Search results for: teaching and materials design
301 Circulating Public Perception on Agroforestry: Discourse Networks Analysis Using Social Media and Online News Media in Four Countries of the Sahel Region
Authors: Luisa Müting, Wisnu Harto Adiwijoyo
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Agroforestry systems transform the agricultural landscapes in the Sahel region of Africa, providing food and farming products consumed for subsistence or sold for income. In the incrementally dry climate of the Sahel region, the spreading of agroforestry practices is integral for policymaker efforts to counteract land degradation and provide soil restoration in the region. Several measures on agroforestry practices have been implemented in the region by governmental and non-governmental institutions in recent years. However, despite the efforts, past research shows that awareness of how policies and interventions are being consumed and perceived by the public remains low. Therefore, interpreting public policy dilemmas by analyzing the public perception regarding agroforestry concepts and practices is necessary. Public perceptions and discourses can be an essential driver or constraint for the adoption of agroforestry practices in the region. Thus, understanding the public discourse behavior of crucial stakeholders could assist policymakers in developing inclusive and contextual policies that are relevant to the context of agroforestry adoption in Sahel region. To answer how information about agroforestry spreads and is perceived by the public. As internet usage increased drastically over the past decade, reaching a share of 33 percent of the population being connected to the internet, this research is based on online conversation data. Social media data from Facebook are gathered daily between April 2021 and April 2022 in Djibouti, Senegal, Mali, and Nigeria based on their share of active internet users compared to other countries in the Sahel region. A systematic methodology was applied to the extracted social media using discourse network analysis (DNA). This study then clustered the data by the types of agroforestry practices, sentiments, and country. Additionally, this research extracted the text data from online news media during the same period to pinpoint events related to the topic of agroforestry. The preliminary result indicates that tree management, crops, and livestock integration, diversifying species and genetic resources, and focusing on interactions and productivity across the agricultural system; are the most notable keywords in agroforestry-related conversations within the four countries in the Sahel region. Additionally, approximately 84 percent of the discussions were still dominated by big actors, such as NGO or government actors. Furthermore, as a subject of communication within agroforestry discourse, the Great Green Wall initiative generates almost 60 percent positive sentiment within the captured social media data, effectively having a more significant outreach than general agroforestry topics. This study provides an understanding for scholars and policymakers with a springboard for further research or policy design on agroforestry in the four countries of the Sahel region with systematically uncaptured novel data from the internet.Keywords: sahel, djibouti, senegal, mali, nigeria, social networks analysis, public discourse analysis, sentiment analysis, content analysis, social media, online news, agroforestry, land restoration
Procedia PDF Downloads 102300 Creating Moments and Memories: An Evaluation of the Starlight 'Moments' Program for Palliative Children, Adolescents and Their Families
Authors: C. Treadgold, S. Sivaraman
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The Starlight Children's Foundation (Starlight) is an Australian non-profit organisation that delivers programs, in partnership with health professionals, to support children, adolescents, and their families who are living with a serious illness. While supporting children and adolescents with life-limiting conditions has always been a feature of Starlight's work, providing a dedicated program, specifically targeting and meeting the needs of the paediatric palliative population, is a recent area of focus. Recognising the challenges in providing children’s palliative services, Starlight initiated a research and development project to better understand and meet the needs of this group. The aim was to create a program which enhances the wellbeing of children, adolescents, and their families receiving paediatric palliative care in their community through the provision of on-going, tailored, positive experiences or 'moments'. This paper will present the results of the formative evaluation of this unique program, highlighting the development processes and outcomes of the pilot. The pilot was designed using an innovation methodology, which included a number of research components. There was a strong belief that it needed to be delivered in partnership with a dedicated palliative care team, helping to ensure the best interests of the family were always represented. This resulted in Starlight collaborating with both the Victorian Paediatric Palliative Care Program (VPPCP) at the Royal Children's Hospital, Melbourne, and the Sydney Children's Hospital Network (SCHN) to pilot the 'Moments' program. As experts in 'positive disruption', with a long history of collaborating with health professionals, Starlight was well placed to deliver a program which helps children, adolescents, and their families to experience moments of joy, connection and achieve their own sense of accomplishment. Building on Starlight’s evidence-based approach and experience in creative service delivery, the program aims to use the power of 'positive disruption' to brighten the lives of this group and create important memories. The clinical and Starlight team members collaborate to ensure that the child and family are at the centre of the program. The design of each experience is specific to their needs and ensures the creation of positive memories and family connection. It aims for each moment to enhance quality of life. The partnership with the VPPCP and SCHN has allowed the program to reach families across metropolitan and regional locations. In late 2019 a formative evaluation of the pilot was conducted utilising both quantitative and qualitative methodologies to document both the delivery and outcomes of the program. Central to the evaluation was the interviews conducted with both clinical teams and families in order to gain a comprehensive understanding of the impact of and satisfaction with the program. The findings, which will be shared in this presentation, provide practical insight into the delivery of the program, the key elements for its success with families, and areas which could benefit from additional research and focus. It will use stories and case studies from the pilot to highlight the impact of the program and discuss what opportunities, challenges, and learnings emerged.Keywords: children, families, memory making, pediatric palliative care, support
Procedia PDF Downloads 99299 Insufficiency of Cardioprotection at Adaptation to Chronic Hypoxia and at Remote Postconditioning in Young and Aged Rats with Metabolic Syndrome, the Role of Metabolic Disorders or Opioid Signaling
Authors: Natalia V. Naryzhnaya, Alexandr V. Mukhomedzyanov, Ivan A. Derkachev, Boris K. Kurbatov, Leonid N. Maslov
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Background: Techniques of adaptation to hypoxia and remote postconditioning (RPost) have great prospects for use in the clinic. However, recent studies have shown low efficacy of remote postconditioning in patients with AMI. We hypothesize that the reasons for this inefficiency may be metabolic disorders, which are very common, especially in patients with cardiovascular disease, and age of patients. The purpose of the study was to reveal the effectiveness of adaptation to chronic hypoxia and RPost. To determine the possible relationship between the decrease in the effectiveness of projective impacts and disorders of carbohydrate and lipid metabolism. Design: The study was carried out on Wistar rats 60 day old. MetS was induced by high-carbohydrate, high-fat diet (HСHFD). Modeling MS led to the formation of obesity, hypertension, impaired lipid and carbohydrate metabolism, hyperleptinemia, and moderate stress. Groups with adaptation to chronic hypoxia were subjected to hypoxia for 21 days at 12% O2 and 0.3% CO2 after complete of HСHFD. All animals were subjected to 45 min coronary occlusion and 120 min reperfusion. Groups with RPost, immediately after the end of ischemia, tourniquets were applied to the hind limbs in the area of the hip joint (3 times in the mode of 5 min ischemia, 5 min reperfusion). Results: RPost led to a twofold reduction of infarct size in rats with intact metabolism (р < 0.0001), while in rats with MetS, a decrease in infarct size during RPost was 25 % (p = 0.00003). A direct correlation was found between of infarct size during RPost and the serum leptin level of rats with MetC (r = 0.85). The presented data suggested that a decrease in the efficiency of remote postconditioning in rats with diet-induced metabolic syndrome depends on serum leptin. Chronic hypoxia resulted in a 38% reduced in infarct size in metabolically intact rats. The decrease of cardioprotection was observed in rats with chronic hypoxia and MetS. Infarct size showed a direct correlation with impaired glucose tolerance (AUC, glucose tolerance test, r = 0.034) and serum triglyceride levels (r = 0.39). Our study showed the dependence of cardioprotection in rats with metabolic syndrome during chronic hypoxia and DPost on opioids in the blood serum and myocardium, protein kinase C and NO synthase activity. Conclusion: The results obtained showed that the infarct-limiting efficiency of adaptation to hypoxia and remote postconditioning is reduced or completely absent in animals with metabolic syndrome. The increase in the infarction, in this case, directly depends on the disturbances in carbohydrate. lipid metabolism and opioids signaling. Funding: Investigation of effectiveness of chronic hypoxia at the metabolic syndrome was carried out within the support of Russian Science Foundation Grant 22-15-00048. Studies of the mechanisms of arterial hypertension in induced metabolic syndrome were carried out within the framework of the state assignment (122020300042-4). The work was performed using the Center for Collective Use "Medical Genomics".Keywords: chronic hypoxia, opioids, remote postconditioning, metabolic syndrome
Procedia PDF Downloads 79298 Mobile Learning in Developing Countries: A Synthesis of the Past to Define the Future
Authors: Harriet Koshie Lamptey, Richard Boateng
