Search results for: long term care facility

Authors: Aliyu Mohammed Lawal, Dahiru Ya'u Gital

Abstract:

The problems placed on the environment as a result of energy generation and usage in Nigeria are: Potential damage to the environment health by Co, Co2, Sox and Nox effluent gas emissions and global warming. For instance in the year 2004 in Nigeria energy consumption was 58% oil and 34% natural gas but about 94 million metric tons of Co2 was emitted out of which 64% came from fossil fuels while about 35% came from fuel wood. The findings from this research on how to alleviate these problems are that long term sustainable development solutions should be enhanced globally; energy should be used more rationally renewable energy resources should be exploited and the existing emissions should be controlled to tolerate limits because the increase in energy demand in Nigeria places enormous strain on current energy facilities.

Keywords: energy generation, environmental health, effluent gas emission, global warming, fossil fuel

Procedia PDF Downloads 463

Authors: Yifan Fan, Xudong Luo, Pingping Lin

Abstract:

Nowadays, dialogue systems increasingly become the way for humans to access many computer systems. So, humans can interact with computers in natural language. A dialogue system consists of three parts: understanding what humans say in natural language, managing dialogue, and generating responses in natural language. In this paper, we survey deep learning based methods for dialogue management, response generation and dialogue evaluation. Specifically, these methods are based on neural network, long short-term memory network, deep reinforcement learning, pre-training and generative adversarial network. We compare these methods and point out the further research directions.

Keywords: dialogue management, response generation, deep learning, evaluation

Procedia PDF Downloads 172

Authors: Auni Idi Muhire

Abstract:

Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

Procedia PDF Downloads 281

Authors: Angelika Magiera, Weronika Penar, Czesław Klocek

Abstract:

Intellectual disability (ID) affects approximately 1.55% of children and adults in the society of developed countries. Depending on the ID degree, the patient is burdened with additional disease entities. Intellectual disability does not only limits a person’s opportunities to participate in social life but also affects whole families. People with ID belong to the group of risk of mental illnesses, they are less emotionally stable, while families are predisposed to depression. The study was held in a day care center for people with intellectual disabilities (of various degrees of disability) on 26 people. Nurses and carers also took part. The age range of study groups ranged from 22 to 67 years. Therapeutic classes were held for four independent mixed groups (sex and intellectual disability degree) from 6 to 7 people each, lasting no more than 30 minutes. They were created by the facility's staff to make sure that a group is stable. The animal assisted activity took place with a 2.5-year-old Ragdoll cat. The animal has passed the exam (certificate entitling her to take part in felinotherapy) and had 1.5 years of work experience. Due to the different degrees of ID, an individual emotional state survey was conducted among the caregivers of those who were involved in the activity, to assess the impact of animal assisted activity with a cat on patients. A positive effect on the emotional state of people with different types of intellectual disability was observed. Caregivers and nurses of those participating in the study express willingness to continue these types of classes and consider them necessary for this group of people.

Keywords: intellectual disabilities, animal-assisted activity, cat, feline, emotions

Procedia PDF Downloads 141

Authors: Damian Graham, Ashleigh H. Hall, Damani R. Sulph, Michael A. James, Shawn B. Vassell

Abstract:

This paper assesses the design and feasibility of a Materials Recovery Facility (MRF) in Jamaica as a possible green industry approach to the nation’s economic and solid waste management problems. Jamaica is a developing nation that is vulnerable to climate change that can affect its blue economy and tourism on which it is heavily reliant. Jamaica’s National Solid Waste Management Authority (NSWMA) collects only a fraction of all the solid waste produced annually which is then transported to dumpsites. The remainder is either burnt by the population or disposed of illegally. These practices negatively impact the environment, threaten the sustainability of economic growth from blue economy and tourism and its waste management system is predominantly a cost centre. The implementation of an MRF could boost the manufacturing sector, contribute to economic growth, and be a catalyst in creating a green industry with multiple downstream value chains with supply chain linkages. Globally, there is a trend to reuse and recycle that created an international market for recycled solid waste. MRFs enable the efficient sorting of solid waste into desired recoverable materials thus providing a gateway for entrance to the international trading of recycled waste. Research into the current state and effort to improve waste management in Jamaica in contrast with the similar and more advanced territories are outlined. The study explores the concept of green industrialization and its applicability to vulnerable small state economies like Jamaica. The study highlights the possible contributions and benefits derived from MRFs as a seeding factory that can anchor the reverse and forward logistics of other green industries as part of a logistic-cantered economy. Further, the study showcases an engineering economic analysis that assesses the viability of the implementation of an MRF in Jamaica. This research outlines the potential cost of constructing and operating an MRF and provides a realistic cash flow estimate to establish a baseline for profitability. The approach considers quantitative and qualitative data, assumptions, and modelling using industrial engineering tools and techniques that are outlined. Techniques of facility planning, system analysis and operations research with a focus on linear programming techniques are expressed. Approaches to overcome some implementation challenges including policy, technology and public education are detailed. The results of this study present a reasonable judgment of the prospects of incorporating an MRF to improve Jamaica’s solid waste management and contribute to socioeconomic and environmental benefits and an alternate pathway for economic sustainability.

