan city for work and livelihood. Women working in that field remain unrecognized as people of low socio-economic status. They are usually willing to do domestic work as daily wage workers, single wage earners, street vendors, family businesses like agricultural activities, domestic workers, and self-employed. Usually, these women accept such jobs because they do not have such an opportunity as they lack the basic level of education that is required for better-paid jobs. The unorganized sector, on the other hand, has no such clear-cut employer-employee relationships and lacks most forms of social protection. Having no fixed employer, these workers are casual, contractual, migrant, home-based, own-account workers who attempt to earn a living from whatever meager assets and skills they possess. Women have become more empowered both financially and individually through small-scale business ownership or entrepreneurship development and in household-based work. In-depth interviews have been done with 10 participants in order to understand their living styles, habits, self-identity, and empowerment in their society in order to evaluate the key challenges that they may face following by qualitative research approach. Transcription has been done from the collected data. The three-layer coding technique guides the data analysis process, encompassing – open coding, axial coding, and selective coding. Women’s Entrepreneurship is one of the foremost concerns as the Government, and non-government institutions are readily serving this domain with the primary objectives of promoting self-employment opportunities in general and empowering women in specific. Thus, despite hardship and unrecognition unorganized sector provides a huge array of opportunities for rural and sub-urban poor to earn. Also, the upper section of society tends to depend on this working force. This study gave an idea about the well-being, and meaning in life, life satisfaction on the basis of their lived experience.Keywords: marginalized women, psychological empowerment, relative poverty, and unorganized sector.
Procedia PDF Downloads 581014 An Examination of Crisis Communication in Sport: Lessons from Sport Organizations Responding to Coronavirus Disease Outbreak
Authors: Geumchan Hwang
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Professional sport leagues in Europe and North America are shut down due to novel coronavirus disease (COVID-19) outbreak. Football leagues in Europe (e.g., La Liga, English Premier League, Bundesliga, Serie A, and Ligue 1) and big four professional sport leagues in North America (e.g., National Football League, Major League Baseball, National Basketball Association, and National Hockey League) are indefinitely suspended or delayed. COVID-19 outbreak has a growing negative impact on economics of sport leagues. For example, loss of revenue in Europe’s top five leagues due to the COVID-19 pandemic was estimated at € 4 billion and loss of revenue in the NBA was estimated at $650 million as of March 2020. In the unprecedented difficult situation, sport teams and leagues try to communicate with sport fans through diverse media platforms. In sport, however, very few studies have been done regarding how sport organizations effectively communicate with sport fans during pandemics, such as COVID-19 outbreak. Understanding sport organizations’ crisis communication is important to develop effective crisis management strategies for sport organizations. Therefore, the purpose of the study is to examine how sport organizations communicate with sport fans via online platforms in COVID-19 outbreak and how sport fans evaluate their communication strategies. 9 official sport league sites (i.e., five major football leagues in Europe and four major sport leagues in North America) and COVID-19 news articles published between January and June in 2020 will be analyzed in terms of coronavirus information, teams and players’ live update, fan interaction, fan support, and community engagement. In addition, comments posted on social media sites (i.e., Facebook and Twitter) of major sport leagues will be also analyzed to examine how sport fans perceive online messages provided by sport leagues as an effective communication strategy. To measure the effectiveness of crisis communication performance, five components (i.e., prompt, compassionate, honest, informative, and interactive) of crisis communication will be collected from leagues’ official websites information and social media posts. Upon completing data collection, content analysis method will be used to evaluate effectiveness of crisis communication among 9 professional sport leagues. The results of the study will provide athletic directors, administrators, and public relations managers in sport organizations with practical information regarding how athlete celebrities and sport organizations should interact with their fans in pandemic situations. In particular, this study will contribute to developing specific crisis management plan for sport organizations. For instance, football teams and leagues in Europe will be able to create standard manuals to minimize damages caused by disease outbreak, such as COVID-19 outbreak.Keywords: COVID-19, communication, sport leagues, fans
Procedia PDF Downloads 1381013 Effect of Antimony on Microorganisms in Aerobic and Anaerobic Environments
Authors: Barrera C. Monserrat, Sierra-Alvarez Reyes, Pat-Espadas Aurora, Moreno Andrade Ivan
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Antimony is a toxic and carcinogenic metalloid considered a pollutant of priority interest by the United States Environmental Protection Agency. It is present in the environment in two oxidation states: antimonite (Sb (III)) and antimony (Sb (V)). Sb (III) is toxic to several aquatic organisms, but the potential inhibitory effect of Sb species for microorganisms has not been extensively evaluated. The fate and possible toxic impact of antimony on aerobic and anaerobic wastewater treatment systems are unknown. For this reason, the objective of this study was to evaluate the microbial toxicity of Sb (V) and Sb (III) in aerobic and anaerobic environments. Sb(V) and Sb(III) were used as potassium hexahydroxoantimonate (V) and potassium antimony tartrate, respectively (Sigma-Aldrich). The toxic effect of both Sb species in anaerobic environments was evaluated on methanogenic activity and the inhibition of hydrogen production of microorganisms from a wastewater treatment bioreactor. For the methanogenic activity, batch experiments were carried out in 160 mL serological bottles; each bottle contained basal mineral medium (100 mL), inoculum (1.5 g of VSS/L), acetate (2.56 g/L) as substrate, and variable concentrations of Sb (V) or Sb (III). Duplicate bioassays were incubated at 30 ± 2°C on an orbital shaker (105 rpm) in the dark. Methane production was monitored by gas chromatography. The hydrogen production inhibition tests were carried out in glass bottles with a working volume of 0.36 L. Glucose (50 g/L) was used as a substrate, pretreated inoculum (5 g VSS/L), mineral medium and varying concentrations of the two species of antimony. The bottles were kept under stirring and at a temperature of 35°C in an AMPTSII device that recorded hydrogen production. The toxicity of Sb on aerobic microorganisms (from a wastewater activated sludge treatment plant) was tested with a Microtox standardized toxicity test and respirometry. Results showed that Sb (III) is more toxic than Sb (V) for methanogenic microorganisms. Sb (V) caused a 50% decrease in methanogenic activity at 250 mg/L. In contrast, exposure to Sb (III) resulted in a 50% inhibition at a concentration of only 11 mg/L, and an almost complete inhibition (95%) at 25 mg/L. For hydrogen-producing microorganisms, Sb (III) and Sb (V) inhibited 50% of this production with 12.6 mg/L and 87.7 mg/L, respectively. The results for aerobic environments showed that 500 mg/L of Sb (V) do not inhibit the Allivibrio fischeri (Microtox) activity or specific oxygen uptake rate of activated sludge. In the case of Sb (III), this caused a loss of 50% of the respiration of the microorganisms at concentrations below 40 mg/L. The results obtained indicate that the toxicity of the antimony will depend on the speciation of this metalloid and that Sb (III) has a significantly higher inhibitory potential compared to Sb (V). It was shown that anaerobic microorganisms can reduce Sb (V) to Sb (III). Acknowledgments: This work was funded in part by grants from the UA-CONACYT Binational Consortium for the Regional Scientific Development and Innovation (CAZMEX), the National Institute of Health (NIH ES- 04940), and PAPIIT-DGAPA-UNAM (IN105220).Keywords: aerobic inhibition, antimony reduction, hydrogen inhibition, methanogenic toxicity
