Search results for: rapid diet assessment
7166 Physicochemical and Biochemical Characterization of Olea europea Var. Oleaster Oil and Determination of Its Effects on Blood Parameters
Authors: Asma Gherib, Imen Merzougui, Cherifa Henchiri
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This present study has allowed to evaluate the physico chemical characteristics, fatty acid composition and the hypolipidemic effect of Oleaster oil Olea europea var. Oleaster, from the area of El Kala, "Eastern Algeria" on rats "Wistar albinos". The physico chemical characteristics: acidity (0,73%), peroxide value (14, 16 meqO2/kg oil) and iodine value (74,08 g iodine/100 g of oil) are consistent with international standards. The dosage of FA revealed a wealth of oil with UFA (76,7%), mainly composed of 65.43% of MUFA whose major fatty acid is oleic acid (63,57%). The experiment on rats receiving a diet rich in saturated fats and hydrogenated oils revealed that the consumption of Oleaster oil at the dose of 10 g and 20 g for 15 and 30 days improves plasma lipid profile by decreasing the rates of TC, TG, TL, and LDL-C with an increase in the rate of HDL-C serum. The importance of these effects depends on the dose and period of treatment.Keywords: oleaster oil, fatty acid, Olea europea, oleic acid, lipid profile
Procedia PDF Downloads 4887165 Clinical Audit of Selected Nephrology Nursing Procedures Performed in Nephrology Unit of AIIMS with a View to Develop Nephrology Nursing Procedure Protocol
Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma
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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis
Procedia PDF Downloads 1027164 The Analysis of Expenses for Research and Development Activities in Turkey
Authors: Gökhan Karhan, Yavuz Elitok
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Nowadays, inequality between developing and underdeveloped countries has a rapid increment. Developed countries impress the underdeveloped countries to become dependent through them. For that reason, Turkey has to increase its capability of making technological innovations. It has tried to be identified by examining the expenses of R&D in public, mercantile establishments and universities in Turkey that which expense is not enough and which expense should be doubled. As a result, developing new resolution strategies will be easier.Keywords: competitive strength, research and development, technological innovation, Turkey
Procedia PDF Downloads 3647163 Analysis of Subjective Indicators of Quality of Life in Makurdi
Authors: Irene Doosuur Mngutyo
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The preliminary stages in the development of human communities are the formation of a correct understanding of people’s needs. However, perception of human needs is highly subjective and difficult to aggregate. Quality of life measurements are an appropriate means for achieving an understanding of Human needs. Hence this study endeavors to measure quality of life in Makurdi using subjective indices to measure three aspects of subjective wellbeing. A sample of 400 respondents achieved by applying the Taro Yamane formula to Makurdi’s projected population. Questionnaires were randomly distributed to residents of nine wards in Makurdi. Findings from a pilot study( N=100) demonstrated that among the 2 aspects of overall quality of life investigated,22% had a mean low overall assessment of quality of life now being3on the scale and an even poorer assessment for projected quality in the next five years by 17%(3)although an equal percentage are hopeful for a better life(10)in the next five years.60% of the respondents record very rare positive feelings while only 10% have positive feelings always on the eudaimonic scale69%strongly agree that they have a purposeful and meaningful life. Findings indicate good social ties as a strong indicator for perceived good feelings and even though quality of life is perceived as low there is optimism for the future.Keywords: quality of life, subjective indicators, development, urban planning
Procedia PDF Downloads 4007162 Pakistan’s Taxation System: A Critical Appraisal
Authors: Khalid Javed, Rashid Mahmood
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The constitution empowers the Federal Government to collect taxes on income other than agricultural income, taxes on capital value, customs, excise duties and sales taxes. The Central Board of Revenue (CBR) and its subordinate departments administer the tax system. Each of the three principal taxes has a different history and different set of issues. For a large number of income tax payers the core of the business process is pre-audit and assessment by a tax official. This process gives considerable discretion to tax officials, with potential for abuse. Moreover, this process is also not tenable as the number of taxpayers increase. The report is focused on a total overhaul of the process and organization of income tax. Sales tax is recent and its process and organization is adjusted to the needs of an expanding tax base. These are based on self-assessment and selective audit. Similarly, in customs the accent is on accelerating and broadening the changes begun in recent years. Before long, central excise will be subsumed in sales tax. During the nineties, despite many changes in the tax regime and introduction of withholding and presumptive taxes, Federal Government tax to GDP ratio has varied narrowly around eleven percent. The tax base has grown but still remains narrow and skewed. The number of income tax filers is around one million.Keywords: central board of revenue, GDP, sale tax, income tax
Procedia PDF Downloads 4427161 Time, Uncertainty, and Technological Innovation
Authors: Xavier Everaert
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Ever since the publication of “The Problem of Social” cost, Coasean insights on externalities, transaction costs, and the reciprocal nature of harms, have been widely debated. What has been largely neglected however, is the role of technological innovation in the mitigation of negative externalities or transaction costs. Incorporating future uncertainty about negligence standards or expected restitution costs and the profit opportunities these uncertainties reveal to entrepreneurs, allow us to frame problems regarding social costs within the reality of rapid technological evolution.Keywords: environmental law and economics, entrepreneurship, commons, pollution, wildlife
Procedia PDF Downloads 4217160 Data Quality on Regular Immunization Programme at Birkod District: Somali Region, Ethiopia
Authors: Eyob Seife, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew, Yohans Demis
