Search results for: Edward Browell

Authors: Edward Nartey

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Although the boundaries of sustainable performance and growth in the field of service supply chains (SCs) have been broadened by scholars in recent years, research on the impact and promises of Industry 4.0 Destructive Technologies (IDTs) on sustainability performance under disruptive events is still scarce. To mitigate disruptions in the SC and improve efficiency by identifying areas for cost savings, organizations have resorted to investments in digitalization, automation, and control mechanisms in recent years. However, little is known about the sustainability implications for IDT adoption and controls in service SCs, especially during disruptive events. To investigate this paradox, survey data were sought from 223 public health managers across Ghana and analyzed via covariance-based structural equations modelling. The results showed that both formal and informal control have a positive and significant relationship with IDT adoption. In addition, formal control has a significant and positive relationship with environmental and economic sustainability but an insignificant relationship with social sustainability. Furthermore, informal control positively impacts economic performance but has an insignificant relationship with social and environmental sustainability. While the findings highlight the prevalence of the IDTs being initiated by Ghanaian public health institutions (PHIs), this study concludes that the installed control systems in these organizations are inadequate for promoting sustainable SC behaviors under destructive events. Thus, in crisis situations, PHIs need to redesign their control systems to facilitate IDT integration towards sustainability issues in SCs.

Keywords: industry 4.0 destructive technologies, formal control, informal control, sustainable supply chain performance, public health organizations

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Authors: Angel Mauricio Castillo

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The background to the way theatrical performances and music dramas- as they were known in the mid-nineteenth century, provided the audience with a complete immersion into the feelings of the characters through poetry, music and other artistic representations which create a false sense of reality. However, a novel representation on stage some eighty years later, which is non-cathartic, is significant because it represents the antithesis to the common creations of the period and is originated by the separation of the elements as a dominant. A succinct description of the basic methodologies includes the sense of defamiliarization that results as a near translation of the German word Verfremdung will be referred to along this work as the V-effect (also known as the ‘alienation effect’) and will embody the representation of the performing techniques that enables the audience to watch a play being fully aware of its nature. A play might sometimes present the audience with a constant reminder that it is only a play; therefore, all elements will be introduced to provoke dissimilar reactions and opinions. A clear indication of the major findings of the study is that there is a strong correlation between Hegel, Marx and Brecht as it is disclosed how the didactics of Literature have been influencing not only Brecht’s productions but also every educational context in which these ideas are intertwined. The result is a new dialectical process that is to say, a new thesis that creates independent thinking skills on the part of the audience. Therefore, this model opposes to the Hegelian formula thesis-antithesis-synthesis in that the synthesis in the Brechtian theatre will inevitably fall into the category of a different thesis within an enlightening type of discourse. The confronting ideas of illusion versus reality will create a new dialectical thesis instead of resulting into a synthesis.

Keywords: Brechtian theatre, didactics, literature, education

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Authors: Kelebaone Tsamaase, Rapelang Kemoabe, Japhet Sakala, Edward Rakgati, Ishmael Zibani

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Increasing demand for energy, depletion of non-renewable energy, effects of climate change, the abundance of renewable energy such as solar energy have increased the interest in investing in renewable energies, in particular solar photovoltaic (PV) energy. Solar photovoltaic energy systems as part of clean technology are considered to be environmentally friendly, freely available, offer clean production systems, long term costs benefits as opposed to conventional sources, and are the attractive power source for a wide range of applications in remote areas where there is no easy access to the national grid. To get maximum electrical power, maximum solar power should penetrate the module and be converted accordingly. However, some environmental and other geographical related factors reduce the electrical power. One of them is dust which accumulates on the surface of the module and forming a dust layer and in the process obstructing the solar power from penetrating PV module. This study intends to improve the performance of solar photovoltaic (PV) energy modules by establishing soil accumulation effects correction factor from dust characteristics and properties, and also from dust accumulation and retention pattern on PV module surface. The non-urban dry deposition flux model was adapted to determine monthly and yearly dust accumulation pattern. Consideration was done on prevailing environmental and other geographical conditions. Preliminary results showed that cumulative dust settlement increased during the months of July to October leading to a higher drop in module electrical output power.

Keywords: dust, electrical power output, PV module, soil correction factor

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Authors: Margaret S. Gumisiriza, Ernest. R. Mbega, Patrick Ndakidemi, Businge K. Edward

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The purpose of the paper was to assess existing literature regarding hydroponics in both the developing and developed countries. Furthermore, relate it to the context of African countries, how they can implement it and benefit from it in the face of climate change, high population growth rates, and reduced food production. Agriculture remains the major economic activity for a number of African countries. It is the source of income for most peasants, and still contributes to the Gross Domestic Product in most of these African countries. Unfortunately, climate change coupled with the increasing rates of population growth; rural-urban migration; and urbanization have led to food insecurity due to a reduction of available land for agriculture. This has further intensified the food security dilemma in Africa, especially in urban areas, where land is already limited. Considering the aforementioned state of affairs, there is an increasing demand for interventions that can help farmers in Africa to cope with climate change and increase food production. This review explores hydroponic farming and how it can be used as a climate-smart farming system in Africa’s rural and urban areas. Specifically, the review focuses on hydroponics, requirements for hydroponic farming and the state of hydroponic farming in LDCs and Developed countries (DCs). From the review, it was observed that African countries especially those that receive a lot of sunlight would highly benefit from the solar-powered hydroponic farming systems. Further, still, this farming system will help African countries cope with the challenges of high population pressure in urban areas and climate change as it qualifies to be an urban farming system.

Keywords: Africa, climate-smart agriculture, solar-powered-hydroponics, urban-farming

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Authors: Gemma Postil, Claire Zanin, Michael Halpin, Caroline Ritter

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Illness experience research typically focuses on people that are living with a medical condition; however, the broad consequences of the COVID-19 pandemic are impacting those without the virus itself, as many experienced extensive lockdowns, social isolation, and distress. Drawing on conceptual work in the illness experience literature, we argue that policy and social changes tied to COVID-19 produce biographical disruptions. In this sense, we argue that the COVID-19 pandemic produces illness experience without illness, as the pandemic comprehensively impacts health and biography. This paper draws on 30 in-depth interviews with young adults living in Prince Edward Island (PEI), which were conducted as part of a larger project to understand how young adults navigate compliance with the COVID-19 pandemic. We then inductively analyzed the interviews with a constructivist grounded theory approach. Specifically, we demonstrate that young adults living in PEI during the COVID-19 pandemic experienced biographical disruptions throughout the pandemic despite not contracting the virus. First, we detail how some participants experience biographical acceleration, with the pandemic accelerating relationships, home buying, and career planning. Second, we demonstrate biographical stagnation, wherein participants report being unable to pursue major life milestones. Lastly, we describe biographical regression, wherein participants feel they are losing ground during the pandemic and are actively falling behind their peers. These findings provide the novel application of illness experience concepts to the context of the COVID-19 pandemic, contribute to work on illness experience and ambiguity, and extend Bury’s conceptualization of biographical disruption. In conclusion, we demonstrate that young adults experienced the biographical disruption expected from having COVID-19 without having an illness, highlighting the depth to which the pandemic affected young adults.

