Search results for: priority to repair
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1343

Search results for: priority to repair

143 Evaluating the Knowledge and Skill of Final Year Pharmacy Students in Maternal and Child Health at a University in South Africa

Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie

Abstract:

Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.

Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa

Procedia PDF Downloads 126
142 Novel Framework for MIMO-Enhanced Robust Selection of Critical Control Factors in Auto Plastic Injection Moulding Quality Optimization

Authors: Seyed Esmail Seyedi Bariran, Khairul Salleh Mohamed Sahari

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Apparent quality defects such as warpage, shrinkage, weld line, etc. are such an irresistible phenomenon in mass production of auto plastic appearance parts. These frequently occurred manufacturing defects should be satisfied concurrently so as to achieve a final product with acceptable quality standards. Determining the significant control factors that simultaneously affect multiple quality characteristics can significantly improve the optimization results by eliminating the deviating effect of the so-called ineffective outliers. Hence, a robust quantitative approach needs to be developed upon which major control factors and their level can be effectively determined to help improve the reliability of the optimal processing parameter design. Hence, the primary objective of current study was to develop a systematic methodology for selection of significant control factors (SCF) relevant to multiple quality optimization of auto plastic appearance part. Auto bumper was used as a specimen with the most identical quality and production characteristics to APAP group. A preliminary failure modes and effect analysis (FMEA) was conducted to nominate a database of pseudo significant significant control factors prior to the optimization phase. Later, CAE simulation Moldflow analysis was implemented to manipulate four rampant plastic injection quality defects concerned with APAP group including warpage deflection, volumetric shrinkage, sink mark and weld line. Furthermore, a step-backward elimination searching method (SESME) has been developed for systematic pre-optimization selection of SCF based on hierarchical orthogonal array design and priority-based one-way analysis of variance (ANOVA). The development of robust parameter design in the second phase was based on DOE module powered by Minitab v.16 statistical software. Based on the F-test (F 0.05, 2, 14) one-way ANOVA results, it was concluded that for warpage deflection, material mixture percentage was the most significant control factor yielding a 58.34% of contribution while for the other three quality defects, melt temperature was the most significant control factor with a 25.32%, 84.25%, and 34.57% contribution for sin mark, shrinkage and weld line strength control. Also, the results on the he least significant control factors meaningfully revealed injection fill time as the least significant factor for both warpage and sink mark with respective 1.69% and 6.12% contribution. On the other hand, for shrinkage and weld line defects, the least significant control factors were holding pressure and mold temperature with a 0.23% and 4.05% overall contribution accordingly.

Keywords: plastic injection moulding, quality optimization, FMEA, ANOVA, SESME, APAP

Procedia PDF Downloads 326
141 Identifying the Risks on Philippines’ Pre- and Post-Disaster Media Communication on Natural Hazards

Authors: Neyzielle Ronnicque Cadiz

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The Philippine is a hotbed of disasters and is a locus of natural hazards. With an average of 20 typhoons entering the Philippine Area of Responsibility (PAR) each year, seven to eight (7-8) of which makes landfall. The country rather inevitably suffers from climate-related calamities. With this vulnerability to natural hazards, the relevant hazard-related issues that come along with the potential threat and occurrence of a disaster oftentimes garners lesser media attention than when a disaster actually occurred. Post-disaster news and events flood the content of news networks primarily focusing on, but not limited to, the efforts of the national government in resolving post-disaster displacement, and all the more on the community leaders’ incompetence in disaster mitigation-- even though the University of the Philippines’ NOAH Center work hand in hand with different stakeholders for disaster mitigation communication efforts. Disaster risk communication is actually a perennial dilemma. There are so many efforts to reach the grassroots level but emergency and disaster preparedness messages inevitably fall short.. The Philippines is very vulnerable to hazards risk and disasters but social media posts and communication efforts mostly go unnoticed, if not argued upon. This study illustrates the outcomes of a research focusing on the print, broadcast, and social media’s role on disaster communication involving the natural catastrophic events that took place in the Philippines from 2009 to present. Considering the country’s state of development, this study looks on the rapid and reliable communication between the government, and the relief/rescue workers in the affected regions; and how the media portrays these efforts effectively. Learning from the disasters that have occurred in the Philippines over the past decade, effective communication can ensure that any efforts to prepare and respond to disasters can make a significant difference. It can potentially either break or save lives. Recognizing the role of communications is not only in improving the coordination of vital services for post disaster; organizations gave priority in reexamining disaster preparedness mechanisms through the Communication with Communities (CwC) programs. This study, however, looks at the CwC efforts of the Philippine media platforms. CwC, if properly utilized by the media, is an essential tool in ensuring accountability and transparency which require effective exchange of information between disasters and survivors and responders. However, in this study, it shows that the perennial dilemma of the Philippine media is that the Disaster Risk Reduction and Management (DRRM) efforts of the country lie in the clouded judgment of political aims. This kind of habit is a multiplier of the country’s risk and insecurity. Sometimes the efforts in urging the public to take action seem useless because the challenge lies on how to achieve social, economic, and political unity using the tri-media platform.

Keywords: Philippines at risk, pre/post disaster communication, tri-media platform, UP NOAH

Procedia PDF Downloads 150
140 The Valuable Triad of Adipokine Indices to Differentiate Pediatric Obesity from Metabolic Syndrome: Chemerin, Progranulin, Vaspin

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: adipokine indices, metabolic syndrome, obesity indices, pediatric obesity

Procedia PDF Downloads 182
139 Bioclimatic Devices in the Historical Rural Building: A Carried out Analysis on Some Rural Architectures in Puglia

Authors: Valentina Adduci

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The developing research aims to define in general the criteria of environmental sustainability of rural buildings in Puglia and particularly in the manor farm. The main part of the study analyzes the relationship / dependence between the rural building and the landscape which, after many stratifications, results clearly identified and sometimes also characterized in a positive way. The location of the manor farm, in fact, is often conditioned by the infrastructural network and by the structure of the agricultural landscape. The manor farm, without the constraints due to the urban pattern’s density, was developed in accordance with a logical settlement that gives priority to the environmental aspects. These vernacular architectures are the most valuable example of how our ancestors have planned their dwellings according to nature. The 237 farms, analysis’ object, have been reported in cartography through the GIS system; a symbol has been assigned to each of them to identify the architectural typology and a different color for the historical period of construction. A datasheet template has been drawn up, and it has made possible a deeper understanding of each manor farm. This method provides a faster comparison of the most recurring characters in all the considered buildings, except for those farms which benefited from special geographical conditions, such as proximity to the road network or waterways. Below there are some of the most frequently constants derived from the statistical study of the examined buildings: southeast orientation of the main facade; placement of the sheep pen on the ground tilted and exposed to the south side; larger windowed surface on the south elevation; smaller windowed surface on the north elevation; presence of shielding vegetation near the more exposed elevations to the solar radiation; food storage’s rooms located on the ground floor or in the basement; animal shelter located in north side of the farm; presence of tanks and wells, sometimes combined with a very accurate channeling storm water system; thick layers of masonry walls, inside of which were often obtained hollow spaces to house stairwells or depots for the food storage; exclusive use of local building materials. The research aims to trace the ancient use of bioclimatic constructive techniques in the Apulian rural architecture and to define those that derive from an empirical knowledge and those that respond to an already encoded design. These constructive expedients are especially useful to obtain an effective passive cooling, to promote the natural ventilation and to built ingenious systems for the recovery and the preservation of rainwater and are still found in some of the manor farms analyzed, most of them are, today, in a serious state of neglect.

