Search results for: audit hours

Authors: Hosam A. Shawky, Amr A. Abdel Fatah, Moustafa M. S. Abo ElFad, Abdel Hameed M. El-Aassar

Abstract:

Water desalination projects based on reverse osmosis technology are being introduced in Egypt to combat drinking water shortage in remote areas. Reverse osmosis (RO) desalination is a pressure driven process. This paper focuses on the design of an integrated brackish water and seawater RO desalination and solar Photovoltaic (PV) technology. A small Mobile PV driven RO desalination plant prototype without batteries is designed and tested. Solar-driven reverse osmosis desalination can potentially break the dependence of conventional desalination on fossil fuels, reduce operational costs, and improve environmental sustainability. Moreover, the innovative features incorporated in the newly designed PV-RO plant prototype are focusing on improving the cost effectiveness of producing drinkable water in remote areas. This is achieved by maximizing energy yield through an integrated automatic single axis PV tracking system with programmed tilting angle adjustment. An autonomous cleaning system for PV modules is adopted for maximizing energy generation efficiency. RO plant components are selected so as to produce 4-5 m3/day of potable water. A basic criterion in the design of this PV-RO prototype is to produce a minimum amount of fresh water by running the plant during peak sun hours. Mobility of the system will provide potable water to isolated villages and population as well as ability to provide good drinking water to different number of people from any source that is not drinkable.

Keywords: design, reverse osmosis, photovoltaic, energy, desalination, Egypt

Procedia PDF Downloads 555

Authors: Aneta Binkowska, Grzegorz Michalak, Slawomir Pilip, Lukasz Bondaruk, Daniel Celinski, Robert Slotwinski

Abstract:

Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma treated in the ED, including 32 patients that met inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (group A with ISS ≥20, group B with ISS <20). Serum levels of TNF-α and sTNFR1 were determined after admission to the ED and after 3, 6, 12 and 24 hours. The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs B TNF-α 2.46 pg/ml vs 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs 875.2 p<0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications ( C+ vs C- 1561.5 pg/ml vs 930.6 pg/ml). Spearman's correlation showed a statistically significant positive correlation between the baseline concentrations of IL-6 (r=0.38, p<0.043) and sTNFR1 (r=0.59, p=0.001) and the ISS scores. The high diagnostic sensitivity calculated from the ROC (receiver operating characteristic) curves was found for the concentrations of both cytokines: TNF α (AUC=0.91, p=0.004) and sTNFR1 (AUC=0.86, p=0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, is significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with high mortality.

Keywords: cytokine, SIRS, MODS, trauma

Procedia PDF Downloads 145

Authors: Dina F. Mansour, Dalia O. Saleh, Rasha E. Mostafa

Abstract:

Cyclophosphamide (CP), the most commonly used chemotherapeutic agent, was reported to cause many side effects including urotoxicity, cardiotoxicity, gonadotoxicity, and hepatotoxicity; this limits its clinical practice. In the present study, the protective effect of genistein (GEN), the major phytoestrogen in soy products that possesses various pharmacological activities, has been investigated against CP-induced acute liver damage in rats. Forty adult Sprague-Dawley rats were allocated into five groups. The first group received the vehicles and act as normal control. In the other groups, rats were injected with a single dose of CP (200 mg/kg, i.p). The last three groups were pretreated with subcutaneous GEN at doses of 0.5, 1 and 2 mg/kg/day, respectively, for 15 consecutive days prior CP injection. Forty-eight hours following CP injection, rats of all groups were investigated for the serum levels of alanine transaminase and aspartate transaminase, as well as the liver contents of reduced glutathione, malondialdehyde, nitrite, interleukin-1β, and myeloperoxidase. Histopathological examination of liver tissues was also conducted. CP resulted in acute liver damage in rats as evidenced by alteration of liver function biomarkers, oxidative stress, and inflammatory markers; that was confirmed by the histopathological outcomes. Pretreatment of rats with GEN significantly protected against CP-induced deterioration of liver function and showed marked anti-oxidant and anti-inflammatory properties that were demonstrated by the biochemical and histopathological findings. In conclusion, the present findings demonstrated the protective effects of GEN against CP-induced liver damage and suggested role of its antioxidant and anti-inflammatory activities.

Keywords: cyclophosphamide, genistein, inflammation, interleukin-1β, liver, myeloperoxidase, oxidative stress

Procedia PDF Downloads 287

Authors: Asim Majeed, Anwar Ul Haq, Ayesha Asim, Mike Lloyd-Williams, Arshad Jamal, Usman Butt

Abstract:

This study aims to investigate the impact of data leak of M&S customers on digital communities. Modern businesses are using digital communities as an important public relations tool for marketing purposes. This form of communication helps companies to build better relationship with their customers which also act as another source of information. The communication between the customers and the organizations is not regulated so users may post positive and negative comments. There are new platforms being developed on a daily basis and it is very crucial for the businesses to not only get themselves familiar with those but also know how to reach their existing and perspective consumers. The driving force of marketing and communication in modern businesses is the digital communities and these are continuously increasing and developing. This phenomenon is changing the way marketing is conducted. The current research has discussed the implications on M&S business performance since the data was exploited on digital communities; users contacted M&S and raised the security concerns. M&S closed down its website for few hours to try to resolve the issue. The next day M&S made a public apology about this incidence. This information was proliferated on various digital communities and it has impacted negatively on M&S brand name, sales and customers. The content analysis approach is being used to collect qualitative data from 100 digital bloggers including social media communities such as Facebook and Twitter. The results and finding provide useful new insights into the nature and form of security concerns of digital users. Findings have theoretical and practical implications. This research will showcase a large corporation utilizing various digital community platforms and can serve as a model for future organizations.