Procedia PDF Downloads 1671012 Infant and Young Child-Feeding Practices in Mongolia
Authors: Otgonjargal Damdinbaljir
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Background: Infant feeding practices have a major role in determining the nutritional status of children and are associated with household socioeconomic and demographic factors. In 2010, Mongolia used WHO 2008 edition of Indicators for assessing infant and young child feeding practices for the first time. Objective: To evaluate the feeding status of infants and young children under 2 years old in Mongolia. Materials and Methods: The study was conducted by cluster random sampling. The data on breastfeeding and complementary food supplement of the 350 infants and young children aged 0-23 months in 21 provinces of the 4 economic regions of the country and capital Ulaanbaatar city were collected through questionnaires. The feeding status was analyzed according to the WHO 2008 edition of Indicators for assessing infant and young child feeding practices. Analysis of data: Survey data was analysed using the PASW statistics 18.0 and EPI INFO 2000 software. For calculation of overall measures for the entire survey sample, analyses were stratified by region. Age-specific feeding patterns were described using frequencies, proportions and survival analysis. Logistic regression was done with feeding practice as dependent and socio demographic factors as independent variables. Simple proportions were calculated for each IYCF indicator. The differences in the feeding practices between sexes and age-groups, if any, were noted using chi-square test. Ethics: The Ethics Committee under the auspices of the Ministry of Health approved the study. Results: A total of 350 children aged 0-23 months were investigated. The rate of ever breastfeeding of children aged 0-23 months reached up to 98.2%, while the percentage of early initiation of breastfeeding was only 85.5%. The rates of exclusive breastfeeding under 6 months, continued breastfeeding for 1 year, and continued breastfeeding for 2 years were 71.3%, 74% and 54.6%, respectively. The median time of giving complementary food was the 6th month and the weaning time was the 9th month. The rate of complementary food supplemented from 6th-8th month in time was 80.3%. The rates of minimum dietary diversity, minimum meal frequency, and consumption of iron-rich or iron-fortified foods among children aged 6-23 months were 52.1%, 80.8% (663/813) and 30.1%, respectively. Conclusions: The main problems revealed from the study were inadequate category and frequency of complementary food, and the low rate of consumption of iron-rich or iron-fortified foods were the main issues to be concerned on infant feeding in Mongolia. Our findings have highlighted the need to encourage mothers to enrich their traditional wheat- based complementary foods add more animal source foods and vegetables.Keywords: complementary feeding, early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency
Procedia PDF Downloads 4801011 Community Engagement: Experience from the SIREN Study in Sub-Saharan Africa
Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia
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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke
Procedia PDF Downloads 4281010 Atypical Retinoid ST1926 Nanoparticle Formulation Development and Therapeutic Potential in Colorectal Cancer
Authors: Sara Assi, Berthe Hayar, Claudio Pisano, Nadine Darwiche, Walid Saad
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Nanomedicine, the application of nanotechnology to medicine, is an emerging discipline that has gained significant attention in recent years. Current breakthroughs in nanomedicine have paved the way to develop effective drug delivery systems that can be used to target cancer. The use of nanotechnology provides effective drug delivery, enhanced stability, bioavailability, and permeability, thereby minimizing drug dosage and toxicity. As such, the use of nanoparticle (NP) formulations in drug delivery has been applied in various cancer models and have shown to improve the ability of drugs to reach specific targeted sites in a controlled manner. Cancer is one of the major causes of death worldwide; in particular, colorectal cancer (CRC) is the third most common type of cancer diagnosed amongst men and women and the second leading cause of cancer related deaths, highlighting the need for novel therapies. Retinoids, consisting of natural and synthetic derivatives, are a class of chemical compounds that have shown promise in preclinical and clinical cancer settings. However, retinoids are limited by their toxicity and resistance to treatment. To overcome this resistance, various synthetic retinoids have been developed, including the adamantyl retinoid ST1926, which is a potent anti-cancer agent. However, due to its limited bioavailability, the development of ST1926 has been restricted in phase I clinical trials. We have previously investigated the preclinical efficacy of ST1926 in CRC models. ST1926 displayed potent inhibitory and apoptotic effects in CRC cell lines by inducing early DNA damage and apoptosis. ST1926 significantly reduced the tumor doubling time and tumor burden in a xenograft CRC model. Therefore, we developed ST1926-NPs and assessed their efficacy in CRC models. ST1926-NPs were produced using Flash NanoPrecipitation with the amphiphilic diblock copolymer polystyrene-b-ethylene oxide and cholesterol as a co-stabilizer. ST1926 was formulated into NPs with a drug to polymer mass ratio of 1:2, providing a stable formulation for one week. The contin ST1926-NP diameter was 100 nm, with a polydispersity index of 0.245. Using the MTT cell viability assay, ST1926-NP exhibited potent anti-growth activities as naked ST1926 in HCT116 cells, at pharmacologically achievable concentrations. Future studies will be performed to study the anti-tumor activities and mechanism of action of ST1926-NPs in a xenograft mouse model and to detect the compound and its glucuroconjugated form in the plasma of mice. Ultimately, our studies will support the use of ST1926-NP formulations in enhancing the stability and bioavailability of ST1926 in CRC.Keywords: nanoparticles, drug delivery, colorectal cancer, retinoids
Procedia PDF Downloads 1001009 Efforts to Revitalize Piipaash Language: An Explorative Study to Develop Culturally Appropriate and Contextually Relevant Teaching Materials for Preschoolers
Authors: Shahzadi Laibah Burq, Gina Scarpete Walters
