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Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut

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Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.

Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women

Procedia PDF Downloads 321

Authors: Adonis Menezes, J. C. Passos

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The current panorama of technology in heat transfer and the scarcity of information about the convective boiling of CO₂ and hydrocarbon in small diameter channels motivated the development of this work. Among non-halogenated refrigerants, CO₂/ R744 has distinct thermodynamic properties compared to other fluids. The R744 presents significant differences in operating pressures and temperatures, operating at higher values compared to other refrigerants, and this represents a challenge for the design of new evaporators, as the original systems must normally be resized to meet the specific characteristics of the R744, which creates the need for a new design and optimization criteria. To carry out the convective boiling tests of CO₂, an experimental apparatus capable of storing (m= 10kg) of saturated CO₂ at (T = -30 ° C) in an accumulator tank was used, later this fluid was pumped using a positive displacement pump with three pistons, and the outlet pressure was controlled and could reach up to (P = 110bar). This high-pressure saturated fluid passed through a Coriolis type flow meter, and the mass velocities varied between (G = 20 kg/m².s) up to (G = 1000 kg/m².s). After that, the fluid was sent to the first test section of circular cross-section in diameter (D = 4.57mm), where the inlet and outlet temperatures and pressures, were controlled and the heating was promoted by the Joule effect using a source of direct current with a maximum heat flow of (q = 100 kW/m²). The second test section used a cross-section with multi-channels (seven parallel channels) with a square cross-section of (D = 2mm) each; this second test section has also control of temperature and pressure at the inlet and outlet as well as for heating a direct current source was used, with a maximum heat flow of (q = 20 kW/m²). The fluid in a biphasic situation was directed to a parallel plate heat exchanger so that it returns to the liquid state, thus being able to return to the accumulator tank, continuing the cycle. The multi-channel test section has a viewing section; a high-speed CMOS camera was used for image acquisition, where it was possible to view the flow patterns. The experiments carried out and presented in this report were conducted in a rigorous manner, enabling the development of a database on the convective boiling of the R744 in macro and micro channels. The analysis prioritized the processes from the beginning of the convective boiling until the drying of the wall in a subcritical regime. The R744 resurfaces as an excellent alternative to chlorofluorocarbon refrigerants due to its negligible ODP (Ozone Depletion Potential) and GWP (Global Warming Potential) rates, among other advantages. The results found in the experimental tests were very promising for the use of CO₂ in micro-channels in convective boiling and served as a basis for determining the flow pattern map and correlation for determining the heat transfer coefficient in the convective boiling of CO₂.

Keywords: convective boiling, CO₂/R744, macro-channels, micro-channels

Procedia PDF Downloads 143

Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula

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Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.

Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation

Procedia PDF Downloads 210

Authors: H. Mayton, X. Yan, A. G. Taylor

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Infested tomato seeds were used to investigate the influence of Xanthomonas euvesicatoria on germination and seed to seedling transmission in a controlled environment and greenhouse assays in an effort to develop effective seed treatments and characterize seed borne transmission of bacterial leaf spot of tomato. Bacterial leaf spot of tomato, caused by four distinct Xanthomonas species, X. euvesicatoria, X. gardneri, X. perforans, and X. vesicatoria, is a serious disease worldwide. In the United States, disease prevention is expensive for commercial growers in warm, humid regions of the country, and crop losses can be devastating. In this study, four different infested tomato seed lots were extracted from tomato fruits infected with bacterial leaf spot from a field in New York State in 2017 that had been inoculated with X. euvesicatoria. In addition, vacuum infiltration at 61 kilopascals for 1, 5, 10, and 15 minutes and seed soaking for 5, 10, 15, and 30 minutes with different bacterial concentrations were used to artificially infest seed in the laboratory. For controlled environment assays, infested tomato seeds from the field and laboratory were placed othe n moistened blue blotter in square plastic boxes (10 cm x 10 cm) and incubated at 20/30 ˚C with an 8/16 hour light cycle, respectively. Infested tomato seeds from the field and laboratory were also planted in small plastic trays in soil (peat-lite medium) and placed in the greenhouse with 24/18 ˚C day and night temperatures, respectively, with a 14-hour photoperiod. Seed germination was assessed after eight days in the laboratory and 14 days in the greenhouse. Polymerase chain reaction (PCR) using the hrpB7 primers (RST65 [5’- GTCGTCGTTACGGCAAGGTGGTG-3’] and RST69 [5’-TCGCCCAGCGTCATCAGGCCATC-3’]) was performed to confirm presence or absence of the bacterial pathogen in seed lots collected from the field and in germinating seedlings in all experiments. For infested seed lots from the field, germination was lowest (84%) in the seed lot with the highest level of bacterial infestation (55%) and ranged from 84-98%. No adverse effect on germination was observed from artificially infested seeds for any bacterial concentration and method of infiltration when compared to a non-infested control. Germination in laboratory assays for artificially infested seeds ranged from 82-100%. In controlled environment assays, 2.5 % were PCR positive for the pathogen, and in the greenhouse assays, no infected seedlings were detected. From these experiments, X. euvesicatoria does not appear to adversely influence germination. The lowest rate of germination from field collected seed may be due to contamination with multiple pathogens and saprophytic organisms as no effect of artificial bacterial seed infestation in the laboratory on germination was observed. No evidence of systemic movement from seed to seedling was observed in the greenhouse assays; however, in the controlled environment assays, some seedlings were PCR positive. Additional experiments are underway with green fluorescent protein-expressing isolates to further characterize seed to seedling transmission of the bacterial leaf spot pathogen in tomato.

Keywords: bacterial leaf spot, seed germination, tomato, Xanthomonas euvesicatoria

Procedia PDF Downloads 134

Authors: Dieudonne Uwizeye, Reuben Muhayiteto

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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

Procedia PDF Downloads 179

Authors: Shamsa Al Sharji, Athar Al Jabri, Haitham Al Dughaishi, Mirfat Al Barwani, Raja Al Rawahi, Raiya Al Rajhi, Shurooq Al Ruqaishi, Thamreen Al Zadjali, Iman Al Humaidi

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Background: External Ventricular Drains (EVDs) are critical in managing traumatic brain injuries and hydrocephalus by controlling intracranial pressure, but they carry a high risk of infection. Infection rates vary globally, ranging from 5% to 45%, leading to increased morbidity, prolonged hospital stays, and higher healthcare costs. Nursing protocols play a pivotal role in reducing these infection rates. This study investigates the impact of a structured nursing protocol on EVD-associated infections in adult neurosurgery patients at the Directorate General of Khoula Hospital, Oman, from January to September 2024. Methods: A cluster-randomized trial was conducted across neurosurgery wards and the ICU. The intervention group followed a comprehensive nursing protocol, including strict sterile insertion, standardized dressing changes, infection control training, and regular clinical audits. The control group received standard care. The primary outcome was the incidence of EVD-associated infections, with secondary outcomes including protocol compliance, infection severity, recovery times, length of stay, and 30-day mortality. Statistical analysis was conducted using Chi-square tests, paired t-tests, and logistic regression to assess the differences between groups. Results: The study involved 75 patients, with an overall infection rate of 13.3%. The intervention group showed a reduced infection rate of 8.9% compared to 20% in the control group. Compliance rates for key nursing actions were high, with 89.7% for hand hygiene and 86.2% for wound dressing. The relative risk of infection was 0.44 in the intervention group, reflecting a 55.6% reduction. Logistic regression identified obesity as a significant predictor of EVD infections. Although mortality rates were slightly higher in the intervention group, the number needed to treat (NNT) of 9 suggests that the nursing protocol may improve survival outcomes. Conclusion: This study demonstrates that structured nursing protocols can reduce EVD-related infections and improve patient outcomes in neurosurgery. While the findings are promising, further research with larger sample sizes is needed to confirm these results and optimize infection control strategies in neurosurgical care.

