Search results for: Catharine Ward Thompson
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 304

Search results for: Catharine Ward Thompson

124 The Utilization of Tea Extract within the Realm of the Food Industry

Authors: Raana Babadi Fathipour

Abstract:

Tea, a beverage widely cherished across the globe, has captured the interest of scholars with its recent acknowledgement for possessing noteworthy health advantages. Of particular significance is its proven ability to ward off ailments such as cancer and cardiovascular afflictions. Moreover, within the realm of culinary creations, lipid oxidation poses a significant challenge for food product development. In light of these aforementioned concerns, this present discourse turns its attention towards exploring diverse methodologies employed in extracting polyphenols from various types of tea leaves and examining their utility within the vast landscape of the ever-evolving food industry. Based on the discoveries unearthed in this comprehensive investigation, it has been determined that the fundamental constituents of tea are polyphenols possessed of intrinsic health-enhancing properties. This includes an assortment of catechins, namely epicatechin, epigallocatechin, epicatechin gallate, and epigallocatechin gallate. Moreover, gallic acid, flavonoids, flavonols and theaphlavins have also been detected within this aromatic beverage. Of these myriad components examined vigorously in this study's analysis, catechin emerges as particularly beneficial. Multiple techniques have emerged over time to successfully extract key compounds from tea plants, including solvent-based extraction methodologies, microwave-assisted water extraction approaches and ultrasound-assisted extraction techniques. In particular, consideration is given to microwave-assisted water extraction method as a viable scheme which effectively procures valuable polyphenols from tea extracts. This methodology appears adaptable for implementation within sectors such as dairy production along with meat and oil industries alike.

Keywords: camellia sinensis, extraction, food application, shelf life, tea

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123 Monitoring Prolong Use of Intravenous Antibiotics: Antimicrobial Stewardship

Authors: Komal Fizza

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Irrational and non-judicious use of antibiotics pave the way for an upsurge in antibiotic resistance, diminished effectiveness of different therapeutic regimens and as well as impounding effect on disease management leading to further morbidities. In the backdrop of this the current research is aimed to assess whether antimicrobial prescribing is in accordance with the Infectious Disease Society of America Guidelines in hospitalized patients at Shifa International Hospital, Islamabad, Pakistan. Shifa International Hospital, Islamabad is a 500 bed hospital. With the help of MIS team a form wad developed that gave the information about medical records number, name of the patient, day of start of antibiotic, the day antibiotic is supposed to be stopped and as well as the diagnosis of the patient. A ward pharmacist was employed to generate this report on a daily basis. The therapeutic regiment was reviewed by the pharmacist by monitoring the clinical progress, laboratory report and diagnosis. On the basis of this information, pharmacist made suggestions and forwarded to the hospital doctors responsible for prescribing antibiotics. If desired, changes were made regularly. In the current research our main focus was to implement this action and therefore, started monitoring patients who were on antibiotic regimens for more than 10-15 days. We took this initiative since November, 2013. At the start of the program a maximum 19 patients/day were reported to be on antibiotic regimen for more than 10-15 days. After the implementation of the initiative, the number of patients was decreased to fifteen patients per day in December, further decreased to 7 in the month of January and 9 and 6 in February and March respectively. The average patient census was 350. The current pilot study highlighted the role of pharmacist in initiating antibiotic stewardship programs in hospital settings.

Keywords: stewardship, antibiotics, resistance, clinical process

Procedia PDF Downloads 329
122 Students' Performance, Perception and Attitude towards Interactive Online Modules to Improve Undergraduate Quantitative Skills in Biological Science

Authors: C. Suphioglu , V. Simbag, J. Markham, C. Coady, S. Belward, G. Di Trapani, P. Chunduri, J. Chuck, Y. Hodgson, L. Lluka, L. Poladian, D. Watters

Abstract:

Advances in science have made quantitative skills (QS) an essential graduate outcome for undergraduate science programs in Australia and other parts of the world. However, many students entering into degrees in Australian universities either lack these skills or have little confidence in their ability to apply them in their biological science units. It has been previously reported that integration of quantitative skills into life science programs appears to have a positive effect on student attitudes towards the importance of mathematics and statistics in biological sciences. It has also been noted that there is deficiency in QS resources available and applicable to undergraduate science students in Australia. MathBench (http://mathbench.umd.edu) is a series of online modules involving quantitative biology scenarios developed by the University of Maryland. Through collaboration with Australian universities, a project was funded by the Australian government through its Office for Learning and Teaching (OLT) to develop customized MathBench biology modules to promote the quantitative skills of undergraduate biology students in Australia. This presentation will focus on the assessment of changes in performance, perception and attitude of students in a third year Cellular Physiology unit after use of interactive online cellular diffusion modules modified for the Australian context. The modules have been designed to integrate QS into the biological science curriculum using familiar scenarios and informal language and providing students with the opportunity to review solutions to diffusion QS-related problems with interactive graphics. This paper will discuss results of pre and post MathBench quizzes composed of general and module specific questions that assessed change in student QS after MathBench; and pre and post surveys, administered before and after using MathBench modules to evaluate the students’ change in perception towards the influence of the modules, their attitude towards QS and on the development of their confidence in completing the inquiry-based activity as well as changes to their appreciation of the relevance of mathematics to cellular processes. Results will be compared to changes reported by Thompson et al., (2010) at the University of Maryland and implications for further integration of interactive online activities in the curriculum will be explored and discussed.