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Mobile learning (m-learning) is a novel approach to knowledge acquisition and dissemination and is gaining global attention. Steady progress in wireless technologies and the portability of communication devices continue to broaden the scope and use of mobiles. With the convergence of Web functionality onto mobile platforms and the affordability and availability of mobile technology, m-learning has the potential of being the next prevalent channel of education in both formal and informal settings. There is substantive literature on developed countries but the state in developing countries (DCs) however appears vague. This paper is a synthesis of extant literature on mobile learning in DCs. The research interest is based on the fact that in DCs, mobile communication and internet connectivity are popular. However, its use in education is under explored. There are some reviews on the state, conceptualizations, trends and teacher education, but to the authors’ knowledge, no study has focused on mobile learning adoption and integration issues. This study examines issues and gaps associated with its adoption and integration in DCs higher education institutions. A qualitative build-up of literature was conducted using articles pooled from electronic databases (Google Scholar and ERIC). To enable criteria for inclusion and incorporate diverse study perspectives, search terms used were m-learning, DCs, higher education institutions, challenges, benefits, impact, gaps and issues. The synthesis revealed that though mobile technology has diffused globally, its pedagogical pursuit in DCs remains quite low. The absence of a mobile Web and the difficulty of resource conversion into mobile format due to lack of funding and technical competence is a stumbling block. Again, the lack of established design and implementation rules to guide the development of m-learning platforms in DCs is a hindrance. The absence of access restrictions on devices poses security threats to institutional systems. Negative perceptions that devices are taking over faculty roles lead to resistance in some situations. Resistance to change can be a hindrance to the acceptance and success of new systems. Lack of interest for m-learning is also attributed to lower technological literacy levels of the underprivileged masses. Scholarly works on m-learning in DCs is yet to mature. Most technological innovations are handed down from developed countries, and this constantly creates a lag for DCs. Lack of theoretical grounding was also identified which reduces the objectivity of study reports. The socio-cultural terrain of DCs results in societies with different views and needs that have been identified as a hindrance to research. Institutional commitment decisions, adequate funding for the necessary infrastructural development as well as multiple stakeholder participation is important for project success. Evidence suggests that while adoption decisions are readily made, successful integration of the concept for its full benefits to be realized is often neglected. Recommendations to findings were made to provide possible remedies to identified issues.Keywords: developing countries, higher education institutions, mobile learning, literature review
Procedia PDF Downloads 225297 Approach for the Mathematical Calculation of the Damping Factor of Railway Bridges with Ballasted Track
Authors: Andreas Stollwitzer, Lara Bettinelli, Josef Fink
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The expansion of the high-speed rail network over the past decades has resulted in new challenges for engineers, including traffic-induced resonance vibrations of railway bridges. Excessive resonance-induced speed-dependent accelerations of railway bridges during high-speed traffic can lead to negative consequences such as fatigue symptoms, distortion of the track, destabilisation of the ballast bed, and potentially even derailment. A realistic prognosis of bridge vibrations during high-speed traffic must not only rely on the right choice of an adequate calculation model for both bridge and train but first and foremost on the use of dynamic model parameters which reflect reality appropriately. However, comparisons between measured and calculated bridge vibrations are often characterised by considerable discrepancies, whereas dynamic calculations overestimate the actual responses and therefore lead to uneconomical results. This gap between measurement and calculation constitutes a complex research issue and can be traced to several causes. One major cause is found in the dynamic properties of the ballasted track, more specifically in the persisting, substantial uncertainties regarding the consideration of the ballasted track (mechanical model and input parameters) in dynamic calculations. Furthermore, the discrepancy is particularly pronounced concerning the damping values of the bridge, as conservative values have to be used in the calculations due to normative specifications and lack of knowledge. By using a large-scale test facility, the analysis of the dynamic behaviour of ballasted track has been a major research topic at the Institute of Structural Engineering/Steel Construction at TU Wien in recent years. This highly specialised test facility is designed for isolated research of the ballasted track's dynamic stiffness and damping properties – independent of the bearing structure. Several mechanical models for the ballasted track consisting of one or more continuous spring-damper elements were developed based on the knowledge gained. These mechanical models can subsequently be integrated into bridge models for dynamic calculations. Furthermore, based on measurements at the test facility, model-dependent stiffness and damping parameters were determined for these mechanical models. As a result, realistic mechanical models of the railway bridge with different levels of detail and sufficiently precise characteristic values are available for bridge engineers. Besides that, this contribution also presents another practical application of such a bridge model: Based on the bridge model, determination equations for the damping factor (as Lehr's damping factor) can be derived. This approach constitutes a first-time method that makes the damping factor of a railway bridge calculable. A comparison of this mathematical approach with measured dynamic parameters of existing railway bridges illustrates, on the one hand, the apparent deviation between normatively prescribed and in-situ measured damping factors. On the other hand, it is also shown that a new approach, which makes it possible to calculate the damping factor, provides results that are close to reality and thus raises potentials for minimising the discrepancy between measurement and calculation.Keywords: ballasted track, bridge dynamics, damping, model design, railway bridges
Procedia PDF Downloads 164296 GIS and Remote Sensing Approach in Earthquake Hazard Assessment and Monitoring: A Case Study in the Momase Region of Papua New Guinea
Authors: Tingneyuc Sekac, Sujoy Kumar Jana, Indrajit Pal, Dilip Kumar Pal
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Tectonism induced Tsunami, landslide, ground shaking leading to liquefaction, infrastructure collapse, conflagration are the common earthquake hazards that are experienced worldwide. Apart from human casualty, the damage to built-up infrastructures like roads, bridges, buildings and other properties are the collateral episodes. The appropriate planning must precede with a view to safeguarding people’s welfare, infrastructures and other properties at a site based on proper evaluation and assessments of the potential level of earthquake hazard. The information or output results can be used as a tool that can assist in minimizing risk from earthquakes and also can foster appropriate construction design and formulation of building codes at a particular site. Different disciplines adopt different approaches in assessing and monitoring earthquake hazard throughout the world. For the present study, GIS and Remote Sensing potentials were utilized to evaluate and assess earthquake hazards of the study region. Subsurface geology and geomorphology were the common features or factors that were assessed and integrated within GIS environment coupling with seismicity data layers like; Peak Ground Acceleration (PGA), historical earthquake magnitude and earthquake depth to evaluate and prepare liquefaction potential zones (LPZ) culminating in earthquake hazard zonation of our study sites. The liquefaction can eventuate in the aftermath of severe ground shaking with amenable site soil condition, geology and geomorphology. The latter site conditions or the wave propagation media were assessed to identify the potential zones. The precept has been that during any earthquake event the seismic wave is generated and propagates from earthquake focus to the surface. As it propagates, it passes through certain geological or geomorphological and specific soil features, where these features according to their strength/stiffness/moisture content, aggravates or attenuates the strength of wave propagation to the surface. Accordingly, the resulting intensity of shaking may or may not culminate in the collapse of built-up infrastructures. For the case of earthquake hazard zonation, the overall assessment was carried out through integrating seismicity data layers with LPZ. Multi-criteria Evaluation (MCE) with Saaty’s Analytical Hierarchy Process (AHP) was adopted for this study. It is a GIS technology that involves integration of several factors (thematic layers) that can have a potential contribution to liquefaction triggered by earthquake hazard. The factors are to be weighted and ranked in the order of their contribution to earthquake induced liquefaction. The weightage and ranking assigned to each factor are to be normalized with AHP technique. The spatial analysis tools i.e., Raster calculator, reclassify, overlay analysis in ArcGIS 10 software were mainly employed in the study. The final output of LPZ and Earthquake hazard zones were reclassified to ‘Very high’, ‘High’, ‘Moderate’, ‘Low’ and ‘Very Low’ to indicate levels of hazard within a study region.Keywords: hazard micro-zonation, liquefaction, multi criteria evaluation, tectonism
Procedia PDF Downloads 266295 A Realist Review of Influences of Community-Based Interventions on Noncommunicable Disease Risk Behaviors
Authors: Ifeyinwa Victor-Uadiale, Georgina Pearson, Sophie Witter, D. Reidpath
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Introduction: Smoking, alcohol misuse, unhealthy diet, and physical inactivity are the primary drivers of noncommunicable diseases (NCD), including cardiovascular diseases, cancers, respiratory diseases, and diabetes, worldwide. Collectively, these diseases are the leading cause of all global deaths, most of which are premature, affecting people between 30 and 70 years. Empirical evidence suggests that these risk behaviors can be modified by community-based interventions (CBI). However, there is little insight into the mechanisms and contextual factors of successful community interventions that impact risk behaviours for chronic diseases. This study examined “Under what circumstances, for whom, and how, do community-based interventions modify smoking, alcohol use, unhealthy diet, and physical inactivity among adults”. Adopting the Capability (C), Opportunity (O), Motivation (M), Behavior (B) (COM-B) framework for behaviour change, it sought to: (1) identify the mechanisms through which CBIs could reduce tobacco use and alcohol consumption and increase physical activity and the consumption of healthy diets and (2) examine the contextual factors that trigger the impact of these mechanisms on these risk behaviours among adults. Methods: Pawson’s realist review method was used to examine the literature. Empirical evidence and theoretical understanding were combined to develop a realist program theory that explains how CBIs influence NCD risk behaviours. Documents published between 2002 and 2020 were systematically searched in five electronic databases (CINAHL, Cochrane Library, Medline, ProQuest Central, and PsycINFO). They were included if they reported on community-based interventions aimed at cardiovascular diseases, cancers, respiratory diseases, and diabetes in a global context; and had an outcome targeted at smoking, alcohol, physical activity, and diet. Findings: Twenty-nine scientific documents were retrieved and included in the review. Over half of them (n = 18; 62%) focused on three of the four risk behaviours investigated in this review. The review identified four mechanisms: capability, opportunity, motivation, and social support that are likely to change the dietary and physical activity behaviours in adults given certain contexts. There were weak explanations of how the identified mechanisms could likely change smoking and alcohol consumption habits. In addition, eight contextual factors that may affect how these mechanisms impact physical activity and dietary behaviours were identified: suitability to work and family obligations, risk status awareness, socioeconomic status, literacy level, perceived need, availability and access to resources, culture, and group format. Conclusion: The findings suggest that CBIs are likely to improve the physical activity and dietary habits of adults if the intervention function seeks to educate, incentivize, change the environment, and model the right behaviours. The review applies and advances theory, realist research, and the design and implementation of community-based interventions for NCD prevention.Keywords: community-based interventions, noncommunicable disease, realist program theory, risk behaviors