Keywords: EVD, CSF, nursing protocol, EVD infection

Procedia PDF Downloads 24

Authors: Hassiba Benguergoura, Kamal Chanane, Sâad Moulay

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Pervaporation (PV), a membrane-based separation technology, has gained much attention because of its energy saving capability and low-cost, especially for separation of azeotropic or close-boiling liquid mixtures. There are two crucial issues for industrial application of pervaporation process. The first is developing membrane material and tailoring membrane structure to obtain high pervaporation performances. The second is modeling pervaporation transport to better understand of the above-mentioned structure–pervaporation relationship. Many models were proposed to predict the mass transfer process, among them, solution-diffusion model is most widely used in describing pervaporation transport including preferential sorption, diffusion and evaporation steps. For modeling pervaporation transport, the permeation flux, which depends on the solubility and diffusivity of components in the membrane, should be obtained first. Traditionally, the solubility was calculated according to the Flory–Huggins theory. Separation of the benzene (Bz)/cyclohexane (Cx) mixture is industrially significant. Numerous papers have been focused on the Bz/Cx system to assess the PV properties of membrane materials. Membranes with both high permeability and selectivity are desirable for practical application. Several new polymers have been prepared to get both high permeability and selectivity. Styrene-butadiene rubbers (SBR), dense membranes cross-linked by chloromethylation were used in the separation of benzene/cyclohexane mixtures. The impact of chloromethylation reaction as a new method of cross-linking SBR on the pervaporation performance have been reported. In contrast to the vulcanization with sulfur, the cross-linking takes places on styrene units of polymeric chains via a methylene bridge. The partial pervaporative (PV) fluxes of benzene/cyclohexane mixtures in styrene-butadiene rubber (SBR) were predicted using Fick's first law. The predicted partial fluxes and the PV separation factor agreed well with the experimental data by integrating Fick's law over the benzene concentration. The effects of feed concentration and operating temperature on the predicted permeation flux by this proposed model are investigated. The predicted permeation fluxes are in good agreement with experimental data at lower benzene concentration in feed, but at higher benzene concentration, the model overestimated permeation flux. The predicted and experimental permeation fluxes all increase with operating temperature increasing. Solvent sorption levels for benzene/ cyclohexane mixtures in a SBR membrane were determined experimentally. The results showed that the solvent sorption levels were strongly affected by the feed composition. The Flory- Huggins equation generates higher R-square coefficient for the sorption selectivity.

Keywords: benzene, cyclohexane, pervaporation, permeation, sorption modeling, SBR

Procedia PDF Downloads 326

Authors: Precious Ehiomogue, Ifechukwude Israel Ahuchaogu, Isiguzo Edwin Ahaneku

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Vermicompost is the product of the decomposition process using various species of worms, to create a mixture of decomposing vegetable or food waste, bedding materials, and vemicast. This process is called vermicomposting, while the rearing of worms for this purpose is called vermiculture. Several works have verified the adsorption of toxic metals using vermicompost but the application is still scarce for the retention of organic compounds. This research brings to knowledge the effectiveness of earthworm waste (vermicompost) for the remediation of crude oil contaminated soils. The remediation methods adopted in this study were two soil washing methods namely, batch and column process which represent laboratory and in-situ remediation. Characterization of the vermicompost and crude oil contaminated soil were performed before and after the soil washing using Fourier transform infrared (FTIR), scanning electron microscopy (SEM), X-ray fluorescence (XRF), X-ray diffraction (XRD) and Atomic adsorption spectrometry (AAS). The optimization of washing parameters, using response surface methodology (RSM) based on Box-Behnken Design was performed on the response from the laboratory experimental results. This study also investigated the application of machine learning models [Artificial neural network (ANN), Adaptive neuro fuzzy inference system (ANFIS). ANN and ANFIS were evaluated using the coefficient of determination (R²) and mean square error (MSE)]. Removal efficiency obtained from the Box-Behnken design experiment ranged from 29% to 98.9% for batch process remediation. Optimization of the experimental factors carried out using numerical optimization techniques by applying desirability function method of the response surface methodology (RSM) produce the highest removal efficiency of 98.9% at absorbent dosage of 34.53 grams, adsorbate concentration of 69.11 (g/ml), contact time of 25.96 (min), and pH value of 7.71, respectively. Removal efficiency obtained from the multilevel general factorial design experiment ranged from 56% to 92% for column process remediation. The coefficient of determination (R²) for ANN was (0.9974) and (0.9852) for batch and column process, respectively, showing the agreement between experimental and predicted results. For batch and column precess, respectively, the coefficient of determination (R²) for RSM was (0.9712) and (0.9614), which also demonstrates agreement between experimental and projected findings. For the batch and column processes, the ANFIS coefficient of determination was (0.7115) and (0.9978), respectively. It can be concluded that machine learning models can predict the removal of crude oil from polluted soil using vermicompost. Therefore, it is recommended to use machines learning models to predict the removal of crude oil from contaminated soil using vermicompost.

Keywords: ANFIS, ANN, crude-oil, contaminated soil, remediation and vermicompost

Procedia PDF Downloads 111

Authors: Akinola Helen Olufunke, Soetan Olatunbosun Jonathan, Adeleye Oludamola

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Introduction: Antibiotic resistance has grown significantly, which is a major cause for concern. There have not been many significant developments in antibiotics over the past few decades, and practically all of the ones that are currently in use are losing effectiveness against pathogenic germs. Researchers are starting to focus more on the physiologically active compounds found in plants, particularly phytobiotics in poultry production. Consumption of chicken products is among the greatest in the country, but numerous nations, including Nigeria, use excessive amounts of necessary antibiotics in poultry farming, endangering the safety of such goods (through antimicrobial residues). Drug resistance has become a widespread issue as a result of the risky use of antibiotics in the chicken production industry. In order to replace antibiotics, biotic or natural products like phytobiotics (also known as botanicals or phytogenics) have drawn a lot of interest. Phytobiotics or their components are thought to be a relatively recent category of natural herbs that have acquired acceptance and favor among chicken farmers. The addition of several phytobiotic additions to poultry feed has demonstrated its capacity to improve both the broiler and layer populations' productivity. Design: Experimental research design and cross-sectional study was carried out at every 300 purposively selected farming household in the six-geopolitical zone in Nigeria. Data Analysis: A semi-structured questionnaire was administered to each farmer, and quantitative data were analyzed using Statistical Package for Social Science (SPSS) while the Chi-square test was used to analyze factors mitigating the use of Phytobiotics. Result: The result shows that the benefits associated with the use of phytobiotics are contributed to growth promotion in chickens and enhancement of productive performance of broiler and layer, which could be attributed to their antioxidant activity. The result further revealed that factors mitigating the use of phytobiotics were lack of knowledge in the use of phytobiotics, overdose or underdose usage, and seasonal availability of the phytobiotics. Others are the educational level of the farmers, intrinsic motivation, income poultry farming experience, price of phytobiotics based additives feeds, and intensity of extension agents in visiting them. Conclusion: The difficulties associated with using phytobiotics in chicken farms limit their willingness to boost productivity. The study found that most farmers were ignorant, which prevented them from handling this notion and turning their poultry into a viable enterprise while also allowing them to be creative. They believed that packing phytobiotics-based additive feed was expensive, and lastly, the seasonal availability of some phytobiotics. Recommendation: Further research in phytobiotics use in Nigeria should be carried out in order to establish its efficiency, safety, and awareness.