Keywords: bioclimatic devices, farmstead, rural landscape, sustainability

Procedia PDF Downloads 361
138 Socially Sustainable Urban Rehabilitation Projects: Case Study of Ortahisar, Trabzon

Authors: Elif Berna Var

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Cultural, physical, socio-economic, or politic changes occurred in urban areas might be resulted in the decaying period which may cause social problems. As a solution to that, urban renewal projects have been used in European countries since World War II whereas they have gained importance in Turkey after the 1980s. The first attempts were mostly related to physical or economic aspects which caused negative effects on social pattern later. Thus, social concerns have also started to include in renewal processes in developed countries. This integrative approach combining social, physical, and economic aspects promotes creating more sustainable neighbourhoods for both current and future generations. However, it is still a new subject for developing countries like Turkey. Concentrating on Trabzon-Turkey, this study highlights the importance of socially sustainable urban renewal processes especially in historical neighbourhoods where protecting the urban identity of the area is vital, as well as social structure, to create sustainable environments. Being in the historic city centre and having remarkable traditional houses, Ortahisar is an important image for Trabzon. Because of the fact that architectural and historical pattern of the area is still visible but need rehabilitations, it is preferred to use 'urban rehabilitation' as a way of urban renewal method for this study. A project is developed by the local government to create a secondary city centre and a new landmark for the city. But it is still ambiguous if this project can provide social sustainability of area which is one of the concerns of the research. In the study, it is suggested that social sustainability of an area can be achieved by several factors. In order to determine the factors affecting the social sustainability of an urban rehabilitation project, previous studies have been analysed and some common features are attempted to define. To achieve this, firstly, several analyses are conducted to find out social structure of Ortahisar. Secondly, structured interviews are implemented to 150 local people which aims to measure satisfaction level, awareness, the expectation of them, and to learn their demographical background in detail. Those data are used to define the critical factors for a more socially sustainable neighbourhood in Ortahisar. Later, the priority of those factors is asked to 50 experts and 150 local people to compare their attitudes and to find common criterias. According to the results, it can be said that social sustainability of Ortahisar neighbourhood can be improved by considering various factors like quality of urban areas, demographical factors, public participation, social cohesion and harmony, proprietorial factors, facilities of education and employment. In the end, several suggestions are made for Ortahisar case to promote more socially sustainable urban neighbourhood. As a pilot study highlighting the importance of social sustainability, it is hoped that this attempt might be the contributory effect on achieving more socially sustainable urban rehabilitation projects in Turkey.

Keywords: urban rehabilitation, social sustainability, Trabzon, Turkey

Procedia PDF Downloads 351
137 Comparative Studies on the Needs and Development of Autotronic Maintenance Training Modules for the Training of Automobile Independent Workshop Service Technicians in North – Western Region, Nigeria

Authors: Muhammad Shuaibu Birniwa

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Automobile Independent Workshop Service Technicians (popularly called roadside mechanics) are technical personals that repairs most of the automobile vehicles in Nigeria. Majority of these mechanics acquired their skills through apprenticeship training. Modern vehicle imported into the country posed greater challenges to the present automobile technicians particularly in the area of carrying out maintenance repairs of these latest automobile vehicles (autotronics vehicle) due to their inability to possessed autotronic skills competency. To source for solution to the above mentioned problems, therefore a research is carried out in North – Western region of Nigeria to produce a suitable maintenance training modules that can be used to train the technicians for them to upgrade/acquire the needed competencies for successful maintenance repair of the autotronic vehicles that were running everyday on the nation’s roads. A cluster sampling technique is used to obtain a sample from the population. The population of the study is all autotronic inclined lecturers, instructors and independent workshop service technicians that are within North – Western region of Nigeria. There are seven states (Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto and Zamfara) in the study area, these serves as clusters in the population. Five (5) states were randomly selected to serve as the sample size. The five states are Jigawa, Kano, Katsina, Kebbi and Zamfara, the entire population of the five states which serves as clusters is (183), lecturers (44), instructors (49) and autotronic independent workshop service technicians (90), all of them were used in the study because of their manageable size. 183 copies of autotronic maintenance training module questionnaires (AMTMQ) with 174 and 149 question items respectively were administered and collected by the researcher with the help of an assistants, they are administered to 44 Polytechnic lecturers in the department of mechanical engineering, 49 instructors in skills acquisition centres/polytechnics and 90 master craftsmen of an independent workshops that are autotronic inclined. Data collected for answering research questions 1, 3, 4 and 5 were analysed using SPSS software version 22, Grand Mean and standard deviation were used to answer the research questions. Analysis of Variance (ANOVA) was used to test null hypotheses one (1) to three (3) and t-test statistical tool is used to analyzed hypotheses four (4) and five (5) all at 0.05 level of significance. The research conducted revealed that; all the objectives, contents/tasks, facilities, delivery systems and evaluation techniques contained in the questionnaire were required for the development of the autotronic maintenance training modules for independent workshop service technicians in the north – western zone of Nigeria. The skills upgrade training conducted by federal government in collaboration with SURE-P, NAC and SMEDEN was not successful because the educational status of the target population was not considered in drafting the needed training modules. The mode of training used does not also take cognizance of the theoretical aspect of the trainees, especially basic science which rendered the programme ineffective and insufficient for the tasks on ground.

Keywords: autotronics, roadside, mechanics, technicians, independent

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136 Swedish Police Officers' Experiences of Meeting with Women Who Were Raped

Authors: Lisa Rudolfsson

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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.

Keywords: focus groups, police, raped women, restoration

Procedia PDF Downloads 96
135 Forum Shopping in Biotechnology Law: Understanding Conflict of Laws in Protecting GMO-Based Inventions as Part of a Patent Portfolio in the Greater China Region

Authors: Eugene C. Lim

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This paper seeks to examine the extent to which ‘forum shopping’ is available to patent filers seeking protection of GMO (genetically modified organisms)-based inventions in Hong Kong. Under Hong Kong’s current re-registration system for standard patents, an inventor must first seek patent protection from one of three Designated Patent Offices (DPO) – those of the People’s Republic of China (PRC), the Europe Union (EU) (designating the UK), or the United Kingdom (UK). The ‘designated patent’ can then be re-registered by the successful patentee in Hong Kong. Interestingly, however, the EU and the PRC do not adopt a harmonized approach toward the patenting of GMOs, and there are discrepancies in their interpretation of the phrase ‘animal or plant variety’. In view of these divergences, the ability to effectively manage ‘conflict of law’ issues is an important priority for multinational biotechnology firms with a patent portfolio in the Greater China region. Generally speaking, both the EU and the PRC exclude ‘animal and plant varieties’ from the scope of patentable subject matter. However, in the EU, Article 4(2) of the Biotechnology Directive allows a genetically modified plant or animal to be patented if its ‘technical feasibility is not limited to a specific variety’. This principle has allowed for certain ‘transgenic’ mammals, such as the ‘Harvard Oncomouse’, to be the subject of a successful patent grant in the EU. There is no corresponding provision on ‘technical feasibility’ in the patent legislation of the PRC. Although the PRC has a sui generis system for protecting plant varieties, its patent legislation allows the patenting of non-biological methods for producing transgenic organisms, not the ‘organisms’ themselves. This might lead to a situation where an inventor can obtain patent protection in Hong Kong over transgenic life forms through the re-registration of a patent from a more ‘biotech-friendly’ DPO, even though the subject matter in question might not be patentable per se in the PRC. Through a comparative doctrinal analysis of legislative provisions, cases and court interpretations, this paper argues that differences in the protection afforded to GMOs do not generally prejudice the ability of global MNCs to obtain patent protection in Hong Kong. Corporations which are able to first obtain patents for GMO-based inventions in Europe can generally use their European patent as the basis for re-registration in Hong Kong, even if such protection might not be available in the PRC itself. However, the more restrictive approach to GMO-based patents adopted in the PRC would be more acutely felt by enterprises and inventors based in mainland China. The broader scope of protection offered to GMO-based patents in Europe might not be available in Hong Kong to mainland Chinese patentees under the current re-registration model for standard patents, unless they have the resources to apply for patent protection as well from another (European) DPO as the basis for re-registration.

Keywords: biotechnology, forum shopping, genetically modified organisms (GMOs), greater China region, patent portfolio

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134 Tuberculosis Outpatient Treatment in the Context of Reformation of the Health Care System

Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy

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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.

Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis

Procedia PDF Downloads 129
133 Sensitivity and Uncertainty Analysis of Hydrocarbon-In-Place in Sandstone Reservoir Modeling: A Case Study

Authors: Nejoud Alostad, Anup Bora, Prashant Dhote

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Kuwait Oil Company (KOC) has been producing from its major reservoirs that are well defined and highly productive and of superior reservoir quality. These reservoirs are maturing and priority is shifting towards difficult reservoir to meet future production requirements. This paper discusses the results of the detailed integrated study for one of the satellite complex field discovered in the early 1960s. Following acquisition of new 3D seismic data in 1998 and re-processing work in the year 2006, an integrated G&G study was undertaken to review Lower Cretaceous prospectivity of this reservoir. Nine wells have been drilled in the area, till date with only three wells showing hydrocarbons in two formations. The average oil density is around 300API (American Petroleum Institute), and average porosity and water saturation of the reservoir is about 23% and 26%, respectively. The area is dissected by a number of NW-SE trending faults. Structurally, the area consists of horsts and grabens bounded by these faults and hence compartmentalized. The Wara/Burgan formation consists of discrete, dirty sands with clean channel sand complexes. There is a dramatic change in Upper Wara distributary channel facies, and reservoir quality of Wara and Burgan section varies with change of facies over the area. So predicting reservoir facies and its quality out of sparse well data is a major challenge for delineating the prospective area. To characterize the reservoir of Wara/Burgan formation, an integrated workflow involving seismic, well, petro-physical, reservoir and production engineering data has been used. Porosity and water saturation models are prepared and analyzed to predict reservoir quality of Wara and Burgan 3rd sand upper reservoirs. Subsequently, boundary conditions are defined for reservoir and non-reservoir facies by integrating facies, porosity and water saturation. Based on the detailed analyses of volumetric parameters, potential volumes of stock-tank oil initially in place (STOIIP) and gas initially in place (GIIP) were documented after running several probablistic sensitivity analysis using Montecalro simulation method. Sensitivity analysis on probabilistic models of reservoir horizons, petro-physical properties, and oil-water contacts and their effect on reserve clearly shows some alteration in the reservoir geometry. All these parameters have significant effect on the oil in place. This study has helped to identify uncertainty and risks of this prospect particularly and company is planning to develop this area with drilling of new wells.

Keywords: original oil-in-place, sensitivity, uncertainty, sandstone, reservoir modeling, Monte-Carlo simulation

Procedia PDF Downloads 174
132 Comparing Radiographic Detection of Simulated Syndesmosis Instability Using Standard 2D Fluoroscopy Versus 3D Cone-Beam Computed Tomography

Authors: Diane Ghanem, Arjun Gupta, Rohan Vijayan, Ali Uneri, Babar Shafiq

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Introduction: Ankle sprains and fractures often result in syndesmosis injuries. Unstable syndesmotic injuries result from relative motion between the distal ends of the tibia and fibula, anatomic juncture which should otherwise be rigid, and warrant operative management. Clinical and radiological evaluations of intraoperative syndesmosis stability remain a challenging task as traditional 2D fluoroscopy is limited to a uniplanar translational displacement. The purpose of this pilot cadaveric study is to compare the 2D fluoroscopy and 3D cone beam computed tomography (CBCT) stress-induced syndesmosis displacements. Methods: Three fresh-frozen lower legs underwent 2D fluoroscopy and 3D CIOS CBCT to measure syndesmosis position before dissection. Syndesmotic injury was simulated by resecting the (1) anterior inferior tibiofibular ligament (AITFL), the (2) posterior inferior tibiofibular ligament (PITFL) and the inferior transverse ligament (ITL) simultaneously, followed by the (3) interosseous membrane (IOM). Manual external rotation and Cotton stress test were performed after each of the three resections and 2D and 3D images were acquired. Relevant 2D and 3D parameters included the tibiofibular overlap (TFO), tibiofibular clear space (TCS), relative rotation of the fibula, and anterior-posterior (AP) and medial-lateral (ML) translations of the fibula relative to the tibia. Parameters were measured by two independent observers. Inter-rater reliability was assessed by intraclass correlation coefficient (ICC) to determine measurement precision. Results: Significant mismatches were found in the trends between the 2D and 3D measurements when assessing for TFO, TCS and AP translation across the different resection states. Using 3D CBCT, TFO was inversely proportional to the number of resected ligaments while TCS was directly proportional to the latter across all cadavers and ‘resection + stress’ states. Using 2D fluoroscopy, this trend was not respected under the Cotton stress test. 3D AP translation did not show a reliable trend whereas 2D AP translation of the fibula was positive under the Cotton stress test and negative under the external rotation. 3D relative rotation of the fibula, assessed using the Tang et al. ratio method and Beisemann et al. angular method, suggested slight overall internal rotation with complete resection of the ligaments, with a change < 2mm - threshold which corresponds to the commonly used buffer to account for physiologic laxity as per clinical judgment of the surgeon. Excellent agreement (>0.90) was found between the two independent observers for each of the parameters in both 2D and 3D (overall ICC 0.9968, 95% CI 0.995 - 0.999). Conclusions: The 3D CIOS CBCT appears to reliably depict the trend in TFO and TCS. This might be due to the additional detection of relevant rotational malpositions of the fibula in comparison to the standard 2D fluoroscopy which is limited to a single plane translation. A better understanding of 3D imaging may help surgeons identify the precise measurements planes needed to achieve better syndesmosis repair.

Keywords: 2D fluoroscopy, 3D computed tomography, image processing, syndesmosis injury

Procedia PDF Downloads 48
131 A Review on Agricultural Landscapes as a Habitat of Rodents

Authors: Nadeem Munawar, Tariq Mahmood, Paula Rivadeneira, Ali Akhter

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In this paper, we review on rodent species which are common inhabitants of agricultural landscapes where they are an important prey source for a wide variety of avian, reptilian, and mammalian predators. Agricultural fields are surrounded by fallow land, which provide suitable sites for shelter and breeding for rodents, while shrubs, grasses, annual weeds and forbs may provide supplementary food. The assemblage of rodent’s fauna in the cropland habitats including cropped fields, meadows and adjacent field structures like hedgerows, woodland and field margins fluctuates seasonally. The mature agricultural crops provides good source of food and shelter to the rodents and these factors along with favorable climatic factors/season facilitate breeding activities of these rodent species. Changes in vegetation height and vegetative cover affect two important aspects of a rodent’s life: food and shelter. In addition, during non-crop period vegetation can be important for building nests above or below ground and it provides thermal protection for rodents from heat and cold. The review revealed that rodents form a very diverse group of mammals, ranging from tiny pigmy mice to big capybaras, from arboreal flying squirrels to subterranean mole rats, from opportunistic omnivores (e.g. Norway rats) to specialist feeders (e.g. the North African fat sand rats that feed on a single family of plants only). It is therefore no surprise that some species thrive well under the conditions that are found in agricultural fields. The review on the population dynamics of the rodent species indicated that they are agricultural pests probably due to the heterogeneous landscape and to the high rotativity of vegetable crop cultivation. They also cause damage to various crops, directly and indirectly, by gnawing, spoilage, contamination and hoarding activities, besides this behavior they have also significance importance in agricultural habitat. The burrowing activities of rodents alter the soil properties around their burrows which improve its aeration, infiltration, increase the water holding capacity and thus encourage plant growth. These properties are beneficial for the soil because they affect absorption of phosphorus, absorption zinc, copper, other nutrients and the uptake of water and thus rodents are known as indicator species in agricultural fields. Our review suggests that wide crop field’s borders, particularly those contiguous to various cropland fields, should be understood as priority sites for nesting, feeding, and cover for the rodent’s fauna. The goal of this review paper is to provide a comprehensive synthesis of understanding regarding rodent habitat and biodiversity in agricultural landscapes.

Keywords: agricultural landscapes, food, indicator species, shelter

Procedia PDF Downloads 141
130 CSR Communication Strategies: Stakeholder and Institutional Theories Perspective

