Search results for: life cycle cost
1563 Graphene Supported Nano Cerium Oxides Hybrid as an Electrocatalyst for Oxygen Reduction Reactions
Authors: Siba Soren, Purnendu Parhi
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Today, the world is facing a severe challenge due to depletion of traditional fossil fuels. Scientists across the globe are working for a solution that involves a dramatic shift to practical and environmentally sustainable energy sources. High-capacity energy systems, such as metal-air batteries, fuel cells, are highly desirable to meet the urgent requirement of sustainable energies. Among the fuel cells, Direct methanol fuel cells (DMFCs) are recognized as an ideal power source for mobile applications and have received considerable attention in recent past. In this advanced electrochemical energy conversion technologies, Oxygen Reduction Reaction (ORR) is of utmost importance. However, the poor kinetics of cathodic ORR in DMFCs significantly hampers their possibilities of commercialization. The oxygen is reduced in alkaline medium either through a 4-electron (equation i) or a 2-electron (equation ii) reduction pathway at the cathode ((i) O₂ + 2H₂O + 4e⁻ → 4OH⁻, (ii) O₂ + H₂O + 2e⁻ → OH⁻ + HO₂⁻ ). Due to sluggish ORR kinetics the ability to control the reduction of molecular oxygen electrocatalytically is still limited. The electrocatalytic ORR starts with adsorption of O₂ on the electrode surface followed by O–O bond activation/cleavage and oxide removal. The reaction further involves transfer of 4 electrons and 4 protons. The sluggish kinetics of ORR, on the one hand, demands high loading of precious metal-containing catalysts (e.g., Pt), which unfavorably increases the cost of these electrochemical energy conversion devices. Therefore, synthesis of active electrocatalyst with an increase in ORR performance is need of the hour. In the recent literature, there are many reports on transition metal oxide (TMO) based ORR catalysts for their high activity TMOs are also having drawbacks like low electrical conductivity, which seriously affects the electron transfer process during ORR. It was found that 2D graphene layer is having high electrical conductivity, large surface area, and excellent chemical stability, appeared to be an ultimate choice as support material to enhance the catalytic performance of bare metal oxide. g-C₃N₄ is also another candidate that has been used by the researcher for improving the ORR performance of metal oxides. This material provides more active reaction sites than other N containing carbon materials. Rare earth oxide like CeO₂ is also a good candidate for studying the ORR activity as the metal oxide not only possess unique electronic properties but also possess catalytically active sites. Here we will discuss the ORR performance (in alkaline medium) of N-rGO/C₃N₄ supported nano Cerium Oxides hybrid synthesized by microwave assisted Solvothermal method. These materials exhibit superior electrochemical stability and methanol tolerance capability to that of commercial Pt/C.Keywords: oxygen reduction reaction, electrocatalyst, cerium oxide, graphene
Procedia PDF Downloads 1991562 Whole Exome Sequencing in Characterizing Mysterious Crippling Disorder in India
Authors: Swarkar Sharma, Ekta Rai, Ankit Mahajan, Parvinder Kumar, Manoj K Dhar, Sushil Razdan, Kumarasamy Thangaraj, Carol Wise, Shiro Ikegawa M.D., K.K. Pandita M.D.
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Rare disorders are poorly understood hence, remain uncharacterized or patients are misdiagnosed and get poor medical attention. A rare mysterious skeletal disorder that remained unidentified for decades and rendered many people physically challenged and disabled for life has been reported in an isolated remote village ‘Arai’ of Poonch district of Jammu and Kashmir. This village is located deep in mountains and the population residing in the region is highly consanguineous. In our survey of the region, 70 affected people were reported, showing similar phenotype, in the village with a population of approximately 5000 individuals. We were able to collect samples from two multi generational extended families from the village. Through Whole Exome sequencing (WES), we identified a rare variation NM_003880.3:c.156C>A NP_003871.1:p.Cys52Ter, which results in introduction of premature stop codon in WISP3 gene. We found this variation perfectly segregating with the disease in one of the family. However, this variation was absent in other family. Interestingly, a novel splice site mutation at position c.643+1G>A of WISP3 gene, perfectly segregating with the disease was observed in the second family. Thus, exploiting WES and putting different evidences together (familial histories and genetic data, clinical features, radiological and biochemical tests and findings), the disease has finally been diagnosed as a very rare recessive hereditary skeletal disease “Progressive Pseudorheumatoid Arthropathy of Childhood” (PPAC) also known as “Spondyloepiphyseal Dysplasia Tarda with Progressive Arthropathy” (SEDT-PA). This genetic characterization and identification of the disease causing mutations will aid in genetic counseling, critically required to curb this rare disorder and to prevent its appearance in future generations in the population. Further, understanding of the role of WISP3 gene the biological pathways should help in developing treatment for the disorder.Keywords: whole exome sequencing, Next Generation Sequencing, rare disorders
Procedia PDF Downloads 4131561 Body Mass Index and Dietary Habits among Nursing College Students Living in the University Residence in Kirkuk City, Iraq
Authors: Jenan Shakoor
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Obesity prevalence is increasing worldwide. University life is a challenging period especially for students who have to leave their familiar surroundings and settle in a new environment. The current study aimed to assess the diet and exercise habits and their association with body mass index (BMI) among nursing college students living at Kirkuk University residence. This was a descriptive study. A non-probability (purposive) sample of 101 students living in Kirkuk University residence was recruited during the period from the 15th November 2015 to the 5th May 2016. A questionnaire was constructed for the purpose of the study which consisted of four parts: the demographic characteristics of the study sample, eating habits, eating at college and healthy habits. The data were collected by interviewing the study sample and the weight and height were measured by a trained researcher at the college. Descriptive statistical analysis was undertaken. Data were prepared, organized and entered into the computer file; the Statistical Package for Social Science (SPSS 20) was used for data analysis. A p value≤ 0.05 was accepted as statistical significant. A total of 63 (62.4%) of the sample were aged20-21with a mean age of 22.1 (SD±0.653). A third of the sample 38 (37.6%) were from level four at college, 67 (66.3%) were female and 46 45.5% of participants were from a middle socio-economic status. 14 (13.9%) of the study sample were overweight (BMI =25-29.9kg/m2) and 6 (5.9%) were obese (BMI≥30kg/m2) compared to 73 (72.3%) were of normal weight (BMI =18.5-24.9kg/m2). With regard to eating habits and exercise, 42 (41.6%) of the students rarely ate breakfast, 79 (78.2%) eat lunch at university residence, 77 (78.2%) of the students reported rarely doing exercise and 62 (61.4%) of them were sleeping for less than eight hours. No significant association was found between the variables age, sex, level of college and socio-economic status and BMI, while there was a significant association between eating lunch at university and BMI (p =0.03). No significant association was found between eating habits, healthy habits and BMI. The prevalence of overweight and obesity among the study sample was 19.8% with female students being more obese than males. Further studies are needed to identify BMI among residence students in other colleges and increasing the awareness of undergraduate students to healthy food habits.Keywords: body mass index, diet, obesity, university residence
Procedia PDF Downloads 2211560 The ICC, International Criminal Justice and International Politics
Authors: Girma Y. Iyassu Menelik
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The international community has gone through indescribable atrocities resulting from acts of war. These atrocities turned Europe and Africa into a wilderness of bloodshed and crime. In the period 1960- 1970s Africa witnessed unprecedented and well-documented assaults on life and property. This necessitated the adoption, signing and ratification of the International Criminal Court, establishment of the International Court of Justice which is a great achievement for the protection and fulfilling of human rights in the context of international political instability. The ICC came as an important opportunity to advance justice for serious crimes committed in violation of international law. Thus the Rome statute has become a formidable contribution to peace and security. There are concerns that the ICC is targeting African states. However, the ICC cannot preside over cases that are not parties to the Rome statute unless the UN Security council refers the situation or the relevant state asks the court to become involved. The instable international political situation thus deals with criminal prosecutions where amnesty is not permissible or is strongly repudiated. The court has become important justice instruments for states that are unable or unwilling to fulfill their obligation to address legacies of massive human rights violations. The ICJ as a court has a twofold role; to settle legal disputes submitted to it by states, and to give advisory opinions on legal questions referred to it by duly authorized United Nations organs and specialized agencies. All members of the UN are ipso facto parties to the statute of the ICJ. The court gives advisory opinion on any legal question. These courts are the most appropriate fora to pronounce on international crimes and are in a better position to know and apply international law. Cases that have been brought to the courts include Rwanda’s genocide, Liberia’s Charles Taylor etc. The receptiveness and cooperation of the local populations are important to the courts and if the ICC and ICJ can provide appropriate protections for the physical and economic safety of victims then peace and human rights observance can be attained. This paper will look into the effectiveness and impediments of these courts in handling criminal and injustices in international politics as while as what needs to be done to strengthen the capacity of these courts.Keywords: ICC, international politics, justice, UN security council, violence, protection, fulfilling