Keywords: illness experience, lived experience, biographical disruption, COVID-19, young adults

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Authors: Amrashaa Singh

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In the digital age and the large cyberspace, Data Protection and Privacy have become major issues in this technological era. There was a time when social media and online shopping websites were treated as a blessing for the people. But now the tables have turned, and the people have started to look at them with suspicion. They are getting aware of the privacy implications, and they do not feel as safe as they used to initially. When Edward Snowden informed the world about the snooping United States Security Agencies had been doing, that is when the picture became clear for the people. After the Cambridge Analytica case where the data of Facebook users were stored without their consent, the doubts arose in the minds of people about how safe they actually are. In India, the case of spyware Pegasus also raised a lot of concerns. It was used to snoop on a lot of human right activists and lawyers and the company which invented the spyware claims that it only sells it to the government. The paper will be dealing with the privacy concerns in the Indian perspective with an analytical methodology. The Supreme Court here had recently declared a right to privacy a Fundamental Right under Article 21 of the Constitution of India. Further, the Government is also working on the Data Protection Bill. The point to note is that India is still a developing country, and with the bill, the government aims at data localization. But there are doubts in the minds of many people that the Government would actually be snooping on the data of the individuals. It looks more like an attempt to curb dissenters ‘lawfully’. The focus of the paper would be on these issues in India in light of the European Union (EU) General Data Protection Regulation (GDPR). The Indian Data Protection Bill is also said to be loosely based on EU GDPR. But how helpful would these laws actually be is another concern since the economic and social conditions in both countries are very different? The paper aims at discussing these concerns, how good or bad is the intention of the government behind the bill, and how the nations can act together and draft common regulations so that there is some uniformity in the laws and their application.

Keywords: Article 21, data protection, dissent, fundamental right, India, privacy

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Authors: Edward Poluyi, Eghosa Morgan, Charles Poluyi, Chibuikem Ikwuegbuenyi, Grace Imaguezegie

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Background: Current epidemiological studies have examined the associations between moderate and severe traumatic brain injury (TBI) and their risks of developing neurodegenerative diseases. Concussion, also known as mild TBI (mTBI), is however quite distinct from moderate or severe TBIs. Only few studies in this burgeoning area have examined concussion—especially repetitive episodes—and neurodegenerative diseases. Thus, no definite relationship has been established between them. Objectives : This review will discuss the available literature linking concussion and amyotrophic lateral sclerosis (ALS) and Alzheimer’s disease (AD). Materials and Methods: Given the complexity of this subject, a realistic review methodology was selected which includes clarifying the scope and developing a theoretical framework, developing a search strategy, selection and appraisal, data extraction, and synthesis. A detailed literature matrix was set out in order to get relevant and recent findings on this topic. Results: Presently, there is no objective clinical test for the diagnosis of concussion because the features are less obvious on physical examination. Absence of an objective test in diagnosing concussion sometimes leads to skepticism when confirming the presence or absence of concussion. Intriguingly, several possible explanations have been proposed in the pathological mechanisms that lead to the development of some neurodegenerative disorders (such as ALS and AD) and concussion but the two major events are deposition of tau proteins (abnormal microtubule proteins) and neuroinflammation, which ranges from glutamate excitotoxicity pathways and inflammatory pathways (which leads to a rise in the metabolic demands of microglia cells and neurons), to mitochondrial function via the oxidative pathways.

Keywords: amyotrophic lateral sclerosis, Alzheimer's disease, mild traumatic brain injury, neurodegeneration

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Authors: Nayak Amar, Turner Naomi, Gobina Edward

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The Scottish Higher Education Institutes must report their scope 1 & 2 emissions, whereas reporting scope 3 is optional. Scope 3 is indirect emissions which embodies a significant component of total carbon footprint and therefore it is important to record, measure and report it accurately. Robert Gordon University (RGU) reported only business travel, grid transmission and distribution, water supply and transport, and recycling scope 3 emissions. This study estimates the RGUs total scope 3 emissions by comparing it with a similar HEI in scale. The scope 3 emission reporting of sixteen Scottish HEI was studied. Glasgow Caledonian University was identified as the nearest neighbour by comparing its students' full time equivalent, staff full time equivalent, research-teaching split, budget, and foundation year. Apart from the peer, data was also collected from the Higher Education Statistics Agency database. RGU reported emissions from business travel, grid transmission and distribution, water supply, and transport and recycling. This study estimated RGUs scope 3 emissions from procurement, student-staff commute, and international student trip. The result showed that RGU covered only 11% of the scope 3 emissions. The major contributor to scope 3 emissions were procurement (48%), student commute (21%), international student trip (16%), and staff commute (4%). The estimated scope 3 emission was more than 14 times the reported emissions. This study has shown the relative importance of each scope 3 emissions source, which gives a guideline for the HEIs, on where to focus their attention to capture maximum scope 3 emissions. Moreover, it has demonstrated that it is possible to estimate the scope 3 emissions with limited data.

