Search results for: combined lifestyle intervention
3522 The Effect of Flue Gas Condensation on the Exergy Efficiency and Economic Performance of a Waste-To-Energy Plant
Authors: Francis Chinweuba Eboh, Tobias Richards
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In this study, a waste-to-energy combined heat and power plant under construction was modelled and simulated with the Aspen Plus software. The base case process plant was evaluated and compared when integrated with flue gas condensation (FGC) in order to find out the impact of the exergy efficiency and economic feasibility as well as the effect of overall system exergy losses and revenue generated in the investigated plant. The economic evaluations were carried out using the vendor cost data from Aspen process economic analyser. The results indicate that 4 % increase in the exergy efficiency and 29 % reduction in the exergy loss in the flue gas were obtained when the flue gas condensation was incorporated. Furthermore, with the integrated FGC, the net present values (NPV) and income generated in the base process plant were increased by 29 % and 10 % respectively after 20 years of operation.Keywords: economic feasibility, exergy efficiency, exergy losses, flue gas condensation, waste-to-energy
Procedia PDF Downloads 1903521 The Potential Use of Crude Palm Oil Liquid Wastes to Improve Nutrient Levels in Vegetable Plants
Authors: Hasan Basri Jumin
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Application of crude palm oil waste combined to suitable concentration of benzyl-adenine give the significant effect to mean relative growth rate of vegetable plants and the same pattern in net assimilation rate crude palm oil waste has also significantly increased during 28 days old plants. Combination of treatment of suitable concentration of crude palm oil and benzyl adenine increased the growth and production of vegetable plants. The relative growth rate of vegetable plants was rapid 3 weeks after planting and gradually decreased at the end of the harvest time period. Combination of 400 mg.l-1 CPO with 1.0 mgl-1 till 10mgl-1 BA increased the Mean Relative Growth Rate (MRGR), Net assimilation rate (NAR), Leaf area and dry weight of Brassica juncea, Brassica oleraceae and Lactuca sativa.Keywords: benzyladenine, crude-palm-oil, nutrient, vegetable, waste
Procedia PDF Downloads 1943520 Power Integrity Analysis of Power Delivery System in High Speed Digital FPGA Board
Authors: Anil Kumar Pandey
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Power plane noise is the most significant source of signal integrity (SI) issues in a high-speed digital design. In this paper, power integrity (PI) analysis of multiple power planes in a power delivery system of a 12-layer high-speed FPGA board is presented. All 10 power planes of HSD board are analyzed separately by using 3D Electromagnetic based PI solver, then the transient simulation is performed on combined PI data of all planes along with voltage regulator modules (VRMs) and 70 current drawing chips to get the board level power noise coupling on different high-speed signals. De-coupling capacitors are placed between power planes and ground to reduce power noise coupling with signals.Keywords: power integrity, power-aware signal integrity analysis, electromagnetic simulation, channel simulation
Procedia PDF Downloads 4363519 Using Group Concept Mapping to Identify a Pharmacy-Based Trigger Tool to Detect Adverse Drug Events
Authors: Rodchares Hanrinth, Theerapong Srisil, Peeraya Sriphong, Pawich Paktipat
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The trigger tool is the low-cost, low-tech method to detect adverse events through clues called triggers. The Institute for Healthcare Improvement (IHI) has developed the Global Trigger Tool for measuring and preventing adverse events. However, this tool is not specific for detecting adverse drug events. The pharmacy-based trigger tool is needed to detect adverse drug events (ADEs). Group concept mapping is an effective method for conceptualizing various ideas from diverse stakeholders. This technique was used to identify a pharmacy-based trigger to detect adverse drug events (ADEs). The aim of this study was to involve the pharmacists in conceptualizing, developing, and prioritizing a feasible trigger tool to detect adverse drug events in a provincial hospital, the northeastern part of Thailand. The study was conducted during the 6-month period between April 1 and September 30, 2017. Study participants involved 20 pharmacists (17 hospital pharmacists and 3 pharmacy lecturers) engaging in three concept mapping workshops. In this meeting, the concept mapping technique created by Trochim, a highly constructed qualitative group technic for idea generating and sharing, was used to produce and construct participants' views on what triggers were potential to detect ADEs. During the workshops, participants (n = 20) were asked to individually rate the feasibility and potentiality of each trigger and to group them into relevant categories to enable multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the trigger list, cluster list, point map, point rating map, cluster map, and cluster rating map. The three workshops together resulted in 21 different triggers that were structured in a framework forming 5 clusters: drug allergy, drugs induced diseases, dosage adjustment in renal diseases, potassium concerning, and drug overdose. The first cluster is drug allergy such as the doctor’s orders for dexamethasone injection combined with chlorpheniramine injection. Later, the diagnosis of drug-induced hepatitis in a patient taking anti-tuberculosis drugs is one trigger in the ‘drugs induced diseases’ cluster. Then, for the third cluster, the doctor’s orders for enalapril combined with ibuprofen in a patient with chronic kidney disease is the example of a trigger. The doctor’s orders for digoxin in a patient with hypokalemia is a trigger in a cluster. Finally, the doctor’s orders for naloxone with narcotic overdose was classified as a trigger in a cluster. This study generated triggers that are similar to some of IHI Global trigger tool, especially in the medication module such as drug allergy and drug overdose. However, there are some specific aspects of this tool, including drug-induced diseases, dosage adjustment in renal diseases, and potassium concerning which do not contain in any trigger tools. The pharmacy-based trigger tool is suitable for pharmacists in hospitals to detect potential adverse drug events using clues of triggers.Keywords: adverse drug events, concept mapping, hospital, pharmacy-based trigger tool