Keywords: mitigating, antibiotics, phytobiotics, poultry farming

Procedia PDF Downloads 171

Authors: Z. M. Biyasheva, M. Zh. Tleubergenova, Y. A. Zaripova, A. L. Shakirov, V. V. Dyachkov

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In recent years, interest in ecogenetic and biomedical problems related to the effects on the population of radon and its daughter decay products has increased significantly. Of particular interest is the assessment of the consequence of irradiation at hazardous radon areas, which includes the Almaty region due to the large number of tectonic faults that enhance radon emanation. In connection with the foregoing, the purpose of this work was to study the genetic effects of exposure to supernormal radon doses on the alpha-radiation model. Irradiation does not affect the growth of the cell, but rather its ability to differentiate. In addition, irradiation can lead to somatic mutations, morphoses and modifications. These damages most likely occur from changes in the composition of the substances of the cell. Such changes are epigenetic since they affect the regulatory processes of ontogenesis. Variability in the expression of regulatory genes refers to conditional mutations that modify the formation of signs of intraspecific similarity. Characteristic features of these conditional mutations are the dominant type of their manifestation, phenotypic asymmetry and their instability in the generations. Currently, the terms “morphosis” and “modification” are used to describe epigenetic variability, which are maintained in Drosophila melanogaster cultures using linkaged X- chromosomes, and the mutant X-chromosome is transmitted along the paternal line. In this paper, we investigated the epigenetic effects of alpha particles, whose source in nature is mainly radon and its daughter decay products. In the experiment, an isotope of plutonium-238 (Pu²³⁸), generating radiation with an energy of about 5500 eV, was used as a source of alpha particles. In an experiment in the first generation (F₁), deformities or morphoses were found, which can be called "radiation syndromes" or mutations, the manifestation of which is similar to the pleiotropic action of genes. The proportion of morphoses in the experiment was 1.8%, and in control 0.4%. In this experiment, the morphoses in the flies of the first and second generation looked like black spots, or melanomas on different parts of the imago body; "generalized" melanomas; curled, curved wings; shortened wing; bubble on one wing; absence of one wing, deformation of thorax, interruption and violation of tergite patterns, disruption of distribution of ocular facets and bristles; absence of pigmentation of the second and third legs. Statistical analysis by the Chi-square method showed the reliability of the difference in experiment and control at P ≤ 0.01. On the basis of this, it can be considered that alpha particles, which in the environment are mainly generated by radon and its isotopes, have a mutagenic effect that manifests itself, mainly in the formation of morphoses or deformities.

Keywords: alpha-radiation, genotoxicity, morphoses, radioecology, radon

Procedia PDF Downloads 152

Authors: Simon Caba, Raja Abou Ackl, Svend Rasmussen, Nicholas E. Pedersen

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It is a challenge to directly monitor cavitation in a pump application during operation because of a lack of visual access to validate the presence of cavitation and its form of appearance. In this work, experimental investigations are carried out in an inline single-stage centrifugal pump with optical access. Hence, it gives the opportunity to enhance the value of CFD tools and standard cavitation measurements. Experiments are conducted using two impellers running in the same volute at 3000 rpm and the same flow rate. One of the impellers used is optimized for lower NPSH₃% by its blade design, whereas the other one is manufactured using a standard casting method. The cavitation is detected by pump performance measurements, vibration measurements and high-speed image recordings. The head drop and the pump casing vibration caused by cavitation are correlated with the visual appearance of the cavitation. The vibration data is recorded in an axial direction of the impeller using accelerometers recording at a sample rate of 131 kHz. The vibration frequency domain data (up to 20 kHz) and the time domain data are analyzed as well as the root mean square values. The high-speed recordings, focusing on the impeller suction side, are taken at 10,240 fps to provide insight into the flow patterns and the cavitation behavior in the rotating impeller. The videos are synchronized with the vibration time signals by a trigger signal. A clear correlation between cloud collapses and abrupt peaks in the vibration signal can be observed. The vibration peaks clearly indicate cavitation, especially at higher NPSHA values where the hydraulic performance is not affected. It is also observed that below a certain NPSHA value, the cavitation started in the inlet bend of the pump. Above this value, cavitation occurs exclusively on the impeller blades. The impeller optimized for NPSH₃% does show a lower NPSH₃% than the standard impeller, but the head drop starts at a higher NPSHA value and is more gradual. Instabilities in the head drop curve of the optimized impeller were observed in addition to a higher vibration level. Furthermore, the cavitation clouds on the suction side appear more unsteady when using the optimized impeller. The shape and location of the cavitation are compared to 3D fluid flow simulations. The simulation results are in good agreement with the experimental investigations. In conclusion, these investigations attempt to give a more holistic view on the appearance of cavitation by comparing the head drop, vibration spectral data, vibration time signals, image recordings and simulation results. Data indicates that a criterion for cavitation detection could be derived from the vibration time-domain measurements, which requires further investigation. Usually, spectral data is used to analyze cavitation, but these investigations indicate that the time domain could be more appropriate for some applications.

Keywords: cavitation, centrifugal pump, head drop, high-speed image recordings, pump vibration

Procedia PDF Downloads 179

Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

Procedia PDF Downloads 237

Authors: B. M. Y. I. Basnayake, G. G. T. Nisansala, P. I. J. B. Wijewickrama, U. S. Weerathunga, K. W. M. Y. D. Gunasekara, N. K. Jayasekera, A. W. Kalupahana, R. S. Kalupahana, A. Silva- Fletcher, K. S. A. Kottawatta

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Antimicrobial resistance (AMR) has attracted significant attention worldwide as an emerging threat to public health. Understanding the role of livestock and wildlife with the shared environment in the maintenance and transmission of AMR is of utmost importance due to its interactions with humans for combating the issue in one health approach. This study aims to investigate the extent of AMR distribution among wild animals, livestock, and environment cohabiting in a rural ecosystem in Sri Lanka: Hambegamuwa. One square km area at Hambegamuwa was mapped using GPS as the sampling area. The study was conducted for a period of five months from November 2020. Voided fecal samples were collected from 130 wild animals, 123 livestock: buffalo, cattle, chicken, and turkey, with 36 soil and 30 water samples associated with livestock and wildlife. From the samples, Escherichia coli (E. coli) was isolated, and their AMR profiles were investigated for 12 antimicrobials using the disk diffusion method following the CLSI standard. Seventy percent (91/130) of wild animals, 93% (115/123) of livestock, 89% (32/36) of soil, and 63% (19/30) of water samples were positive for E. coli. Maximum of two E. coli from each sample to a total of 467 were tested for the sensitivity of which 157, 208, 62, and 40 were from wild animals, livestock, soil, and water, respectively. The highest resistance in E. coli from livestock (13.9%) and wild animals (13.3%) was for ampicillin, followed by streptomycin. Apart from that, E. coli from livestock and wild animals revealed resistance mainly against tetracycline, cefotaxime, trimethoprim/ sulfamethoxazole, and nalidixic acid at levels less than 10%. Ten cefotaxime resistant E. coli were reported from wild animals, including four elephants, two land monitors, a pigeon, a spotted dove, and a monkey which was a significant finding. E. coli from soil samples reflected resistance primarily against ampicillin, streptomycin, and tetracycline at levels less than in livestock/wildlife. Two water samples had cefotaxime resistant E. coli as the only resistant isolates out of 30 water samples tested. Of the total E. coli isolates, 6.4% (30/467) was multi-drug resistant (MDR) which included 18, 9, and 3 isolates from livestock, wild animals, and soil, respectively. Among 18 livestock MDRs, the highest (13/ 18) was from poultry. Nine wild animal MDRs were from spotted dove, pigeon, land monitor, and elephant. Based on CLSI standard criteria, 60 E. coli isolates, of which 40, 16, and 4 from livestock, wild animal, and environment, respectively, were screened for Extended Spectrum β-Lactamase (ESBL) producers. Despite being a rural ecosystem, AMR and MDR are prevalent even at low levels. E. coli from livestock, wild animals, and the environment reflected a similar spectrum of AMR where ampicillin, streptomycin, tetracycline, and cefotaxime being the predominant antimicrobials of resistance. Wild animals may have acquired AMR via direct contact with livestock or via the environment, as antimicrobials are rarely used in wild animals. A source attribution study including the effects of the natural environment to study AMR can be proposed as this less contaminated rural ecosystem alarms the presence of AMR.

