Search results for: Valdênia Carvalho e Almeida

Authors: Ana Caroline Ibrahim Lino, Denise Bomtempo Birche de Carvalho

Abstract:

The background of this research is the international process of control and monitoring of illicit psychoactive substances that has commenced in the early 20th century. This process was intensified with the UN Single Convention on Narcotic Drugs of 1961 and had its culmination in the 1970s with the "War on drugs", a doctrine undertaken by the United States of America. Since then, the phenomenon of drug prohibition has been pushing debates around alternatives of public policies to confront their consequences at a global level and in the specific context of Latin America. Previous research has answered the following key questions: a) With what characteristics and models has the international illicit drug control system consolidated in Latin America with the creation of the Organization of American States (OAS) and the Inter-American Drug Abuse Control Commission (CICAD)? b) What drug policies and programs were determined as guidelines for the member states by the OAS and CICAD? The present paper mainly addresses the analysis of the drug strategies developed by the OAS/CICAD for the Americas from 2004 to 2016. The primary sources have been extracted from the OAS/CICAD documents and reports, listed on the Internet sites of these organizations. Secondary sources refer to bibliographic research on the subject with the following descriptors: illicit drugs, public policies, international organizations, OAS, CICAD, and reducing the demand and supply of illicit drugs. The "content analysis" technique was used to organize the collected material and to choose the axes of analysis. The results show that the policies, strategies, and action plans for Latin America had been focused on anti-drug actions since the creation of the Commission until 2010. The discourses and policies to reduce drug demand and supply were of great importance for solving the problem. However, the real focus was on eliminating the substances by controlling the production, marketing, and distribution of illicit drugs. Little attention was given to the users and their families. The research is of great relevance to the Social Work. The guidelines and parameters of the Social Worker's profession are in line with the need for social, ethical, and political strengthening of any dimension that guarantees the rights of users of psychoactive substances. In addition, it contributed to the understanding of the political, economic, social, and cultural factors that structure the prohibitionism, whose matrix anchors the deprivation of rights and violence.

Keywords: illicit drug policies, international organizations, latin America, prohibitionism, reduce the demand and supply of illicit drugs

Procedia PDF Downloads 163

Authors: Emy Nayana Pinto, Denise Bomtempo Birche De Carvalho

Abstract:

In the present study, the harmful use of illicit drugs is seen as a public health problem and as one of the expressions of the social question, since its consequences fall mainly on the poorer classes of the population. This perspective is a counterpoint to the dominant paradigm on illicit drug policy at the global level, whose centrality lies within the criminal justice arena. The 'drug problem' is internationally combated through fragmented approaches that focus its actions on banning and criminalizing users. In this sense, the research seeks to answer the following key questions: What are the influences of the prohibitionism in the recommendations of the United Nations (UN), the World Health Organization (WHO), and the formulation of drug policies in member countries? What are the actors that have been provoking the prospect of breaking with the prohibitionist paradigm? What is the WHO contribution to the rupture with the prohibitionist paradigm and the displacement of the drug problem in the field of public health? The general objective of this work is to seek evidence from the perspective of rupture with the prohibitionist paradigm in the field of drugs policies at the global and regional level, through analysis of documents of the World Health Organization (WHO), between the years of 2001 to 2016. The research was carried out in bibliographical and documentary sources. The bibliographic sources contributed to the approach with the object and the theoretical basis of the research. The documentary sources served to answer the research questions and evidence the existence of the perspective of change in drug policy. Twenty-two documents of the UN system were consulted, of which fifteen had the contribution of the World Health Organization (WHO). In addition to the documents that directly relate to the subject of the research, documents from various agencies, programs, and offices, such as the Joint United Nations Program on HIV/AIDS (UNAIDS) and the United Nations Office on Drugs and Crime (UNODC), which also has drugs as the central or transversal theme of its performance. The results showed that from the 2000s it was possible to find in the literature review and in the documentary analysis evidence of the critique of the prohibitionist paradigm parallel to the construction of a new perspective for drug policy at the global level and the displacement of criminal justice approaches for the scope of public health, with the adoption of alternative and pragmatic interventions based on human rights, scientific evidence and the reduction of social damages and health by the misuse of illicit drugs.

Keywords: illicit drugs, international organizations, prohibitionism, public health, World Health Organization

Procedia PDF Downloads 157

Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Cristo Martins

Abstract:

Payment for Environmental Services (PSA) has been a strategy used since the late 1990s by Latin American countries to finance environmental conservation. Payment for Environmental Services has been absorbing a growing amount of time in the discussions around environmentally sustainable development strategies in the world. In Brazil, this theme has permeated the discussions since the publication of the new Forest Code. The objective of this work was to verify the perception of the resident farmers in the region of Ponte Alta, Gama, Federal District, Brazil, on environmental legislation and Payments for Environmental Services. The work was carried out in 99 rural properties of the family farmers of the Rural Nucleus Ponte Alta, Administrative Region of Gama, in the city of Brasília, Federal District, Brazil. The present research is characterized methodologically as a quantitative, exploratory, and descriptive nature. The data treatment was performed through descriptive statistical analysis and hypothesis testing. The perceptions about environmental legislation in the rural area of Ponte Alta, Gama, DF respondents were positive. Although most of the family farmers interviewed have some knowledge about environmental legislation, it is perceived that in practice, the environmental adequacy of property is ineffective given the current situation of sustainable rural development; there is an abyss between what is envisaged by legislation and reality in the field. Thus, as in the reports of other researchers, it is verified that the majority of respondents are not aware of PSA (62.62%). Among those interviewed who were aware of the subject, two learned through the course, three through the university, two through TV and five through other people. The planting of native forest species on the rural property was the most informed practice by farmers if they received some Environmental Service Payment (PSA). Reflections on the environment allow us to infer that the effectiveness and fulfillment of the incentives and rewards in the scope of public policies to encourage the maintenance of environmental services, already existing in all spheres of government, are of great relevance to the process of environmental sustainability of rural properties. The relevance of the present research is an important tool to promote the discussion and formulation of public policies focused on sustainable rural development, especially on payments for environmental services; it is a space of great interest for the strengthening of the social group dedicated to production. Public policies that are efficient and accessible to the small rural producers become decisive elements for the promotion of changes in behavior in the field, be it economic, social, or environmental.

Keywords: forest code, public policy, rural development, sustainable agriculture

Procedia PDF Downloads 156

Authors: Renan Caseiro De Almeida, Mateus Mello Garrute

Abstract:

The world walks to be ever more globalised. This trend promotes an increase on the number of transnational commercial transactions. The main modal for carriage of goods is by sea, and many countries have their economies dependent on the maritime freightage – it could be because they exercise largely this activity or because they follow the tendency of using the maritime logistic widely. Among these ones, Brazil is included. This nation counts with sixteen ports with good capacities, which receive most of the international income by sea. It is estimated that 85 per cent of the total influx of goods in Brazil is by maritime modal, leaving mere 15 per cent for the other ones. This made it necessary to develop maritime law in international and national basis, to create a standard to be applied with the intention to harmonize the transnational carriage of goods by sea. Maritime contracts are very specific and have interesting peculiarities, but in their range, little research has been made on what causes the main divergences when it comes to international contracts: the jurisdiction conflict. Likewise any other international contract, it is common for the parties to set a forum selection clause to choose the forum which will be able to judge the litigations that could rise from a maritime transport contract and, consequently, also which law should be applied to the cases. However, the forum choice in Brazil has always been somewhat polemical – not only in the maritime law sphere - for sometimes national tribunals overlook the parties’ choice and call the competence for themselves. In this sense, it is interesting to mention that the Mexico Convention of 1994 about the law applicable to international contracts did not gain strength in Brazil, nor even reached the Congress to be considered for ratification. Furthermore, it is also noteworthy that Brazil has a new Civil Procedure Code, which was put into reinforcement in 2016 bringing new legal provisions specifically about the forum selection. This represented a mark in the national legal system in this matter. Therefore, this paper intends to give an insight through Brazilian jurisprudence, making an analysis of how this issue has been treated on litigations about maritime contracts in the national tribunals, as well as the solutions found by the Brazilian legal system for the jurisdiction conflicts in those cases. To achieve the expected results, the hypothetical-deductive method will be used in combination with researches on doctrine and legislations. Also, jurisprudential research and case law study will have a special role, since the main point of this paper is to verify and study the position of the courts in Brazil in a specific matter. As a country of civil law, the Brazilian judges and tribunals are very attached to the rules displayed on codes. However, the jurisprudential understanding has been changing during the years and with the advent of the new rules about the applicable law and forum selection clause, it is noticeable that new winds are being blown.

