Search results for: drop-off effect
829 Getting It Right Before Implementation: Using Simulation to Optimize Recommendations and Interventions After Adverse Event Review
Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos
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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation
Procedia PDF Downloads 152828 Comparison Between Bispectral Index Guided Anesthesia and Standard Anesthesia Care in Middle Age Adult Patients Undergoing Modified Radical Mastectomy
Authors: Itee Chowdhury, Shikha Modi
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Introduction: Cancer is beginning to outpace cardiovascular disease as a cause of death affecting every major organ system with profound implications for perioperative management. Breast cancer is the most common cancer in women in India, accounting for 27% of all cancers. The small changes in analgesic management of cancer patients can greatly improve prognosis and reduce the risk of postsurgical cancer recurrence as opioid-based analgesia has a deleterious effect on cancer outcomes. Shortened postsurgical recovery time facilitates earlier return to intended oncological therapy maximising the chance of successful treatment. Literature reveals that the role of BIS since FDA approval has been assessed in various types of surgeries, but clinical data on its use in oncosurgical patients are scanty. Our study focuses on the role of BIS-guided anaesthesia for breast cancer surgery patients. Methods: A prospective randomized controlled study in patients aged 36-55years scheduled for modified radical mastectomy was conducted in 51 patients in each group who met the inclusion and exclusion criteria, and randomization was done by sealed envelope technique. In BIS guided anaesthesia group (B), sevoflurane was titrated to keep the BIS value 45-60, and thereafter if the patient showed hypertension/tachycardia, an opioid was given. In standard anaesthesia care (group C), sevoflurane was titrated to keep MAC in the range of 0.8-1, and fentanyl was given if the patient showed hypertension/tachycardia. Intraoperative opioid consumption was calculated. Postsurgery recovery characteristics, including Aldrete score, were assessed. Patients were questioned for pain, PONV, and recall of the intraoperative event. A comparison of age, BMI, ASA, recovery characteristics, opioid, and VAS score was made using the non-parametric Mann-Whitney U test. Categorical data like intraoperative awareness of surgery and PONV was studied using the Chi-square test. A comparison of heart rate and MAP was made by an independent sample t-test. #ggplot2 package was used to show the trend of the BIS index for all intraoperative time points for each patient. For a statistical test of significance, the cut-off p-value was set as <0.05. Conclusions: BIS monitoring led to reduced opioid consumption and early recovery from anaesthesia in breast cancer patients undergoing MRM resulting in less postoperative nausea and vomiting and less pain intensity in the immediate postoperative period without any recall of the intraoperative event. Thus, the use of a Bispectral index monitor allows for tailoring of anaesthesia administration with a good outcome.Keywords: bispectral index, depth of anaesthesia, recovery, opioid consumption
Procedia PDF Downloads 127827 Multi-Criteria Selection and Improvement of Effective Design for Generating Power from Sea Waves
Authors: Khaled M. Khader, Mamdouh I. Elimy, Omayma A. Nada
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Sustainable development is the nominal goal of most countries at present. In general, fossil fuels are the development mainstay of most world countries. Regrettably, the fossil fuel consumption rate is very high, and the world is facing the problem of conventional fuels depletion soon. In addition, there are many problems of environmental pollution resulting from the emission of harmful gases and vapors during fuel burning. Thus, clean, renewable energy became the main concern of most countries for filling the gap between available energy resources and their growing needs. There are many renewable energy sources such as wind, solar and wave energy. Energy can be obtained from the motion of sea waves almost all the time. However, power generation from solar or wind energy is highly restricted to sunny periods or the availability of suitable wind speeds. Moreover, energy produced from sea wave motion is one of the cheapest types of clean energy. In addition, renewable energy usage of sea waves guarantees safe environmental conditions. Cheap electricity can be generated from wave energy using different systems such as oscillating bodies' system, pendulum gate system, ocean wave dragon system and oscillating water column device. In this paper, a multi-criteria model has been developed using Analytic Hierarchy Process (AHP) to support the decision of selecting the most effective system for generating power from sea waves. This paper provides a widespread overview of the different design alternatives for sea wave energy converter systems. The considered design alternatives have been evaluated using the developed AHP model. The multi-criteria assessment reveals that the off-shore Oscillating Water Column (OWC) system is the most appropriate system for generating power from sea waves. The OWC system consists of a suitable hollow chamber at the shore which is completely closed except at its base which has an open area for gathering moving sea waves. Sea wave's motion pushes the air up and down passing through a suitable well turbine for generating power. Improving the power generation capability of the OWC system is one of the main objectives of this research. After investigating the effect of some design modifications, it has been concluded that selecting the appropriate settings of some effective design parameters such as the number of layers of Wells turbine fans and the intermediate distance between the fans can result in significant improvements. Moreover, simple dynamic analysis of the Wells turbine is introduced. Furthermore, this paper strives for comparing the theoretical and experimental results of the built experimental prototype.Keywords: renewable energy, oscillating water column, multi-criteria selection, Wells turbine
Procedia PDF Downloads 163826 The Effect of Technology on Skin Development and Progress
Authors: Haidy Weliam Megaly Gouda
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Dermatology is often a neglected specialty in low-resource settings despite the high morbidity associated with skin disease. This becomes even more significant when associated with HIV infection, as dermatological conditions are more common and aggressive in HIV-positive patients. African countries have the highest HIV infection rates, and skin conditions are frequently misdiagnosed and mismanaged because of a lack of dermatological training and educational material. The frequent lack of diagnostic tests in the African setting renders basic clinical skills all the more vital. This project aimed to improve the diagnosis and treatment of skin disease in the HIV population in a district hospital in Malawi. A basic dermatological clinical tool was developed and produced in collaboration with local staff and based on available literature and data collected from clinics. The aim was to improve diagnostic accuracy and provide guidance for the treatment of skin disease in HIV-positive patients. A literature search within Embassy, Medline and Google Scholar was performed and supplemented through data obtained from attending 5 Antiretroviral clinics. From the literature, conditions were selected for inclusion in the resource if they were described as specific, more prevalent, or extensive in the HIV population or have more adverse outcomes if they develop in HIV patients. Resource-appropriate treatment options were decided using Malawian Ministry of Health guidelines and textbooks specific to African dermatology. After the collection of data and discussion with local clinical and pharmacy staff, a list of 15 skin conditions was included, and a booklet was created using the simple layout of a picture, a diagnostic description of the disease and treatment options. Clinical photographs were collected from local clinics (with full consent of the patient) or from the book ‘Common Skin Diseases in Africa’ (permission granted if fully acknowledged and used in a not-for-profit capacity). This tool was evaluated by the local staff alongside an educational teaching session on skin disease. This project aimed to reduce uncertainty in diagnosis and provide guidance for appropriate treatment in HIV patients by gathering information into one practical and manageable resource. To further this project, we hope to review the effectiveness of the tool in practice.Keywords: prevalence and pattern of skin diseases, impact on quality of life, rural Nepal, interventions, quality switched ruby laser, skin color river blindness, clinical signs, circularity index, grey level run length matrix, grey level co-occurrence matrix, local binary pattern, object detection, ring detection, shape identification
Procedia PDF Downloads 62825 Effect of Internet Addiction on Dietary Behavior and Lifestyle Characteristics among University Students
Authors: Hafsa Kamran, Asma Afreen, Zaheer Ahmed
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Internet addiction, an emerging mental health disorder from last two decades, is manifested by the inability in the controlled use of internet leading to academics, social, physiological and/or psychological difficulties. The present study aimed to assess the levels of internet addiction among university students in Lahore and to explore the effects of internet addiction on their dietary behavior and lifestyle. It was an analytical cross-sectional study. Data was collected from October to December 2016 from students of four universities selected through two-stage sampling method. The numbers of participants were 500 and 13 questionnaires were rejected due to incomplete information. Levels of Internet Addiction (IA) were calculated using Young Internet Addiction Test (YIAT). Data was also collected on students’ demographics, lifestyle factors and dietary behavior using self-reported questionnaire. Data was analyzed using SPSS (version 21). Chi-square test was applied to evaluate the relationship between variables. Results of the study revealed that 10% of the population had severe internet addiction while moderate Internet Addiction was present in 42%. High prevalence was found among males (11% vs. 8%), private sector university students (p = 0.008) and engineering students (p = 0.000). The lifestyle habits of internet addicts were significantly of poorer quality than normal users (p = 0.05). Internet addiction was found associated with lesser physically activity (p = 0.025), had shorter duration of physical activity (p = 0.016), had more disorganized sleep pattern (p = 0.023), had less duration of sleep (p = 0.019), reported being more tired and sleepy in class (p = 0.033) and spending more time on internet as compared to normal users. Severe and moderate internet addicts also found to be more overweight and obese than normal users (p = 0.000). The dietary behavior of internet addicts was significantly poorer than normal users. Internet addicts were found to skip breakfast more than a normal user (p = 0.039). Common reasons for meal skipping were lack of time and snacking between meals (p = 0.000). They also had increased meal size (p = 0.05) and habit of snacking while using the internet (p = 0.027). Fast food (p = 0.016) and fried items (p = 0.05) were most consumed snacks, while carbonated beverages (p = 0.019) were most consumed beverages among internet addicts. Internet Addicts were found to consume less than recommended daily servings of dairy (p = 0.008) and fruits (p = 0.000) and more servings of meat group (p = 0.025) than their no internet addict counterparts. In conclusion, in this study, it was demonstrated that internet addicts have unhealthy dietary behavior and inappropriate lifestyle habits. University students should be educated regarding the importance of balanced diet and healthy lifestyle, which are critical for effectual primary prevention of numerous chronic degenerative diseases. Furthermore, it is necessary to raise awareness concerning adverse effects of internet addiction among youth and their parents.Keywords: dietary behavior, internet addiction, lifestyle, university students