Keywords: AMR, Escherichia coli, livestock, wildlife

Procedia PDF Downloads 216

Authors: Nokwethaba Makhanya, Babatunde J. Abiodun, Piotr Wolski

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Climate change possibly intensifies hydrological droughts and reduces water availability in river basins. Despite this, most research on climate change effects in southern Africa has focused exclusively on meteorological droughts. This thesis projects the potential impact of climate change on the future characteristics of hydrological droughts in the Limpopo River Basin (LRB). The study uses regional climate model (RCM) measurements (from the Coordinated Regional Climate Downscaling Experiment, CORDEX) and a combination of hydrological simulations (using the Soil and Water Assessment Tool Plus model, SWAT+) to predict the impacts at four global warming levels (GWLs: 1.5℃, 2.0℃, 2.5℃, and 3.0℃) under the RCP8.5 future climate scenario. The SWAT+ model was calibrated and validated with a streamflow dataset observed over the basin, and the sensitivity of model parameters was investigated. The performance of the SWAT+LRB model was verified using the Nash-Sutcliffe efficiency (NSE), Percent Bias (PBIAS), Root Mean Square Error (RMSE), and coefficient of determination (R²). The Standardized Precipitation Evapotranspiration Index (SPEI) and the Standardized Precipitation Index (SPI) have been used to detect meteorological droughts. The Soil Water Index (SSI) has been used to define agricultural drought, while the Water Yield Drought Index (WYLDI), the Surface Run-off Index (SRI), and the Streamflow Index (SFI) have been used to characterise hydrological drought. The performance of the SWAT+ model simulations over LRB is sensitive to the parameters CN2 (initial SCS runoff curve number for moisture condition II) and ESCO (soil evaporation compensation factor). The best simulation generally performed better during the calibration period than the validation period. In calibration and validation periods, NSE is ≤ 0.8, while PBIAS is ≥ ﹣80.3%, RMSE ≥ 11.2 m³/s, and R² ≤ 0.9. The simulations project a future increase in temperature and potential evapotranspiration over the basin, but they do not project a significant future trend in precipitation and hydrological variables. However, the spatial distribution of precipitation reveals a projected increase in precipitation in the southern part of the basin and a decline in the northern part of the basin, with the region of reduced precipitation projected to increase with GWLs. A decrease in all hydrological variables is projected over most parts of the basin, especially over the eastern part of the basin. The simulations predict meteorological droughts (i.e., SPEI and SPI), agricultural droughts (i.e., SSI), and hydrological droughts (i.e., WYLDI, SRI) would become more intense and severe across the basin. SPEI-drought has a greater magnitude of increase than SPI-drought, and agricultural and hydrological droughts have a magnitude of increase between the two. As a result, this research suggests that future hydrological droughts over the LRB could be more severe than the SPI-drought projection predicts but less severe than the SPEI-drought projection. This research can be used to mitigate the effects of potential climate change on basin hydrological drought.

Keywords: climate change, CORDEX, drought, hydrological modelling, Limpopo River Basin

Procedia PDF Downloads 128

Authors: Mariam Mtunguja, Henry Laswai, Yasinta Muzanilla, Joseph Ndunguru

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Starchy tuberous roots of cassava provide food for people but also find application in various industries. Recently there has been the focus of concentrated research efforts to fully exploit its potential as a sustainable multipurpose crop. High starch yield is the important trait for commercial cassava production for the starch industries. Furthermore, cyanide present in cassava root poses a health challenge in the use of cassava for food. Farming communities where cassava is a staple food, prefer bitter (high cyanogenic) varieties as protection from predators and thieves. As a result, food insecure farmers prefer growing bitter cassava. This has led to cyanide intoxication to this farming communities. Cassava farmers can benefit from marketing cassava to starch producers thereby improving their income and food security. This will decrease dependency on cassava as staple food as a result of increased income and be able to afford other food sources. To achieve this, adequate information is required on the right cassava cultivars and appropriate harvesting period so as to maximize cassava production and profitability. This study aimed at identifying suitable cassava cultivars and optimum time of harvest to maximize starch production. Six commonly grown cultivars were identified and planted in a complete random block design and further analysis was done to assess variation in physicochemical characteristics, starch yield and cyanogenic potentials across three environments. The analysis showed that there is a difference in physicochemical characteristics between landraces (p ≤ 0.05), and can be targeted to different industrial applications. Among landraces, dry matter (30-39%), amylose (11-19%), starch (74-80%) and reducing sugars content (1-3%) varied when expressed on a dry weight basis (p ≤ 0.05); however, only one of the six genotypes differed in crystallinity and mean starch granule particle size, while glucan chain distribution and granule morphology were the same. In contrast, the starch functionality features measured: swelling power, solubility, syneresis, and digestibility differed (p ≤ 0.05). This was supported by Partial least square discriminant analysis (PLS-DA), which highlighted the divergence among the cassavas based on starch functionality, permitting suggestions for the targeted uses of these starches in diverse industries. The study also illustrated genotypic difference in starch yield and cyanogenic potential. Among landraces, Kiroba showed potential for maximum starch yield (12.8 t ha-1) followed by Msenene (12.3 t ha-1) and third was Kilusungu (10.2 t ha-1). The cyanide content of cassava landraces was between 15 and 800 ppm across all trial sites. GGE biplot analysis further confirmed that Kiroba was a superior cultivar in terms of starch yield. Kilusungu had the highest cyanide content and average starch yield, therefore it can also be suitable for use in starch production.

Keywords: cyanogen, cassava starch, food security, starch yield

Procedia PDF Downloads 220

Authors: Samuel N. Forjuoh, Marcia G. Ory, Jaewoong Won, Samuel D. Towne, Suojin Wang, Chanam Lee

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The public health burden of obesity is well established as is the influence of physical activity (PA) on the health and wellness of individuals who are obese. This study examined the influence of selected demographic, health, and socioenvironmental factors on the walking behaviors of middle-aged and older overweight and obese adults. Online and paper surveys were administered to community-dwelling overweight and obese adults aged ≥ 50 years residing in four cities in central Texas and seen by a family physician in the primary care clinic from October 2013 to June 2014. Descriptive statistics were used to characterize participants’ anthropometric and demographic data as well as their health conditions and walking, socioenvironmental, and more broadly defined PA behaviors. Then Pearson chi-square tests were used to assess differences between participants who reported walking the recommended ≥ 150 minutes for any purpose in a typical week as a proxy to meeting the U.S. Centers for Disease Control and Prevention’s PA guidelines and those who did not. Finally, logistic regression was used to predict walking the recommended ≥ 150 minutes for any purpose, controlling for covariates. The analysis was conducted in 2016. Of the total sample (n=253, survey response rate of 6.8%), the majority were non-Hispanic white (81.7%), married (74.5%), male (53.5%), and reported an annual household income of ≥ $50,000 (65.7%). Approximately, half were employed (49.6%), or had at least a college degree (51.8%). Slightly more than 1 in 5 (n=57, 22.5%) reported walking the recommended ≥150 minutes for any purpose in a typical week. The strongest predictors of walking the recommended ≥ 150 minutes for any purpose in a typical week in adjusted analysis were related to education and a high favorable perception of the neighborhood environment. Compared to those with a high school diploma or some college, participants with at least a college degree were five times as likely to walk the recommended ≥ 150 minutes for any purpose (OR=5.55, 95% CI=1.79-17.25). Walking the recommended ≥ 150 minutes for any purpose was significantly associated with participants who disagreed that there were many distracted drivers (e.g., on the cell phone while driving) in their neighborhood (OR=4.08, 95% CI=1.47-11.36) and those who agreed that there are sidewalks or protected walkways (e.g., walking trails) in their neighborhood (OR=3.55, 95% CI=1.10-11.49). Those employed were less likely to walk the recommended ≥ 150 minutes for any purpose compared to those unemployed (OR=0.31, 95% CI=0.11-0.85) as were those who reported some difficulty walking for a quarter of a mile (OR=0.19, 95% CI=0.05-0.77). Other socio-environmental factors such as having care-giver responsibilities for elders, someone to walk with, or a dog in the household as well as Walk Score™ were not significantly associated with walking the recommended ≥ 150 minutes for any purpose in a typical week. Neighborhood perception appears to be an important factor associated with the walking behaviors of middle-aged and older overweight and obese individuals. Enhancing the neighborhood environment (e.g., providing walking trails) may promote walking among these individuals.