Procedia PDF Downloads 4511559 Frailty Patterns in the US and Implications for Long-Term Care
Authors: Joelle Fong
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Older persons are at greatest risk of becoming frail. As survival to the age of 80 and beyond continues to increase, the health and frailty of older Americans has garnered much recent attention among policy makers and healthcare administrators. This paper examines patterns in old-age frailty within a multistate actuarial model that characterizes the stochastic process of biological ageing. Using aggregate population-level U.S. mortality data, we implement a stochastic aging model to examine cohort trends and gender differences in frailty distributions for older Americans born 1865 – 1894. The stochastic ageing model, which draws from the fields of actuarial science and gerontology, is well-established in the literature. The implications for public health insurance programs are also discussed. Our results suggest that, on average, women tend to be frailer than men at older ages and reveal useful insights about the magnitude of the male-female differential at critical age points. Specifically, we note that the frailty statuses of males and females are actually quite comparable from ages 65 to 80. Beyond age 80, however, the frailty levels start to diverge considerably implying that women are moving quicker into worse states of health than men. Tracking average frailty by gender over 30 successive birth cohorts, we also find that frailty levels for both genders follow a distinct peak-and-trough pattern. For instance, frailty among 85-year old American survivors increased in years 1954-1963, decreased in years 1964-1971, and again started to increase in years 1972-1979. A number of factors may have accounted for these cohort differences including differences in cohort life histories, differences in disease prevalence, differences in lifestyle and behavior, differential access to medical advances, as well as changes in environmental risk factors over time. We conclude with a discussion on the implications of our findings on spending for long-term care programs within the broader health insurance system.Keywords: actuarial modeling, cohort analysis, frail elderly, health
Procedia PDF Downloads 2461558 A Qualitative Evaluation of a Civic Curriculum to Increase Global Citizenship Competences in University Students in the Netherlands
Authors: Park Eri, Sklad Marcin, Tsirogianni Stavroula
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In a world where there is increasing exchange and movement of populations groups, and interconnectedness, there are plenty of opportunities for mutual cultural enrichment. However, in everyday life, relations among different cultural groups do not go that smoothly often resulting in discrimination, inequalities and violence. The increasing differentiation of roles, values and worldviews raise a lot of tensions and dilemmas for the state and people -especially in western liberal societies- about issues of acceptance, fairness, justice, autonomy, plurality, freedom, equality and cohesion. Cultural diversity requires a deeper understanding of the roots, meaning and consequences of group differences. We argue, that a psychology from the standpoint of the subject needs to be developed further according to new societal needs. This means within a globalised society, issues regarding the construction of the other as another have become of utmost importance. In constructing the other human beings construct their ideal and possible worlds and meanings about their lives and their significance by drawing on a set of cultural norms, beliefs and values embedded in the different contexts whereby they find themselves in. In this article, we are describing a series of exercises developed in collaboration with University students in the Netherlands that have been piloted with undergraduate 2nd year University Psychology students. These exercises aimed at making tangible and obvious how students apply different moral principles and norms to regulate relationships, which are linked to hegemonic ideological forces. The exercises were in the form of thought experiments that included 8 moral dilemmas, inspired by the moral foundations theory, that touched on different moral principles. The moral dilemmas were built onto each other in incremental steps: from a very tangible/hands-on level to more challenging and demanding ones which require to step into pre-existing networks on knowledge and discourses. After the execution of every dilemma, a discussion followed, which is focused on building links between the ‘theme of the exercise’ and participants’ own lives experiences. In this paper, we provide an evaluation of the methodology used through a discursive analysis of the discussion between the students and the teacher.Keywords: citizenship, moral dilemmas, social justice, education
Procedia PDF Downloads 3241557 Predictors of Lost to Follow-Up among HIV Patients Attending Anti-Retroviral Therapy Treatment Centers in Nigeria
Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer
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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up
Procedia PDF Downloads 3051556 A Novel Nanocomposite Membrane Designed for the Treatment of Oil/Gas Produced Water
Authors: Zhaoyang Liu, Detao Qin, Darren Delai Sun
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The onshore production of oil and gas (for example, shale gas) generates large quantities of wastewater, referred to be ‘produced water’, which contains high contents of oils and salts. The direct discharge of produced water, if not appropriately treated, can be toxic to the environment and human health. Membrane filtration has been deemed as an environmental-friendly and cost-effective technology for treating oily wastewater. However, conventional polymeric membranes have their drawbacks of either low salt rejection rate or high membrane fouling tendency when treating oily wastewater. Recent years, forward osmosis (FO) membrane filtration has emerged as a promising technology with its unique advantages of low operation pressure and less membrane fouling tendency. However, until now there is still no report about FO membranes specially designed and fabricated for treating the oily and salty produced water. In this study, a novel nanocomposite FO membrane was developed specially for treating oil- and salt-polluted produced water. By leveraging the recent advance of nanomaterials and nanotechnology, this nanocomposite FO membrane was designed to be made of double layers: an underwater oleophobic selective layer on top of a nanomaterial infused polymeric support layer. Wherein, graphene oxide (GO) nanosheets were selected to add into the polymeric support layer because adding GO nanosheets can optimize the pore structures of the support layer, thus potentially leading to high water flux for FO membranes. In addition, polyvinyl alcohol (PVA) hydrogel was selected as the selective layer because hydrated and chemically-crosslinked PVA hydrogel is capable of simultaneously rejecting oil and salt. After nanocomposite FO membranes were fabricated, the membrane structures were systematically characterized with the instruments of TEM, FESEM, XRD, ATR-FTIR, surface zeta-potential and Contact angles (CA). The membrane performances for treating produced waters were tested with the instruments of TOC, COD and Ion chromatography. The working mechanism of this new membrane was also analyzed. Very promising experimental results have been obtained. The incorporation of GO nanosheets can reduce internal concentration polarization (ICP) effect in the polymeric support layer. The structural parameter (S value) of the new FO membrane is reduced by 23% from 265 ± 31 μm to 205 ± 23 μm. The membrane tortuosity (τ value) is decreased by 20% from 2.55 ± 0.19 to 2.02 ± 0.13 μm, which contributes to the decrease of S value. Moreover, the highly-hydrophilic and chemically-cross-linked hydrogel selective layer present high antifouling property under saline oil/water emulsions. Compared with commercial FO membrane, this new FO membrane possesses three times higher water flux, higher removal efficiencies for oil (>99.9%) and salts (>99.7% for multivalent ions), and significantly lower membrane fouling tendency (<10%). To our knowledge, this is the first report of a nanocomposite FO membrane with the combined merits of high salt rejection, high oil repellency and high water flux for treating onshore oil/gas produced waters. Due to its outstanding performance and ease of fabrication, this novel nanocomposite FO membrane possesses great application potential in wastewater treatment industry.Keywords: nanocomposite, membrane, polymer, graphene oxide