Procedia PDF Downloads 95294 Explaining the Acceptance and Adoption of Digital Technologies: Digital Government in Saudi Arabia
Authors: Mohammed Alhamed
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This research examines the factors influencing the acceptance and adoption of digital technologies in Saudi Arabia’s government sector by focusing on government employees' attitudes toward digital transformation initiatives. As digital technologies increasingly integrate into public sectors worldwide, there is a requirement to enhance citizen empowerment and government-public interactions as well as understand their impact in unique socio-political contexts like Saudi Arabia. The study aims to explore user attitudes, identify the main challenges, and investigate factors that affect the intention to use digital applications in governmental settings. The study employs a mixed-methods approach by combining quantitative and qualitative data collection to provide a comprehensive view of digital government application adoption. Data was collected through two online surveys administered to 870 government employees and face-to-face semi-structured interviews with 24 participants. This dual approach allows for both statistical analysis and thematic exploration, which provides a deeper understanding of user behaviour, perceived benefits, challenges and attitudes toward these digital applications. Quantitative data were analyzed to identify significant variables influencing adoption, while qualitative responses were coded thematically to uncover recurring themes related to user trust, security, usability and socio-political influences. The results indicate that digital government applications are largely valued for their ability to increase efficiency and accessibility and streamline processes like online documentation and inter-departmental coordination. However, the study highlights that security, privacy, and confidentiality concerns constitute substantial barriers to adoption, with participants calling for stronger cybersecurity measures and data protection policies. Moreover, usability emerged as a key theme that intuitively interfaces in encouraging adoption as respondents emphasized the importance of user-friendly. Additionally, the study found that Saudi Arabia’s unique cultural and organizational dynamics impact acceptance levels with factors like hierarchical structures and varying levels of digital literacy shaping user attitudes. A significant limitation of the study is its exclusive focus on government employees, which may limit the generalizability of the findings to other stakeholder groups, such as the general public. Despite this, the study offers valuable views for policymakers. This, in turn, suggests best practices and guidelines that could enhance the design and implementation of digital government projects. By addressing the identified barriers and leveraging the factors that drive adoption, the study underscores the potential for digital government initiatives to improve efficiency, transparency and responsiveness in Saudi Arabia's public sector. Furthermore, these findings may provide a roadmap for similar countries aiming to adopt digital government solutions within comparable socio-political and economic contexts.Keywords: acceptance, adoption, digital technologies, digital government, Saudi Arabia
Procedia PDF Downloads 11293 Carbon-Foam Supported Electrocatalysts for Polymer Electrolyte Membrane Fuel Cells
Authors: Albert Mufundirwa, Satoru Yoshioka, K. Ogi, Takeharu Sugiyama, George F. Harrington, Bretislav Smid, Benjamin Cunning, Kazunari Sasaki, Akari Hayashi, Stephen M. Lyth
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Polymer electrolyte membrane fuel cells (PEMFCs) are electrochemical energy conversion devices used for portable, residential and vehicular applications due to their low emissions, high efficiency, and quick start-up characteristics. However, PEMFCs generally use expensive, Pt-based electrocatalysts as electrode catalysts. Due to the high cost and limited availability of platinum, research and development to either drastically reduce platinum loading, or replace platinum with alternative catalysts is of paramount importance. A combination of high surface area supports and nano-structured active sites is essential for effective operation of catalysts. We synthesize carbon foam supports by thermal decomposition of sodium ethoxide, using a template-free, gram scale, cheap, and scalable pyrolysis method. This carbon foam has a high surface area, highly porous, three-dimensional framework which is ideal for electrochemical applications. These carbon foams can have surface area larger than 2500 m²/g, and electron microscopy reveals that they have micron-scale cells, separated by few-layer graphene-like carbon walls. We applied this carbon foam as a platinum catalyst support, resulting in the improved electrochemical surface area and mass activity for the oxygen reduction reaction (ORR), compared to carbon black. Similarly, silver-decorated carbon foams showed higher activity and efficiency for electrochemical carbon dioxide conversion than silver-decorated carbon black. A promising alternative to Pt-catalysts for the ORR is iron-impregnated nitrogen-doped carbon catalysts (Fe-N-C). Doping carbon with nitrogen alters the chemical structure and modulates the electronic properties, allowing a degree of control over the catalytic properties. We have adapted our synthesis method to produce nitrogen-doped carbon foams with large surface area, using triethanolamine as a nitrogen feedstock, in a novel bottom-up protocol. These foams are then infiltrated with iron acetate (FeAc) and pyrolysed to form Fe-N-C foams. The resulting Fe-N-C foam catalysts have high initial activity (half-wave potential of 0.68 VRHE), comparable to that of commercially available Pt-free catalysts (e.g., NPC-2000, Pajarito Powder) in acid solution. In alkaline solution, the Fe-N-C carbon foam catalysts have a half-wave potential of 0.89 VRHE, which is higher than that of NPC-2000 by almost 10 mVRHE, and far out-performing platinum. However, the durability is still a problem at present. The lessons learned from X-ray absorption spectroscopy (XAS), transmission electron microscopy (TEM), X-ray photoelectron spectroscopy (XPS), and electrochemical measurements will be used to carefully design Fe-N-C catalysts for higher performance PEMFCs.Keywords: carbon-foam, polymer electrolyte membrane fuel cells, platinum, Pt-free, Fe-N-C, ORR
Procedia PDF Downloads 180292 Low-Cost, Portable Optical Sensor with Regression Algorithm Models for Accurate Monitoring of Nitrites in Environments
Authors: David X. Dong, Qingming Zhang, Meng Lu
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Nitrites enter waterways as runoff from croplands and are discharged from many industrial sites. Excessive nitrite inputs to water bodies lead to eutrophication. On-site rapid detection of nitrite is of increasing interest for managing fertilizer application and monitoring water source quality. Existing methods for detecting nitrites use spectrophotometry, ion chromatography, electrochemical sensors, ion-selective electrodes, chemiluminescence, and colorimetric methods. However, these methods either suffer from high cost or provide low measurement accuracy due to their poor selectivity to nitrites. Therefore, it is desired to develop an accurate and economical method to monitor nitrites in environments. We report a low-cost optical sensor, in conjunction with a machine learning (ML) approach to enable high-accuracy detection of nitrites in water sources. The sensor works under the principle of measuring molecular absorptions of nitrites at three narrowband wavelengths (295 nm, 310 nm, and 357 nm) in the ultraviolet (UV) region. These wavelengths are chosen because they have relatively high sensitivity to nitrites; low-cost light-emitting devices (LEDs) and photodetectors are also available at these wavelengths. A regression model is built, trained, and utilized to minimize cross-sensitivities of these wavelengths to the same analyte, thus achieving precise and reliable measurements with various interference ions. The measured absorbance data is input to the trained model that can provide nitrite concentration prediction for the sample. The sensor is built with i) a miniature quartz cuvette as the test cell that contains a liquid sample under test, ii) three low-cost UV LEDs placed on one side of the cell as light sources, with each LED providing a narrowband light, and iii) a photodetector with a built-in amplifier and an analog-to-digital converter placed on the other side of the test cell to measure the power of transmitted light. This simple optical design allows measuring the absorbance data of the sample at the three wavelengths. To train the regression model, absorbances of nitrite ions and their combination with various interference ions are first obtained at the three UV wavelengths using a conventional spectrophotometer. Then, the spectrophotometric data are inputs to different regression algorithm models for training and evaluating high-accuracy nitrite concentration prediction. Our experimental results show that the proposed approach enables instantaneous nitrite detection within several seconds. The sensor hardware costs about one hundred dollars, which is much cheaper than a commercial spectrophotometer. The ML algorithm helps to reduce the average relative errors to below 3.5% over a concentration range from 0.1 ppm to 100 ppm of nitrites. The sensor has been validated to measure nitrites at three sites in Ames, Iowa, USA. This work demonstrates an economical and effective approach to the rapid, reagent-free determination of nitrites with high accuracy. The integration of the low-cost optical sensor and ML data processing can find a wide range of applications in environmental monitoring and management.Keywords: optical sensor, regression model, nitrites, water quality
Procedia PDF Downloads 72291 The Influence of a Radio Intervention on Farmers’ Practices in Climate Change Mitigation and Adaptation in Kilifi, Kenya
Authors: Fiona Mwaniki