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Piipaash, representing one large family of North American languages, Yuman, is reported as one of the seriously endangered languages in the Salt River Pima-Maricopa Indian Community of Arizona. In a collaborative venture between Arizona State University (ASU) and Salt River Pima-Maricopa Indian Community (SRPMIC), efforts have been made to revitalize and preserve the Piipaash language and its cultural heritage. The present study is one example of several other language documentation and revitalization initiatives that Humanities Lab ASU has taken. This study was approved to receive a “Beyond the lab” grant after the researchers successfully created a Teaching Guide for Early Childhood Piipaash storybook during their time working in the Humanities Lab. The current research is an extension of the previous project and focuses on creating customized teaching materials and tools for the teachers and parents of the students of the Early Enrichment Program at SRPMIC. However, to determine and maximize the usefulness of the teaching materials with regards to their reliability, validity, and practicality in the given context, this research aims to conduct Environmental Analysis and Need Analysis. Environmental Analysis seeks to evaluate the Early Enrichment Program situation and Need Analysis to investigate the specific and situated requirements of the teachers to assist students in building target language skills. The study employs a qualitative methods approach for the collection of the data. Multiple data collection strategies are used concurrently to gather information from the participants. The research tools include semi-structured interviews with the program administrators and teachers, classroom observations, and teacher shadowing. The researchers utilize triangulation of the data to maintain validity in the process of data interpretation. The preliminary results of the study show a need for culturally appropriate materials that can further the learning of students of the target language as well as the culture, i.e., clay pots and basket-making materials. It was found that the course and teachers focus on developing the Listening and Speaking skills of the students. Moreover, to assist the young learners beyond the classroom, the teachers could make use of send-home teaching materials to reinforce the learning (i.e., coloring books, including illustrations of culturally relevant animals, food, and places). Audio language resources are also identified as helpful additional materials for the parents to assist the learning of the kids.Keywords: indigenous education, materials development, need analysis, piipaash language revitalizaton
Procedia PDF Downloads 891008 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review
Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish
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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education
Procedia PDF Downloads 841007 Correlation between Visual Perception and Social Function in Patients with Schizophrenia
Authors: Candy Chieh Lee
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Objective: The purpose of this study is to investigate the relationship between visual perception and social function in patients with schizophrenia. The specific aims are: 1) To explore performances in visual perception and social function in patients with schizophrenia 2) to examine the correlation between visual perceptual skills and social function in patients with schizophrenia The long-term goal is to be able to provide the most adequate intervention program for promoting patients’ visual perceptual skills and social function, as well as compensatory techniques. Background: Perceptual deficits in schizophrenia have been well documented in the visual system. Clinically, a considerable portion (up to 60%) of schizophrenia patients report distorted visual experiences such as visual perception of motion, color, size, and facial expression. Visual perception is required for the successful performance of most activities of daily living, such as dressing, making a cup of tea, driving a car and reading. On the other hand, patients with schizophrenia usually exhibit psychotic symptoms such as auditory hallucination and delusions which tend to alter their perception of reality and affect their quality of interpersonal relationship and limit their participation in various social situations. Social function plays an important role in the prognosis of patients with schizophrenia; lower social functioning skills can lead to poorer prognosis. Investigations on the relationship between social functioning and perceptual ability in patients with schizophrenia are relatively new but important as the results could provide information for effective intervention on visual perception and social functioning in patients with schizophrenia. Methods: We recruited 50 participants with schizophrenia in the mental health hospital (Taipei City Hospital, Songde branch, Taipei, Taiwan) acute ward. Participants who have signed consent forms, diagnosis of schizophrenia and having no organic vision deficits were included. Participants were administered the test of visual-perceptual skills (non-motor), third edition (TVPS-3) and the personal and social performance scale (PSP) for assessing visual perceptual skill and social function. The assessments will take about 70-90 minutes to complete. Data Analysis: The IBM SPSS 21.0 will be used to perform the statistical analysis. First, descriptive statistics will be performed to describe the characteristics and performance of the participants. Lastly, Pearson correlation will be computed to examine the correlation between PSP and TVPS-3 scores. Results: Significant differences were found between the means of participants’ TVPS-3 raw scores of each subtest with the age equivalent raw score provided by the TVPS-3 manual. Significant correlations were found between all 7 subtests of TVPS-3 and PSP total score. Conclusions: The results showed that patients with schizophrenia do exhibit visual perceptual deficits and is correlated social functions. Understanding these facts of patients with schizophrenia can assist health care professionals in designing and implementing adequate rehabilitative treatment according to patients’ needs.Keywords: occupational therapy, social function, schizophrenia, visual perception
Procedia PDF Downloads 1381006 The Importance of Urban Pattern and Planting Design in Urban Transformation Projects
Authors: Mustafa Var, Yasin Kültiğin Yaman, Elif Berna Var, Müberra Pulatkan
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This study deals with real application of an urban transformation project in Trabzon, Turkey. It aims to highlight the significance of using native species in terms of planting design of transformation projects which will also promote sustainability of urban identity. Urban identity is a phenomenon shaped not only by physical, but also by natural, spatial, social, historical and cultural factors. Urban areas face with continuous change which can be whether positive or negative way. If it occurs in a negative way that may have some destructive effects on urban identity. To solve this problematic issue, urban renewal movements initally started after 1840s around the world especially in the cities with ports. This process later followed by the places where people suffered a lot from fires and has expanded to all over the world. In Turkey, those processes have been experienced mostly after 1980s as country experienced the worst effects of unplanned urbanization especially in 1950-1990 period. Also old squares, streets, meeting points, green areas, Ottoman bazaars have changed slowly. This change was resulted in alienation of inhabitants to their environments. As a solution, several actions were taken like Mass Housing Laws which was enacted in 1981 and 1984 or urban transformation projects. Although projects between 1990-2000 were tried to satisfy the expectations of local inhabitants by the help of several design solutions to promote cultural identity; unfortunately