Keywords: Digital, communities, performance, dissemination, implications, data, exploitation

Procedia PDF Downloads 378

Authors: Leila M. Carvalho, Maria Erica S. Oliveira, Arnoud C. Neto, Elza I. Ida, Massami Shimokomaki, Marta S. Madruga

Abstract:

The quality of broiler breast meat is changing as a result of the continuing emphasis on genetic selection for a more efficient meat production. Breast meat has been classified as PSE (pale, soft, exudative), DFD (dark, firm, dry) and normal color meat, and recently a third group has emerged: the so-called PFN (pale, firm, non-exudative) meat. This classification was based on pH, color and functional properties. The aim of this work was to confirm the existence of PFN and PSE meat by biochemical characterization and functional properties. Twenty four hours of refrigerated fillet, Pectoralis major, m. samples (n= 838) were taken from Cobb flocks 42-48 days old, obtained in Northeastern Brazil tropical region, the Northeastern, considered to have only dry and wet seasons. Color (L*), pH, water holding capacity (WHC), values were evaluated and compared with PSE group samples. These samples were classified as Normal (465.8), PSE meat (L*≥53; pH<5.8) and PFN (L*≥53; pH>5.8). The occurrence of control meat, PSE and PFN was 69.09%, 11.10% and 19.81%, respectively. Samples from PFN presented 4.0-5.0% higher WHC in relation to PSE meat and similar to control group. These results are explained by the fact that PSE meat syndrome occurs because of higher protein denaturation as the consequence of a simultaneous lower pH values under warm carcass sooner after slaughtering impairing the myofibril proteins functional properties. Conversely, PFN samples follow normal glycolysis rate maintaining the normal proteins activities. In conclusion, the results reported herein confirm the existence of this emerging broiler meat group with similar properties as control group and it should be considered as normal breast meat group.

Keywords: broiler breast meat, funcional properties, PFN, PSE

Procedia PDF Downloads 232

Authors: Gholamzadeh Sakineh, Jedi Maryam, Fereshteh Dehghanrad

Abstract:

Background: Mental and psychological issues are common among older adults. Positive psychology theorists and researchers recommend focusing on constructs such as happiness, life satisfaction and hope rather than dwelling on negative experiences and perceptions. Objective: The research aim was to evaluate the impact of hope therapy interventions on the life satisfaction, happiness, and hopefulness of older adults in Iran. Methodology: This study used a quasi-experimental design. A convenience sample of 32 older adults was recruited from a retirement center in Shiraz, Iran. Participants were randomly assigned to either a control group (n = 16) or an experimental group (n = 16). The experimental group received eight sessions of hope therapy, each lasting 1.5 hours. The data for this study were collected using Snyder's Adult Hope Scale (AHS), Oxford Happiness Questionnaire, and Life Satisfaction Index-Z. The questionnaires were administered before, immediately after the intervention, and two months later. Descriptive and analytical statistical tests were used to analyze the data using SPSS version 19. Descriptive statistics were used to describe the sample characteristics and the distribution of the data. Analytical statistics were used to test the research hypotheses. Findings: The results showed that the hope therapy intervention significantly increased the life satisfaction and hopefulness of older adults (p < 0.05). In addition, the influence of time was also significant (p < 0.05). However, the intervention did not affect happiness in statistically significant ways. Conclusions: The findings of this study support the theoretical importance of hope therapy in improving the life satisfaction and hopefulness of older adults. Hope therapy interventions can be considered as an effective way to improve the emotional well-being and quality of life of older adults.

Keywords: older adults, life satisfaction, happiness, hopefulness, hope therapy

Procedia PDF Downloads 63

Authors: A. H. Bekhet, N. Helmy

Abstract:

Background: Physical therapists are knowledgeable in treatment and prevention of musculoskeletal injuries; however, they have occupational musculoskeletal injuries because Physical therapy profession requires effort that may lead to work-related musculoskeletal disorders. No previous studies among physical therapists have been reported in Egypt. We aim to assess the prevalence and risk factors of musculoskeletal disorders among physical therapist’s seniors versus internship students. Method: We conducted a cross-sectional study in faculty of physical therapy Cairo university Prevalence and risk factors of musculoskeletal injuries were assessed using self-administered questionnaire with closed-ended questions. Seniors therapist was defined as a physical therapist with more than 5 years of work experience. Data were analyzed using SPSS 22.0 for Windows. Results: The study included 106 physical therapists (Junior = 72; senior = 34), the mean age of senior therapists was 30.1 (SD 6.3) years and junior therapists were 22.8 (SD 2.4). Female subjects constituted 83.9% of the studied sample. The mean hours of contact with patients was higher among junior therapists 6.4 (SD 2.6) vs. 5.7 (SD 2.1) among senior therapists. The prevalence of a musculoskeletal injury, once or more in their lifetime, was significantly higher among senior therapists (86% vs. 66.7%; p = 0.04). The highest risk factor in increasing the symptoms of the injury among junior therapists was maintaining a position for a prolonged period of time at 28% while performing manual therapy techniques was the highest risk factor among senior therapists at 32%. 53% of senior therapists have limited their patient contact time as a result of their injury in comparison to 25% of junior therapists (p = 0.09). Conclusion: the presented study shows that the prevalence of musculoskeletal injuries, once or more in their lifetime, is significantly higher among senior therapists.