Keywords: engineering-economic analysis, facility design, green industry, MRF, manufacturing, plant layout, solid-waste management, sustainability, waste disposal

Procedia PDF Downloads 232

Authors: Sara R. Knigge, Sugat R. Tuladhar, Hans-Klaus HöFfler, Tobias Schilling, Tim Kaufeld, Axel Haverich

Abstract:

Tissue engineered (TE) heart valves based on degradable electrospun fiber scaffold represent a promising approach to overcome the known limitations of mechanical or biological prostheses. But the mechanical stress in the high-pressure system of the human circulation is a severe challenge for the delicate materials. Hence, the prediction of the scaffolds` in vivo degradation kinetics must be as accurate as possible to prevent fatal events in future animal or even clinical trials. Therefore, this study investigates whether long-term testing in full blood provides more meaningful results regarding the degradation behavior than conventional tests in simulated body fluids (SBF) or Phosphate Buffered Saline (PBS). Fiber mats were produced from a polycaprolactone (PCL)/tetrafluoroethylene solution by electrospinning. The morphology of the fiber mats was characterized via scanning electron microscopy (SEM). A maximum physiological degradation environment utilizing a test set-up with porcine full blood was established. The set-up consists of a reaction vessel, an oxygenator unit, and a roller pump. The blood parameters (pO2, pCO2, temperature, and pH) were monitored with an online test system. All tests were also carried out in the test circuit with SBF and PBS to compare conventional degradation media with the novel full blood setting. The polymer's degradation is quantified by SEM picture analysis, differential scanning calorimetry (DSC), and Raman spectroscopy. Tensile and cyclic loading tests were performed to evaluate the mechanical integrity of the scaffold. Preliminary results indicate that PCL degraded slower in full blood than in SBF and PBS. The uptake of water is more pronounced in the full blood group. Also, PCL preserved its mechanical integrity longer when degraded in full blood. Protein absorption increased during the degradation process. Red blood cells, platelets, and their aggregates adhered on the PCL. Presumably, the degradation led to a more hydrophilic polymeric surface which promoted the protein adsorption and the blood cell adhesion. Testing degradable implants in full blood allows for developing more reliable scaffold materials in the future. Material tests in small and large animal trials thereby can be focused on testing candidates that have proven to function well in an in-vivo-like setting.

Keywords: Electrospun scaffold, full blood degradation test, long-term polymer degradation, tissue engineered aortic heart valve

Procedia PDF Downloads 156

Authors: Andrea N. Ofori-Boadu

Abstract:

The purpose is to develop a conceptual model of subcontractor development practices and processes that strengthen the integration of subcontractors into construction supply chain systems for improved subcontractor performance on Leadership in Energy and Environmental Design (LEED) certified building projects. The construction management of a LEED project has an important objective of meeting sustainability certification requirements. This is in addition to the typical project management objectives of cost, time, quality, and safety for traditional projects; and, therefore increases the complexity of LEED projects. Considering that construction management organizations rely heavily on subcontractors, poor performance on complex projects such as LEED projects has been largely attributed to the unsatisfactory preparation of subcontractors. Furthermore, the extensive use of unique and non-repetitive short term contracts limits the full integration of subcontractors into construction supply chains and hinders long-term cooperation and benefits that could enhance performance on construction projects. Improved subcontractor development practices are needed to better prepare and manage subcontractors, so that complex objectives can be met or exceeded. While supplier development and supply chain theories and practices for the manufacturing sector have been extensively investigated to address similar challenges, investigations in the construction sector are not that obvious. Consequently, the objective of this research is to investigate effective subcontractor development practices and processes to guide construction management organizations in their development of a strong network of high performing subcontractors. Drawing from foundational supply chain and supplier development theories in the manufacturing sector, a mixed interpretivist and empirical methodology is utilized to assess the body of knowledge within literature for conceptual model development. A self-reporting survey with five-point Likert scale items and open-ended questions is administered to 30 construction professionals to estimate their perceptions of the effectiveness of 37 practices, classified into five subcontractor development categories. Data analysis includes descriptive statistics, weighted means, and t-tests that guide the effectiveness ranking of practices and categories. The results inform the proposed three-phased LEED subcontractor development program model which focuses on preparation, development and implementation, and monitoring. Highly ranked LEED subcontractor pre-qualification, commitment, incentives, evaluation, and feedback practices are perceived as more effective, when compared to practices requiring more direct involvement and linkages between subcontractors and construction management organizations. This is attributed to unfamiliarity, conflicting interests, lack of trust, and resource sharing challenges. With strategic modifications, the recommended practices can be extended to other non-LEED complex projects. Additional research is needed to guide the development of subcontractor development programs that strengthen direct involvement between construction management organizations and their network of high performing subcontractors. Insights from this present research strengthen theoretical foundations to support future research towards more integrated construction supply chains. In the long-term, this would lead to increased performance, profits and client satisfaction.