those modern projects has also been resulted in alienation of urban environments to the inhabitants. Those projects were initially done by TOKI (Housing Development Administration of Turkey) and later followed by the Ministry of Environment and Urbanization after 2011. Although they had significant potentials to create healthy urban environments, they could not use this opportunity in an effective way. The reason for their failure is that their architectural styles and planting designs are unrespectful to local identity and environments. Generally, it can be said that the most of the urban transformation projects implementing in Turkey nearly have no concerns about the locality. However, those projects can be used as a positive tool for enhanching the urban identity of cities by means of local planting material. For instance, Kyoto can be identified by Japanese Maple trees or Seattle can be specified by Dahlia. In the same way, in Turkey, Istanbul city can be identified by Judas and Stone Pine trees or Giresun city can be identified by Cherry trees. Thus, in this paper, the importance of conserving urban identity is discussed specificly with the help of using local planting elements. After revealing the mistakes that are made during urban transformation projects, the techniques and design criterias for preserving and promoting urban identity are examined. In the end, it is emphasized that every city should have their own original, local character and specific planting design which can be used for highlighting its identity as well as architectural elements.Keywords: urban identity, urban transformation, planting design, landscape architecture
Procedia PDF Downloads 5461005 Implementation of Performance Management and Development System: The Case of the Eastern Cape Provincial Department of Health, South Africa
Authors: Thanduxolo Elford Fana
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Rationale and Purpose: Performance management and development system are central to effective and efficient service delivery, especially in highly labour intensive sectors such as South African public health. Performance management and development systems seek to ensure that good employee performance is rewarded accordingly, while those who underperform are developed so that they can reach their full potential. An effective and efficiently implemented performance management system motivates and improves employee engagement. The purpose of this study is to examine the implementation of the performance management and development system and the challenges that are encountered during its implementation in the Eastern Cape Provincial Department of Health. Methods: A qualitative research approach and a case study design was adopted in this study. The primary data were collected through observations, focus group discussions with employees, a group interview with shop stewards, and in-depth interviews with supervisors and managers, from April 2019 to September 2019. There were 45 study participants. In-depth interviews were held with 10 managers at facility level, which included chief executive officer, chief medical officer, assistant director’s in human resources management, patient admin, operations, finance, and two area manager and two operation managers nursing. A group interview was conducted with five shop stewards and an in-depth interview with one shop steward from the group. Five focus group discussions were conducted with clinical and non-clinical staff. The focus group discussions were supplemented with an in-depth interview with one person from each group in order to counter the group effect. Observations included moderation committee, contracting, and assessment meetings. Findings: The study shows that the performance management and development system was not properly implemented. There was non-compliance to performance management and development system policy guidelines in terms of time lines for contracting, evaluation, payment of incentives to good performers, and management of poor performance. The study revealed that the system is ineffective in raising the performance of employees and unable to assist employees to grow. The performance bonuses were no longer paid to qualifying employees. The study also revealed that lack of capacity and commitment, poor communication, constant policy changes, financial constraints, weak and highly bureaucratic management structures, union interference were challenges that were encountered during the implementation of the performance management and development system. Lastly, employees and supervisors were rating themselves three irrespective of how well or bad they performed. Conclusion: Performance management is regarded as vital to improved performance of the health workforce and healthcare service delivery among populations. Effective implementation of performance management and development system depends on well-capacitated and unbiased management at facility levels. Therefore, there is an urgent need to improve communication, link performance management to rewards, and capacitate staff on performance management and development system, as it is key to improved public health sector outcomes or performance.Keywords: challenges, implementation, performance management and development system, public hospital
Procedia PDF Downloads 1351004 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit
Authors: Gokulan Vethanayakam, Daniel Aston
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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation
Procedia PDF Downloads 661003 A Measurement Instrument to Determine Curricula Competency of Licensure Track Graduate Psychotherapy Programs in the United States
Authors: Laith F. Gulli, Nicole M. Mallory
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We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.Keywords: addiction, competency, curriculum, psychotherapy
Procedia PDF Downloads 1511002 The Pioneering Model in Teaching Arabic as a Mother Tongue through Modern Innovative Strategies
Authors: Rima Abu Jaber Bransi, Rawya Jarjoura Burbara
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This study deals with two pioneering approaches in teaching Arabic as a mother tongue: first, computerization of literary and functional texts in the mother tongue; second, the pioneering model in teaching writing skills by computerization. The significance of the study lies in its treatment of a serious problem that is faced in the era of technology, which is the widening gap between the pupils and their mother tongue. The innovation in the study is that it introduces modern methods and tools and a pioneering instructional model that turns the process of mother tongue teaching into an effective, meaningful, interesting and motivating experience. In view of the Arabic language diglossia, standard Arabic and spoken Arabic, which constitutes a serious problem to the pupil in understanding unused words, and in order to bridge the gap between the pupils and their mother tongue, we resorted to computerized techniques; we took texts from the pre-Islamic period (Jahiliyya), starting with the Mu'allaqa of Imru' al-Qais and other selected functional texts and computerized them for teaching in an interesting way that saves time and effort, develops high thinking strategies, expands the literary good taste among the pupils, and gives the text added values that neither the book, the blackboard, the teacher nor the worksheets provide. On the other hand, we have developed a pioneering computerized model that aims to develop the pupil's ability to think, to provide his imagination with the elements of growth, invention and connection, and motivate him to be creative, and raise level of his scores and scholastic achievements. The model consists of