Keywords: musculoskeletal injuries, occupational injuries, physical therapists, work related disorders

Procedia PDF Downloads 275

Authors: Xavier Bertrand, Alexandre Cayrel

Abstract:

The early phase of an aircraft development is instrumental as it really drives the potential of a new concept. Any weakness in the high-level design (wing planform, moveable surfaces layout etc.) will be extremely difficult and expensive to recover later in the aircraft development process. Aerodynamic evaluation in this very early development phase is driven by two main criteria: a short lead-time to allow quick iterations of the geometrical design, and a high quality of the calculations to get an accurate & reliable assessment of the current status. These two criteria are usually quite contradictory. Actually, short lead time of a couple of hours from end-to-end can be obtained with very simple tools (semi-empirical methods for instance) although their accuracy is limited, whereas higher quality calculations require heavier/more complex tools, which obviously need more complex inputs as well, and a significantly longer lead time. At this point, the choice has to be done between accuracy and lead-time. A brand new approach has been developed within Airbus, aiming at obtaining quickly high quality evaluations of the aerodynamic of an aircraft. This methodology is based on a joint use of Surrogate Modelling and a lifting line code. The Surrogate Modelling is used to get the wing sections characteristics (e.g. lift coefficient vs. angle of attack), whatever the airfoil geometry, the status of the moveable surfaces (aileron/spoilers) or the high-lift devices deployment. From these characteristics, the lifting line code is used to get the 3D effects on the wing whatever the flow conditions (low/high Mach numbers etc.). This methodology has been applied successfully to a concept of medium range aircraft.

Keywords: aerodynamics, lifting line, surrogate model, CFD

Procedia PDF Downloads 330

Authors: Wittaya Apai, Satippong Rattanakam, Suttinee Likhittragulrung, Nuttanai Tungmunkongvorakul, Sompetch Jaroensuk

Abstract:

The objective of this study was to find some alternative ways to decrease sulfur dioxide (SO₂) residue problem and prolong storage life in fresh longan for export. Office of Agricultural Research and Development Region 1, Chiang Mai province conducted the research and development from 2016-2018. A grade longan cv. Daw fruit with panicle attached was placed in 11.5 kg commercial perforated plastic basket. They had 5 selected treatments comprising of 3 baskets as replication for each treatment, i.e. 1.5% SO₂ fumigation prior to insert SO₂-generated pads (Uvasys®) (1.5% SO₂+SO₂ pad), dipping in 5% hydrochloric acid (HCl) mixed with 1% sodium metabisulfite (SMS) for 5 min (5% HCl +1% SMS), ozone (O₃) fumigation for 1 hours (h) prior to 1.5% SO₂ fumigation (O₃ 1 h+1.5% SO₂), 1.5% SO₂ fumigation prior to O₃ fumigation for 1 h (1.5% SO₂+O₃ 1 h) and 1.5% SO₂ fumigation alone as commercial treatment (1.5% SO₂). They were stored at 5 ˚C, 90% relative humidity (RH) for 40-80 days. The results found that the possible treatments were 1.5% SO₂+O₃ 1 h and 5% HCl +1% SMS respectively and prevented pericarp browning for 80 days at 5 ºC. There were no significant changes in some parameters in any treatments; 1.5% SO₂+O₃ 1 h and 1.5% SO₂ during storage, i.e., pericarp browning, flesh discoloration, disease incidence (%) and sensory evaluation during storage. Application 1.5% SO₂+O₃ 1 h had a tendency less both SO₂ residue in fruit and disease incidence (%) including brighter pericarp color as compared with commercial 1.5% SO₂ alone. Moreover, HCl 5%+SMS 1% showed the least SO₂ residue in whole fruit below codex tolerance at 50 mg/kg throughout period of time. The fruit treated with 1.5% SO₂+O₃ 1 h, 1.5% SO₂, 5% HCl+1% SMS, O₃ 1 h+1.5% SO₂, and 1.5% SO₂+SO₂ pad could prolong storage life for 40, 40, 40, 30 and 30 days respectively at 5°C, 90% RH. Thus, application 1.5% SO₂+O₃ 1 h and/or 5% HCl +1% SMS could be used for extending shelf life fresh longan exported to restricted countries due to less SO₂ residue and fruit quality was maintained as compared with the conventional method.

Keywords: longan, sulfur dioxide, ozone fumigation, sodium metabisulfite

Procedia PDF Downloads 105

Authors: Rostam Abdi, Ahmad Abdi, Zahra Vahedi Langrodi

Abstract:

The aim of this study is to investigate four-week resistance exercise and milk supplement on NT-proBNP and plasma troponin I of male students. Concerning the methodology of the study, 21 senior high school students of Ardebil city were selected. The selected subjects were randomly shared in three groups of control, exercise- water and exercise- milk. The exercise program includes resistance exercise for a big muscle group. The subjects of control group rested during the study and did not participate in any training. The subjects of exercise- water experimental group immediately received 400 cc water after exercise and exercise- milk group immediately received 400 cc low fat milk. Control-water groups consumed the same amount of water. 48 hours before and after the last exercise session, the blood sample of the subjects were taken for measuring the variables. NT-proBNP and Troponin I concentrations were measured by ELISA. For data analysis, one-way variance analysis test, correlated t-test and Bonferroni post hoc test were used. The significant difference of p ≤ 0.05 was accepted. Resistance training along with milk consumption leads to increase of plasma NT-proBNP, however; this increase has not reached the significant level. Furthermore, meaningful increase was observed in plasma NT–proBNP in exercise group between pretest and posttest values. Furthermore, no meaningful difference was observed between groups in terms of Troponin I after milk consumption. It seems that endurance exercises lead to change in the structure of heart muscle and is along with an increase of NT-proBNP. Furthermore, there is the possibility that milk consumption can lead to release of heart troponin I. The mechanism through which protein supplements have been put on heart troponin I is unknown and requires more research.