Keywords: HEI, university, emission calculations, scope 3 emissions, emissions reporting

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Authors: Madeleine Gadd, Rose How, Edward Mathews, John Buchanan, Vicky Cottrell, Andre Coetzee, Karuna Katti

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Introduction: Triphallia, a congenital anomaly describing the presence of three distinct penile shafts, has been reported only once in the literature. This case report describes the serendipitous discovery of the first reported human case of partial orthotopic triphallia during cadaveric dissection. Case Summary: Despite the normal appearance of external genitalia on examination, the dissection of a 78-year-old male revealed a remarkable anatomical variation: two small supernumerary penises situated in a transverse orientation postero inferiorly to the primary penis. The main and the larger supernumerary penile shafts displayed their own corpora cavernosa and glans penis, sharing a single urethra, which coursed through the secondary penis prior to its passage through the primary penis. The smallest of the supernumerary penises was similar in dimension to the secondary penis, at 3.7cm long and 1.2cm wide (compared to the secondary penis at 3.8cm long and 1.3cm wide). However, it lacked a urethra and a typical arrangement of the corpora cavernosa and spongiosum, making this a case of partial triphallia rather than true triphallia. Conclusion: This case report provides a comprehensive anatomical description of partial triphallia in a cadaver, shedding light on the morphology, embryology, and clinical implications of this anomaly. This case report underscores the importance of meticulous anatomical dissections, particularly since, without dissection, this anatomical variation would have remained undiscovered. Although we can only speculate the functional implications of this condition, understanding such anatomical variations contributes to both knowledge of human anatomy and clinical management, should the condition be encountered in living individuals.

Keywords: triphallia, diphallia, congenital abnormalities, genitourinary abnormalities, urology

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Authors: Hammache Nadir

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The scientific study of human learning and memory is now more than 125 years old. Psychologists have conducted thousands of experiments, correlational analyses, and field studies during this time, in addition to other research conducted by those from neighboring fields. A huge knowledge base has been carefully built up over the decades. Given this backdrop, we may ask ourselves: What great changes in education have resulted from this huge research base? How has the scientific study of learning and memory changed practices in education from those of, say, a century ago? Have we succeeded in building a translational educational science to rival medical science (in which biological knowledge is translated into medical practice) or types of engineering (in which, e.g., basic knowledge in chemistry is translated into products through chemical engineering)? The answer, I am afraid, is rather mixed. Psychologists and psychological research have influenced educational practice, but in fits and starts. After all, some of the great founders of American psychology—William James, Edward L. Thorndike, John Dewey, and others—are also revered as important figures in the history of education. And some psychological research and ideas have made their way into education—for instance, computer-based cognitive tutors for some specific topics have been developed in recent years—and in years past, such practices as teaching machines, programmed learning, and, in higher education, the Keller Plan were all important. These older practices have not been sustained. Was that because they failed or because of a lack of systematic research showing they were effective? At any rate, in 2012, we cannot point to a well-developed translational educational science in which research about learning and memory, thinking and reasoning, and related topics is moved from the lab into controlled field trials (like clinical trials in medicine) and the tested techniques, if they succeed, are introduced into broad educational practice. We are just not there yet, and one question that arises is how we could achieve a translational educational science.

Keywords: affective, education, cognition, pshychology

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Authors: Lidia Kowalska, Edward Arseniuk

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Glume and leaf blotch is a disease of wheat caused by necrotrophic fungus Parastagonospora nodorum. It is a serious pathogen in many wheat-growing areas throughout the world. Use of resistant cultivars is the most effective and economical means to control the above-mentioned disease. Plant breeders and pathologists have worked intensively to incorporate resistance to the pathogen in new cultivars. Conventional methods of breeding for resistance can be supported by using the biotechnological ones, i.e., somatic embryogenesis and androgenesis. Therefore, an effort was undertaken to compare genetic variation in P. nodorum resistance among winter wheat somaclones, dihaploids and conventional varieties. For the purpose, a population of 16 somaclonal and 4 dihaploid wheat lines from six crosses were used to assess their resistance to P. nodorum under field conditions. Lines were grown in disease-free (fungicide protected) and inoculated micro plots in 2 replications of a split-plot design in a single environment. The plant leaves were inoculated with a mixture of P. nodorum isolates three times. Spore concentrations were adjusted to 4 x 10⁶ of viable spores per one milliliter. The disease severity was rated on a scale, where > 90% – susceptible, < 10% - resistant. Disease ratings of plant leaves showed statistically significant differences among all lines tested. Higher resistance to P. nodorum was observed more often on leaves of somaclonal lines than on dihaploid ones. On average, disease, severity reached 15% on leaves of somaclones and 30% on leaves of dihaploids. Some of the genotypes were showing low leaf infection, e.g. dihaploid D-33 (disease severity 4%) and a somaclone S-1 (disease severity 2%). The results from this study prove that dihaploid and somaclonal variation might be successfully used as an additional source of wheat resistance to the pathogen and it could be recommended to use in commercial breeding programs. The reported results prove that biotechnological methods may effectively be used in breeding for disease resistance of wheat to fungal necrotrophic pathogens.

Keywords: glume and leaf blotch, somaclonal, androgenic variation, wheat, resistance breeding

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Authors: Ameer A. Jebur, William Atherton, Rafid M. Alkhaddar, Edward Loffill

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Superstructures like offshore platforms, tall buildings, transition towers, skyscrapers and bridges are normally designed to resist compression, uplift and lateral forces from wind waves, negative skin friction, ship impact and other applied loads. Better understanding and the precise simulation of the response of batter piles under the action of independent uplift loads is a vital topic and an area of active research in the field of geotechnical engineering. This paper investigates the use of finite element code (FEC) to examine the behaviour of model batter piles penetrated in dense sand, subjected to pull-out pressure by means of numerical modelling. The concept of the Winkler Model (beam on elastic foundation) has been used in which the interaction between the pile embedded depth and adjacent soil in the bearing zone is simulated by nonlinear p-y curves. The analysis was conducted on different pile slenderness ratios (lc⁄d) ranging from 7.5, 15.22 and 30 respectively. In addition, the optimum batter angle for a model steel pile penetrated in dense sand has been chosen to be 20° as this is the best angle for this simulation as demonstrated by other researcher published in literature. In this numerical analysis, the soil response is idealized as elasto-plastic and the model piles are described as elastic materials for the purpose of simulation. The results revealed that the applied loads affect the pullout pile capacity as well as the lateral pile response for dense sand together with varying shear strength parameters linked to the pile critical depth. Furthermore, the pile pull-out capacity increases with increasing the pile aspect ratios.