Keywords: applicable law, forum selection clause, international business, international maritime contracts, litigation in courts

Procedia PDF Downloads 274

Authors: Christina Klippel, Lucia Pezzi, Silvio Neto, Rafael Bertani, Priscila Mendes, Flavio Machado, Aline Szeliga, Maria Cosendey, Adilson Mariz, Raquel Santos, Lys Bendett, Pedro Velasco, Thalita Rolleigh, Bruna Bellote, Daria Coelho, Bruna Martins, Julia Almeida, Juliana Cerqueira

Abstract:

This project presents a framework for teaching intracranial pressure monitoring (ICP) concepts using a low-cost experimental model in a neurointensive care education program. Data concerning ICP monitoring contribute to the patient's clinical assessment and may dictate the course of action of a health team (nursing, medical staff) and influence decisions to determine the appropriate intervention. This study aims to present a safe method for teaching ICP monitoring to medical students in a Simulation Center. Methodology: Medical school teachers, along with students from the 4th year, built an experimental model for teaching ICP measurement. The model consists of a mannequin's head with a plastic bag inside simulating the cerebral ventricle and an inserted ventricular catheter connected to the ICP monitoring system. The bag simulating the ventricle can also be changed for others containing bloody or infected simulated cerebrospinal fluid. On the mannequin's ear, there is a blue point indicating the right place to set the "zero point" for accurate pressure reading. The educational program includes four steps: 1st - Students receive a script on ICP measurement for reading before training; 2nd - Students watch a video about the subject created in the Simulation Center demonstrating each step of the ICP monitoring and the proper care, such as: correct positioning of the patient, anatomical structures to establish the zero point for ICP measurement and a secure range of ICP; 3rd - Students train the procedure in the model. Teachers help students during training; 4th - Student assessment based on a checklist form. Feedback and correction of wrong actions. Results: Students expressed interest in learning ICP monitoring. Tests concerning the hit rate are still being performed. ICP's final results and video will be shown at the event. Conclusion: The study of intracranial pressure measurement based on an experimental model consists of an effective and controlled method of learning and research, more appropriate for teaching neurointensive care practices. Assessment based on a checklist form helps teachers keep track of student learning progress. This project offers medical students a safe method to develop intensive neurological monitoring skills for clinical assessment of patients with neurological disorders.

Keywords: neurology, intracranial pressure, medical education, simulation

Procedia PDF Downloads 172

Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

Abstract:

Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

Procedia PDF Downloads 362

Authors: Rafael Castilho Carvalho, Edjair de Souza Mota

Abstract:

As the largest contributor to the biogeochemical functioning of the Earth system, the Amazon Rainforest has the greatest biodiversity on the planet, harboring about 15% of all the world's flora. Recognition and preservation are the focus of research that seeks to mitigate drastic changes, especially anthropic ones, which irreversibly affect this biome. Functional and low-cost monitoring alternatives to reduce these impacts are a priority, such as those using technologies such as Low Power Wide Area Networks (LPWAN). Promising, reliable, secure and with low energy consumption, LPWAN can connect thousands of IoT devices, and in particular, LoRa is considered one of the most successful solutions to facilitate forest monitoring applications. Despite this, the forest environment, in particular the Amazon Rainforest, is a challenge for these technologies, requiring work to identify and validate the use of technology in a real environment. To investigate the feasibility of deploying LPWAN in remote water quality monitoring of rivers in the Amazon Region, a LoRa-based test bed consisting of a Lora transmitter and a LoRa receiver was set up, both parts were implemented with Arduino and the LoRa chip SX1276. The experiment was carried out at the Federal University of Amazonas, which contains one of the largest urban forests in Brazil. There are several springs inside the forest, and the main goal is to collect water quality parameters and transmit the data through the forest in real time to the gateway at the uni. In all, there are nine water quality parameters of interest. Even with a high collection frequency, the amount of information that must be sent to the gateway is small. However, for this application, the battery of the transmitter device is a concern since, in the real application, the device must run without maintenance for long periods of time. With these constraints in mind, parameters such as Spreading Factor (SF) and Coding Rate (CR), different antenna heights, and distances were tuned to better the connectivity quality, measured with RSSI and loss rate. A handheld spectrum analyzer RF Explorer was used to get the RSSI values. Distances exceeding 200 m have soon proven difficult to establish communication due to the dense foliage and high humidity. The optimal combinations of SF-CR values were 8-5 and 9-5, showing the lowest packet loss rates, 5% and 17%, respectively, with a signal strength of approximately -120 dBm, these being the best settings for this study so far. The rains and climate changes imposed limitations on the equipment, and more tests are already being conducted. Subsequently, the range of the LoRa configuration must be extended using a mesh topology, especially because at least three different collection points in the same water body are required.

Keywords: IoT, LPWAN, LoRa, coverage, loss rate, forest

Procedia PDF Downloads 90

Authors: Luciana S. Almeida

Abstract:

Nanotechnology has revolutionized the world of science and technology bringing great expectations due to its great potential of application in the most varied industrial sectors. The same characteristics that make nanoparticles interesting from the point of view of the technological application, these may be undesirable when released into the environment. The small size of nanoparticles facilitates their diffusion and transport in the atmosphere, water, and soil and facilitates the entry and accumulation of nanoparticles in living cells. The main objective of this study is to evaluate the environmental regulatory process of nanomaterials in the Brazilian scenario. Three specific objectives were outlined. The first is to carry out a global scientometric study, in a research platform, with the purpose of identifying the main lines of study of nanomaterials in the environmental area. The second is to verify how environmental agencies in other countries have been working on this issue by means of a bibliographic review. And the third is to carry out an assessment of the Brazilian Nanotechnology Draft Law 6741/2013 with the state environmental agencies. This last one has the aim of identifying the knowledge of the subject by the environmental agencies and necessary resources available in the country for the implementation of the Policy. A questionnaire will be used as a tool for this evaluation to identify the operational elements and build indicators through the Environment of Evaluation Application, a computational application developed for the development of questionnaires. At the end will be verified the need to propose changes in the Draft Law of the National Nanotechnology Policy. Initial studies, in relation to the first specific objective, have already identified that Brazil stands out in the production of scientific publications in the area of nanotechnology, although the minority is in studies focused on environmental impact studies. Regarding the general panorama of other countries, some findings have also been raised. The United States has included the nanoform of the substances in an existing program in the EPA (Environmental Protection Agency), the TSCA (Toxic Substances Control Act). The European Union issued a draft of a document amending Regulation 1907/2006 of the European Parliament and Council to cover the nanoform of substances. Both programs are based on the study and identification of environmental risks associated with nanomaterials taking into consideration the product life cycle. In relation to Brazil, regarding the third specific objective, it is notable that the country does not have any regulations applicable to nanostructures, although there is a Draft Law in progress. In this document, it is possible to identify some requirements related to the environment, such as environmental inspection and licensing; industrial waste management; notification of accidents and application of sanctions. However, it is not known if these requirements are sufficient for the prevention of environmental impacts and if national environmental agencies will know how to apply them correctly. This study intends to serve as a basis for future actions regarding environmental management applied to the use of nanotechnology in Brazil.

Keywords: environment; management; nanotecnology; politics

Procedia PDF Downloads 123

Authors: Anderson Braga Mendes, Wallington Felipe de Almeida, Cicero Medeiros da Silva

Abstract:

This study aimed to assess the lifespan of the fish transposition system of the Itaipu Power Plant (Brazil/Paraguay) by using 3D hydrodynamic modeling and Churchill trapping effiency in order to identify the sedimentological equilibrium configuration in the main pond of the Piracema Channel, which is part of a 10 km hydraulic circuit that enables fish migration from downstream to upstream (and vice-versa) the Itaipu Dam, overcoming a 120 m water drop. For that, bottom data from 2002 (its opening year) and 2015 were collected and analyzed, besides bed material at 12 stations to the purpose of identifying their granulometric profiles. The Shields and Yalin and Karahan diagrams for initiation of motion of bed material were used to determine the critical bed shear stress for the sedimentological equilibrium state based on the sort of sediment (grain size) to be found at the bottom once the balance is reached. Such granulometry was inferred by analyzing the grosser material (fine and medium sands) which inflows the pond and deposits in its backwater zone, being adopted a range of diameters within the upper and lower limits of that sand stratification. The software Delft 3D was used in an attempt to compute the bed shear stress at every station under analysis. By modifying the input bathymetry of the main pond of the Piracema Channel so as to the computed bed shear stress at each station fell within the intervals of acceptable critical stresses simultaneously, it was possible to foresee the bed configuration of the main pond when the sedimentological equilibrium is reached. Under such condition, 97% of the whole pond capacity will be silted, and a shallow water course with depths ranging from 0.2 m to 1.5 m will be formed; in 2002, depths ranged from 2 m to 10 m. Out of that water path, the new bottom will be practically flat and covered by a layer of water 0.05 m thick. Thus, in the future the main pond of the Piracema Channel will lack its purpose of providing a resting place for migrating fish species, added to the fact that it may become an insurmountable barrier for medium and large sized specimens. Everything considered, it was estimated that its lifespan, from the year of its opening to the moment of the sedimentological equilibrium configuration, will be approximately 95 years–almost half of the computed lifespan of Itaipu Power Plant itself. However, it is worth mentioning that drawbacks concerning the silting in the main pond will start being noticed much earlier than such time interval owing to the reasons previously mentioned.

