Search results for: one year follow-up
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4870

Search results for: one year follow-up

3700 Tests and Comparison of Two Mobile Industrial Analytical Systems for Mercury Speciation in Flue Gas

Authors: Karel Borovec, Jerzy Gorecki, Tadeas Ochodek

Abstract:

Combustion of solid fuels is one of the main sources of mercury in the environment. To reduce the amount of mercury emitted to the atmosphere, it is necessary to modify or optimize old purification technologies or introduce the new ones. Effective reduction of mercury level in the flue gas requires the use of speciation systems for mercury form determination. This paper describes tests and provides comparison of two industrial portable and continuous systems for mercury speciation in the flue gas: Durag HM-1400 TRX with a speciation module and the Portable Continuous Mercury Speciation System based on the SGM-8 mercury speciation set, made by Nippon Instruments Corporation. Additionally, the paper describes a few analytical problems that were encountered during a two-year period of using the systems.

Keywords: continuous measurement, flue gas, mercury determination, speciation

Procedia PDF Downloads 193
3699 An Analysis of the Strategic Pathway to Building a Successful Mobile Advertising Business in Nigeria: From Strategic Intent to Competitive Advantage

Authors: Pius A. Onobhayedo, Eugene A. Ohu

Abstract:

Nigeria has one of the fastest growing mobile telecommunications industry in the world. In the absence of fixed connection access to the Internet, access to the Internet is primarily via mobile devices. It, therefore, provides a test case for how to penetrate the mobile market in an emerging economy. We also hope to contribute to a sparse literature on strategies employed in building successful data-driven mobile businesses in emerging economies. We, therefore, sought to identify and analyse the strategic approach taken in a successful locally born mobile data-driven business in Nigeria. The analysis was carried out through the framework of strategic intent and competitive advantages developed from the conception of the company to date. This study is based on an exploratory investigation of an innovative digital company based in Nigeria specializing in the mobile advertising business. The projected growth and high adoption of mobile in this African country, coinciding with the smartphone revolution triggered by the launch of iPhone in 2007 opened a new entrepreneurial horizon for the founder of the company, who reached the conclusion that ‘the future is mobile’. This dream led to the establishment of three digital businesses, designed for convergence and complementarity of medium and content. The mobile Ad subsidiary soon grew to become a truly African network with operations and campaigns across West, East and South Africa, successfully delivering campaigns in several African countries including Nigeria, Kenya, South Africa, Ghana, Uganda, Zimbabwe, and Zambia amongst others. The company recently declared a 40% year-end profit which was nine times that of the previous financial year. This study drew from an in-depth interview with the company’s founder, analysis of primary and secondary data from and about the business, as well as case studies of digital marketing campaigns. We hinge our analysis on the strategic intent concept which has been proposed to be an engine that drives the quest for sustainable strategic advantage in the global marketplace. Our goal was specifically to identify the strategic intents of the founder and how these were transformed creatively into processes that may have led to some distinct competitive advantages. Along with the strategic intents, we sought to identify the respective absorptive capacities that constituted favourable antecedents to the creation of such competitive advantages. Our recommendations and findings will be pivotal information for anybody wishing to invest in the world’s fastest technology business space - Africa.

Keywords: Africa, competitive advantage, competitive strategy, digital, mobile business, marketing, strategic intent

Procedia PDF Downloads 432
3698 Two Day Ahead Short Term Load Forecasting Neural Network Based

Authors: Firas M. Tuaimah

Abstract:

This paper presents an Artificial Neural Network based approach for short-term load forecasting and exactly for two days ahead. Two seasons have been discussed for Iraqi power system, namely summer and winter; the hourly load demand is the most important input variables for ANN based load forecasting. The recorded daily load profile with a lead time of 1-48 hours for July and December of the year 2012 was obtained from the operation and control center that belongs to the Ministry of Iraqi electricity. The results of the comparison show that the neural network gives a good prediction for the load forecasting and for two days ahead.

Keywords: short-term load forecasting, artificial neural networks, back propagation learning, hourly load demand

Procedia PDF Downloads 458
3697 Transverse Testicular Ectopia: A Case Report with Review of Literature

Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

Abstract:

Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

Procedia PDF Downloads 337
3696 Investigating Early Markers of Alzheimer’s Disease Using a Combination of Cognitive Tests and MRI to Probe Changes in Hippocampal Anatomy and Functionality

Authors: Netasha Shaikh, Bryony Wood, Demitra Tsivos, Michael Knight, Risto Kauppinen, Elizabeth Coulthard

Abstract:

Background: Effective treatment of dementia will require early diagnosis, before significant brain damage has accumulated. Memory loss is an early symptom of Alzheimer’s disease (AD). The hippocampus, a brain area critical for memory, degenerates early in the course of AD. The hippocampus comprises several subfields. In contrast to healthy aging where CA3 and dentate gyrus are the hippocampal subfields with most prominent atrophy, in AD the CA1 and subiculum are thought to be affected early. Conventional clinical structural neuroimaging is not sufficiently sensitive to identify preferential atrophy in individual subfields. Here, we will explore the sensitivity of new magnetic resonance imaging (MRI) sequences designed to interrogate medial temporal regions as an early marker of Alzheimer’s. As it is likely a combination of tests may predict early Alzheimer’s disease (AD) better than any single test, we look at the potential efficacy of such imaging alone and in combination with standard and novel cognitive tasks of hippocampal dependent memory. Methods: 20 patients with mild cognitive impairment (MCI), 20 with mild-moderate AD and 20 age-matched healthy elderly controls (HC) are being recruited to undergo 3T MRI (with sequences designed to allow volumetric analysis of hippocampal subfields) and a battery of cognitive tasks (including Paired Associative Learning from CANTAB, Hopkins Verbal Learning Test and a novel hippocampal-dependent abstract word memory task). AD participants and healthy controls are being tested just once whereas patients with MCI will be tested twice a year apart. We will compare subfield size between groups and correlate subfield size with cognitive performance on our tasks. In the MCI group, we will explore the relationship between subfield volume, cognitive test performance and deterioration in clinical condition over a year. Results: Preliminary data (currently on 16 participants: 2 AD; 4 MCI; 9 HC) have revealed subfield size differences between subject groups. Patients with AD perform with less accuracy on tasks of hippocampal-dependent memory, and MCI patient performance and reaction times also differ from healthy controls. With further testing, we hope to delineate how subfield-specific atrophy corresponds with changes in cognitive function, and characterise how this progresses over the time course of the disease. Conclusion: Novel sequences on a MRI scanner such as those in route in clinical use can be used to delineate hippocampal subfields in patients with and without dementia. Preliminary data suggest that such subfield analysis, perhaps in combination with cognitive tasks, may be an early marker of AD.