Procedia PDF Downloads 2511555 Relative Expression and Detection of MUB Adhesion Domains and Plantaricin-Like Bacteriocin among Probiotic Lactobacillus plantarum-Group Strains Isolated from Fermented Foods
Authors: Sundru Manjulata Devi, Prakash M. Halami
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The immemorial use of fermented foods from vegetables, dairy and other biological sources are of great demand in India because of their health benefits. However, the diversity of Lactobacillus plantarum group (LPG) of vegetable origin has not been revealed yet, particularly with reference to their probiotic functionalities. In the present study, the different species of probiotic Lactobacillus plantarum group (LPG) i.e., L. plantarum subsp. plantarum MTCC 5422 (from fermented cereals), L. plantarum subsp. argentoratensis FG16 (from fermented bamboo shoot) and L. paraplantarum MTCC 9483 (from fermented gundruk) (as characterized by multiplex recA PCR assay) were considered to investigate their relative expression of MUB domains of mub gene (mucin binding protein) by Real time PCR. Initially, the allelic variation in the mub gene was assessed and found to encode three different variants (Type I, II and III). All the three types had 8, 9 and 10 MUB domains respectively (as analysed by Pfam database) and were found to be responsible for adhesion of bacteria to the host intestinal epithelial cells. These domains either get inserted or deleted during speciation or evolutionary events and lead to divergence. The reverse transcriptase qPCR analysis with mubLPF1+R1 primer pair supported variation in amplicon sizes with 300, 500 and 700 bp among different LPG strains. The relative expression of these MUB domains significantly unregulated in the presence of 1% mucin in overnight grown cultures. Simultaneously, the mub gene expressed efficiently by 7 fold in the culture L. paraplantarum MTCC 9483 with 10 MUB domains. An increase in the expression levels for L. plantarum subsp. plantarum MTCC 5422 and L. plantarum subsp. argentoratensis FG16 (MCC 2974) with 9 and 8 repetitive domains was around 4 and 2 fold, respectively. The detection and expression of an integrase (int) gene in the upstream region of mub gene reveals the excision and integration of these repetitive domains. Concurrently, an in vitro adhesion assay to mucin and exclusion of pathogens (such as Listeria monocytogenes and Micrococcus leuteus) was investigated and observed that the L. paraplantarum MTCC 9483 with more adhesion domains has more ability to adhere to mucin and inhibited the growth of pathogens. The production and expression of plantaricin-like bacteriocin (plnNC8 type) in MTCC 9483 suggests the pathogen inhibition. Hence, the expression of MUB domains can act as potential biomarkers in the screening of a novel probiotic LPG strain with adherence property. The present study provides a platform for an easy, rapid, less time consuming, low-cost methodology for the detection of potential probiotic bacteria. It was known that the traditional practices followed in the preparation of fermented bamboo shoots/gundruk/cereals of Indian foods contain different kinds of neutraceuticals for functional food and novel compounds with health promoting factors. In future, a detailed study of these food products can add more nutritive value, consumption and suitable for commercialization.Keywords: adhesion gene, fermented foods, MUB domains, probiotics
Procedia PDF Downloads 2711554 Analyses of Copper Nanoparticles Impregnated Wood and Its Fungal Degradation Performance
Authors: María Graciela Aguayo, Laura Reyes, Claudia Oviedo, José Navarrete, Liset Gómez, Hugo Torres
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Most wood species used in construction deteriorate when exposed to environmental conditions that favor wood-degrading organisms’ growth. Therefore, chemical protection by impregnation allows more efficient use of forest resources extending the wood useful life. A wood protection treatment which has attracted considerable interest in the scientific community during the last decade is wood impregnation with nano compounds. Radiata pine is the main wood species used in the Chilean construction industry, with total availability of 8 million m³ sawn timber. According to the requirements of the American Wood Protection Association (AWPA) and the Chilean Standards (NCh) radiata pine timber used in construction must be protected due to its low natural durability. In this work, the impregnation with copper nanoparticles (CuNP) was studied in terms of penetration and its protective effect against wood rot fungi. Two concentrations: 1 and 3 g/L of NPCu were applied by impregnation on radiata pine sapwood. Test penetration under AWPA A3-91 standard was carried out, and wood decay tests were performed according to EN 113, with slight modifications. The results of penetration for 1 g/L CuNP showed an irregular total penetration, and the samples impregnated with 3 g/L showed a total penetration with uniform concentration (blue color in all cross sections). The impregnation wood mass losses due to fungal exposure were significantly reduced, regardless of the concentration of the solution or the fungus. In impregnated wood samples, exposure to G. trabeum resulted ML values of 2.70% and 1.19% for 1 g/L and 3 g/L CuNP, respectively, and exposure to P. placenta resulted in 4.02% and 0.70%-ML values for 1 g/L and 3 g/L CuNP, respectively. In this study, the penetration analysis confirmed a uniform distribution inside the wood, and both concentrations were effective against the tested fungi, giving mass loss values lower than 5%. Therefore, future research in wood preservatives should focus on new nanomaterials that are more efficient and environmentally friendly. Acknowledgments: CONICYT FONDEF IDeA I+D 2019, grant number ID19I10122.Keywords: copper nanoparticles, fungal degradation, radiata pine wood, wood preservation
Procedia PDF Downloads 2011553 Installation of an Inflatable Bladder and Sill Walls for Riverbank Erosion Protection and Improved Water Intake Zone Smokey Hill River – Salina, Kansas
Authors: Jeffrey A. Humenik
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Environmental, Limited Liability Corporation (EMR) provided civil construction services to the U.S. Army Corps of Engineers, Kansas City District, for the placement of a protective riprap blanket on the west bank of the Smoky Hill River, construction of 2 shore abutments and the construction of a 140 foot long sill wall spanning the Smoky Hill River in Salina, Kansas. The purpose of the project was to protect the riverbank from erosion and hold back water to a specified elevation, creating a pool to ensure adequate water intake for the municipal water supply. Geotextile matting and riprap were installed for streambank erosion protection. An inflatable bladder (AquaDam®) was designed to the specific river dimension and installed to divert the river and allow for dewatering during the construction of the sill walls and cofferdam. AquaDam® consists of water filled polyethylene tubes to create aqua barriers and divert water flow or prevent flooding. A challenge of the project was the fact that 100% of the sill wall was constructed within an active river channel. The threat of flooding of the work area, damage to the aqua dam by debris, and potential difficulty of water removal presented a unique set of challenges to the construction team. Upon completion of the West Sill Wall, floating debris punctured the AquaDam®. The manufacturing and delivery of a new AquaDam® would delay project completion by at least 6 weeks. To keep the project ahead of schedule, the decision was made to construct an earthen cofferdam reinforced with rip rap for the construction of the East Abutment and East Sill Wall section. During construction of the west sill wall section, a deep scour hole was encountered in the wall alignment that prevented EMR from using the natural rock formation as a concrete form for the lower section of the sill wall. A formwork system was constructed, that allowed the west sill wall section to be placed in two horizontal lifts of concrete poured on separate occasions. The first sectional lift was poured to fill in the scour hole and act as a footing for the second sectional lift. Concrete wall forms were set on the first lift and anchored to the surrounding riverbed in a manner that the second lift was poured in a similar fashion as a basement wall. EMR’s timely decision to keep the project moving toward completion in the face of changing conditions enabled project completion two (2) months ahead of schedule. The use of inflatable bladders is an effective and cost-efficient technology to divert river flow during construction. However, a secondary plan should be part of project design in the event debris transported by river punctures or damages the bladders.Keywords: abutment, AquaDam®, riverbed, scour
Procedia PDF Downloads 1571552 Application of Bundle Care to Reduce Invasive Catheter-Associated Infection in High Risk Units at a Medical Center
Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng
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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work
Procedia PDF Downloads 1551551 Detection and Identification of Antibiotic Resistant UPEC Using FTIR-Microscopy and Advanced Multivariate Analysis