Keywords: 3D hydrodynamic modeling, Churchill trapping efficiency, fish crossing system, Itaipu power plant, lifespan, sedimentological equilibrium

Procedia PDF Downloads 234

Authors: Lívia Pinheiro Carvalho, Luciana Di Thommazo-Luporini, Rafael Luís Luporini, José Carlos Bonjorno Junior, Renata Pedrolongo Basso Vanelli, Manoel Carneiro de Oliveira Junior, Rodolfo de Paula Vieira, Renata Trimer, Renata G. Mendes, Mylène Aubertin-Leheudre, Audrey Borghi-Silva

Abstract:

Rationale: Cardiorespiratory fitness (CRF) and functional capacity in young obese and normal-weight people are associated with metabolic and cardiovascular diseases and mortality. However, it remains unclear whether their metabolically healthy (MH) or at risk (AR) phenotype influences cardiorespiratory fitness in this vulnerable population such as obese adults but also in normal-weight people. HOMA insulin resistance index (HI) and leptin-adiponectin ratio (LA) are strong markers for characterizing those phenotypes that we hypothesized to be associated with physical fitness. We also hypothesized that an easy and feasible exercise test could identify a subpopulation at risk to develop metabolic and related disorders. Methods: Thirty-nine sedentary men and women (20-45y; 18.530 kg.m-2) underwent a clinical evaluation, including the six-minute step test (ST), a well-validated and reliable test for young people. Body composition assessment was done by a tetrapolar bioimpedance in a fasting state and in the folicular phase for women. A maximal cardiopulmonary exercise testing, as well as the ST, evaluated the oxygen uptake at the peak of the test (VO2peak) by an ergospirometer Oxycon Mobile. Lipids, glucose, insulin were analysed and the ELISA method quantified the serum leptin and adiponectin from blood samples. Volunteers were divided in two groups: AR or MH according to a HI cutoff of 1.95, which was previously determined in the literature. T-test for comparison between groups, Pearson´s test to correlate main variables and ROC analysis for discriminating AR from up-and-down cycles in ST (SC) were applied (p<0.05). Results: Higher LA, fat mass (FM) and lower HDL, SC, leg lean mass (LM) and VO2peak were found in AR than in MH. Significant correlations were found between VO2peak and SC (r= 0.80) as well as between LA and FM (r=0.87), VO2peak (r=-0.73), and SC (r=-0.65). Area under de curve showed moderate accuracy (0.75) of SC <173 to discriminate AR phenotype. Conclusion: Our study found that at risk obese and normal-weight subjects showed an unhealthy metabolism as well as a poor CRF and functional daily activity capacity. Additionally, a simple and less costly functional test associated with above-mentioned aspects is able to identify ‘at risk’ subjects for primary intervention with important clinical and health implications.

Keywords: aerobic capacity, exercise, fitness, metabolism, obesity, 6MST

Procedia PDF Downloads 356

Authors: Joana Almeida, Kendall Reid, Jonas Bengtsson

Abstract:

Pallets are devices that are used for moving and storing freight and are nearly omnipresent in supply chains. The market is dominated by timber pallets, with plastic being a common alternative. Either option underpins the use of important resources (oil, land, timber), the emission of greenhouse gases and additional waste generation in most supply chains. This study uses a dynamic approach to the life cycle assessment (LCA) of pallets. It demonstrates that what ultimately defines the environmental burden of pallets in the supply chain is how often the length of its lifespan, which depends on the durability of the material and on how pallets are utilized. This study proposes a life cycle assessment (LCA) of pallets in supply chains supported by an algorithm that estimates pallet durability in function of material resilience and of logistics. The LCA runs from cradle-to-grave, including raw material provision, manufacture, transport and end of life. The scope is representative of timber and plastic pallets in the Australian and South-East Asia markets. The materials included in this analysis are: -tropical mixed hardwood, unsustainably harvested in SE Asia; -certified softwood, sustainably harvested; -conventional plastic, a mix of virgin and scrap plastic; -recycled plastic pallets, 100% mixed plastic scrap, which are being pioneered by Re > Pal. The logistical model purports that more complex supply chains and rougher handling subject pallets to higher stress loads. More stress shortens the lifespan of pallets in function of their composition. Timber pallets can be repaired, extending their lifespan, while plastic pallets cannot. At the factory gate, softwood pallets have the lowest carbon footprint. Re > pal follows closely due to its burden-free feedstock. Tropical mixed hardwood and plastic pallets have the highest footprints. Harvesting tropical mixed hardwood in SE Asia often leads to deforestation, leading to emissions from land use change. The higher footprint of plastic pallets is due to the production of virgin plastic. Our findings show that manufacture alone does not determine the sustainability of pallets. Even though certified softwood pallets have lower carbon footprint and their lifespan can be extended by repair, the need for re-supply of materials and disposal of waste timber offsets this advantage. It also leads to most waste being generated among all pallets. In a supply chain context, Re > Pal pallets have the lowest footprint due to lower replacement and disposal needs. In addition, Re > Pal are nearly ‘waste neutral’, because the waste that is generated throughout their life cycle is almost totally offset by the scrap uptake for production. The absolute results of this study can be confirmed by progressing the logistics model, improving data quality, expanding the range of materials and utilization practices. Still, this LCA demonstrates that considering logistics, raw materials and material durability is central for sustainable decision-making on pallet purchasing, management and disposal.

Keywords: carbon footprint, life cycle assessment, recycled plastic, waste

Procedia PDF Downloads 225

Authors: Joao Almeida, Ana Azevedo, Myriam Kanoun-Boule, Maria Ines Santos, Antonio Tadeu

Abstract:

The effects of the increasing expansion of cities and climate changes have encouraged European countries and regions to adopt nature-based solutions with ability to mitigate environmental issues and improve life in cities. Among these strategies, green roofs and urban gardens have been considered ingenious solutions, since they have the desirable potential to improve air quality, prevent floods, reduce the heat island effect and restore biodiversity in cities. However, an additional consumption of fresh water and mineral nutrients is necessary to sustain larger green urban areas. This communication discusses the main technical features of a new system to manage urine recovery at the building level and its application in green roofs. The depletion of critical nutrients like phosphorus constitutes an emergency. In turn, their elimination through urine is one of the principal causes for their loss. Thus, urine recovery in buildings may offer numerous advantages, constituting a valuable fertilizer abundantly available in cities and reducing the load on wastewater treatment plants. Although several urine-diverting toilets have been developed for this purpose and some experiments using urine directly in agriculture have already been carried out in Europe, several challenges have emerged with this practice concerning collection, sanitization, storage and application of urine in buildings. To our best knowledge, current buildings are not designed to receive these systems and integrated solutions with ability to self-manage the whole process of urine recovery, including separation, maturation and storage phases, are not known. Additionally, if from a hygiene point of view human urine may be considered a relatively safe fertilizer, the risk of disease transmission needs to be carefully analysed. A reduction in microorganisms can be achieved by storing the urine in closed tanks. However, several factors may affect this process, which may result in a higher survival rate for some pathogens. In this work, urine effluent was collected under real conditions, stored in closed containers and kept in climatic chambers under variable conditions simulating cold, temperate and tropical climates. These samples were subjected to a first physicochemical and microbiological control, which was repeated over time. The results obtained so far suggest that maturation conditions were reached for all the three temperatures and that a storage period of less than three months is required to achieve a strong depletion of microorganisms. The authors are grateful for the Project WashOne (POCI-01-0247-FEDER-017461) funded by the Operational Program for Competitiveness and Internationalization (POCI) of Portugal 2020, with the support of the European Regional Development Fund (FEDER).