Keywords: construction management, general contractor, supply chain, sustainable construction

Procedia PDF Downloads 114

Authors: David Idiata

Abstract:

This paper is directed at using the UKCP09 climate change projection tool to predict the effect of climate change on the dynamic modulus of asphalt concrete is Southern England knowing that there is a pressing challenge directly facing infrastructure in the urban cities in the world today due to climate change. Climate change causes change in the environment which in turn impacts on the long-term structural performance of structures. From the projection values obtained, it was discovered that as the temperature increases, the dynamic modulus reduces and this effect was more on the South West which have temperature range of 36.8 oC to 48.3 oC and dynamic modulus range of 2,212 MPa to 1256 MPa.

Keywords: dynamic modulus, asphalt concrete, UKCP09, Southern England

Procedia PDF Downloads 366

Authors: Thumesha Jayatilake

Abstract:

As platform work continues to proliferate, algorithmic management, which takes care of its operational role, poses complex challenges, including job satisfaction, worker involvement, ethical decision-making, and worker well-being. This conceptual paper scrutinizes how algorithmic management influences virtue development among platform workers, with an emphasis on the effects of role conflict and role ambiguity. Using an interdisciplinary approach, the research elucidates the complex relationship between algorithmic management systems and the ethical dimensions of work. The study also incorporates the interplay of human interaction and short-term task orientation, thus broadening the understanding of the impacts of algorithmic management on virtue development. The findings have significant implications for policymakers, academics, and industry practitioners, illuminating the ethical complexities presented by the use of algorithms in modern employment settings.

Keywords: algorithmic management, ethics, platform work, virtue

Procedia PDF Downloads 78

Authors: Johnson C. Y. Pang, Amy S. N. Fu, Ryan K. L. Lee, Allan C. L. Fu

Abstract:

Dry needling (DN) is one of the puncturing methods that involves the insertion of needles into the tender spots of the human body without the injection of any substance. DN has long been used to treat the patient with knee pain caused by knee osteoarthritis (KOA) and patellofemoral pain syndrome (PFPS), but the effectiveness is still inconsistent. This study aimed to conduct a systematic review and meta-analysis to assess the intervention methods and effects of DN with and without ultrasound guidance for treating pain and dysfunctions in people with KOA and PFPS. Design: This systematic review adhered to the PRISMA reporting guidelines. The registration number of the study protocol published in the PROSPERO database was CRD42021221419. Six electronic databases were searched manually through CINAHL Complete (1976-2020), Cochrane Library (1996-2020), EMBASE (1947-2020), Medline (1946-2020), PubMed (1966-2020), and Psychinfo (1806-2020) in November 2020. Randomized controlled trials (RCTs) and controlled clinical trials were included to examine the effects of DN on knee pain, including KOA and PFPS. The key concepts included were: DN, acupuncture, ultrasound guidance, KOA, and PFPS. Risk of bias assessment and qualitative analysis were conducted by two independent reviewers using the PEDro score. Results: Fourteen articles met the inclusion criteria, and eight of them were high-quality papers in accordance with the PEDro score. There were variations in the techniques of DN. These included the direction, depth of insertion, number of needles, duration of stay, needle manipulation, and the number of treatment sessions. Meta-analysis was conducted on eight articles. DN group showed positive short-term effects (from immediate after DN to less than 3 months) on pain reduction for both KOA and PFPS with the overall standardized mean difference (SMD) of -1.549 (95% CI=-0.588 to -2.511); with great heterogeneity (P=0.002, I²=96.3%). In subgroup analysis, DN demonstrated significant effects in pain reduction on PFPS (p < 0.001) that could not be found in subjects with KOA (P=0.302). At 3-month post-intervention, DN also induced significant pain reduction in both subjects with KOA and PFPS with an overall SMD of -0.916 (95% CI=-0.133 to -1.699, and great heterogeneity (P=0.022, I²=95.63%). Besides, DN induced significant short-term improvement in function with the overall SMD=6.069; 95% CI=8.595 to 3.544; with great heterogeneity (P<0.001, I²=98.56%) when analyzed was conducted on both KOA and PFPS groups. In subgroup analysis, only PFPS showed a positive result with SMD=6.089, P<0.001; while KOA showed statistically insignificant with P=0.198 in short-term effect. Similarly, at 3-month post-intervention, significant improvement in function after DN was found when the analysis was conducted in both groups with the overall SMD=5.840; 95% CI=9.252 to 2.428; with great heterogeneity (P<0.001, I²=99.1%), but only PFPS showed significant improvement in sub-group analysis (P=0.002, I²=99.1%). Conclusions: The application of DN in KOA and PFPS patients varies among practitioners. DN is effective in reducing pain and dysfunction at short-term and 3-month post-intervention in individuals with PFPS. To our best knowledge, no study has reported the effects of DN with ultrasound guidance on KOA and PFPS. The longer-term effects of DN on KOA and PFPS are waiting for further study.