Keywords: Alzheimer's disease, dementia, memory, cognition, hippocampus

Procedia PDF Downloads 569
3695 Challenge in Teaching Physics during the Pandemic: Another Way of Teaching and Learning

Authors: Edson Pierre, Gustavo de Jesus Lopez Nunez

Abstract:

The objective of this work is to analyze how physics can be taught remotely through the use of platforms and software to attract the attention of 2nd-year high school students at Colégio Cívico Militar Professor Carmelita Souza Dias and point out how remote teaching can be a teaching-learning strategy during the period of social distancing. Teaching physics has been a challenge for teachers and students, permeating common sense with the great difficulty of teaching and learning the subject. The challenge increased in 2020 and 2021 with the impact caused by the new coronavirus pandemic (Sars-Cov-2) and its variants that have affected the entire world. With these changes, a new teaching modality emerged: remote teaching. It brought new challenges and one of them was promoting distance research experiences, especially in physics teaching, since there are learning difficulties and it is often impossible for the student to relate the theory observed in class with the reality that surrounds them. Teaching physics in schools faces some difficulties, which makes it increasingly less attractive for young people to choose this profession. Bearing in mind that the study of physics is very important, as it puts students in front of concrete and real situations, situations that physical principles can respond to, helping to understand nature, nourishing and nurturing a taste for science. The use of new platforms and software, such as PhET Interactive Simulations from the University of Colorado at Boulder, is a virtual laboratory that has numerous simulations of scientific experiments, which serve to improve the understanding of the content taught practically, facilitating student learning and absorption of content, being a simple, practical and free simulation tool, attracts more attention from students, causing them to acquire greater knowledge about the subject studied, or even a quiz, bringing certain healthy competitiveness to students, generating knowledge and interest in the themes used. The present study takes the Theory of Social Representations as a theoretical reference, examining the content and process of constructing the representations of teachers, subjects of our investigation, on the evaluation of teaching and learning processes, through a methodology of qualitative. The result of this work has shown that remote teaching was really a very important strategy for the process of teaching and learning physics in the 2nd year of high school. It provided greater interaction between the teacher and the student. Therefore, the teacher also plays a fundamental role since technology is increasingly present in the educational environment, and he is the main protagonist of this process.

Keywords: physics teaching, technologies, remote learning, pandemic

Procedia PDF Downloads 59
3694 Using Repetition of Instructions in Course Design to Improve Instructor Efficiency and Increase Enrollment in a Large Online Course

Authors: David M. Gilstrap

Abstract:

Designing effective instructions is a critical dimension of effective teaching systems. Due to a void in interpersonal contact, online courses present new challenges in this regard, especially with large class sizes. This presentation is a case study in how the repetition of instructions within the course design was utilized to increase instructor efficiency in managing a rapid rise in enrollment. World of Turf is a two-credit, semester-long elective course for non-turfgrass majors at Michigan State University. It is taught entirely online and solely by the instructor without any graduate teaching assistants. Discussion forums about subject matter are designated for each lecture, and those forums are moderated by a few undergraduate turfgrass majors. The instructions as to the course structure, navigation, and grading are conveyed in the syllabus and course-introduction lecture. Regardless, students email questions about such matters, and the number of emails increased as course enrollment grew steadily during the first three years of its existence, almost to a point that the course was becoming unmanageable. Many of these emails occurred because the instructor was failing to update and operate the course in a timely and proper fashion because he was too busy answering emails. Some of the emails did help the instructor ferret out poorly composed instructions, which he corrected. Beginning in the summer semester of 2015, the instructor overhauled the course by segregating content into weekly modules. The philosophy envisioned and embraced was that there can never be too much repetition of instructions in an online course. Instructions were duplicated within each of these modules as well as associated modules for syllabus and schedules, getting started, frequently asked questions, practice tests, surveys, and exams. In addition, informational forums were created and set aside for questions about the course workings and each of the three exams, thus creating even more repetition. Within these informational forums, students typically answer each other’s questions, which demonstrated to the students that that information is available in the course. When needed, the instructor interjects with corrects answers or clarifies any misinformation which students might be putting forth. Increasing the amount of repetition of instructions and strategic enhancements to the course design have resulted in a dramatic decrease in the number of email replies necessitated by the instructor. The resulting improvement in efficiency allowed the instructor to raise enrollment limits thus effecting a ten-fold increase in enrollment over a five-year period with 1050 students registered during the most recent academic year, thus becoming easily the largest online course at the university. Because of the improvement in course-delivery efficiency, sufficient time was created that allowed the instructor to development and launch an additional online course, hence further enhancing his productivity and value in terms of the number of the student-credit hours for which he is responsible.