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Climate change is considered a serious threat to sustainable development globally and as one of the greatest ecological, economic and social challenges of our time. The global demand for food is projected to increase by 60% by 2050. Small holder farmers who are vulnerable to the adverse effects of climate change are expected to contribute to this projected demand. Effective climate change education and communication is therefore required for smallholder and subsistence farmers’ in order to build communities that are more climate change aware, prepared and resilient. In Kenya radio is the most important and dominant mass communication tool for agricultural extension. This study investigated the potential role of radio in influencing farmers’ understanding and use of climate change information. The broad aims of this study were three-fold. Firstly, to identify Kenyan farmers’ perceptions and responses to the impacts of climate change. Secondly, to develop radio programs that communicate climate change information to Kenyan farmers and thirdly, to evaluate the impact of information disseminated through radio on farmers’ understanding and responses to climate change mitigation and adaptation. This study was conducted within the farming community of Kilifi County, located along the Kenyan coast. Education and communication about climate change was undertaken using radio to make available information understandable to different social and cultural groups. A mixed methods pre-and post-intervention design that provided the opportunity for triangulating results from both quantitative and qualitative data was used. Quantitative and qualitative data was collected simultaneously, where quantitative data was collected through semi structured surveys with 421 farmers’ and qualitative data was derived from 11 focus group interviews, six interviews with key informants and nine climate change experts. The climate change knowledge gaps identified in the initial quantitative and qualitative data were used in developing radio programs. Final quantitative and qualitative data collection and analysis enabled an assessment of the impact of climate change messages aired through radio on the farming community in Kilifi County. Results of this study indicate that 32% of the farmers’ listened to the radio programs and 26% implemented technologies aired on the programs that would help them adapt to climate change. The most adopted technologies were planting drought tolerant crops including indigenous crop varieties, planting trees, water harvesting and use of manure. The proportion of farmers who indicated they knew “a fair amount” about climate change increased significantly (Z= -5.1977, p < 0.001) from 33% (at the pre intervention phase of this study) to 64% (post intervention). However, 68% of the farmers felt they needed “a lot more” information on agriculture interventions (43%), access to financial resources (21%) and the effects of climate change (15%). The challenges farmers’ faced when adopting the interventions included lack of access to financial resources (18%), high cost of adaptation measures (17%), and poor access to water (10%). This study concludes that radio effectively complements other agricultural extension methods and has the potential to engage farmers’ on climate change issues and motivate them to take action.Keywords: climate change, climate change intervention, farmers, radio
Procedia PDF Downloads 338290 Examining the Impact of De-Escalation Training among Emergency Department Nurses
Authors: Jonathan D. Recchi
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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.Keywords: de-escalation, nursing, emergency department, workplace violence
Procedia PDF Downloads 104289 Purple Spots on Historical Parchments: Confirming the Microbial Succession at the Basis of Biodeterioration
Authors: N. Perini, M. C. Thaller, F. Mercuri, S. Orlanducci, A. Rubechini, L. Migliore
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The preservation of cultural heritage is one of the major challenges of today’s society, because of the fundamental right of future generations to inherit it as the continuity with their historical and cultural identity. Parchments, consisting of a semi-solid matrix of collagen produced from animal skin (i.e., sheep or goats), are a significant part of the cultural heritage, being used as writing material for many centuries. Due to their animal origin, parchments easily undergo biodeterioration. The most common biological damage is characterized by isolated or coalescent purple spots that often leads to the detachment of the superficial layer and the loss of the written historical content of the document. Although many parchments with the same biodegradative features were analyzed, no common causative agent has been found so far. Very recently, a study was performed on a purple-damaged parchment roll dated back 1244 A.D, the A.A. Arm. I-XVIII 3328, belonging to the oldest collection of the Vatican Secret Archive (Fondo 'Archivum Arcis'), by comparing uncolored undamaged and purple damaged areas of the same document. As a whole, the study gave interesting results to hypothesize a model of biodeterioration, consisting of a microbial succession acting in two main phases: the first one, common to all the damaged parchments, is characterized by halophilic and halotolerant bacteria fostered by the salty environment within the parchment maybe induced by bringing of the hides; the second one, changing with the individual history of each parchment, determines the identity of its colonizers. The design of this model was pivotal to this study, performed by different labs of the Tor Vergata University (Rome, Italy), in collaboration with the Vatican Secret Archive. Three documents, belonging to a collection of dramatically damaged parchments archived as 'Faldone Patrizi A 19' (dated back XVII century A.D.), were analyzed through a multidisciplinary approach, including three updated technologies: (i) Next Generation Sequencing (NGS, Illumina) to describe the microbial communities colonizing the damaged and undamaged areas, (ii) RAMAN spectroscopy to analyze the purple pigments, (iii) Light Transmitted Analysis (LTA) to evaluate the kind and entity of the damage to native collagen. The metagenomic analysis obtained from NGS revealed DNA sequences belonging to Halobacterium salinarum mainly in the undamaged areas. RAMAN spectroscopy detected pigments within the purple spots, mainly bacteriorhodopsine/rhodopsin-like pigments, a purple transmembrane protein containing retinal and present in Halobacteria. The LTA technique revealed extremely damaged collagen structures in both damaged and undamaged areas of the parchments. In the light of these data, the study represents a first confirmation of the microbial succession model described above. The demonstration of this model is pivotal to start any possible new restoration strategy to bring back historical parchments to their original beauty, but also to open opportunities for intervention on a huge amount of documents.Keywords: biodeterioration, parchments, purple spots, ecological succession
Procedia PDF Downloads 171288 Productivity of Grain Sorghum-Cowpea Intercropping System: Climate-Smart Approach
Authors: Mogale T. E., Ayisi K. K., Munjonji L., Kifle Y. G.
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Grain sorghum and cowpea are important staple crops in many areas of South Africa, particularly the Limpopo Province. The two crops are produced under a wide range of unsustainable conventional methods, which reduces productivity in the long run. Climate-smart traditional methods such as intercropping can be adopted to ensure sustainable production of these important two crops in the province. A no-tillage field experiment was laid out in a randomised complete block design (RCBD) with four replications over two seasons in two distinct agro-ecological zones, Syferkuil and Ofcolacoin, the province to assess the productivity of sorghum-cowpea intercropped under two cowpea densities.LCi Ultra compact photosynthesis machine was used to collect photosynthetic rate data biweekly between 11h00 and 13h00 until physiological maturity. Biomass and grain yield of the component crops in binary and sole cultures were determined at harvest maturity from middle rows of 2.7 m2 area. The biomass was oven dried in the laboratory at 65oC till constant weight. To obtain grain yield, harvested sorghum heads and cowpea pods were threshed, cleaned, and weighed. Harvest index (HI) and land equivalent ratio (LER) of the two crops were calculated to assess intercrop productivity relative to sole cultures. Data was analysed using the statistical analysis software system (SAS) 9.4 version, followed by mean separation using the least significant difference method. The photosyntheticrate of sorghum-cowpea intercrop was influenced by cowpea density and sorghum cultivar. Photosynthetic rate under low density was higher compared to high density, but this was dependent on the growing conditions. Dry biomass accumulation, grain yield, and harvest index differed among the sorghum cultivars and cowpea in both binary and sole cultures at the two test locations during the 2018/19 and 2020/21 growing seasons. Cowpea grain and dry biomass yields werein excess of 60% under high density compared to low density in both binary and sole cultures. The results revealed that grain yield accumulation of sorghum cultivars was influenced by the density of the companion cowpea crop as well as the production season. For instant, at Syferkuil, Enforcer and Ns5511 accumulated high yield under low density, whereas, at Ofcolaco, the higher yield was recorded under high density. Generally, under low cowpea density, cultivar Enforcer produced relatively higher grain yield whereas, under higher density, Titan yield was superior. The partial and total LER varied with growing season and the treatments studied. The total LERs exceeded 1.0 at the two locations across seasons, ranging from 1.3 to 1.8. From the results, it can be concluded that resources were used more efficiently in sorghum-cowpea intercrop at both Syferkuil and Ofcolaco. Furthermore, intercropping system improved photosynthetic rate, grain yield, and dry matter accumulation of sorghum and cowpea depending on growing conditions and density of cowpea. Hence, the sorghum-cowpea intercropping system can be adopted as a climate-smart practice for sustainable production in the Limpopo province.Keywords: cowpea, climate-smart, grain sorghum, intercropping
Procedia PDF Downloads 222287 A Randomised Controlled Trial and Process Evaluation of the Lifestart Parenting Programme
Authors: Sharon Millen, Sarah Miller, Laura Dunne, Clare McGeady, Laura Neeson
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This paper presents the findings from a randomised controlled trial (RCT) and process evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid family visitors and it is offered to parents regardless of their social, economic or other circumstances. The RCT evaluated the effectiveness of the programme and the process evaluation documented programme delivery and included a qualitative exploration of parent and child outcomes. 424 parents and children participated in the RCT: 216 in the intervention group and 208 in the control group across the island of Ireland. Parent outcomes included: parental knowledge of child development, parental efficacy, stress, social support, parenting skills and embeddedness in the community. Child outcomes included cognitive, language and motor development and social-emotional and behavioural development. Both groups were tested at baseline (when children were less than 1 year old), mid-point (aged 3) and at post-test (aged 5). Data were collected during a home visit, which took two hours. The process evaluation consisted of interviews with parents (n=16 at baseline and end-point), and focus groups with Lifestart Coordinators (n=9) and Family Visitors (n=24). Quantitative findings from the RCT indicated that, compared to the control group, parents who received the Lifestart programme reported reduced parenting-related stress, increased knowledge of their child’s development, and improved confidence in their parenting role. These changes were statistically significant and consistent with the hypothesised pathway of change depicted in the logic model. There was no evidence of any change in parents’ embeddedness in the community. Although four of the five child outcomes showed small positive change for children who took part in the programme, these were not statistically significant and there is no evidence that the programme improves child cognitive and non-cognitive skills by immediate post-test. The qualitative process evaluation highlighted important challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which formed part of the data collection. This highlights the potential importance of appropriate incentives in relation to recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they experienced as a result of the Lifestart programme was increased knowledge and confidence in their parenting ability. The outcomes and pathways perceived by parents and described in the interviews are also consistent with the findings of the RCT and the theory of change underpinning the programme. This hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediate the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme.Keywords: parent-child relationship, parental self-efficacy, parental stress, school readiness