Keywords: slenderness ratio, soil-pile interaction, winkler model (beam on elastic foundation), pull-out capacity

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Authors: Amriana Hifizah, Philip Edward Vercoe, Graeme Bruce Martin, Teuku Reza Ferasy, Muhammad Hambal

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Many native forage plant species have been used in Indonesia as feed for ruminants. However, less information is available about how these plants affect productivity, let alone methane emissions. In the province of Aceh, where the traditional practice is to feed local forages to small ruminants, the farmers are not satisfied with the productivity of their livestock, and they attribute this problem to poor availability and too few options for good quality forages. Forage quality is reduced by high environmental temperatures which increase the amount of lignification. In addition to reducing productivity, these factors also increase enteric methane production. A preliminary survey about potential forage species was completed in three different districts, two of low elevation and one of high elevation: Syiah Kuala (05°30’5.08” N to 095°24’7.35” E), elevation 29 m MSL; Kajhu (05°32’34.6” N to 095°21’17.7” E), elevation 30 m MSL; Lembah Seulawah (05°28'06.4" N to 095°43' 14.2" E), elevation 254 m MSL. Information about local plants was collected in a semi-structured interview with scientists, government field officers and local farmers, in the city of Banda Aceh and in those three districts. The outcome was a list 40 species that could be useful, of which 21 were selected for further study. The selection process was based on several criteria: high availability, high protein content, low toxicity, and evidence of secondary metabolites (eg, history of medicinal plants for both human and animals). For some of the selected medicinal plants, there is experimental evidence of effects on methane production during rumen fermentation. Subsequently, the selected forages were tested for their effects on rumen fermentation in vitro, using batch culture. The data produced will be used to identify forages with the potential to reduce CH4 emissions. These candidates will then be assessed for their benefits (fermentability and productivity) and potential deleterious side-effects.

Keywords: batch culture, forage, methane, rumen

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Authors: Edward Holupka, John Rossman, Tye Morancy, Joseph Aronovitz, Irving Kaplan

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A common modality for the treatment of early stage prostate cancer is the implantation of radioactive seeds directly into the prostate. The radioactive seeds are positioned inside the prostate to achieve optimal radiation dose coverage to the prostate. These radioactive seeds are positioned inside the prostate using Transrectal ultrasound imaging. Once all of the planned seeds have been implanted, two dimensional transaxial transrectal ultrasound images separated by 2 mm are obtained through out the prostate, beginning at the base of the prostate up to and including the apex. A common deep neural network, called DetectNet was trained to automatically determine the position of the implanted radioactive seeds within the prostate under ultrasound imaging. The results of the training using 950 training ultrasound images and 90 validation ultrasound images. The commonly used metrics for successful training were used to evaluate the efficacy and accuracy of the trained deep neural network and resulted in an loss_bbox (train) = 0.00, loss_coverage (train) = 1.89e-8, loss_bbox (validation) = 11.84, loss_coverage (validation) = 9.70, mAP (validation) = 66.87%, precision (validation) = 81.07%, and a recall (validation) = 82.29%, where train and validation refers to the training image set and validation refers to the validation training set. On the hardware platform used, the training expended 12.8 seconds per epoch. The network was trained for over 10,000 epochs. In addition, the seed locations as determined by the Deep Neural Network were compared to the seed locations as determined by a commercial software based on a one to three months after implant CT. The Deep Learning approach was within \strikeout off\uuline off\uwave off2.29\uuline default\uwave default mm of the seed locations determined by the commercial software. The Deep Learning approach to the determination of radioactive seed locations is robust, accurate, and fast and well within spatial agreement with the gold standard of CT determined seed coordinates.

Keywords: prostate, deep neural network, seed implant, ultrasound

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Authors: Ayobami Kehinde

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The literary representations of the family, tradition and change in African literature offer an immense, and as yet little theorised area of literary scholarship. Therefore, this paper explores the nexus among the family, tradition and change in five purposively selected post-colonial African fiction: Chimamanda Adichie’s Purple Hibiscus, Wale Okediran’s Tenants of the House, J. M. Coetzee’s In the Heart of the Country, Tsitsi Dangrembga’s Nervous Condition and Meja Mwangi’s Striving for the Wind. The methodology centres on analysing, questioning, undermining and celebrating the family and its contemporary vicissitudes as depicted in the texts. This is with a view to exploring the postcolonial novel with references to concepts developed by major theorists in the field of postcolonial studies, including Frantz Fanon, Edward Said, Gayatri Spivak, Homi Bhabha, Kwame Appiah and Achille Mbembe. It is revealed that in spite of the fact that the family is a vital institution, the primary social unit in any community, an agent of acculturation and the first focus of development, independence and growth, the texts reflect a diversity of problems confronting the family unit in Africa. These include the multiple problems of disrupted family lives, enforced family separation, political and personal violence with the domestic environment. It is concluded that the post-colonial African novel is a quintessential weapon to analyse the continent, opening up to the reader the specific expressions and experiences of human lives and their wider contexts. Therefore, the post-colonial African novel is a primary socio-cultural indicator representing an immense variety of lived realities in the continent. The study, therefore, suggests a concerted concern with the preservation of traditional family structures and other related aspects, such as cultural values, spirituality, gender roles and mutual trust.

Keywords: family, African fiction, postcolonialism, African tradition, domestic dissonance

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Authors: Eveline Muika Kabongo, Peter Delobelle, Ferdinand Mukumbang, Edward Nicol

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Introduction: Studies have been conducted to establish the effect of the MomConnect program in South Africa, but these studies did not focus on the stakeholders' and implementers' perspectives and the underlying program theory of the MomConnect initiative program. We strived to obtain stakeholders’ perspectives and assumptions on the MomConnect program and develop an initial program theory (IPT) of how the MomConnect initiative was expected to work. Methods: A realist-informed explanatory design used. The interviewer was performed with 10 key informants selected purposively among MomConnect key informants at the a national level of NDoH South Africa. The interview was done via zoom and lasted for 30 to 60 minutes. Introduction and abduction inferencing approaches were applied. The deductive and inductive approaches were performed during the analysis. ICAMO hereustic framework was used to analysed the data in order to get key informants expectations on how the MomConnect will work or not. Results: We developed three folk’s theories illustrating how the key informants’ expected the MomConnect to work. These theories showed that the MomConnect intended to provide users with health information and education that will empower and motivate them with knowledge which will allow the improvement of health services delivery among HCPs and improvement of the uptake of MCH services among pregnant women and mothers and decrease the rate of maternal and child mortality in the country. The lack of an updated mechanism to link women to the outcome was an issue. Another problem enlightened was the introduction of the WhatsApp program instead of SMS messaging, which was free of charge to women. Conclusion: The Folk’s theory developed from this study provided an insight into how the MomConnect was expected to work and what did not work. The folk’s theory will be merged with information from candidate theories on synthesis review and document review to develop our initial program theory of the MomConnect initiative.