Keywords: dry needling, knee osteoarthritis, patellofemoral pain syndrome, ultrasound guidance

Procedia PDF Downloads 138

Authors: R. Pussinen, V. Jankovic, U. Herzberg, M. Cerrada-Gimenez, T. Huhtala, A. Nurmi, T. Ahtoniemi

Abstract:

Targeted over-expression of human α-synuclein using viral-vector mediated gene delivery into the substantia nigra of rats and non-human primates has been reported to lead to dopaminergic cell loss and the formation of α-synuclein aggregates reminiscent of Lewy bodies. We have previously shown how AAV-mediated expression of α-synuclein is seen in the chronic phenotype of the rats over 16 week follow-up period. In the context of these findings, we attempted to further characterize this long term PD related functional and motor deficits as well as neurochemical and neuropathological changes in AAV-mediated α-synuclein transfection model in rats during chronic follow-up period. Different titers of recombinant AAV expressing human α-synuclein (A53T) were stereotaxically injected unilaterally into substantia nigra of Wistar rats. Rats were allowed to recover for 3 weeks prior to initial baseline behavioral testing with rotational asymmetry test, stepping test and cylinder test. A similar behavioral test battery was applied again at weeks 5, 9,12 and 15. In addition to traditionally used rat PD model tests, MotoRater test system, a high speed kinematic gait performance monitoring was applied during the follow-up period. Evaluation focused on animal gait between groups. Tremor analysis was performed on weeks 9, 12 and 15. In addition to behavioral end-points, neurochemical evaluation of dopamine and its metabolites were evaluated in striatum. Furthermore, integrity of the dopamine active transport (DAT) system was evaluated by using 123I- β-CIT and SPECT/CT imaging on weeks 3, 8 and 12 after AAV- α-synuclein transfection. Histopathology was examined from end-point samples at 3 or 12 weeks after AAV- α-synuclein transfection to evaluate dopaminergic cell viability and microglial (Iba-1) activation status in substantia nigra by using stereological analysis techniques. This study focused on the characterization and validation of previously published AAV- α-synuclein transfection model in rats but with the addition of novel end-points. We present the long term phenotype of AAV- α-synuclein transfected rats with traditionally used behavioral tests but also by using novel fine motor analysis techniques and tremor analysis which provide new insight to unilateral effects of AAV α-synuclein transfection. We also present data about neurochemical and neuropathological end-points for the dopaminergic system in the model and how well they correlate with behavioral phenotype.

Keywords: adeno-associated virus, alphasynuclein, animal model, Parkinson’s disease

Procedia PDF Downloads 297

Authors: Raj Kumar Rajak, Bharat Mishra

Abstract:

Bio-battery represents an entirely new long term, reasonable, reachable and ecofriendly approach to production of sustainable energy. Types of batteries have been developed using MnO₂ in various ways. MnO₂ is suitable with physical, chemical, electrochemical, and catalytic properties, serving as an effective cathodic depolarizer and may be considered as being the life blood of the battery systems. In the present experimental work, we have studied the effect of generation of power by bio-battery using different concentrations of MnO₂. The tests show that it is possible to generate electricity using cow’s urine as an electrolyte. After ascertaining the optimum concentration of MnO₂, various battery parameters and performance indicates that cow urine solely produces power of 695 mW, while a combination with MnO₂ (40%) enhances power of bio-battery, i.e. 1377 mW. On adding more and more MnO₂ to the electrolyte, the power suppressed because inflation of internal resistance. The analysis of the data produced from experiment shows that MnO₂ is quite suitable to energize the bio-battery.