Procedia PDF Downloads 444286 Moral Decision-Making in the Criminal Justice System: The Influence of Gruesome Descriptions
Authors: Michel Patiño-Sáenz, Martín Haissiner, Jorge Martínez-Cotrina, Daniel Pastor, Hernando Santamaría-García, Maria-Alejandra Tangarife, Agustin Ibáñez, Sandra Baez
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It has been shown that gruesome descriptions of harm can increase the punishment given to a transgressor. This biasing effect is mediated by negative emotions, which are elicited upon the presentation of gruesome descriptions. However, there is a lack of studies inquiring the influence of such descriptions on moral decision-making in people involved in the criminal justice system. Such populations are of special interest since they have experience dealing with gruesome evidence, but also formal education on how to assess evidence and gauge the appropriate punishment according to the law. Likewise, they are expected to be objective and rational when performing their duty, because their decisions can impact profoundly people`s lives. Considering these antecedents, the objective of this study was to explore the influence gruesome written descriptions on moral decision-making in this group of people. To that end, we recruited attorneys, judges and public prosecutors (Criminal justice group, CJ, n=30) whose field of specialty is criminal law. In addition, we included a control group of people who did not have a formal education in law (n=30), but who were paired in age and years of education with the CJ group. All participants completed an online, Spanish-adapted version of a moral decision-making task, which was previously reported in the literature and also standardized and validated in the Latin-American context. A series of text-based stories describing two characters, one inflicting harm on the other, were presented to participants. Transgressor's intentionality (accidental vs. intentional harm) and language (gruesome vs. plain) used to describe harm were manipulated employing a within-subjects and a between-subjects design, respectively. After reading each story, participants were asked to rate (a) the harmful action's moral adequacy, (b) the amount of punishment deserving the transgressor and (c) how damaging was his behavior. Results showed main effects of group, intentionality and type of language on all dependent measures. In both groups, intentional harmful actions were rated as significantly less morally adequate, were punished more severely and were deemed as more damaging. Moreover, control subjects deemed more damaging and punished more severely any type of action than the CJ group. In addition, there was an interaction between intentionality and group. People in the control group rated harmful actions as less morally adequate than the CJ group, but only when the action was accidental. Also, there was an interaction between intentionality and language on punishment ratings. Controls punished more when harm was described using gruesome language. However, that was not the case of people in the CJ group, who assigned the same amount of punishment in both conditions. In conclusion, participants with job experience in the criminal justice system or criminal law differ in the way they make moral decisions. Particularly, it seems that they are less sensitive to the biasing effect of gruesome evidence, which is probably explained by their formal education or their experience in dealing with such evidence. Nonetheless, more studies are needed to determine the impact this phenomenon has on the fulfillment of their duty.Keywords: criminal justice system, emotions, gruesome descriptions, intentionality, moral decision-making
Procedia PDF Downloads 188285 Investigating the Impact of Migration Background on Pregnancy Outcomes During the End of Period of COVID-19 Pandemic: A Mixed-Method Study
Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi
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Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.Keywords: migration background, pregnancy outcome, covid-19, postpartum
Procedia PDF Downloads 55284 Design and Development of Graphene Oxide Modified by Chitosan Nanosheets Showing pH-Sensitive Surface as a Smart Drug Delivery System for Control Release of Doxorubicin
Authors: Parisa Shirzadeh
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Drug delivery systems in which drugs are traditionally used, multi-stage and at specified intervals by patients, do not meet the needs of the world's up-to-date drug delivery. In today's world, we are dealing with a huge number of recombinant peptide and protean drugs and analogues of hormones in the body, most of which are made with genetic engineering techniques. Most of these drugs are used to treat critical diseases such as cancer. Due to the limitations of the traditional method, researchers sought to find ways to solve the problems of the traditional method to a large extent. Following these efforts, controlled drug release systems were introduced, which have many advantages. Using controlled release of the drug in the body, the concentration of the drug is kept at a certain level, and in a short time, it is done at a higher rate. Graphene is a natural material that is biodegradable, non-toxic, and natural compared to carbon nanotubes; its price is lower than carbon nanotubes and is cost-effective for industrialization. On the other hand, the presence of highly effective surfaces and wide surfaces of graphene plates makes it more effective to modify graphene than carbon nanotubes. Graphene oxide is often synthesized using concentrated oxidizers such as sulfuric acid, nitric acid, and potassium permanganate based on Hummer 1 method. In comparison with the initial graphene, the resulting graphene oxide is heavier and has carboxyl, hydroxyl, and epoxy groups. Therefore, graphene oxide is very hydrophilic and easily dissolves in water and creates a stable solution. On the other hand, because the hydroxyl, carboxyl, and epoxy groups created on the surface are highly reactive, they have the ability to work with other functional groups such as amines, esters, polymers, etc. Connect and bring new features to the surface of graphene. In fact, it can be concluded that the creation of hydroxyl groups, Carboxyl, and epoxy and in fact graphene oxidation is the first step and step in creating other functional groups on the surface of graphene. Chitosan is a natural polymer and does not cause toxicity in the body. Due to its chemical structure and having OH and NH groups, it is suitable for binding to graphene oxide and increasing its solubility in aqueous solutions. Graphene oxide (GO) has been modified by chitosan (CS) covalently, developed for control release of doxorubicin (DOX). In this study, GO is produced by the hummer method under acidic conditions. Then, it is chlorinated by oxalyl chloride to increase its reactivity against amine. After that, in the presence of chitosan, the amino reaction was performed to form amide transplantation, and the doxorubicin was connected to the carrier surface by π-π interaction in buffer phosphate. GO, GO-CS, and GO-CS-DOX characterized by FT-IR, RAMAN, TGA, and SEM. The ability to load and release is determined by UV-Visible spectroscopy. The loading result showed a high capacity of DOX absorption (99%) and pH dependence identified as a result of DOX release from GO-CS nanosheet at pH 5.3 and 7.4, which show a fast release rate in acidic conditions.Keywords: graphene oxide, chitosan, nanosheet, controlled drug release, doxorubicin
Procedia PDF Downloads 120283 Modern Technology-Based Methods in Neurorehabilitation for Social Competence Deficit in Children with Acquired Brain Injury
Authors: M. Saard, A. Kolk, K. Sepp, L. Pertens, L. Reinart, C. Kööp
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Introduction: Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation for social skills has remained undeveloped. Modern technology-based methods create effective and safe learning environments for pediatric social skills remediation. The aim of the study was to implement our structured model of neuro rehab for socio-cognitive deficit using multitouch-multiuser tabletop (MMT) computer-based platforms and virtual reality (VR) technology. Methods: 40 children aged 8-13 years (yrs) have participated in the pilot study: 30 with ABI -epilepsy, traumatic brain injury and/or tic disorder- and 10 healthy age-matched controls. From the patients, 12 have completed the training (M = 11.10 yrs, SD = 1.543) and 20 are still in training or in the waiting-list group (M = 10.69 yrs, SD = 1.704). All children performed the first individual and paired assessments. For patients, second evaluations were performed after the intervention period. Two interactive applications were implemented into rehabilitation design: Snowflake software on MMT tabletop and NoProblem on DiamondTouch Table (DTT), which allowed paired training (2 children at once). Also, in individual training sessions, HTC Vive VR device was used with VR metaphors of difficult social situations to treat social anxiety and train social skills. Results: At baseline (B) evaluations, patients had higher deficits in executive functions on the BRIEF parents’ questionnaire (M = 117, SD = 23.594) compared to healthy controls (M = 22, SD = 18.385). The most impaired components of social competence were emotion recognition, Theory of Mind skills (ToM), cooperation, verbal/non-verbal communication, and pragmatics (Friendship Observation Scale scores only 25-50% out of 100% for patients). In Sentence Completion Task and Spence Anxiety Scale, the patients reported a lack of friends, behavioral problems, bullying in school, and social anxiety. Outcome evaluations: Snowflake on MMT improved executive and cooperation skills and DTT developed communication skills, metacognitive skills, and coping. VR, video modelling and role-plays improved social attention, emotional attitude, gestural behaviors, and decreased social anxiety. NEPSY-II showed improvement in Affect Recognition [B = 7, SD = 5.01 vs outcome (O) = 10, SD = 5.85], Verbal ToM (B = 8, SD = 3.06 vs O = 10, SD = 4.08), Contextual ToM (B = 8, SD = 3.15 vs O = 11, SD = 2.87). ToM Stories test showed an improved understanding of Intentional Lying (B = 7, SD = 2.20 vs O = 10, SD = 0.50), and Sarcasm (B=6, SD = 2.20 vs O = 7, SD = 2.50). Conclusion: Neurorehabilitation based on the Structured Model of Neurorehab for Socio-Cognitive Deficit in children with ABI were effective in social skills remediation. The model helps to understand theoretical connections between components of social competence and modern interactive computerized platforms. We encourage therapists to implement these next-generation devices into the rehabilitation process as MMT and VR interfaces are motivating for children, thus ensuring good compliance. Improving children’s social skills is important for their and their families’ quality of life and social capital.Keywords: acquired brain injury, children, social skills deficit, technology-based neurorehabilitation