Authors: Stephanie Gracelyn Rahaman, Chew Yin Teng, Manjit Singh Sandhu

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Corporate scandals have made stakeholders apprehensive of large companies and expect greater transparency in CSR matters. However, companies find it challenging to strategically communicate CSR to intended stakeholders and in the process may fall short on maximizing on CSR efforts. Given that stakeholders have the ability to either reward good companies or take legal action or boycott against corporate brands who do not act socially responsible, companies must create shared understanding of their CSR activities. As a result, communication has become a strategy for many companies to demonstrate CSR engagement and to minimize stakeholder skepticism. The main objective of this research is to examine the types of CSR communication strategies and predictors that guide CSR communication strategies. Employing Morsing & Schultz’s guide on CSR communication strategies, the study integrates stakeholder and institutional theory to develop a conceptual framework. The conceptual framework hypothesized that stakeholder (instrumental and normative) and institutional (regulatory environment, nature of business, mimetic intention, CSR focus and corporate objectives) dimensions would drive CSR communication strategies. Preliminary findings from semi-structured interviews in Malaysia are consistent with the conceptual model in that stakeholder and institutional expectations guide CSR communication strategies. Findings show that most companies use two-way communication strategies. Companies that identified employees, the public or customers as key stakeholders have started to embrace social media to be in-sync with new trends of communication. This is especially with the Gen Y which is their priority. Some companies creatively use multiple communication channels because they recognize different stakeholders favor different communication channels. Therefore, it appears that companies use two-way communication strategies to complement the perceived limitation of one-way communication strategies as some companies prefer a more interactive platform to strategically engage stakeholders in CSR communication. In addition to stakeholders, institutional expectations also play a vital role in influencing CSR communication. Due to industry peer pressures, corporate objectives (attract international investors and customers), companies may be more driven to excel in social performance. For these reasons companies tend to go beyond the basic mandatory requirement, excel in CSR activities and be known as companies that champion CSR. In conclusion, companies use more two-way than one-way communication and companies use a combination of one and two-way communication to target different stakeholders resulting from stakeholder and institutional dimensions. Finally, in order to find out if the conceptual framework actually fits the Malaysian context, companies’ responses for expected organizational outcomes from communicating CSR were gathered from the interview transcripts. Thereafter, findings are presented to show some of the key organizational outcomes (visibility and brand recognition, portray responsible image, attract prospective employees, positive word-of-mouth, etc.) that companies in Malaysia expect from CSR communication. Based on these findings the conceptual framework has been refined to show the new identified organizational outcomes.

Keywords: CSR communication, CSR communication strategies, stakeholder theory, institutional theory, conceptual framework, Malaysia

Procedia PDF Downloads 267
129 Healthcare Associated Infections in an Intensive Care Unit in Tunisia: Incidence and Risk Factors

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

Procedia PDF Downloads 352
128 Contact Zones and Fashion Hubs: From Circular Economy to Circular Neighbourhoods

Authors: Tiziana Ferrero-Regis, Marissa Lindquist

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Circular Economy (CE) is increasingly seen as the reorganisation of production and consumption, and cities are acknowledged as the sources of many ecological and social problems; at the same time, they can be re-imagined through an ecologically and socially resilient future. The concept of the CE has received pointed critiques for its techno-deterministic orientation, focus on science and transformation by the policy. At the heart of our local re-imagining of the CE into circularity through contact zones there is the acknowledgment of collective, spontaneous and shared imaginations of alternative and sustainable futures through the creation of networks of community initiatives that are transformative, creating opportunities that simultaneously make cities rich and enrich humans. This paper presents a mapping project of the fashion and textile ecosystem in Brisbane, Queensland, Australia. Brisbane is currently the most aspirational city in Australia, as its population growth rate is the highest in the country. Yet, Brisbane is considered the least “fashion city” in the country. In contrast, the project revealed a greatly enhanced picture of distinct fashion and textile clusters across greater Brisbane and the adjacency of key services that may act to consolidate CE community contact zones. Clusters to the north of Brisbane and several locales to the south are zones of a greater mix between public/social amenities, walkable zones and local transport networks with educational precincts, community hubs, concentration of small enterprises, designers, artisans and waste recovery centers that will help to establish knowledge of key infrastructure networks that will support enmeshing these zones together. The paper presents two case studies of independent designers who work on new and re-designed clothing through recovering pre-consumer textiles and that operate from within creative precincts. The first case is designer Nelson Molloy, who recently returned to the inner city suburb of West End with their Chasing Zero Design project. The area was known in the 1980s and 1990s for its alternative lifestyle with creative independent production, thrifty clothing shops, alternative fashion and a socialist agenda. After 30 years of progressive gentrification of the suburb, which has dislocated many of the artists, designers and artisans, West End is seeing the return and amplification of clusters of artisans, artists, designers and architects. The other case study is Practice Studio, located in a new zone of creative growth, Bowen Hills, north of the CBD. Practice Studio combines retail with a workroom, offers repair and remaking services, becoming a point of reference for young and emerging Australian designers and artists. The paper demonstrates the spatial politics of the CE and the way in which new cultural capital is produced thanks to cultural specificities and resources. It argues for the recognition of contact zones that are created by local actors, communities and knowledge networks, whose grass-roots agency is fundamental for the co-production of CE’s systems of local governance.

Keywords: contact zones, circular citities, fashion and textiles, circular neighbourhoods, australia

Procedia PDF Downloads 75
127 Influence of Gamma-Radiation Dosimetric Characteristics on the Stability of the Persistent Organic Pollutants

Authors: Tatiana V. Melnikova, Lyudmila P. Polyakova, Alla A. Oudalova

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As a result of environmental pollution, the production of agriculture and foodstuffs inevitably contain residual amounts of Persistent Organic Pollutants (POP). The special attention must be given to organic pollutants, including various organochlorinated pesticides (OCP). Among priorities, OCP is DDT (and its metabolite DDE), alfa-HCH, gamma-HCH (lindane). The control of these substances spends proceeding from requirements of sanitary norms and rules. During too time often is lost sight of that the primary product can pass technological processing (in particular irradiation treatment) as a result of which transformation of physicochemical forms of initial polluting substances is possible. The goal of the present work was to study the OCP radiation degradation at a various gamma-radiation dosimetric characteristics. The problems posed for goal achievement: to evaluate the content of the priority of OCPs in food; study the character the degradation of OCP in model solutions (with micro concentrations commensurate with the real content of their agricultural and food products) depending upon dosimetric characteristics of gamma-radiation. Qualitative and quantitative analysis of OCP in food and model solutions by gas chromatograph Varian 3400 (Varian, Inc. (USA)); chromatography-mass spectrometer Varian Saturn 4D (Varian, Inc. (USA)) was carried out. The solutions of DDT, DDE, alpha- and gamma- isomer HCH (0.01, 0.1, 1 ppm) were irradiated on "Issledovatel" (60Co) and "Luch - 1" (60Co) installations at a dose 10 kGy with a variation of dose rate from 0.0083 up to 2.33 kGy/sec. It was established experimentally that OCP residual concentration in individual samples of food products (fish, milk, cereal crops, meat, butter) are evaluated as 10-1-10-4 mg/kg, the value of which depends on the factor-sensations territory and natural migration processes. The results were used in the preparation of model solutions OCP. The dependence of a degradation extent of OCP from a dose rate gamma-irradiation has complex nature. According to our data at a dose 10 kGy, the degradation extent of OCP at first increase passes through a maximum (over the range 0.23 – 0.43 Gy/sec), and then decrease with the magnification of a dose rate. The character of the dependence of a degradation extent of OCP from a dose rate is kept for various OCP, in polar and nonpolar solvents and does not vary at the change of concentration of the initial substance. Also in work conditions of the maximal radiochemical yield of OCP which were observed at having been certain: influence of gamma radiation with a dose 10 kGy, in a range of doses rate 0.23 – 0.43 Gy/sec; concentration initial OCP 1 ppm; use of solvent - 2-propanol after preliminary removal of oxygen. Based on, that at studying model solutions of OCP has been established that the degradation extent of pesticides and qualitative structure of OCP radiolysis products depend on a dose rate, has been decided to continue researches radiochemical transformations OCP into foodstuffs at various of doses rate.

Keywords: degradation extent, dosimetric characteristics, gamma-radiation, organochlorinated pesticides, persistent organic pollutants

Procedia PDF Downloads 226
126 Assessing Acute Toxicity and Endocrine Disruption Potential of Selected Packages Internal Layers Extracts

Authors: N. Szczepanska, B. Kudlak, G. Yotova, S. Tsakovski, J. Namiesnik

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In the scientific literature related to the widely understood issue of packaging materials designed to have contact with food (food contact materials), there is much information on raw materials used for their production, as well as their physiochemical properties, types, and parameters. However, not much attention is given to the issues concerning migration of toxic substances from packaging and its actual influence on the health of the final consumer, even though health protection and food safety are the priority tasks. The goal of this study was to estimate the impact of particular foodstuff packaging type, food production, and storage conditions on the degree of leaching of potentially toxic compounds and endocrine disruptors to foodstuffs using the acute toxicity test Microtox and XenoScreen YES YAS assay. The selected foodstuff packaging materials were metal cans used for fish storage and tetrapak. Five stimulants respectful to specific kinds of food were chosen in order to assess global migration: distilled water for aqueous foods with a pH above 4.5; acetic acid at 3% in distilled water for acidic aqueous food with pH below 4.5; ethanol at 5% for any food that may contain alcohol; dimethyl sulfoxide (DMSO) and artificial saliva were used in regard to the possibility of using it as an simulation medium. For each packaging three independent variables (temperature and contact time) factorial design simulant was performed. Xenobiotics migration from epoxy resins was studied at three different temperatures (25°C, 65°C, and 121°C) and extraction time of 12h, 48h and 2 weeks. Such experimental design leads to 9 experiments for each food simulant as conditions for each experiment are obtained by combination of temperature and contact time levels. Each experiment was run in triplicate for acute toxicity and in duplicate for estrogen disruption potential determination. Multi-factor analysis of variation (MANOVA) was used to evaluate the effects of the three main factors solvent, temperature (temperature regime for cup), contact time and their interactions on the respected dependent variable (acute toxicity or estrogen disruption potential). From all stimulants studied the most toxic were can and tetrapak lining acetic acid extracts that are indication for significant migration of toxic compounds. This migration increased with increase of contact time and temperature and justified the hypothesis that food products with low pH values cause significant damage internal resin filling. Can lining extracts of all simulation medias excluding distilled water and artificial saliva proved to contain androgen agonists even at 25°C and extraction time of 12h. For tetrapak extracts significant endocrine potential for acetic acid, DMSO and saliva were detected.