Keywords: bio-batteries, cow’s urine, manganese dioxide, non-conventional

Procedia PDF Downloads 263

Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

Abstract:

Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

Procedia PDF Downloads 146

Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

Abstract:

Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

Procedia PDF Downloads 88

Authors: Calvin Rong, Regina Agassian, Mindy Engle-Friedman

Abstract:

Climate changes, including rising sea levels and increases in global temperature, can have major effects on resource availability, leading to increased competition for resources and rising food prices. The abstract nature and often delayed consequences of many ecological problems cause people focus on immediate, specific, and personal events and circumstances that compel immediate and emotional involvement. This finding may be explained by the challenges humans have in imagining themselves in the future, a shortcoming that interferes with decision-making involving far-off rewards, and leads people to indicate a lower concern toward the future than to present circumstances. The present study sought to assess whether priming people to think of themselves in the future might strengthen the connection to their future selves and stimulate environmentally-protective behavior. We hypothesize that priming participants to think about themselves in the future would increase concern for the future environment. 45 control participants were primed to think about themselves in the present, and 42 participants were primed to think about themselves in the futures. After priming, the participants rated their concern over access to clean water, food, and energy on a scale of 1 to 10. They also rated their predicted care levels for the environment at age points 40, 50, 60, 70, 80, and 90 on a scale of 1(not at all) to 10 (very much). Predicted care levels at age 90 for the experimental group was significantly higher than for the control group. Overall the experimental group rated their concern for resources higher than the control. In comparison to the control group (M=7.60, SD=2.104) participants in the experimental group had greater concern for clean water (M=8.56, SD=1.534). In comparison to the control group (M=7.49, SD=2.041) participants in the experimental group were more concerned about food resources (M=8.41, SD=1.830). In comparison to the control group (M=7.22, SD=1.999) participants in the experimental group were more concerned about energy resources (M=8.07, SD=1.967). This study assessed whether a priming strategy could be used to encourage pro-environmental practices that protect limited resources. Future-self priming helped participants see past short term issues and focus on concern for the future environment.

Keywords: climate change, future, priming, global warming

Procedia PDF Downloads 262

Authors: Vera Lúcia Raposo

Abstract:

The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

Procedia PDF Downloads 391

Authors: Ravid Inbar

Abstract:

CaMKII (calcium-calmodulin dependent protein kinase II) makes up 2% of the protein in our brain and has a critical role in memory formation and long-term potentiation of neurons. Despite this, research has yet to uncover the role of one of the domains on the activation of this kinase. The following proposes to express the protein without the hub domain in E. coli, leaving only the kinase and regulatory segment of the protein. Next, a series of kinase assays will be conducted to elucidate the role the hub domain plays on CaMKII sensitivity to calcium/calmodulin activation. The hub domain may be important for activation; however, it may also be a variety of domains working together to influence protein activation and not the hub alone. Characterization of a protein is critical to the future understanding of the protein's function, as well as for producing pharmacological targets in cases of patients with diseases.

Keywords: CaMKII, hub domain, kinase assays, kinase + reg seg

Procedia PDF Downloads 95

Authors: Mohammed Muzafar, Darshan Ruikar

Abstract:

BIM, an acronym for Building Information Modelling relates to the practice of creating a computer generated model which is capable of displaying the planning, design, construction and operation of a structure. The resulting simulation is a data-rich, object-oriented, intelligent and parametric digital representation of the facility, from which views and data, appropriate to various users needs can be extracted and analysed to generate information that can be used to make decisions and to improve the process of delivering the facility. BIM also refers to a shift in culture that will influence the way the built environment and infrastructure operates and how it is delivered. One of the main issues of concern in the construction industry at present in the UK is its record on Health & Safety (H&S). It is, therefore, important that new technologies such as BIM are developed to help improve the quality of health and safety. Historically the H&S record of the construction industry in the UK is relatively poor as compared to the manufacturing industries. BIM and the digital environment it operates within now allow us to use design and construction data in a more intelligent way. It allows data generated by the design process to be re-purposed and contribute to improving efficiencies in other areas of a project. This evolutionary step in design is not only creating exciting opportunities for the designers themselves but it is also creating opportunity for every stakeholder in any given project. From designers, engineers, contractors through to H&S managers, BIM is accelerating a cultural change. The paper introduces the concept behind a research project that mitigates the H&S risks associated with the construction, operation and maintenance of assets through the adoption of BIM.