Keywords: design, efficiency, instructions, online, repetition

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3693 Spatial Analysis in the Impact of Aquifer Capacity Reduction on Land Subsidence Rate in Semarang City between 2014-2017

Authors: Yudo Prasetyo, Hana Sugiastu Firdaus, Diyanah Diyanah

Abstract:

The phenomenon of the lack of clean water supply in several big cities in Indonesia is a major problem in the development of urban areas. Moreover, in the city of Semarang, the population density and growth of physical development is very high. Continuous and large amounts of underground water (aquifer) exposure can result in a drastically aquifer supply declining in year by year. Especially, the intensity of aquifer use in the fulfilment of household needs and industrial activities. This is worsening by the land subsidence phenomenon in some areas in the Semarang city. Therefore, special research is needed to know the spatial correlation of the impact of decreasing aquifer capacity on the land subsidence phenomenon. This is necessary to give approve that the occurrence of land subsidence can be caused by loss of balance of pressure on below the land surface. One method to observe the correlation pattern between the two phenomena is the application of remote sensing technology based on radar and optical satellites. Implementation of Differential Interferometric Synthetic Aperture Radar (DINSAR) or Small Baseline Area Subset (SBAS) method in SENTINEL-1A satellite image acquisition in 2014-2017 period will give a proper pattern of land subsidence. These results will be spatially correlated with the aquifer-declining pattern in the same time period. Utilization of survey results to 8 monitoring wells with depth in above 100 m to observe the multi-temporal pattern of aquifer change capacity. In addition, the pattern of aquifer capacity will be validated with 2 underground water cavity maps from observation of ministries of energy and natural resources (ESDM) in Semarang city. Spatial correlation studies will be conducted on the pattern of land subsidence and aquifer capacity using overlapping and statistical methods. The results of this correlation will show how big the correlation of decrease in underground water capacity in influencing the distribution and intensity of land subsidence in Semarang city. In addition, the results of this study will also be analyzed based on geological aspects related to hydrogeological parameters, soil types, aquifer species and geological structures. The results of this study will be a correlation map of the aquifer capacity on the decrease in the face of the land in the city of Semarang within the period 2014-2017. So hopefully the results can help the authorities in spatial planning and the city of Semarang in the future.

Keywords: aquifer, differential interferometric synthetic aperture radar (DINSAR), land subsidence, small baseline area subset (SBAS)

Procedia PDF Downloads 178
3692 Assessment of Indoor Air Pollution in Naturally Ventilated Dwellings of Mega-City Kolkata

Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

Abstract:

The US Environmental Protection Agency defines indoor air pollution as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. This study attempts to demonstrate the causal relationship between the indoor air pollution and its determining aspects. Detailed indoor air pollution audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavourable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group in the urban area of the metropolitan. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses the relationship between indoor air pollution levels and factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, air pollution, architecture, urban environment

Procedia PDF Downloads 103
3691 Rebuilding Health Post-Conflict: Case Studies from Afghanistan, Cambodia, and Mozambique

Authors: Spencer Rutherford, Shadi Saleh

Abstract:

War and conflict negatively impact all facets of a health system; services cease to function, resources become depleted, and any semblance of governance is lost. Following cessation of conflict, the rebuilding process includes a wide array of international and local actors. During this period, stakeholders must contend with various trade-offs, including balancing sustainable outcomes with immediate health needs, introducing health reform measures while also increasing local capacity, and reconciling external assistance with local legitimacy. Compounding these factors are additional challenges, including coordination amongst stakeholders, the re-occurrence of conflict, and ulterior motives from donors and governments, to name a few. Therefore, the present paper evaluated health system development in three post-conflict countries over a 12-year timeline. Specifically, health policies, health inputs (such infrastructure and human resources), and measures of governance, from the post-conflict periods of Afghanistan, Cambodia, and Mozambique, were assessed against health outputs and other measures. All post-conflict countries experienced similar challenges when rebuilding the health sector, including; division and competition between donors, NGOs, and local institutions; urban and rural health inequalities; and the re-occurrence of conflict. However, countries also employed unique and effective mechanisms for reconstructing their health systems, including; government engagement of the NGO and private sector; integration of competing factions into the same workforce; and collaborative planning for health policy. Based on these findings, best-practice development strategies were determined and compiled into a 12-year framework. Briefly, during the initial stage of the post-conflict period, primary stakeholders should work quickly to draft a national health strategy in collaboration with the government, and focus on managing and coordinating NGOs through performance-based partnership agreements. With this scaffolding in place, the development community can then prioritize the reconstruction of primary health care centers, increasing and retaining health workers, and horizontal integration of immunization services. The final stages should then concentrate on transferring ownership of the health system national institutions, implementing sustainable financing mechanisms, and phasing-out NGO services. Overall, these findings contribute post-conflict health system development by evaluating the process holistically and along a timeline and can be of further use by healthcare managers, policy-makers, and other health professionals.

Keywords: Afghanistan, Cambodia, health system development, health system reconstruction, Mozambique, post-conflict, state-building

Procedia PDF Downloads 153
3690 A Quantitative Plan for Drawing Down Emissions to Attenuate Climate Change

Authors: Terry Lucas

Abstract:

Calculations are performed to quantify the potential contribution of each greenhouse gas emission reduction strategy. This approach facilitates the visualisation of the relative benefits of each, and it provides a potential baseline for the development of a plan of action that is rooted in quantitative evaluation. Emissions reductions are converted to potential de-escalation of global average temperature. A comprehensive plan is then presented which shows the potential benefits all the way out to year 2100. A target temperature de-escalation of 2oC was selected, but the plan shows a benefit of only 1.225oC. This latter disappointing result is in spite of new and powerful technologies introduced into the equation. These include nuclear fusion and alternative nuclear fission processes. Current technologies such as wind, solar and electric vehicles show surprisingly small constributions to the whole.