Keywords: mHealth, MomConnect program, realist evaluation, maternal and child health, maternal and child health services, introduction, theory-driven

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Authors: Chikwelu Edward Emenike, Ogbuagu Uchenna Fredrick

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About 34% of the solar radiant energy reaching the earth is immediately reflected back to space as incoming radiation by clouds, chemicals, dust in the atmosphere and by the earth’s surface. Most of the remaining 66% warms the atmosphere and land. Most of the incoming solar radiation not reflect away is degraded into low-quality heat and flows into space. The rate at which this energy returns to space as low-quality heat is affected by the presence of molecules of greenhouse gases. Gaseous emission was measured with the aid of Growen gas Analyzer with a digital readout. Total measurements of eight parameters of twelve selected sample locations taken at two different seasons within two months were made. The ambient air quality investigation in Anambra State has shown the overall mean concentrations of gaseous emission at twelve (12) locations. The mean gaseous emissions showed (NO2=0.66ppm, SO2=0.30ppm, CO=43.93ppm, H2S=2.17ppm, CH4=1.27ppm, CFC=1.59ppb, CO2=316.33ppm, N2O=302.67ppb and O3=0.37ppm). These values do not conform to the National Ambient Air Quality Standard (NAAQS) and thus contribute significantly to the global warming. Because some of these gaseous emissions (SO2, NO2) are oxidizing agents, they act as irritants that damage delicate tissues in the eyes and respiratory passages. These can impair lung function and trigger cardiovascular problems as the heart tries to compensate for lack of Oxygen by pumping faster and harder. The major sources of air pollution are transportation, industrial processes, stationary fuel combustion and solid waste disposal, thus much is yet to be done in a developing country like Nigeria. Air pollution control using pollution-control equipment to reduce the major conventional pollutants, relocating people who live very close to dumpsites, processing and treatment of gases to produce electricity, heat, fuel and various chemical components should be encouraged.

Keywords: ambient air, atmosphere, greenhouse gases, anambra state

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Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni

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Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.

Keywords: prep, uptake, continuation, AGYW

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Authors: Louk Aourelien Andrianos, Edward Dommen, Athena Peralta

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Greed, as epitomized by overconsumption of natural resources, is at the root of ecological destruction and unsustainability of modern societies. Presently economies rely on unrestricted structural greed which fuels unlimited economic growth, overconsumption, and individualistic competitive behavior. Structural greed undermines the life support system on earth and threatens ecological integrity, social justice and peace. The World Council of Churches (WCC) has developed a program on ecological and economic justice (EEJ) with the aim to promote an economy of life where the economy is embedded in society and society in ecology. This paper aims at analyzing and assessing the economy of life (EcoLife) by offering an empirical tool to measure and monitor the root causes and effects of unsustainability resulting from human greed on global, national, institutional and individual levels. This holistic approach is based on the integrity of ecology and economy in a society founded on justice. The paper will discuss critical questions such as ‘what is an economy of life’ and ‘how to measure and control it from the effect of greed’. A model called GLIMS, which stands for Greed Lines and Indices Measurement System is used to clarify the concept of greed and help measuring the economy of life index by fuzzy logic reasoning. The inputs of the model are from statistical indicators of natural resources consumption, financial realities, economic performance, social welfare and ethical and political facts. The outputs are concrete measures of three primary indices of ecological, economic and socio-political greed (ECOL-GI, ECON-GI, SOCI-GI) and one overall multidimensional economy of life index (EcoLife-I). EcoLife measurement aims to build awareness of an economy life and to address the effects of greed in systemic and structural aspects. It is a tool for ethical diagnosis and policy making.

Keywords: greed line, sustainability indicators, fuzzy logic, eco-justice, World Council of Churches (WCC)

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Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

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PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

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Authors: Edward A. Osifodunrin, Jose Manuel Dias Lopes

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In Nigeria, enormous efforts/resources had, over the years, been expended on promoting financial inclusion (FI); however, it is seemingly discouraging that many of its self-declared targets on FI remained unachieved, especially amongst the Rural Dwellers and Actors in the Informal Sectors (RDAIS). Expectedly, many reasons had been earmarked for these failures: low literacy level, huge informal/rural sectors, etc. This study posits that in spite of these truly-debilitating factors, these FI policy failures could have been avoided or mitigated if the principles of active and better-managed citizens’ participation had been strictly followed in the (re)design/implementation of its FI policies. In other words, in a bid to mitigate the prevalent FE in Nigeria, this study hypothesizes the positive impact of increased/active citizens’ participation on FI outcome(s), backed by a preliminary empirical validation. Also, the study introduces the RDAIS-focused participatory financial inclusion policy (PFIP) as a major FI policy regeneration/improvement tool. The three categories of respondents that served as research subjects are FI experts in Nigeria (n = 72), RDAIS from the very rural/remote village of Unguwar Dogo in Northern Nigeria (n = 43), and RDAIS from another rural village of Sekere (n = 56) in the Southern region of Nigeria. Using survey design (5-point Likert scale questionnaires), random/stratified sampling, and descriptive/inferential statistics, the study often recorded independent consensus (amongst these three categories of respondents) that RDAIS’s active participation in iterative FI policy initiation, (re)design, implementation, (re)evaluation could indeed give improved FI outcomes. However, some questionnaire items also recorded divergent opinions and various statistically significant differences in the mean scores of these three categories. The PFIP (or any customized version of it) should then be carefully integrated into the NFIS of Nigeria (and possibly in the NFIS of other developing countries) to truly/fully provide FI policy integration for these excluded RDAIS and arrest the prevalence of FE.