Procedia PDF Downloads 120282 Numerical Optimization of Cooling System Parameters for Multilayer Lithium Ion Cell and Battery Packs
Authors: Mohammad Alipour, Ekin Esen, Riza Kizilel
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Lithium-ion batteries are a commonly used type of rechargeable batteries because of their high specific energy and specific power. With the growing popularity of electric vehicles and hybrid electric vehicles, increasing attentions have been paid to rechargeable Lithium-ion batteries. However, safety problems, high cost and poor performance in low ambient temperatures and high current rates, are big obstacles for commercial utilization of these batteries. By proper thermal management, most of the mentioned limitations could be eliminated. Temperature profile of the Li-ion cells has a significant role in the performance, safety, and cycle life of the battery. That is why little temperature gradient can lead to great loss in the performances of the battery packs. In recent years, numerous researchers are working on new techniques to imply a better thermal management on Li-ion batteries. Keeping the battery cells within an optimum range is the main objective of battery thermal management. Commercial Li-ion cells are composed of several electrochemical layers each consisting negative-current collector, negative electrode, separator, positive electrode, and positive current collector. However, many researchers have adopted a single-layer cell to save in computing time. Their hypothesis is that thermal conductivity of the layer elements is so high and heat transfer rate is so fast. Therefore, instead of several thin layers, they model the cell as one thick layer unit. In previous work, we showed that single-layer model is insufficient to simulate the thermal behavior and temperature nonuniformity of the high-capacity Li-ion cells. We also studied the effects of the number of layers on thermal behavior of the Li-ion batteries. In this work, first thermal and electrochemical behavior of the LiFePO₄ battery is modeled with 3D multilayer cell. The model is validated with the experimental measurements at different current rates and ambient temperatures. Real time heat generation rate is also studied at different discharge rates. Results showed non-uniform temperature distribution along the cell which requires thermal management system. Therefore, aluminum plates with mini-channel system were designed to control the temperature uniformity. Design parameters such as channel number and widths, inlet flow rate, and cooling fluids are optimized. As cooling fluids, water and air are compared. Pressure drop and velocity profiles inside the channels are illustrated. Both surface and internal temperature profiles of single cell and battery packs are investigated with and without cooling systems. Our results show that using optimized Mini-channel cooling plates effectively controls the temperature rise and uniformity of the single cells and battery packs. With increasing the inlet flow rate, cooling efficiency could be reached up to 60%.Keywords: lithium ion battery, 3D multilayer model, mini-channel cooling plates, thermal management
Procedia PDF Downloads 164281 Exploring the Application of IoT Technology in Lower Limb Assistive Devices for Rehabilitation during the Golden Period of Stroke Patients with Hemiplegia
Authors: Ching-Yu Liao, Ju-Joan Wong
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Recent years have shown a trend of younger stroke patients and an increase in ischemic strokes with the rise in stroke incidence. This has led to a growing demand for telemedicine, particularly during the COVID-19 pandemic, which has made the need for telemedicine even more urgent. This shift in healthcare is also closely related to advancements in Internet of Things (IoT) technology. Stroke-induced hemiparesis is a significant issue for patients. The medical community believes that if intervention occurs within three to six months of stroke onset, 80% of the residual effects can be restored to normal, a period known as the stroke golden period. During this time, patients undergo treatment and rehabilitation, and neural plasticity is at its best. Lower limb rehabilitation for stroke generally includes exercises such as support standing and walking posture, typically involving the healthy limb to guide the affected limb to achieve rehabilitation goals. Existing gait training aids in hospitals usually involve balance gait, sitting posture training, and precise muscle control, effectively addressing issues of poor gait, insufficient muscle activity, and inability to train independently during recovery. However, home training aids, such as braced and wheeled devices, often rely on the healthy limb to pull the affected limb, leading to lower usage of the affected limb, worsening circular walking, and compensatory movement issues. IoT technology connects devices via the internet to record, receive data, provide feedback, and adjust equipment for intelligent effects. Therefore, this study aims to explore how IoT can be integrated into existing gait training aids to monitor and sensor home rehabilitation movements, improve gait training compensatory issues through real-time feedback, and enable healthcare professionals to quickly understand patient conditions and enhance medical communication. To understand the needs of hemiparetic patients, a review of relevant literature from the past decade will be conducted. From the perspective of user experience, participant observation will be used to explore the use of home training aids by stroke patients and therapists, and interviews with physical therapists will be conducted to obtain professional opinions and practical experiences. Design specifications for home training aids for hemiparetic patients will be summarized. Applying IoT technology to lower limb training aids for stroke hemiparesis can help promote walking function recovery in hemiparetic patients, reduce muscle atrophy, and allow healthcare professionals to immediately grasp patient conditions and adjust gait training plans based on collected and analyzed information. Exploring these potential development directions provides a valuable reference for the further application of IoT technology in the field of medical rehabilitation.Keywords: stroke, hemiplegia, rehabilitation, gait training, internet of things technology
Procedia PDF Downloads 30280 Compromising Quality of Life in Low Income Settlement's: The Case of Ashrayan Prakalpa, Khulna
Authors: Salma Akter, Md. Kamal Uddin
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This study aims to demonstrate how top-down shelter policy and its resultant dwelling environment leads to ‘everyday compromise’ by the grassroots according to subjective (satisfaction) and objective (physical design elements and physical environmental elements) indicators, which are measured across three levels of the settlement; macro (Community), meso (Neighborhood or shelter/built environment) and micro (family). Ashrayan Prakalpa is a resettlement /housing project of Government of Bangladesh for providing shelters and human resources development activities like education, microcredit, and training programme to landless, homeless and rootless people. Despite the integrated nature of the shelter policies (comprises poverty alleviation, employment opportunity, secured tenure, and livelihood training), the ‘quality of life’ issue at the different levels of settlements becomes questionable. As dwellers of shelter units (although formally termed as ‘barracks’ rather shelter or housing) remain on the receiving end of government’s resettlement policies, they often involve with spatial-physical and socio-economic negotiation and assume curious forms of spatial practice, which often upholds contradiction with policy planning. Thus, policy based shelter force dwellers to persistently compromise with their provided built environments both in overtly and covertly. Compromising with prescribed designed space and facilities across living places articulated their negotiation with the quality of allocated space, built form and infrastructures, which in turn exert as less quality of life. The top-down shelter project, Dakshin Chandani Mahal Ashrayan Prakalpa at Dighalia Upazila, the study area located at the Eastern fringe area of Khulna, Bangladesh, is still in progress to resettle internally displaced and homeless people. In terms of methodology, this research is primarily exploratory and adopts a case study method, and an analytical framework is developed through the deductive approach for evaluating the quality of life. Secondary data have been obtained from housing policy analysis and relevant literature review, while key informant interview, focus group discussion, necessary drawings and photographs and participant observation across dwelling, neighborhood, and community level have also been administered as primary data collection methodology. Findings have revealed that various shortages, inadequacies, and negligence of policymakers force to compromise with allocated designed space, physical infrastructure and economic opportunities across dwelling, neighborhood and mostly community level. Thus, the outcome of this study can be beneficial for a global-level understating of the compromising the ‘quality of life’ under top-down shelter policy. Locally, for instance, in the context of Bangladesh, it can help policymakers and concerned authorities to formulate the shelter policies and take initiatives to improve the well-being of marginalized.Keywords: Ashrayan Prakalpa, compromise, displaced people, quality of life
Procedia PDF Downloads 151279 Transport of Reactive Carbo-Iron Composite Particles for in situ Groundwater Remediation Investigated at Laboratory and Field Scale
Authors: Sascha E. Oswald, Jan Busch