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Developing countries continue to face preventable communicable diseases, such as vaccine-preventable diseases. The Expanded Programme on Immunization (EPI) was established by the World Health Organization in 1974 to control these diseases. Health data use is crucial in decision-making, but ensuring data quality remains challenging. The study aimed to assess the accuracy ratio, timeliness, and quality index of regular immunization programme data in the Birkod district of the Somali Region, Ethiopia. For poor data quality, technical, contextual, behavioral, and organizational factors are among contributors. The study used a quantitative cross-sectional design conducted in September 2022GC using WHO-recommended data quality self-assessment tools. The accuracy ratio and timeliness of reports on regular immunization programmes were assessed for two health centers and three health posts in the district for one fiscal year. Moreover, the quality index assessment was conducted at the district level and health facilities by trained assessors. The study found poor data quality in the accuracy ratio and timeliness of reports at all health units, which includes zeros. Overreporting was observed for most facilities, particularly at the health post level. Health centers showed a relatively better accuracy ratio than health posts. The quality index assessment revealed poor quality at all levels. The study recommends that responsible bodies at different levels improve data quality using various approaches, such as the capacitation of health professionals and strengthening the quality index components. The study highlighted the need for attention to data quality in general, specifically at the health post level, and improving the quality index at all levels, which is essential.Keywords: Birkod District, data quality, quality index, regular immunization programme, Somali Region-Ethiopia
Procedia PDF Downloads 907159 Shear Reinforcement of Stone Columns During Soil Liquefaction
Authors: Zeineb Ben Salem, Wissem Frikha, Mounir Bouassida
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The aim of this paper is to assess the effectiveness of stone columns as a liquefaction countermeasure focusing on shear reinforcementbenefit. In fact, stone columns which have high shear modulus relative to the surrounding soils potentially can carry higher shear stress levels. Thus, stone columns provide shear reinforcement and decrease the Cyclic Shear Stress Ratio CSR to which the treated soils would be subjected during an earthquake. In order to quantify the level of shear stress reduction in reinforced soil, several approaches have been developed. Nevertheless, the available approaches do not take into account the improvement of the soil parameters, mainly the shear modulusdue to stone columns installation. Indeed, in situ control tests carried out before and after the installation of stone columns based upon the results of collected data derived from 24 case histories have given evidence of the improvement of the existing soil properties.In this paper, the assessment of shear reinforcement of stone columns that accounts such improvement of the soil parameters due to stone column installation is investigated. Comparative results indicate that considering the improvement effects considerably affect the assessment of shear reinforcement for liquefaction analysis of reinforced soil by stone columns.Keywords: stone column, liquefaction, shear reinforcement, CSR, soil improvement
Procedia PDF Downloads 1537158 Desing of PSS and SVC to Improve Power System Stability
Authors: Mahmoud Samkan
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In this paper, the design and assessment of new coordination between Power System Stabilizers (PSSs) and Static Var Compensator (SVC) in a multimachine power system via statistical method are proposed. The coordinated design problem of PSSs and SVC over a wide range of loading conditions is handled as an optimization problem. The Bacterial Swarming Optimization (BSO), which synergistically couples the Bacterial Foraging (BF) with the Particle Swarm Optimization (PSO), is employed to seek for optimal controllers parameters. By minimizing the proposed objective function, in which the speed deviations between generators are involved; stability performance of the system is enhanced. To compare the capability of PSS and SVC, both are designed independently, and then in a coordinated manner. Simultaneous tuning of the BSO based coordinated controller gives robust damping performance over wide range of operating conditions and large disturbance in compare to optimized PSS controller based on BSO (BSOPSS) and optimized SVC controller based on BSO (BSOSVC). Moreover, a statistical T test is executed to validate the robustness of coordinated controller versus uncoordinated one.Keywords: SVC, PSSs, multimachine power system, coordinated design, bacteria swarm optimization, statistical assessment
Procedia PDF Downloads 3767157 HPSEC Application as a New Indicator of Nitrification Occurrence in Water Distribution Systems
Authors: Sina Moradi, Sanly Liu, Christopher W. K. Chow, John Van Leeuwen, David Cook, Mary Drikas, Soha Habibi, Rose Amal
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In recent years, chloramine has been widely used for both primary and secondary disinfection. However, a major concern with the use of chloramine as a secondary disinfectant is the decay of chloramine and nitrification occurrence. The management of chloramine decay and the prevention of nitrification are critical for water utilities managing chloraminated drinking water distribution systems. The detection and monitoring of nitrification episodes is usually carried out through measuring certain water quality parameters, which are commonly referred to as indicators of nitrification. The approach taken in this study was to collect water samples from different sites throughout a drinking water distribution systems, Tailem Bend – Keith (TBK) in South Australia, and analyse the samples by high performance size exclusion chromatography (HPSEC). We investigated potential association between the water qualities from HPSEC analysis with chloramine decay and/or nitrification occurrence. MATLAB 8.4 was used for data processing of HPSEC data and chloramine decay. An increase in the absorbance signal of HPSEC profiles at λ=230 nm between apparent molecular weights of 200 to 1000 Da was observed at sampling sites that experienced rapid chloramine decay and nitrification while its absorbance signal of HPSEC profiles at λ=254 nm decreased. An increase in absorbance at λ=230 nm and AMW < 500 Da was detected for Raukkan CT (R.C.T), a location that experienced nitrification and had significantly lower chloramine residual (<0.1 mg/L). This increase in absorbance was not detected in other sites that did not experience nitrification. Moreover, the UV absorbance at 254 nm of the HPSEC spectra was lower at R.C.T. than other sites. In this study, a chloramine residual index (C.R.I) was introduced as a new indicator of chloramine decay and nitrification occurrence, and is defined based on the ratio of area underneath the HPSEC spectra at two different wavelengths of 230 and 254 nm. The C.R.I index is able to indicate DS sites that experienced nitrification and rapid chloramine loss. This index could be useful for water treatment and distribution system managers to know if nitrification is occurring at a specific location in water distribution systems.Keywords: nitrification, HPSEC, chloramine decay, chloramine residual index
Procedia PDF Downloads 2987156 D-Care: Diabetes Care Application to Enhance Diabetic Awareness to Diabetes in Indonesia