four basic stages in teaching according to the following order: 1. The Preparatory stage, 2. The reading comprehension stage, 3. The writing stage, 4. The evaluation stage. Our lecture will introduce a detailed description of the model with illustrations and samples from the units that we built through highlighting some aspects of the uniqueness and innovation that are specific to this model and the different integrated tools and techniques that we developed. One of the most significant conclusions of this research is that teaching languages through the employment of new computerized strategies is very likely to get the Arabic speaking pupils out of the circle of passive reception into active and serious action and interaction. The study also emphasizes the argument that the computerized model of teaching can change the role of the pupil's mind from being a store of knowledge for a short time into a partner in producing knowledge and storing it in a coherent way that prevents its forgetfulness and keeping it in memory for a long period of time. Consequently, the learners also turn into partners in evaluation by expressing their views, giving their notes and observations, and application of the method of peer-teaching and learning.Keywords: classical poetry, computerization, diglossia, writing skill
Procedia PDF Downloads 2251001 Contamination by Heavy Metals of Some Environmental Objects in Adjacent Territories of Solid Waste Landfill
Authors: D. Kekelidze, G. Tsotadze, G. Maisuradze, L. Akhalbedashvili, M. Chkhaidze
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Statement of Problem: The problem of solid wastes -dangerous sources of environmental pollution,is the urgent issue for Georgia as there are no waste-treatment and waste- incineration plants. Urban peripheral and rural areas, frequently along small rivers, are occupied by landfills without any permission. The study of the pollution of some environmental objects in the adjacent territories of solid waste landfill in Tbilisi carried out in 2020-2021, within the framework of project: “Ecological monitoring of the landfills surrounding areas and population health risk assessment”. Research objects: This research had goal to assess the ecological state of environmental objects (soil cover and surface water) in the territories, adjacent of solid waste landfill, on the base of changes heavy metals' (HM) concentration with distance from landfill. An open sanitary landfill for solid domestic waste in Tbilisi locates at suburb Lilo surrounded with densely populated villages. Content of following HM was determined in soil and river water samples: Pb, Cd, Cu, Zn, Ni, Co, Mn. Methodology: The HM content in samples was measured, using flame atomic absorption spectrophotometry (spectrophotometer of firm Perkin-Elmer AAnalyst 200) in accordance with ISO 11466 and GOST Р 53218-2008. Results and discussion: Data obtained confirmed migration of HM mainly in terms of the distance from the polygon that can be explained by their areal emissions and storage in open state, they could also get into the soil cover under the influence of wind and precipitation. Concentration of Pb, Cd, Cu, Zn always increases with approaching to landfill. High concentrations of Pb, Cd are characteristic of the soil covers of the adjacent territories around the landfill at a distance of 250, 500 meters.They create a dangerous zone, since they can later migrate into plants, enter in rivers and lakes. The higher concentrations, compared to the maximum permissible concentrations (MPC) for surface waters of Georgia, are observed for Pb, Cd. One of the reasons for the low concentration of HM in river water may be high turbidity – as is known, suspended particles are good natural sorbents that causes low concentration of dissolved forms. Concentration of Cu, Ni, Mn increases in winter, since in this season the rivers are switched to groundwater feeding. Conclusion: Soil covers of the areas adjacent to the landfill in Lilo are contaminated with HM. High concentrations in soils are characteristic of lead and cadmium. Elevated concentrations in comparison with the MPC for surface waters adopted in Georgia are also observed for Pb, Cd at checkpoints along and below (1000 m) of the landfill downstream. Data obtained confirm migration of HM to the adjacent territories of the landfill and to the Lochini River. Since the migration and toxicity of metals depends also on the presence of their mobile forms in water bodies, samples of bottom sediments should be taken too. Bottom sediments reflect a long-term picture of pollution, they accumulate HM and represent a constant source of secondary pollution of water bodies. The study of the physicochemical forms of metals is one of the priority areas for further research.Keywords: landfill, pollution, heavy metals, migration
Procedia PDF Downloads 1011000 Refurbishment Methods to Enhance Energy Efficiency of Brick Veneer Residential Buildings in Victoria
Authors: Hamid Reza Tabatabaiefar, Bita Mansoury, Mohammad Javad Khadivi Zand
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The current energy and climate change impacts of the residential building sector in Australia are significant. Thus, the Australian Government has introduced more stringent regulations to improve building energy efficiency. In 2006, the Australian residential building sector consumed about 11% (around 440 Petajoule) of the total primary energy, resulting in total greenhouse gas emissions of 9.65 million tonnes CO2-eq. The gas and electricity consumption of residential dwellings contributed to 30% and 52% respectively, of the total primary energy utilised by this sector. Around 40 percent of total energy consumption of Australian buildings goes to heating and cooling due to the low thermal performance of the buildings. Thermal performance of buildings determines the amount of energy used for heating and cooling of the buildings which profoundly influences energy efficiency. Employing sustainable design principles and effective use of construction materials can play a crucial role in improving thermal performance of new and existing buildings. Even though awareness has been raised, the design phase of refurbishment projects is often problematic. One of the issues concerning the refurbishment of residential buildings is mostly the consumer market, where most work consists of moderate refurbishment jobs, often without assistance of an architect and partly without a building permit. There is an individual and often fragmental approach that results in lack of efficiency. Most importantly, the decisions taken in the early stages of the design determine the final result; however, the assessment of the environmental performance only happens at the end of the design process, as a reflection of the design outcome. Finally, studies have identified the lack of knowledge, experience and best-practice examples as barriers in refurbishment projects. In the context of sustainable development and the need to reduce energy demand, refurbishing the ageing residential building constitutes a necessary action. Not only it does provide huge potential for energy savings, but it is also economically and socially relevant. Although the advantages have been identified, the guidelines come in the form of general suggestions that fail to address the diversity of each project. As a result, it has been recognised that there is a strong need to develop guidelines for optimised retrofitting of existing residential buildings in order to improve their energy performance. The current study investigates the effectiveness of different energy retrofitting techniques and examines the impact of employing those methods on energy consumption of residential brick veneer buildings in Victoria (Australia). Proposing different remedial solutions for improving the energy performance of residential brick veneer buildings, in the simulation stage, annual energy usage analyses have been carried out to determine heating and cooling energy consumptions of the buildings for different proposed retrofitting techniques. Then, the results of employing different retrofitting methods have been examined and compared in order to identify the most efficient and cost-effective remedial solution for improving the energy performance of those buildings with respect to the climate condition in Victoria and construction materials of the studied benchmark building.Keywords: brick veneer residential buildings, building energy efficiency, climate change impacts, cost effective remedial solution, energy performance, sustainable design principles