Keywords: determinants of walking, obesity, older adults, physical activity

Procedia PDF Downloads 259

Authors: Carol Okigbo

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Mathematical problem solving has long been accorded an important place in mathematics curricula at every education level in both advanced and emerging economies. Its classroom approaches have varied, such as teaching for problem-solving, teaching about problem-solving, and teaching mathematics through problem-solving. It requires engaging in tasks for which the solution methods are not eminent, making sense of problems and persevering in solving them by exhibiting processes, strategies, appropriate attitude, and adequate exposure. Teachers play important roles in helping students acquire competency in problem-solving; thus, they are expected to be good problem-solvers and have proper conceptions of problem-solving. Studies show that teachers’ conceptions influence their decisions about what to teach and how to teach. Therefore, how teachers view their roles in teaching problem-solving will depend on their pedagogical conceptions of problem-solving. If teaching problem-solving is a major component of secondary school mathematics instruction, as recommended by researchers and mathematics educators, then it is necessary to establish teachers’ conceptions, what they do, and how they approach problem-solving. This study is designed to determine secondary school teachers’ conceptions regarding mathematical problem solving, its current situation, how teachers’ conceptions relate to their demographics, as well as the interaction patterns in the mathematics classroom. There have been many studies of mathematics problem solving, some of which addressed teachers’ conceptions using single-method approaches, thereby presenting only limited views of this important phenomenon. To address the problem more holistically, this study adopted an integrated mixed methods approach which involved a quantitative survey, qualitative analysis of open-ended responses, and ethnographic observations of teachers in class. Data for the analysis came from a random sample of 327 secondary school mathematics teachers in two Nigerian states - Anambra State and Enugu State who completed a 45-item questionnaire. Ten of the items elicited demographic information, 11 items were open-ended questions, and 25 items were Likert-type questions. Of the 327 teachers who responded to the questionnaires, 37 were randomly selected and observed in their classes. Data analysis using ANOVA, t-tests, chi-square tests, and open coding showed that the teachers had different conceptions about problem-solving, which fall into three main themes: practice on exercises and word application problems, a process of solving mathematical problems, and a way of teaching mathematics. Teachers reported that no period is set aside for problem-solving; typically, teachers solve problems on the board, teach problem-solving strategies, and allow students time to struggle with problems on their own. The result shows a significant difference between male and female teachers’ conception of problems solving, a significant relationship among teachers’ conceptions and academic qualifications, and teachers who have spent ten years or more teaching mathematics were significantly different from the group with seven to nine years of experience in terms of their conceptions of problem-solving.

Keywords: conceptions, education, mathematics, problem solving, teacher

Procedia PDF Downloads 76

Authors: Nicholus M. Warstadt, Andres D. Mallipudi, Oluwadamilola Idowu, Joshua Rodriguez, Madison M. Hunt, Soma Pathak, Laura P. Weber

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Endotracheal intubation is a core procedure performed by emergency physicians. This procedure is a high risk, and failure results in substantial morbidity and mortality. Fiberoptic intubation (FOI) is the standard of care in difficult airway protocols, yet no widespread practice exists for training emergency medicine (EM) residents in the technical acquisition of FOI skills. Simulation on mannequins is commonly utilized to teach advanced airway techniques. As part of a program to introduce FOI into our ED, residents received hands-on training in FOI as part of our weekly resident education conference. We hypothesized that prior to the hands-on training, residents had little experience with FOI and were uncomfortable with using fiberoptic as a modality. We further hypothesized that resident comfort with FOI would increase following the training. The education intervention consisted of two hours of focused airway teaching and skills acquisition for PGY 1-4 residents. One hour was dedicated to four case-based learning stations focusing on standard, pediatric, facial trauma, and burn airways. Direct, video, and fiberoptic airway equipment were available to use at the residents’ discretion to intubate mannequins at each station. The second hour involved direct instructor supervision and immediate feedback during deliberate practice for FOI of a mannequin. Prior to the hands-on training, a pre-survey was sent via email to all EM residents at NYU Grossman School of Medicine. The pre-survey asked how many FOI residents have performed in the ED, OR, and on a mannequin. The pre-survey and a post-survey asked residents to rate their comfort with FOI on a 5-point Likert scale ("extremely uncomfortable", "somewhat uncomfortable", "neither comfortable nor uncomfortable", "somewhat comfortable", and "extremely comfortable"). The post-survey was administered on site immediately following the training. A two-sample chi-square test of independence was calculated comparing self-reported resident comfort on the pre- and post-survey (α ≤ 0.05). Thirty-six of a total of 70 residents (51.4%) completed the pre-survey. Of pre-survey respondents, 34 residents (94.4%) had performed 0, 1 resident (2.8%) had performed 1, and 1 resident (2.8%) had performed 2 FOI in the ED. Twenty-five residents (69.4%) had performed 0, 6 residents (16.7%) had performed 1, 2 residents (5.6%) had performed 2, 1 resident (2.8%) had performed 3, and 2 residents (5.6%) had performed 4 FOI in the OR. Seven residents (19.4%) had performed 0, and 16 residents (44.4%) had performed 5 or greater FOI on a mannequin. 29 residents (41.4%) attended the hands-on training, and 27 out of 29 residents (93.1%) completed the post-survey. Self-reported resident comfort with FOI significantly increased in post-survey compared to pre-survey questionnaire responses (p = 0.00034). Twenty-one of 27 residents (77.8%) report being “somewhat comfortable” or “extremely comfortable” with FOI on the post-survey, compared to 9 of 35 residents (25.8%) on the pre-survey. We show that dedicated FOI training is associated with increased learner comfort with such techniques. Further direction includes studying technical competency, skill retention, translation to direct patient care, and optimal frequency and methodology of future FOI education.

Keywords: airway, emergency medicine, fiberoptic intubation, medical simulation, skill acquisition

Procedia PDF Downloads 180

Authors: Sharon Jackson White

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Purpose: Nurse practitioners (NPs) practicing within hospital medicine play a significant role in caring for patients who might benefit from palliative care (PC) services. Using the Theory of Planned Behavior, the purpose of this study was to examine the relationships among facilitators to referral, barriers to referral, self-efficacy with end-of-life discussions, history of referral, and referring to PC among NPs in hospital medicine. Hypotheses: 1) Perceived facilitators to referral will be associated with a higher history of referral and a higher number of referrals to PC. 2) Perceived barriers to referral will be associated with a lower history of referral and a lower number of referrals to PC. 3) Increased self-efficacy with end-of-life discussions will be associated with a higher history of referral and a higher number of referrals to PC. 4) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the history of referral to PC. 5) Perceived facilitators to referral, perceived barriers to referral, and self–efficacy with end-of-life discussions will contribute to a significant variance in the number of referrals to PC. Significance: Previous studies of referring patients to PC within the hospital setting care have focused on physician practices. Identifying factors that influence NPs referring hospitalized patients to PC is essential to ensure that patients have access to these important services. This study incorporates the SNRS mission of advancing nursing research through the dissemination of research findings and the promotion of nursing science. Methods: A cross-sectional, predictive correlational study was conducted. History of referral to PC, facilitators to referring to PC, barriers to referring to PC, self-efficacy in end-of-life discussions, and referral to PC were measured using the PC referral case study survey, facilitators and barriers to PC referral survey, and self-assessment with end-of-life discussions survey. Data were analyzed descriptively and with Pearson’s Correlation, Spearman’s Rho, point-biserial correlation, multiple regression, logistic regression, Chi-Square test, and the Mann-Whitney U test. Results: Only one facilitator (PC team being helpful with establishing goals of care) was significantly associated with referral to PC. Three variables were statistically significant in relation to the history of referring to PC: “Inclined to refer: PC can help decrease the length of stay in hospital”, “Most inclined to refer: Patients with serious illnesses and/or poor prognoses”, and “Giving bad news to a patient or family member”. No predictor variables contributed a significant variance in the number of referrals to PC for all three case studies. There were no statistically significant results showing a relationship between the history of referral and referral to PC. All five hypotheses were partially supported. Discussion: Findings from this study emphasize the need for further research on NPs who work in hospital settings and what factors influence their behaviors of referring to PC. Since there is an increase in NPs practicing within hospital settings, future studies should use a larger sample size and incorporate hospital medicine NPs and other types of NPs that work in hospitals.