Keywords: resistance exercise, milk, NT-proBNP, Troponin I

Procedia PDF Downloads 246

Authors: Elma C. Sultan

Abstract:

The study concentrated on Vernacular Language Origin and Students’ Accent Neutralization of the College of Arts and Sciences fourth students in Samar State University, Catbalogan City answering respondent’s locale profile, vernacular language origin in terms of local dialect/s and domestic language/s used; the significant relationship between vernacular language origin and accent neutralization of the respondents; and the proposed activities to adopt in neutralizing students’ accent. It utilized the descriptive-correlational method of research determining the significant relationship between vernacular language origin and students’ accent neutralization. The researcher used: (1) questionnaire divided into three parts: the first part identified the students’ locale; the second part determined the respondents’ domestic language/s used while the third part identified their local language/s used, (2) validated accent neutralization assessment tool, (3) statistical treatments in the analysis of data: percentage to determine the profile of the students; chi-square test for independence to determine the significant relationship between vernacular language origin and students’ accent neutralization. Findings of the study showed that vowel and diphthong sound production, domestic and local languages in indigenous, and native dialects are significantly related to accent neutralization. While, slow reading speed has a higher possibility in affecting accent neutralization. These caused designing a 50-hour short-term program for accent neutralization focusing in the correct vowel and diphthong sounds production and appropriate reading speed in preparation for the respondents’ search for BPO employment. This short-term program ran for 5 hours in a day for five days in a week.

Keywords: accent neutralization, dialect, diphthongs, indigenous, language origin, language, native, reading speed, vernacular, vowels

Procedia PDF Downloads 481

Authors: Juan Manuel Uriarte Lopez, Hector Raul Guemez Gaxiola, Javier Alonso Romo Rubio, Juan Manuel Romo Valdez

Abstract:

The objective of this investigation was to determine the influence of the use of recycled vegetable oil from restaurants in the productive performance of sows in lactation. Twenty-four hybrids lactating sows (Landrace x Yorkshire) were divided into three treatments with eight sows per treatment. On day 107 of gestation, the sows were moved to the mesh floor maternity cages in an environment regulated by the environment regulated (2.4 × 0.6 m) contained an area (2.4 × 0.5 m) for newborn pigs on each side, all diets were provided as a dry powder, and the sows received free access to water throughout the experimental period. After farrowing, the sows were fasted for 12 hours, the daily feed ration gradually increased, and the sows had ad libitum access to feed on the fourth day. The diets used were corn-soybean meal-based, containing 0 (CONT), recycled vegetable oil 1.0 % (RVOL), or recycled vegetable oil 1.5 % (RVOH) for 30 days. The diets contained similar calculated levels of crude protein and metabolizable energy and contained vitamins and minerals that exceeded National Research Council (1998) recommendations; sows were fed three times daily. On day 30, piglets were weaned, and performances of lactating sows and nursery piglets were recorded. Results indicated that average daily feed intake (5.58, 5.55, and 5.49 kg for CONT, RVOL, and RVO, respectively) of sows were not affected (P > 0.05) by different dietary. There was no difference in the average body weight of piglets on the day of birth, with 1.33, 1.36, and 1.35 kg, respectively (P > 0.05). There was no difference in average body weight of piglets on day 30, with 6.91, 6.75, and 7.05 kg, respectively 0.05) between treatments numbers of weaned piglets per sow (9.95, 9.80, and 9.80) were not affected by treatments (P > 0.05).In conclusion, the substitution of virgin vegetable oil for recycled vegetable oil in the diet does not affect the productive performance of lactating sows.

Keywords: lactating, sow, vegetable, oil

Procedia PDF Downloads 275

Authors: Rachel Luz P. Vivas-rica, Gloria G. Delan, Christine M. Corrales, Alfonso S. Piquero, Irene A. Monte

Abstract:

ABSTRACT -Selected Integrated Coastal Resource Management Program (ICRMP) sites in Southwestern Cebu were studied employing a stratified proportional sampling method using semi-structured questionnaires. Four hundred sixteen (416) respondents from five barangays with Marine Protected Areas (MPAs) and four barangays without marine sanctuaries were considered in the study. Results showed similarity of socio-economic characteristics in terms of average age, majority were middle aged, and married. Households were male dominated, obtained low education for both MPA and Non-MPA areas. In terms of occupation, majority in both areas engaged in fulltime fishing however part time jobs as carpenter, construction worker, driver or farmer as another income source. Most of the households were nuclear families with average family size of five for both MPA and Non-MPA. Fishing experience ranged from less than 1 year to more than 50 years. Fishing grounds were within the 15 kilometer radius of each considered site. Even if the respondents were totally dependent on fishing as a major source of income, still their income is way below the poverty threshold both in the MPA and Non-MPA areas. This is further explained by the marginality of their fishing implements wherein majority uses gill nets, hook & line, spear and paddle boat in fishing. Their volume of catch from an average of 6 hours fishing expedition ranges from half a kilo to a maximum of 4 kilos. Majority are not members of fishing groups or organizations.