Keywords: quantitative skills, MathBench, maths in biology

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121 Households’ Willingness to Pay for Environmental and General Health Safety during the Advent of Ebola Virus Diseases in Nigeria

Authors: Shittu Bisi Agnes

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Studies on households’ willingness to pay for environmental and general health safety in the advent of Ebola virus Diseases in Nigeria was carried out. This is aimed at revealing the means by which the virus was eventually eradicated in Nigeria as widely claimed in the media. This study therefore attempted to determine the environmental and general health condition in the State Of Osun, how socio-economic characteristics of the people affected willingness to pay. And also provide platform for the reduction of environmental and general health problems. Data were collected with the aid of well-structured questionnaire and administer 150 randomly selected people of study area, and oral interview was also utilized. Data collected were analyzed using both descriptive tools and inferential statistics vis-a-viz regression analysis. Findings showed 92.5% of respondents was aware of ebola virus diseases outbreak in Nigeria, 8.5% was unaware of any disease outbreak. And 65.7% of respondents was strongly willing to pay for environmental and general health safety 27.1% was fairly willing, 5.7% was indifferent and 1.7% was unwilling to pay. 5% rated the level of environmental and general health condition in the area has been good, 53.6% rated theirs has been fair, 33.6% as been poor. The average willingness to pay per household per month were #500.00, #250.00, #150.00 and #100.00 respectively for the four categories. It was recommended that policy instruments to increase peoples' income will accelerate eradication of environmental and general health problems, environmental health education in form of talk shop, workshop, lectures and seminars could be organized at the political ward levels, churches, mosque, and at schools. Environmental and general health safety related information could be disseminated through mass media, market women, and functional unions.

Keywords: ebola virus diseases (EVD), socio-economic, safety, pay, Osun

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120 Advanced Technology for Natural Gas Liquids (NGL) Recovery Using Residue Gas Split

Authors: Riddhiman Sherlekar, Umang Paladia, Rachit Desai, Yash Patel

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The competitive scenario of the oil and gas market is a challenge for today’s plant designers to achieve designs that meet client expectations with shrinking budgets, safety requirements, and operating flexibility. Natural Gas Liquids have three main industrial uses. They can be used as fuels, or as petrochemical feedstock or as refinery blends that can be further processed and sold as straight run cuts, such as naphtha, kerosene and gas oil. NGL extraction is not a chemical reaction. It involves the separation of heavier hydrocarbons from the main gas stream through pressure as temperature reduction, which depending upon the degree of NGL extraction may involve cryogenic process. Previous technologies i.e. short cycle dry desiccant absorption, Joule-Thompson or Low temperature refrigeration, lean oil absorption have been giving results of only 40 to 45% ethane recoveries, which were unsatisfying depending upon the current scenario of down turn market. Here new technology has been suggested for boosting up the recoveries of ethane+ up to 95% and up to 99% for propane+ components. Cryogenic plants provide reboiling to demethanizers by using part of inlet feed gas, or inlet feed split. If the two stream temperatures are not similar, there is lost work in the mixing operation unless the designer has access to some proprietary design. The concept introduced in this process consists of reboiling the demethanizer with the residue gas, or residue gas split. The innovation of this process is that it does not use the typical inlet gas feed split type of flow arrangement to reboil the demethanizer or deethanizer column, but instead uses an open heat pump scheme to that effect. The residue gas compressor provides the heat pump effect. The heat pump stream is then further cooled and entered in the top section of the column as a cold reflux. Because of the nature of this design, this process offers the opportunity to operate at full ethane rejection or recovery. The scheme is also very adaptable to revamp existing facilities. This advancement can be proven not only in enhancing the results but also provides operational flexibility, optimize heat exchange, introduces equipment cost reduction, opens a future for the innovative designs while keeping execution costs low.

Keywords: deethanizer, demethanizer, residue gas, NGL

Procedia PDF Downloads 238
119 Consumers’ Willingness to Pay for Organic Vegetables in Oyo State

Authors: Olanrewaju Kafayat, O., Salman Kabir, K.

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The role of organic agriculture in providing food and income is now gaining wider recognition (Van Elzakker et al 2007). The increasing public concerns about food safety issues on the use of fertilizers, pesticide residues, growth hormones, GM organisms, and increasing awareness of environmental quality issues have led to an expanding demand for environmentally friendly products (Thompson, 1998; Rimal et al., 2005). As a result national governments are concerned about diet and health, and there has been renewed recognition of the role of public policy in promoting healthy diets, thus to provide healthier, safer, more confident citizens (Poole et al., 2007), With these benefits, a study into organic vegetables is very vital to all the major stakeholders. This study analyzed the willingness of consumers to pay for organic vegetables in Oyo state, Nigeria. Primary data was collected with the aid of structured questionnaire administered to 168 respondents. These were selected using multistage random sampling. The first stage involved the selection two (2) ADP zones out of the three (3) ADP zones in Oyo state, The second stage involved the random selection of two (2) local government areas each out of the two (2) ADP zones which are; Ibadan South West and Ogbomoso North and random selection of 4 wards each from the local government areas. The third stage involved random selection of 42 household each from of the local government areas. Descriptive statistics, the principal component analysis, and the logistic regression were used to analyze the data. Results showed 55 percent of the respondents were female while 80 percent were  50 years. 74 percent of the respondents agreed that organic vegetables are of better quality. 31 percent of the respondents were aware of organic vegetables as against 69 percent who were not aware. From the logistic model, educational attainment, amount spent on organic vegetables monthly, better quality of organic vegetables and accessibility to organic vegetables were significant and had a positive relationship on willingness to pay for organic vegetable. The variables that were significant and had a negative relationship with WTP are less attractiveness of organic vegetables and household size of the respondents. This study concludes that consumers with higher level of education were more likely to be aware and willing to pay for organic vegetables than those with low levels of education, the study therefore recommends creation of awareness on the relevance of consuming organic vegetables through effective marketing and educational campaigns.