Keywords: citizens’ participation, development, financial inclusion, formal financial services, national financial inclusion strategy, participatory financial inclusion policy, rural dwellers and actors in the informal sectors

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Authors: Mike T. Wei, Douglas N. Mintz, Lisa A. Mandl, Arielle W. Fein, Jayme C. Burket, Yuo-Yu Lee, Wei-Ti Huang, Vivian P. Bykerk, Mark P. Figgie, Edward F. Di Carlo, Bruce N. Cronstein, Susan M. Goodman

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Background/Purpose: Rheumatoid arthritis (RA) patients have excellent total hip arthroplasty (THA) survival, and methotrexate (MTX), an anti-inflammatory disease modifying drug which may affect bone reabsorption, may play a role. The purpose of this study is to determine the diagnosis leading to revision THA (rTHA) in RA patients and to assess the association of radiographic lucency with MTX use. Methods: All patients with validated diagnosis of RA in the institution’s THA registry undergoing rTHA from May 2007 - February 2011 were eligible. Diagnosis leading to rTHA and medication use was determined by chart review. Osteolysis was evaluated on available radiographs by measuring maximum lucency in each Gruen zone. Differences within RA patients with/without MTX in osteolysis, demographics, and medications were assessed with chi-squared, Fisher's exact tests or Mann-Whitney U tests as appropriate. The error rate for multiple comparisons of lucency in the different Gruen zones was corrected via false discovery rate methods. A secondary analysis was performed to determine differences in diagnoses leading to revision between RA and matched OA controls (2:1 match by sex age +/- 5 years). OA exclusion criteria included presence of rheumatic diseases, use of MTX, and lack of records. Results: 51 RA rTHA were identified and compared with 103 OA. Mean age for RA was 57.7 v 59.4 years for OA (p = 0.240). 82.4% RA were female v 83.5% OA (p = 0.859). RA had lower BMI than OA (25.5 v 28.2; p = 0.166). There was no difference in diagnosis leading to rTHA, including infection (RA 3.9 v OA 6.8%; p = 0.719) or dislocation (RA 23.5 v OA 23.3%; p = 0.975). There was no significant difference in the length of time the implant was in before revision: RA 11.0 v OA 8.8 years (p = 0.060). Among RA with/without MTX, there was no difference in use of biologics (30.0 v 43.3%, p = 0.283), steroids (47.6 v 50.0%, p = 0.867) or bisphosphonates (23.8 v 33.3%, p = 0.543). There was no difference in rTHA diagnosis with/without MTX, including loosening (52.4 v 56.7%, p = 0.762). There was no significant difference in lucencies with MTX use in any Gruen zone. Patients with MTX had femoral stem subsidence of 3.7mm v no subsidence without MTX (p = 0.006). Conclusion: There was no difference in the diagnosis leading to rTHR in RA and OA, although RA trended longer prior to rTHA. In this small retrospective study, there were no significant differences associated with MTX exposure or radiographic lucency among RA patients. The significance of subsidence is not clear. Further study of arthroplasty survival in RA patients is warranted.

Keywords: hip arthroplasty, methotrexate, revision arthroplasty, rheumatoid arthritis

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Authors: R. Edward Minchin Jr.

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The U.S. Federal Highway Administration (FHWA) Every Day Counts Program (EDC) has resulted in state DOTs putting evermore emphasis on speeding up the delivery of highway and bridge construction projects for use by the driving public. This has resulted in an increase in the use of alternative construction delivery systems such as design-build (D-B), construction manager at-risk (CMR) or construction manager/general contractor (CM/GC), and adding alternative technical concepts (ATCs) to traditional design-bid-build (DBB) contracts. ATCs have exhibited great potential for delivering substantial benefits like cost savings, increased constructability, and quicker project delivery. Previous research has found that knowledge of project constructability was lacking in state Department of Transportation (DOT) planning, programming, and environmental staffs. Many agencies have therefore relied on a set of ‘acceptable’ design solutions over the years of working with their local resource agencies. The result is that the permitting process for several government agencies has become increasingly restrictive with the result that the DOTs and their industry partners lose the ability to innovate after a permit is approved. The intent of this paper is to report on the research team’s progress in this ongoing effort furnish the United States government with a uniform set of guidelines for the application of constructability reviews during all phases of project development and delivery. The research uses surveys and interviews to determine which states have implemented formal programs to ensure that the constructor is furnished with a set of contract documents that affords said constructor with the best possible opportunity to successfully construct the project with the highest quality standards, within the contract duration and without exceeding the construction budget. Once these states are identified, workshops are held all over the nation, resulting in the team learning the best current practices and giving the team the ability to recommend new practices that will improve the process. The plan is for the FHWA to encourage or require state DOTs to use these practices on all federally funded highway and bridge construction projects. The project deliverable is a Guidebook for FHWA to use in disseminating the recommended practices to the states.

Keywords: alternative construction delivery, alternative technical concepts, constructability, construction design plans

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Authors: Valeria Abreu Minero, Edward Barker, Hannah Dickson, Francois Husson, Sandra Flynn, Jennifer Shaw

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Purpose – The purpose of this paper is to identify offender typologies based on aspects of the offenders’ psychopathology and their associations with crime scene behaviours using data derived from the National Confidential Enquiry into Suicide and Safety in Mental Health concerning homicides in England and Wales committed by offenders in contact with mental health services in the year preceding the offence (n=759). Design/methodology/approach – The authors used multiple correspondence analysis to investigate the interrelationships between the variables and hierarchical agglomerative clustering to identify offender typologies. Variables describing: the offender’s mental health history; the offenders’ mental state at the time of offence; characteristics useful for police investigations; and patterns of crime scene behaviours were included. Findings – Results showed differences in the offender’s histories in relation to their crime scene behaviours. Further, analyses revealed three homicide typologies: externalising, psychosis and depression. Analyses revealed three homicide typologies: externalising, psychotic and depressive. Practical implications – These typologies may assist the police during homicide investigations by: furthering their understanding of the crime or likely suspect; offering insights into crime patterns; provide advice as to what an offender’s offence behaviour might signify about his/her mental health background; findings suggest information concerning offender psychopathology may be useful for offender profiling purposes in cases of homicide offenders with schizophrenia, depression and comorbid diagnosis of personality disorder and alcohol/drug dependence. Originality/value – Empirical studies with an emphasis on offender profiling have almost exclusively focussed on the inference of offender demographic characteristics. This study provides a first step in the exploration of offender psychopathology and its integration to the multivariate analysis of offence information for the purposes of investigative profiling of homicide by identifying the dominant patterns of mental illness within homicidal behaviour.