Keywords: integrated coastal resource management program, marine protected areas, socio-economic, poverty threshold

Procedia PDF Downloads 504

Authors: Nouira Mariem, Ennigrou Samir

Abstract:

Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.

Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia

Procedia PDF Downloads 64

Authors: Prabir Kumar Paul, Joyeeta Mitra

Abstract:

Ergosterol, is an important fungal metabolite on phylloplane which is not synthesised by plants. However, the functional requirement of ergosterol to the plants is still an enigma. Being ubiquitously present in all plants except algae needs an insight into its physiological implication. The present study aimed at understanding if and how ergosterol influences the physiology of chloroplast particularly the activity of RuBisCo and carbonic anhydrase. The concept of the study was based on one of our earlier observation of enhanced Hills reaction in plants treated with fungal metabolites which contained ergosterol. The fungal metabolite treated plants had a significantly high concentration of photosynthetic pigments. Eight-week-old tomato plants raised under aseptic conditions at 25 + 10 C, 75 % relative humidity and 12 hour L/D photoperiod. Metabolites of Aspergillus niger and Fusarium oxysporum were sprayed on plants either singly or in a 1: 1 combination. A separate group of plants was also treated with 0.5, 1.0, 3.0, 5.0. 7.0 mg ergosterol / ml of n- heptane. Control plants were treated with sterile distilled water only. Plants were sampled at 24, 48, 72 and 96 hours of treatment. RuBisCo and carbonic anhydrase was estimated from sampled leaves. RuBisCo was separated on 1D SDS-PAGE and subjected to MALDI – TOF- TOF – MS analysis. The presence of ergosterol in fungal metabolites was confirmed. Fungal metabolites significantly enhanced the concentration and activity of RuBisCo and carbonic anhydrase. The Vmax activity of the enzymes was significantly high in metabolite treated plants. 1:1 mix of metabolite was more effective than when applied individually. Insilico analysis revealed, RuBisCo subunits had a binding site for ergosterol and in its presence affinity of Co2 to the enzyme increased by several folds. Invivo activity of RuBisCo was significantly elicited by ergosterol. Results of the present study indicate that ergosterol from phylloplane microfungi probably regulates the binding of Co2 to RuBisCo along with activity of carbonic anhydrase thereby modulating the physiology of choloroplast.

Keywords: carbonic anhydrase, ergosterol, phylloplane, RuBisCo

Procedia PDF Downloads 213

Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

Abstract:

Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

Procedia PDF Downloads 185

Authors: Onur Yel

Abstract:

This study represents the removal of harmful dye substances from wastewaters by using waste and cheap adsorbents. Rapid population growth and industrialization occasion anthropogenic pollution which gives irreversible damage to the environment. One of the ways in which water pollution occurs is caused by the release of the dyestuffs in the textile industry. The release of dyestuffs to the environment directly damages the living creatures that have acquired water habitat. Especially, wastewater cannot be used for nutritional purposes. In addition, some adsorbents have mutagenic and/or carcinogenic effects. By blocking photosynthesis, it hinders the inhibition of photosynthetic bacteria in the water, which damages the ecological balance and also causes the formation of malodorous compounds. Moreover, the lack of oxygen can pose a serious danger to the lives of other living organisms that need oxygen. In recent years, some physical and chemical methods are preferred for the removal of dyestuffs. However, the utilization of these methods is expensive. For this reason, the availability of new and cheap adsorbents becomes the more significant issue. In this study, an investigation of various variables on the removal of Methylene Blue and Acid Red-88 dyestuffs from wastewaters by the usage of pulverized cypress cones has been carried out. Thus, various masses of absorbent (0.1-0.25-0.5-1-2-4-5 grams) are used in 50, 100, 150, 200, 300 ppm concentrations of Methylene Blue and Acid Red-88 dyestuffs’ solutions, and with a variety of the interaction time (0.25-0.5-1-2-4-5 hours). The mixtures were centrifuged and the absorbance of the filtrates was measured on a UV spectrophotometer to determine their remaining concentrations. In the study, the highest removal ratio of Acid Red-88 dyestuff was found to be 81% at 200 ppm of dyestuff with 2 grams of adsorbent at 300 minutes. For Methylene Blue experiments, the removal percentage was found as 98% where 2 grams of adsorbent is used in 200 ppm dyestuff solution at 120 minutes of interaction.

Keywords: acid red-88, biosorption, methylene blue, cypress cones, water pollution

Procedia PDF Downloads 124

Authors: Gabriella Dravecz, László Péter, Zsolt Kis

Abstract:

Abstract— The growth of optical LiNbO3 single crystal and its physical and chemical properties are well known on the macroscopic scale. Nowadays the rare-earth doped single crystals became important for coherent quantum optical experiments: electromagnetically induced transparency, slow down of light pulses, coherent quantum memory. The expansion of applications is increasingly requiring the production of nano scaled LiNbO3 particles. For example, rare-earth doped nanoscaled particles of lithium niobate can be act like single photon source which can be the bases of a coding system of the quantum computer providing complete inaccessibility to strangers. The polyol method is a chemical synthesis where oxide formation occurs instead of hydroxide because of the high temperature. Moreover the polyol medium limits the growth and agglomeration of the grains producing particles with the diameter of 30-200 nm. In this work nano scaled LiNbO3 was prepared by the polyol method. The starting materials (niobium oxalate and LiOH) were diluted in H2O2. Then it was suspended in ethylene glycol and heated up to about the boiling point of the mixture with intensive stirring. After the thermal equilibrium was reached, the mixture was kept in this temperature for 4 hours. The suspension was cooled overnight. The mixture was centrifuged and the particles were filtered. Dynamic Light Scattering (DLS) measurement was carried out and the size of the particles were found to be 80-100 nms. This was confirmed by Scanning Electron Microscope (SEM) investigations. The element analysis of SEM showed large amount of Nb in the sample. The production of LiNbO3 nano particles were succesful by the polyol method. The agglomeration of the particles were avoided and the size of 80-100nm could be reached.