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The in-situ dechlorination of contamination by chlorinated solvents in groundwater via zero-valent iron (nZVI) is potentially an efficient and prompt remediation method. A key requirement is that nZVI has to be introduced in the subsurface in a way that substantial quantities of the contaminants are actually brought into direct contact with the nZVI in the aquifer. Thus it could be a more flexible and precise alternative to permeable reactive barrier techniques using granular iron. However, nZVI are often limited by fast agglomeration and sedimentation in colloidal suspensions, even more so in the aquifer sediments, which is a handicap for the application to treat source zones or contaminant plumes. Colloid-supported nZVI show promising characteristics to overcome these limitations and Carbo-Iron Colloids is a newly developed composite material aiming for that. The nZVI is built onto finely ground activated carbon of about a micrometer diameter acting as a carrier for it. The Carbo-Iron Colloids are often suspended with a polyanionic stabilizer, and carboxymethyl cellulose is one with good properties for that. We have investigated the transport behavior of Carbo-Iron Colloids (CIC) on different scales and for different conditions to assess its mobility in aquifer sediments as a key property for making its application feasible. The transport properties were tested in one-dimensional laboratory columns, a two-dimensional model aquifer and also an injection experiment in the field. Those experiments were accompanied by non-invasive tomographic investigations of the transport and filtration processes of CIC suspensions. The laboratory experiments showed that a larger part of the CIC can travel at least scales of meters for favorable but realistic conditions. Partly this is even similar to a dissolved tracer. For less favorable conditions this can be much smaller and in all cases a particular fraction of the CIC injected is retained mainly shortly after entering the porous medium. As field experiment a horizontal flow field was established, between two wells with a distance of 5 meters, in a confined, shallow aquifer at a contaminated site in North German lowlands. First a tracer test was performed and a basic model was set up to define the design of the CIC injection experiment. Then CIC suspension was introduced into the aquifer at the injection well while the second well was pumped and samples taken there to observe the breakthrough of CIC. This was based on direct visual inspection and total particle and iron concentrations of water samples analyzed in the laboratory later. It could be concluded that at least 12% of the CIC amount injected reached the extraction well in due course, some of it traveling distances larger than 10 meters in the non-uniform dipole flow field. This demonstrated that these CIC particles have a substantial mobility for reaching larger volumes of a contaminated aquifer and for interacting there by their reactivity with dissolved contaminants in the pore space. Therefore they seem suited well for groundwater remediation by in-situ formation of reactive barriers for chlorinated solvent plumes or even source removal.Keywords: carbo-iron colloids, chlorinated solvents, in-situ remediation, particle transport, plume treatment
Procedia PDF Downloads 246278 Welfare and Sustainability in Beef Cattle Production on Tropical Pasture
Authors: Andre Pastori D'Aurea, Lauriston Bertelli Feranades, Luis Eduardo Ferreira, Leandro Dias Pinto, Fabiana Ayumi Shiozaki
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The aim of this study was to improve the production of beef cattle on tropical pasture without harming this environment. On tropical pastures, cattle's live weight gain is lower than feedlot, and forage production is seasonable, changing from season to season. Thus, concerned with sustainable livestock production, the Premix Company has developed strategies to improve the production of beef cattle on tropical pasture to ensure sustainability of welfare and production. There are two important principles in this productivity system: 1) increase individual gains with use of better supplementation and 2) increase the productivity units with better forage quality like corn silage or other forms of forage conservations, actually used only in winter, and adding natural additives in the diet. This production system was applied from June 2017 to May 2018 in the Research Center of Premix Company, Patrocínio Paulista, São Paulo State, Brazil. The area used had 9 hectares of pasture of Brachiaria brizantha. 36 steers Nellore were evaluated for one year. The initial weight was 253 kg. The parameters used were daily average gain and gain per area. This indicated the corrections to be made and helped design future fertilization. In this case, we fertilized the pasture with 30 kg of nitrogen per animal divided into two parts. The diet was pasture and protein-energy supplements (0.4% of live weight). The supplement used was added with natural additive Fator P® – Premix Company). Fator P® is an additive composed by amino acids (lysine, methionine and tyrosine, 16400, 2980 and 3000 mg.kg-1 respectively), minerals, probiotics (Saccharomyces cerevisiae, 7 x 10E8 CFU.kg-1) and essential fatty acids (linoleic and oleic acids, 108.9 and 99g.kg-1 respectively). Due to seasonal changes, in the winter we supplemented the diet by increasing the offer of forage, supplementing with maize silage. It was offered 1% of live weight in silage corn and 0.4% of the live weight in protein-energetic supplements with additive Fator P ®. At the end of the period, the productivity was calculated by summing the individual gains for the area used. The average daily gain of the animals were 693 grams per day and was produced 1.005 kg /hectare/year. This production is about 8 times higher than the average of Brazilian meat national production. To succeed in this project, it is necessary to increase the gains per area, so it is necessary to increase the capacity per area. Pasture management is very important to the project's success because the dietary decisions were taken from the quantity and quality of the forage. We, therefore, recommend the use of animals in the growth phase because the response to supplementation is greater in that phase and we can allocate more animals per area. This system's carbon footprint reduces emissions by 61.2 percent compared to the Brazilian average. This beef cattle production system can be efficient and environmentally friendly to the natural. Another point is that bovines will benefit from their natural environment without competing or having an impact on human food production.Keywords: cattle production, environment, pasture, sustainability
Procedia PDF Downloads 149277 Non-Invasive Characterization of the Mechanical Properties of Arterial Walls
Authors: Bruno RamaëL, GwenaëL Page, Catherine Knopf-Lenoir, Olivier Baledent, Anne-Virginie Salsac
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No routine technique currently exists for clinicians to measure the mechanical properties of vascular walls non-invasively. Most of the data available in the literature come from traction or dilatation tests conducted ex vivo on native blood vessels. The objective of the study is to develop a non-invasive characterization technique based on Magnetic Resonance Imaging (MRI) measurements of the deformation of vascular walls under pulsating blood flow conditions. The goal is to determine the mechanical properties of the vessels by inverse analysis, coupling imaging measurements and numerical simulations of the fluid-structure interactions. The hyperelastic properties are identified using Solidworks and Ansys workbench (ANSYS Inc.) solving an optimization technique. The vessel of interest targeted in the study is the common carotid artery. In vivo MRI measurements of the vessel anatomy and inlet velocity profiles was acquired along the facial vascular network on a cohort of 30 healthy volunteers: - The time-evolution of the blood vessel contours and, thus, of the cross-section surface area was measured by 3D imaging angiography sequences of phase-contrast MRI. - The blood flow velocity was measured using a 2D CINE MRI phase contrast (PC-MRI) method. Reference arterial pressure waveforms were simultaneously measured in the brachial artery using a sphygmomanometer. The three-dimensional (3D) geometry of the arterial network was reconstructed by first creating an STL file from the raw MRI data using the open source imaging software ITK-SNAP. The resulting geometry was then transformed with Solidworks into volumes that are compatible with Ansys softwares. Tetrahedral meshes of the wall and fluid domains were built using the ANSYS Meshing software, with a near-wall mesh refinement method in the case of the fluid domain to improve the accuracy of the fluid flow calculations. Ansys Structural was used for the numerical simulation of the vessel deformation and Ansys CFX for the simulation of the blood flow. The fluid structure interaction simulations showed that the systolic and diastolic blood pressures of the common carotid artery could be taken as reference pressures to identify the mechanical properties of the different arteries of the network. The coefficients of the hyperelastic law were identified using Ansys Design model for the common carotid. Under large deformations, a stiffness of 800 kPa is measured, which is of the same order of magnitude as the Young modulus of collagen fibers. Areas of maximum deformations were highlighted near bifurcations. This study is a first step towards patient-specific characterization of the mechanical properties of the facial vessels. The method is currently applied on patients suffering from facial vascular malformations and on patients scheduled for facial reconstruction. Information on the blood flow velocity as well as on the vessel anatomy and deformability will be key to improve surgical planning in the case of such vascular pathologies.Keywords: identification, mechanical properties, arterial walls, MRI measurements, numerical simulations
Procedia PDF Downloads 319276 Determinants of Corporate Social Responsibility Adoption: Evidence from China
Authors: Jing (Claire) LI
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More than two decades from 2000 to 2020 of economic reforms have brought China unprecedented economic growth. There is an urgent call of research towards corporate social responsibility (CSR) in the context of China because while China continues to develop into a global trading market, it suffers from various serious problems relating to CSR. This study analyses the factors affecting the adoption of CSR practices by Chinese listed companies. The author proposes a new framework of factors of CSR adoption. Following common organisational factors and external factors in the literature (including organisational support, company size, shareholder pressures, and government support), this study introduces two additional factors, dynamic capability and regional culture. A survey questionnaire was conducted on the CSR adoption of Chinese listed companies in Shen Zhen and Shang Hai index from December 2019 to March 2020. The survey was conducted to collect data on the factors that affect the adoption of CSR. After collection of data, this study performed factor analysis to reduce the number of measurement items to several main factors. This procedure is to confirm the proposed framework and ensure the significant factors. Through analysis, this study identifies four grouped factors as determinants of the CSR adoption. The first factor loading includes dynamic capability and organisational support. The study finds that they are positively related to the first factor, so the first factor mainly reflects the capabilities of companies, which is one component in internal factors. In the second factor, measurement items of stakeholder pressures mainly are from regulatory bodies, customer and supplier, employees and community, and shareholders. In sum, they are positively related to the second factor and they reflect stakeholder pressures, which is one component of external factors. The third factor reflects organisational characteristics. Variables include company size and cultural score. Among these variables, company size is negatively related to the third factor. The resulted factor loading of the third factor implies that organisational factor is an important determinant of CSR adoption. Cultural consistency, the variable in the fourth factor, is positively related to the factor. It represents the difference between perception of managers and actual culture of the organisations in terms of cultural dimensions, which is one component in internal factors. It implies that regional culture is an important factor of CSR adoption. Overall, the results are consistent with previous literature. This study is of significance from both theoretical and empirical perspectives. First, from the significance of theoretical perspective, this research combines stakeholder theory, dynamic capability view of a firm, and neo-institutional theory in CSR research. Based on association of these three theories, this study introduces two new factors (dynamic capability and regional culture) to have a better framework for CSR adoption. Second, this study contributes to empirical literature of CSR in the context of China. Extant Chinese companies lack recognition of the importance of CSR practices adoption. This study built a framework and may help companies to design resource allocation strategies and evaluate future CSR and management practices in an early stage.Keywords: China, corporate social responsibility, CSR adoption, dynamic capability, regional culture