Authors: Samara R. Dania, Maulana S. Aji, Dewi Lestari
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Diabetes is a common disease in Indonesia. One of the risk factors of diabetes is an unhealthy diet which is consuming food that contains too much glucose, one of glucose sources presents in food containing carbohydrate. The purpose of this study is to identify the amount of glucose level in the consumed food. The authors use literature studies for this research method. For the results of this study, the authors expect diabetics to be more aware of diabetes by applying daily dietary regulation through D-Care. D-Care is an application that can enhance people awareness to diabetes in Indonesia. D-Care provides two menus; there are nutrition calculation and healthy food. Nutrition calculation menu is used for knowing estimated glucose intake level by calculating food that consumed each day. Whereas healthy food menu, it provides a combination of healthy food menu for diabetic. The conclusion is D-Care is useful to be used for reducing diabetes prevalence in Indonesia.Keywords: D-Care, diabetes, awareness, healthy food
Procedia PDF Downloads 4197155 Optimization of Traffic Agent Allocation for Minimizing Bus Rapid Transit Cost on Simplified Jakarta Network
Authors: Gloria Patricia Manurung
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Jakarta Bus Rapid Transit (BRT) system which was established in 2009 to reduce private vehicle usage and ease the rush hour gridlock throughout the Jakarta Greater area, has failed to achieve its purpose. With gradually increasing the number of private vehicles ownership and reduced road space by the BRT lane construction, private vehicle users intuitively invade the exclusive lane of BRT, creating local traffic along the BRT network. Invaded BRT lanes costs become the same with the road network, making BRT which is supposed to be the main public transportation in the city becoming unreliable. Efforts to guard critical lanes with preventing the invasion by allocating traffic agents at several intersections have been expended, lead to the improving congestion level along the lane. Given a set of number of traffic agents, this study uses an analytical approach to finding the best deployment strategy of traffic agent on a simplified Jakarta road network in minimizing the BRT link cost which is expected to lead to the improvement of BRT system time reliability. User-equilibrium model of traffic assignment is used to reproduce the origin-destination demand flow on the network and the optimum solution conventionally can be obtained with brute force algorithm. This method’s main constraint is that traffic assignment simulation time escalates exponentially with the increase of set of agent’s number and network size. Our proposed metaheuristic and heuristic algorithms perform linear simulation time increase and result in minimized BRT cost approaching to brute force algorithm optimization. Further analysis of the overall network link cost should be performed to see the impact of traffic agent deployment to the network system.Keywords: traffic assignment, user equilibrium, greedy algorithm, optimization
Procedia PDF Downloads 2297154 Parent’s Expectations and School Achievement: Longitudinal Perspective among Chilean Pupils
Authors: Marine Hascoet, Valentina Giaconi, Ludivine Jamain
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The aim of our study is to examine if the family socio-economic status (SES) has an influence on students’ academic achievement. We first make the hypothesis that the more their families have financial and social resources, the more students succeed at school. We second make the hypothesis that this family SES has also an impact on parents’ expectations about their children educational outcomes. Moreover, we want to study if that parents’ expectations play the role of mediator between parents’ socio-economic status and the student’ self-concept and academic outcome. We test this model with a longitudinal design thanks to the census-based assessment from the System of Measurement of the Quality of Education (SIMCE). The SIMCE tests aim to assess all the students attending to regular education in a defined level. The sample used in this study came from the SIMCE assessments done three times: in 4th, 8th and 11th grade during the years 2007, 2011 and 2014 respectively. It includes 156.619 students (75.084 boys and 81.535 girls) that had valid responses for the three years. The family socio-economic status was measured at the first assessment (in 4th grade). The parents’ educational expectations and the students’ self-concept were measured at the second assessment (in 8th grade). The achievement score was measured twice; once when children were in 4th grade and a second time when they were in 11th grade. To test our hypothesis, we have defined a structural equation model. We found that our model fit well the data (CFI = 0.96, TLI = 0.95, RMSEA = 0.05, SRMR = 0.05). Both family SES and prior achievements predict parents’ educational expectations and effect of SES is important in comparison to the other coefficients. These expectations predict students’ achievement three years later (with prior achievement controlled) but not their self-concept. Our model explains 51.9% of the achievement in the 11th grade. Our results confirm the importance of the parents’ expectations and the significant role of socio-economic status in students’ academic achievement in Chile.Keywords: Chilean context, parent’s expectations, school achievement, self-concept, socio-economic status
Procedia PDF Downloads 1417153 Evaluation of Different Inoculation Methods of Entomopathogenic Fungi on Their Endophytism and Pathogenicity against Chilo partellus (Swinhoe)
Authors: Mubashar Iqbal, Iqra Anjum, Muhammad Dildar Gogi, Muhammad Jalal Arif
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The present study was carried to screen out the effective entomopathogenic fungi (EPF) inoculation method in maize and to evaluate pathogenicity and oviposition-choice in C. partellus. Three entomopathogenic fungi (EPF) formulations Pacer® (Metarhizium anisopliae), Racer® (Beauveria bassiana) and Meailkil® (Verticillium lecanii) were evaluated at three concentrations (5000, 10000 and 20000 ppm) for their endophytism in maize and pathogenicity in C. partellus. The stock solution of the highest concentration (20,000 ppm) was prepared and next lower from stock solution. In the first experiment, three EPF was inoculated in maize plant by four methods, i.e., leaf-inoculation (LI), whorl-inoculation (WI), shoot-inoculation (SI) and root-inoculation (RI). Leaf-discs and stem-cutting were sampled in all four inoculation methods and placed on fungus growth media in Petri dishes. In the second experiment, pathogenicity, pupal formation, adult emergence, sex ratio, oviposition-choice, and growth index of C. partellus were calculated. The leaves and stem of the inoculated plants were given to the counted number of larvae of C. Partellus. The mortality of larvae was recorded on daily basis till the pupation. The result shows that maximum percent mortality (86.67%) was