Keywords: lithium-niobate, nanoparticles, polyol, SEM

Procedia PDF Downloads 112

Authors: Ya-Yi Yen

Abstract:

The operating room is a medical environment full of high-risk, high-complexity and high-cost. In addition to assuring patient safety, the operating room should effort on the efficient and safe medical quality for the surgical patients of high risk, elders, and children. If the nursing staffs of operation room carry on the pre-operative visiting prior to surgery, the patient's anxiety and complications are expected to be alleviated, and the hospitalization days may also be shortened. Purpose: Applying the information system to enhance pre-operative visiting, case tracking, and effectiveness recording Method: (I) Application the information system to screen cases by integrating the operation scheduling, and linking the severe surgery codes, for to shorten the time to track cases of operative visiting. Through the improvement, the time required decreased to 1.5 minutes per day from 20 minutes per day, and nursing staffs’ satisfaction with satisfaction for tracking and visiting procedure of case increased to 86% from 54%. (II)The electronic establishment of the operative visiting record enhanced the integrity of the operative visiting record. The integrity rate was rise to 92% from 66%, while nursing staffs’ satisfaction with the visiting record increased to 82% from 61.3%. Since information technology continues evolving, the application of information technology is helpful to the integration of nursing information, simplification of processes, and saving of man-hours. This article introduces the application of information systems to simplify the processes and improve the effectiveness of operation visiting and tracking, including the saving of time, improving the integrity rate of record, and improving the satisfaction of nursing staffs.

Keywords: effectiveness, information system, perioperative nursing, pre-operative visiting

Procedia PDF Downloads 127

Authors: Euan Donley

Abstract:

Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

Procedia PDF Downloads 502

Authors: Januar Parlaungan Siregar, Davindra Brabu Mathivanan, Dandi Bachtiar, Mohd Ruzaimi Mat Rejab, Tezara Cionita

Abstract:

Natural fibres play a significant role in mass industries such as automotive, construction and sports. Many researchers have found that the natural fibres are the best replacement for the synthetic fibres in terms of cost, safety, and degradability due to the shortage of landfill and ingestion of non biodegradable plastic by animals. This study mainly revolved around pineapple leaf fibre (PALF) which is available abundantly in tropical countries and with excellent mechanical properties. The composite formed in this study is highly biodegradable as both fibre and matrix are both derived from natural based products. The matrix which is polylactic acid (PLA) is made from corn starch which gives the upper hand as both material are renewable resources are easier to degrade by bacteria or enzyme. The PALF is treated with different alkaline solution to remove excessive moisture in the fibre to provide better interfacial bonding with PLA. Thereafter the PALF is washed with distilled water several times before placing in vacuum oven at 80°C for 48 hours. The dried PALF later were mixed with PLA using extrusion method using fibre in percentage of 30 by weight. The temperature for all zone were maintained at 160°C with the screw speed of 50 rpm for better bonding and afterwards the products of the mixture were pelletized using pelletizer. The pellets were placed in the specimen-sized mould for hot compression under the temperature of 170°C at 5 MPa for 5 min and subsequently were cold pressed under room temperature at 5 MPa for 5 min. The specimen were tested for tensile and flexure strength according to American Society for Testing and Materials (ASTM) D638 and D790 respectively. The effect of surface modification on PALF with different alkali solution will be investigated and compared.

Keywords: natural fibre, PALF, PLA, composite

Procedia PDF Downloads 283

Authors: S. Ahmad, M. Rizwan, B. Ayub, S. Mehmood, P. Akhtar

Abstract:

This experiment was conducted to investigate the effect of supplementation of pure herbal blend on growth performance of boilers. One hundred and twenty birds were randomly distributed into 4 experimental units of 3 replicates (10 birds/replicate) as: negative control (basal diet), positive control (Lincomycin at the rate of 5g/bag), pure herbal blend at the rate of 150g/bag and pure herbal blend at the rate of 300g/bag. The data regarding weekly feed intake, body weight gain and feed conversion ratio were recorded, and fecal samples were collected at the end of starter and finisher phase for nutrient digestibility trial. The results of feed intake showed significant (P < 0.05) results in 1st (305g), 2nd (696.88g), 3rd (1046.9g) and 4th (1173.2g) week and feed conversion ratio indicated significant (P < 0.05) variations in 1st (2.54) and 4th (2.28) week of age. Also, both starter and finisher phase indicated significant (P < 0.05) differences among all treatment groups in feed intake (2023.4g) and (2302.6g) respectively. The statistical analysis indicated significant (P < 0.05) results in crop filling percentage (86.6%) after 2 hours of first feed supplementation. In case of nutrient digestibility trial, results showed significant (P < 0.05) values of crude protein and crude fat in starter phase as 69.65% and 56.62% respectively, and 69.57% and 48.55% respectively, in finisher phase. Based on overall results, it was concluded that the dietary inclusion of pure herbal blend containing neem tree leaves powder, garlic powder, ginger powder and turmeric powder increase the production performance of broilers.