Keywords: climate change, emissions, drawdown, energy

Procedia PDF Downloads 128
3689 Cross-Comparison between Land Surface Temperature from Polar and Geostationary Satellite over Heterogenous Landscape: A Case Study in Hong Kong

Authors: Ibrahim A. Adeniran, Rui F. Zhu, Man S. Wong

Abstract:

Owing to the insufficiency in the spatial representativeness and continuity of in situ temperature measurements from weather stations (WS), the use of temperature measurement from WS for large-range diurnal analysis in heterogenous landscapes has been limited. This has made the accurate estimation of land surface temperature (LST) from remotely sensed data more crucial. Moreover, the study of dynamic interaction between the atmosphere and the physical surface of the Earth could be enhanced at both annual and diurnal scales by using optimal LST data derived from satellite sensors. The tradeoff between the spatial and temporal resolution of LSTs from satellite’s thermal infrared sensors (TIRS) has, however, been a major challenge, especially when high spatiotemporal LST data are recommended. It is well-known from existing literature that polar satellites have the advantage of high spatial resolution, while geostationary satellites have a high temporal resolution. Hence, this study is aimed at designing a framework for the cross-comparison of LST data from polar and geostationary satellites in a heterogeneous landscape. This could help to understand the relationship between the LST estimates from the two satellites and, consequently, their integration in diurnal LST analysis. Landsat-8 satellite data will be used as the representative of the polar satellite due to the availability of its long-term series, while the Himawari-8 satellite will be used as the data source for the geostationary satellite because of its improved TIRS. For the study area, Hong Kong Special Administrative Region (HK SAR) will be selected; this is due to the heterogeneity in the landscape of the region. LST data will be retrieved from both satellites using the Split window algorithm (SWA), and the resulting data will be validated by comparing satellite-derived LST data with temperature data from automatic WS in HK SAR. The LST data from the satellite data will then be separated based on the land use classification in HK SAR using the Global Land Cover by National Mapping Organization version3 (GLCNMO 2013) data. The relationship between LST data from Landsat-8 and Himawari-8 will then be investigated based on the land-use class and over different seasons of the year in order to account for seasonal variation in their relationship. The resulting relationship will be spatially and statistically analyzed and graphically visualized for detailed interpretation. Findings from this study will reveal the relationship between the two satellite data based on the land use classification within the study area and the seasons of the year. While the information provided by this study will help in the optimal combination of LST data from Polar (Landsat-8) and geostationary (Himawari-8) satellites, it will also serve as a roadmap in the annual and diurnal urban heat (UHI) analysis in Hong Kong SAR.

Keywords: automatic weather station, Himawari-8, Landsat-8, land surface temperature, land use classification, split window algorithm, urban heat island

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3688 Simo-syl: A Computer-Based Tool to Identify Language Fragilities in Italian Pre-Schoolers

Authors: Marinella Majorano, Rachele Ferrari, Tamara Bastianello

Abstract:

The recent technological advance allows for applying innovative and multimedia screen-based assessment tools to test children's language and early literacy skills, monitor their growth over the preschool years, and test their readiness for primary school. Several are the advantages that a computer-based assessment tool offers with respect to paper-based tools. Firstly, computer-based tools which provide the use of games, videos, and audio may be more motivating and engaging for children, especially for those with language difficulties. Secondly, computer-based assessments are generally less time-consuming than traditional paper-based assessments: this makes them less demanding for children and provides clinicians and researchers, but also teachers, with the opportunity to test children multiple times over the same school year and, thus, to monitor their language growth more systematically. Finally, while paper-based tools require offline coding, computer-based tools sometimes allow obtaining automatically calculated scores, thus producing less subjective evaluations of the assessed skills and provide immediate feedback. Nonetheless, using computer-based assessment tools to test meta-phonological and language skills in children is not yet common practice in Italy. The present contribution aims to estimate the internal consistency of a computer-based assessment (i.e., the Simo-syl assessment). Sixty-three Italian pre-schoolers aged between 4;10 and 5;9 years were tested at the beginning of the last year of the preschool through paper-based standardised tools in their lexical (Peabody Picture Vocabulary Test), morpho-syntactical (Grammar Repetition Test for Children), meta-phonological (Meta-Phonological skills Evaluation test), and phono-articulatory skills (non-word repetition). The same children were tested through Simo-syl assessment on their phonological and meta-phonological skills (e.g., recognise syllables and vowels and read syllables and words). The internal consistency of the computer-based tool was acceptable (Cronbach's alpha = .799). Children's scores obtained in the paper-based assessment and scores obtained in each task of the computer-based assessment were correlated. Significant and positive correlations emerged between all the tasks of the computer-based assessment and the scores obtained in the CMF (r = .287 - .311, p < .05) and in the correct sentences in the RCGB (r = .360 - .481, p < .01); non-word repetition standardised test significantly correlates with the reading tasks only (r = .329 - .350, p < .05). Further tasks should be included in the current version of Simo-syl to have a comprehensive and multi-dimensional approach when assessing children. However, such a tool represents a good chance for the teachers to early identifying language-related problems even in the school environment.

Keywords: assessment, computer-based, early identification, language-related skills

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3687 Factors That Contribute to Differences in Climate Change Reporting

Authors: Petra F. A. Dilling, Sinan Caykoylu

Abstract:

The aim of this study was to shed light on the understanding of the factors determining a company’s disclosure on climate change reporting. The underlying study examines the effect of gender diversity and the mediating effect of female representation in management and on the board of directors and the existence of a dedicated sustainability board committee. To test the study’s objectives, the authors use a global sample of the largest companies and their reporting for the year 2020. The results suggest that corporate female participation has a significant influence on the quality of climate change reporting. In addition, having a dedicated sustainability board committee also significantly impacts the non-financial disclosure of climate change information.

Keywords: climate change, non-financial reporting, governance, board diversity, sustainability, CSR

Procedia PDF Downloads 116
3686 Dynamic Performance Analysis of Distribution/ Sub-Transmission Networks with High Penetration of PV Generation

Authors: Cristian F.T. Montenegro, Luís F. N. Lourenço, Maurício B. C. Salles, Renato M. Monaro

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More PV systems have been connected to the electrical network each year. As the number of PV systems increases, some issues affecting grid operations have been identified. This paper studied the impacts related to changes in solar irradiance on a distribution/sub-transmission network, considering variations due to moving clouds and daily cycles. Using MATLAB/Simulink software, a solar farm of 30 MWp was built and then implemented to a test network. From simulations, it has been determined that irradiance changes can have a significant impact on the grid by causing voltage fluctuations outside the allowable thresholds. This work discussed some local control strategies and grid reinforcements to mitigate the negative effects of the irradiance changes on the grid.