Procedia PDF Downloads 201824 Methods Used to Achieve Airtightness of 0.07 Ach@50Pa for an Industrial Building
Authors: G. Wimmers
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The University of Northern British Columbia needed a new laboratory building for the Master of Engineering in Integrated Wood Design Program and its new Civil Engineering Program. Since the University is committed to reducing its environmental footprint and because the Master of Engineering Program is actively involved in research of energy efficient buildings, the decision was made to request the energy efficiency of the Passive House Standard in the Request for Proposals. The building is located in Prince George in Northern British Columbia, a city located at the northern edge of climate zone 6 with an average low between -8 and -10.5 in the winter months. The footprint of the building is 30m x 30m with a height of about 10m. The building consists of a large open space for the shop and laboratory with a small portion of the floorplan being two floors, allowing for a mezzanine level with a few offices as well as mechanical and storage rooms. The total net floor area is 1042m² and the building’s gross volume 9686m³. One key requirement of the Passive House Standard is the airtight envelope with an airtightness of < 0.6 ach@50Pa. In the past, we have seen that this requirement can be challenging to reach for industrial buildings. When testing for air tightness, it is important to test in both directions, pressurization, and depressurization, since the airflow through all leakages of the building will, in reality, happen simultaneously in both directions. A specific detail or situation such as overlapping but not sealed membranes might be airtight in one direction, due to the valve effect, but are opening up when tested in the opposite direction. In this specific project, the advantage was the overall very compact envelope and the good volume to envelope area ratio. The building had to be very airtight and the details for the windows and doors installation as well as all transitions from walls to roof and floor, the connections of the prefabricated wall panels and all penetrations had to be carefully developed to allow for maximum airtightness. The biggest challenges were the specific components of this industrial building, the large bay door for semi-trucks and the dust extraction system for the wood processing machinery. The testing was carried out in accordance with EN 132829 (method A) as specified in the International Passive House Standard and the volume calculation was also following the Passive House guideline resulting in a net volume of 7383m3, excluding all walls, floors and suspended ceiling volumes. This paper will explore the details and strategies used to achieve an airtightness of 0.07 ach@50Pa, to the best of our knowledge the lowest value achieved in North America so far following the test protocol of the International Passive House Standard and discuss the crucial steps throughout the project phases and the most challenging details.Keywords: air changes, airtightness, envelope design, industrial building, passive house
Procedia PDF Downloads 148823 IN-SEAN: The Pace of Economic Cooperation between India and ASEAN
Authors: Eumsin Payan
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The article desires the Association of Southeast Asian Nations (ASEAN) to take interest in the policies and give importance to India over other powerful countries in the World, including powerful countries in Asia, comprising of: People’s Republic of China (PRC), Russia, and India countries with the ability to drive the Asian continent, specifically, the ASEAN Economic Community (AEC). (Japan was incapable of stepping up to become the leader of ASEAN due to the fact that Japan has created “wounds” from military history with too many countries in Asia, including wounds from the Greater East Asia War, combining with economic problems Japan is currently facing and also several natural disasters, therefore Japan is not considered a good option of our era.) China appears to be an option that stands out, which could be seen through countless published articles in the general public. However, this article desires to propose India as an option to develop and drive the relationship between ASEAN countries in the future development of Computer Science Technology and allow India to be the leader in driving the Asian Economy in place of China and the United States. As for Russia, its location is distant and apart from South East Asia. Moreover, Russia does not give as much importance to ASEAN. In this light, the author perceives that India already has the “Look East” policy. Therefore, it would be simple for ASEAN to look back at India by simply starting cooperation through policies related to collaboration in the areas of computer science. In effect, this will continuously adjust and improve the relationship towards cooperation in the areas of economics, society, and culture. Referring to the above, the author suggests a word that could be used to call the relationship between India and ASEAN, INSEAN or IN-SEAN. Hereinafter, the author hopes that Thailand, in the position of one in the five founders of ASEAN, could become the leader or be the entity that pushes forward the ASEAN policies that will increase the importance of looking towards India. India is an emerging giant that has the ability to step up in Asia. With the proficient use of English, India is able to pass on the knowledge and drive the ASEAN’s Economic relationship better than China or Russia, as faced with higher language barriers. Moreover, India has cultivated democratic civilization from the colonization of the British Empire, similar to other nations of Southeast Asia, which are familiar with various heritage cultures that the British has brought them. The most important aspect in the author’s perspective is the fact that India is not aggressive and that they have courtesy. Through developing policies of the East through the “Look East” policy, it enabled India to establish a more smooth relationship with Asian countries comparing to China. China has imposed harsh policies towards democracy to the land above the South China Sea, which directly affect the ASEAN countries. From the above reasons, India, therefore, is an appropriate option in the establishment of a closer relationship with ASEAN, as the author has proposed relationship as INSEAN or IN-SEAN.Keywords: IN-SEAN, INSEAN, look west policy, look east policy, ASEAN, India
Procedia PDF Downloads 646822 Requirement Engineering for Intrusion Detection Systems in Wireless Sensor Networks
Authors: Afnan Al-Romi, Iman Al-Momani
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The urge of applying the Software Engineering (SE) processes is both of vital importance and a key feature in critical, complex large-scale systems, for example, safety systems, security service systems, and network systems. Inevitably, associated with this are risks, such as system vulnerabilities and security threats. The probability of those risks increases in unsecured environments, such as wireless networks in general and in Wireless Sensor Networks (WSNs) in particular. WSN is a self-organizing network of sensor nodes connected by wireless links. WSNs consist of hundreds to thousands of low-power, low-cost, multi-function sensor nodes that are small in size and communicate over short-ranges. The distribution of sensor nodes in an open environment that could be unattended in addition to the resource constraints in terms of processing, storage and power, make such networks in stringent limitations such as lifetime (i.e. period of operation) and security. The importance of WSN applications that could be found in many militaries and civilian aspects has drawn the attention of many researchers to consider its security. To address this important issue and overcome one of the main challenges of WSNs, security solution systems have been developed by researchers. Those solutions are software-based network Intrusion Detection Systems (IDSs). However, it has been witnessed, that those developed IDSs are neither secure enough nor accurate to detect all malicious behaviours of attacks. Thus, the problem is the lack of coverage of all malicious behaviours in proposed IDSs, leading to unpleasant results, such as delays in the detection process, low detection accuracy, or even worse, leading to detection failure, as illustrated in the previous studies. Also, another problem is energy consumption in WSNs caused by IDS. So, in other words, not all requirements are implemented then traced. Moreover, neither all requirements are identified nor satisfied, as for some requirements have been compromised. The drawbacks in the current IDS are due to not following structured software development processes by researches and developers when developing IDS. Consequently, they resulted in inadequate requirement management, process, validation, and verification of requirements quality. Unfortunately, WSN and SE research communities have been mostly impermeable to each other. Integrating SE and WSNs is a real subject that will be expanded as technology evolves and spreads in industrial applications. Therefore, this paper will study the importance of Requirement Engineering when developing IDSs. Also, it will study a set of existed IDSs and illustrate the absence of Requirement Engineering and its effect. Then conclusions are drawn in regard of applying requirement engineering to systems to deliver the required functionalities, with respect to operational constraints, within an acceptable level of performance, accuracy and reliability.Keywords: software engineering, requirement engineering, Intrusion Detection System, IDS, Wireless Sensor Networks, WSN