Keywords: food packaging, extraction, migration, toxicity, biotest

Procedia PDF Downloads 160
125 A Computational Approach to Screen Antagonist’s Molecule against Mycobacterium tuberculosis Lipoprotein LprG (Rv1411c)

Authors: Syed Asif Hassan, Tabrej Khan

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Tuberculosis (TB) caused by bacillus Mycobacterium tuberculosis (Mtb) continues to take a disturbing toll on human life and healthcare facility worldwide. The global burden of TB remains enormous. The alarming rise of multi-drug resistant strains of Mycobacterium tuberculosis calls for an increase in research efforts towards the development of new target specific therapeutics against diverse strains of M. tuberculosis. Therefore, the discovery of new molecular scaffolds targeting new drug sites should be a priority for a workable plan for fighting resistance in Mycobacterium tuberculosis (Mtb). Mtb non-acylated lipoprotein LprG (Rv1411c) has a Toll-like receptor 2 (TLR2) agonist actions that depend on its association with triacylated glycolipids binding specifically with the hydrophobic pocket of Mtb LprG lipoprotein. The detection of a glycolipid carrier function has important implications for the role of LprG in Mycobacterial physiology and virulence. Therefore, considering the pivotal role of glycolipids in mycobacterial physiology and host-pathogen interactions, designing competitive antagonist (chemotherapeutics) ligands that competitively bind to glycolipid binding domain in LprG lipoprotein, will lead to inhibition of tuberculosis infection in humans. In this study, a unified approach involving ligand-based virtual screening protocol USRCAT (Ultra Shape Recognition) software and molecular docking studies using Auto Dock Vina 1.1.2 using the X-ray crystal structure of Mtb LprG protein was implemented. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the Ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has the higher hypothetical affinity, also has greater negative value. Based on the USRCAT, Lipinski’s values and molecular docking results, [(2R)-2,3-di(hexadecanoyl oxy)propyl][(2S,3S,5S,6R)-3,4,5-trihydroxy-2,6-bis[[(2R,3S,4S,5R,6S)-3,4,5-trihydroxy-6 (hydroxymethyl)tetrahydropyran-2-yl]oxy]cyclohexyl] phosphate (XPX) was confirmed as a promising drug-like lead compound (antagonist) binding specifically to the hydrophobic domain of LprG protein with affinity greater than that of PIM2 (agonist of LprG protein) with a free binding energy of -9.98e+006 Kcal/mol and binding affinity of -132 Kcal/mol, respectively. A further, in vitro assay of this compound is required to establish its potency in inhibiting molecular evasion mechanism of MTB within the infected host macrophages. These results will certainly be helpful in future anti-TB drug discovery efforts against Multidrug-Resistance Tuberculosis (MDR-TB).

Keywords: antagonist, agonist, binding affinity, chemotherapeutics, drug-like, multi drug resistance tuberculosis (MDR-TB), RV1411c protein, toll-like receptor (TLR2)

Procedia PDF Downloads 246
124 Carbon Footprint of Educational Establishments: The Case of the University of Alicante

Authors: Maria R. Mula-Molina, Juan A. Ferriz-Papi

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Environmental concerns are increasingly obtaining higher priority in sustainability agenda of educational establishments. This is important not only for its environmental performance in its own right as an organization, but also to present a model for its students. On the other hand, universities play an important role on research and innovative solutions for measuring, analyzing and reducing environmental impacts for different activities. The assessment and decision-making process during the activity of educational establishments is linked to the application of robust indicators. In this way, the carbon footprint is a developing indicator for sustainability that helps understand the direct impact on climate change. But it is not easy to implement. There is a large amount of considering factors involved that increases its complexity, such as different uses at the same time (research, lecturing, administration), different users (students, staff) or different levels of activity (lecturing, exam or holidays periods). The aim of this research is to develop a simplified methodology for calculating and comparing carbon emissions per user at university campus considering two main aspects for carbon accountings: Building operations and transport. Different methodologies applied in other Spanish university campuses are analyzed and compared to obtain a final proposal to be developed in this type of establishments. First, building operation calculation considers the different uses and energy sources consumed. Second, for transport calculation, the different users and working hours are calculated separately, as well as their origin and traveling preferences. For every transport, a different conversion factor is used depending on carbon emissions produced. The final result is obtained as an average of carbon emissions produced per user. A case study is applied to the University of Alicante campus in San Vicente del Raspeig (Spain), where the carbon footprint is calculated. While the building operation consumptions are known per building and month, it does not happen with transport. Only one survey about the habit of transport for users was developed in 2009/2010, so no evolution of results can be shown in this case. Besides, building operations are not split per use, as building services are not monitored separately. These results are analyzed in depth considering all factors and limitations. Besides, they are compared to other estimations in other campuses. Finally, the application of the presented methodology is also studied. The recommendations concluded in this study try to enhance carbon emission monitoring and control. A Carbon Action Plan is then a primary solution to be developed. On the other hand, the application developed in the University of Alicante campus cannot only further enhance the methodology itself, but also render the adoption by other educational establishments more readily possible and yet with a considerable degree of flexibility to cater for their specific requirements.

Keywords: building operations, built environment, carbon footprint, climate change, transport

Procedia PDF Downloads 261
123 Effect of Supplementation of Hay with Noug Seed Cake (Guizotia abyssinica), Wheat Bran and Their Mixtures on Feed Utilization, Digestiblity and Live Weight Change in Farta Sheep

Authors: Fentie Bishaw Wagayie

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This study was carried out with the objective of studying the response of Farta sheep in feed intake and live weight change when fed on hay supplemented with noug seed cake (NSC), wheat bran (WB), and their mixtures. The digestibility trial of 7 days and 90 days of feeding trial was conducted using 25 intact male Farta sheep with a mean initial live weight of 16.83 ± 0.169 kg. The experimental animals were arranged randomly into five blocks based on the initial live weight, and the five treatments were assigned randomly to each animal in a block. Five dietary treatments used in the experiment comprised of grass hay fed ad libitum (T1), grass hay ad libitum + 300 g DM WB (T2), grass hay ad libitum + 300 g DM (67% WB: 33% NSC mixture) (T3), grass hay ad libitum + 300 g DM (67% NSC: 33% WB) (T4) and 300 g DM/ head/day NSC (T5). Common salt and water were offered ad libitum. The supplements were offered twice daily at 0800 and 1600 hours. The experimental sheep were kept in individual pens. Supplementation of NSC, WB, and their mixtures significantly increased (p < 0.01) the total dry matter (DM) (665.84-788 g/head/day) and (p < 0.001) crude protein (CP) intake. Unsupplemented sheep consumed significantly higher (p < 0.01) grass hay DM (540.5g/head/day) as compared to the supplemented treatments (365.8-488 g/h/d), except T2. Among supplemented sheep, T5 had significantly higher (p < 0.001) CP intake (99.98 g/head/day) than the others (85.52-90.2 g/head/day). Supplementation significantly improved (p < 0.001) the digestibility of CP (66.61-78.9%), but there was no significant effect (p > 0.05) on DM, OM, NDF, and ADF digestibility between supplemented and control treatments. Very low CP digestibility (11.55%) observed in the basal diet (grass hay) used in this study indicated that feeding sole grass hay could not provide nutrients even for the maintenance requirement of growing sheep. Significant final and daily live weight gain (p < 0.001) in the range of 70.11-82.44 g/head/day was observed in supplemented Farta sheep, but unsupplemented sheep lost weight by 9.11g/head/day. Numerically, among the supplemented treatments, sheep supplemented with a higher proportion of NSC in T4 (201 NSC + 99 g WB) gained more weight than the rest, though not statistically significant (p > 0.05). The absence of statistical difference in daily body weight gain between all supplemented sheep indicated that the supplementation of NSC, WB, and their mixtures had similar potential to provide nutrients. Generally, supplementation of NSC, WB, and their mixtures to the basal grass hay diet improved feed conversion ratio, total DM intake, CP intake, and CP digestibility, and it also improved the growth performance with a similar trend for all supplemented Farta sheep over the control group. Therefore, from a biological point of view, to attain the required level of slaughter body weight within a short period of the growing program, sheep producer can use all the supplement types depending upon their local availability, but in the order of priority, T4, T5, T3, and T2, respectively. However, based on partial budget analysis, supplementation of 300 g DM/head /day NSC (T5) could be recommended as profitable for producers with no capital limitation, whereas T4 supplementation (201 g NSC + 99 WB DM/day) is recommended when there is capital scarcity.