Keywords: building information modeling, BIM levels, health, safety, integration

Procedia PDF Downloads 259

Authors: Hsin-Yi Lo, Chia-Yu Hsu

Abstract:

This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

Procedia PDF Downloads 86

Authors: Emily Saurman, David Lyle

Abstract:

In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

Procedia PDF Downloads 237

Authors: S. Mantzoukis, M. Gerasimou, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

Abstract:

Purpose: Patients in Intensive Care Units (ICU) are exposed to a different spectrum of microorganisms relative to the hospital. Due to the fact that the majority of these patients are intubated, bronchial secretions should be examined. Material and Method: Bronchial secretions should be taken with care so as not to be mixed with sputum or saliva. The bronchial secretions are placed in a sterile container and then inoculated into blood, Mac Conkey No2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. After this period, if any number of microbial colonies are detected, gram staining is performed and then the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) followed by a sensitivity test in the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017 the Laboratory of Microbiology received 365 samples of bronchial secretions from the Intensive Care Unit. 237 were found positive. S. epidermidis was identified in 1 specimen, A. baumannii in 60, K. pneumoniae in 42, P. aeruginosa in 50, C. albicans in 40, P. mirabilis in 4, E. coli in 4, S. maltophilia in 6, S. marcescens in 6, S. aureus in 12, S. pneumoniae in 1, S. haemolyticus in 4, P. fluorescens in 1, E. aerogenes in 1, E. cloacae in 5. Conclusions: The majority of ICU patients appear to be a fertile ground for the development of infections. The nature of the findings suggests that a significant part of the bacteria found comes from the unit (nosocomial infection).

Keywords: bronchial secretions, cultures, infections, intensive care units

Procedia PDF Downloads 191

Authors: Kristin Prentice, Carri Hand

Abstract:

As the Canadian population ages and chronic health conditions continue to escalate, older adults will require various types of housing, such as long term care or retirement homes. Moving to a new home may require a change in leisure activities and social networks, which could be challenging to maintain identity and create a sense of home. Leisure has been known to help older adults maintain or increase their quality of life and life satisfaction and may help older adults in moving to new homes. Sense of home and identity within older adults' transitions to new homes are concepts that may also relate to leisure engagement. Literature is scant regarding the role of leisure in older adults moving to new homes and how the sense of home and identity inter-relate. This study aims to explore how leisure may play a role in older adults' transitioning to new homes, including how sense of home and identity inter-relate. An ethnographic approach will be used to understand the culture of older adults transitioning to new homes. This study will involve older adults who have recently relocated to a mid-sized city in Ontario, Canada. The study will focus on the older adult’s interactions with and connections to their home environment through leisure. Data collection will take place via video-conferencing and will include a narrative interview and two other interviews to discuss an activity diary of leisure engagement pre and post move and mental maps to capture spaces where participants engaged in leisure. Participants will be encouraged to share photographs of leisure engagement taken inside and outside their home to help understand the social spaces the participants refer to in their activity diaries and mental maps. Older adults attempt to adjust to their new homes by maintaining their identity, developing a sense of home through creating attachment to place, and maintaining social networks, all of which have been linked to engaging in leisure. This research will provide insight into the role of leisure in this transition process and the extent that the home and community can contribute to aiding their transition to the new home. This research will contribute to existing literature on the inter-relationships of leisure, sense of home, and identity and how they relate to older adults moving to new homes. This research also has potential for influencing policy and practice for meeting the housing needs of older adults.