Keywords: reactive power control, solar irradiance, utility-scale PV systems, voltage fluctuations

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3685 Problem Based Learning and Teaching by Example in Dimensioning of Mechanisms: Feedback

Authors: Nicolas Peyret, Sylvain Courtois, Gaël Chevallier

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This article outlines the development of the Project Based Learning (PBL) at the level of a last year’s Bachelor’s Degree. This form of pedagogy has for objective to allow a better involving of the students from the beginning of the module. The theoretical contributions are introduced during the project to solving a technological problem. The module in question is the module of mechanical dimensioning method of Supméca a French engineering school. This school issues a Master’s Degree. While the teaching methods used in primary and secondary education are frequently renewed in France at the instigation of teachers and inspectors, higher education remains relatively traditional in its practices. Recently, some colleagues have felt the need to put the application back at the heart of their theoretical teaching. This need is induced by the difficulty of covering all the knowledge deductively before its application. It is therefore tempting to make the students 'learn by doing', even if it doesn’t cover some parts of the theoretical knowledge. The other argument that supports this type of learning is the lack of motivation the students have for the magisterial courses. The role-play allowed scenarios favoring interaction between students and teachers… However, this pedagogical form known as 'pedagogy by project' is difficult to apply in the first years of university studies because of the low level of autonomy and individual responsibility that the students have. The question of what the student actually learns from the initial program as well as the evaluation of the competences acquired by the students in this type of pedagogy also remains an open problem. Thus we propose to add to the pedagogy by project format a regressive part of interventionism by the teacher based on pedagogy by example. This pedagogical scenario is based on the cognitive load theory and Bruner's constructivist theory. It has been built by relying on the six points of the encouragement process defined by Bruner, with a concrete objective, to allow the students to go beyond the basic skills of dimensioning and allow them to acquire the more global skills of engineering. The implementation of project-based teaching coupled with pedagogy by example makes it possible to compensate for the lack of experience and autonomy of first-year students, while at the same time involving them strongly in the first few minutes of the module. In this project, students have been confronted with the real dimensioning problems and are able to understand the links and influences between parameter variations and dimensioning, an objective that we did not reach in classical teaching. It is this form of pedagogy which allows to accelerate the mastery of basic skills and so spend more time on the engineer skills namely the convergence of each dimensioning in order to obtain a validated mechanism. A self-evaluation of the project skills acquired by the students will also be presented.

Keywords: Bruner's constructivist theory, mechanisms dimensioning, pedagogy by example, problem based learning

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3684 Identification of Flood Prone Areas in Adigrat Town Using Boolean Logic with GIS and Remote Sensing Technique

Authors: Fikre Belay Tekulu

Abstract:

The Adigrat town lies in the Tigray region of Ethiopia. This region is mountainous and experiences a semiarid type of climate. Most of the rainfall occurs in four months of the year, which are June to September. During this season, flood is a common natural disaster, especially in urban areas. In this paper, an attempt is made to identify flood-prone areas in Adigrat town using Boolean logic with GIS and remote sensing techniques. Three parameters were incorporated as land use type, elevation, and slope. Boolean logic was used as land use equal to buildup land, elevation less than 2430 m, and slope less than 5 degrees. As a result, 0.575 km² was identified severely affected by floods during the rainy season.

Keywords: flood, GIS, hydrology, Adigrat

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3683 Harmful Algal Poisoning Symptoms in Coastal Areas of Nigeria

Authors: Medina Kadiri

Abstract:

Nigeria has an extensive coastline of 853 km long between latitude 4°10′ to 6°20′ N and longitude 2°45′ to 8°35′ E and situated in the Gulf of Guinea within the Guinea Current Large Marine Ecosystem. There is a substantial coastal community relying on this region for their livelihood of fishing, aquaculture, mariculture for various sea foods either for consumption or economic sustenance or both. Socio-economic study was conducted, using questionnaires and interview, to investigate the health symptoms of harmful algae experienced by these communities on consumption of sea foods. Eighteen symptoms were recorded. Of the respondents who experienced symptoms after consumption of sea foods, overall, more people (33.5%) experienced vomiting as a symptom, followed by nausea (14.03%) and then diarrhea (13.57%). Others were headache (9.95%), mouth tingling (8.6%) and tiredness (7.24%).The least were muscle pain, rashes, confusion, chills, burning sensation, breathing difficulty and balance difficulty which represented 0.45% each and the rest (dizziness, digestive tract tumors, itching, memory loss, & stomach pain) were less than 3% each. In terms of frequency, the most frequent symptom was diarrhea with 87.5% occurrence, closely followed by vomiting with 81.3%. Tiredness was 75% while nausea was 62.5% and headache 50%. Others such as dizziness, itching, memory loss, mouth tingling and stomach pain had about 40% occurrence or less. The least occurring symptoms were muscle pain, rashes, confusion, chills and balance difficulty and burning sensation occurring only once i.e 6.3%. Breathing difficulty was last but one with 12.5%. Visible symptom from seafood and the particular seafood consumed that prompted the visible symptoms, shows that 3.5% of the entire respondents who ate crab experienced various symptoms ranging from vomiting (2.4%), itching (0.5%) and headache (0.4%). For periwinkle, vomiting had 1.7%, while 1.2% represented diarrhea and nausea symptom comprised 0.8% of all the respondents who ate periwinkle. Some respondents who consumed fish shows that 0.4% of the respondents had Itching. From the respondents who preferred to consume shrimps/crayfish and crab, shrimps/crayfish, crab and periwinkle, the most common illness was tiredness (1.2%), while 0.5% had experienced diarrhea and many others. However, for most respondents who claimed to have no preference for any seafood, with 55.7% affirming this with vomiting being the highest (6.1%), followed closely by mouth tingling/ burning sensation (5.8%). Examining the seasonal influence on visible symptoms revealed that vomiting occurred more in the month of January with 5.5%, while headache and itching were predominant in October with (2.8%). Nausea has 3.1% in January than any season of the year, 2.6% of the entire respondents opined to have experience diarrhea in October than in any other season of the year. Regular evaluation of harmful algal poisoning symptoms is recommended for coastal communities.