Keywords: consumers awareness, willingness to pay, organic vegetables, Oyo State

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118 The Relationship between Self-Care Behaviour and Quality of Life Among Heart Failure Patients in Jakarta, Indonesia

Authors: Shedy Maharani Nariswari, Prima Agustia Nova, I. Made Kariasa

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Background. Heart Failure (HF) is a chronic and progressive condition associated with significant morbidity, mortality, health care expenditures, and a high readmission rate over the years. Self‐care is essential to manage chronic heart failure in the long term, and it is related to better outcomes and can enhance the quality of life. Objective. The aims of this study were to describe the relationship between self-care behavior and quality of life among heart failure patients in East Jakarta, Indonesia. Methods. This study used a correlational-descriptive design with a cross-sectional study, the sampling method used purposive sampling method. Self-care was measured using Self-care Heart Failure Index version 6.2, and quality of life was measured using The Minnesota Living with Heart Failure. Pearson correlation and Spearman-rho correlations are used to analyze the data. Results. We recruited 103 patients with HF in both outpatient and inpatient ward: mean age 59.26 ± 11.643 years, 63.1% male. Patients with higher levels of education were associated with higher self-care maintenance (p= 0.007). The patient's average quality of life is quite high, with a score of 72,07 ± 16,89. There were a significant relationship among self-care maintenance (r=0,305, p=0,001), self-care management (r=0,330, p=0,001), and self-care confidence (r=0,335, p=0,001) towards the quality of life. Most participants have inadequate self-care maintenance, self-care management, and self-care confidence (score < 70), while the score of quality of life is categorized as poor. Conclusion. The self-care behaviors were limited among patients living with HF in Indonesia yet was associated with better quality of life. It is necessary to promote health related to knowledge and adherence to self-care behavior so that it can improve the quality of life of heart failure patients. This study can be used as a reference to promote self-care among patients with heart failure, it can help to enhance their quality of life.

Keywords: heart failure, self-care maintenance, self-care management, self-care confidence, quality of life

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117 Integrating Molecular Approaches to Understand Diatom Assemblages in Marine Environment

Authors: Shruti Malviya, Chris Bowler

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Environmental processes acting at multiple spatial scales control marine diatom community structure. However, the contribution of local factors (e.g., temperature, salinity, etc.) in these highly complex systems is poorly understood. We, therefore, investigated the diatom community organization as a function of environmental predictors and determined the relative contribution of various environmental factors on the structure of marine diatoms assemblages in the world’s ocean. The dataset for this study was derived from the Tara Oceans expedition, constituting 46 sampling stations from diverse oceanic provinces. The V9 hypervariable region of 18s rDNA was organized into assemblages based on their distributional co-occurrence. Using Ward’s hierarchical clustering, nine clusters were defined. The number of ribotypes and reads varied within each cluster-three clusters (II, VIII and IX) contained only a few reads whereas two of them (I and IV) were highly abundant. Of the nine clusters, seven can be divided into two categories defined by a positive correlation with phosphate and nitrate and a negative correlation with longitude and, the other by a negative correlation with salinity, temperature, latitude and positive correlation with Lyapunov exponent. All the clusters were found to be remarkably dominant in South Pacific Ocean and can be placed into three classes, namely Southern Ocean-South Pacific Ocean clusters (I, II, V, VIII, IX), South Pacific Ocean clusters (IV and VII), and cosmopolitan clusters (III and VI). Our findings showed that co-occurring ribotypes can be significantly associated into recognizable clusters which exhibit a distinct response to environmental variables. This study, thus, demonstrated distinct behavior of each recognized assemblage displaying a taxonomic and environmental signature.

Keywords: assemblage, diatoms, hierarchical clustering, Tara Oceans

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116 Detection and Classification Strabismus Using Convolutional Neural Network and Spatial Image Processing

Authors: Anoop T. R., Otman Basir, Robert F. Hess, Eileen E. Birch, Brooke A. Koritala, Reed M. Jost, Becky Luu, David Stager, Ben Thompson

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Strabismus refers to a misalignment of the eyes. Early detection and treatment of strabismus in childhood can prevent the development of permanent vision loss due to abnormal development of visual brain areas. We developed a two-stage method for strabismus detection and classification based on photographs of the face. The first stage detects the presence or absence of strabismus, and the second stage classifies the type of strabismus. The first stage comprises face detection using Haar cascade, facial landmark estimation, face alignment, aligned face landmark detection, segmentation of the eye region, and detection of strabismus using VGG 16 convolution neural networks. Face alignment transforms the face to a canonical pose to ensure consistency in subsequent analysis. Using facial landmarks, the eye region is segmented from the aligned face and fed into a VGG 16 CNN model, which has been trained to classify strabismus. The CNN determines whether strabismus is present and classifies the type of strabismus (exotropia, esotropia, and vertical deviation). If stage 1 detects strabismus, the eye region image is fed into stage 2, which starts with the estimation of pupil center coordinates using mask R-CNN deep neural networks. Then, the distance between the pupil coordinates and eye landmarks is calculated along with the angle that the pupil coordinates make with the horizontal and vertical axis. The distance and angle information is used to characterize the degree and direction of the strabismic eye misalignment. This model was tested on 100 clinically labeled images of children with (n = 50) and without (n = 50) strabismus. The True Positive Rate (TPR) and False Positive Rate (FPR) of the first stage were 94% and 6% respectively. The classification stage has produced a TPR of 94.73%, 94.44%, and 100% for esotropia, exotropia, and vertical deviations, respectively. This method also had an FPR of 5.26%, 5.55%, and 0% for esotropia, exotropia, and vertical deviation, respectively. The addition of one more feature related to the location of corneal light reflections may reduce the FPR, which was primarily due to children with pseudo-strabismus (the appearance of strabismus due to a wide nasal bridge or skin folds on the nasal side of the eyes).