Authors: Uraib Sharaha, Ahmad Salman, Eladio Rodriguez-Diaz, Elad Shufan, Klaris Riesenberg, Irving J. Bigio, Mahmoud Huleihel
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Antimicrobial drugs have played an indispensable role in controlling illness and death associated with infectious diseases in animals and humans. However, the increasing resistance of bacteria to a broad spectrum of commonly used antibiotics has become a global healthcare problem. Many antibiotics had lost their effectiveness since the beginning of the antibiotic era because many bacteria have adapted defenses against these antibiotics. Rapid determination of antimicrobial susceptibility of a clinical isolate is often crucial for the optimal antimicrobial therapy of infected patients and in many cases can save lives. The conventional methods for susceptibility testing require the isolation of the pathogen from a clinical specimen by culturing on the appropriate media (this culturing stage lasts 24 h-first culturing). Then, chosen colonies are grown on media containing antibiotic(s), using micro-diffusion discs (second culturing time is also 24 h) in order to determine its bacterial susceptibility. Other methods, genotyping methods, E-test and automated methods were also developed for testing antimicrobial susceptibility. Most of these methods are expensive and time-consuming. Fourier transform infrared (FTIR) microscopy is rapid, safe, effective and low cost method that was widely and successfully used in different studies for the identification of various biological samples including bacteria; nonetheless, its true potential in routine clinical diagnosis has not yet been established. The new modern infrared (IR) spectrometers with high spectral resolution enable measuring unprecedented biochemical information from cells at the molecular level. Moreover, the development of new bioinformatics analyses combined with IR spectroscopy becomes a powerful technique, which enables the detection of structural changes associated with resistivity. The main goal of this study is to evaluate the potential of the FTIR microscopy in tandem with machine learning algorithms for rapid and reliable identification of bacterial susceptibility to antibiotics in time span of few minutes. The UTI E.coli bacterial samples, which were identified at the species level by MALDI-TOF and examined for their susceptibility by the routine assay (micro-diffusion discs), are obtained from the bacteriology laboratories in Soroka University Medical Center (SUMC). These samples were examined by FTIR microscopy and analyzed by advanced statistical methods. Our results, based on 700 E.coli samples, were promising and showed that by using infrared spectroscopic technique together with multivariate analysis, it is possible to classify the tested bacteria into sensitive and resistant with success rate higher than 90% for eight different antibiotics. Based on these preliminary results, it is worthwhile to continue developing the FTIR microscopy technique as a rapid and reliable method for identification antibiotic susceptibility.Keywords: antibiotics, E.coli, FTIR, multivariate analysis, susceptibility, UTI
Procedia PDF Downloads 1761550 Effect of Dose-Dependent Gamma Irradiation on the Fatty Acid Profile of Mud Crab, Scylla Serrata: A GC-FID Study
Authors: Keethadath Arshad, Kappalli Sudha
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Mud crab, Scylla Serrata, a commercially important shellfish with high global demand appears to be the rich source of dietary fatty acids. Its increased production through aquaculture and highly perishable nature would necessitate improved techniques for their proper preservation. Optimized irradiation has been identified as an effective method to facilitate safety and extended shelf life for a broad range of the perishable food items including finfishes and shellfishes. The present study analyzed the effects of dose-dependent gamma irradiation on the fatty acid profile of the muscle derived from the candidate species (S. serrata) at both qualitative and quantitative levels. Wild grown, average sized, intermolt male S. Serrata were gamma irradiated (^60C, 3.8kGy/ hour) at the dosage of 0.5kGy, 1.0kGy and 2.0kGy using gamma chamber. Total lipid extracted by Folch method, after methylation, were analyzed for the presence fatty acids adopting Gas Chromatograph equipped with flame ionization detector by comparing with the authentic FAME reference standards. The tissue from non-irradiated S. serrata showed the presence of 12 SFA, 6 MUFA, 8PUFA and 2 TF; PUFA includes medicinally important ω-3 FA such as C18:3, C20:5 and C22:6 and ω-6 FA such as γ- C18:3 and C20:2. Dose-dependent gamma irradiation reduced the number of detectable fatty acids (10, 8 and 8 SFA, 6, 6 and 5MUFA, 7, 7, and 6 PUFA and 1, 1, and 0 TF in 0.5kGy, 1.0kGy and 2kGy irradiated samples respectively). Major fatty acids detected in both irradiated and non-irradiated samples were as follows: SFA- C16:0, C18:0, C22:0 and C14:0; MUFA - C18:1 and C16:1and PUFA- C18:2, C20:5, C20:2 and C22:6. Irradiation doses ranging from 1-2kGy substantially reduced the ω-6 C18:3 and ω-3 C18:3. However, the omega fatty acids such as C20:5, C22:6 and C20:2 could survive even after 2kGy irradiation. Significantly, trans fat like C18:2T and C18:1T were completely disappeared upon 2kGy irradiation. From the overall observations made from the present study, it is suggested that irradiation dose up to 1kGy is optimum to maintain the fatty acid profile and eradicate the trans fat of the muscle derived from S. serrata.Keywords: fatty acid profile, food preservation, gamma irradiation, scylla serrata
Procedia PDF Downloads 2781549 Disentangling the Sources and Context of Daily Work Stress: Study Protocol of a Comprehensive Real-Time Modelling Study Using Portable Devices
Authors: Larissa Bolliger, Junoš Lukan, Mitja Lustrek, Dirk De Bacquer, Els Clays
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Introduction and Aim: Chronic workplace stress and its health-related consequences like mental and cardiovascular diseases have been widely investigated. This project focuses on the sources and context of psychosocial daily workplace stress in a real-world setting. The main objective is to analyze and model real-time relationships between (1) psychosocial stress experiences within the natural work environment, (2) micro-level work activities and events, and (3) physiological signals and behaviors in office workers. Methods: An Ecological Momentary Assessment (EMA) protocol has been developed, partly building on machine learning techniques. Empatica® wristbands will be used for real-life detection of stress from physiological signals; micro-level activities and events at work will be based on smartphone registrations, further processed according to an automated computer algorithm. A field study including 100 office-based workers with high-level problem-solving tasks like managers and researchers will be implemented in Slovenia and Belgium (50 in each country). Data mining and state-of-the-art statistical methods – mainly multilevel statistical modelling for repeated data – will be used. Expected Results and Impact: The project findings will provide novel contributions to the field of occupational health research. While traditional assessments provide information about global perceived state of chronic stress exposure, the EMA approach is expected to bring new insights about daily fluctuating work stress experiences, especially micro-level events and activities at work that induce acute physiological stress responses. The project is therefore likely to generate further evidence on relevant stressors in a real-time working environment and hence make it possible to advise on workplace procedures and policies for reducing stress.Keywords: ecological momentary assessment, real-time, stress, work
Procedia PDF Downloads 1621548 Succinct Perspective on the Implications of Intellectual Property Rights and 3rd Generation Partnership Project in the Rapidly Evolving Telecommunication Industry
Authors: Arnesh Vijay
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Ever since its early introduction in the late 1980s, the mobile industry has been rapidly evolving with each passing year. The development witnessed is not just in its ability to support diverse applications, but also its extension into diverse technological means to access and offer various services to users. Amongst the various technologies present, radio systems have clearly emerged as a strong contender, due to its fine attributes of accessibility, reachability, interactiveness, and cost efficiency. These advancements have no doubt guaranteed unprecedented ease, utility and sophistication to the cell phone users, but caused uncertainty due to the interdependence of various systems, making it extremely complicated to exactly map concepts on to 3GPP (3rd Generation Partnership Project) standards. Although the close interrelation and interdependence of intellectual property rights and mobile standard specifications have been widely acknowledged by the technical and legal community; there, however, is a requirement for clear distinction between the scope and future-proof of inventions to influence standards and its market place adoptability. For this, collaborative work is required between intellectual property professionals, researchers, standardization specialists and country specific legal experts. With the evolution into next generation mobile technology, i.e., to 5G systems, there is a need for further work to be done in