Keywords: sustainable green roofs and urban gardens, urban nutrient cycle, urine-based fertilizers, urine recovery in buildings

Procedia PDF Downloads 166

Authors: Thaís T. Valério Caetano, Lívia de Carvalho Ferreira, João Máximo De Siqueira, Carlos Alexandre Carollo, Arthur Ladeira Macedo, Vanessa C. Stein

Abstract:

Nicotiana glauca, commonly known as wild tobacco or tobacco bush, belongs to the Solanaceae family. It is native to South America but has become naturalized in various regions, including Australia, California, Africa, and the Mediterranean. N. glauca is listed in the Global Invasive Species Database (GISD) and the Invasive Species Compendium (CABI). It is known for producing pyridine alkaloids, including anabasine, which is highly toxic. Anabasine is predominantly found in the leaves and can cause severe health issues such as neuromuscular blockade, respiratory arrest, and cardiovascular problems when ingested. Mistaken identity with edible plants like spinach has resulted in food poisoning cases in Israel and Brazil. Anabasine, a minor alkaloid constituent of tobacco, may contribute to tobacco addiction by mimicking or enhancing the effects of nicotine. Therefore, it is essential to investigate the production pattern of anabasine and its relationship to the developmental stages of the plant. This study aimed to establish the relationship between the phenological plant age, cultivation place, and the increase in anabasine concentration, which can lead to human intoxication cases. In this study, N. glauca plants were collected from three different rural areas in Brazil during a year to examine leaves at various stages of development. Samples were also obtained from cultivated plants in Marilândia, Minas Gerais, Brazil, as well as from Divinópolis, Minas Gerais, Brazil, and Arraial do Cabo, Rio de Janeiro, Brazil. In vitro cultivated plants on MS medium were included in the study. The collected leaves were dried, powdered, and stored. Alkaloid extraction was performed using a methanol and water mixture, followed by liquid-liquid extraction with chloroform. The anabasine content was determined using HPLC-DAD analysis with nicotine as a standard. The results indicated that anabasine production increases with the plant's development, peaking in adult leaves during the reproduction phase and declining afterward. In vitro, plants showed similar anabasine production to young leaves. The successful adaptation of N. glauca in new environments poses a global problem, and the correlation between anabasine production and the plant's developmental stages has been understudied. The presence of substances produced by the plant can pose a risk to other species, especially when mistaken for edible plants. The findings from this study shed light on the pattern of anabasine production and its association with plant development, contributing to a better understanding of the potential risks associated with N. glauca and the importance of accurate identification.

Keywords: alkaloid production, invasive species, nicotiana glauca, plant phenology

Procedia PDF Downloads 86

Authors: Natalia Caldeira De Carvalho, Tassia Batista Pessato, Luis Gustavo R. Fernandes, Ricardo L. Zollner, Flavia Maria Netto

Abstract:

Protein hydrolysates are ingredients of enteral diets and hypoallergenic formulas. Enzymatic hydrolysis is the most commonly used method for reducing the antigenicity of milk protein. The antigenicity and physicochemical characteristics of the protein hydrolysates depend on the reaction parameters. Among them, pH has been pointed out as of the major importance. Hydrolysis reaction in laboratory scale is commonly carried out under controlled pH (pH-stat). However, from the industrial point of view, controlling pH during hydrolysis reaction may be infeasible. This study evaluated the impact of pH control on the physicochemical properties and antigenicity of the hydrolysates of whey proteins with Alcalase. Whey protein isolate (WPI) solutions containing 3 and 7 % protein (w/v) were hydrolyzed with Alcalase 50 and 100 U g-1 protein at 60°C for 180 min. The reactions were carried out under controlled and uncontrolled pH conditions. Hydrolyses performed under controlled pH (pH-stat) were initially adjusted and maintained at pH 8.5. Hydrolyses carried out without pH control were initially adjusted to pH 8.5. Degree of hydrolysis (DH) was determined by OPA method, peptides profile was evaluated by HPLC-RP, and molecular mass distribution by SDS-PAGE/Tricine. The residual α-lactalbumin (α-La) and β-lactoglobulin (β-Lg) concentrations were determined using commercial ELISA kits. The specific IgE and IgG binding capacity of hydrolysates was evaluated by ELISA technique, using polyclonal antibodies obtained by immunization of female BALB/c mice with α-La, β-Lg and BSA. In hydrolysis under uncontrolled pH, the pH dropped from 8.5 to 7.0 during the first 15 min, remaining constant throughout the process. No significant difference was observed between the DH of the hydrolysates obtained under controlled and uncontrolled pH conditions. Although all hydrolysates showed hydrophilic character and low molecular mass peptides, hydrolysates obtained with and without pH control exhibited different chromatographic profiles. Hydrolysis under uncontrolled pH released, predominantly, peptides between 3.5 and 6.5 kDa, while hydrolysis under controlled pH released peptides smaller than 3.5 kDa. Hydrolysis with Alcalase under all conditions studied decreased by 99.9% the α-La and β-Lg concentrations in the hydrolysates detected by commercial kits. In general, β-Lg concentrations detected in the hydrolysates obtained under uncontrolled pH were significantly higher (p<0.05) than those detected in hydrolysates produced with pH control. The anti-α-La and anti-β-Lg IgE and IgG responses to all hydrolysates decreased significantly compared to WPI. Levels of specific IgE and IgG to the hydrolysates were below 25 and 12 ng ml-1, respectively. Despite the differences in peptide composition and α-La and β-Lg concentrations, no significant difference was found between IgE and IgG binding capacity of hydrolysates obtained with or without pH control. These results highlight the impact of pH on the hydrolysates characteristics and their concentrations of antigenic protein. Divergence between the antigen detection by commercial ELISA kits and specific IgE and IgG binding response was found in this study. This result shows that lower protein detection does not imply in lower protein antigenicity. Thus, the use of commercial kits for allergen contamination analysis should be cautious.

Keywords: allergy, enzymatic hydrolysis, milk protein, pH conditions, physicochemical characteristics

Procedia PDF Downloads 303

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

Abstract:

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

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

Procedia PDF Downloads 156

Authors: Maria Fatima Almeida, Rodrigo Calili, George Soares, João Krause, Myrthes Marcele Dos Santos, Anna Carolina Suzano E. Silva, Marcos Alexandre Da

Abstract:

In Brazil, the building sector accounts for 1/6 of energy consumption and 50% of electricity consumption. A complex sector with several driving actors plays an essential role in the country's economy. Currently, the digitalization readiness in this sector is still low, mainly due to the high investment costs and the difficulty of estimating the benefits of digital technologies in buildings. Nevertheless, the potential contribution of digitalization for increasing energy efficiency in the building sector in Brazil has been pointed out as relevant in the political and sectoral contexts, both in the medium and long-term horizons. To contribute to the debate on the possible evolving trajectories of digitalization in the building sector in Brazil and to subsidize the formulation or revision of current public policies and managerial decisions, three future scenarios were created to anticipate the potential energy efficiency in the building sector in Brazil due to digitalization by 2050. This work aims to present these scenarios as a basis to foresight the potential energy efficiency in this sector, according to different digitalization paces - slow, moderate, or fast in the 2050 horizon. A methodological approach was proposed to create alternative prospective scenarios, combining the Global Business Network (GBN) and the Laboratory for Investigation in Prospective Strategy and Organisation (LIPSOR) methods. This approach consists of seven steps: (i) definition of the question to be foresighted and time horizon to be considered (2050); (ii) definition and classification of a set of key variables, using the prospective structural analysis; (iii) identification of the main actors with an active role in the digital and energy spheres; (iv) characterization of the current situation (2021) and identification of main uncertainties that were considered critical in the development of alternative future scenarios; (v) scanning possible futures using morphological analysis; (vi) selection and description of the most likely scenarios; (vii) foresighting the potential energy efficiency in each of the three scenarios, namely slow digitalization; moderate digitalization, and fast digitalization. Each scenario begins with a core logic and then encompasses potentially related elements, including potential energy efficiency. Then, the first scenario refers to digitalization at a slow pace, with induction by the government limited to public buildings. In the second scenario, digitalization is implemented at a moderate pace, induced by the government in public, commercial, and service buildings, through regulation integrating digitalization and energy efficiency mechanisms. Finally, in the third scenario, digitalization in the building sector is implemented at a fast pace in the country and is strongly induced by the government, but with broad participation of private investments and accelerated adoption of digital technologies. As a result of the slow pace of digitalization in the sector, the potential for energy efficiency stands at levels below 10% of the total of 161TWh by 2050. In the moderate digitalization scenario, the potential reaches 20 to 30% of the total 161TWh by 2050. Furthermore, in the rapid digitalization scenario, it will reach 30 to 40% of the total 161TWh by 2050.