Procedia PDF Downloads 291999 Polypyrrole as Bifunctional Materials for Advanced Li-S Batteries
Authors: Fang Li, Jiazhao Wang, Jianmin Ma
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The practical application of Li-S batteries is hampered due to poor cycling stability caused by electrolyte-dissolved lithium polysulfides. Dual functionalities such as strong chemical adsorption stability and high conductivity are highly desired for an ideal host material for a sulfur-based cathode. Polypyrrole (PPy), as a conductive polymer, was widely studied as matrixes for sulfur cathode due to its high conductivity and strong chemical interaction with soluble polysulfides. Thus, a novel cathode structure consisting of a free-standing sulfur-polypyrrole cathode and a polypyrrole coated separator was designed for flexible Li-S batteries. The PPy materials show strong interaction with dissoluble polysulfides, which could suppress the shuttle effect and improve the cycling stability. In addition, the synthesized PPy film with a rough surface acts as a current collector, which improves the adhesion of sulfur materials and restrain the volume expansion, enhancing the structural stability during the cycling process. For further enhancing the cycling stability, a PPy coated separator was also applied, which could make polysulfides into the cathode side to alleviate the shuttle effect. Moreover, the PPy layer coated on commercial separator is much lighter than other reported interlayers. A soft-packaged flexible Li-S battery has been designed and fabricated for testing the practical application of the designed cathode and separator, which could power a device consisting of 24 light-emitting diode (LED) lights. Moreover, the soft-packaged flexible battery can still show relatively stable cycling performance after repeated bending, indicating the potential application in flexible batteries. A novel vapor phase deposition method was also applied to prepare uniform polypyrrole layer coated sulfur/graphene aerogel composite. The polypyrrole layer simultaneously acts as host and adsorbent for efficient suppression of polysulfides dissolution through strong chemical interaction. The density functional theory (DFT) calculations reveal that the polypyrrole could trap lithium polysulfides through stronger bonding energy. In addition, the deflation of sulfur/graphene hydrogel during the vapor phase deposition process enhances the contact of sulfur with matrixes, resulting in high sulfur utilization and good rate capability. As a result, the synthesized polypyrrole coated sulfur/graphene aerogel composite delivers a specific discharge capacity of 1167 mAh g⁻¹ and 409.1 mAh g⁻¹ at 0.2 C and 5 C respectively. The capacity can maintain at 698 mAh g⁻¹ at 0.5 C after 500 cycles, showing an ultra-slow decay rate of 0.03% per cycle.Keywords: polypyrrole, strong chemical interaction, long-term stability, Li-S batteries
Procedia PDF Downloads 140998 Potential of Croatia as an Attractive Tourist Destination for the Russian Market
Authors: Maja Martinovic, Valentina Zarkovic, Hrvoje Maljak
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Europe is one of the most popular tourist destinations in the world, in which tourism occupies a significant place among the most relevant economic activities, and this applies to the Republic of Croatia as well. Based on this study, the authors intended to encourage and support the creation of an effective tourism policy in Croatia that would be based on the profiling of certain target groups. Another objective was to compare the results obtained from the customer analysis with the market analysis of the tourism industry in Croatia. The objective is to adapt the current tourist offer according to the identified needs and expectations of a particular tourist group in order to increase the attractiveness of Croatia as a tourist destination and motivate greater attendance of the targeted tourist groups. The current research was oriented towards the Russian market as the target group. Therefore, the authors wanted to encourage a discussion on how to attract more Russian guests. Consequently, the intention of the research was a detailed analysis of Russian tourists, in order to gain a better understanding of their travelling motives and tendencies. Furthermore, attention was paid to the expectations of Russian customers and to compare them with the Croatian tourist offer, and to determine whether there is a possibility for an overlap. The method used to obtain the information required was a survey conducted among Russian citizens about their travelling habits. The research was carried out on the basis of 166 participants of different age, gender, profession and income group. The sampling and distribution of the survey took place between May and July 2016. The results provided from the research indicate that Croatian tourism has certain unrealized potential considering the popularization of Croatia as a tourist destination, and there is a capacity for increasing the revenues within the group of Russian tourists. Such a conclusion is based on the fact that the Croatian tourist offer and the preferences of the Russian guests are compatible, i.e. they overlap in many aspects. The results demonstrate that beautiful nature, cultural and historical heritage as well as the sun and sea, play a leading role in attracting more Russian tourists. It is precisely these elements that form the three pillars of the Croatian tourist offer. On the other hand, the profiling revealed that the most desirable destinations for the Russian guests are Italy and Spain, both of which provide the same main tourist attractions as Croatia. Therefore, the focus of the strategic ideas given in the paper shifted to other tourism segments, such as type of accommodation, sales channels, travel motives, additional offer and seasonality etc., in order to gain advantage in the Russian market, the Mediterranean region and tourism in general. The purpose of the research is to serve as a foundation for analysing the attractiveness of the other tourist destinations in the Russian market, as well as to be a general basis for a more detailed profiling of the various specific target groups of the Russian and other tourist groups.Keywords: Croatia, Russian market, target groups, tourism, tourist destination
Procedia PDF Downloads 322997 Computational Homogenization of Thin Walled Structures: On the Influence of the Global vs Local Applied Plane Stress Condition
Authors: M. Beusink, E. W. C. Coenen