this field, which has been felt now more than ever before. Based on these lines, this poster will briefly describe the importance of intellectual property rights in the European market. More specifically, will analyse the role played by intellectual property in various standardization institutes, such as 3GPP (3rd generation partnership project) and ITU (International Telecommunications Union). The main intention: to ensure the scope and purpose is well defined, and concerned parties on all four sides are well informed on the clear significance of good proposals which not only bring economic revenue to the company but those that are capable of improving the technology and offer better services to mankind. The poster will comprise different sections. The first segment begins with a background on the rapidly evolving mobile technology, with a brief insight on the industrial impact of standards and its relation to intellectual property rights. Next, section two will succinctly outline the interplay between patents and standards; explicitly discussing the ever changing and rapidly evolving relationship between the two sectors. Then the remaining sections will examine ITU and its role played in international standards development, touching upon the various standardization process and the common patent policies and related guidelines. Finally, it proposes ways to improve the collaboration amongst various sectors for a more evolved and sophisticated next generation mobile telecommunication system. The sole purpose here is to discuss methods to reduce the gap and enhance the exchange of information between the two sectors to offer advanced technologies and services to mankind.Keywords: mobile technology, mobile standards, intellectual property rights, 3GPP
Procedia PDF Downloads 1281547 The Use of Intraarticular Aqueous Sarapin for Treatment of Chronic Knee Pain in Elderly Patients in a Primary Care Setting
Authors: Robert E. Kenney, Richard B. Aguilar, Efrain Antunez, Gregory Schor-Haskin, Rafael Rey, Catie Falcon, Luis Arce
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This study sought to explore the effect of Sarapin injections on chronic knee pain (CKP). Many adults suffer from CKP which is most often attributed to osteoarthritis. Current treatment regimens for CKP involve the use NSAIDS medications, injections with steroids/analgesic, platelet rich plasma injections, or orthopedic surgical interventions. Sarapin is a commercially available homeopathic aqueous extract from the pitcher plant. Studies on the use of Sarapin as a treatment for cervical, thoracic, and lumbosacral facet joint nerve blocks have been performed with mixed results. There is little available evidence on the use of Sarapin in CKP. This study examines the effect of a series of 3 weekly injections of aqueous Sarapin in 95 elderly patients with CKP in a primary care setting. Cano Health, a primary care group, identified 95 successive patients with CKP from its multimodal physiotherapy program for chronic pain. Patients underwent evaluation by a clinician, underwent diagnostic Xrays of the knees, and the treatment plan with three weekly Sarapin injections was discussed. A pain and functional limitation survey (a modified Lower Extremity Functional Scale (mLEFS)) was administered prior to initiating treatment (Entry Survey (ES)). Each patient received an intraarticular injection of 2 cc of aqueous Sarapin with 1cc 1% lidocaine during weeks 1, 2 and 3. The mLEFS was administered again at week 4, one week after the third Sarapin injection (Exit Survey (ExS)). Demographics: Mean Age 62 +/- 9.8; 73% female; 89% Hispanic/Latino; mean time between ES and ExS was 27.5 +/-8.2 days. Survey: The mLEFS was based on a published Lower Extremity Functional Scale and each patient rated their pain or functional limitation from 0 (no difficulty) to 5 (severe difficulty) for 10 questions. Answers were summed and compared. Maximum score for severe difficulty would be 50 points. Results: Mean pain/functional scores: ES was 30.3 +/-12.1 and ExS was 19.5 +/- 12.5. This represents a relative improvement of 35.7% (P<0.00001). A total of 81% (77/95) of the patients showed improvement in symptoms at week four as assessed by the mLEFS. There were 11 patients who reported an increase in their survey scores while 7 patients reported no change. When evaluating the cohort that reported improvement, the ES was 30.9 +/-11.4 and ExS was 16.3 +/-9.8 yielding a 47.2% relative improvement (P<0.00001). Injections were well tolerated, and no adverse events were reported. Conclusions: In this cohort of 95 elderly patients with CKP, treatment with 3 weekly injections of Sarapin significantly improved pain and function as assessed by a mLEFS survey. The majority (81%) of patients responded positively to therapy, 12% had worsening symptoms and 7% reported no change. The use of intraarticular injections of Sarapin for CKP was shown to be an effective modality of treatment. Sarapin’s low cost, tolerability, and ease of use make it an attractive alternative to NSAIDS, steroids, PRP or surgical intervention for this common debilitating condition.Keywords: Sarapin, intraarticular, chronic knee pain, osteoarthritis
Procedia PDF Downloads 911546 Self-Disclosure and Privacy Management Behavior in Social Media: Privacy Calculus Perspective
Authors: Chien-Wen Chen, Nguyen Duong Thuy Trang, Yu-Hsuan Chang
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With the development of information technology, social networking sites are inseparable from life and have become an important way for people to communicate. Nonetheless, privacy issues are raised by the presence of personal information on social networking sites. However, users can benefit from using the functions of social networking sites, which also leads to users worrying about the leakage of personal information without corresponding privacy protection behaviors, which is called the privacy paradox. However, previous studies have questioned the viewpoint of the privacy paradox, believing that users are not so naive and that people with privacy concerns will conduct privacy management. Consequently, this study is based on the view of privacy calculation perspective to investigate the privacy behavior of users on social networking sites. Among them, social benefits and privacy concerns are taken as the expected benefits and costs in the viewpoint of privacy calculation. At the same time, this study also explores the antecedents, including positive feedback, self-presentation, privacy policy, and information sensitivity, and the consequence of privacy behavior of weighing benefits and costs, including self-disclosure and three privacy management strategies by interpersonal boundaries (Preventive, Censorship, and Corrective). The survey respondents' characteristics and prior use experience of social networking sites were analyzed. As a consequence, a survey of 596 social network users was conducted online to validate the research framework. The results show that social benefit has the greatest influence on privacy behavior. The most important external factors affecting privacy behavior are positive feedback, followed by the privacy policy and information sensitivity. In addition, the important findings of this study are that social benefits will positively affect privacy management. It shows that users can get satisfaction from interacting with others through social networking sites. They will not only disclose themselves but also manage their privacy on social networking sites after considering social benefits and privacy management on social networking sites, and it expands the adoption of the Privacy Calculus Perspective framework from prior research. Therefore, it is suggested that as the functions of social networking sites increase and the development of social networking sites, users' needs should be understood and updated in order to ensure the sustainable operation of social networking.Keywords: privacy calculus perspective, self-disclosure, privacy management, social benefit, privacy concern
Procedia PDF Downloads 931545 Investigating the Strategies for Managing On-plot Sanitation Systems’ Faecal Waste in Developing Regions: The Case of Ogun State, Nigeria
Authors: Olasunkanmi Olapeju