Keywords: strabismus, deep neural networks, face detection, facial landmarks, face alignment, segmentation, VGG 16, mask R-CNN, pupil coordinates, angle deviation, horizontal and vertical deviation

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115 Vineyard Soils of Karnataka - Characterization, Classification and Soil Site Suitability Evaluation

Authors: Harsha B. R., K. S. Anil Kumar

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Land characterization, classification, and soil suitability evaluation of grapes-growing pedons were assessed at fifteen taluks covering four agro climatic zones of Karnataka. Study on problems and potentials of grapes cultivation in selected agro-climatic zones was carried out along with the plant sample analysis. Twenty soil profiles were excavated as study site based on the dominance of area falling under grapes production and existing spatial variability of soils. The detailed information of profiles and horizon wise soil samples were collected to study the morphological, physical, chemical, and fertility characteristics. Climatic analysis and water retention characteristics of soils of major grapes-growing areas were also done. Based on the characterisation and classification study, it was revealed that soils of Doddaballapur (Bangalore Blue and Wine grapes), Bangalore North (GKVK Farm, Rajankunte, and IIHR Farm), Devanahalli, Magadi, Hoskote, Chikkaballapur (Dilkush and Red globe), Yelaburga, Hagari Bommanahalli, Bagalkot (UHS farm) and Indi fall under the soil order Alfisol. Vijaypur pedon of northern dry zone was keyed out as Vertisols whereas, Jamkhandi and Athani as Inceptisols. Properties of Aridisols were observed in B. Bagewadi (Manikchaman and Thompson Seedless) and Afzalpur. Soil fertility status and its mapping using GIS technique revealed that all the nutrients were found to be in adequate range except nitrogen, potassium, zinc, iron, and boron, which indicated the need for application along with organic matter to improve the SOC status. Varieties differed among themselves in yield and plant nutrient composition depending on their age, climatic, soil, and management requirements. Bangalore North (GKVK farm) and Jamkhandi are having medium soil organic carbon stocks of 6.21 and 6.55 kg m⁻³, respectively. Soils of Bangalore North (Rajankunte) were highly suitable (S1) for grapes cultivation. Under northern Karnataka, Vijayapura, B. Bagewadi, Indi, and Afzalpur vineyards were good performers despite the limitations of fertility and free lime content.

Keywords: land characterization, suitability, soil orders, soil organic carbon stock

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114 Knowledge and Capabilities of Primary Caregivers in Providing Quality Care for Elderly Patients with Post- Operative Hip Fracture, Songklanagarind Hospital

Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae

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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.

Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients

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113 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation

Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj

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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.

Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization

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112 Opioid Administration on Patients Hospitalized in the Emergency Department

Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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111 Pattern of ICU Admission due to Drug Problems

Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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110 Germplasm Collections and Morphological Studies of Andropogongayanus-Andropogon tectorum Complex in Southwestern Nigeria

Authors: Ojo F. M., Nwekeocha C. C., Faluyi J. O.

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Morphological studies were carried out on Andropogongayanus-Andropogontectorum complex collected in Southwestern Nigeria to provide full characterizationof the two species of Andropogon; elucidating their population dynamics. Morphological data from selected accessions of A. gayanus and A. tectorum from different parts of Southwestern Nigeria were collected and characterized using an adaptation of the Descriptors for Wild and Cultivated Rice (Oryza spp). Preliminary morphological descriptions were carried out at the points of collection. Garden populations were raised from the vegetative parts of some accessions, and hybrids were maintained in Botanical Garden of the Obafemi Awolowo University, Ile- Ife. The data obtained were subjected to inferential tests and Duncan’s multiple range test. This study has revealed distribution pattern of the two species in the area of study, which suggests a south-ward migration of Andropogongayanus from the northern vegetational zones of Nigeria to the southern ecological zones. The migration of A. gayanus around Igbeti with occasional occurrence of A. tectorum along the roadsides without any distinct phenotypic hybrid and Budo-Ode in Oyo State has been established as the southern limit of the spread of A. gayanus, the migration of A. gayanus to the South is not an invasion but a slow process. A. gayanus was not encountered in Osun, Ondo, Ekiti, and Ogun States. Andropogongayanus and Andropogon tectorum not only emerge from the rootstocks rapidly but can also produce independent propagules by rooting at some nodes. The plants can spread by means of these propagules even if it does not produce sexual or apomictic seeds. This potential for vegetative propagation, in addition to the perennial habit, confer considerable advantage for colonization by the Andropogongayanus-AndropogontectorumComplex.

Keywords: accessions, distribution, migration, propagation

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109 CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire

Authors: Ammar Ayad Issa Al-Rifaie, Zuhreya Muazu, Maysam Ali Abdulwahid, Dermot Gleeson

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The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.