Keywords: weight gain, supplement, Farta sheep, hay as basal diet

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122 Magnetron Sputtered Thin-Film Catalysts with Low Noble Metal Content for Proton Exchange Membrane Water Electrolysis

Authors: Peter Kus, Anna Ostroverkh, Yurii Yakovlev, Yevheniia Lobko, Roman Fiala, Ivan Khalakhan, Vladimir Matolin

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Hydrogen economy is a concept of low-emission society which harvests most of its energy from renewable sources (e.g., wind and solar) and in case of overproduction, electrochemically turns the excess amount into hydrogen, which serves as an energy carrier. Proton exchange membrane water electrolyzers (PEMWE) are the backbone of this concept. By fast-response electricity to hydrogen conversion, the PEMWEs will not only stabilize the electrical grid but also provide high-purity hydrogen for variety of fuel cell powered devices, ranging from consumer electronics to vehicles. Wider commercialization of PEMWE technology is however hindered by high prices of noble metals which are necessary for catalyzing the redox reactions within the cell. Namely, platinum for hydrogen evolution reaction (HER), running on cathode, and iridium for oxygen evolution reaction (OER) on anode. Possible way of how to lower the loading of Pt and Ir is by using conductive high-surface nanostructures as catalyst supports in conjunction with thin-film catalyst deposition. The presented study discusses unconventional technique of membrane electron assembly (MEA) preparation. Noble metal catalysts (Pt and Ir) were magnetron sputtered in very low loadings onto the surface of porous sublayers (located on gas diffusion layer or directly on membrane), forming so to say localized three-phase boundary. Ultrasonically sprayed corrosion resistant TiC-based sublayer was used as a support material on anode, whereas magnetron sputtered nanostructured etched nitrogenated carbon (CNx) served the same role on cathode. By using this configuration, we were able to significantly decrease the amount of noble metals (to thickness of just tens of nanometers), while keeping the performance comparable to that of average state-of-the-art catalysts. Complex characterization of prepared supported catalysts includes in-cell performance and durability tests, electrochemical impedance spectroscopy (EIS) as well as scanning electron microscopy (SEM) imaging and X-ray photoelectron spectroscopy (XPS) analysis. Our research proves that magnetron sputtering is a suitable method for thin-film deposition of electrocatalysts. Tested set-up of thin-film supported anode and cathode catalysts with combined loading of just 120 ug.cm⁻² yields remarkable values of specific current. Described approach of thin-film low-loading catalyst deposition might be relevant when noble metal reduction is the topmost priority.

Keywords: hydrogen economy, low-loading catalyst, magnetron sputtering, proton exchange membrane water electrolyzer

Procedia PDF Downloads 142
121 Rethinking Modernization Strategy of Muslim Society: The Need for Value-Based Approach

Authors: Louay Safi

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The notion of secular society that evolved over the last two centuries was initially intended to free the public sphere from religious imposition, before it assumed the form a comprehensive ideology whose aim is to prevent any overt religious expression from the public space. The negative view of religious expression, and the desire by political elites to purge the public space from all forms of religious expressions were first experienced in the Middle East in the last decades of the twentieth century in relation to Islam, before it manifests itself in the twentieth century Europe. Arab regimes were encouraged by European democracies to marginalize all forms of religious expressions in the public as part of the secularization process that was deemed necessary for modernization and progress. The prohibition of Islamic symbols and outlawing the headscarf was first undertaken to Middle Eastern republics, such as Turkey in 1930s and Syria in 1970s, before it is implemented recently in France. Secularization has been perceived by European powers as the central aspect of social and political liberalization, and was given priority over democratization and human rights, so much so that European elites were willing to entrust the task of nurturing liberal democracy to Arab autocrats and dictators. Not only did the strategy of empowering autocratic regimes to effect liberal democratic culture failed, but it contributed to the rise of Islamist extremism and produced failed states in Syria and Iraq that undermine both national and global peace and stability. The paper adopts the distinction made by John Rawls between political and comprehensive liberalism to argue that the modernization via secularization in Muslim societies is counterproductive and has subverted early successful efforts at democratization and reform in the Middle East. Using case studies that illustrate the role of the secularization strategy in Syria, Iran, and Egypt in undermining democratic and reformist movements in those countries, the paper calls for adopting a different approach rooted in liberal and democratic values rather than cultural practices and lifestyle. The paper shows that Islamic values as articulated by reform movements support a democratic and pluralist political order, and emphasizes the need to legitimize and support social forces that advocate democracy and human rights. Such an alternative strategy allows for internal competition among social groups for popular support, and therefore enhances the chances that those with inclusive and forward-looking political principles and policies would create a democratic and pluralist political order more conducive to meaningful national and global cooperation, and respectful of human dignity.

Keywords: democracy, Islamic values, political liberalism, secularization

Procedia PDF Downloads 147
120 Age-Related Health Problems and Needs of Elderly People Living in Rural Areas in Poland

Authors: Anna Mirczak

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Introduction: In connection with the aging of the population and the increase in the number of people with chronic illnesses, the priority objective for public health has become not only lengthening life, but also improving quality of life in older persons, as well as maintenance of their relative independence and active participation in social life. The most important determinant of a person’s quality of life is health. According to the literature, older people with chronic illness who live in rural settings are at greater risk for poor outcomes than their urban counterparts. Furthermore research characterizes the rural elderly as having a higher incidence of sickness, dysfunction, disability, restricted mobility, and acute and chronic conditions than their urban citizens. It is dictated by the overlapping certain specific socio-economic factors typical for rural areas which include: social and geography exclusion, limited access to health care centers, and low socioeconomic status. Aim of the study: The objective of this study was to recognize health status and needs of older people living in selected rural areas in Poland and evaluate the impacts of working in the farm on their health status. Material and methods: The study was performed personally, using interviews based on the structural questionnaires, during the period from March 2011 to October 2012. The group of respondents consisted 203 people aged 65 years and over living in selected rural areas in Poland. The analysis of collected research material was performed using the statistical package SPSS 19 for Windows. The level of significance for the tested the hypotheses assumed value of 0.05. Results: The mean age of participants was 75,5 years (SD=5,7) range from 65 to 94 years. Most of the interviewees had children (89.2%) and grandchildren (83.7) and lived mainly with family members (75.9%) mostly in double (46.8%) and triple (20.8%) household. The majority of respondents (71,9%) were physical working on the farm. At the time of interview, each of the respondents reported that they had been diagnosed with at least one chronic diseases by their GP. The most common were: hypertension (67,5%), osteoarthritis (44,8%), atherosclerosis (43,3%), cataract (40,4%), arrhythmia (28,6%), diabetes mellitus (19,7%) and stomach or duodenum ulcer diseases (17,2%).The number of diseases occurring of the sample was dependent on gender and age. Significant associations were observed between working on the farm and frequency of occurrence cardiovascular diseases, the gastrointestinal tract dysfunction and sensory disorders. Conclusions: The most common causes of disability among older citizens were: chronic diseases, malnutrition and complaints about access to health services (especially to cardiologist and an ophthalmologist). Health care access and health status are a particular concern in rural areas where the population is older, has lower education and income levels, and is more likely to be living in medically underserved areas than is the case in urban areas.