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A large chunk of global population are not yet connected to water borne faecal management systems that rely on flush mechanisms and sewers networks that are linked with a central treatment plant. Only about 10% of sub-Saharan African countries are connected to central sewage systems. In Nigeria, majority of the population do not only depend on on-plot sanitation systems, a huge chunk do not also have access to safe and improved toilets. Apart from the organizational challenges and technical capacity, the other major factors that account for why faecal waste management is yet unimproved in developing countries are faulty planning frameworks that fail to maintain balance between urbanization dynamics and infrastructures, and misconceptions about what modern sanitation is all about. In most cases, the quest to implement developmental patterns that integrate modern sewers based sanitation systems have huge financial and political costs. Faecal waste management in poor countries largely lacks the needed political attention and budgetary prioritization. Yet, the on-plot sanitation systems being mainly relied upon the need to be managed in a manner that is sustainable and healthy, pending when development would embrace a more sustainable off-site central sewage system. This study is aimed at investigating existing strategies for managing on-plot sanitation systems’ faecal waste in Ogun state, Nigeria, with the aim of recommending sustainable sanitation management systems. The study adopted the convergent parallel variant of the mixed-mode technique, which involves the adoption of both quantitative and qualitative method of data collection. Adopting a four-level multi-stage approach, which is inclusive of all political divisions in the study area, a total of 330 questionnaires were respectively administered in the study area. Moreover, the qualitative data adopted the purposive approach in scoping down to 33 key informants. SPSS software (Version 22.0) was employed for descriptively analysis. The study shows that about 52% of households adopt the non-recovery management (NRM) means of burying their latrines with sand sludge shrinkage with chemicals such as carbides. The dominance of the non-recovery management means seriously constrains the quest for faecal resource recovery. Essentially, the management techniques adopted by households depend largely on the technology of their sanitary containments, emptying means available, the ability of households to pay for the cost of emptying, and the social acceptability of the reusability of faecal waste, which determines faecal resource recoverability. The study suggests that there is a need for municipal authorities in the study area to urgently intervene in the sanitation sector and consider it a key element of the planning process. There is a need for a comprehensive plan that would ensure a seamless transition to the adoption of a modern sanitation management system.Keywords: faecal, management, planning, waste, sanitation, sustainability
Procedia PDF Downloads 1051544 Pineapple Patriarch: Local Agency in Sustainability Initiatives despite Community Reliance on Pineapple Monoculture
Authors: Afshan Golriz
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This paper addresses the nuances in the relationship between the rural community of Volcan, Costa Rica, and the presence of multinational pineapple giant Pineapple Development Corporation (PINDECO). The paper analyzes the continuous negotiation between the need for environmental protection in the face of pineapple monoculture and the socioeconomic dependencies of the community on the company. Drawing on eight years of ethnographic work in Volcan de Buenos Aires and relying on intergenerational interviews that document oral histories, this article provides a socio-historical account of the economic and environmental impact of the presence of PINDECO in the southern zone of the country. The paper draws on interviews and in-depth participant observation, conducted by the author in intermittent periods over eight years. The research sheds light on the tensions between the village and PINDECO, as simultaneous acceptance of and opposition to the company persist by different stakeholders in the region. In doing so, this paper examines the strikingly powerful affinity toward the company and the community's regard for PINDECO as the town patriarch despite social and environmental injustices. In demonstrating these tensions, the author problematizes the practice of conducting foreign environmental research in developing countries, and more importantly, proposing changes to environmental conservation and socioeconomic structures without understanding community reliance on the presence of corporations such as PINDECO and the threats that changes to existing structures could pose to community members' livelihoods. In complicating these common western academic practices, the author takes an anti-colonial approach to environmental research, refusing the assumption that the affinity toward the company by the community of Volcan is rooted in ignorance, lack of education, or lack of interest in environmental conservation. The author instead highlights local knowledge and agency, demonstrating the many ways in which the community itself is producing knowledge and taking action. Through this paper, common assumptions regarding the agency of such communities are contested, and the grassroots environmental initiatives of Volcan, Costa Rica are brought to life.Keywords: environmental conservation, grassroots movements, local knowledge, agricultural multinational
Procedia PDF Downloads 1371543 Exploring Error-Minimization Protocols for Upper-Limb Function During Activities of Daily Life in Chronic Stroke Patients
Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp
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Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task
Procedia PDF Downloads 601542 Mapping the Adoption Process of Communication Technology to Maintain Contact between Older Adults with Intellectual Disability in Out-of-home Residence and Their Families: A Multiple-Case Study Research
Authors: Carmit Noa Shpigelman, Michal Isaacson
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Over the last decades, the improvement in welfare and health services and the increase in awareness of the needs of people with intellectual disability has led to an increase in their life expectancy, and many of them enter into old age. Furthermore, many older adults with intellectual disability live in out-of-home residence. This situation, in addition to the parents' aging process as the main caregivers, may lead to a reduction in contact with the family and, as a result, decreased level of the residents' (older adults with intellectual disability) well-being. A plausible solution for this condition may be using communication technologies. Previous studies indicate that using communication technologies among older adults contributes to maintaining the relationship with others, decreasing the older adult's sense of loneliness, and increasing their level of well-being. Using communication technologies may be especially valuable for older adults in the current global pandemic of COVID-19 and the associated restrictions of social distancing. However, to date, research on using communication technologies among people with intellectual disability has focused on younger cohorts. Moreover, research on the adoption of technologies among older adults with intellectual disability has focused more on assistive technologies and less on communication technologies. To address these practice and research gaps, the present study focuses on the adoption process of communication technology among older adults with intellectual disability (over the age of 45 years) who live in supported accommodation. Fifteen residents participated in an intervention program where they received a tablet with a video communication application and through which they were able to contact their families. A multiple-case study methodology was applied to capture the experiences, including barriers and needs, of the residents from three perspectives: the resident, the family member, and a staff member from the residential setting. The data was collected via quantitative and qualitative measures at different time points over the intervention. The findings demonstrate the contribution of using communication technology for the well-being of older adults with intellectual disability in supported accommodation. The findings also map the adoption process among this population, including pitfalls. The present study contributes to developing best practices on how to accommodate communication technologies to older adults with intellectual disability for maintaining contact with others.Keywords: adoption, aging, communication, intellectual disability, technology
Procedia PDF Downloads 2391541 Comparison of the Chest X-Ray and Computerized Tomography Scans Requested from the Emergency Department
Authors: Sahabettin Mete, Abdullah C. Hocagil, Hilal Hocagil, Volkan Ulker, Hasan C. Taskin
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Objectives and Goals: An emergency department is a place where people can come for a multitude of reasons 24 hours a day. As it is an easy, accessible place, thanks to self-sacrificing people who work in emergency departments. But the workload and overcrowding of emergency departments are increasing day by day. Under these circumstances, it is important to choose a quick, easily accessible and effective test for diagnosis. This results in laboratory and imaging tests being more than 40% of all emergency department costs. Despite all of the technological advances in imaging methods and available computerized tomography (CT), chest X-ray, the older imaging method, has not lost its appeal and effectiveness for nearly all emergency physicians. Progress in imaging methods are very convenient, but physicians should consider the radiation dose, cost, and effectiveness, as well as imaging methods to be carefully selected and used. The aim of the study was to investigate the effectiveness of chest X-ray in immediate diagnosis against the advancing technology by comparing chest X-ray and chest CT scan results of the patients in the emergency department. Methods: Patients who applied to Bulent Ecevit University Faculty of Medicine’s emergency department were investigated retrospectively in between 1 September 2014 and 28 February 2015. Data were obtained via MIAMED (Clear Canvas Image Server v6.2, Toronto, Canada), information management system which patients’ files are saved electronically in the clinic, and were retrospectively scanned. The study included 199 patients who were 18 or older, had both chest X-ray and chest CT imaging. Chest X-ray images were evaluated by the emergency medicine senior assistant in the emergency department, and the findings were saved to the study form. CT findings were obtained from already reported