Keywords: coastal, harmful algae, human poisoning symptoms, Nigeria, phycotoxins

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3682 Achieving Them Both: Business and Wellness Outcomes in Health Organizations – the 'Tip' Laser Intervention

Authors: Shosh Kazaz, Shmuel Banai, Vered Zilberberg

Abstract:

Optimizing high business performance and employee's well-being simultaneously often challenges organizations. 'TIP' intervention enables achieving them both as the given project demonstrates. Increasing outcomes and improving performance were the initial motivators for this explorative project, followed by a request of the head of the Cardiology department: 'I know we are the best at our clinical practice, but we need to take it further and break our own glass ceiling.' Two guided interventions were conducted in two different units within the department, designed to implement advanced managerial and business-oriented tools, along with 'soft tools' based on coaching psychology and particularly wellness coaching. The organ department multi-disciplinary teams were assembled, aiming to manage and lead the process: mapping the patients' flow, creating solutions, implementing, assessing, improving and assimilating them. Approximately four months later, without additional external resources, meaningful results emerged by the teams in terms of business and performance: shortening the hospitalization length at a given procedure (from 7 to 2.1 days); increasing the availability of Catheterization laboratory by 16% daily – resulting profitability raise; improving patients' journey and experience. A year later, those results are maintained. Furthermore, interviews with the participants revealed positive perceptions regarding the department; a higher sense of joyfulness, connectedness, belonging and a better department climate were reported. Additionally, participants reported a higher sense of fulfillment as opposed to their earliest skepticism and cynicism about their ability to enhance outcomes without more resources (budget and/or manpower), experiencing a mindset change toward the possibility of leading personal and professional growth processes. These reports were supported by analyzing a set of questionnaires that the participants completed, parallel to a control group of non-participating colleagues. Although the assessment was taken a year after the completion of the project and during 'covid-19th-3rd national quarantine, the results indicated a significant impact on several personal parameters associated with wellness, compared to the control group. The participants were higher in self-efficacy and organizational commitment; men were higher in resilience and optimism and women were higher in well-being. In conclusion, the 'TIP' relatively short intervention integrates advanced managerial and wellness coaching tools, empowers organizational resources: Team, Individual and Process and by that generates multi-impact measurable results in terms of employee's wellness parameters along with business performance and patient care.

Keywords: coaching, health and wellness, health management, leadership and well-being

Procedia PDF Downloads 181
3681 Methylphenidate Use by Canadian Children and Adolescents and the Associated Adverse Reactions

Authors: Ming-Dong Wang, Abigail F. Ruby, Michelle E. Ross

Abstract:

Methylphenidate is a first-line treatment drug for attention deficit hyperactivity disorder (ADHD), a common mental health disorder in children and adolescents. Over the last several decades, the rate of children and adolescents using ADHD medication has been increasing in many countries. A recent study found that the prevalence of ADHD medication use among children aged 3-18 years increased in 13 different world regions between 2001 and 2015, where the absolute increase ranged from 0.02 to 0.26% per year. The goal of this study was to examine the use of methylphenidate in Canadian children and its associated adverse reactions. Methylphenidate use information among young Canadians aged 0-14 years was extracted from IQVIA data on prescriptions dispensed by pharmacies between April 2014 and June 2020. The adverse reaction information associated with methylphenidate use was extracted from the Canada Vigilance database for the same time period. Methylphenidate use trends were analyzed based on sex, age group (0-4 years, 5-9 years, and 10-14 years), and geographical location (province). The common classes of adverse reactions associated with methylphenidate use were sorted, and the relative risks associated with methylphenidate use as compared with two second-line amphetamine medications for ADHD were estimated. This study revealed that among Canadians aged 0-14 years, every 100 people used about 25 prescriptions (or 23,000 mg) of methylphenidate per year during the study period, and the use increased with time. Boys used almost three times more methylphenidate than girls. The amount of drug used was inversely associated with age: Canadians aged 10-14 years used nearly three times as many drugs compared to those aged 5-9 years. Seasonal methylphenidate use patterns were apparent among young Canadians, but the seasonal trends differed among the three age groups. Methylphenidate use varied from region to region, and the highest methylphenidate use was observed in Quebec, where the use of methylphenidate was at least double that of any other province. During the study period, Health Canada received 304 adverse reaction reports associated with the use of methylphenidate for Canadians aged 0-14 years. The number of adverse reaction reports received for boys was 3.5 times higher than that for girls. The three most common adverse reaction classes were psychiatric disorders, nervous system disorders and injury, poisoning procedural complications. The number one commonly reported adverse reaction for boys was aggression (11.2%), while for girls, it was a tremor (9.6%). The safety profile in terms of adverse reaction classes associated with methylphenidate use was similar to that of the selected control products. Methylphenidate is a commonly used pharmaceutical product in young Canadians, particularly in the province of Quebec. Boys used approximately three times more of this product as compared to girls. Future investigation is needed to determine what factors are associated with the observed geographic variations in Canada.