Procedia PDF Downloads 322821 Carbon Nanofibers as the Favorite Conducting Additive for Mn₃O₄ Catalysts for Oxygen Reactions in Rechargeable Zinc-Air Battery
Authors: Augustus K. Lebechi, Kenneth I. Ozoemena
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Rechargeable zinc-air batteries (RZABs) have been described as one of the most viable next-generation ‘beyond-the-lithium-ion’ battery technologies with great potential for renewable energy storage. It is safe, with a high specific energy density (1086 Wh/kg), environmentally benign, and low-cost, especially in resource-limited African countries. For widespread commercialization, the sluggish oxygen reaction kinetics pose a major challenge that impedes the reversibility of the system. Hence, there is a need for low-cost and highly active bifunctional electrocatalysts. Manganese oxide catalysts on carbon conducting additives remain the best couple for the realization of such low-cost RZABs. In this work, hausmannite Mn₃O₄ nanoparticles were synthesized through the annealing method from commercial electrolytic manganese dioxide (EMD), multi-walled carbon nanotubes (MWCNTs) were synthesized via the chemical vapor deposition (CVD) method and carbon nanofibers (CNFs) were synthesized via the electrospinning process with subsequent carbonization. Both Mn₃O₄ catalysts and the carbon conducting additives (MWCNT and CNF) were thoroughly characterized using X-ray powder diffraction spectroscopy (XRD), scanning electron microscopy (SEM), thermogravimetry analysis (TGA) and X-ray photoelectron spectroscopy (XPS). Composite electrocatalysts (Mn₃O₄/CNT and Mn₃O₄/CNF) were investigated for oxygen evolution reaction (OER) and oxygen reduction reaction (ORR) in an alkaline medium. Using the established electrocatalytic modalities for evaluating the electrocatalytic performance of materials (including double layer, electrochemical active surface area, roughness factor, specific current density, and catalytic stability), CNFs proved to be the most efficient conducting additive material for the Mn₃O₄ catalyst. From the DFT calculations, the higher performance of the CNFs over the MWCNTs is related to the ability of the CNFs to allow for a more favorable distribution of the d-electrons of the manganese (Mn) and enhanced synergistic effect with Mn₃O₄ for weaker adsorption energies of the oxygen intermediates (O*, OH* and OOH*). In a proof-of-concept, Mn₃O₄/CNF was investigated as the air cathode for rechargeable zinc-air battery (RZAB) in a micro-3D-printed cell configuration. The RZAB showed good performance in terms of open circuit voltage (1.77 V), maximum power density (177.5 mW cm-2), areal-discharge energy and cycling stability comparable to Pt/C (20 wt%) + IrO2. The findings here provide fresh physicochemical perspectives on the future design and utility of CNFs for developing manganese-based RZABs.Keywords: bifunctional electrocatalyst, oxygen evolution reaction, oxygen reduction reactions, rechargeable zinc-air batteries.
Procedia PDF Downloads 64820 Nutritional Education in Health Resort Institutions in the Face of Demographic and Epidemiological Changes in Poland
Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga
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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.Keywords: health care system, nutritional education, public health, spa and treatment
Procedia PDF Downloads 114819 Assessment of Dietary Patterns of Saudi Patients with Type 2 Diabetes Mellitus in Ramadan and Non-Ramadan Periods
Authors: Abdullah S. Alghamdi, Khaled Alghamdi, Richard O. Jenkins, Parvez I. Haris
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Background: Unhealthy diet is one of the modifiable risk factors for developing type 2 diabetes mellitus (T2DM). Improvement in diet can be beneficial for countering diabetes. For example, HbA1c, an important biomarker for diabetes, can be reduced by 1.1% through only alteration in diet. Ramadan fasting has been reported to provide positive health benefits. However, optimal benefits are not achieved, often due to poor dietary habits and lifestyle. There is a need to better understand the dietary habits of people fasting during Ramadan, so that necessary improvements can be made to develop this form of fasting as a non-pharmacological strategy for management and prevention of T2DM. Aim: This study aimed to assess the dietary patterns of Saudi adult patients with T2DM over three different periods (before, during, and after Ramadan) and relate this to HbA1c levels. Methods: This study recruited 82 Saudi with T2DM, who chose to fast during Ramadan, from the Endocrine and Diabetic Centre of Al Iman General Hospital, Riyadh, Saudi Arabia. Ethical approvals for the study were obtained from De Montfort University and Saudi Ministry of Health. Dietary patterns were assessed by a self-administered questionnaire in each period. This assessment included the diet type and frequency. Blood samples were collected in each period for determination of HbA1c. Results: The number of meals per day for the participants significantly decreased during Ramadan (P < 0.001). The consumption of fruit and vegetables significantly increased during Ramadan (P = 0.017). However, the consumption of sugary drinks significantly increased during and after Ramadan (P = 0.005). Approximately 60% of the patients indicated that they ate sugary foods at least once per week. The consumption of bread and rice was reported to be at least two times per week. The consumption of rice significantly reduced during Ramadan (P = 0.002). The mean HbA1c significantly varied between periods (P = 0.001), with lowest level during Ramadan compared to before and after Ramadan. The increase in the consumption of fruits and vegetables had a medium effect size on the reduction in HbA1c during Ramadan. There was a variance of 7.7% in the mean difference in HbA1c levels between groups (who changed their fruit and vegetable consumption) which can be accounted for by the increase in the consumption of fruits and vegetables. Likewise, 9.3% of the variance in the mean HbA1c difference between the groups was accounted for by a decrease in the consumption of rice. Conclusion: The increase in the frequency of fruit and vegetables intake, and especially the reduction in the frequency of rice consumption, during Ramadan produce beneficial effects in reducing HbA1c level. Therefore, further improving the dietary habits of patients with T2DM, such as reducing their sugary drinks intake, may help them to obtain greater benefits from Ramadan fasting in the management of their diabetes. It is recommended that dietary guidance is provided to the public to maximise health benefits through Ramadan fasting.Keywords: Diabetes, Diet, Fasting, HbA1c, Ramadan
Procedia PDF Downloads 164818 Driver of Migration and Appropriate Policy Concern Considering the Southwest Coastal Part of Bangladesh
Authors: Aminul Haque, Quazi Zahangir Hossain, Dilshad Sharmin Chowdhury
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The human migration is getting growing concern around the world, and recurrent disasters and climate change impact have great influence on migration. Bangladesh is one of the disaster prone countries that/and has greater susceptibility to stress migration by recurrent disasters and climate change. The study was conducted to investigate the factors that have a strong influence on current migration and changing pattern of life and livelihood means of the southwest coastal part of Bangladesh. Moreover, the study also revealed a strong relationship between disasters and migration and appropriate policy concern. To explore this relation, both qualitative and quantitative methods were applied to a questionnaire survey at household level and simple random sampling technique used in the sampling process along with different secondary data sources for understanding policy concern and practices. The study explores the most influential driver of migration and its relationship with social, economic and environmental drivers. The study denotes that, the environmental driver has a greater effect on the intention of permanent migration (t=1.481, p-value=0.000) at the 1 percent significance level. The significant number of respondents denotes that abrupt pattern of cyclone, flood, salinity intrusion and rainfall are the most significant environmental driver to make a decision on permanent migration. The study also found that the temporary migration pattern has 2-fold increased compared to last ten (10) years. It also appears from the study that environmental factors have a great implication on the changing pattern of the occupation of the study area and it has reported that about 76% of the respondent now in the changing modality of livelihood compare to their traditional practices. The study bares that the migration has foremost impact on children and women by increasing hardship and creating critical social security. The exposure-route of permanent migration is not smooth indeed, these migrations creating urban and conflict in Chittagong hill tracks of Bangladesh. The study denotes that there is not any safeguard of the stress migrant on existing policy and not have any measures for safe migration and resettlement rather considering the emergency response and shelter. The majority of (98%) people believes that migration is not to be the adoption strategies, but contrary to this young group of respondent believes that safe migration could be the adaptation strategy which could bring a positive result compare to the other resilience strategies. On the other hand, the significant number of respondents uttered that appropriate policy measure could be an adaptation strategy for being the formation of a resilient community and reduce the migration by meaningful livelihood options with appropriate protection measure.Keywords: environmental driver, livelihood, migration, resilience
Procedia PDF Downloads 264817 Densities and Volumetric Properties of {Difurylmethane + [(C5 – C8) N-Alkane or an Amide]} Binary Systems at 293.15, 298.15 and 303.15 K: Modelling Excess Molar Volumes by Prigogine-Flory-Patterson Theory
Authors: Belcher Fulele, W. A. A. Ddamba