recorded at high concentration (20000ppm) of Beauveria bassiana by leaf inoculation method. For oviposition choice bioassay, the newly emerged adults were fed on diet (water, honey and yeast in 9:1:1) for 48 hours. One pair of C. Partellus were aspirated from the rearing cages and were detained in large test tube plugged with diet soaked cotton. A set of four plants for each treatment were prepared and randomized inside the large oviposition chamber. The test tubes were opened and fitted in the hole made in the wall of oviposition chamber in front of each treatment. The oviposition chamber was placed in a completely dark laboratory to eliminate the effect of light on moth’s behavior. The plants were removed from the oviposition chamber after the death of adults. The number of eggs deposited on the plant was counted. The results of 2nd experiment revealed that in all EPF and inoculation methods, the fecundity, egg fertility and growth index of C. partellus decreased with the increase in concentration being significantly higher at low concentration (5000ppm) and lower at higher concentration (20000ppm). Application of B. bassiana demonstrated that minimum fecundity (126.83), egg fertility (119.52) and growth index (15%) in C. partellus followed by M. anisopliae with fecundity (135.93), egg fertility (132.29) and growth index (17.50%) while V. lecanii show higher values of fecundity (137.37), egg fertility (1135.42) and growth index (20%). Overall leaf inoculation method showed least fecundity (123.89) with egg fertility (115.36) and growth index (14%) followed by whorl, shoot inoculation method and root inoculation method show higher values of fecundity, egg fertility and growth index.Keywords: Beauveria bassiana, Chilo partellus, entomopathoganic, Metarhizium anisopliae, Verticillium lecanii
Procedia PDF Downloads 1387152 Effect of Dietary Inclusion of Moringa oleifera Leaf Meal on Blood Biochemical Changes and Lipid Profile of Vanaraja Chicken in Tropics
Authors: Kaushalendra Kumar, Abhishek Kumar, Chandra Moni, Sanjay Kumar, P. K. Singh, Ajeet Kumar
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Present study investigated the dietary inclusion of Moringa oleifera leaf meal (MOLM) on production efficiency, hemato-biochemical profile and economy of Vanaraja birds under tropical condition. Experiment was conducted for a period of 56 days on 300 Vanaraja birds randomly divided in to five different experimental groups including control of 60 birds each group replicated with 20 chicks in each replicate. T1, T2, T3, T4, and T5 were offered with 0, 5, 10, 15, and 20% Moringa oleifera leaf meal along with basal ration. All the standard managemental practices were followed during experimental period including vaccination schedule. Locally available Moringa oleifera leaves were harvested at mature stage and allowed to dry under shady and aerated conditions. Thereafter, dried leaves were milled to make a leaf meal and stored in the airtight nylon bags to avoid any possible contamination from foreign material and use for experiment. Production parameters were calculated based on the amount of feed consumed and weight gain every weeks. The body weight gain of T2 group was significantly (P < 0.05) higher side whereas T3 group was comparable with control. The feed conversion ratio for T2 group was found to be significantly (P < 0.05) lower than all other treatment groups, while none of the group was comparable with each other. At the end of the experiment blood samples were collected from birds for haematology study while serum biochemistry performed using spectrophotometer following statndard protocols. The haematological attributes were significantly (P > 0.05) not differed among the groups. However, serum biochemistry showed significant reduction (P < 0.05) of blood urea nitrogen, uric acid and creatinine level with higher level of MOLM diet, indicates better utilization of protein supplemented through MOLM. The total cholesterol and triglyceride level was declined significantly (P < 0.05) as compare to control group with increased level of MOLM in basal diet, decreasing trend of serum cholesterol noted. However, value of HDL for T3 group was highest and for T1 group was lowest but no significant difference (P < 0.05) found among the groups. It might be due to presence of β-sitosterol a bioactive compound present in MOLM which causes lowering of plasma concentration of LDL. During experiment total, LDL and VLDL level was found to be decreased significantly (P < 0.05) as compare to control group. It was observed that the production efficiency of birds significantly improved with 5% followed by 10% Moringa oleifera leaf meal among the treatment groups. However, the maximum profit per kg live weight was noted in 10 % level and least profit observed in 20% MOLM fed group. It was concluded that the dietary inclusion of MOLM improved overall performances without affecting metabolic status and effective in reducing cholesterol level reflects healthy chicken production for human consumption.Keywords: hemato biochemistry, Moringa oleifera leaf meal, performance, Vanaraja birds
Procedia PDF Downloads 2077151 Effect of Supplementation with Fresh Citrus Pulp on Growth Performance, Slaughter Traits and Mortality in Guinea Pigs
Authors: Carlos Minguez, Christian F. Sagbay, Erika E. Ordoñez
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Guinea pigs (Cavia porcellus) play prominent roles as experimental models for medical research and as pets. However, in developing countries like South America, the Philippines, and sub-Saharan Africa, the meat of guinea pigs is an economic source of animal protein for the poor and malnourished humans because guinea pigs are mainly fed with forage and do not compete directly with human beings for food resources, such as corn or wheat. To achieve efficient production of guinea pigs, it is essential to provide insurance against vitamin C deficiency. The objective of this research was to investigate the effect of the partial replacement of alfalfa with fresh citrus pulp (Citrus sinensis) in a diet of guinea pigs on the growth performance, slaughter traits and mortality during the fattening period (between 20 and 74 days of age). A total of 300 guinea pigs were housed in collective cages of about ten animals (2 x 1 x 0.4 m) and were distributed into two completely randomized groups. Guinea pigs in both groups were fed ad libitum, with a standard commercial pellet diet (10 MJ of digestible energy/kg, 17% crude protein, 11% crude fiber, and 4.5% crude fat). Control group was supplied with fresh alfalfa as forage. In the treatment group, 30% of alfalfa was replaced by fresh citrus pulp. Growth traits, including body weight (BW), average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR), were measured weekly. On day 74, the animals were slaughtered, and slaughter traits, including live weight at slaughter (LWS), full gastrointestinal tract weight (FGTW), hot carcass weight (with head; HCW), cold carcass weight (with head; CCW), drip loss percentage (DLP) and dressing out carcass yield percentage (DCY), were evaluated. Contrasts between groups were obtained by calculated generalized least squares