Keywords: palliative care, nurse practitioners, hospital medicine, referral

Procedia PDF Downloads 73

Authors: Hayder H. Kareem, Shunqi Pan

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Groundwater is a vital water resource in many areas in the world, particularly in the Middle-East region where the water resources become scarce and depleting. Sustainable management and planning of the groundwater resources become essential and urgent given the impact of the global climate change. In the recent years, numerical models have been widely used to predict the flow pattern and assess the water resources security, as well as the groundwater quality affected by the contaminants transported. In this study, MODFLOW is used to study the current status of groundwater resources and the risk of water resource security in the region centred at Al-Najaf City, which is located in the mid-west of Iraq and adjacent to the Euphrates River. In this study, a conceptual model is built using the geologic and hydrogeologic collected for the region, together with the Digital Elevation Model (DEM) data obtained from the "Global Land Cover Facility" (GLCF) and "United State Geological Survey" (USGS) for the study area. The computer model is also implemented with the distributions of 69 wells in the area with the steady pro-defined hydraulic head along its boundaries. The model is then applied with the recharge rate (from precipitation) of 7.55 mm/year, given from the analysis of the field data in the study area for the period of 1980-2014. The hydraulic conductivity from the measurements at the locations of wells is interpolated for model use. The model is calibrated with the measured hydraulic heads at the locations of 50 of 69 wells in the domain and results show a good agreement. The standard-error-of-estimate (SEE), root-mean-square errors (RMSE), Normalized RMSE and correlation coefficient are 0.297 m, 2.087 m, 6.899% and 0.971 respectively. Sensitivity analysis is also carried out, and it is found that the model is sensitive to recharge, particularly when the rate is greater than (15mm/year). Hydraulic conductivity is found to be another parameter which can affect the results significantly, therefore it requires high quality field data. The results show that there is a general flow pattern from the west to east of the study area, which agrees well with the observations and the gradient of the ground surface. It is found that with the current operational pumping rates of the wells in the area, a dry area is resulted in Al-Najaf City due to the large quantity of groundwater withdrawn. The computed water balance with the current operational pumping quantity shows that the Euphrates River supplies water into the groundwater of approximately 11759 m3/day, instead of gaining water of 11178 m3/day from the groundwater if no pumping from the wells. It is expected that the results obtained from the study can provide important information for the sustainable and effective planning and management of the regional groundwater resources for Al-Najaf City.

Keywords: Al-Najaf city, conceptual modelling, groundwater, unconfined aquifer, visual MODFLOW

Procedia PDF Downloads 213

Authors: Fatemeh Faramarzi, Hosein Mahjoob

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Building dams on rivers for utilization of water resources causes problems in hydrodynamic equilibrium and results in leaving all or part of the sediments carried by water in dam reservoir. This phenomenon has also significant impacts on water and sediment flow regime and in the long term can cause morphological changes in the environment surrounding the river, reducing the useful life of the reservoir which threatens sustainable development through inefficient management of water resources. In the past, empirical methods were used to predict the sedimentation amount in dam reservoirs and to estimate its efficient lifetime. But recently the mathematical and computational models are widely used in sedimentation studies in dam reservoirs as a suitable tool. These models usually solve the equations using finite element method. This study compares the results from tow software packages, GSTARS4 & HEC-6, in the prediction of the sedimentation amount in Dez dam, southern Iran. The model provides a one-dimensional, steady-state simulation of sediment deposition and erosion by solving the equations of momentum, flow and sediment continuity and sediment transport. GSTARS4 (Generalized Sediment Transport Model for Alluvial River Simulation) which is based on a one-dimensional mathematical model that simulates bed changes in both longitudinal and transverse directions by using flow tubes in a quasi-two-dimensional scheme to calibrate a period of 47 years and forecast the next 47 years of sedimentation in Dez Dam, Southern Iran. This dam is among the highest dams all over the world (with its 203 m height), and irrigates more than 125000 square hectares of downstream lands and plays a major role in flood control in the region. The input data including geometry, hydraulic and sedimentary data, starts from 1955 to 2003 on a daily basis. To predict future river discharge, in this research, the time series data were assumed to be repeated after 47 years. Finally, the obtained result was very satisfactory in the delta region so that the output from GSTARS4 was almost identical to the hydrographic profile in 2003. In the Dez dam due to the long (65 km) and a large tank, the vertical currents are dominant causing the calculations by the above-mentioned method to be inaccurate. To solve this problem, we used the empirical reduction method to calculate the sedimentation in the downstream area which led to very good answers. Thus, we demonstrated that by combining these two methods a very suitable model for sedimentation in Dez dam for the study period can be obtained. The present study demonstrated successfully that the outputs of both methods are the same.

Keywords: Dez Dam, prediction, sedimentation, water resources, computational models, finite element method, GSTARS4, HEC-6

Procedia PDF Downloads 313

Authors: Amin Salighehdar, Ziwen Ye, Mingzhe Liu, Ionut Florescu, Alan F. Blumberg

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Storm surge is an abnormal water level caused by a storm. Accurate prediction of a storm surge is a challenging problem. Researchers developed various ensemble modeling techniques to combine several individual forecasts to produce an overall presumably better forecast. There exist some simple ensemble modeling techniques in literature. For instance, Model Output Statistics (MOS), and running mean-bias removal are widely used techniques in storm surge prediction domain. However, these methods have some drawbacks. For instance, MOS is based on multiple linear regression and it needs a long period of training data. To overcome the shortcomings of these simple methods, researchers propose some advanced methods. For instance, ENSURF (Ensemble SURge Forecast) is a multi-model application for sea level forecast. This application creates a better forecast of sea level using a combination of several instances of the Bayesian Model Averaging (BMA). An ensemble dressing method is based on identifying best member forecast and using it for prediction. Our contribution in this paper can be summarized as follows. First, we investigate whether the ensemble models perform better than any single forecast. Therefore, we need to identify the single best forecast. We present a methodology based on a simple Bayesian selection method to select the best single forecast. Second, we present several new and simple ways to construct ensemble models. We use correlation and standard deviation as weights in combining different forecast models. Third, we use these ensembles and compare with several existing models in literature to forecast storm surge level. We then investigate whether developing a complex ensemble model is indeed needed. To achieve this goal, we use a simple average (one of the simplest and widely used ensemble model) as benchmark. Predicting the peak level of Surge during a storm as well as the precise time at which this peak level takes place is crucial, thus we develop a statistical platform to compare the performance of various ensemble methods. This statistical analysis is based on root mean square error of the ensemble forecast during the testing period and on the magnitude and timing of the forecasted peak surge compared to the actual time and peak. In this work, we analyze four hurricanes: hurricanes Irene and Lee in 2011, hurricane Sandy in 2012, and hurricane Joaquin in 2015. Since hurricane Irene developed at the end of August 2011 and hurricane Lee started just after Irene at the beginning of September 2011, in this study we consider them as a single contiguous hurricane event. The data set used for this study is generated by the New York Harbor Observing and Prediction System (NYHOPS). We find that even the simplest possible way of creating an ensemble produces results superior to any single forecast. We also show that the ensemble models we propose generally have better performance compared to the simple average ensemble technique.

Keywords: Bayesian learning, ensemble model, statistical analysis, storm surge prediction

Procedia PDF Downloads 309

Authors: Aguasanta Miguel Sarmiento, José Miguel Dávila, María Luisa de la Torre

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Acid mine drainage (AMD) is an acidic leachate with high levels of metals and sulphates in solution, which seriously affects the durability and strength of metallic materials used in the construction of structural and mechanical components. This paper presents the results of the evolution over time of the reduction in tensile strength and defects in AISI 304 stainless steel in contact with acid mine drainage. For this purpose, a total of 30 bars with a diameter of 8 mm and a length of 14 cm were placed transversely in the course of a stream contaminated by AMD from the sulphide mines of the Iberian Pyritic Belt (SW Spain). This stream has average pH values of 2.6, a potential of 660 mV, and average concentrations of 12 g/L of sulphates, 1.2 g/L of Fe, 191 mg/L of Zn, etc. Every two months of exposure, 6 stainless steel bars were extracted from the acid stream. They were subjected to surface roughness analysis carried out with the help of Mitutoyo Surftest SJ-210 surface roughness tester. The analysis was carried out at three different points on 5 specimens from each series. The average reading of each parameter is calculated in order to ensure the accuracy of the measurements and the surface coverage. Arithmetic mean roughness value (Ra), mean roughness depth (Rz), and root mean square roughness (Rq) were measured. Five specimens from each series were statically tensile tested using universal equipment (Servosis ME 403 of 200kN). The specimens were clamped at their ends with two grips for cylindrical sections, and the tensile force was applied at a constant speed of 0.5 kN/s, according to the requirements of standard UNE-EN ISO 6892-1: 2020. To determine the modulus of elasticity, limits close to 15% and 55% of the maximum load were used, depending on the course of each test. Field Emission Scanning Electron Microscopy (FESEM) was used to observe corrosion products and defects generated by exposure to AMD. Energy dispersive X-ray spectrometry (EDS) was used to analyse the chemical composition of the corrosion products formed. For this purpose, small pieces were cut from the resulting specimens, cleaned, and embedded in epoxy resin. The results show that after only 5 months of exposure of AISI 304 stainless steel to the mining environment, the surface roughness increases significantly, with average depths almost 6 times greater than the initial one. Cracks are observed on the surface of the material, which increases in size with the time of exposure. A large number of grains with a composition of more than 57% Pb and 16% Sn can be observed inside these cracks. Tensile tests show a reduction in the resistance of this material after only two months of exposure. The results show the serious problems that would result from the use of this material for the use of mechanical components in a sulphide mining environment, not only because of the significant reduction in the lifetime of such components, but also because of the implications for human safety.