Keywords: adverse reaction risk, methylphenidate, prescription trend, use variation

Procedia PDF Downloads 155
3680 Vulnerability Assessment of Groundwater Quality Deterioration Using PMWIN Model

Authors: A. Shakoor, M. Arshad

Abstract:

The utilization of groundwater resources in irrigation has significantly increased during the last two decades due to constrained canal water supplies. More than 70% of the farmers in the Punjab, Pakistan, depend directly or indirectly on groundwater to meet their crop water demands and hence, an unchecked paradigm shift has resulted in aquifer depletion and deterioration. Therefore, a comprehensive research was carried at central Punjab-Pakistan, regarding spatiotemporal variation in groundwater level and quality. Processing MODFLOW for window (PMWIN) and MT3D (solute transport model) models were used for existing and future prediction of groundwater level and quality till 2030. The comprehensive data set of aquifer lithology, canal network, groundwater level, groundwater salinity, evapotranspiration, groundwater abstraction, recharge etc. were used in PMWIN model development. The model was thus, successfully calibrated and validated with respect to groundwater level for the periods of 2003 to 2007 and 2008 to 2012, respectively. The coefficient of determination (R2) and model efficiency (MEF) for calibration and validation period were calculated as 0.89 and 0.98, respectively, which argued a high level of correlation between the calculated and measured data. For solute transport model (MT3D), the values of advection and dispersion parameters were used. The model used for future scenario up to 2030, by assuming that there would be no uncertain change in climate and groundwater abstraction rate would increase gradually. The model predicted results revealed that the groundwater would decline from 0.0131 to 1.68m/year during 2013 to 2030 and the maximum decline would be on the lower side of the study area, where infrastructure of canal system is very less. This lowering of groundwater level might cause an increase in the tubewell installation and pumping cost. Similarly, the predicted total dissolved solids (TDS) of the groundwater would increase from 6.88 to 69.88mg/L/year during 2013 to 2030 and the maximum increase would be on lower side. It was found that in 2030, the good quality would reduce by 21.4%, while marginal and hazardous quality water increased by 19.28 and 2%, respectively. It was found from the simulated results that the salinity of the study area had increased due to the intrusion of salts. The deterioration of groundwater quality would cause soil salinity and ultimately the reduction in crop productivity. It was concluded from the predicted results of groundwater model that the groundwater deteriorated with the depth of water table i.e. TDS increased with declining groundwater level. It is recommended that agronomic and engineering practices i.e. land leveling, rainwater harvesting, skimming well, ASR (Aquifer Storage and Recovery Wells) etc. should be integrated to meliorate management of groundwater for higher crop production in salt affected soils.

Keywords: groundwater quality, groundwater management, PMWIN, MT3D model

Procedia PDF Downloads 374
3679 Marginalized Children's Drawings Speak for Themselves: Self Advocacy for Protecting Their Rights

Authors: Bhavneet Bharti, Prahbhjot Malhi, Vandana Thakur

Abstract:

Introduction: Children of the urban migrant laborers have great difficulty in accessing government programs which are otherwise routinely available in rural settings. These include programs for child care, nutrition, health and education. There are major communicative fault-lines preventing advocacy for these marginalized children. The overarching aim of this study was to investigate the role of an innovative strategy of children’s drawings in supporting communication between children, social workers, pediatricians and other child advocates to fulfil their fundamental child rights. Materials and Methods: The data was collected over a period of one-year April 2015 to April 2016 during the routine visits by the members of the Social Pediatrics team including a social worker, pediatricians and an artist to the makeshift colony of migrant laborers. Once a week a drawing session was organized where the children including adolescents were asked to any drawing and provide a narrative thereafter. 5-30 children attended these weekly sessions for one year. All these drawings were then classified into various themes and exhibited on 16th April 2016 in the Govt. College of Art Museum. The forum was used for advocacy of Child Rights of these underprivileged children to Secretary social welfare. Results: Mean (SD) age of children in present observational study was 8.5 (2.5) years, with 60% of the boys. Majority of children demonstrated themes which were local and contextualized to their daily needs, threats and festivals which clearly underscored their fundamental right to basic services and equality of opportunities to achieve their full development Drawings of tap with flowing water, queues of people collecting water from hand pumps reflect the local problem of water availability for these children. Young children talking about fear of rape and murder following their drawings indicate the looming threat of potential abuse and neglect. Besides reality driven drawing, children also echoed supernatural beliefs, dangers and festivities in their drawings. Anyone who watched these children at work with art materials was able to see the intense level of absorption, clearly indicating the enjoyment they received, making it a meaningful activity. Indeed, this self-advocacy through art exhibition led to the successful establishment of mobile Anganwadi (A social safety net programme of the government) in their area of stay. Conclusions: This observational study is an example of how children were able to do self-advocacy to protect their rights. Of particular importance, these drawings address how psychologists and other child advocates can ensure in a child-centered manner that the voice of children is heard and represented in all assessments of their well-being and future care options.

Keywords: child advocacy, children drawings, child rights, marginalized children

Procedia PDF Downloads 174
3678 EMG Based Orthosis for Upper Limb Rehabilitation in Hemiparesis Patients

Authors: Nancy N. Sharmila, Aparna Mishra

Abstract:

Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

Procedia PDF Downloads 440
3677 Preschoolers’ Selective Trust in Moral Promises

Authors: Yuanxia Zheng, Min Zhong, Cong Xin, Guoxiong Liu, Liqi Zhu

Abstract:

Trust is a critical foundation of social interaction and development, playing a significant role in the physical and mental well-being of children, as well as their social participation. Previous research has demonstrated that young children do not blindly trust others but make selective trust judgments based on available information. The characteristics of speakers can influence children’s trust judgments. According to Mayer et al.’s model of trust, these characteristics of speakers, including ability, benevolence, and integrity, can influence children’s trust judgments. While previous research has focused primarily on the effects of ability and benevolence, there has been relatively little attention paid to integrity, which refers to individuals’ adherence to promises, fairness, and justice. This study focuses specifically on how keeping/breaking promises affects young children’s trust judgments. The paradigm of selective trust was employed in two experiments. A sample size of 100 children was required for an effect size of w = 0.30,α = 0.05,1-β = 0.85, using G*Power 3.1. This study employed a 2×2 within-subjects design to investigate the effects of moral valence of promises (within-subjects factor: moral vs. immoral promises), and fulfilment of promises (within-subjects factor: kept vs. broken promises) on children’s trust judgments (divided into declarative and promising contexts). In Experiment 1 adapted binary choice paradigms, presenting 118 preschoolers (62 girls, Mean age = 4.99 years, SD = 0.78) with four conflict scenarios involving the keeping or breaking moral/immoral promises, in order to investigate children’s trust judgments. Experiment 2 utilized single choice paradigms, in which 112 preschoolers (57 girls, Mean age = 4.94 years, SD = 0.80) were presented four stories to examine their level of trust. The results of Experiment 1 showed that preschoolers selectively trusted both promisors who kept moral promises and those who broke immoral promises, as well as their assertions and new promises. Additionally, the 5.5-6.5-year-old children are more likely to trust both promisors who keep moral promises and those who break immoral promises more than the 3.5- 4.5-year-old children. Moreover, preschoolers are more likely to make accurate trust judgments towards promisor who kept moral promise compared to those who broke immoral promises. The results of Experiment 2 showed significant differences of preschoolers’ trust degree: kept moral promise > broke immoral promise > broke moral promise ≈ kept immoral promise. This study is the first to investigate the development of trust judgement in moral promise among preschoolers aged 3.5-6.5. The results show that preschoolers can consider both valence and fulfilment of promises when making trust judgments. Furthermore, as preschoolers mature, they become more inclined to trust promisors who keep moral promises and those who break immoral promises. Additionally, the study reveals that preschoolers have the highest level of trust in promisors who kept moral promises, followed by those who broke immoral promises. Promisors who broke moral promises and those who kept immoral promises are trusted the least. These findings contribute valuable insights to our understanding of moral promises and trust judgment.