values. Mortality was evaluated by Fisher's exact test due to low numbers in some cells. In the first week, there were significant differences in the growth traits BW, ADG, FI, and FCR, which were superior in control group. These differences may have been due to the origin of the young guinea pigs, which, before weaning, were all raised without fresh citrus pulp, and they were not familiarized with the new supplement. In the second week, treatment group had significantly increased ADG compared with control group, which may have been the result of a process of compensatory growth. During subsequent weeks, no significant differences were observed between animals raised in the two groups. Neither were any significant differences observed across the total fattening period. No significant differences in slaughter traits or mortality rate were observed between animals from the two groups. In conclusion, although there were no significant differences in growth performance, slaughter traits, or mortality, the use of fresh citrus pulp is recommended. Fresh citrus pulp is a by-product of orange juice industry and it is cheap or free. Forage made with fresh citrus pulp could reduce about of 30 % the quantity of alfalfa in guinea pig for meat and as consequence, reduce the production costs.Keywords: fresh citrus, growth, Guinea pig, mortality
Procedia PDF Downloads 1927150 Enhancing Cognitive and Emotional Well-Being in an 85-Year-Old American-Dominican Veteran through Neuropsychological Intervention and Cognitive Stimulation
Authors: Natividad Natalia Angeles Manuel
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In the Dominican Republic, American-Dominican veterans face unique challenges due to their dual identities and wartime experiences. This case study examines an 85-year-old veteran with memory impairments and emotional distress linked to military service. A neuropsychological assessment using standardized tools evaluated cognitive domains and functional abilities. Significant deficits in memory, orientation, semantic memory, and executive functions, alongside symptoms of Post-Traumatic Stress Disorder and depression, were identified. A six-month cognitive stimulation program included tailored interventions to enhance memory, attention, and executive skills through weekly sessions and group activities. Medical and physical therapy support aimed to improve overall cognitive, functional, and emotional outcomes. Follow-up evaluations showed improvements in memory retention, attention, task proficiency, and reduced depressive symptoms, highlighting the program's effectiveness in promoting emotional well-being and quality of life. Despite ongoing memory challenges and military-related nightmares, the veteran responded positively to interventions, demonstrating resilience and motivation. This study emphasizes the importance of personalized neuropsychological interventions for American-Dominican veterans in the Dominican Republic. Through assessment tools and focused cognitive stimulation strategies, healthcare providers can successfully alleviate cognitive and emotional challenges stemming from traumatic experiences in elderly veterans. Overall, integrated neuropsychological assessment and stimulation programs are shown to enhance cognitive resilience and emotional well-being, thus contributing to an enhanced quality of life for aging American-Dominican veterans.Keywords: neuropsychology, cognitive stimulation, American-Dominican veterans, Dominican Republic, PTSD, memory deficits
Procedia PDF Downloads 357149 Geospatial Techniques for Impact Assessment of Canal Rehabilitation Program in Sindh, Pakistan
Authors: Sumaira Zafar, Arjumand Zaidi, Muhammad Arslan Hafeez
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Indus Basin Irrigation System (IBIS) is the largest contiguous irrigation system of the world comprising Indus River and its tributaries, canals, distributaries, and watercourses. A big challenge faced by IBIS is transmission losses through seepage and leaks that account to 41 percent of the total water derived from the river and about 40 percent of that is through watercourses. Irrigation system rehabilitation programs in Pakistan are focused on improvement of canal system at the watercourse level (tertiary channels). Under these irrigation system management programs more than 22,800 watercourses have been improved or lined out of 43,000 (12,900 Kilometers) watercourses. The evaluation of the improvement work is required at this stage to testify the success of the programs. In this paper, emerging technologies of GIS and satellite remote sensing are used for impact assessment of watercourse rehabilitation work in Sindh. To evaluate the efficiency of the improved watercourses, few parameters are selected like soil moisture along watercourses, availability of water at tail end and changes in cultivable command areas. Improved watercourses details and maps are acquired from National Program for Improvement of Watercourses (NPIW) and Space and Upper Atmospheric Research Commission (SUPARCO). High resolution satellite images of Google Earth for the year of 2004 to 2013 are used for digitizing command areas. Temporal maps of cultivable command areas show a noticeable increase in the cultivable land served by improved watercourses. Field visits are conducted to validate the results. Interviews with farmers and landowners also reveal their overall satisfaction in terms of availability of water at the tail end and increased crop production.Keywords: geospatial, impact assessment, watercourses, GIS, remote sensing, seepage, canal lining
Procedia PDF Downloads 3517148 Assessment of Teacher Qualification Status of University Teachers in North West Nigeria; Bayero University Kano in Perspective
Authors: Collins Augustine Ekpiwre
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Both the National Policy on Education (NPE) and the Teachers’ Registration Council of Nigeria (TRCN) gave the directive that all teachers in Nigerian schools should be trained teachers to enable them to be more effective in their teaching responsibilities. This applies to university teachers as well; they are required to acquire teacher qualifications such as Post Graduate Diploma in Education (PGDE) or Professional Diploma in Education (PDE) or Technical Teachers Certificate (TTC) or at least, National Certificate of Education (NCE) in addition to possessing academic qualifications in their specialized areas of study. It is on this ground that this study carried out an assessment of university teachers’ qualification status in Bayero University, Kano. The population of the study comprised all the teachers in the university. Data was collected through an examination of the documented official records of the qualification profile of all the teachers in the university obtained from its various faculties. The collected data was analyzed through descriptive statistic of simple percentage and frequency. Based on the findings of the study and in order to strengthen the teacher qualification status of teachers in the university, a few recommendations, for example, special salary scale should be made available to university teachers with appropriate teacher qualifications, were offered.Keywords: Teacher, university teacher, teacher qualification, university education