Keywords: ageing, health status, older people, rural

Procedia PDF Downloads 245
119 Treatment of Neuronal Defects by Bone Marrow Stem Cells Differentiation to Neuronal Cells Cultured on Gelatin-PLGA Scaffolds Coated with Nano-Particles

Authors: Alireza Shams, Ali Zamanian, Atefehe Shamosi, Farnaz Ghorbani

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Introduction: Although the application of a new strategy remains a remarkable challenge for treatment of disabilities due to neuronal defects, progress in Nanomedicine and tissue engineering, suggesting the new medical methods. One of the promising strategies for reconstruction and regeneration of nervous tissue is replacing of lost or damaged cells by specific scaffolds after Compressive, ischemic and traumatic injuries of central nervous system. Furthermore, ultrastructure, composition, and arrangement of tissue scaffolds are effective on cell grafts. We followed implantation and differentiation of mesenchyme stem cells to neural cells on Gelatin Polylactic-co-glycolic acid (PLGA) scaffolds coated with iron nanoparticles. The aim of this study was to evaluate the capability of stem cells to differentiate into motor neuron-like cells under topographical cues and morphogenic factors. Methods and Materials: Bone marrow mesenchymal stem cells (BMMSCs) was obtained by primary cell culturing of adult rat bone marrow got from femur bone by flushing method. BMMSCs were incubated with DMEM/F12 (Gibco), 15% FBS and 100 U/ml pen/strep as media. Then, BMMSCs seeded on Gel/PLGA scaffolds and tissue culture (TCP) polystyrene embedded and incorporated by Fe Nano particles (FeNPs) (Fe3o4 oxide (M w= 270.30 gr/mol.). For neuronal differentiation, 2×10 5 BMMSCs were seeded on Gel/PLGA/FeNPs scaffolds was cultured for 7 days and 0.5 µ mol. Retinoic acid, 100 µ mol. Ascorbic acid,10 ng/ml. Basic fibroblast growth factor (Sigma, USA), 250 μM Iso butyl methyl xanthine, 100 μM 2-mercaptoethanol, and 0.2 % B27 (Invitrogen, USA) added to media. Proliferation of BMMSCs was assessed by using MTT assay for cell survival. The morphology of BMMSCs and scaffolds was investigated by scanning electron microscopy analysis. Expression of neuron-specific markers was studied by immunohistochemistry method. Data were analyzed by analysis of variance, and statistical significance was determined by Turkey’s test. Results: Our results revealed that differentiation and survival of BMMSCs into motor neuron-like cells on Gel/PLGA/FeNPs as a biocompatible and biodegradable scaffolds were better than those cultured in Gel/PLGA in absence of FeNPs and TCP scaffolds. FeNPs had raised physical power but decreased capacity absorption of scaffolds. Well defined oriented pores in scaffolds due to FeNPs may activate differentiation and synchronized cells as a mechanoreceptor. Induction effects of magnetic FeNPs by One way flow of channels in scaffolds help to lead the cells and can facilitate direction of their growth processes. Discussion: Progression of biological properties of BMMSCs and the effects of FeNPs spreading under magnetic field was evaluated in this investigation. In vitro study showed that the Gel/PLGA/FeNPs scaffold provided a suitable structure for motor neuron-like cells differentiation. This could be a promising candidate for enhancing repair and regeneration in neural defects. Dynamic and static magnetic field for inducing and construction of cells can provide better results for further experimental studies.

Keywords: differentiation, mesenchymal stem cells, nano particles, neuronal defects, Scaffolds

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118 Chemical vs Visual Perception in Food Choice Ability of Octopus vulgaris (Cuvier, 1797)

Authors: Al Sayed Al Soudy, Valeria Maselli, Gianluca Polese, Anna Di Cosmo

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Cephalopods are considered as a model organism with a rich behavioral repertoire. Sophisticated behaviors were widely studied and described in different species such as Octopus vulgaris, who has evolved the largest and more complex nervous system among invertebrates. In O. vulgaris, cognitive abilities in problem-solving tasks and learning abilities are associated with long-term memory and spatial memory, mediated by highly developed sensory organs. They are equipped with sophisticated eyes, able to discriminate colors even with a single photoreceptor type, vestibular system, ‘lateral line analogue’, primitive ‘hearing’ system and olfactory organs. They can recognize chemical cues either through direct contact with odors sources using suckers or by distance through the olfactory organs. Cephalopods are able to detect widespread waterborne molecules by the olfactory organs. However, many volatile odorant molecules are insoluble or have a very low solubility in water, and must be perceived by direct contact. O. vulgaris, equipped with many chemosensory neurons located in their suckers, exhibits a peculiar behavior that can be provocatively described as 'smell by touch'. The aim of this study is to establish the priority given to chemical vs. visual perception in food choice. Materials and methods: Three different types of food (anchovies, clams, and mussels) were used, and all sessions were recorded with a digital camera. During the acclimatization period, Octopuses were exposed to the three types of food to test their natural food preferences. Later, to verify if food preference is maintained, food was provided in transparent screw-jars with pierced lids to allow both visual and chemical recognition of the food inside. Subsequently, we tested alternatively octopuses with food in sealed transparent screw-jars and food in blind screw-jars with pierced lids. As a control, we used blind sealed jars with the same lid color to verify a random choice among food types. Results and discussion: During the acclimatization period, O. vulgaris shows a higher preference for anchovies (60%) followed by clams (30%), then mussels (10%). After acclimatization, using the transparent and pierced screw jars octopus’s food choices resulted in 50-50 between anchovies and clams, avoiding mussels. Later, guided by just visual sense, with transparent but not pierced jars, their food preferences resulted in 100% anchovies. With pierced but not transparent jars their food preference resulted in 100% anchovies as first food choice, the clams as a second food choice result (33.3%). With no possibility to select food, neither by vision nor by chemoreception, the results were 20% anchovies, 20% clams, and 60% mussels. We conclude that O. vulgaris uses both chemical and visual senses in an integrative way in food choice, but if we exclude one of them, it appears clear that its food preference relies on chemical sense more than on visual perception.

Keywords: food choice, Octopus vulgaris, olfaction, sensory organs, visual sense

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117 Mental Health on Three Continents: A Comparison of Mental Health Disorders in the Usa, India and Brazil

Authors: Henry Venter, Murali Thyloth, Alceu Casseb

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Historically, mental and substance use disorders were not a global health priority. Since the 1993 World Development Report, the importance of the contribution of mental health and substance abuse on the relative global burden associated with disease morbidity has been recognized with 300 million people worldwide suffering from depression alone. This led to an international effort to improve the mental health of populations around the world. Despite these efforts some countries remain at the top of the list of countries with the highest rate of mental illness. Important research questions were asked: Would there be commonalities regarding mental health between these countries; would there be common factors leading to the high prevalence of mental illness; and how prepared are these countries with mental health delivery? Findings from this research can aid organizations and institutions preparing mental health service providers to focus training and preparation to address specific needs revealed by the study. Methods: Researchers decided to compare three distinctly different countries at the top of the list of countries with the highest rate of mental illness, the USA, India and Brazil, situated on three different continents with different economies and lifestyles. Data were collected using archival research methodology, reviewing records and findings of international and national health and mental health studies to subtract and compare data and findings. Results: The findings indicated that India is the most depressed country in the world, followed by the USA (and China) with Brazil in Latin America with the greatest number of depressed individuals. By 2020 roughly 20% of India, acountry of over one billion citizens, will suffer from some form of mental illnees, yet there are less than 4,000 experts available. In the USA 164.8 million people were substance abusers and an estimate of 47.6 million adults, 18 or older, had any mental illness in 2018. That means that about one in five adults in the USA experiences some form of mental illness each year, but only 41% of those affected received mental health care or services in the past year. Brazil has the greatest number of depressed individuals, in Latin America. Adults living in Sao Paulo megacity has prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world with more than one million adults with serious impairment levels. Discussion: The results show that, despite the vast socioeconomic differences between the three countries, there are correlations regarding mental health prevalence and difficulty to provide adequate services including a lack of awareness of how serious mental illness is, stigma for seeking mental illness, with comorbidity a common phenomenon, and a lack of partnership between different levels of service providers, which weakens mental health service delivery. The findings also indicate that mental health training institutions have a monumental task to prepare personnel to address the future mental health needs in each of the countries compared, which will constitute the next phase of the research.