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Study of solvent systems contributes to the understanding of intermolecular interactions that occur in binary mixtures. These interactions involves among others strong dipole-dipole interactions and weak van de Waals interactions which are of significant application in pharmaceuticals, solvent extractions, design of reactors and solvent handling and storage processes. Binary mixtures of solvents can thus be used as a model to interpret thermodynamic behavior that occur in a real solution mixture. Densities of pure DFM, n-alkanes (n-pentane, n-hexane, n-heptane and n-octane) and amides (N-methylformamide, N-ethylformamide, N,N-dimethylformamide and N,N-dimethylacetamide) as well as their [DFM + ((C5-C8) n-alkane or amide)] binary mixtures over the entire composition range, have been reported at temperature 293.15, 298.15 and 303.15 K and atmospheric pressure. These data has been used to derive the thermodynamic properties: the excess molar volume of solution, apparent molar volumes, excess partial molar volumes, limiting excess partial molar volumes, limiting partial molar volumes of each component of a binary mixture. The results are discussed in terms of possible intermolecular interactions and structural effects that occur in the binary mixtures. The variation of excess molar volume with DFM composition for the [DFM + (C5-C7) n-alkane] binary mixture exhibit a sigmoidal behavior while for the [DFM + n-octane] binary system, positive deviation of excess molar volume function was observed over the entire composition range. For each of the [DFM + (C5-C8) n-alkane] binary mixture, the excess molar volume exhibited a fall with increase in temperature. The excess molar volume for each of [DFM + (NMF or NEF or DMF or DMA)] binary system was negative over the entire DFM composition at each of the three temperatures investigated. The negative deviations in excess molar volume values follow the order: DMA > DMF > NEF > NMF. Increase in temperature has a greater effect on component self-association than it has on complex formation between molecules of components in [DFM + (NMF or NEF or DMF or DMA)] binary mixture which shifts complex formation equilibrium towards complex to give a drop in excess molar volume with increase in temperature. The Prigogine-Flory-Patterson model has been applied at 298.15 K and reveals that the free volume is the most important contributing term to the excess experimental molar volume data for [DFM + (n-pentane or n-octane)] binary system. For [DFM + (NMF or DMF or DMA)] binary mixture, the interactional term and characteristic pressure term contributions are the most important contributing terms in describing the sign of experimental excess molar volume. The mixture systems contributed to the understanding of interactions of polar solvents with proteins (amides) with non-polar solvents (alkanes) in biological systems.Keywords: alkanes, amides, excess thermodynamic parameters, Prigogine-Flory-Patterson model
Procedia PDF Downloads 355816 Assessing Children’s Probabilistic and Creative Thinking in a Non-formal Learning Context
Authors: Ana Breda, Catarina Cruz
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Daily, we face unpredictable events, often attributed to chance, as there is no justification for such an occurrence. Chance, understood as a source of uncertainty, is present in several aspects of human life, such as weather forecasts, dice rolling, and lottery. Surprisingly, humans and some animals can quickly adjust their behavior to handle efficiently doubly stochastic processes (random events with two layers of randomness, like unpredictable weather affecting dice rolling). This adjustment ability suggests that the human brain has built-in mechanisms for perceiving, understanding, and responding to simple probabilities. It also explains why current trends in mathematics education include probability concepts in official curriculum programs, starting from the third year of primary education onwards. In the first years of schooling, children learn to use a certain type of (specific) vocabulary, such as never, always, rarely, perhaps, likely, and unlikely, to help them to perceive and understand the probability of some events. These are keywords of crucial importance for their perception and understanding of probabilities. The development of the probabilistic concepts comes from facts and cause-effect sequences resulting from the subject's actions, as well as the notion of chance and intuitive estimates based on everyday experiences. As part of a junior summer school program, which took place at a Portuguese university, a non-formal learning experiment was carried out with 18 children in the 5th and 6th grades. This experience was designed to be implemented in a dynamic of a serious ice-breaking game, to assess their levels of probabilistic, critical, and creative thinking in understanding impossible, certain, equally probable, likely, and unlikely events, and also to gain insight into how the non-formal learning context influenced their achievements. The criteria used to evaluate probabilistic thinking included the creative ability to conceive events classified in the specified categories, the ability to properly justify the categorization, the ability to critically assess the events classified by other children, and the ability to make predictions based on a given probability. The data analysis employs a qualitative, descriptive, and interpretative-methods approach based on students' written productions, audio recordings, and researchers' field notes. This methodology allowed us to conclude that such an approach is an appropriate and helpful formative assessment tool. The promising results of this initial exploratory study require a future research study with children from these levels of education, from different regions, attending public or private schools, to validate and expand our findings.Keywords: critical and creative thinking, non-formal mathematics learning, probabilistic thinking, serious game
Procedia PDF Downloads 27815 Labile and Humified Carbon Storage in Natural and Anthropogenically Affected Luvisols
Authors: Kristina Amaleviciute, Ieva Jokubauskaite, Alvyra Slepetiene, Jonas Volungevicius, Inga Liaudanskiene
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The main task of this research was to investigate the chemical composition of the differently used soil in profiles. To identify the differences in the soil were investigated organic carbon (SOC) and its fractional composition: dissolved organic carbon (DOC), mobile humic acids (MHA) and C to N ratio of natural and anthropogenically affected Luvisols. Research object: natural and anthropogenically affected Luvisol, Akademija, Kedainiai, distr. Lithuania. Chemical analyses were carried out at the Chemical Research Laboratory of Institute of Agriculture, LAMMC. Soil samples for chemical analyses were taken from the genetics soil horizons. SOC was determined by the Tyurin method modified by Nikitin, measuring with spectrometer Cary 50 (VARIAN) in 590 nm wavelength using glucose standards. For mobile humic acids (MHA) determination the extraction procedure was carried out using 0.1 M NaOH solution. Dissolved organic carbon (DOC) was analyzed using an ion chromatograph SKALAR. pH was measured in 1M H2O. N total was determined by Kjeldahl method. Results: Based on the obtained results, it can be stated that transformation of chemical composition is going through the genetic soil horizons. Morphology of the upper layers of soil profile which is formed under natural conditions was changed by anthropomorphic (agrogenic, urbogenic, technogenic and others) structure. Anthropogenic activities, mechanical and biochemical disturbances destroy the natural characteristics of soil formation and complicates the interpretation of soil development. Due to the intensive cultivation, the pH values of the curve equals (disappears acidification characteristic for E horizon) with natural Luvisol. Luvisols affected by agricultural activities was characterized by a decrease in the absolute amount of humic substances in separate horizons. But there was observed more sustainable, higher carbon sequestration and thicker storage of humic horizon compared with forest Luvisol. However, the average content of humic substances in the soil profile was lower. Soil organic carbon content in anthropogenic Luvisols was lower compared with the natural forest soil, but there was more evenly spread over in the wider thickness of accumulative horizon. These data suggest that the organization of geo-ecological declines and agroecological increases in Luvisols. Acknowledgement: This work was supported by the National Science Program ‘The effect of long-term, different-intensity management of resources on the soils of different genesis and on other components of the agro-ecosystems’ [grant number SIT-9/2015] funded by the Research Council of Lithuania.Keywords: agrogenization, dissolved organic carbon, luvisol, mobile humic acids, soil organic carbon
Procedia PDF Downloads 236814 The Comparison of Physical Fitness across Age and Gender in the Lithuanian Primary School Students: Population-Based Cross-Sectional Study
Authors: Arunas Emeljanovas, Brigita Mieziene, Vida Cesnaitiene, Ingunn Fjortoft, Lise Kjonniksen
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Background: Gender differences in physical fitness were tracked in many studies with lower effect in preschool children and increasing difference among genders across age. In Lithuania, on a population level, secular trends in physical fitness were regularly observed each ten years for the last two decades for 11-18 years old students. However, there is apparently a lack of such epidemiological studies among primary school students. Assessing and monitoring physical fitness from an early age is of particular importance seeking to develop and strengthen physical abilities of youths for future health benefits. The goal of the current study was to indicate age and gender differences in anthropometric measures, musculoskeletal, motor and cardiorespiratory fitness in Lithuanian primary school children. Methods: The study included 3456 1-4th grade students from 6 to 10 years. The data reliably represents the population of primary school children in Lithuania. Among them, 1721 (49.8 percent) were boys. Physical fitness was measured by the 9-item test battery, developed by Fjørtoft and colleagues (2011). Height and weight were measured and body mass index was calculated. Student t test evaluated differences in physical fitness between boys and girls, ANOVA was performed to indicate differences across age. Results: All anthropometric and fitness means that were identified as significantly different were better in boys than in girls and in older than younger students (p < .05). Among anthropometric measures, height was higher in boys aged 7 through 9 years. Weight and BMI differed among boys and girls only at 8 years old. Means of height and weight increased significantly across all ages. Among musculoskeletal fitness tests, means of standing broad jump, throwing a tennis ball and pushing a medicine ball were different between genders within each age group and across all ages. Differences between genders were less likely in motor fitness than in musculoskeletal or cardiorespiratory fitness. Differences in means of shuttle run 10 x 5 test between genders occurred at age 6, 9 and 10 years; running 20 m at age 6 and 9 years, and climbing wall bars at age 9 and 10. Means of Reduced Cooper test representing cardiorespiratory fitness were different between genders within each age group but did not differ among age 6 and 8 as well as 7 and 8 years in boys, and among age 7 and 8 years in girls. Conclusion: In general, the current study confirms gender differences in musculoskeletal, motor and cardiorespiratory fitness found in other studies across the world in primary school and older children. Observed gender differences might be explained by higher physical activity in boys rather than girls. As it is explained by previous literature, older boys and girls had better performances than younger ones, because of the components of fitness change as a function of growth, maturation, development, and interactions among the three processes.Keywords: primary school children, motor fitness, musculoskeletal fitness, cardiovascular fitness