Keywords: acid mine drainage, corrosion, mechanical properties, stainless steel

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Authors: Jaeyoung Lee, Minji Je

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Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.

Keywords: adolescent, coitus, female, sexually transmitted diseases

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Authors: Margareth Guimaraes Lima, Marilisa Berti A. Barros, Deborah Carvalho Malta

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The relationship between physical activity (PA) and depression has been investigated, in both, observational and clinical studies: PA can integrate the treatments for depression; the physical inactivity (PI) may contribute to increase depression symptoms; and on the other hand, emotional problems can decrease PA. The main of this study was analyze the association among leisure and transportation PI and time watching television (TV) according to depression (minor and major), evaluated with the Patient Health Questionnaire (PHQ-9). The association was also analyzed by gender. This is a cross-sectional study. Data were obtained from the National Health Survey 2013 (PNS), performed with representative sample of the Brazilian adult population, in 2013. The PNS collected information from 60,202 individuals, aged 18 years or more. The independent variable were: leisure time physical inactivity (LTPI), considering inactive or insufficiently actives (categories were linked for analyzes), those who do not performed a minimum of 150 or 74 minutes of moderate or vigorous LTPA, respectively, by week; transportation physical inactivity (TPI), individuals who did not reached 150 minutes, by week, travelling by bicycle or on foot to work or other activities; daily time watching TV > 5 hours. The principal independent variable was depression, identified by PHQ-9. Individuals were classified with major depression, with > 5 symptoms, more than seven days, but one of the symptoms was “depressive mood” or “lack of interest or pleasure”. The others had minor depression. The variables used to adjustment were gender, age, schooling and chronic disease. The prevalence of LTPI, TPI and TV time were estimated according to depression, and differences were tested with Chi-Square test. Adjusted prevalence ratios were estimated using multiple Poisson regression models. The analyzes also had stratification by gender. Mean age of the studied population was 42.9 years old (CI95%:42.6-43.2) and 52.9% were women. 77.5% and 68.1% were inactive or insufficiently active in leisure and transportation, respectively and 13.3% spent time watching TV 5 > hours. 6% and 4.1% of the Brazilian population were diagnosed with minor or major depression. LTPI prevalence was 5% and 9% higher among individuals with minor and major depression, respectively, comparing with no depression. The prevalence of TPI was 7% higher in those with major depression. Considering larger time watching TV, the prevalence was 45% and 74% higher among those with minor and major depression, respectively. Analyzing by gender, the associations were greater in men than women and TPI was note be associated, in women. The study detected the higher prevalence of leisure time physical inactivity and, especially, time spent watching TV, among individuals with major and minor depression, after to adjust for a number of potential confounding factors. TPI was only associated with major disorders and among men. Considering the cross-sectional design of the research, these associations can point out the importance of the mental problems control of the population to increase PA and decrease the sedentary lifestyle; on the other hand, the study highlight the need of interventions by encouraging people with depression, to practice PA, even to transportation.

Keywords: depression, physical activity, PHQ-9, sedentary lifestyle

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Authors: Marthese Azzopardi, Liberato Camilleri

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This research was performed to investigate the study habits and level of difficulty perceived by post-secondary students in Biology at Advanced-level topics after completing their first year of study. At the end of a two-year ‘sixth form’ course, Maltese students sit for the Matriculation and Secondary Education Certificate (MATSEC) Advanced-level biology exam as a requirement to pursue science-related studies at the University of Malta. The sample was composed of 23 students (16 taking Chemistry and seven taking some ‘Other’ subject at the Advanced Level). The cohort comprised seven males and 16 females. A questionnaire constructed by the authors, was answered anonymously during the last lecture at the end of the first year of study, in May 2016. The Chi square test revealed that gender plays no effect on the various study habits (c² (6) = 5.873, p = 0.438). ‘Reading both notes and textbooks’ was the most common method adopted by males (71.4%), whereas ‘Writing notes on each topic’ was that mostly used by females (81.3%). The Mann-Whitney U test showed no significant difference in the study habits of students and the mean assessment mark obtained at the end of the first year course (p = 0.231). Statistical difference was found with the One-ANOVA test when comparing the mean assessment mark obtained at the end of the first year course when students are clustered by their Secondary Education Certificate (SEC) grade (p < 0.001). Those obtaining a SEC grade of 2 and 3 got the highest mean assessment of 68.33% and 66.9%, respectively [SEC grading is 1-7, where 1 is the highest]. The Friedman test was used to compare the mean difficulty rating scores provided for the difficulty of each topic. The mean difficulty rating score ranges from 1 to 4, where the larger the mean rating score, the higher the difficulty. When considering the whole group of students, nine topics out of 21 were perceived as significantly more difficult than the other topics. Protein synthesis, DNA Replication and Biomolecules were the most difficult, in that order. The Mann-Whitney U test revealed that the perceived level of difficulty in comprehending Biomolecules is significantly lower for students taking Chemistry compared to those not choosing the subject (p = 0.018). Protein Synthesis was claimed as the most difficult by Chemistry students and Biomolecules by those not studying Chemistry. DNA Replication was the second most difficult topic perceived by both groups. The Mann-Whitney U test was used to examine the effect of gender on the perceived level of difficulty in comprehending various topics. It was found that females have significantly more difficulty in comprehending Biomolecules than males (p=0.039). Protein synthesis was perceived as the most difficult topic by males (mean difficulty rating score = 3.14), while Biomolecules, DNA Replication and Protein synthesis were of equal difficulty for females (mean difficulty rating score = 3.00). Males and females perceived DNA Replication as equally difficult (mean difficulty rating score = 3.00). Discovering the students’ study habits and perceived level of difficulty of specific topics is vital for the lecturer to offer guidance that leads to higher academic achievement.

Keywords: biology, perceived difficulty, post-secondary, study habits

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Authors: Jacqueline Y. Thompson, Sam Watson, Lee Middleton, Karla Hemming

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Introduction: The odds ratio (estimated via logistic regression) is a well-established and common approach for estimating covariate-adjusted binary treatment effects when comparing a treatment and control group with dichotomous outcomes. Its popularity is primarily because of its stability and robustness to model misspecification. However, the situation is different for the relative risk and risk difference, which are arguably easier to interpret and better suited to specific designs such as non-inferiority studies. So far, there is no equivalent, widely acceptable approach to estimate an adjusted relative risk and risk difference when conducting clinical trials. This is partly due to the lack of a comprehensive evaluation of available candidate methods. Methods/Approach: A simulation study is designed to evaluate the performance of relevant candidate methods to estimate relative risks to represent conditional and marginal estimation approaches. We consider the log-binomial, generalised linear models (GLM) with iteratively weighted least-squares (IWLS) and model-based standard errors (SE); log-binomial GLM with convex optimisation and model-based SEs; log-binomial GLM with convex optimisation and permutation tests; modified-Poisson GLM IWLS and robust SEs; log-binomial generalised estimation equations (GEE) and robust SEs; marginal standardisation and delta method SEs; and marginal standardisation and permutation test SEs. Independent and identically distributed datasets are simulated from a randomised controlled trial to evaluate these candidate methods. Simulations are replicated 10000 times for each scenario across all possible combinations of sample sizes (200, 1000, and 5000), outcomes (10%, 50%, and 80%), and covariates (ranging from -0.05 to 0.7) representing weak, moderate or strong relationships. Treatment effects (ranging from 0, -0.5, 1; on the log-scale) will consider null (H0) and alternative (H1) hypotheses to evaluate coverage and power in realistic scenarios. Performance measures (bias, mean square error (MSE), relative efficiency, and convergence rates) are evaluated across scenarios covering a range of sample sizes, event rates, covariate prognostic strength, and model misspecifications. Potential Results, Relevance & Impact: There are several methods for estimating unadjusted and adjusted relative risks. However, it is unclear which method(s) is the most efficient, preserves type-I error rate, is robust to model misspecification, or is the most powerful when adjusting for non-prognostic and prognostic covariates. GEE estimations may be biased when the outcome distributions are not from marginal binary data. Also, it seems that marginal standardisation and convex optimisation may perform better than GLM IWLS log-binomial.