Keywords: offender profiling, mental illness, psychopathology, multivariate analysis, homicide, crime scene analysis, crime scene behviours, investigative advice

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Authors: Chi-Feng Lai, Wen-Chun Liao Liao

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Many people are bothered by sleep difficulties in Taiwan’s society. However, majority of patients get medical treatments without a comprehensive sleep assessment. It is still a big challenge to formulate a comprehensive assessment of sleep difficulties in clinical settings, even though many assessment tools have existed in literature. This study tries to implement reliable and effective ‘comprehensive sleep assessment scales’ in a medical center and to explore differences in sleep-related factors between clinic clients with or without sleep difficulty complaints. The comprehensive sleep assessment (CSA) scales were composed of 5 dimensions: ‘personal factors’, ‘physiological factors’, ‘psychological factors’, ‘social factors’ and ‘environmental factors, and were first evaluated by expert validity and 20 participants with test-retest reliability. The Content Validity Index (CVI) of the CSA was 0.94 and the alpha of the consistency reliability ranged 0.996-1.000. Clients who visited sleep clinic due to sleep difficulties (n=32, 16 males and 16 females, ages 43.66 ±14.214) and gender-and age- matched healthy subjects without sleep difficulties (n=96, 47 males and 49 females, ages 41.99 ±13.69) were randomly recruited at a ratio of 1:3 (with sleep difficulties vs. without sleep difficulties) to compare their sleep and the CSA factors. Results show that all clinic clients with sleep difficulties did have poor sleep quality (PSQI>5) and mild to moderate daytime sleepiness (ESS >11). Personal factors of long working hours (χ2= 10.315, p=0.001), shift workers (χ2= 8.964, p=0.003), night shift (χ2=9.395, p=0.004) and perceived stress (χ2=9.503, p=0.002) were disruptors of sleep difficulties. Physiological factors from physical examination including breathing by mouth, low soft palate, high narrow palate, Edward Angle, tongue hypertrophy, and occlusion of the worn surface were observed in clinic clients. Psychological factors including higher perceived stress (χ2=32.542, p=0.000), anxiety and depression (χ2=32.868, p=0.000); social factors including lack of leisure activities (χ2=39.857, p=0.000), more drinking habits (χ2=1.798, p=0.018), irregular amount and frequency in meals (χ2=5.086, p=0.024), excessive dinner (χ2=21.511, p=0.000), being incapable of getting up on time due to previous poor night sleep (χ2=4.444, p=0.035); and environmental factors including lights (χ2=7.683, p=0.006), noise (χ2=5.086, p=0.024), low or high bedroom temperature (χ2=4.595, p=0.032) were existed in clients. In conclusion, the CSA scales can work as valid and reliable instruments for evaluating sleep-related factors. Findings of this study provide important reference for assessing clinic clients with sleep difficulties.

Keywords: comprehensive sleep assessment, sleep-related factors, sleep difficulties

Procedia PDF Downloads 274

Authors: Yahoel Van Essen, Gordon Ho, Brett Russell, Hans-Georg Worms, Xiao Lin Long, Edward David Cooper, Avner Bachar

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Weeds reduce farm and forest productivity, invade crops, smother pastures and some can harm livestock. Farmers need to spend a significant amount of money to control weeds by means of biological, chemical, cultural, and physical methods. To solve the global agricultural labor shortage and remove poisonous chemicals, a fully autonomous, eco-friendly, and sustainable weeding technology is developed. This takes the form of a weeding robot, ‘Roboweeder’. Roboweeder includes a four-wheel-drive self-driving vehicle, a 4-DOF robotic arm which is mounted on top of the vehicle, an electromagnetic wave generator (magnetron) which is mounted on the “wrist” of the robotic arm, 48V battery packs, and a control/communication system. Cameras are mounted on the front and two sides of the vehicle. Using image processing and recognition, distinguish types of weeds are detected before being eliminated. The electromagnetic wave technology is applied to heat the individual weeds and clusters dielectrically causing them to wilt and die. The 4-DOF robotic arm was modeled mathematically based on its structure/mechanics, each joint’s load, brushless DC motor and worm gear’ characteristics, forward kinematics, and inverse kinematics. The Proportional-Integral-Differential control algorithm is used to control the robotic arm’s motion to ensure the waveguide aperture pointing to the detected weeds. GPS and machine vision are used to traverse the farm and avoid obstacles without the need of supervision. A Roboweeder prototype has been built. Multiple test trials show that Roboweeder is able to detect, point, and kill the pre-defined weeds successfully although further improvements are needed, such as reducing the “weeds killing” time and developing a new waveguide with a smaller waveguide aperture to avoid killing crops surrounded. This technology changes the tedious, time consuming and expensive weeding processes, and allows farmers to grow more, go organic, and eliminate operational headaches. A patent of this technology is pending.

Keywords: autonomous navigation, machine vision, precision heating, sustainable and eco-friendly

Procedia PDF Downloads 252

Authors: Mike Yaw Osei-Atweneboana, John Asiedu Larbi, Edward Jenner Tettevi

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Background: The lymphatic filariasis (LF) control programme has been on-going in Ghana since 2000. This community-wide approach involves the use of ivermectin (IVM) and albendazole (ALB). Soil-transmitted helminth (STH) infections control is augmented within this programme; however, in areas where LF is not prevalent, albendazole alone is administered to school children. The purpose of this study was therefore, to determine the efficacy of albendazole against soils transmitted helminths and the impact of mass drug administration of albendazole and ivermectin on the health status of children of school going age and pregnant women. Material/Methods: This was a twelve months longitudinal study. A total of 412 subjects including school children (between the ages of 2-17 years) and pregnant women were randomly selected from four endemic communities in Kpandai district of the Northern region. Coprological assessment for parasites was based on the Kato–Katz technique in both dry and rainy seasons at baseline, 21 days and 3 months post-treatment. Single-dose albendazole treatment was administered to all patients at baseline. Preserved samples are currently under molecular studies to identify possible single nucleotide polymorphism (SNP) within the beta tubulin gene which is associated with benzimidazole resistance. Results: Of all the parasites found (hookworm, Trichuris trichiura, Hymenolepis nana, and Taenia sp.); hookworm was the most prevalent. In the dry season, the overall STHs prevalence at pre-treatment was 29%, while 9% and 13% prevalence was recorded at 21 days, and three months after treatment respectively. However, in the rainy season, the overall STHs prevalence was 8%, while 4% and 12% was recorded at 21 days and three months respectively after ALB treatment. In general, ALB treatment resulted in an overall hookworm egg count reduction rate of 89% in the dry season and 93% in the rainy season, while the T. trichiura egg count reduction rate was 100% in both seasons. Conclusions: STH infections still remains a significant public health burden in Ghana. Hookworm infection seems to respond poorly or sub-optimally to ALB, raising concerns of possible emergence of resistance which may lead to a major setback for the control and elimination of STH infections, especially hookworm infections.