Procedia PDF Downloads 4297147 Genetic Instabilities in Marine Bivalve Following Benzo(α)pyrene Exposure: Utilization of Combined Random Amplified Polymorphic DNA and Comet Assay
Authors: Mengjie Qu, Yi Wang, Jiawei Ding, Siyu Chen, Yanan Di
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Marine ecosystem is facing intensified multiple stresses caused by environmental contaminants from human activities. Xenobiotics, such as benzo(α)pyrene (BaP) have been discharged into marine environment and cause hazardous impacts on both marine organisms and human beings. As a filter-feeder, marine mussels, Mytilus spp., has been extensively used to monitor the marine environment. However, their genomic alterations induced by such xenobiotics are still kept unknown. In the present study, gills, as the first defense barrier in mussels, were selected to evaluate the genetic instability alterations induced by the exposure to BaP both in vivo and in vitro. Both random amplified polymorphic DNA (RAPD) assay and comet assay were applied as the rapid tools to assess the environmental stresses due to their low money- and time-consumption. All mussels were identified to be the single species of Mytilus coruscus before used in BaP exposure at the concentration of 56 μg/l for 1 & 3 days (in vivo exposure) or 1 & 3 hours (in vitro). Both RAPD and comet assay results were showed significantly increased genomic instability with time-specific altering pattern. After the recovery period in 'in vivo' exposure, the genomic status was as same as control condition. However, the relative higher genomic instabilities were still observed in gill cells after the recovery from in vitro exposure condition. Different repair mechanisms or signaling pathway might be involved in the isolated gill cells in the comparison with intact tissues. The study provides the robust and rapid techniques to exam the genomic stability in marine organisms in response to marine environmental changes and provide basic information for further mechanism research in stress responses in marine organisms.Keywords: genotoxic impacts, in vivo/vitro exposure, marine mussels, RAPD and comet assay
Procedia PDF Downloads 2797146 Long-Term Exposure, Health Risk, and Loss of Quality-Adjusted Life Expectancy Assessments for Vinyl Chloride Monomer Workers
Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai
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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer
Procedia PDF Downloads 1957145 Application of Mathematical Models for Conducting Long-Term Metal Fume Exposure Assessments for Workers in a Shipbuilding Factory
Authors: Shu-Yu Chung, Ying-Fang Wang, Shih-Min Wang
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To conduct long-term exposure assessments are important for workers exposed to chemicals with chronic effects. However, it usually encounters with several constrains, including cost, workers' willingness, and interference to work practice, etc., leading to inadequate long-term exposure data in the real world. In this study, an integrated approach was developed for conducting long-term exposure assessment for welding workers in a shipbuilding factory. A laboratory study was conducted to yield the fume generation rates under various operating conditions. The results and the measured environmental conditions were applied to the near field/far field (NF/FF) model for predicting long term fume exposures via the Monte Carlo simulation. Then, the predicted long-term concentrations were used to determine the prior distribution in Bayesian decision analysis (BDA). Finally, the resultant posterior distributions were used to assess the long-term exposure and serve as basis for initiating control strategies for shipbuilding workers. Results show that the NF/FF model was a suitable for predicting the exposures of metal contents containing in welding fume. The resultant posterior distributions could effectively assess the long-term exposures of shipbuilding welders. Welders' long-term Fe, Mn and Pb exposures were found with high possibilities to exceed the action level indicating preventive measures should be taken for reducing welders' exposures immediately. Though the resultant posterior distribution can only be regarded as the best solution based on the currently available predicting and monitoring data, the proposed integrated approach can be regarded as a possible solution for conducting long term exposure assessment in the field.Keywords: Bayesian decision analysis, exposure assessment, near field and far field model, shipbuilding industry, welding fume
Procedia PDF Downloads 1407144 Evaluation of Health Risk Degree Arising from Heavy Metals Present in Drinking Water
Authors: Alma Shehu, Majlinda Vasjari, Sonila Duka, Loreta Vallja, Nevila Broli
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Humans consume drinking water from several sources, including tap water, bottled water, natural springs, filtered tap water, etc. The quality of drinking water is crucial for human survival given the fact that the consumption of contaminated drinking water is related to many diseases and deaths all over the world. This study represents the investigation of the quality and health risks of different types of drinking waters being consumed by the population in Albania, arising from heavy metals content. Investigated water included industrialized water, tap water, and spring water. In total, 20 samples were analyzed for the content of Pb, Cd, Cr, Ni, Cu, Fe, Zn, Al, and Mn. Determination of each metal concentration in selected samples was conducted by atomic absorption spectroscopy method with electrothermal atomization, GFAAS. Water quality was evaluated by comparing the obtained metals concentrations with the recommended maximum limits, according to the European Directive (98/83/EC) and Guidelines for Drinking Water Quality (WHO, 2017). Metal Index (MI) was used to assess the overall water quality due to heavy metals content. Health risk assessment was conducted based on the recommendations of the USEPA (1996), human health risk assessment, via ingestion. Results of this investigation showed that Al, Ni, Fe, and Cu were the metals found in higher concentrations while Cd exhibited the lowest concentration. Among the analyzed metals, Al (one sample) and Ni (in five samples) exceeded the maximum allowed limit. Based on the pollution metal index, it was concluded that the overall quality of Glina bottled water can be considered as toxic to humans, while the quality of bottled water (Trebeshina) was classified as moderately toxic. Values of health risk quotient (HQ) varied between 1x10⁻⁶-1.3x10⁻¹, following the order Ni > Cd > Pb > Cu > Al > Fe > Zn > Mn. All the values were lower than 1, which suggests that the analyzed samples exhibit no health risk for humans.Keywords: drinking water, health risk assessment, heavy metals, pollution index
Procedia PDF Downloads 1307143 Assessment of Energy Consumption in Cluster Redevelopment: A Case Study of Bhendi Bazar in Mumbai
Authors: Insiya Kapasi, Roshni Udyavar Yehuda