Keywords: promise, trust, moral judgement, preschoolers

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3676 The Morocco's Return to the African Union: A New Era in the Kingdom's Foreign Policy

Authors: L. Ponomarenko, Rachid Kaouar

Abstract:

Morocco has rejoined the African Union and more than 30 years after it left the continental body due to the recognition of the Arabic Republic of Western Sahara. Morocco was readmitted after a one year campaign led by the King himself, who was visiting the Eastern African country with the aim to expend the kingdom presence in new region in Africa after that it managed to build a large influence net in the West Africa region. The return of Morocco can be a beginning of a new era in the foreign policy of Morocco, specially, in the policy towards the state-quo of the Western Sahara conflict, which is considerate as one the biggest obstacle for the cooperation and integration process in the region of North Africa. As a member-state of the African Union Morocco has lot more to lose, according to that the Moroccan position must be more flexible.

Keywords: African Union, Algeria, Morocco, North African Region, Western Sahara

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3675 Case Report: Complex Regional Pain Syndrome

Authors: Farah Al Zaabi, Sarah Amrani

Abstract:

Complex regional pain syndrome (CRPS) is a chronic pain condition that develops in an extremity following a fracture, soft tissue injury, or surgery. It is a neuropathic pain disorder that is accompanied by the characteristic skin manifestations that are needed for the diagnosis. We report the case of a 30 year old male, who has findings consistent with CRPS and has been followed for over two years by multiple specialties within the healthcare system without obtaining a diagnosis. The symptoms he presented with were treated based on the specialty he was seeing, rather than unified and recognized as a single disease process. Our case highlights the complexity of chronic pain, which can sometimes present with skin manifestations, and the importance of involving a pain specialist early for both the medical and physical recovery of CRPS patients.

Keywords: complex regional pain syndrome, chronic pain, skin changes of CRPS, dermatological manifestions of CRPS

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3674 Metachromatic Leukodystrophy: A Case Report

Authors: Mary Rose Eunice S. Gundayao, Manolo M. Fernandez

Abstract:

Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder with an autosomal recessive inheritance pattern. Lysosomal storage disorders are often severe, follow a progressively neurodegenerative path, and may result in multi-organ failure, potentially leading to death within 5 to 6 years in cases of early-onset forms. There are limited data regarding cases of MLD in Filipino children. This is the case of a 2-year-old Filipino girl who presented with progressive neurological deterioration and was diagnosed with metachromatic leukodystrophy by molecular genetic testing. This case report aims to present this patient’s clinical history, neurological findings, diagnosis and novel genetic mutations causing MLD. A concise review of updated literature on MLD will be discussed.

Keywords: metachromatic leukodystrophy, ARSA gene, peripheral neuropathy, case report, demyelinating disease

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3673 Prospection of Technology Production in Physiotherapy in Brazil

Authors: C. M. Priesnitz, G. Zanandrea, J. P. Fabris, S. L. Russo, M. E. Camargo

Abstract:

This study aimed to the prospection the physiotherapy area technological production registered with the National Intellectual Property Institute (INPI) in Brazil, for understand the evolution of the technological production in the country over time and visualize the distribution this production request in Brazil. There was an evolution in the technology landscape, where the average annual deposits had an increase of 102%, from 3.14 before the year 2004 to 6,33 after this date. It was found differences in the distribution of the number the deposits requested to each Brazilian region, being that of the 132 request, 68,9% were from the southeast region. The international patent classification evaluated the request deposits, and the more found numbers were A61H and A63B. So even with an improved panorama of technology production, this should still have incentives since it is an important tool for the development of the country.

Keywords: distribution, evolution, patent, physiotherapy, technological prospecting

Procedia PDF Downloads 322
3672 The Wine List Design by Upscale Restaurants

Authors: A. Oliveira-Brochado, R. Vinhas da Silva

Abstract:

This paper investigates the structure and content of the wine lists in upscale restaurants in Portugal (N=61). The respondents considered that a wine list should be easy to use and to modify, well-designed, modern and varied. Respondents also stated that they perform on average 6 revisions to the wine list per year. The restaurant owner, the restaurant manager and the sommelier were the main persons in charge of the wine list design. One of the mostimportant reasons for selecting wines across most restaurants was to ‘complement the menu’ and ‘pairing food with wine’. Restaurants also reported to be relatively independent from suppliers and magazine evaluations. Moreover, this work revealed that the restaurant wine list is considered by restaurateurs as a strategic tool to sell wine as a complement to the menu, to improve customer satisfaction and loyalty, to increase restaurant value and to enhance a successful positioning.

Keywords: Portugal, restaurants, wine list design, hospitality

Procedia PDF Downloads 443
3671 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating

Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton

Abstract:

Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.

Keywords: adolescent, binge eating, mental illness, obesity

Procedia PDF Downloads 353