Keywords: neem tree leave, garlic, ginger, herbal blend, broiler

Procedia PDF Downloads 179

Authors: K. Mohammed, M. Agarwal, J. Mewman, Y. Ren

Abstract:

An optimum technic has been developed for extracting volatile organic compounds which contribute to the aroma of lime fruit (Citrus aurantifolia). The volatile organic compounds of healthy and infested lime fruit with California red scale Aonidiella aurantii were characterized using headspace solid phase microextraction (HS-SPME) combined with gas chromatography (GC) coupled flame ionization detection (FID) and gas chromatography with mass spectrometry (GC-MS) as a very simple, efficient and nondestructive extraction method. A three-phase 50/30 μm PDV/DVB/CAR fibre was used for the extraction process. The optimal sealing and fibre exposure time for volatiles reaching equilibrium from whole lime fruit in the headspace of the chamber was 16 and 4 hours respectively. 5 min was selected as desorption time of the three-phase fibre. Herbivorous activity induces indirect plant defenses, as the emission of herbivorous-induced plant volatiles (HIPVs), which could be used by natural enemies for host location. GC-MS analysis showed qualitative differences among volatiles emitted by infested and healthy lime fruit. The GC-MS analysis allowed the initial identification of 18 compounds, with similarities higher than 85%, in accordance with the NIST mass spectral library. One of these were increased by A. aurantii infestation, D-limonene, and three were decreased, Undecane, α-Farnesene and 7-epi-α-selinene. From an applied point of view, the application of the above-mentioned VOCs may help boost the efficiency of biocontrol programs and natural enemies’ production techniques.

Keywords: lime fruit, Citrus aurantifolia, California red scale, Aonidiella aurantii, VOCs, HS-SPME/GC-FID-MS

Procedia PDF Downloads 195

Authors: William Cheng, Rini Sekartini

Abstract:

Background: Sleep is essential for children because it provides enhancement for the neural system activities that give physiologic effects for the body to support growth and development. One of the modifiable factors that relates with sleep is nutrition, which includes nutritional status, iron intake, and magnesium intake. Nutritional status represents the balance between nutritional intake and expenditure, while iron and magnesium are micronutrients that are related to sleep regulation. The aim of this study is to identify prevalence of sleep disturbance among Indonesian children and to evaluate its relation with aspect to nutrition. Methods : A cross-sectional study involving children aged 5 to 7-years-old in an urban primary health care between 2012 and 2013 was carried out. Related data includes anthropometric status, iron intake, and magnesium intake. Iron and magnesium intake was obtained by 24-hours food recall procedure. Sleep Disturbance Scale for Children (SDSC) was used as the diagnostic tool for sleep disturbance, with score under 39 indicating presence of problem. Results: Out of 128 school-aged children included in this study, 28 (23,1%) of them were found to have sleep disturbance. The majority of children had good nutritional status, with only 15,7% that were severely underweight or underweight, and 12,4% that were identified as stunted. On the contrary, 99 children (81,8%) were identified to have inadequate magnesium intake and 56 children (46,3%) with inadequate iron intake. Our analysis showed there was no significant relation between all of the nutritional status indicators and sleep disturbance (p>0,05%). Moreover, inadequate iron and magnesium intake also failed to prove significant relation with sleep disturbance in this population. Conclusion: Almost fourth of school-aged children in Indonesia were found to have sleep disturbance and further study are needed to overcome this problem. According to our finding, there is no correlation between nutritional status, iron intake, magnesium intake, and sleep disturbance.

Keywords: iron intake, magnesium intake, nutritional status, school-aged children, sleep disturbance

Procedia PDF Downloads 448

Authors: Rosy Chaudhary, Pushpa Parajuli

Abstract:

Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

Procedia PDF Downloads 326

Authors: Alireza Yavar, Sukiman Sarmani, Kok Siong Khoo

Abstract:

Trace element analysis of human hair has the potential to disclose retroactive information about an individual’s nutritional status and exposure. The residents of villages in Kandal province of Cambodia, due to dietary habits, lifestyle and ecological conditions, are unprotected from toxic elements particularly arsenic (As). The purpose of this research was to valuation levels of toxic and vital elements in scalp human hair. Scalp hair samples of 12-17 school children from three villages of Anglong Romiot (AR), Svay Romiot (SR) and Kampong Kong (KK) in the Kandal province of Cambodia were evaluated using k0- instrumental neutron activation method (k0-INAA). The samples were irradiated 6 hours in a Malaysian nuclear agency (MNA) research reactor and afterward, an HPGe detector was utilized to obtain gamma peaks of radionuclides in samples. We achieved profiles of 31 elements in human hair in our studied area, namely, As, Au, Br, Ca, Ce, Co, Dy, Eu152m, Hg197, Hg203, Ho, Ir, K, La, Lu, Mn, Na, Pa, Pt195m, Pt197, Sb, Sc46, Sc47, Sm, Sn117m, W181, W187, Yb169, Yb175, Zn and Zn69m. The precision of the method was assessed by evaluating ERM-DB001-human hair as certified reference materials (CRMs), and which experimental result of ERM-DB001 was consistent with certified values. Whereas Arsenic (As) pollution is major contamination in our studied area, correlation between the concentration of As and other elements were determined by Pearson’s correlation test that it may be useful as a database source for toxic and essential elements in the hair of teenage individuals in our studied area

Keywords: scalp human hair, toxic and essential elements, Kandal province of Cambodia, k₀- instrumental neutron activation method