Keywords: leisure, older adults, transition, identity

Procedia PDF Downloads 125

Authors: B. Sadek, N. Khan, D. Łażewska, K. Kieć-Kononowicz

Abstract:

The effects of the non-imidazole histamine H3 receptor (H3R) antagonist DL77 in passive avoidance paradigm (PAP) and novel object recognition (NOR) task in MK801-induced cognitive deficits associated with schizophrenia (CDS) in adult male rats, and applying donepezil (DOZ) as a reference drug were investigated. The results show that acute systemic administration of DL77 (2.5, 5, and 10 mg/kg, i.p.) significantly improved MK801-induced (0.1 mg/kg, i.p.) memory deficits in PAP. The ameliorating activity of DL77 (5 mg/kg, i.p.) in MK801-induced deficits was partly reversed when rats were pretreated with the centrally-acting H2R antagonist zolantidine (ZOL, 10 mg/kg, i.p.) or with the antimuscarinic antagonist scopolamine (SCO, 0.1 mg/kg, i.p.), but not with the CNS penetrant H1R antagonist pyrilamine (PYR, 10 mg/kg, i.p.). Moreover, the memory enhancing effect of DL77 (5 mg/kg, i.p.) in MK801-induced memory deficits in PAP was strongly reversed when rats were pretreated with a combination of ZOL (10 mg/kg, i.p.) and SCO (1.0 mg/kg, i.p.). Furthermore, the significant ameliorative effect of DL77 (5 mg/kg, i.p.) on MK801-induced long-term memory (LTM) impairment in NOR test was comparable to the DOZ-provided memory-enhancing effect, and was abrogated when animals were pretreated with the histamine H3R agonist R-(α)-methylhistamine (RAMH, 10 mg/kg, i.p.). However, DL77(5 mg/kg, i.p.) failed to provide procognitive effect on MK801-induced short-term memory (STM) impairment in NOR test. In addition, DL77 (5 mg/kg) did not alter anxiety levels and locomotor activity of animals naive to elevated-plus maze (EPM), demonstrating that improved performances with DL77 (5 mg/kg) in PAP or NOR are unrelated to changes in emotional responding or spontaneous locomotor activity. These results provide evidence for the potential of H3Rs for the treatment of neurodegenerative disorders related to impaired memory function, e.g. CDS.

Keywords: histamine H3 receptor, antagonist, learning, memory impairment, passive avoidance paradigm, novel object recognition

Procedia PDF Downloads 206

Authors: Sa-Kil Kim, Jang-Soo Lee

Abstract:

On March 31, 1993, a severe fire accident took place in a nuclear power plant located in Narora in North India. The event involved a major fire in the turbine building of NAPS unit-1 and resulted in a total loss of power to the unit for 17 hours. In addition, there was a heavy ingress of smoke in the control room, mainly through the intake of the ventilation system, forcing the operators to vacate the control room. The Narora fire accident provides us lessons indicating that operators could lose their mind and predictable behaviors during a fire. After the Fukushima accident, which resulted from a natural disaster, unanticipated external events are also required to be prepared and controlled for the ultimate safety of nuclear power plants. From last year, our research team has developed a test and evaluation facility that can simulate external events such as an earthquake and fire based on the operators’ real-sense. As one of the results of the project, we proposed a unit real-sense-based facility that can simulate fire events in a control room for utilizing a test-bed of human factor validation. The test-bed has the operator’s workstation shape and functions to simulate fire conditions such as smoke, heat, and auditory alarms in accordance with the prepared fire scenarios. Furthermore, the test-bed can be used for the operators’ training and experience.

Keywords: human behavior in fire, human factors validation, nuclear power plants, real-sense-based fire simulation

Procedia PDF Downloads 288

Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

Abstract:

Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

Procedia PDF Downloads 93

Authors: Marta D'Onofrio

Abstract:

The debate on the digitalization of the economy has raised questions about how both labor and the regulation of work processes are changing due to the introduction of digital technologies in the productive system. Within the literature, the term ‘digital labor’ is commonly used to identify the impact of digitalization on labor. Despite the wide use of this term, it is still not available an unambiguous definition of it, and this could create confusion in the use of terminology and in the attempts of classification. As a consequence, the purpose of this paper is to provide for a definition and to propose a classification of ‘digital labor’, resorting to the theoretical approach of organizational studies.

Keywords: digital labor, digitalization, data-driven algorithms, big data, organizational studies

Procedia PDF Downloads 160

Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

Abstract:

Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

Procedia PDF Downloads 403

Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

Abstract:

Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

Procedia PDF Downloads 441

Authors: Mustafa Kavraz

Abstract:

This study investigated the differences in the objective parameters of sound depending on the changes in the lengths of the lateral surfaces of a space and on the replacement of the sound absorbers that are placed on these surfaces. To this end, three models of room were chosen. The widths and heights of these rooms were the same but the lengths of the rooms were changed. The smallest room was 8 m. wide and 10 m. long. The lengths of the other two rooms were 15 m. and 20 m. For each model, the differences in the objective parameters of sound were determined by keeping all the material in the space intact and by changing only the positions of the sound absorbers that were placed on the walls. The sound absorbers that were used on the walls were of two different sizes. The sound absorbers that were placed on the walls were 4 m and 8 m. long and story-height (3 m.). In all model room types, the sound absorbers were placed on the long walls in three different ways: at the end of the long walls where the long walls meet the front wall; at the end of the long walls where the long walls meet the back wall; and in the middle part of the long walls. Except for the specially placed sound absorbers, the ground, wall and ceiling surfaces were covered with three different materials. There were no constructional elements such as doors and windows on the walls. On the surfaces, the materials specified in the Odeon 10 material library were used as coating material. Linoleum was used as flooring material, painted plaster as wall coating material and gypsum boards as ceiling covering (2 layers with a total of 32 mm. thickness). These were preferred due to the fact that they are the commonly used materials for these purposes. This study investigated the differences in the objective parameters of sound depending on the changes in the lengths of the lateral surfaces of a space and on the replacement of the sound absorbers that are placed on these surfaces. To this end, three models of room were chosen. The widths and heights of these rooms were the same but the lengths of the rooms were changed. The smallest room was 8 m. wide and 10 m. long. The lengths of the other two rooms were 15 m. and 20 m. For each model, the differences in the objective parameters of sound were determined by keeping all the material in the space intact and by changing only the positions of the sound absorbers that were placed on the walls. The sound absorbers that were used on the walls were of two different sizes. The sound absorbers that were placed on the walls were 4 m and 8 m. long and story-height (3 m.). In all model room types, the sound absorbers were placed on the long walls in three different ways: at the end of the long walls where the long walls meet the front wall; at the end of the long walls where the long walls meet the back wall; and in the middle part of the long walls. Except for the specially placed sound absorbers, the ground, wall and ceiling surfaces were covered with three different materials. There were no constructional elements such as doors and windows on the walls. On the surfaces, the materials specified in the Odeon 10 material library were used as coating material. Linoleum was used as flooring material, painted plaster as wall coating material and gypsum boards as ceiling covering (2 layers with a total of 32 mm. thickness). These were preferred due to the fact that they are the commonly used materials for these purposes.

Keywords: sound absorber, room model, objective parameters of sound, jnd

Procedia PDF Downloads 377

Authors: Wanwadee Neamsakul

Abstract:

VARK learning style is an effective method of learning that could enhance all skills of the students like visual (V), auditory (A), read/write (R), and kinesthetic (K). This learning style benefits the students in terms of professional competencies, critical thinking and lifelong learning which are the desirable characteristics of the nursing students. This study aimed to develop a model of teaching and learning clinical practicum at postpartum ward for nursing students by using VARK learning styles, and evaluate the nursing students’ opinions about the developmental model. A methodology used for this study was research and development (R&D). The model was developed by focus group discussion with five obstetric nursing instructors who have experiences teaching Maternal Newborn and Midwifery I subject. The activities related to practices in the postpartum (PP) ward including all skills of VARK were assigned into the matrix table. The researcher asked the experts to supervise the model and adjusted the model following the supervision. Subsequently, it was brought to be tried out with the nursing students who practiced on the PP ward. Thirty third year nursing students from one of the northern Nursing Colleges, Academic year 2015 were purposive sampling. The opinions about the satisfaction of the model were collected using a questionnaire which was tested for its validity and reliability. Data were analyzed using descriptive statistics. The developed model composed of 27 activities. Seven activities were developed as enhancement of visual skills for the nursing students (25.93%), five activities as auditory skills (18.52%), six activities as read and write skills (22.22%), and nine activities as kinesthetic skills (33.33%). Overall opinions about the model were reported at the highest level of average satisfaction (mean=4.63, S.D=0.45). In the aspects of visual skill (mean=4.80, S.D=0.45) was reported at the highest level of average satisfaction followed by auditory skill (mean=4.62, S.D=0.43), read and write skill (mean=4.57, S.D=0.46), and kinesthetic skill (mean=4.53, S.D=0.45) which were reported at the highest level of average satisfaction, respectively. The nursing students reported that the model could help them employ all of their skills during practicing and taking care of the postpartum women and newborn babies. They could establish self-confidence while providing care and felt proud of themselves by the benefits of the model. It can be said that using VARK learning style to develop the model could enhance both nursing students’ competencies and positive attitude towards the nursing profession. Consequently, they could provide quality care for postpartum women and newborn babies effectively in the long run.

Keywords: model, nursing students, postpartum ward, teaching and learning clinical practicum

Procedia PDF Downloads 155