Keywords: mental health epidemiology, mental health disorder, mental health prevalence, mental health treatment

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116 Method for Requirements Analysis and Decision Making for Restructuring Projects in Factories

Authors: Rene Hellmuth

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The requirements for the factory planning and the building concerned have changed in the last years. Factory planning has the task of designing products, plants, processes, organization, areas, and the building of a factory. Regular restructuring gains more importance in order to maintain the competitiveness of a factory. Restrictions regarding new areas, shorter life cycles of product and production technology as well as a VUCA (volatility, uncertainty, complexity and ambiguity) world cause more frequently occurring rebuilding measures within a factory. Restructuring of factories is the most common planning case today. Restructuring is more common than new construction, revitalization and dismantling of factories. The increasing importance of restructuring processes shows that the ability to change was and is a promising concept for the reaction of companies to permanently changing conditions. The factory building is the basis for most changes within a factory. If an adaptation of a construction project (factory) is necessary, the inventory documents must be checked and often time-consuming planning of the adaptation must take place to define the relevant components to be adapted, in order to be able to finally evaluate them. The different requirements of the planning participants from the disciplines of factory planning (production planner, logistics planner, automation planner) and industrial construction planning (architect, civil engineer) come together during reconstruction and must be structured. This raises the research question: Which requirements do the disciplines involved in the reconstruction planning place on a digital factory model? A subordinate research question is: How can model-based decision support be provided for a more efficient design of the conversion within a factory? Because of the high adaptation rate of factories and its building described above, a methodology for rescheduling factories based on the requirements engineering method from software development is conceived and designed for practical application in factory restructuring projects. The explorative research procedure according to Kubicek is applied. Explorative research is suitable if the practical usability of the research results has priority. Furthermore, it will be shown how to best use a digital factory model in practice. The focus will be on mobile applications to meet the needs of factory planners on site. An augmented reality (AR) application will be designed and created to provide decision support for planning variants. The aim is to contribute to a shortening of the planning process and model-based decision support for more efficient change management. This requires the application of a methodology that reduces the deficits of the existing approaches. The time and cost expenditure are represented in the AR tablet solution based on a building information model (BIM). Overall, the requirements of those involved in the planning process for a digital factory model in the case of restructuring within a factory are thus first determined in a structured manner. The results are then applied and transferred to a construction site solution based on augmented reality.

Keywords: augmented reality, digital factory model, factory planning, restructuring

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115 Modification of Hyrax Expansion Screw to Be Used as an Intro-Oral Distractor for Anterior Maxillary Distraction in a Patient with Cleft Lip and Palate: A Case Report

Authors: Ananya Hazare, Ranjit Kamble

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Introduction: Patients with Cleft lip and palate (CL/P) can present with a maxillary retrution after cleft repair. Anterior Maxillary distraction osteogenesis (AMD) is a technique that provides simultaneous skeletal advancement and expansion of the soft tissues related to an anterior segment of the maxilla. This case presented is a case of AMD. The advantage of this technique is that the occlusion in the posterior segment can be maintained, and only the segment in cross bite is advanced for correction of the midfacial deficiency. The other alternative treatment is anterior movement by a Lefort 1 osteotomy. When a Lefort 1 osteotomy is compared with the Distraction osteogenesis or AMD, the disadvantages of the Le Fort 1 include a higher risk of morbidity, requirement of fixation, relapse tendency and unexpected changes in the nasal form. These complications were eliminated by AMD technique. This was followed by placement of the implant in the bone formed after AMD. Hence complete surgical, orthodontic and prosthodontics rehabilitation of the patient was done by an interdisciplinary approach. Methods: Patient presented with repaired UCL/P of the right side with midfacial retrusion. Intro-oral examination revealed a good occlusion in the posterior arch and anterior Crossbite from canine to canine. Patient's both maxillary lateral incisors were missing. The lower arch was well aligned with all teeth present. The study models when scored according to GOSLON yardstick received a score of 4. After pre-surgical orthodontic phase was completed an intraoral distractor was fabricated by modification of HYRAX expansion screw. After surgery, low subapical osteotomy cuts were placed and the distractor was fixed. The latency period of 5 days was observed after which the distraction was started. Distraction was done at a rate of 1 mm/day with a rhythm of 0.5mm in morning and 0.5mm in the evening. The total distraction of 12 mm was done. After a consolidation period, the distractor was removed, and retention by a removable partial denture was given. Radiographic examination confirmed mature bone formation in the distracted segment. Implants were placed and allowed to osseointegrate for approximately 4 months and were then loaded with abutments. Results: Total distraction done was 12mm and after relapse it was 8mm. After consolidation phase the radiographic examination revealed a B2 quality of bone according to the Misch's classification and sufficient height from the maxillary sinus. These findings were indicative for placement of implants in the distracted bone formed in premolar region. Implants were placed and after radiographic evidence of osseointegration was seen they were loaded with abutments. Thus resulting in a complete rehabilitation of a cleft patient by an interdisciplinary approach. Conclusion: Anterior maxillary distraction can be used as an alternative method instead of complete distraction osteogenesis or Lefort 1 advancement of maxilla in cases where the advancement needed is minimum. Use of HYRAX expansion screw modified as intra-oral distractor can be used in such cases, which significantly reduces the cost of treatment, as expensive distractors are not used. This technique is very useful and efficient in countries like India where the patient cannot afford expensive treatment options.

Keywords: cleft lip and palate, distraction osteogenesis, anterior maxillary distraction, orthodontics and dentofacial orthopaedics, hyrax expansion screw modification

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114 Screening of Osteoporosis in Aging Populations

Authors: Massimiliano Panella, Sara Bortoluzzi, Sophia Russotto, Daniele Nicolini, Carmela Rinaldi

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Osteoporosis affects more than 200 million people worldwide. About 75% of osteoporosis cases are undiagnosed or diagnosed only when a bone fracture occurs. Since osteoporosis related fractures are significant determinants of the burden of disease and health and social costs of aging populations, we believe that this is the early identification and treatment of high-risk patients should be a priority in actual healthcare systems. Screening for osteoporosis by dual energy x-ray absorptiometry (DEXA) is not cost-effective for general population. An alternative is pulse-echo ultrasound (PEUS) because of the minor costs. To this end, we developed an early detection program for osteoporosis with PEUS, and we evaluated is possible impact and sustainability. We conducted a cross-sectional study including 1,050 people in Italy. Subjects with >1 major or >2 minor risk factors for osteoporosis were invited to PEUS bone mass density (BMD) measurement at the proximal tibia. Based on BMD values, subjects were classified as healthy subjects (BMD>0.783 g/cm²) and pathological including subjects with suspected osteopenia (0.783≤BMD>0.719 g/cm²) or osteoporosis (BMD ≤ 0.719 g/cm²). The responder rate was 60.4% (634/1050). According to the risk, PEUS scan was recommended to 436 people, of whom 300 (mean age 45.2, 81% women) accepted to participate. We identified 240 (80%) healthy and 60 (20%) pathological subjects (47 osteopenic and 13 osteoporotic). We observed a significant association between high risk people and reduced bone density (p=0.043) with increased risks for female gender, older ages, and menopause (p<0.01). The yearly cost of the screening program was 8,242 euros. With actual Italian fracture incidence rates in osteoporotic patients, we can reasonably expect in 20 years that at least 6 fractures will occur in our sample. If we consider that the mean costs per fracture in Italy is today 16,785 euros, we can estimate a theoretical cost of 100,710 euros. According to literature, we can assume that the early treatment of osteoporosis could avoid 24,170 euros of such costs. If we add the actual yearly cost of the treatments to the cost of our program and we compare this final amount of 11,682 euros to the avoidable costs of fractures (24,170 euros) we can measure a possible positive benefits/costs ratio of 2.07. As a major outcome, our study let us to early identify 60 people with a significant bone loss that were not aware of their condition. This diagnostic anticipation constitutes an important element of value for the project, both for the patients, for the preventable negative outcomes caused by the fractures, and for the society in general, because of the related avoidable costs. Therefore, based on our finding, we believe that the PEUS based screening performed could be a cost-effective approach to early identify osteoporosis. However, our study has some major limitations. In fact, in our study the economic analysis is based on theoretical scenarios, thus specific studies are needed for a better estimation of the possible benefits and costs of our program.

Keywords: osteoporosis, prevention, public health, screening

Procedia PDF Downloads 99