Keywords: alcohol screening, AUDIT-C, CAGE, hazardous drinking

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108 Using Nature-Based Solutions to Decarbonize Buildings in Canadian Cities

Authors: Zahra Jandaghian, Mehdi Ghobadi, Michal Bartko, Alex Hayes, Marianne Armstrong, Alexandra Thompson, Michael Lacasse

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The Intergovernmental Panel on Climate Change (IPCC) report stated the urgent need to cut greenhouse gas emissions to avoid the adverse impacts of climatic changes. The United Nations has forecasted that nearly 70 percent of people will live in urban areas by 2050 resulting in a doubling of the global building stock. Given that buildings are currently recognised as emitting 40 percent of global carbon emissions, there is thus an urgent incentive to decarbonize existing buildings and to build net-zero carbon buildings. To attain net zero carbon emissions in communities in the future requires action in two directions: I) reduction of emissions; and II) removal of on-going emissions from the atmosphere once de-carbonization measures have been implemented. Nature-based solutions (NBS) have a significant role to play in achieving net zero carbon communities, spanning both emission reductions and removal of on-going emissions. NBS for the decarbonisation of buildings can be achieved by using green roofs and green walls – increasing vertical and horizontal vegetation on the building envelopes – and using nature-based materials that either emit less heat to the atmosphere thus decreasing photochemical reaction rates, or store substantial amount of carbon during the whole building service life within their structure. The NBS approach can also mitigate urban flooding and overheating, improve urban climate and air quality, and provide better living conditions for the urban population. For existing buildings, de-carbonization mostly requires retrofitting existing envelopes efficiently to use NBS techniques whereas for future construction, de-carbonization involves designing new buildings with low carbon materials as well as having the integrity and system capacity to effectively employ NBS. This paper presents the opportunities and challenges in respect to the de-carbonization of buildings using NBS for both building retrofits and new construction. This review documents the effectiveness of NBS to de-carbonize Canadian buildings, identifies the missing links to implement these techniques in cold climatic conditions, and determine a road map and immediate approaches to mitigate the adverse impacts of climate change such as urban heat islanding. Recommendations are drafted for possible inclusion in the Canadian building and energy codes.

Keywords: decarbonization, nature-based solutions, GHG emissions, greenery enhancement, buildings

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107 Urban Road Network Connectivity and Accessibility Analysis Using RS and GIS: A Case Study of Chandannagar City

Authors: Joy Ghosh, Debasmita Biswas

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The road network of any area is the most important indicator of regional planning. For proper utilization of urban road networks, the structural parameters such as connectivity and accessibility should be analyzed and evaluated. This paper aims to explain the application of GIS on urban road network connectivity and accessibility analysis with a case study of Chandannagar City. This paper has been made to analyze the road network connectivity through various connectivity measurements like the total number of nodes and links, Cyclomatic Number, Alpha Index, Beta Index, Gamma index, Eta index, Pi index, Theta Index, and Aggregated Transport Score, Road Density based on existing road network in Chandannagar city in India. Accessibility is measured through the shortest Path Matrix, associate Number, and Shimbel Index. Various urban services, such as schools, banks, Hospitals, petrol pumps, ATMs, police stations, theatres, parks, etc., are considered for the accessibility analysis for each ward. This paper also highlights the relationship between urban land use/ land cover (LULC) and urban road network and population density using various spatial and statistical measurements. The datasets were collected through a field survey of 33 wards of the Chandannagar Municipal Corporation area, and the secondary data were collected through an open street map and satellite image of LANDSAT8 OLI & TIRS from USGS. Chandannagar was actually once a French colony, and at that time, various sort of planning was applied, but now Chandannagar city continues to grow haphazardly because that city is facing some problems; the knowledge gained from this paper helps to create a more efficient and accessible road network. Therefore, it would be suggested that some wards need to improve their connectivity and accessibility for the future growth and development of Chandannagar.

Keywords: accessibility, connectivity, transport, road network

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106 Regional Anesthesia in Carotid Surgery: A Single Center Experience

Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Riteesh Bookun

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Patients with carotid stenosis, which may be asymptomatic or symptomatic in the form of transient ischaemic attack (TIA), amaurosis fugax, or stroke, often require an endarterectomy to reduce stroke risk. Risks of this procedure include stroke, death, myocardial infarction, and cranial nerve damage. Carotid endarterectomy is most commonly performed under general anaesthetic, however, it can also be undertaken with a regional anaesthetic approach. Our tertiary centre generally performs carotid endarterectomy under regional anaesthetic. Our major tertiary hospital mostly utilises regional anaesthesia for carotid endarterectomy. We completed a cross-sectional analysis of all cases of carotid endarterectomy performed under regional anaesthesia across a 10-year period between January 2010 to March 2020 at our institution. 350 patients were included in this descriptive analysis, and demographic details for patients, indications for surgery, procedural details, length of surgery, and complications were collected. Data was cross tabulated and presented in frequency tables to describe these categorical variables. 263 of the 350 patients in the analysis were male, with a mean age of 71 ± 9. 172 patients had a history of ischaemic heart disease, 104 had diabetes mellitus, 318 had hypertension, and 17 patients had chronic kidney disease greater than Stage 3. 13.1% (46 patients) were current smokers, and the majority (63%) were ex-smokers. Most commonly, carotid endarterectomy was performed conventionally with patch arterioplasty 96% of the time (337 patients). The most common indication was TIA and stroke in 64% of patients, 18.9% were classified as asymptomatic, and 13.7% had amaurosis fugax. There were few general complications, with 9 wound complications/infections, 7 postoperative haematomas requiring return to theatre, 3 myocardial infarctions, 3 arrhythmias, 1 exacerbation of congestive heart failure, 1 chest infection, and 1 urinary tract infection. Specific complications to carotid endarterectomy included 3 strokes, 1 postoperative TIA, and 1 cerebral bleed. There were no deaths in our cohort. This analysis of a large cohort of patients from a major tertiary centre who underwent carotid endarterectomy under regional anaesthesia indicates the safety of such an approach for these patients. Regional anaesthesia holds the promise of less general respiratory and cardiac events compared to general anaesthesia, and in this vulnerable patient group, calls for comparative research between local and general anaesthesia in carotid surgery.