Keywords: building digitalization, energy efficiency, scenario building, prospective structural analysis, morphological analysis

Procedia PDF Downloads 116

Authors: Zélia Maria Da Costa Ludwig, Maria José Valenzuela Bell, Geraldo Henriques Da Silva, Thales Alves Faraco, Victor Rocha Da Silva, Daniel Rotmeister Teixeira, Vírgilio De Carvalho Dos Anjos, Valdemir Ludwig

Abstract:

Advances in telecommunications grow with the development of optical amplifiers based on rare earth ions. The focus has been concentrated in silicate glasses although their amplified spontaneous emission is limited to a few tens of nanometers (~ 40nm). Recently, phosphate glasses have received great attention due to their potential application in optical data transmission, detection, sensors and laser detector, waveguide and optical fibers, besides its excellent physical properties such as high thermal expansion coefficients and low melting temperature. Compared with the silica glasses, phosphate glasses provide different optical properties such as, large transmission window of infrared, and good density. Research on the improvement of physical and chemical durability of phosphate glass by addition of heavy metals oxides in P2O5 has been performed. The addition of Na2O further improves the solubility of rare earths, while increasing the Al2O3 links in the P2O5 tetrahedral results in increased durability and aqueous transition temperature and a decrease of the coefficient of thermal expansion. This work describes the structural and spectroscopic characterization of a phosphate glass matrix doped with different Er (Erbium) concentrations. The phosphate glasses containing Er3+ ions have been prepared by melt technique. A study of the optical absorption, luminescence and lifetime was conducted in order to characterize the infrared emission of Er3+ ions at 1540 nm, due to the radiative transition 4I13/2 → 4I15/2. Our results indicate that the present glass is a quite good matrix for Er3+ ions, and the quantum efficiency of the 1540 nm emission was high. A quenching mechanism for the mentioned luminescence was not observed up to 2,0 mol% of Er concentration. The Judd-Ofelt parameters, radiative lifetime and quantum efficiency have been determined in order to evaluate the potential of Er3+ ions in new phosphate glass. The parameters follow the trend as Ω2 > Ω4 > Ω6. It is well known that the parameter Ω2 is an indication of the dominant covalent nature and/or structural changes in the vicinity of the ion (short range effects), while Ω4 and Ω6 intensity parameters are long range parameters that can be related to the bulk properties such as viscosity and rigidity of the glass. From the PL measurements, no red or green upconversion was measured when pumping the samples with laser excitation at 980 nm. As future prospects: Synthesize this glass system with silver in order to determine the influence of silver nanoparticles on the Er3+ ions.

Keywords: phosphate glass, erbium, luminescence, glass system

Procedia PDF Downloads 510

Authors: Kever Bruno Paradelo Gomes, Rosana Carvalho Martins

Abstract:

The home gardens areas are production systems, which are located near the homes and are quite common in the tropics. They consist of agricultural and forest species and may also involve the raising of small animals to produce food for subsistence as well as income generation, with a special focus on the conservation of biodiversity. Home gardens are diverse Agroforestry systems with multiple uses, among many, food security, income aid, traditional medicine. The work was carried out on rural properties of the family farmers of the Ponte Alta Rural Nucleus, Gama Administrative Region, in the city of Brasília, Federal District- Brazil. The present research is characterized methodologically as a quantitative, exploratory and descriptive nature. The instruments used in this research were: bibliographic survey and semi-structured questionnaire. The data collection was performed through the application of a semi-structured questionnaire, containing questions that referred to the perception and behavior of the interviewed producer on the subject under analysis. In each question, the respondent explained his knowledge about sustainability, agroecological practices, environmental legislation, conservation methods, forest and medicinal species, ago social and socioeconomic characteristics, use and purpose of agroforestry and technical assistance. The sample represented 55.62% of the universe of the study. We interviewed 99 people aged 18-83 years, with a mean age of 49 years. The low level of education, coupled with the lack of training and guidance for small family farmers in the Ponte Alta Rural Nucleus, is one of the limitations to the development of practices oriented towards sustainable and agroecological agriculture in the nucleus. It is observed that 50.5% of the interviewed people landed with agroforestry yards less than 20 years ago, and only 16.17% of them are older than 35 years. In identifying agriculture as the main activity of most of the rural properties studied, attention is drawn to the cultivation of medicinal plants, fruits and crops as the most extracted products. However, it is verified that the crops in the backyards have the exclusive purpose of family consumption, which could be complemented with the marketing of the surplus, as well as with the aggregation of value to the cultivated products. Initiatives such as this may contribute to the increase in family income and to the motivation and value of the crop in agroecological gardens. We conclude that home gardens of Ponte Alta are highly diverse thus contributing to local biodiversity conservation of are managed by women to ensure food security and allows income generation. The tradition of existing knowledge on the use and management of the diversity of resources used in agroforestry yards is of paramount importance for the development of sustainable alternative practices.

Keywords: agriculture, agroforestry system, rural development, sustainability

Procedia PDF Downloads 141

Authors: Willian C. De Brito, Hernan D. C. Munoz, Erlan V. C. Carvalho, Helder L. C. De Oliveira

Abstract:

In order to improve commute time for small distance trips and relieve large cities traffic, a new transport category has been the subject of research and new designs worldwide. The air taxi travel market promises to change the way people live and commute by using the concept of vehicles with the ability to take-off and land vertically and to provide passenger’s transport equivalent to a car, with mobility within large cities and between cities. Today’s civil air transport remains costly and accounts for 2% of the man-made CO₂ emissions. Taking advantage of this scenario, many companies have developed their own Vertical Take Off and Landing (VTOL) design, seeking to meet comfort, safety, low cost and flight time requirements in a sustainable way. Thus, the use of green power supplies, especially batteries, and fully electric power plants is the most common choice for these arising aircrafts. However, it is still a challenge finding a feasible way to handle with the use of batteries rather than conventional petroleum-based fuels. The batteries are heavy and have an energy density still below from those of gasoline, diesel or kerosene. Therefore, despite all the clear advantages, all electric aircrafts (AEA) still have low flight autonomy and high operational cost, since the batteries must be recharged or replaced. In this sense, this paper addresses a way to optimize the energy consumption in a typical mission of an aerial taxi aircraft. The approach and landing procedure was chosen to be the subject of an optimization genetic algorithm, while final programming can be adapted for take-off and flight level changes as well. A real tilt rotor aircraft with fully electric power plant data was used to fit the derived dynamic equations of motion. Although a tilt rotor design is used as a proof of concept, it is possible to change the optimization to be applied for other design concepts, even those with independent motors for hover and cruise flight phases. For a given trajectory, the best set of control variables are calculated to provide the time history response for aircraft´s attitude, rotors RPM and thrust direction (or vertical and horizontal thrust, for independent motors designs) that, if followed, results in the minimum electric power consumption through that landing path. Safety, comfort and design constraints are assumed to give representativeness to the solution. Results are highly dependent on these constraints. For the tested cases, performance improvement ranged from 5 to 10% changing initial airspeed, altitude, flight path angle, and attitude.

Keywords: air taxi travel, all electric aircraft, batteries, energy consumption, genetic algorithm, landing performance, optimization, performance improvement, tilt rotor, VTOL design

Procedia PDF Downloads 115

Authors: Antònio Inês, Davide Silva, Filipa Carvalho, Luís Filipe-Riberiro, Fernando M. Nunes, Luís Abrunhosa, Fernanda Cosme

Abstract:

The presence of mycotoxins in foodstuff is a matter of concern for food safety. Mycotoxins are toxic secondary metabolites produced by certain molds, being ochratoxin A (OTA) one of the most relevant. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L-β-phenylalanine via an amide bond. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. OTA contamination of wines might be a risk to consumer health, thus requiring treatments to achieve acceptable standards for human consumption. The maximum acceptable level of OTA in wines is 2.0 μg/kg according to the Commission regulation No. 1881/2006. Therefore, the aim of this work was to reduce OTA to safer levels using different fining agents, as well as their impact on white wine physicochemical characteristics. To evaluate their efficiency, 11 commercial fining agents (mineral, synthetic, animal and vegetable proteins) were used to get new approaches on OTA removal from white wine. Trials (including a control without addition of a fining agent) were performed in white wine artificially supplemented with OTA (10 µg/L). OTA analyses were performed after wine fining. Wine was centrifuged at 4000 rpm for 10 min and 1 mL of the supernatant was collected and added of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v). Also, the solid fractions obtained after fining, were centrifuged (4000 rpm, 15 min), the resulting supernatant discarded, and the pellet extracted with 1 mL of the above solution and 1 mL of H2O. OTA analysis was performed by HPLC with fluorescence detection. The most effective fining agent in removing OTA (80%) from white wine was a commercial formulation that contains gelatin, bentonite and activated carbon. Removals between 10-30% were obtained with potassium caseinate, yeast cell walls and pea protein. With bentonites, carboxymethylcellulose, polyvinylpolypyrrolidone and chitosan no considerable OTA removal was verified. Following, the effectiveness of seven commercial activated carbons was also evaluated and compared with the commercial formulation that contains gelatin, bentonite and activated carbon. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. Trial and OTA analysis were performed as explained previously. The results showed that in white wine all activated carbons except one reduced 100% of OTA. The commercial formulation that contains gelatin, bentonite and activated carbon reduced only 73% of OTA concentration. These results may provide useful information for winemakers, namely for the selection of the most appropriate oenological product for OTA removal, reducing wine toxicity and simultaneously enhancing food safety and wine quality.