Procedia PDF Downloads 208813 The Effect of Positional Release Technique versus Kinesio Tape on Iliocostalis lumborum in Back Myofascial Pain Syndrome
Authors: Shams Khaled Abdelrahman Abdallah Elbaz, Alaa Aldeen Abd Al Hakeem Balbaa
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Purpose: The purpose of this study was to compare the effects of Positional Release Technique versus Kinesio Tape on pain level, pressure pain threshold level and functional disability in patients with back myofascial pain syndrome at iliocostalis lumborum. Backgrounds/significance: Myofascial Pain Syndrome is a common muscular pain syndrome that arises from trigger points which are hyperirritable, painful and tender points within a taut band of skeletal muscle. In more recent literature, about 75% of patients with musculoskeletal pain presenting to a community medical centres suffer from myofascial pain syndrome.Iliocostalis lumborum are most likely to develop active trigger points. Subjects: Thirty patients diagnosed as back myofascial pain syndrome with active trigger points in iliocostalis lumborum muscle bilaterally had participated in this study. Methods and materials: Patients were randomly distributed into two groups. The first group consisted of 15 patients (8 males and 7 females) with mean age 30.6 (±3.08) years, they received positional release technique which was applied 3 times per session, 3/week every other day for 2 weeks. The second group consisted of 15 patients(5 males, 10 females) with a mean age 30.4 (±3.35) years, they received kinesio tape which was applied and changed every 3 days with one day off for a total 3 times in 2 weeks. Both techniques were applied over trigger points of the iliocostalis lumborum bilaterally. Patients were evaluated pretreatment and posttreatment program for Pain intensity (Visual analogue scale), pressure pain threshold (digital pressure algometry), and functional disability (The Oswestry Disability Index). Analyses: Repeated measures MANOVA was used to detect differences within and between groups pre and post treatment. Then the univariate ANOVA test was conducted for the analysis of each dependant variable within and between groups. All statistical analyses were done using SPSS. with significance level set at p<0.05 throughout all analyses. Results: The results revealed that there was no significant difference between positional release technique and kinesio tape technique on pain level, pressure pain threshold and functional activities (p > 0.05). Both groups of patients showed significant improvement in all the measured variables (p < 0.05) evident by significant reduction of both pain intensity and functional disability as well as significant increase of pressure pain threshold Conclusions : Both positional release technique and kinesio taping technique are effective in reducing pain level, improving pressure pain threshold and improving function in treating patients who suffering from back myofascial pain syndrome at iliocostalis lumborum. As there was no statistically significant difference was proven between both of them.Keywords: positional release technique, kinesio tape, myofascial pain syndrome, Iliocostalis lumborum
Procedia PDF Downloads 231812 Awareness and Perception of Food Safety, Nutrition and Food Security among Omani Women
Authors: Abeer Al Kalbani
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Oman is a sub-tropical country with limited water resources, harsh weather and limited soil fertility, constraining food production. Therefore, it largely depends on international markets to assure supply of food. In the light of these circumstances, food security in Oman is defined as the ability of the country to grant the staple food needs of people (e.g. rice, wheat, lentil, sugar, dates, dairy products, fish and plant or vegetable oils). It also involves exporting local goods with high production rates to exchange them with required food products. This concept of food security includes the availability of food through production and/or importing, stability of the market prices during all circumstances, and the ability of people to meet their needs within their income capabilities. As a result, most of the food security work is focused on availability and access dimensions of the issue. Not much research is focused on the utilization aspect of food security in Oman. Although women play a vital role in food security, there is limited research on women’s role in food security neither in Oman nor in neighboring Gulf countries. Women play an important role not only by carrying the responsibility of feeding their families but also by setting the consumption model for the household. Therefore, the research aims to contribute to the work done on food security in Oman and similar regions of the world by studying the role women play at the utilization level. Methods used in this research include Qualitative unstructured interviews, focus groups, survey questionnaire and an experimental study. Based on the FAO definition of food security, it consists of availability, access, utilization and sustainability. Results from a pilot study conducted for this research on two groups of women in Oman; urban and rural women, showed that women in Oman are responsible for achieving these four pillars at the household level. Moreover, awareness of women increased as their educational level increased. Urban women showed more awareness and openness to adopt healthier and proper food related choices than rural women. Urban women seem also more open than rural women to new ideas and concepts and ways to healthier food. However, both urban and rural women claim that no training and educational programs are available for them and awareness of food security in general remains relatively low in both groups. In the light of these findings, this research attempts to further investigate the social beliefs, practices and attitudes women adopt in relation to food purchase, storage, preparation and consumption as considered as important parts of the food system. It also seeks to examine the effect of educational training programs and media on the level of women awareness on the issue.Keywords: food security, household food security, utilization, role of women
Procedia PDF Downloads 405811 Use of Locomotor Activity of Rainbow Trout Juveniles in Identifying Sublethal Concentrations of Landfill Leachate
Authors: Tomas Makaras, Gintaras Svecevičius
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Landfill waste is a common problem as it has an economic and environmental impact even if it is closed. Landfill waste contains a high density of various persistent compounds such as heavy metals, organic and inorganic materials. As persistent compounds are slowly-degradable or even non-degradable in the environment, they often produce sublethal or even lethal effects on aquatic organisms. The aims of the present study were to estimate sublethal effects of the Kairiai landfill (WGS: 55°55‘46.74“, 23°23‘28.4“) leachate on the locomotor activity of rainbow trout Oncorhynchus mykiss juveniles using the original system package developed in our laboratory for automated monitoring, recording and analysis of aquatic organisms’ activity, and to determine patterns of fish behavioral response to sublethal effects of leachate. Four different concentrations of leachate were chosen: 0.125; 0.25; 0.5 and 1.0 mL/L (0.0025; 0.005; 0.01 and 0.002 as part of 96-hour LC50, respectively). Locomotor activity was measured after 5, 10 and 30 minutes of exposure during 1-minute test-periods of each fish (7 fish per treatment). The threshold-effect-concentration amounted to 0.18 mL/L (0.0036 parts of 96-hour LC50). This concentration was found to be even 2.8-fold lower than the concentration generally assumed to be “safe” for fish. At higher concentrations, the landfill leachate solution elicited behavioral response of test fish to sublethal levels of pollutants. The ability of the rainbow trout to detect and avoid contaminants occurred after 5 minutes of exposure. The intensity of locomotor activity reached a peak within 10 minutes, evidently decreasing after 30 minutes. This could be explained by the physiological and biochemical adaptation of fish to altered environmental conditions. It has been established that the locomotor activity of juvenile trout depends on leachate concentration and exposure duration. Modeling of these parameters showed that the activity of juveniles increased at higher leachate concentrations, but slightly decreased with the increasing exposure duration. Experiment results confirm that the behavior of rainbow trout juveniles is a sensitive and rapid biomarker that can be used in combination with the system for fish behavior monitoring, registration and analysis to determine sublethal concentrations of pollutants in ambient water. Further research should be focused on software improvement aimed to include more parameters of aquatic organisms’ behavior and to investigate the most rapid and appropriate behavioral responses in different species. In practice, this study could be the basis for the development and creation of biological early-warning systems (BEWS).Keywords: fish behavior biomarker, landfill leachate, locomotor activity, rainbow trout juveniles, sublethal effects
Procedia PDF Downloads 271810 Ozonation as an Effective Method to Remove Pharmaceuticals from Biologically Treated Wastewater of Different Origin
Authors: Agne Jucyte Cicine, Vytautas Abromaitis, Zita Rasuole Gasiunaite, I. Vybernaite-Lubiene, D. Overlinge, K. Vilke