data by radiology department in the clinic. Chest X-ray was evaluated with seven questions in terms of technique and dose adequacy. Patients’ age, gender, application complaints, comorbid diseases, vital signs, physical examination findings, diagnosis, chest X-ray findings and chest CT findings were evaluated. Data saved and statistical analyses have made via using SPSS 19.0 for Windows. And the value of p < 0.05 were accepted statistically significant. Results: 199 patients were included in the study. In 38,2% (n=76) of all patients were diagnosed with pneumonia and it was the most common diagnosis. The chest X-ray imaging technique was appropriate in patients with the rate of 31% (n=62) of all patients. There was not any statistically significant difference (p > 0.05) between both imaging methods (chest X-ray and chest CT) in terms of determining the rates of displacement of the trachea, pneumothorax, parenchymal consolidation, increased cardiothoracic ratio, lymphadenopathy, diaphragmatic hernia, free air levels in the abdomen (in sections including the image), pleural thickening, parenchymal cyst, parenchymal mass, parenchymal cavity, parenchymal atelectasis and bone fractures. Conclusions: When imaging findings, showing cases that needed to be quickly diagnosed, were investigated, chest X-ray and chest CT findings were matched at a high rate in patients with an appropriate imaging technique. However, chest X-rays, evaluated in the emergency department, were frequently taken with an inappropriate technique.Keywords: chest x-ray, chest computerized tomography, chest imaging, emergency department
Procedia PDF Downloads 1941540 The Effect of Three-Dimensional Morphology on Vulnerability Assessment of Atherosclerotic Plaque
Authors: M. Zareh, H. Mohammadi, B. Naser
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Atherosclerotic plaque rupture is the main trigger of heart attack and brain stroke which are the leading cause of death in developed countries. Better understanding of rupture-prone plaque can help clinicians detect vulnerable plaques- rupture prone or instable plaques- and apply immediate medical treatment to prevent these life-threatening cardiovascular events. Therefore, there are plenty of studies addressing disclosure of vulnerable plaques properties. Necrotic core and fibrous tissue are two major tissues constituting atherosclerotic plaque; using histopathological and numerical approaches, many studies have demonstrated that plaque rupture is strongly associated with a large necrotic core and a thin fibrous cap, two morphological characteristic which can be acquired by two-dimensional imaging of atherosclerotic plaque present in coronary and carotid arteries. Plaque rupture is widely considered as a mechanical failure inside plaque tissue; this failure occurs when the stress within plaque excesses the strength of tissue material; hence, finite element method, a strong numerical approach, has been extensively applied to estimate stress distribution within plaques with different compositions which is then used for assessment of various vulnerability characteristics including plaque morphology, material properties and blood pressure. This study aims to evaluate significance of three-dimensional morphology on vulnerability degree of atherosclerotic plaque. To reach this end, different two-dimensional geometrical models of atherosclerotic plaques are considered based on available data and named Main 2D Models (M2M). Then, for each of these M2Ms, two three-dimensional idealistic models are created. These two 3D models represent two possible three-dimensional morphologies which might exist for a plaque with similar 2D morphology to one of M2Ms. Finite element method is employed to estimate stress, von-Mises stress, within each 3D models. Results indicate that for each M2Ms stress can significantly varies due to possible 3D morphological changes in that plaque. Also, our results show that an atherosclerotic plaque with thick cap may experience rupture if it has a critical 3D morphology. This study highlights the effect of 3D geometry of plaque on its instability degree and suggests that 3D morphology of plaque might be necessary to more effectively and accurately assess atherosclerotic plaque vulnerability.Keywords: atherosclerotic plaque, plaque rupture, finite element method, 3D model
Procedia PDF Downloads 3111539 Evaluation of Relationship between Job Stress Dimensions with Occupational Accidents in Industrial Factories in Southwest of Iran
Authors: Ali Ahmadi, Maryam Abbasi, Mohammad Mehdi Parsaei
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Background: Stress in the workplace today is one of the most important public health concerns and a serious threat to the health of the workforce worldwide. Occupational stress can cause occupational events and reduce quality of life. As a result, it has a very undesirable impact on the performance of organizations, companies, and their human resources. This study aimed to evaluate the relationship between job stress dimensions and occupational accidents in industrial factories in Southwest Iran. Materials and Methods: This cross-sectional study was conducted among 200 workers in the summer of 2023 in the Southwest of Iran. To select participants, we used a convenience sampling method. The research tools in this study were the Health and Safety Executive (HSE) stress questionnaire with 35 questions and 7 dimensions and demographic information. A high score on this questionnaire indicates that there is low job stress and pressure. All workers completed the informed consent form. Univariate analysis was performed using chi-square and T-test. Multiple regression analysis was used to estimate the odds ratios (OR) and 95% confidence interval (CI) for the association of stress-related factors with job accidents in participants. Stata 14.0 software was used for analysis. Results: The mean age of the participants was 39.81(6.36) years. The prevalence of job accidents was 28.0% (95%CI: 21.0, 34.0). Based on the results of the multiple logistic regression with the adjustment of the effect of the confounding variables, one increase in the score of the demand dimension had a protective impact on the risk of job accidents(aOR=0.91,95%CI:0.85-0.95). Additionally, an increase in one of the scores of the managerial support (aOR=0.89, 95% CI: 0.83-0.95) and peer support (aOR=0.76, 95%CI: 0.67-87) dimensions was associated with a lower number of job accidents. Among dimensions, an increase in the score of relationship (aOR=0.89, 95%CI: 0.80-0.98) and change (aOR=0.86, 95%CI: 0.74-0.96) reduced the odds of the accident's occurrence among the workers by 11% and 16%, respectively. However, there was no significant association between role and control dimensions and the job accident (p>0.05). Conclusions: The results show that the prevalence of job accidents was alarmingly high. Our results suggested that an increase in scores of dimensions HSE questioners is significantly associated with a decrease the accident occurrence in the workplace. Therefore, planning to address stressful factors in the workplace seems necessary to prevent occupational accidents.Keywords: HSE, Iran, job stress occupational accident, safety, occupational health
Procedia PDF Downloads 721538 Water Problems, Social Mobilization and Migration: A Case Study of Lake Urmia
Authors: Fatemeh Dehghan Khangahi, Hakan Gunes
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Transforming a public necessity into a commercial commodity becomes more and more evident as time goes on, and it is one of the issues of water shortage. Development projects of countries, consume the water and waterbeds in various forms, ignoring the concepts such as sustainability and the negative effects they place on the environment, pollute and change the ways of waterways. Throughout these processes, the water basins and all the vital environments sometimes can suffer damage to the irreparable level. In this context, the issue of Lake Urmia that is located in the North West of Iran left alone by drought, has been researched. The lake, which is on the list of UNESCO's biosphere reserves, is now exposed to the danger of desiccation. If the desiccation is fully realized, more than 5.000.000 people that they are living around the lake, will have to migrate as a result of negative living conditions. As a matter of fact, along with the recent years of increasing drought level, regional migrations have begun. In addition to migration issues, it is also necessary to specify the negative effects on human and all-round’s life that depend on the formation of salt storms, mixing of salt into the air and soil, which threaten human health seriously because the lake is salty. The main aim of this work is to raise national and international awareness of this problem, which is an environment and a human tragedy at the same time. This research has two basic questions: 1) In the case of Lake Urmia, what are environmental problems and how they have emerged and what is the role of governments? 2) What is the social consequence of this problem in relation to the first question? In response, after the literature search, having a comparative view of the situation of the Aral Sea and the Great Salt Lake (Utah, USA), which involved the two major international examples. The first, one is related to the terms of population and migration, the second is about biological properties. Then, data and status information that provided after 3 years area research has been evaluated. Towards the end, with the support of qualitative and quantitative methods, the study of social mobilization in the region has been carried out. An example of it is using the public space of TRAXTOR matches like a protests area.Keywords: environment problems, water, social mobilization, Lake Urmia, migration