Keywords: hookworm, sub-optimal response, albendazole, trichuriasis, soil-transmitted helminths

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Authors: Andrew Wee

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As a result of the Italian Independence Wars starting in 1848, Italy began to change through unification. People gradually moved away from some of their traditional practices and values, such as the long-held belief that women were inferior to men, as part of the Risorgimento. Italians began to take interest in opera as a form of emotional release. As opera became more popular and prominent in their culture, it aided in the dissemination of ideas, especially stimulating the spread of imperialism, in the late 19th century, as Italy began extending its presence to other countries. In order to collect the information needed to analyze Italy’s foreign presence, it was necessary to consult texts concerning the culture of the Risorgimento. These texts included primary sources from operatic composers and contemporary recorded accounts. Letters from Giuseppe Verdi, a leader in opera during the Risorgimento, have been scrutinized for indications of popular attitudes of the time. The cultural context of the Risorgimento is essential to understanding the Italian motives and attitudes towards the outside world. On the more political side, research has also entailed the study of historical data of general laws, policies, and their purposes concerning geopolitical boundaries and foreign affairs, such as Edward Said’s thesis on Orientalism. By establishing these two characteristics of Italy, the paper will thoroughly illustrate Italy’s presence in foreign affairs. Texts have been searched with the intent of using information that reveals Italian attitudes toward exotic countries to determine whether their demeanor was positive or condescending. Motives behind sources have been interpreted in context in order to form a complete picture of the Italian sentiment towards foreigners. Additionally, research pertaining to Italian nationalism and imperialism such as song and literature has been used. The primary form of research has been the division of sources that are culturally based and those that are political in nature. Opera had always been developing since its creation in the 17th century, and in the 19th century, the bel canto movement revolutionized opera and its role in Italian society. This paper uses evidence that popular sentiment was influenced by opera to support the belief that the evolution of opera was as a result of the nationalist sentiment, and in turn fueled the cultural movement known as the Risorgimento. In this way, opera proceeded to affect Italian culture by spreading the idea of imperialism.

Keywords: opera, Italian unification, music history, imperialism

Procedia PDF Downloads 346

Authors: Dana El-Mughayyar, Neil Manson, Erin Bigney, Eden Richardson, Dean Tripp, Edward Abraham

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Use of narcotics to treat pain has increased over the past two decades and is a contributing factor to the current public health crisis. Understanding the pre-operative risks of chronic narcotic use may be aided through investigation of psychological measures. The objective of the reported study is to determine predictors of narcotic use two years post-surgery in a thoracolumbar spine surgery population, including an array of psychological factors. A prospective observational study of 191 consecutively enrolled adult patients having undergone thoracolumbar spine surgery is presented. Baseline measures of interest included the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia, Multidimensional Scale for Perceived Social Support (MSPSS), Chronic Pain Acceptance Questionnaire (CPAQ-8), Oswestry Disability Index (ODI), Numeric Rating Scales for back and leg pain (NRS-B/L), SF-12’s Mental Component Summary (MCS), narcotic use and demographic variables. The post-operative measure of interest is narcotic use at 2-year follow-up. Narcotic use is collapsed into binary categories of use and no use. Descriptive statistics are run. Chi Square analysis is used for categorical variables and an ANOVA for continuous variables. Significant variables are built into a hierarchical logistic regression to determine predictors of post-operative narcotic use. Significance is set at α < 0.05. Results: A total of 27.23% of the sample were using narcotics two years after surgery. The regression model included ODI, NRS-Leg, time with condition, chief complaint, pre-operative drug use, gender, MCS, PCS subscale helplessness, and CPAQ subscale pain willingness and was significant χ² (13, N=191)= 54.99; p = .000. The model accounted for 39.6% of the variance in narcotic use and correctly predicted in 79.7% of cases. Psychological variables accounted for 9.6% of the variance over and above the other predictors. Conclusions: Managing chronic narcotic usage is central to the patient’s overall health and quality of life. Psychological factors in the preoperative period are significant predictors of narcotic use 2 years post-operatively. The psychological variables are malleable, potentially allowing surgeons to direct their patients to preventative resources prior to surgery.

Keywords: narcotics, psychological factors, quality of life, spine surgery

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Authors: Calvin Ralph, Edward Archer, Alistair McIlhagger

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3D woven textile composites continue to emerge as an advanced material for structural applications and composite manufacture due to their bespoke nature, through thickness reinforcement and near net shape capabilities. When 3D woven preforms are produced, they are in their optimal physical state. As 3D weaving is a dry preforming technology it relies on compression of the preform to achieve the desired composite thickness, fibre volume fraction (Vf) and consolidation. This compression of the preform during manufacture results in changes to its thickness and architecture which can often lead to under-performance or changes of the 3D woven composite. Unlike traditional 2D fabrics, the bespoke nature and variability of 3D woven architectures makes it difficult to know exactly how each 3D preform will behave during processing. Therefore, the focus of this study is to investigate the effect of compression on differing 3D woven architectures in terms of structure, crimp or fibre waviness and thickness as well as analysing the accuracy of available software to predict how 3D woven preforms behave under compression. To achieve this, 3D preforms are modelled and compression simulated in Wisetex with varying architectures of binder style, pick density, thickness and tow size. These architectures have then been woven with samples dry compression tested to determine the compressibility of the preforms under various pressures. Additional preform samples were manufactured using Resin Transfer Moulding (RTM) with varying compressive force. Composite samples were cross sectioned, polished and analysed using microscopy to investigate changes in architecture and crimp. Data from dry fabric compression and composite samples were then compared alongside the Wisetex models to determine accuracy of the prediction and identify architecture parameters that can affect the preform compressibility and stability. Results indicate that binder style/pick density, tow size and thickness have a significant effect on compressibility of 3D woven preforms with lower pick density allowing for greater compression and distortion of the architecture. It was further highlighted that binder style combined with pressure had a significant effect on changes to preform architecture where orthogonal binders experienced highest level of deformation, but highest overall stability, with compression while layer to layer indicated a reduction in fibre crimp of the binder. In general, simulations showed a relative comparison to experimental results; however, deviation is evident due to assumptions present within the modelled results.

Keywords: 3D woven composites, compression, preforms, textile composites

Procedia PDF Downloads 135