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Pharmaceutical pollution in aquatic environments has become a growing concern. Various active pharmaceutical ingredient (API) residues, hormones, antibiotics, or/and psychiatric drugs, have already been discovered in different environmental compartments. Due to existing ineffective wastewater treatment technologies to remove APIs, an underestimated amount can enter the ecosystem by discharged treated wastewater. Especially, psychiatric compounds, such as carbamazepine (CBZ) and venlafaxine (VNX), persist in effluent even post-treatment. Therefore, these pharmaceuticals usually exceed safe environmental levels and pose risks to the aquatic environment, particularly to sensitive ecosystems such as the Baltic Sea. CBZ, known for its chemical stability and long biodegradation time, accumulates in the environment, threatening aquatic life and human health through the food chain. As the use of medication rises, there is an urgent need for advanced wastewater treatment to reduce pharmaceutical contamination and meet future regulatory requirements. In this study, we tested advanced oxidation technology using ozone to remove two commonly used psychiatric drugs (carbamazepine and venlafaxine) from biologically treated wastewater effluent. Additionally, general water quality parameters (suspended matter (SPM), dissolved organic carbon (DOC), chemical oxygen demand (COD), and bacterial presence were analyzed. Three wastewater treatment plants (WWTPs) representing different anthropogenic pressures were selected: 1) resort, 2) resort and residential, and 3) residential, industrial, and resort. Wastewater samples for the experiment were collected during the summer season after mechanical and biological treatment and ozonated for 5, 10, and 15 minutes. The initial dissolved ozone concentration of 7,3±0,7 mg/L was held constant during all the experiments. Pharmaceutical levels in this study exceeded the predicted no-effect concentration (PNEC) of 500 and 90 ng L⁻¹ for CBZ and VNX, respectively, in all WWTPs, except CBZ in WWTP 1. Initial CBZ contamination was found to be lower in WWTP 1 (427.4 ng L⁻¹), compared with WWTP 2 (1266.5 ng L⁻¹) and 3 (119.2 ng L⁻¹). VNX followed a similar trend with concentrations of 341.2 ng L⁻¹, 361.4 ng L⁻¹, and 390.0 ng L⁻¹, respectively, for WWTPs 1, 2, and 3. It was determined that CBZ was not detected in the effluent after 5 minutes of ozonation in any of the WWTPs. Contrarily, VNX was still detected after 5, 10, and 15 minutes of treatment with ozone, however, under the limits of quantification (LOD) (<5ng L⁻¹). Additionally, general pollution of SPM, DOC, COD, and bacterial contamination was reduced notably after 5 minutes of treatment with ozone, while no bacterial growth was obtained. Although initial pharmaceutical levels exceeded PNECs, indicating ongoing environmental risks, ozonation demonstrated high efficiency in reducing pharmaceutical and general contamination in wastewater with different pollution matrices.Keywords: Baltic Sea, ozonation, pharmaceuticals, wastewater treatment plants
Procedia PDF Downloads 19809 Modulation of Receptor-Activation Due to Hydrogen Bond Formation
Authors: Sourav Ray, Christoph Stein, Marcus Weber
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A new class of drug candidates, initially derived from mathematical modeling of ligand-receptor interactions, activate the μ-opioid receptor (MOR) preferentially at acidic extracellular pH-levels, as present in injured tissues. This is of commercial interest because it may preclude the adverse effects of conventional MOR agonists like fentanyl, which include but are not limited to addiction, constipation, sedation, and apnea. Animal studies indicate the importance of taking the pH value of the chemical environment of MOR into account when designing new drugs. Hydrogen bonds (HBs) play a crucial role in stabilizing protein secondary structure and molecular interaction, such as ligand-protein interaction. These bonds may depend on the pH value of the chemical environment. For the MOR, antagonist naloxone and agonist [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAMGO) form HBs with ionizable residue HIS 297 at physiological pH to modulate signaling. However, such interactions were markedly reduced at acidic pH. Although fentanyl-induced signaling is also diminished at acidic pH, HBs with HIS 297 residue are not observed at either acidic or physiological pH for this strong agonist of the MOR. Molecular dynamics (MD) simulations can provide greater insight into the interaction between the ligand of interest and the HIS 297 residue. Amino acid protonation states are adjusted to the model difference in system acidity. Unbiased and unrestrained MD simulations were performed, with the ligand in the proximity of the HIS 297 residue. Ligand-receptor complexes were embedded in 1-palmitoyl-2-oleoyl-sn glycero-3-phosphatidylcholine (POPC) bilayer to mimic the membrane environment. The occurrence of HBs between the different ligands and the HIS 297 residue of MOR at acidic and physiological pH values were tracked across the various simulation trajectories. No HB formation was observed between fentanyl and HIS 297 residue at either acidic or physiological pH. Naloxone formed some HBs with HIS 297 at pH 5, but no such HBs were noted at pH 7. Interestingly, DAMGO displayed an opposite yet more pronounced HB formation trend compared to naloxone. Whereas a marginal number of HBs could be observed at even pH 5, HBs with HIS 297 were more stable and widely present at pH 7. The HB formation plays no and marginal role in the interaction of fentanyl and naloxone, respectively, with the HIS 297 residue of MOR. However, HBs play a significant role in the DAMGO and HIS 297 interaction. Post DAMGO administration, these HBs might be crucial for the remediation of opioid tolerance and restoration of opioid sensitivity. Although experimental studies concur with our observations regarding the influence of HB formation on the fentanyl and DAMGO interaction with HIS 297, the same could not be conclusively stated for naloxone. Therefore, some other supplementary interactions might be responsible for the modulation of the MOR activity by naloxone binding at pH 7 but not at pH 5. Further elucidation of the mechanism of naloxone action on the MOR could assist in the formulation of cost-effective naloxone-based treatment of opioid overdose or opioid-induced side effects.Keywords: effect of system acidity, hydrogen bond formation, opioid action, receptor activation
Procedia PDF Downloads 175808 The Coaching on Lifestyle Intervention (CooL): Preliminary Results and Implementation Process
Authors: Celeste E. van Rinsum, Sanne M. P. L. Gerards, Geert M. Rutten, Ien A. M. van de Goor, Stef P. J. Kremers
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Combined lifestyle interventions have shown to be effective in changing and maintaining behavioral lifestyle changes and reducing overweight and obesity. A lifestyle coach is expected to promote lifestyle changes in adults related to physical activity and diet. The present Coaching on Lifestyle (CooL) study examined participants’ physical activity level, dietary behavioral, and motivational changes immediately after the intervention and at 1.5 years after baseline. In CooL intervention a lifestyle coach coaches individuals from eighteen years and older with (a high risk of) obesity in group and individual sessions. In addition a process evaluation was conducted in order to examine the implementation process and to be able to interpret the changes within the participants. This action-oriented research has a pre-post design. Participants of the CooL intervention (N = 200) completed three questionnaires: at baseline, immediately after the intervention (on average after 44 weeks), and at 1.5 years after baseline. T-tests and linear regressions were conducted to test self-reported changes in physical activity (IPAQ), dietary behaviors, their quality of motivation for physical activity (BREQ-3) and for diet (REBS), body mass index (BMI), and quality of life (EQ-5D-3L). For the process evaluation, we used individual and group interviews, observations and document analyses to gain insight in the implementation process (e.g. the recruitment) and how the intervention was valued by the participants, lifestyle coaches, and referrers. The study is currently ongoing and therefore the results presented here are preliminary. On average, the participants that finished the intervention and those that have completed the long-term measurement improved their level of vigorous-intense physical activity, sedentary behavior, sugar-sweetened beverage consumption and BMI. Mixed results were observed in motivational regulation for physical activity and nutrition. Moreover, an improvement on the quality of life dimension anxiety/depression was found, also in the long-term. All the other constructs did not show significant change over time. The results of the process evaluation have shown that recruitment of clients was difficult. Participants evaluated the intervention positively and the lifestyle coaches have continuously adapted the structure and contents of the intervention throughout the study period, based on their experiences and feedback from research. Preliminary results indicate that the CooL-intervention may have beneficial effects on overweight and obese participants in terms of energy balance-related behaviors, weight reduction, and quality of life. Recruitment of participants and embedding the position of the lifestyle coach in traditional care structures is challenging.Keywords: combined lifestyle intervention, effect evaluation, lifestyle coaching, process evaluation, overweight, the Netherlands
Procedia PDF Downloads 229807 Changes in Attitudes of State Towards Orthodox Church: Greek Case after Eurozone Crisis in Alexis Tsipras Era
Authors: Zeynep Selin Balci, Altug Gunal