Keywords: anaesthesia, carotid endarterectomy, stroke, carotid stenosis

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105 Demarcating Wetting States in Pressure-Driven Flows by Poiseuille Number

Authors: Anvesh Gaddam, Amit Agrawal, Suhas Joshi, Mark Thompson

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An increase in surface area to volume ratio with a decrease in characteristic length scale, leads to a rapid increase in pressure drop across the microchannel. Texturing the microchannel surfaces reduce the effective surface area, thereby decreasing the pressured drop. Surface texturing introduces two wetting states: a metastable Cassie-Baxter state and stable Wenzel state. Predicting wetting transition in textured microchannels is essential for identifying optimal parameters leading to maximum drag reduction. Optical methods allow visualization only in confined areas, therefore, obtaining whole-field information on wetting transition is challenging. In this work, we propose a non-invasive method to capture wetting transitions in textured microchannels under flow conditions. To this end, we tracked the behavior of the Poiseuille number Po = f.Re, (with f the friction factor and Re the Reynolds number), for a range of flow rates (5 < Re < 50), and different wetting states were qualitatively demarcated by observing the inflection points in the f.Re curve. Microchannels with both longitudinal and transverse ribs with a fixed gas fraction (δ, a ratio of shear-free area to total area) and at a different confinement ratios (ε, a ratio of rib height to channel height) were fabricated. The measured pressure drop values for all the flow rates across the textured microchannels were converted into Poiseuille number. Transient behavior of the pressure drop across the textured microchannels revealed the collapse of liquid-gas interface into the gas cavities. Three wetting states were observed at ε = 0.65 for both longitudinal and transverse ribs, whereas, an early transition occurred at Re ~ 35 for longitudinal ribs at ε = 0.5, due to spontaneous flooding of the gas cavities as the liquid-gas interface ruptured at the inlet. In addition, the pressure drop in the Wenzel state was found to be less than the Cassie-Baxter state. Three-dimensional numerical simulations confirmed the initiation of the completely wetted Wenzel state in the textured microchannels. Furthermore, laser confocal microscopy was employed to identify the location of the liquid-gas interface in the Cassie-Baxter state. In conclusion, the present method can overcome the limitations posed by existing techniques, to conveniently capture wetting transition in textured microchannels.

Keywords: drag reduction, Poiseuille number, textured surfaces, wetting transition

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104 Revised Risk Priority Number in Failure Mode and Effects Analysis Model from the Perspective of Healthcare System

Authors: Fatemeh Rezaei, Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshnas

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Background: Failure Modes and Effect Analysis is now having known as the main methods of risk assessment and the accreditation requirements for many organizations. The Risk Priority Number (RPN) approach is generally preferred, especially for its easiness of use. Indeed it does not require statistical data, but it is based on subjective evaluations given by the experts about the Occurrence (O i), the Severity (Si) and the Detectability (D i) of each cause of failure. Methods: This study is a quantitative – qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment was conducted to calculate RPN score. Results; We have studied patient’s journey process in surgery ward and the most important phase of the process determined Transport of the patient from the holding area to the operating room. Failures of the phase with the highest priority determined by defining inclusion criteria included severity (clinical effect, claim consequence, waste of time and financial loss), occurrence (time- unit occurrence and degree of exposure to risk) and preventability (degree of preventability and defensive barriers) and quantifying risks priority criteria in the context of RPN index. Ability of improved RPN reassess by root cause (RCA) analysis showed some variations. Conclusions: Finally, It could be concluded that understandable criteria should have been developed according to personnel specialized language and communication field. Therefore, participation of both technical and clinical groups is necessary to modify and apply these models.

Keywords: failure mode, effects analysis, risk priority number(RPN), health system, risk assessment

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103 Shifting to Electronic Operative Notes in Plastic surgery

Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

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Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

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102 Utilization of Family Planning Methods and Associated Factors among Women of Reproductive Age Group in Sunsari, Nepal

Authors: Punam Kumari Mandal, Namita Yangden, Bhumika Rai, Achala Niraula, Sabitra Subedi

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introduction: Family planning not only improves women’s health but also promotes gender equality, better child health, and improved education outcomes, including poverty reduction. The objective of this study is to assess the utilization of family planning methods and associated factors in Sunsari, Nepal. methodology: A cross-sectional analytical study was conducted among women of the reproductive age group (15-49 years) in Sunsari in 2020. Nonprobability purposive sampling was used to collect information from 212 respondents through face-to-face interviews using a Semi-structured interview schedule from ward no 1 of Barju rural municipality. Data processing was done by using SPSS “statistics for windows, version 17.0(SPSS Inc., Chicago, III.USA”). Descriptive analysis and inferential analysis (binary logistic regression) were used to find the association of the utilization of family planning methods with selected demographic variables. All the variables with P-value <0.1 in bivariate analysis were included in multivariate analysis. A P-value of <0.05 was considered to indicate statistical significance at a level of significance of 5%. results: This study showed that the mean age and standard deviation of the respondents were 26±7.03, and 91.5 % of respondent’s age at marriage was less than 20 years. Likewise, 67.5% of respondents use any methods of family planning, and 55.2% of respondents use family planning services from the government health facility. Furthermore, education (AOR 1.579, CI 1.013-2.462)., husband’s occupation (AOR 1.095, CI 0.744-1.610)., type of family (AOR 2.741, CI 1.210-6.210)., and no of living son (AOR 0.259 CI 0.077-0.872)are the factors associated with the utilization of family planning methods. conclusion: This study concludes that two-thirds of reproductive-age women utilize family planning methods. Furthermore, education, the husband’s occupation, the type of family, and no of living sons are the factors associated with the utilization of family planning methods. This reflects that awareness through mass media, including behavioral communication, is needed to increase the utilization of family planning methods.