Keywords: wine, ota removal, food safety, fining

Procedia PDF Downloads 542

Authors: Rideci Farias, Haroldo Paranhos, Joyce Silva, Elson Almeida, Hellen Silva, Lucas Silva

Abstract:

The constant growth of the fleet of vehicles in the big cities, makes that the Engineering is dynamic, with respect to the new solutions for traffic flow in general. In the Federal District (DF), Brazil, it is no different. The city of Brasilia, Capital of Brazil, and Cultural Heritage of Humanity by UNESCO, is projected to 500 thousand inhabitants, and today circulates more than 3 million people in the city, and with a fleet of more than one vehicle for every two inhabitants. The growth of the city to the North region, made that the urban planning presented solutions for the fleet in constant growth. In this context, a complex of viaducts, road accesses, creation of new rolling roads and duplication of the Bragueto bridge over Paranoa lake in the northern part of the city was designed, giving access to the BR-020 highway, denominated Clover of North Triage (TTN). In the geopedological context, the region is composed of hydromorphic soils, with the presence of the water level at some times of the year. From the geotechnical point of view, are soils with SPT < 4 and Resistance not drained, Su < 50 kPa. According to urban planning in Brasília, special art works can not rise in the urban landscape, contrasting with the urban characteristics of the architects Lúcio Costa and Oscar Niemeyer. Architects hired to design the new Capital of Brazil. The urban criterion then created the technical impasse, resulting in the technical need to ‘bury’ the works of art and in turn the access greenhouses at different levels, in regions of low support soil and water level Outcrossing, generally inducing the need for this study and design. For the adoption of the appropriate solution, Standard Penetration Test (SPT), Vane Test, Diagnostic peritoneal lavage (DPL) and auger boring campaigns were carried out. With the comparison of the results of these tests, the profiles of resistance of the soils and water levels were created in the studied sections. Geometric factors such as existing sidewalks and lack of elevation for the discharge of deep drainage water have inhibited traditional techniques for total removal of soft soils, thus avoiding the use of temporary drawdown and shoring of excavations. Thus, a structural layer was designed to reinforce the subgrade by means of the ‘needling’ of the soft soil, without the need for longitudinal drains. In this context, the article presents the geological and geotechnical studies carried out, but also the dimensioning of the reinforcement layer on the soft soil with a view to the main objective of this solution that is to allow the execution of the civil works without the interference in the roads in use, Execution of services in rainy periods, presentation of solution compatible with drainage characteristics and soft soil reinforcement.

Keywords: layer, reinforcement, soft soil, clover of north triage

Procedia PDF Downloads 229

Authors: Márcia Afonso, Cristina Fael, Marisa Dinis-Almeida

Abstract:

Population growth in cities has led to an increase in the infrastructures construction, including buildings and roadways. This aspect leads directly to the soils waterproofing. In turn, changes in precipitation patterns are developing into higher and more frequent intensities. Thus, these two conjugated aspects decrease the rainwater infiltration into soils and increase the volume of surface runoff. The practice of green and sustainable urban solutions has encouraged research in these areas. The porous asphalt pavement, as a green infrastructure, is part of practical solutions set to address urban challenges related to land use and adaptation to climate change. In this field, permeable pavements with porous asphalt mixtures (PA) have several advantages in terms of reducing the runoff generated by the floods. The porous structure of these pavements, compared to a conventional asphalt pavement, allows the rainwater infiltration in the subsoil, and consequently, the water quality improvement. This green infrastructure solution can be applied in cities, particularly in streets or parking lots to mitigate the floods effects. Over the years, the pores of these pavements can be filled by sediment, reducing their function in the rainwater infiltration. Thus, double layer porous asphalt (DLPA) was developed to mitigate the clogging effect and facilitate the water infiltration into the lower layers. This study intends to deepen the knowledge of the performance of DLPA when subjected to clogging. The experimental methodology consisted on four evaluation phases of the DLPA infiltration capacity submitted to three precipitation events (100, 200 and 300 mm/h) in each phase. The evaluation first phase determined the behavior after DLPA construction. In phases two and three, two 500 g/m² clogging cycles were performed, totaling a 1000 g/m² final simulation. Sand with gradation accented in fine particles was used as clogging material. In the last phase, the DLPA was subjected to simple sweeping and vacuuming maintenance. A precipitation simulator, type sprinkler, capable of simulating the real precipitation was developed for this purpose. The main conclusions show that the DLPA has the capacity to drain the water, even after two clogging cycles. The infiltration results of flows lead to an efficient performance of the DPLA in the surface runoff attenuation, since this was not observed in any of the evaluation phases, even at intensities of 200 and 300 mm/h, simulating intense precipitation events. The infiltration capacity under clogging conditions decreased about 7% on average in the three intensities relative to the initial performance that is after construction. However, this was restored when subjected to simple maintenance, recovering the DLPA hydraulic functionality. In summary, the study proved the efficacy of using a DLPA when it retains thicker surface sediments and limits the fine sediments entry to the remaining layers. At the same time, it is guaranteed the rainwater infiltration and the surface runoff reduction and is therefore a viable solution to put into practice in permeable pavements.

Keywords: clogging, double layer porous asphalt, infiltration capacity, rainfall intensity

Procedia PDF Downloads 492

Authors: Monisha Elumalai, Joana Guerreiro, Joana Carvalho, Marta Prado

Abstract:

DNA biosensors popularity has been increasing over the past few years. Traditional analytical techniques tend to require complex steps and expensive equipment however DNA biosensors have the advantage of getting simple, fast and economic. Additionally, the combination of DNA biosensors with nanomaterials offers the opportunity to improve the selectivity, sensitivity and the overall performance of the devices. DNA biosensors are based on oligonucleotides as sensing elements. These oligonucleotides are highly specific to complementary DNA sequences resulting in the hybridization of the strands. DNA biosensors are not only an advantage in the clinical field but also applicable in numerous research areas such as food analysis or environmental control. Zebra Mussels (ZM), Dreissena polymorpha are invasive species responsible for enormous negative impacts on the environment and ecosystems. Generally, the detection of ZM is made when the observation of adult or macroscopic larvae's is made however at this stage is too late to avoid the harmful effects. Therefore, there is a need to develop an analytical tool for the early detection of ZM. Here, we present a portable plasmonic biosensor for the detection of environmental DNA (eDNA) released to the environment from this invasive species. The plasmonic DNA biosensor combines gold nanoparticles, as transducer elements, due to their great optical properties and high sensitivity. The detection strategy is based on the immobilization of a short base pair DNA sequence on the nanoparticles surface followed by specific hybridization in the presence of a complementary target DNA. The hybridization events are tracked by the optical response provided by the nanospheres and their surrounding environment. The identification of the DNA sequences (synthetic target and probes) to detect Zebra mussel were designed by using Geneious software in order to maximize the specificity. Moreover, to increase the optical response enzyme amplification of DNA might be used. The gold nanospheres were synthesized and characterized by UV-visible spectrophotometry and transmission electron microscopy (TEM). The obtained nanospheres present the maximum localized surface plasmon resonance (LSPR) peak position are found to be around 519 nm and a diameter of 17nm. The DNA probes modified with a sulfur group at one end of the sequence were then loaded on the gold nanospheres at different ionic strengths and DNA probe concentrations. The optimal DNA probe loading will be selected based on the stability of the optical signal followed by the hybridization study. Hybridization process leads to either nanoparticle dispersion or aggregation based on the presence or absence of the target DNA. Finally, this detection system will be integrated into an optical sensing platform. Considering that the developed device will be used in the field, it should fulfill the inexpensive and portability requirements. The sensing devices based on specific DNA detection holds great potential and can be exploited for sensing applications in-loco.