Procedia PDF Downloads 1341537 Improving Breastfeeding Practices and Infants’ Growth through Promoting for “Feed Your Baby like a Baby’’
Authors: Ammal M. Metwally, Walaa A. Basha, Ghada A. Abdel-Latif, Amira S. El Rifay
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Introduction: Improving breastfeeding practices does not always link to interventions relying on improving nutrition awareness and education alone but needs cultural and behavioral insights. Aim: Our study provided educational intervention through the use of the social marketing (SM) approach, which was respectable to societal norms allowing more conscious choices by mothers to achieve the maximum potential of physical growth of their infants. This study evaluated the effectiveness of the used approach for improving breastfeeding practices and the physical growth of infants aged up to 2 years. Methodology: A quasi-experimental intervention design with a posttest-only control design was done over three years duration to motivate mothers’ voluntary behavioral change toward breastfeeding promotion using SM principles: product, price, place, and promotion. The interventions targeted 464 pregnant women in their last trimester, mothers of children up to 2 years, and 1454 women in their childbearing period. Results: Most mothers showed increased awareness about the benefits of breastfeeding and became interested in breastfeeding their children outside the house using the breastfeeding cover (Gawn). Breastfeeding initiation, exclusive breastfeeding under six months, frequency of breastfeeding per day, and percentage of children who continued breastfeeding till two years were significantly increased (from 30%, 23 %, 56%, and 32% to 62 %, 47.3 %, 69 %, and 43.5 %). With the attention of the nutritional educational sessions three or more times, the majority of indicators had the most significant improvement. The females who recorded underweight results over males during the first two years of life significantly improved after the intervention (from 53.8 % to 15.4%, respectively). At the same time, females that were found to be obese before the intervention (7.7 %) became no longer obese. Conclusions: Nutritional interventions that are based on the use SM approach showed improvement for the majority of the key performance indicators. Although they doubled their value before the intervention, the majority were still modest (below 50 %). With sustained use of the SM approach, infants will achieve their maximum potential for physical growth by providing economically disadvantaged mothers with breastfeeding support.Keywords: social marketing approach, early breastfeeding initiation, exclusive breastfeeding, responsiveness to cues of hunger and satiety, physical growth of infants
Procedia PDF Downloads 941536 A Rare Case of Synchronous Colon Adenocarcinoma
Authors: Mohamed Shafi Bin Mahboob Ali
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Introduction: Synchronous tumor is defined as the presence of more than one primary malignant lesion in the same patient at the indexed diagnosis. It is a rare occurrence, especially in the spectrum of colorectal cancer, which accounts for less than 4%. The underlying pathology of a synchronous tumor is thought to be due to a genomic factor, which is microsatellite instability (MIS) with the involvement of BRAF, KRAS, and the GSRM1 gene. There are no specific sites of occurrence for the synchronous colorectal tumor, but many studies have shown that a synchronous tumor has about 43% predominance in the ascending colon with rarity in the sigmoid colon. Case Report: We reported a case of a young lady in the middle of her 30's with no family history of colorectal cancer that was diagnosed with a synchronous adenocarcinoma at the descending colon and rectosigmoid region. The lady's presentation was quite perplexing as she presented to the district hospital initially with simple, uncomplicated hemorrhoids and constipation. She was then referred to our center for further management as she developed a 'football' sized right gluteal swelling with a complete intestinal obstruction and bilateral lower-limb paralysis. We performed a CT scan and biopsy of the lesion, which found that the tumor engulfed the sacrococcygeal region with more than one primary lesion in the colon as well as secondaries in the liver. The patient was operated on after a multidisciplinary meeting was held. Pelvic exenteration with tumor debulking and anterior resection were performed. Postoperatively, she was referred to the oncology team for chemotherapy. She had a tremendous recovery in eight months' time with a partial regain of her lower limb power. The patient is still under our follow-up with an improved quality of life post-intervention. Discussion: Synchronous colon cancer is rare, with an incidence of 2.4% to 12.4%. It has male predominance and is pathologically more advanced compared to a single colon lesion. Down staging the disease by means of chemoradiotherapy has shown to be effective in managing this tumor. It is seen commonly on the right colon, but in our case, we found it on the left colon and the rectosigmoid. Conclusion: Managing a synchronous colon tumor could be challenging to surgeons, especially in deciding the extent of resection and postoperative functional outcomes of the bowel; thus, individual treatment strategies are needed to tackle this pathology.Keywords: synchronous, colon, tumor, adenocarcinoma
Procedia PDF Downloads 1091535 Program of Health/Safety Integration and the Total Worker Health Concept in the Improvement of Absenteeism of the Work Accommodation Management
Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira
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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.Keywords: absenteeism, health/safety integration, work accommodation management, total worker health
Procedia PDF Downloads 1591534 Nutrition Budgets in Uganda: Research to Inform Implementation
Authors: Alexis D'Agostino, Amanda Pomeroy
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Background: Resource availability is essential to effective implementation of national nutrition policies. To this end, the SPRING Project has collected and analyzed budget data from government ministries in Uganda, international donors, and other nutrition implementers to provide data for the first time on what funding is actually allocated to implement nutrition activities named in the national nutrition plan. Methodology: USAID’s SPRING Project used the Uganda Nutrition Action Plan (UNAP) as the starting point for budget analysis. Thorough desk reviews of public budgets from government, donors, and NGOs were mapped to activities named in the UNAP and validated by key informants (KIs) across the stakeholder groups. By relying on nationally-recognized and locally-created documents, SPRING provided a familiar basis for discussions to increase credibility and local ownership of findings. Among other things, the KIs validated the amount, source, and type (specific or sensitive) of funding. When only high-level budget data were available, KIs provided rough estimates of the percentage of allocations that were actually nutrition-relevant, allowing creation of confidence intervals around some funding estimates. Results: After validating data and narrowing in on estimates of funding to nutrition-relevant programming, researchers applied a formula to estimate overall nutrition allocations. In line with guidance by the SUN Movement and its three-step process, nutrition-specific funding was counted at 100% of its allocation amount, while nutrition sensitive funding was counted at 25%. The vast majority of nutrition funding in Uganda is off-budget, with over 90 percent of all nutrition funding is provided outside of the government system. Overall allocations are split nearly evenly between nutrition-specific and –sensitive activities. In FY 2013/14, the two-year study’s baseline year, on- and off-budget funding for nutrition was estimated to be around 60 million USD. While the 60 million USD allocations compare favorably to the 66 million USD estimate of the cost of the UNAP, not all activities are sufficiently funded. Those activities with a focus on behavior change were the most underfunded. In addition, accompanying qualitative research suggested that donor funding for nutrition activities may shift government funding into other areas of work, making it difficult to estimate the sustainability of current nutrition investments.Conclusions: Beyond providing figures, these estimates can be used together with the qualitative results of the study to explain how and why these amounts were allocated for particular activities and not others, examine the negotiation process that occurred, and suggest options for improving the flow of finances to UNAP activities for the remainder of the policy tenure. By the end of the PBN study, several years of nutrition budget estimates will be available to compare changes in funding over time. Halfway through SPRING’s work, there is evidence that country stakeholders have begun to feel ownership over the ultimate findings and some ministries are requesting increased technical assistance in nutrition budgeting. Ultimately, these data can be used within organization to advocate for more and improved nutrition funding and to improve targeting of nutrition allocations.Keywords: budget, nutrition, financing, scale-up
Procedia PDF Downloads 448