Keywords: family planning methods, utilization. factors, women, community

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101 Health Literacy for Self-Care by Female Patients Diagnosed with Diabetes at a Selected Hospital in Limpopo Province of South Africa

Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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100 Impact of Maternal Nutrition on Newborn Anthropometry and Hemoglobin

Authors: Vinay Mishra, Meena Malkani

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Objectives: To study the effect of physical maternal nutritional markers (viz. weight, height, gestational weight gain, BMI) and third-trimester haemoglobin concentration on anthropometry and cord blood haemoglobin of their newborn. Methods: Study area: Post-natal ward of a tertiary care hospital in an urban area. Study population: All post-partum women and their newborns. Sample size: 100. Maternal and neonatal data and anthropometric measurements were recorded in semi-structured case proforma. Data analysis: The data obtained was analysed using SPSS 20 software.The comparison between the groups was done using One-Way Analysis of Variance for two groups. For more than two groups comparisons further posthoc analysis was done using Tukey test. Pearson correlation coefficient was used for correlating the variables. A P value less than 0.05 was considered significant. Results: 1. Out of the 100 studied mothers, 52% were anaemic. 2. Cord blood haemoglobin values decreased significantly with the order of birth. 3. Cord blood haemoglobin of normal-weight newborns is significantly higher as compared to that of LBW newborns. 4. Cord blood haemoglobin has strong statistical significance with maternal anaemia. 5. Pre-pregnancy weight and gestational weight gain significantly influence the neonates anthropometry. Conclusions: 1. Birth order has a prominent inverse effect on the cord blood haemoglobin. 2. Majority of the expectant mothers are anaemic and give birth to LBW babies with reduced anthropometric markers. 3. Pre-pregnancy weight, height and gestational weight gain has a very significant impact on the neonatal anthropometry. 4. Thus, maternal nutrition during gestation and during the crucial periods of growth in the pre-child bearing age group has a very significant impact on foetal development.

Keywords: maternal nutrition, anthropometry, cord blood hemoglobin, newborn

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99 Nitrous Oxide Wastage: Putting Strategies “In the Pipeline” to Reduce Carbon Emissions from Nitrous Oxide

Authors: F. Gallop, C. Ward, M. Zaky, M. Vaghela, R. Sabaratnam

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Nitrous oxide (N₂O) has been used in anaesthesia for over 150 years owing to advantageous physical and pharmacological properties. However, with a global warming potential of 310, we have an urgent responsibility to reduce its usage and emission. Anecdotal evidence in our hospital trust suggests minimal N₂O usage, yet our theatres receive a staggering supply. This warranted further investigation. We used a data collection tool to prospectively capture quantitative and qualitative data regarding N₂O cases during one week: this recorded demographics, N₂O indications, clinical management, and total N₂O consumption in litres. In addition, N₂O usage in dental sedation suites and paediatric theatres was separately quantified. Pipeline supply data was acquired from British Oxygen Company accounts. We captured 490 cases. 4% (n=19) used N₂O, 63% (n=12) of these in dental theatres. Common N₂0 indications were induction speed (37%) and rapidly increasing anaesthesia depth (32%). In adult cases, N₂O was always used intraoperatively rather than solely at induction. 74% (n=14) of anaesthetists reported environmental concern over using N₂O. The week’s total N₂O usage was 8109 litres, amounting to 421,668 litres annually. However, the annual N₂O pipeline supply is 2,997,000 litres; an enormous 1.8 million Kg of CO₂. Our results supportively demonstrate that the N₂O pipeline supply greatly exceeds its clinical use. Acknowledging clinical areas not audited, the discrepancy between supply and usage suggests approximately 2.5 million litres of yearly wastage. We consequently recommend terminating the N₂O pipeline supply in minimally used areas, eliminating 1.5 million Kg of CO₂ emissions. High usage clinical areas could consider portable N₂O cylinders as an alternative. In Sweden, N₂O destruction technology is routinely used to minimise CO₂ emissions. Our results support National Health System investment in similar infrastructure.

Keywords: anaesthesia, environment, medical gases, nitrous oxide, sustainability

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98 A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations

Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

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97 Clinical Audit of Selected Nephrology Nursing Procedures Performed in Nephrology Unit of AIIMS with a View to Develop Nephrology Nursing Procedure Protocol