Keywords: ZM DNA, DNA probes, nicking enzyme, gold nanoparticles

Procedia PDF Downloads 248

Authors: M. Isabel Santos, Ana Breda, Ana Margarida Almeida

Abstract:

Research on academic abilities of individuals with autism spectrum disorder (ASD) underlines the importance of mathematics interventions. Yet the proposal of digital applications for children and youth with ASD continues to attract little attention, namely, regarding the development of mathematical reasoning, being the use of the digital technologies an area of great interest for individuals with this disorder and its use is certainly a facilitative strategy in the development of their mathematical abilities. The use of digital technologies can be an effective way to create innovative learning opportunities to these students and to develop creative, personalized and constructive environments, where they can develop differentiated abilities. The children with ASD often respond well to learning activities involving information presented visually. In this context, we present the digital Learning Environment on Mathematics for Autistic children (LEMA) that was a research project conducive to a PhD in Multimedia in Education and was developed by the Thematic Line Geometrix, located in the Department of Mathematics, in a collaboration effort with DigiMedia Research Center, of the Department of Communication and Art (University of Aveiro, Portugal). LEMA is a digital mathematical learning environment which activities are dynamically adapted to the user’s profile, towards the development of mathematical abilities of children aged 6–12 years diagnosed with ASD. LEMA has already been evaluated with end-users (both students and teacher’s experts) and based on the analysis of the collected data readjustments were made, enabling the continuous improvement of the prototype, namely considering the integration of universal design for learning (UDL) approaches, which are of most importance in ASD, due to its heterogeneity. The learning strategies incorporated in LEMA are: (i) provide options to custom choice of math activities, according to user’s profile; (ii) integrates simple interfaces with few elements, presenting only the features and content needed for the ongoing task; (iii) uses a simple visual and textual language; (iv) uses of different types of feedbacks (auditory, visual, positive/negative reinforcement, hints with helpful instructions including math concept definitions, solved math activities using split and easier tasks and, finally, the use of videos/animations that show a solution to the proposed activity); (v) provides information in multiple representation, such as text, video, audio and image for better content and vocabulary understanding in order to stimulate, motivate and engage users to mathematical learning, also helping users to focus on content; (vi) avoids using elements that distract or interfere with focus and attention; (vii) provides clear instructions and orientation about tasks to ease the user understanding of the content and the content language, in order to stimulate, motivate and engage the user; and (viii) uses buttons, familiarly icons and contrast between font and background. Since these children may experience little sensory tolerance and may have an impaired motor skill, besides the user to have the possibility to interact with LEMA through the mouse (point and click with a single button), the user has the possibility to interact with LEMA through Kinect device (using simple gesture moves).

Keywords: autism spectrum disorder, digital technologies, inclusion, mathematical abilities, mathematical learning activities

Procedia PDF Downloads 116

Authors: Ribeiro A., Vilarinho C., Luisa A., Carvalho J

Abstract:

The pig meat industry generates large volumes of by- and co-products like blood, bones, skin, trimmings, organs, viscera, and skulls, among others, during slaughtering and meat processing and must be treated and disposed of ecologically. The yield of these by-products has been reported to account for about 10% to 15% of the value of the live animal in developed countries, although animal by-products account for about two-thirds of the animal after slaughter. It was selected for further valorization of the principal wastes produced throughout the value chain of pig meat production: Pig Manure, Pig Bones, Fats, Skins, Pig Hair, Wastewater, Wastewater sludges, and other animal subproducts type III. According to the potential valorization options, these wastes will be converted into Biomethane, Fertilizers (phosphorus and digestate), Hydroxyapatite, and protein hydrolysates (Keratin and Collagen). This work includes comprehensive technical and economic analyses (TEA) for each valorization route or applied technology. Metrics such as Net Present Value (NPV), Internal Rate of Return (IRR), and payback periods were used to evaluate economic feasibility. From this analysis, it can be concluded that, for Biogas Production, the scenarios using pig manure, wastewater sludges and mixed grass and leguminous wastes presented a remarkably high economic feasibility. Scenarios showed high economic feasibility with a positive payback period, NPV, and IRR. The optimal scenario combining pig manure with mixed grass and leguminous wastes had a payback period of 1.2 years and produced 427,6269 m³ of biomethane annually. Regarding the Chemical Extraction of Phosphorous and Nitrogen, results proved that the process is economically unviable due to negative cash flows despite high recovery rates. The TEA of Hydrolysis and Extraction of Keratin Hydrolysates indicate that a unit processing and valorizing 10 tons of pig hair per year for the production of keratin hydrolysate has an NPV of 907,940 €, an IRR of 13.07%, and a Payback period of 5.41 years. All of these indicators suggest a highly potential project to explore in the future. On the opposite, the results of Hydrolysis and Extraction of Collagen Hydrolysates showed a process economically unviable with negative cash flows in all scenarios due to the high-fat content in raw materials. In fact, the results from the valorization of 10 tons of pig skin had a negative cash flow of 453 743,88 €. TEA results of Extraction and purification of Hydroxyapatite from Pig Bones with Pyrolysis indicate that unit processing and valorizing 10 tons of pig bones per year for the production of hydroxyapatite has an NPV of 1 274 819,00 €, an IRR of 65.43%, and a Payback period of 1,5 years over a timeline of 10 years with a discount rate of 10%. These valorization routes, circular economy and bio-refinery approach offer significant contributions to sustainable bio-based operations within the agri-food industry. This approach transforms waste into valuable resources, enhancing both environmental and economic outcomes and contributing to a more sustainable and circular bioeconomy.

Keywords: techno-economic analysis (TEA), pig meat processing wastes, circular economy, bio-refinery

Procedia PDF Downloads 17

Authors: Pedro Felgueiras, Ana Miguel, Nélson Almeida, Raquel Silva

Abstract:

Objective: Through the study of a clinical case of delusional somatic disorder secondary to phantogeusia, we aim to highlight the importance of considering psychosomatic conditions in differential diagnosis, as well as to emphasize the complexity of its comprehension, treatment, and respective impact on patients’ functioning. Methods: Bearing this in mind, we conducted a critical analysis of a case series based on patient observations, clinical data, and complementary diagnostic methods, as well as a non-systematic review of the literature on the subject. Results: A 61-year-old female patient with no history of psychiatric conditions. Family psychiatric history of mood disorder (depression), with psychotic features found in her mother. Medical history of many comorbidities affecting different organ systems (endocrine, gastrointestinal, genitourinary, ophthalmological). Documented neuroticism traits of personality. The patient’s family described a persistent concern about several physical symptoms across her life, with a continuous effort to obtain explanations about any sensation out of her normal perception. Since being subjected to endoscopy in 2018, she started complaints of persistent phantogeusia (acid taste) and developed excessive thoughts, feelings, and behaviors associated with this somatic symptom. The patient was evaluated by several medical specialties, and an extensive panel of medical exams was carried out, excluding any disease. Besides all the investigation and with no evidence of disease signs, acute anxiety, time, and energy dispended to this symptom culminated in severe psychosocial impairment. The patient was admitted to a psychiatric ward for investigation and treatment of this clinical picture, leading to the diagnosis of the delusional somatic disorder. In order to exclude the acute organic etiology of this psychotic disorder, an analytic panel was carried out with no abnormal results. In the context of a psychotic clinical picture, a CT scan was performed, which revealed a right cortical vascular lesion. Neuropsychological evaluation was made, with the description of cognitive functioning being globally normative. During treatment with an antipsychotic (pimozide), a complete remission of the somatic delusion was associated with the disappearance of gustative perception disturbance. In follow-up, a relapse of gustative sensation was documented, and her thoughts and speech were dominated by concerns about multiple somatic symptoms. Conclusion: In terms of abnormal bodily sensations, the oral cavity is one of the frequent sites of delusional disorder. Patients with these gustatory perception distortions complain about unusual sensations without corresponding abnormal findings in the oral area. Its pathophysiology has not been fully elucidated yet. In terms of its comprehensive psychopathology, this case was hypothesized as a paranoid development of a delusional somatic disorder triggered by a post-invasive procedure phantogeusia (which is described as a possible side effect of an endoscopy) in a patient with an anankastic personality. This case presents interesting psychopathology, reinforcing the complexity of psychosomatic disorders in terms of their etiopathogenesis, clinical treatment, and long-term prognosis.