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The increased application of novel structural materials, such as high grade asphalt, concrete and laminated composites, has sparked the need for a better understanding of the often complex, non-linear mechanical behavior of such materials. The effective macroscopic mechanical response is generally dependent on the applied load path. Moreover, it is also significantly influenced by the microstructure of the material, e.g. embedded fibers, voids and/or grain morphology. At present, multiscale techniques are widely adopted to assess micro-macro interactions in a numerically efficient way. Computational homogenization techniques have been successfully applied over a wide range of engineering cases, e.g. cases involving first order and second order continua, thin shells and cohesive zone models. Most of these homogenization methods rely on Representative Volume Elements (RVE), which model the relevant microstructural details in a confined volume. Imposed through kinematical constraints or boundary conditions, a RVE can be subjected to a microscopic load sequence. This provides the RVE's effective stress-strain response, which can serve as constitutive input for macroscale analyses. Simultaneously, such a study of a RVE gives insight into fine scale phenomena such as microstructural damage and its evolution. It has been reported by several authors that the type of boundary conditions applied to the RVE affect the resulting homogenized stress-strain response. As a consequence, dedicated boundary conditions have been proposed to appropriately deal with this concern. For the specific case of a planar assumption for the analyzed structure, e.g. plane strain, axisymmetric or plane stress, this assumption needs to be addressed consistently in all considered scales. Although in many multiscale studies a planar condition has been employed, the related impact on the multiscale solution has not been explicitly investigated. This work therefore focuses on the influence of the planar assumption for multiscale modeling. In particular the plane stress case is highlighted, by proposing three different implementation strategies which are compatible with a first-order computational homogenization framework. The first method consists of applying classical plane stress theory at the microscale, whereas with the second method a generalized plane stress condition is assumed at the RVE level. For the third method, the plane stress condition is applied at the macroscale by requiring that the resulting macroscopic out-of-plane forces are equal to zero. These strategies are assessed through a numerical study of a thin walled structure and the resulting effective macroscale stress-strain response is compared. It is shown that there is a clear influence of the length scale at which the planar condition is applied.Keywords: first-order computational homogenization, planar analysis, multiscale, microstrucutures
Procedia PDF Downloads 233996 Selective Conversion of Biodiesel Derived Glycerol to 1,2-Propanediol over Highly Efficient γ-Al2O3 Supported Bimetallic Cu-Ni Catalyst
Authors: Smita Mondal, Dinesh Kumar Pandey, Prakash Biswas
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During past two decades, considerable attention has been given to the value addition of biodiesel derived glycerol (~10wt.%) to make the biodiesel industry economically viable. Among the various glycerol value-addition methods, hydrogenolysis of glycerol to 1,2-propanediol is one of the attractive and promising routes. In this study, highly active and selective γ-Al₂O₃ supported bimetallic Cu-Ni catalyst was developed for selective hydrogenolysis of glycerol to 1,2-propanediol in the liquid phase. The catalytic performance was evaluated in a high-pressure autoclave reactor. The formation of mixed oxide indicated the strong interaction of Cu, Ni with the alumina support. Experimental results demonstrated that bimetallic copper-nickel catalyst was more active and selective to 1,2-PDO as compared to monometallic catalysts due to bifunctional behavior. To verify the effect of calcination temperature on the formation of Cu-Ni mixed oxide phase, the calcination temperature of 20wt.% Cu:Ni(1:1)/Al₂O₃ catalyst was varied from 300°C-550°C. The physicochemical properties of the catalysts were characterized by various techniques such as specific surface area (BET), X-ray diffraction study (XRD), temperature programmed reduction (TPR), and temperature programmed desorption (TPD). The BET surface area and pore volume of the catalysts were in the range of 71-78 m²g⁻¹, and 0.12-0.15 cm³g⁻¹, respectively. The peaks at the 2θ range of 43.3°-45.5° and 50.4°-52°, was corresponded to the copper-nickel mixed oxidephase [JCPDS: 78-1602]. The formation of mixed oxide indicated the strong interaction of Cu, Ni with the alumina support. The crystallite size decreased with increasing the calcination temperature up to 450°C. Further, the crystallite size was increased due to agglomeration. Smaller crystallite size of 16.5 nm was obtained for the catalyst calcined at 400°C. Total acidic sites of the catalysts were determined by NH₃-TPD, and the maximum total acidic of 0.609 mmol NH₃ gcat⁻¹ was obtained over the catalyst calcined at 400°C. TPR data suggested the maximum of 75% degree of reduction of catalyst calcined at 400°C among all others. Further, 20wt.%Cu:Ni(1:1)/γ-Al₂O₃ catalyst calcined at 400°C exhibited highest catalytic activity ( > 70%) and 1,2-PDO selectivity ( > 85%) at mild reaction condition due to highest acidity, highest degree of reduction, smallest crystallite size. Further, the modified Power law kinetic model was developed to understand the true kinetic behaviour of hydrogenolysis of glycerol over 20wt.%Cu:Ni(1:1)/γ-Al₂O₃ catalyst. Rate equations obtained from the model was solved by ode23 using MATLAB coupled with Genetic Algorithm. Results demonstrated that the model predicted data were very well fitted with the experimental data. The activation energy of the formation of 1,2-PDO was found to be 45 kJ mol⁻¹.Keywords: glycerol, 1, 2-PDO, calcination, kinetic
Procedia PDF Downloads 147995 Classification of Coughing and Breathing Activities Using Wearable and a Light-Weight DL Model
Authors: Subham Ghosh, Arnab Nandi
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Background: The proliferation of Wireless Body Area Networks (WBAN) and Internet of Things (IoT) applications demonstrates the potential for continuous monitoring of physical changes in the body. These technologies are vital for health monitoring tasks, such as identifying coughing and breathing activities, which are necessary for disease diagnosis and management. Monitoring activities such as coughing and deep breathing can provide valuable insights into a variety of medical issues. Wearable radio-based antenna sensors, which are lightweight and easy to incorporate into clothing or portable goods, provide continuous monitoring. This mobility gives it a substantial advantage over stationary environmental sensors like as cameras and radar, which are constrained to certain places. Furthermore, using compressive techniques provides benefits such as reduced data transmission speeds and memory needs. These wearable sensors offer more advanced and diverse health monitoring capabilities. Methodology: This study analyzes the feasibility of using a semi-flexible antenna operating at 2.4 GHz (ISM band) and positioned around the neck and near the mouth to identify three activities: coughing, deep breathing, and idleness. Vector network analyzer (VNA) is used to collect time-varying complex reflection coefficient data from perturbed antenna nearfield. The reflection coefficient (S11) conveys nuanced information caused by simultaneous variations in the nearfield radiation of three activities across time. The signatures are sparsely represented with gaussian windowed Gabor spectrograms. The Gabor spectrogram is used as a sparse representation approach, which reassigns the ridges of the spectrogram images to improve their resolution and focus on essential components. The antenna is biocompatible in terms of specific absorption rate (SAR). The sparsely represented Gabor spectrogram pictures are fed into a lightweight deep learning (DL) model for feature extraction and classification. Two antenna locations are investigated in order to determine the most effective localization for three different activities. Findings: Cross-validation techniques were used on data from both locations. Due to the complex form of the recorded S11, separate analyzes and assessments were performed on the magnitude, phase, and their combination. The combination of magnitude and phase fared better than the separate analyses. Various sliding window sizes, ranging from 1 to 5 seconds, were tested to find the best window for activity classification. It was discovered that a neck-mounted design was effective at detecting the three unique behaviors.Keywords: activity recognition, antenna, deep-learning, time-frequency