Authors: Mamta Thakur, Dr. Shashi Mawar, Ms. Levis Murry, Dr. D.k.sharma

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Aim: The aim of this study is to develop nephrology nursing procedure protocol after clinical audit of current nephrology nursing practices. Materials and methods: This descriptive observational study was conducted on 40 nurses who were working in Nephrology Department of AIIMS, New Delhi to observe their current practices to assess the existing gaps in the practice. The nurses were enrolled through total enumerative sampling. Sociodemographic profile of nurses and clinical profile for site of procedure was collected. Observation checklist was formed on the basis of standard nursing practices, which included 7 dimensions for hemodialysis procedure and 3 dimensions for procedure of assisting renal biopsy. Based on the gaps identified, nephrology nursing procedure protocol will be developed. Nurses were observed during two shifts, and each nurse was observed once. Scoring of items were done in each dimension, and for acceptable practices, nurses have to score ≥80% in each dimension. Results: Data was analyzed using descriptive statistics. Majority of nurses (73.7%) in nephrology ward and (80.9%) in hemodialysis unit have not undergone any special training in nephrology. Most of nurses (80.9%) followed the acceptable nursing practices for procedure of connection for hemodialysis. None of nurses followed the acceptable level (≥80%) of nursing practices for the procedure of predialysis assessment, the procedure for site preparation, during dialysis assessment and post dialysis assessment. None (100%) showed the acceptable level of nursing practices for all the dimensions of assisting renal biopsy procedure. Nephrology nursing procedure protocol was developed by researcher following a rigorous process, and this will reduce the gaps in the nursing practice. Conclusion: Clinical audit found that there were gaps in the existing nursing practices compared to the standardised nursing practices for procedure of hemodialysis and assisting renal biopsy, and these gaps have been addressed by the development of the protocol.

Keywords: nursing practice, nephrology nursing procedure, nursing protocol, renal biopsy, hemodialysis

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96 Trace Elements in Yerba Mate from Brazil and Argentina by Inductively Coupled Plasma Mass Spectrometry

Authors: F. V. Matta, C. M. Donnelly, M. B. Jaafar, N. I. Ward

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‘Yerba Mate’ (Ilex paraguariensis) is a native plant from South America with the main producers being Argentina and Brazil. ‘Mate’ is widely consumed in Argentina, Brazil, Uruguay and Paraguay. The most popular format is as an infusion made from dried leaves of a traditional cup, roasted material in tea bags or iced tea infusions. There are many alleged health benefits resulted from mate consumption, even though there is a lack of conclusive research published in the international literature. The main objective of this study was to develop and evaluate the sample preparation and instrumental analysis stages involved in the determination of trace elements in yerba mate using inductively coupled plasma mass spectrometry (ICP-MS). Specific details on the methods of sample digestion, validation of the ICP-MS analysis especially for polyatomic ion correction and matrix effects associated with the complex medium of mate will be presented. More importantly, mate produced in Brazil and Argentina, is subject to different soil conditions, methods of cultivation and production, especially for loose leaves and tea bags. The highest concentrations for loose mate leaf were for (mg/kg, dry weight): aluminium (253.6 – 506.9 for Brazil (Bra), 230.0 – 541.8 for Argentina (Arg), respectively), manganese (378.3 – 762.6 Bra; 440.8 – 879.9 Arg), iron (32.5 – 85.7 Bra; 28.2 – 132.9 Arg), zinc (28.2 – 91.1 Bra; 39.1 – 92.3 Arg), nickel (2.2 – 4.3 Bra; 2.9 – 10.8 Arg) and copper (4.8 – 9.1 Bra; 4.3 – 9.2 Arg), with lower levels of chromium, cobalt, selenium, molybdenum, cadmium, lead and arsenic. Elemental levels of mate leaf consumed in tea bags were found to be higher, mainly due to only using leaf material (as opposed to leaf and twig for loose packed product). Further implications of the way of consuming yerba mate will be presented, including different infusion methods in Brazil and Argentina. This research provides for the first time an extensive evaluation of mate products from both countries and the possible implications of specific trace elements, especially Mn, Fe, Se, Cu and Zn and the various health claims of consuming yerba mate.

Keywords: beverage analysis, ICP-MS, trace elements, yerba mate

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95 Obesity and Cancer: Current Scientific Evidence and Policy Implications

Authors: Martin Wiseman, Rachel Thompson, Panagiota Mitrou, Kate Allen

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Since 1997 World Cancer Research Fund (WCRF) International and the American Institute for Cancer Research (AICR) have been at the forefront of synthesising and interpreting the accumulated scientific literature on the link between diet, nutrition, physical activity and cancer, and deriving evidence-based Cancer Prevention Recommendations. The 2007 WCRF/AICR 2nd Expert Report was a landmark in the analysis of evidence linking diet, body weight and physical activity to cancer and led to the establishment of the Continuous Update Project (CUP). In 2018, as part of the CUP, WCRF/AICR will publish a new synthesis of the current evidence and update the Cancer Prevention Recommendations. This will ensure that everyone - from policymakers and health professionals to members of the public - has access to the most up-to-date information on how to reduce the risk of developing cancer. Overweight and obesity play a significant role in cancer risk, and rates of both are increasing in many parts of the world. This session will give an overview of new evidence relating obesity to cancer since the 2007 report. For example, since the 2007 Report, the number of cancers for which obesity is judged to be a contributory cause has increased from seven to eleven. The session will also shed light on the well-established mechanisms underpinning obesity and cancer links. Additionally, the session will provide an overview of diet and physical activity related factors that promote positive energy imbalance, leading to overweight and obesity. Finally, the session will highlight how policy can be used to address overweight and obesity at a population level, using WCRF International’s NOURISHING Framework. NOURISHING formalises a comprehensive package of policies to promote healthy diets and reduce obesity and non-communicable diseases; it is a tool for policymakers to identify where action is needed and assess if an approach is sufficiently comprehensive. The framework brings together ten policy areas across three domains: food environment, food system, and behaviour change communication. The framework is accompanied by a regularly updated database providing an extensive overview of implemented government policy actions from around the world. In conclusion, the session will provide an overview of obesity and cancer, highlighting the links seen in the epidemiology and exploring the mechanisms underpinning these, as well as the influences that help determine overweight and obesity. Finally, the session will illustrate policy approaches that can be taken to reduce overweight and obesity worldwide.

Keywords: overweight, obesity, nutrition, cancer, mechanisms, policy

Procedia PDF Downloads 130