Keywords: psychosomatics, delusional somatic disorder, phantogeusia, paranoid development

Procedia PDF Downloads 131

Authors: Lucas Nascimento, Ana Rita, Margarida Soares, André Ribeiro, Zlatina Genisheva, Hugo Silva, Joana Carvalho

Abstract:

The footwear industry is an essential fashion industry, focusing on producing various types of footwear, such as shoes, boots, sandals, sneakers, and slippers. Global footwear consumption has doubled every 20 years since the 1950s. It is estimated that in 1950, each person consumed one new pair of shoes yearly; by 2005, over 20 billion pairs of shoes were consumed. To meet global footwear demand, production reached $24.2 billion, equivalent to about $74 per person in the United States. This means three new pairs of shoes per person worldwide. The issue of footwear waste is related to the fact that shoe production can generate a large amount of waste, much of which is difficult to recycle or reuse. This waste includes scraps of leather, fabric, rubber, plastics, toxic chemicals, and other materials. The search for alternative solutions for waste treatment and valorization is increasingly relevant in the current context, mainly when focused on utilizing waste as a source of substitute materials. From the perspective of the new circular economy paradigm, this approach is of utmost importance as it aims to preserve natural resources and minimize the environmental impact associated with sending waste to landfills. In this sense, the incorporation of waste into industrial sectors that allow for the recovery of large volumes, such as road construction, becomes an urgent and necessary solution from an environmental standpoint. This study explores the use of plastic waste from the footwear industry as a substitute for virgin polymers in bitumen modification, a solution that presents a more sustainable future. Replacing conventional polymers with plastic waste in asphalt composition reduces the amount of waste sent to landfills and offers an opportunity to extend the lifespan of road infrastructures. By incorporating waste into construction materials, reducing the consumption of natural resources and the emission of pollutants is possible, promoting a more circular and efficient economy. In the initial phase of this study, waste materials from end-of-life footwear were selected, and plastic waste with the highest potential for application was separated. Based on a literature review, EVA (ethylene vinyl acetate) and PU (polyurethane) were identified as the polymers suitable for modifying 50/70 classification bitumen. Each polymer was analysed at concentrations of 3% and 5%. The production process involved the polymer's fragmentation to a size of 4 millimetres after heating the materials to 180 ºC and mixing for 10 minutes at low speed. After was mixed for 30 minutes in a high-speed mixer. The tests included penetration, softening point, viscosity, and rheological assessments. With the results obtained from the tests, the mixtures with EVA demonstrated better results than those with PU, as EVA had more resistance to temperature, a better viscosity curve and a greater elastic recovery in rheology.

Keywords: footwear waste, hot asphalt pavement, modified bitumen, polymers

Procedia PDF Downloads 18

Authors: J. Ticona Chambi, E. A. De Almeida, C. A. Andrade Raymundo Gaiotto, A. M. Do Espírito Santo, L. Infantes, S. L. Cuffini

Abstract:

The solubility of active pharmaceutical ingredients (APIs) is challenging for the pharmaceutical industry. The new multicomponent crystalline forms as cocrystal and solvates present an opportunity to improve the solubility of APIs. Commonly, the procedure to obtain multicomponent crystalline forms of a drug starts by screening the drug molecule with the different coformers/solvents. However, it is necessary to develop methods to obtain multicomponent forms in an efficient way and with the least possible environmental impact. The Hansen Solubility Parameters (HSPs) is considered a tool to obtain theoretical knowledge of the solubility of the target compound in the chosen solvent. H-Bond Propensity (HBP), Molecular Complementarity (MC), Coordination Values (CV) are tools used for statistical prediction of cocrystals developed by the Cambridge Crystallographic Data Center (CCDC). The HSPs and the CCDC tools are based on inter- and intra-molecular interactions. The curcumin (Cur), target molecule, is commonly used as an anti‐inflammatory. The demethoxycurcumin (Demcur) and bisdemethoxycurcumin (Bisdcur) are natural analogues of Cur from turmeric. Those target molecules have differences in their solubilities. In this way, the work aimed to analyze and compare different tools for multicomponent forms prediction (solvates) of Cur, Demcur and Biscur. The HSP values were calculated for Cur, Demcur, and Biscur using the chemical group contribution methods and the statistical optimization from experimental data. The HSPmol software was used. From the HSPs of the target molecules and fifty solvents (listed in the HSP books), the relative energy difference (RED) was determined. The probability of the target molecules would be interacting with the solvent molecule was determined using the CCDC tools. A dataset of fifty molecules of different organic solvents was ranked for each prediction method and by a consensus ranking of different combinations: HSP, CV, HBP and MC values. Based on the prediction, 15 solvents were selected as Dimethyl Sulfoxide (DMSO), Tetrahydrofuran (THF), Acetonitrile (ACN), 1,4-Dioxane (DOX) and others. In a starting analysis, the slow evaporation technique from 50°C at room temperature and 4°C was used to obtain solvates. The single crystals were collected by using a Bruker D8 Venture diffractometer, detector Photon100. The data processing and crystal structure determination were performed using APEX3 and Olex2-1.5 software. According to the results, the HSPs (theoretical and optimized) and the Hansen solubility sphere for Cur, Demcur and Biscur were obtained. With respect to prediction analyses, a way to evaluate the predicting method was through the ranking and the consensus ranking position of solvates already reported in the literature. It was observed that the combination of HSP-CV obtained the best results when compared to the other methods. Furthermore, as a result of solvent selected, six new solvates, Cur-DOX, Cur-DMSO, Bicur-DOX, Bircur-THF, Demcur-DOX, Demcur-ACN and a new Biscur hydrate, were obtained. Crystal structures were determined for Cur-DOX, Biscur-DOX, Demcur-DOX and Bicur-Water. Moreover, the unit-cell parameter information for Cur-DMSO, Biscur-THF and Demcur-ACN were obtained. The preliminary results showed that the prediction method is showing a promising strategy to evaluate the possibility of forming multicomponent. It is currently working on obtaining multicomponent single crystals.

Keywords: curcumin, HSPs, prediction, solvates, solubility

Procedia PDF Downloads 63

Authors: Catarina Ferreira Rebelo, Luis Madeira de Carvalho, Fernando González González

Abstract:

The order Passeridae corresponds to the richest and most abundant group of birds, with approximately 6500 species, making it possible to assert that two out of every three bird species are passerines. They are globally distributed and exhibit remarkable morphological and ecological variability. While numerous species of parasites have been identified and described in wild birds, there has been little focus on passeriformes. Seventeen passerines admitted to GREFA, a Wildlife Rehabilitation Center, throughout the months of October, November and December 2022 were analyzed. The species included Aegithalos caudatus, Anthus pratensis, Carduelis chloris, Certhia brachydactyla, Erithacus rubecula, Fringilla coelebs, Parus ater, Passer domesticus, Sturnus unicolor, Sylvia atricapilla, Turdus merula and Turdus philomelos. Data regarding past history was collected, and necropsies were conducted to identify the cause of death and body condition and determine the presence of parasites. Additionally, samples of intestinal content were collected for direct/fecal smear, flotation and sedimentation techniques. Sixteen (94.1%) passerines were considered positive for the presence of parasitic forms in at least one of the techniques used, including parasites detected in necropsy. Adult specimens of both sexes and tritonymphs of Monojoubertia microhylla and ectoparasites of the genus Ornithonyssus were identified. Macroscopic adult endoparasitic forms were also found during necropsies, including Diplotriaena sp., Serratospiculum sp. and Porrocaecum sp.. Parasitism by coccidia was observed with no sporulation. Additionally, eggs of nematodes from various genera were detected, such as Diplotriaena sp., Capillaria sp., Porrocaecum sp., Syngamus sp. and Strongyloides sp., eggs of trematodes, specifically the genus Brachylecithum and cestode oncospheres, whose genera were not identified. To our knowledge, the respiratory nematode Serratospiculum sp. found in this study is being reported for the first time in passerines in the Iberian Peninsula, along with the application of common coprological techniques for the identification of eggs in the intestinal content. The majority of parasites identified utilize intermediary hosts present in the diet of the passerines sampled. Furthermore, the discovery of certain parasites with a direct life cycle could potentially exert greater influence, particularly in specific scenarios such as within nests or during the rehabilitation process in wildlife centers. These parasites may impact intraspecific competition, increase susceptibility to predators or lead to death. However, their cost to wild birds is often not clear, as individuals can endure various parasites without significant harm. Furthermore, wild birds serve as important sources of parasites across different animal groups, including humans and other mammals. This study provides invaluable insights into the parasitic fauna of these birds, not only serving as a cornerstone for future epidemiological investigations but also enhancing our comprehension of these avian species.

Keywords: birds, parasites, passerines, wild, spain

Procedia PDF Downloads 42

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

Procedia PDF Downloads 164