Procedia PDF Downloads 9994 The Relationship between Osteoporosis-Related Knowledge and Physical Activity among Women Age over 50 Years
Authors: P. Tardi, B. Szilagyi, A. Makai, P. Acs, M. Hock, M. Jaromi
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Osteoporosis is becoming a major public health problem, particularly in postmenopausal women, as the incidence of this disease is getting higher. Nowadays, one of the most common chronic musculoskeletal diseases is osteoporosis. Osteoporosis-related knowledge is an important contributor to prevent or to treat osteoporosis. The most important strategies to prevent or treat the disease are increasing the level of physical activity at all ages, cessation of smoking, reduction of alcohol consumption, adequate dietary calcium, and vitamin D intake. The aim of the study was to measure the osteoporosis-related knowledge and physical activity among women age over 50 years. For the measurements, we used the osteoporosis questionnaire (OPQ) to examine the disease-specific knowledge and the global physical activity questionnaire (GPAQ) to measure the quantity and quality of the physical activity. The OPQ is a self-administered 20-item questionnaire with five categories: general information, risk factors, investigations, consequences, and treatment. There are four choices per question (one of them is the 'I do not know'). The filler gets +1 for a good answer, -1 point for a bad answer, and 0 for 'I do not know' answer. We contacted with 326 women (63.08 ± 9.36 year) to fill out the questionnaires. Descriptive analysis was carried out, and we calculated Spearman's correlation coefficient to examine the relationship between the variables. Data were entered into Microsoft Excel, and all statistical analyses were performed using SPSS (Version 24). The participants of the study (n=326) reached 8.76 ± 6.94 points on OPQ. Significant (p < 0.001) differences were found in the results of OPQ according to the highest level of education. It was observed that the score of the participants with osteoporosis (10.07 ± 6.82 points) was significantly (p=0.003) higher than participants without osteoporosis (9.38 ± 6.66 points) and the score of those women (6.49 ± 6.97 points) who did not know that osteoporosis exists in their case. The GPAQ results showed the sample physical activity in the dimensions of vigorous work (479.86 ± 684.02 min/week); moderate work (678.16 ± 804.5 min/week); travel (262.83 ± 380.27 min/week); vigorous recreation (77.71 ± 123.46 min/week); moderate recreation (115.15 ± 154.82 min/week) and total weekly physical activity (1645.99 ± 1432.88 min/week). Significant correlations were found between the osteoporosis-related knowledge and the physical activity in travel (R=0.21; p < 0.001), vigorous recreation (R=0.35; p < 0.001), moderate recreation (R=0.35; p < 0.001), total vigorous minutes/week (R=0.15; p=0.001) and total moderate minutes/week (R=0.13; p=0.04) dimensions. According to the results that were achieved, the highest level of education significantly determines osteoporosis-related knowledge. Physical activity is an important contributor to prevent or to treat osteoporosis, and it showed a significant correlation with osteoporosis-related knowledge. Based on the results, the development of osteoporosis-related knowledge may help to improve the level of physical activity, especially recreation. Acknowledgment: Supported by the ÚNKP-20-1 New National Excellence Program of The Ministry for Innovation and Technology from the Source of the National Research, Development and Innovation Fund.Keywords: osteoporosis, osteoporosis-related knowledge, physical activity, prevention
Procedia PDF Downloads 112993 Pharmacokinetic Assessment of Antimicrobial Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease in Hospitalized Patients Colonized with Pseudomonas aeruginosa
Authors: Juliette Begin, Juliano Colapelle, Andrea Taratanu, Daniel Thirion, Amelie Marsot, Bryan A. Ross
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Chronic obstructive pulmonary disease (COPD), a leading cause of death globally, is characterized by chronic airflow obstruction and acute exacerbations (AECOPDs) that are often triggered by respiratory infections. Pseudomonas aeruginosa (P. aeruginosa), a potentially serious bacterial cause of AECOPDs, is treated with targeted anti-pseudomonal antibiotics. These select few antimicrobials are often used as first-line therapy in patients who are clinically unwell and/or in those suspected of P. aeruginosa-related infection prior to confirmation, potentially contributing to antimicrobial resistance. The present study evaluates prescribing practices in patients with a confirmed sputum history of P. aeruginosa admitted for AECOPD at the McGill University Health Centre (MUHC) and treated with anti-pseudomonal antibiotics. Serum antibiotic concentrations were measured from the same-day peak, trough, and mid-dose blood sampling intervals after reaching steady-state (on or after day 3) and were quantified using ultra-high-performance liquid chromatography (UHPLC). Demographic, clinical, and treatment outcomes were extracted from patient medical charts. Treatment failure was defined by respiratory-related death or mechanical ventilation after ≥3 days of antibiotics; antibiotic therapy extended beyond 2 weeks or a new antibiotic regimen started; or urgent care readmission within 30 days for AECOPD. To date, 9 of 30 planned participants have completed testing: seven received ciprofloxacin, one received meropenem, and one received piperacillin-tazobactam. Due to serum sample batching requirements, the serum ciprofloxacin concentration results for the first 2/8 participants are presented at the time of writing. The first participant had serum levels of 5.45mg/L (T₀), 4.74mg/L (T₅₀), and 4.49mg/L (T₁₀₀), while the second had serum levels of 5mg/L (T₀), 2.6mg/L (T₅₀), and 2.51mg/L (T₁₀₀). Pharmacokinetic parameters Cmax (5.18±0.43mg/L), T₁/₂ (23.56±18.94hours), and AUC (181.9±155.95mg*h/l) were higher than reported monograph values and met target AUC-to-MIC ratio of >125. The patients treated with meropenem and with piperacillin-tazobactam experienced treatment failure. Preliminary results suggest that standard ciprofloxacin dosing in patients experiencing an AECOPD and colonized with P. aeruginosa appears to achieve effective serum concentrations. Final cohort results will inform the pharmacokinetic appropriateness and clinical sufficiency of current AECOPD antimicrobial strategies in P. aeruginosa-colonized patients. This study will guide clinicians in determining the appropriate dosing for AECOPD treatment to achieve therapeutic levels, optimizing outcomes, and minimizing adverse effects. It could also highlight the value of routine antibiotic level monitoring in patients with treatment failure to ensure optimal serum concentrations.Keywords: acute exacerbation, antimicrobial resistance, chronic obstructive pulmonary disease, pharmacokinetics/pharmacodynamics, Pseudomonas aeruginosa
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