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Religion has always an effect on the policies of states. In the case of religion having a central role in defining identity, especially when becoming an independent state, the bond between religious authority and state cannot easily be broken. As independence of Greece from the Ottoman Empire was acquired at the same time with the creation of its own church under the name of the Church of Greece by declaring its independence from the Greek Orthodox Patriarchate in Istanbul, the new church became an important part of Greek national identity. As the Church has the ability to influence Greeks, its rituals, public appearances, and practices are used to provide support to the state. Although there sometimes have been controversies between church and state, it has always been a fact that church is an integral part of the state, which is proved by that paying the salaries of priest by state payroll and them being naturally civil servants. European Union membership, on the other hand, has a changing impact on this relationship. This impact started to be more visible in 2000 when then government decided to exclude the religion section from identity cards. Church’s reaction was to gather people around recalling their religious identity and followed by redefining the content of nationality, which aspired nationalist fronts. After 2015 when leftist coalition Syriza and its self-described atheist leader came to power, the situation for nationalists and Church became more tangling in addition to the economic crisis started in 2010 and evolved into the Eurozone crisis by affecting not only Greece but also other members. Although the church did not have direct confrontations with the government, the fact that Tsipras refused to take the oath on Bible created tensions because it was not acceptable for a state whose Constitution starts ‘in the name of the Holy, Consubstantial and Indivisible Trinity’. Moreover, austerity measures to overcome the economic crisis, which affected the everyday life of citizens in terms of both prices and salaries, did not harm the church’s economic situation much. Considering church being the second biggest landowner after state and paying no taxes, the fact that church was exempt from austerity measures showed to the government the necessity to find a way to make church contribute to solution for the crisis. In 2018, when the government agreed with the head of the church on cutting off the priests from government payroll automatically meaning to end priests’ civil servant status, it created tensions both for church and in society. As a result of the elections held in July 2019, Tsipras could not have the chance to apply the decision as he left the office. In light of these, this study aims to analyze the position of the church in the economic crisis and its effects on Tsipras term. In order to sufficiently understand this, it is to look at the historical changing points of Church’s influence in Greek’s eyes.Keywords: Eurozone crisis, Greece, Orthodox Church, Tsipras
Procedia PDF Downloads 126806 An Exploration of the Experiences of Women in Polygamous Marriages: A Case Study of Matizha Village, Masvingo, Zimbabwe
Authors: Flora Takayindisa, Tsoaledi Thobejane, Thizwilondi Mudau
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This study highlights what people in polygamous marriages face on a daily basis. It argues that there are more disadvantages for women in polygamous marriages than their counterparts in monogamous relationships. The study further suggests that the patriarchal power structure seems to take a powerful and effective role on polygamous marriages in our societies, particularly in Zimbabwe where this study took place. The study explored the intricacies of polygamous marriages and how these dominances can be resolved. The research is therefore presented through the ‘lived realities’ of the affected women in polygamous marriages in Gutu District located in Masvingo Province of Zimbabwe. Polygamous marriages are practised in different societies. Some women who are practising a polygamous lifestyle are emotionally and physically abused in their relationships. Evidence also suggests children from polygamous marriages also suffer psychologically when their fathers take other wives. Relationships within the family are very difficult because of the husband’s seeming favouritism for one wife. Children are mostly affected by disputes between co-wives and they often lack quality time with their fathers. There are mixed feelings about polygamous marriages. There are some people who condemn it saying inhumane. However, considerations must be made of what it might mean to other people who do not have choices of any other form of marriage. The other factor that has to be noted is that polygamous marriages are not always negative. There are some positive things that result from the polygamous marriages. The study was conducted in a village called Matizha. In the study, a qualitative research approach was employed to stimulate awareness of the social, cultural, religious and the effect of economic factors in polygamous marriages. This approach facilitates a unique understanding of the experiences of women in polygamous marriages, their experiences being both negative and positive. The qualitative type of research method enabled the respondents to have an open minded when they were being asked questions. The researcher utilised the feminist theory in the study. The researcher employed guide interviews to acquire information from the participants. The chapter focuses on the participants who took part in the study, how the participants were selected, ethical considerations, data collection, the interview process, the research instruments and the summary. The data was obtained using a guided interview for all the respondents ranging from all ages who are in polygamous marriages. The researcher presented the demographic information of the participants. Thereafter, the researcher presented other aspects of the data collection like social factors, economic factors and also religious affiliation. The conclusions and recommendations are made from the four main themes that came up from the discussions. The recommendations were made for the women, the policies and laws affecting women, and finally, recommendations for future research. It is believed that the overall objectives of the study have been met and research questions have been answered based on the findings of the study discussed.Keywords: co-wives, egalitarianism, experiences, polyandry, polygamy, woman
Procedia PDF Downloads 262805 Effects of Long-Term Exposure of Cadmium to the Ovary of Lithobius forficatus (Myriapoda, Chilopoda)
Authors: Izabela Poprawa, Alina Chachulska-Zymelka, Lukasz Chajec, Grazyna Wilczek, Piotr Wilczek, Sebastian Student, Magdalena Rost-Roszkowska
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Heavy metals polluting the environment, especially soil, have a harmful effect on organisms, because they can damage the organ structure, disturb their function and cause developmental disorders. They can affect not only the somatic tissues but also the germinal tissues. In the natural environment, plants and animals are exposed to short- and long-term exposure to these stressors, which have a major influence on the functioning of these organisms. Numerous animals have been treated as the bioindicators of the environment. Therefore, studies on any alterations caused by, e.g., heavy metals are in the center of interests of not only environmental but also medical and biological science. Myriapods are invertebrates which are bioindicators of the environment. One of the species which lives in the upper layers of soil, particularly under stones and rocks is Lithobius forficatus (Chilopoda), commonly known as the brown centipede or stone centipede. It is a European species of the family Lithobiidae. This centipede living in the soil is exposed to, e.g., heavy metals such as cadmium, lead, arsenic. The main goal of our project was to analyze the impact of long-term exposure to cadmium on the structure of ovary with the emphasis on the course of oogenesis. As the material for analysis of cadmium exposure to ovaries, we chose the centipede species, L. forficatus. Animals were divided into two experimental groups: C – the control group, the animals cultured in laboratory conditions in a horticultural soil; Cd2 – the animals cultured in a horticultural soil supplemented with 80 mg/kg (dry weight) of CdCl2 for 45 days – long-term exposure. Animals were fed with Acheta and Chironomus larvae maintained in tap water. The analyzes were carried out using transmission electron microscopy (TEM), flow cytometry and laser scanning (confocal) microscopy. Here we present the results of long-term exposure to cadmium concentration in soil on the organ responsible for female germ cell formation. Analysis with the use of the transmission electron microscope showed changes in the ultrastructure of both somatic and germ cells in the ovary. Moreover, quantitative analysis revealed the decrease in the percentage of cells viability, the increase in the percentage of cells with depolarized mitochondria and increasing the number of early apoptotic cells. All these changes were statistically significant compared to the control. Additionally, an increase in the ADP/ATP index was recorded. However, changes were not statistically significant to the control. Acknowledgment: The study has been financed by the National Science Centre, Poland, grant no 2017/25/B/NZ4/00420.Keywords: cadmium, centipede, ovary, ultrastructure
Procedia PDF Downloads 118804 Evaluation of Tensile Strength of Natural Fibres Reinforced Epoxy Composites Using Fly Ash as Filler Material
Authors: Balwinder Singh, Veerpaul Kaur Mann
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A composite material is formed by the combination of two or more phases or materials. Natural minerals-derived Basalt fiber is a kind of fiber being introduced in the polymer composite industry due to its good mechanical properties similar to synthetic fibers and low cost, environment friendly. Also, there is a rising trend towards the use of industrial wastes as fillers in polymer composites with the aim of improving the properties of the composites. The mechanical properties of the fiber-reinforced polymer composites are influenced by various factors like fiber length, fiber weight %, filler weight %, filler size, etc. Thus, a detailed study has been done on the characterization of short-chopped Basalt fiber-reinforced polymer matrix composites using fly ash as filler. Taguchi’s L9 orthogonal array has been used to develop the composites by considering fiber length (6, 9 and 12 mm), fiber weight % (25, 30 and 35 %) and filler weight % (0, 5 and 10%) as input parameters with their respective levels and a thorough analysis on the mechanical characteristics (tensile strength and impact strength) has been done using ANOVA analysis with the help of MINITAB14 software. The investigation revealed that fiber weight is the most significant parameter affecting tensile strength, followed by fiber length and fiber weight %, respectively, while impact characterization showed that fiber length is the most significant factor, followed by fly ash weight, respectively. Introduction of fly ash proved to be beneficial in both the characterization with enhanced values upto 5% fly ash weight. The present study on the natural fibres reinforced epoxy composites using fly ash as filler material to study the effect of input parameters on the tensile strength in order to maximize tensile strength of the composites. Fabrication of composites based on Taguchi L9 orthogonal array design of experiments by using three factors fibre type, fibre weight % and fly ash % with three levels of each factor. The Optimization of composition of natural fibre reinforces composites using ANOVA for obtaining maximum tensile strength on fabricated composites revealed that the natural fibres along with fly ash can be successfully used with epoxy resin to prepare polymer matrix composites with good mechanical properties. Paddy- Paddy fibre gives high elasticity to the fibre composite due to presence of approximately hexagonal structure of cellulose present in paddy fibre. Coir- Coir fibre gives less tensile strength than paddy fibre as Coir fibre is brittle in nature when it pulls breakage occurs showing less tensile strength. Banana- Banana fibre has the least tensile strength in comparison to the paddy & coir fibre due to less cellulose content. Higher fibre weight leads to reduction in tensile strength due to increased nuclei of air pockets. Increasing fly ash content reduces tensile strength due to nonbonding of fly ash particles with natural fibre. Fly ash is also not very strong as compared to the epoxy resin leading to reduction in tensile strength.Keywords: tensile strength and epoxy resin. basalt Fiber, taguchi, polymer matrix, natural fiber