Keywords: binary outcomes, statistical methods, clinical trials, simulation study

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Authors: Aguasanta M. Sarmiento, Jose Miguel Davila, Juan Carlos Fortes, Maria Luisa de la Torre

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Acid mine drainage (AMD) is an acidic leachate with high levels of metals and sulphates in solution, which seriously affects the durability and strength of metallic materials used in the construction of structural and mechanical components. This paper presents the results of the evolution over time of the reduction in tensile strength and defects in AISI 304 stainless steel in contact with acid mine drainage. For this purpose, a total of 30 bars with a diameter of 8 mm and a length of 14 cm were placed transversely in the course of a stream contaminated by AMD from the sulphide mines of the Iberian Pyritic Belt (SW Spain). This stream has average pH values of 2.6, a potential of 660 mV and average concentrations of 12 g/L of sulphates, 1.2 g/L of Fe, 191 mg/L of Zn, etc. Every two months of exposure, 6 stainless steel bars were extracted from the acid stream. They were subjected to surface roughness analysis carried out with the help of Mitutoyo Surftest SJ-210 surface roughness tester. The analysis was carried out at three different points on 5 specimens from each series. The average reading of each parameter is calculated in order to ensure the accuracy of the measurements and the surface coverage. Arithmetic mean roughness value (Ra), mean roughness depth (Rz) and root mean square roughness (Rq) were measured. Five specimens from each series were statically tensile tested using universal equipment (Servosis ME 403 of 200kN). The specimens were clamped at their ends with two grips for cylindrical sections, and the tensile force was applied at a constant speed of 0.5 kN/s, according to the requirements of standard UNE-EN ISO 6892-1: 2020. To determine the modulus of elasticity, limits close to 15% and 55% of the maximum load were used, depending on the course of each test. Field Emission Scanning Electron Microscopy (FESEM) was used to observe corrosion products and defects generated by exposure to AMD. Energy dispersive X-ray spectrometry (EDS) was used to analyze the chemical composition of the corrosion products formed. For this purpose, small pieces were cut from the resulting specimens, cleaned and embedded in epoxy resin. The results show that after only 5 months of exposure of AISI 304 stainless steel to the mining environment, the surface roughness increases significantly, with average depths almost 6 times greater than the initial one. Cracks are observed on the surface of the material, which increases in size with the time of exposure. A large number of grains with a composition of more than 57% Pb and 16% Sn can be observed inside these cracks. Tensile tests show a reduction in the resistance of this material after only two months of exposure. The results show the serious problems that would result from the use of this material for the use of mechanical components in a sulphide mining environment, not only because of the significant reduction in the lifetime of such components but also because of the implications for human safety.

Keywords: Acid mine drainage, Corrosion, Mechanical properties, Stainless steel

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Authors: Annie Singh, Ishaan Singh

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Background: Transgenders are people who have a gender identity different from their sex assigned at birth. Their gender behaviour doesn’t match their body anatomy. The community faces discrimination due to their gender identity all across the world. The term transgender is an umbrella term for many people non-conformal to their biological identity; note that the term transgender is different from gender dysphoria, which is a DSM-5 disorder defined as problems faced by an individual due to their non-conforming gender identity. Transgender people have been a part of Indian culture for ages yet have continued to face exclusion and discrimination in society. This has led to the low socio-economic status of the community. Various studies done across the world have established the role of discrimination, harassment and exclusion in the development of psychological disorders. The study is aimed to assess the frequency of stress and anxiety in the transgender population and understand the various factors affecting the same. Methodology: A cross-sectional survey of self consenting transgender individuals above the age of 18 residing in Delhi was done to assess their socioeconomic status and experiential ecology. Recruitment of participants was done with the help of NGOs. The survey was constructed GAD-7 and PSS-10, two well-known scales were used to assess the stress and anxiety levels. Medians, means and ranges are used for reporting continuous data wherever required, while frequencies and percentages are used for categorical data. For associations and comparison between groups in categorical data, the Chi-square test was used, while the Kruskal-Wallis H test was employed for associations involving multiple ordinal groups. SPSS v28.0 was used to perform the statistical analysis for this study. Results: The survey showed that the frequency of stress and anxiety is high in the transgender population. A demographic survey indicates a low socio-economic background. 44% of participants reported facing discrimination on a daily basis; the frequency of discrimination is higher in transwomen than in transmen. Stress and anxiety levels are similar among both transmen and transwomen. Only 34.5% of participants said they had receptive family or friends. The majority of participants (72.7%) reported a positive or neutral experience with healthcare workers. The prevalence of discrimination is significantly lower in the higher educated groups. Analysis of data shows a positive impact of acceptance and reception on mental health, while discrimination is correlated with higher levels of stress and anxiety. Conclusion: The prevalence of widespread transphobia and discrimination faced by the transgender community has culminated in high levels of stress and anxiety in the transgender population and shows variance according to multiple socio-demographic factors. Educating people about the LGBT community formation of support groups, policies and laws are required to establish trust and promote integration.

Keywords: transgender, gender, stress, anxiety, mental health, discrimination, exclusion

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Authors: Saheed A. Adekola, Mabel A. Charles-Davies, Ridwan A. Adekola

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Background: Testosterone is a known androgenic and anabolic steroid, primarily secreted in the testes. It plays an important role in the development of testes and prostate and has a range of biological actions. There is evidence that exposure to mixed chemicals in the workplace leads to the generation of free radicals and inadequate antioxidants leading to oxidative stress, which may serve as an early indicator of a pathophysiologic state. Based on findings, testosterone shows direct antioxidant effects by increasing the activities of antioxidant enzymes like glutathione peroxidase, thus indirectly contributing to antioxidant capacity. Objective: To evaluate the antioxidant role of testosterone as well as the relationship between testosterone and oxidative stress biomarkers in males exposed to mixed chemicals in the automobile repair community. Methods: The study included 43 participants aged 22- 60years exposed to mixed chemicals (EMC) from the automobile repair community. Forty (40) apparently healthy, unexposed, age-matched controls were recruited after informed consent. Demographic, sexual and anthropometric characteristics were obtained from pre-test structured questionnaires using standard methods. Blood samples (10mls) were collected from each subject into plain bottles and sera obtained were used for biochemical analyses. Serum levels of testosterone and luteinizing hormone (LH) were determined by enzyme immunoassay method, EIA (Immunometrics UK.LTD). Levels of total antioxidant capacity (TAC), total plasma peroxide (TPP), Malondialdehyde (MDA), hydrogen peroxide (H2O2), glutathione peroxide (GPX), superoxide dismutase (SOD), glutathione-S-transferase (GST), and reduced glutathione (GSH) were determined using spectrophotometric methods respectively. Results obtained were analyzed using the Student’s t-test and Chi-square test for quantitative variables and qualitative variables respectively. Multiple regression was used to find associations and relationships between the variables. Results: Significant higher concentrations of TPP, MDA, OSI, H2O2 and GST were observed in EMC compared with controls (p < 0.001). Within EMC, significantly higher levels of testosterone, LH and TAC were observed in eugonadic when compared with hypogonadic participants (p < 0.001). Diastolic blood pressure, waist circumference, waist height ratio and waist hip ratio were significantly higher in participants EMC compared with the controls. Sexual history and dietary intake showed that the controls had normal erection during sex and took more vegetables in their diet which may therefore be beneficial. Conclusion: The significantly increased levels of total antioxidant capacity in males exposed to mixed chemicals despite their exposure may probably reflect the contributory antioxidant role testosterone that prevents oxidative stress.

Keywords: mixed chemicals, oxidative stress, antioxidant, hypogonadism testosterone

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