Procedia PDF Downloads 134275 South African Multiple Deprivation-Concentration Index Quantiles Differentiated by Components of Success and Impediment to Tuberculosis Control Programme Using Mathematical Modelling in Rural O. R. Tambo District Health Facilities
Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo
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Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa
Procedia PDF Downloads 170274 Formation of Science Literations Based on Indigenous Science Mbaru Niang Manggarai
Authors: Yuliana Wahyu, Ambros Leonangung Edu
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The learning praxis that is proposed by 2013 Curriculum (K-13) is no longer school-oriented as a supply-driven, but now a demand-driven provider. This vision is connected with Jokowi-Kalla Nawacita program to create a competitive nation in the global era. Competition is a social fact that must be faced. Therefore the curriculum will design a process to be the innovators and entrepreneurs.To get this goal, K-13 implements the character education. This aims at creating the innovators and entrepreneurs from an early age (primary school). One part of strengthening it is literacy formations (reading, numeracy, science, ICT, finance, and culture). Thus, science literacy is an integral part of character education. The above outputs are only formed through the innovative process through intra-curricular (blended learning), co-curriculer (hands-on learning) and extra-curricular (personalized learning). Unlike the curriculums before that child cram with the theories dominating the intellectual process, new breakthroughs make natural, social, and cultural phenomena as learning sources. For example, Science in primary schoolsplaceBiology as the platform. And Science places natural, social, and cultural phenomena as a learning field so that students can learn, discover, solve concrete problems, and the prospects of development and application in their everyday lives. Science education not only learns about facts collection or natural phenomena but also methods and scientific attitudes. In turn, Science will form the science literacy. Science literacy have critical, creative, logical, and initiative competences in responding to the issues of culture, science and technology. This is linked with science nature which includes hands-on and minds-on. To sustain the effectiveness of science learning, K-13 opens a new way of viewing a contextual learning model in which facts or natural phenomena are drawn closer to the child's learning environment to be studied and analyzed scientifically. Thus, the topic of elementary science discussion is the practical and contextual things that students encounter. This research is about to contextualize Science in primary schools at Manggarai, NTT, by placing local wisdom as a learning source and media to form the science literacy. Explicitly, this study discovers the concept of science and mathematics in Mbaru Niang. Mbaru Niang is a forgotten potentials of the centralistic-theoretical mainstream curriculum so far. In fact, the traditional Manggarai community stores and inherits much of the science-mathematical indigenous sciences. In the traditional house structures are full of science and mathematics knowledge. Every details have style, sound and mathematical symbols. Learning this, students are able to collaborate and synergize the content and learning resources in student learning activities. This is constructivist contextual learning that will be applied in meaningful learning. Meaningful learning allows students to learn by doing. Students then connect topics to the context, and science literacy is constructed from their factual experiences. The research location will be conducted in Manggarai through observation, interview, and literature study.Keywords: indigenous science, Mbaru Niang, science literacy, science
Procedia PDF Downloads 209273 Reducing Diagnostic Error in Australian Emergency Departments Using a Behavioural Approach
Authors: Breanna Wright, Peter Bragge
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Diagnostic error rates in healthcare are approximately 10% of cases. Diagnostic errors can cause patient harm due to inappropriate, inadequate or delayed treatment, and such errors contribute heavily to medical liability claims globally. Therefore, addressing diagnostic error is a high priority. In most cases, diagnostic errors are the result of faulty information synthesis rather than lack of knowledge. Specifically, the majority of diagnostic errors involve cognitive factors, and in particular, cognitive biases. Emergency Departments are an environment with heightened risk of diagnostic error due to time and resource pressures, a frequently chaotic environment, and patients arriving undifferentiated and with minimal context. This project aimed to develop a behavioural, evidence-informed intervention to reduce diagnostic error in Emergency Departments through co-design with emergency physicians, insurers, researchers, hospital managers, citizens and consumer representatives. The Forum Process was utilised to address this aim. This involves convening a small (4 – 6 member) expert panel to guide a focused literature and practice review; convening of a 10 – 12 person citizens panel to gather perspectives of laypeople, including those affected by misdiagnoses; and a 18 – 22 person structured stakeholder dialogue bringing together representatives of the aforementioned stakeholder groups. The process not only provides in-depth analysis of the problem and associated behaviours, but brings together expertise and insight to facilitate identification of a behaviour change intervention. Informed by the literature and practice review, the Citizens Panel focused on eliciting the values and concerns of those affected or potentially affected by diagnostic error. Citizens were comfortable with diagnostic uncertainty if doctors were honest with them. They also emphasised the importance of open communication between doctors and patients and their families. Citizens expect more consistent standards across the state and better access for both patients and their doctors to patient health information to avoid time-consuming re-taking of long patient histories and medication regimes when re-presenting at Emergency Departments and to reduce the risk of unintentional omissions. The structured Stakeholder Dialogue focused on identifying a feasible behavioural intervention to review diagnoses in Emergency Departments. This needed to consider the role of cognitive bias in medical decision-making; contextual factors (in Victoria, there is a legislated 4-hour maximum time between ED triage and discharge / hospital admission); resource availability; and the need to ensure the intervention could work in large metropolitan as well as small rural and regional ED settings across Victoria. The identified behavioural intervention will be piloted in approximately ten hospital EDs across Victoria, Australia. This presentation will detail the findings of all review and consultation activities, describe the behavioural intervention developed and present results of the pilot trial.Keywords: behavioural intervention, cognitive bias, decision-making, diagnostic error
Procedia PDF Downloads 129272 Testing Two Actors Contextual Interaction Theory in a Multi Actors Context: Case of COVID-19 Disease Prevention and Control Policy
Authors: Muhammad Fayyaz Nazir, Ellen Wayenberg, Shahzadaah Faahed Qureshi
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Introduction: The study is based on the Contextual Interaction Theory (CIT) constructs to explore the role of policy actors in implementing the COVID-19 Disease Prevention and Control (DP&C) Policy. The study analyzes the role of healthcare workers' contextual factors, such as cognition, motives, and resources, and their interactions in implementing Social Distancing (SD). In this way, we test a two actors policy implementation theory, i.e., the CIT in a three-actor context. Methods: Data was collected through document analysis and semi-structured interviews. For a qualitative study design, interviews were conducted with questions on cognition, motives, and resources from the healthcare workers involved in implementing SD in the local context in Multan – Pakistan. The possible interactions resulting from contextual factors of the policy actors – healthcare workers were identified through framework analysis protocol guided by CIT and supported by trustworthiness criterion and data saturation. Results: This inquiry resulted in theory application, addition, and enrichment. The theoretical application in the three actor's contexts illustrates the different levels of motives, cognition, and resources of healthcare workers – senior administrators, managers, and healthcare professionals. The senior administrators working in National Command and Operations Center (NCOC), Provincial Technical Committees (PTCs), and Districts Covid Teams (DCTs) were playing their role with high motivation. They were fully informed about the policy and moderately resourceful. The policy implementors: healthcare managers working on implementing the SD within their respective hospitals were playing their role with high motivation and were fully informed about the policy. However, they lacked the required resources to implement SD. The target medical and allied healthcare professionals were moderately motivated but lack of resources and information. The interaction resulted in cooperation and the need for learning to manage the future healthcare crisis. However, the lack of resources created opposition to the implementation of SD. Objectives of the Study: The study aimed to apply a two actors theory in a multi actors context. We take this as an opportunity to qualitatively test the theory in a novel situation of the Covid-19 pandemic and make way for its quantitative application by designing a survey instrument so that implementation researchers can apply CIT through multivariate analyses or higher-order statistical modeling. Conclusion: Applying two actors' implementation theory in exploring a complex case of healthcare intervention in three actors context is a unique work that has never been done before, up to the best of our knowledge. So, the work will contribute to the policy implementation studies by applying, extending, and enriching an implementation theory in a novel case of the Covi-19 pandemic, ultimately fulfilling the gap in implementation literature. Policy institutions and other low or middle-income countries can learn from this research and improve SD implementation by working on the variables with weak significance levels.Keywords: COVID-19, disease prevention and control policy, implementation, policy actors, social distancing
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