Procedia PDF Downloads 49803 The Physiological Effects of Thyriod Disorders During the Gestatory Period on Fetal Neurological Development: A Descriptive Review
Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert
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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy
Procedia PDF Downloads 144802 A Paradigm Shift in Patent Protection-Protecting Methods of Doing Business: Implications for Economic Development in Africa
Authors: Odirachukwu S. Mwim, Tana Pistorius
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Since the early 1990s political and economic pressures have been mounted on policy and law makers to increase patent protection by raising the protection standards. The perception of the relation between patent protection and development, particularly economic development, has evolved significantly in the past few years. Debate on patent protection in the international arena has been significantly influenced by the perception that there is a strong link between patent protection and economic development. The level of patent protection determines the extent of development that can be achieved. Recently there has been a paradigm shift with a lot of emphasis on extending patent protection to method of doing business generally referred to as Business Method Patenting (BMP). The general perception among international organizations and the private sectors also indicates that there is a strong correlation between BMP protection and economic growth. There are two diametrically opposing views as regards the relation between Intellectual Property (IP) protection and development and innovation. One school of thought promotes the view that IP protection improves economic development through stimulation of innovation and creativity. The other school advances the view that IP protection is unnecessary for stimulation of innovation and creativity and is in fact a hindrance to open access to resources and information required for innovative and creative modalities. Therefore, different theories and policies attach different levels of protection to BMP which have specific implications for economic growth. This study examines the impact of BMP protection on development by focusing on the challenges confronting economic growth in African communities as a result of the new paradigm in patent law. (Africa is used as a single unit in this study but this should not be construed as African homogeneity. Rather, the views advanced in this study are used to address the common challenges facing many communities in Africa). The study reviews (from the point of views of legal philosophers, policy makers and decisions of competent courts) the relevant literature, patent legislation particularly the International Treaty, policies and legal judgments. Findings from this study suggest that over and above the various criticisms levelled against the extreme liberal approach to the recognition of business methods as patentable subject matter, there are other specific implications that are associated with such approach. The most critical implication of extending patent protection to business methods is the locking-up of knowledge which may hamper human development in general and economic development in particular. Locking up knowledge necessary for economic advancement and competitiveness may have a negative effect on economic growth by promoting economic exclusion, particularly in African communities. This study suggests that knowledge of BMP within the African context and the extent of protection linked to it is crucial in achieving a sustainable economic growth in Africa. It also suggests that a balance is struck between the two diametrically opposing views.Keywords: Africa, business method patenting, economic growth, intellectual property, patent protection
Procedia PDF Downloads 127801 Role of Psychological Capital in Organizational and Personal Outcomes: An Exploratory Study of Medical Professionals in Pakistan
Authors: Shazia Almas, Jaffar Iqbal, Nazia Almas
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In most of the South Asian countries like Pakistan medical profession is one the most valued and respectful professions yet being a medical professional requires an enormous amount of responsibilities and work overload at the same time which possibly can be in contrast with family role of a doctor. Job and family are two primary spheres of a person's life no matter whatever the profession one adopts and the type of family one is running. There is a bi-directional relationship between job and family. The type and nature of work, time schedules, working shifts in medical profession are very demanding in the countries like Pakistan where number of patients is far more higher than the number of doctors available. The work life also have significant impact on family life and vice versa. Because of the sensitivity and interdependency of these relations, today’s overarching and competing demands remain dissatisfactory. The main objective of the current research is to investigate how interpersonal relationships affect work and work affects interpersonal relationships of medical professionals. In line with identifying these facts, the current study aimed to examine the predictive role of psychological capital (self-efficacy, hope, optimism, and resilience), in organizational outcome (job satisfaction) and personal outcome (family satisfaction) amongst male and medical professionals. A total of 350 participants from public and private sector hospitals of Pakistan were recruited through simple random and stratified sampling techniques, with age ranges from 26-50 years. The questionnaire including established and certified self-report measures of Psychological Capital Questionnaire, Job Satisfaction, and Family Satisfaction were adopted to collect the data. The reliability and validity of mentioned instruments were established through Cronbach’s alpha and factor analyses (exploratory and confirmatory) respectively using Structural Equation Modeling (SEM) by AMOS. The proposed hypotheses were tested using Pearson’s Correlation and Regression analyses for predicting effect whereas, t-Test was deployed to verify the difference between male and female health professionals. The results revealed that self-efficacy and optimism predicted job satisfaction while, self-efficacy, hope, and resilience predicted family satisfaction. Moreover, the results depicted significant gender differences in job satisfaction where females were higher on job satisfaction as compared to male medical professionals but no significant differences were observed in levels of family satisfaction between both genders. The study has implications for social, organizational and work policy designers. The study also paves for more researches with positive psychological approach to promote work-family harmony.Keywords: family satisfaction, job satisfaction, medical professionals, psychological capital
Procedia PDF Downloads 250800 Branding in FMCG Sector in India: A Comparison of Indian and Multinational Companies
Authors: Pragati Sirohi, Vivek Singh Rana
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Brand is a name, term, sign, symbol or design or a combination of all these which is intended to identify the goods or services of one seller or a group of sellers and to differentiate them from those of the competitors and perception influences purchase decisions here and so building that perception is critical. The FMCG industry is a low margin business. Volumes hold the key to success in this industry. Therefore, the industry has a strong emphasis on marketing. Creating strong brands is important for FMCG companies and they devote considerable money and effort in developing brands. Brand loyalty is fickle. Companies know this and that is why they relentlessly work towards brand building. The purpose of the study is a comparison between Indian and Multinational companies with regard to FMCG sector in India. It has been hypothesized that after liberalization the Indian companies has taken up the challenge of globalization and some of these are giving a stiff competition to MNCs. There is an existence of strong brand image of MNCs compared to Indian companies. Advertisement expenditures of MNCs are proportionately higher compared to Indian counterparts. The operational area of the study is the country as a whole. Continuous time series data is available from 1996-2014 for the selected 8 companies. The selection of these companies is done on the basis of their large market share, brand equity and prominence in the market. Research methodology focuses on finding trend growth rates of market capitalization, net worth, and brand values through regression analysis by the usage of secondary data from prowess database developed by CMIE (Centre for monitoring Indian Economy). Estimation of brand values of selected FMCG companies is being attempted, which can be taken to be the excess of market capitalization over the net worth of a company. Brand value indices are calculated. Correlation between brand values and advertising expenditure is also measured to assess the effect of advertising on branding. Major results indicate that although MNCs enjoy stronger brand image but few Indian companies like ITC is the outstanding leader in terms of its market capitalization and brand values. Dabur and Tata Global Beverages Ltd are competing equally well on these values. Advertisement expenditures are the highest for HUL followed by ITC, Colgate and Dabur which shows that Indian companies are not behind in the race. Although advertisement expenditures are playing a role in brand building process there are many other factors which affect the process. Also, brand values are decreasing over the years for FMCG companies in India which show that competition is intense with aggressive price wars and brand clutter. Implications for Indian companies are that they have to consistently put in proactive and relentless efforts in their brand building process. Brands need focus and consistency. Brand longevity without innovation leads to brand respect but does not create brand value.Keywords: brand value, FMCG, market capitalization, net worth
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