Procedia PDF Downloads 96

Authors: Nora A. Guerrero, Adan Leon, María I. Sandoval, Romel Perez, Samuel Munoz

Abstract:

The addition of solvents in cyclic steam stimulation is a technique that has shown an impact on the improved recovery of heavy oils. In this technique, it is possible to reduce the steam/oil ratio in the last stages of the process, at which time this ratio increases significantly. The mobility of improved crude oil increases due to the structural changes of its components, which at the same time reflected in the decrease in density and viscosity. In the present work, the effect of the variables such as temperature, time, and weight percentage of naphtha was evaluated, using a factorial design of experiments 23. From the results of analysis of variance (ANOVA) and Pareto diagram, it was possible to identify the effect on viscosity reduction. The experimental representation of the crude-vapor-naphtha interaction was carried out in a batch reactor on a Colombian heavy oil of 12.8° API and 3500 cP. The conditions of temperature, reaction time, and percentage of naphtha were 270-300 °C, 48-66 hours, and 3-9% by weight, respectively. The results showed a decrease in density with values in the range of 0.9542 to 0.9414 g/cm³, while the viscosity decrease was in the order of 55 to 70%. On the other hand, simulated distillation results, according to ASTM 7169, revealed significant conversions of the 315°C+ fraction. From the spectroscopic techniques of nuclear magnetic resonance NMR, infrared FTIR and UV-VIS visible ultraviolet, it was determined that the increase in the performance of the light fractions in the improved crude is due to the breakdown of alkyl chains. The methodology for cyclic steam injection with naphtha and laboratory-scale characterization can be considered as a practical tool in improved recovery processes.

Keywords: viscosity reduction, cyclic steam stimulation, factorial design, naphtha

Procedia PDF Downloads 153

Authors: K. Tomolya, D. Janovszky, A. Sycheva, M. Sveda, A. Roosz

Abstract:

CuZrAl amorphous alloys have attracted high interest due to unique physical and mechanical properties, which can be enhanced by adding of Ni and Ti elements. It is known that this properties can be enhanced by crystallization of amorphous alloys creating nanocrystallines in the matrix. The present work intends to produce nanosized crystalline parti-cle reinforced amorphous matrix composite powders by crystallization of amorphous powders. As the first step the amorphous powders were synthe-tized by ball-milling of crystalline powders. (Cu49Zr45Al6) 80Ni10Ti10 and (Cu49Zr44Al7) 80Ni10Ti10 (at%) alloys were ball-milled for 12 hours in order to reach the fully amorphous structure. The impact en-ergy of the balls during milling causes the change of the structure in the powders. Scanning electron microscopical (SEM) images shows that the phases mixed first and then changed into a fully amorphous matrix. Furthermore, nanosized particles in the amorphous matrix were crystallized by heat treatment of the amorphous powders that was confirmed by TEM measurement. It was of importance to define the tem-perature when the amorphous phase starts to crystal-lize. Amorphous alloys have a special heating curve and characteristic temperatures, which can be meas-ured by differential scanning calorimetry (DSC). A typical DSC curve of an amorphous alloy exhibits an endothermic event characteristic of the equilibrium glass transition (Tg) and a distinct undercooled liquid region, followed by one or two exothermic events corresponding to crystallization processes (Tp). After measuring the DSC traces of the amorphous powders, the annealing temperatures should be determined between Tx and Tp. In our experiments several temperatures from the annealing temperature range were selected and de-pendency of crystallized nanoparticles fraction on their hardness was investigated.

Keywords: amorphous structure, composite, mechanical milling, powder, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), transmission electronmocroscopy (TEM)

Procedia PDF Downloads 430

Authors: B. Kenny

Abstract:

The complications associated with transfusions are well documented, with the serious hazards of transfusion (SHOT) reporting system continuing to report deaths and serious morbidity due to the transfusion of allogenic blood. Many different sources including the TRICC trial, NHMRC and Cochrane recommending similar transfusion triggers/guidelines. Recent studies found the rate of infection (deep infection, wound infection, chest infection, urinary tract infection, and others) were purely a dose response relationship, increasing the Relative Risk by 3.44. It was also noted that each transfused patient stayed in hospital for one additional day. We hypothesise that providing an approved/standardised, guideline with a graphical summary of decision pathways for anaemic patients will reduce unnecessary transfusions. We retrospectively assessed patients undergoing primary knee or hip arthroplasties over a 4 year period, 1459 patients. Of these, 339 (23.24%) patients received allogenic blood transfusions and 858 units of blood were transfused, 9.14% of patients transfused had haemoglobin levels above 100 g/L, 7.67% of patients were transfused without knowing the haemoglobin level, 24 hours prior to transfusion initiation and 4.5% had possible transfusion reactions. Overall, 17% of allogenic transfusions topatients admitted to the Orthopaedic department within a 4 year period were outside NHMRC and Cochrane guidelines/recommendations. If our transfusion frequency is compared with that of other authors/hospitals, transfusion rates are consistently being high. We subsequently implemented a simple guideline for transfusion initiation. This guideline was then assessed. We found the transfusion rate post transfusion implementation to be significantly lower, without increase in patient morbidity or mortalitiy, p <0.001). Transfusion rates and patient outcome can be optimized by a simple graphical aid for decision making.

Keywords: transfusion, morbidity, mortality, neck of femur, fracture, arthroplasty, rehabilitation

Procedia PDF Downloads 227

Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

Abstract:

Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

Procedia PDF Downloads 73