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Cluster Redevelopment is a new concept in the city of Mumbai. Its regulations were laid down by the government in 2009. The concept of cluster redevelopment encompasses a group of buildings defined by a boundary as specified by the municipal authority (in this case, Mumbai), which may be dilapidated or approved for redevelopment. The study analyses the effect of cluster redevelopment in the form of renewal of old group of buildings as compared to refurbishment or restoration - on energy consumption. The methodology includes methods of assessment to determine increase or decrease in energy consumption in cluster redevelopment based on different criteria such as carpet area of the units, building envelope and its architectural elements. Results show that as the area and number of units increase the Energy consumption increases and the EPI (energy performance index) decreases as compared to the base case. The energy consumption per unit area declines by 29% in the proposed cluster redevelopment as compared to the original settlement. It is recommended that although the development is spacious and provides more light and ventilation, aspects such as glass type, traditional architectural features and consumer behavior are critical in the reduction of energy consumption.Keywords: Cluster Redevelopment, Energy Consumption, Energy Efficiency, Typologies
Procedia PDF Downloads 1527142 A Single-Use Endoscopy System for Identification of Abnormalities in the Distal Oesophagus of Individuals with Chronic Reflux
Authors: Nafiseh Mirabdolhosseini, Jerry Zhou, Vincent Ho
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The dramatic global rise in acid reflux has also led to oesophageal adenocarcinoma (OAC) becoming the fastest-growing cancer in developed countries. While gastroscopy with biopsy is used to diagnose OAC patients, this labour-intensive and expensive process is not suitable for population screening. This study aims to design, develop, and implement a minimally invasive system to capture optical data of the distal oesophagus for rapid screening of potential abnormalities. To develop the system and understand user requirements, a user-centric approach was employed by utilising co-design strategies. Target users’ segments were identified, and 38 patients and 14 health providers were interviewed. Next, the technical requirements were developed based on consultations with the industry. A minimally invasive optical system was designed and developed considering patient comfort. This system consists of the sensing catheter, controller unit, and analysis program. Its procedure only takes 10 minutes to perform and does not require cleaning afterward since it has a single-use catheter. A prototype system was evaluated for safety and efficacy for both laboratory and clinical performance. This prototype performed successfully when submerged in simulated gastric fluid without showing evidence of erosion after 24 hours. The system effectively recorded a video of the mid-distal oesophagus of a healthy volunteer (34-year-old male). The recorded images were used to develop an automated program to identify abnormalities in the distal oesophagus. Further data from a larger clinical study will be used to train the automated program. This system allows for quick visual assessment of the lower oesophagus in primary care settings and can serve as a screening tool for oesophageal adenocarcinoma. In addition, this system is able to be coupled with 24hr ambulatory pH monitoring to better correlate oesophageal physiological changes with reflux symptoms. It also can provide additional information on lower oesophageal sphincter functions such as opening times and bolus retention.Keywords: endoscopy, MedTech, oesophageal adenocarcinoma, optical system, screening tool
Procedia PDF Downloads 887141 Effects of a Student-Centered Approach to Assessment on Students' Attitudes towards 'Applied Statistics' Course
Authors: Anduela Lile
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The purpose of this cross sectional study was to investigate the effectiveness of teaching and learning Statistics from a student centered perspective in higher education institutions. Statistics education has emphasized the application of tangible and interesting examples in order to motivate students learning about statistical concepts. Participants in this study were 112 bachelor students enrolled in the ‘Applied Statistics’ course in Sports University of Tirana. Experimental group students received a student-centered teaching approach; Control group students received an instructor-centered teaching approach. This study found student-centered approach student group had statistically significantly higher assessments scores (52.1 ± 18.9) at the end of the evaluation compared to instructor-centered approach student group (61.8 ± 16.4), (t (108) = 2.848, p = 0.005). Results concluded that student-centered perspective can improve student positive attitude to statistical methods and to motivate project work. Therefore, findings of this study may be very useful to the higher education institutions to establish their learning strategies especially for courses related to Statistics.Keywords: student-centered, instructor-centered, course assessment, learning outcomes, applied statistics
Procedia PDF Downloads 2807140 Hydrologic Balance and Surface Water Resources of the Cheliff-Zahrez Basin
Authors: Mehaiguene Madjid, Touhari Fadhila, Meddi Mohamed
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The Cheliff basin offers a good hydrological example for the possibility of studying the problem which elucidated in the future, because of the unclearity in several aspects and hydraulic installation. Thus, our study of the Cheliff basin is divided into two principal parts: The spatial evaluation of the precipitation: also, the understanding of the modes of the reconstitution of the resource in water supposes a good knowledge of the structuring of the precipitation fields in the studied space. In the goal of a good knowledge of revitalizes them in water and their management integrated one judged necessary to establish a precipitation card of the Cheliff basin for a good understanding of the evolution of the resource in water in the basin and that goes will serve as basis for all study of hydraulic planning in the Cheliff basin. Then, the establishment of the precipitation card of the Cheliff basin answered a direct need of setting to the disposition of the researchers for the region and a document of reference that will be completed therefore and actualized. The hydrological study, based on the statistical hydrometric data processing will lead us to specify the hydrological terms of the assessment hydrological and to clarify the fundamental aspects of the annual flow, seasonal, extreme and thus of their variability and resources surface water.Keywords: hydrological assessment, surface water resources, Cheliff, Algeria
Procedia PDF Downloads 3047139 Assessment of Women Involvement in Fishing Activities: A Case Study of Epe and Ibeju Lekki LGA, Lagos
Authors: Temitope Adewale, Oladapo Raji
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The study was designed to investigate the assessment of women's involvement in fishing. In order to give the study a direction, five research questions, as well as two hypotheses, were postulated, and a total of fifty (50) respondents each were selected from two local government areas for the study. This brings a total of one hundred (100) respondents selected from these local government areas in Lagos state. The outcome of the finding indicates that the percentage of the respondents’ age, 49% was between 31 and 35 years, 56% has a working experience of 6-10 years, 61% were married, 69% had secondary education as their educational level. However, findings show that socio-economic characteristics (x2 =15.504, df=6, p < 0.05) and income (r=0.83, p < 0.05) have a significant relationship on the fishing. It was established that the Women in Fish production/processing were faced with a lot of constraints such as high cost of inputs, inadequate electricity supply, lack of adequate capital, non-availability of the improved oven, non-availability of extension agents, inadequate fish landing, lack of transportation facilities, lack of training on financial management and loan acquisition which affected the level of output of women in Fish processing adversely.Keywords: women, fishing, agriculture, Lagos
Procedia PDF Downloads 1457138 Postural Balance And Falls Risk In Persons With Multiple Sclerosis: Effect Of Gender Differences
Authors: Sonda Jallouli, Sameh Ghroubi, Salma Sakka, Abdelmoneem Yahia, Mohamed Habib Elleuch, Imen Ben Dhia, Chokri Mhiri, Omar Hammouda
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The pathophysiology, prevalence, and progression of MS are gender dependent. Indeed, the inflammation is more pronounced in women, but the neurodegeneration is more important in men. In addition, women have more sleep disorders while men suffer more from cognitive decline. These non-physical disorders can negatively affect postural balance and fall risk. However, no study has examined the difference between men and women in those physical parameters in MS. Our objective was to determine the effect gender difference on postural balance and fall risk in MS persons. Methods: Eight men and twelve women with relapsing remitting-MS participated in this study. The assessment includes a posturographic examination to assess static (with eyes opened (EO) and eyes closed (EC)) and dynamic (with EO) postural balance. Unipedal balance and fall risk were assessed by a clinical unipedal balance test and the Four Square Step Test, respectively. Sleep quality was assessed using Spiegel's questionnaire, and cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA) and the Simple Reaction Time Test. Results: Compared to men, women showed an increase in CdPVm in static bipedal condition with EC (p=0.037; d=0.71) and a decrease in MoCA scores (p=0.028; d=1.06). No gender differences were found in the other tests. Discussion: Static postural balance was more impaired in women compared to men. This result could be explained by the more pronounced cognitive decline observed in women compared to men. Indeed, cognitive disorders have been shown to be predictive factors of postural balance impairment. Conclusion: women were less stable than men in the static condition, possibly due to their lower cognitive performance. This gender difference could be taken into account by therapists in training programs.Keywords: multiple sclerosis, bipedal postural balance, fall risk, sleep disturbance, cognitive deficiency
Procedia PDF Downloads 987137 Functional Outcome of Speech, Voice and Swallowing Following Excision of Glomus Jugulare Tumor
Authors: B. S. Premalatha, Kausalya Sahani
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Background: Glomus jugulare tumors arise within the jugular foramen and are commonly seen in females particularly on the left side. Surgical excision of the tumor may cause lower cranial nerve deficits. Cranial nerve involvement produces hoarseness of voice, slurred speech, and dysphagia along with other physical symptoms, thereby affecting the quality of life of individuals. Though oncological clearance is mainly emphasized on while treating these individuals, little importance is given to their communication, voice and swallowing problems, which play a crucial part in daily functioning. Objective: To examine the functions of voice, speech and swallowing outcomes of the subjects, following excision of glomus jugulare tumor. Methods: Two female subjects aged 56 and 62 years had come with a complaint of change in voice, inability to swallow and reduced clarity of speech following surgery for left glomus jugulare tumor were participants of the study. Their surgical information revealed multiple cranial nerve palsies involving the left facial, left superior and recurrent branches of the vagus nerve, left pharyngeal, left soft palate, left hypoglossal and vestibular nerves. Functional outcomes of voice, speech and swallowing were evaluated by perceptual and objective assessment procedures. Assessment included the examination of oral structures and functions, dysarthria by Frenchey dysarthria assessment, cranial nerve functions and swallowing functions. MDVP and Dr. Speech software were used to evaluate acoustic parameters of voice and quality of voice respectively. Results: The study revealed that both the subjects, subsequent to excision of glomus jugulare tumor, showed a varied picture of affected oral structure and functions, articulation, voice and swallowing functions. The cranial nerve assessment showed impairment of the vagus, hypoglossal, facial and glossopharyngeal nerves. Voice examination indicated vocal cord paralysis associated with breathy quality of voice, weak voluntary cough, reduced pitch and loudness range, and poor respiratory support. Perturbation parameters as jitter, shimmer were affected along with s/z ratio indicative of voice fold pathology. Reduced MPD(Maximum Phonation Duration) of vowels indicated that disturbed coordination between respiratory and laryngeal systems. Hypernasality was found to be a prominent feature which reduced speech intelligibility. Imprecise articulation was seen in both the subjects as the hypoglossal nerve was affected following surgery. Injury to vagus, hypoglossal, gloss pharyngeal and facial nerves disturbed the function of swallowing. All the phases of swallow were affected. Aspiration was observed before and during the swallow, confirming the oropharyngeal dysphagia. All the subsystems were affected as per Frenchey Dysarthria Assessment signifying the diagnosis of flaccid dysarthria. Conclusion: There is an observable communication and swallowing difficulty seen following excision of glomus jugulare tumor. Even with complete resection, extensive rehabilitation may be necessary due to significant lower cranial nerve dysfunction. The finding of the present study stresses the need for involvement of as speech and swallowing therapist for pre-operative counseling and assessment of functional outcomes.Keywords: functional outcome, glomus jugulare tumor excision, multiple cranial nerve impairment, speech and swallowing
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