Procedia PDF Downloads 1633518 Mechanical Properties of Sugar Palm Fibre Reinforced Thermoplastic Polyurethane Composites
Authors: Dandi Bachtiar, Mohammed Ausama Abbas, Januar Parlaungan Siregar, Mohd Ruzaimi Bin Mat Rejab
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Short sugar palm fibre and thermoplastic polyurethane were combined to produce new composites by using the extrude method. Two techniques used to prepare a new composite material, firstly, extrusion of the base material with short fibre, secondly hot pressing them. The size of sugar palm fibre was fixed at 250µm. Different weight percent (10 wt%, 20 wt% and 30 wt%) were used in order to optimise preparation process. The optimization of process depended on the characterization mechanical properties such as impact, tensile, and flexural of the new (TPU/SPF) composite material. The results proved that best tensile and impact properties of weight additive fibre applied 10 wt%. There was an increasing trend recorded of flexural properties during increased the fibre loading. Meanwhile, the maximum tensile strength was 14.0 MPa at 10 wt% of the fibre. Moreover, there was no significant effect for additions more than 30 wt% of the fibre.Keywords: composites, natural fibre, polyurethane, sugar palm
Procedia PDF Downloads 3843517 Effects of Aerobic Dance on Systolic Blood Pressure in Stage 1 Hypertensive Individuals in Uganda
Authors: Loyce Nahwera, Joy Wachira, Edwin Kiptolo, Constance Nsibambi, Mshilla Maghanga, Timothy Makubuya
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Introduction: Hypertension is one of the most prominent risk factors for cardiovascular diseases globally, and it can be modified through lifestyle interventions such as exercise. The objective of this study was to investigate the effects of a 12-week aerobic dance programme on systolic blood pressure (SBP) in stage 1 hypertensive individuals. Methods: This study employed an experimental research design. A total of 36 stage 1 hypertensive individuals who were randomly assigned into experimental and control groups completed the study. Systolic BP was measured using a mercury sphygmomanometer at baseline, mid-point and after the program. The experimental group participants trained 3 days a week, 45 minutes per session, at a moderate intensity of 40-60% of maximum oxygen consumption (VO2max) monitored by Garmin heart rate monitors. Data were analyzed using SPSS version 20. The significance level was set at p<0.05. A paired sample t-test was used to compare mean differences within the groups. Results: Data from the 36 participants (22 males and 14 females) (experimental; n=18, control; n=18) show that the experimental group had a mean SBP of 143.83±6.382 mmHg at baseline while the control had a mean of 137.61±6.400 mmHg. Following the end of a 6-week aerobic dance, the mean SBP of the experimental group reduced to 138.06±9.539 mmHg while that of the control marginally decreased to 137.00±8.073 mmHg. At the completion of a 12-week program, the mean SBP of the experimental group reduced to 136.33±9.191 mmHg, while that of the control marginally increased to 139.56±9.954 mmHg. This implies that both the 6-week and 12-week aerobic dance program reduced the SBP of the experimental group by 5.77±7.133 mmHg and 7.50±8.487 mmHg, respectively, while the control group fast reduced marginally by 0.61 before ultimately increasing by 1.95±7.974 mmHg at 12-weeks. The changes were statistically significant (p<0.05) at both 6 and 12 weeks of an aerobic dance program. Conclusion: The study concluded that aerobic dance is an effective non-pharmacological method for managing SBP of stage 1 hypertensive individuals both in the short-term (6 weeks) and long-term (12 weeks).Keywords: aerobic dance, blood pressure, stage 1 hypertension, systolic blood pressure.
Procedia PDF Downloads 543516 Finite Element Analysis of Low-Velocity Impact Damage on Stiffened Composite Panels
Authors: Xuan Sun, Mingbo Tong
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To understand the factors which affect impact damage on composite structures, particularly the effects of impact position and ribs. In this paper, a finite element model (FEM) of low-velocity impact damage on the composite structure was established via the nonlinear finite element method, combined with the user-defined materials subroutine (VUMAT) of the ABAQUS software. The structural elements chosen for the investigation comprised a series of stiffened composite panels, representative of real aircraft structure. By impacting the panels at different positions relative to the ribs, the effect of relative position of ribs was found out. Then the simulation results and the experiments data were compared. Finally, the factors which affect impact damage on the structures were discussed. The paper was helpful for the design of stiffened composite structures.Keywords: stiffened, low-velocity impact, Abaqus, impact energy
Procedia PDF Downloads 6213515 Temperature Dependent Interaction Energies among X (=Ru, Rh) Impurities in Pd-Rich PdX Alloys
Authors: M. Asato, C. Liu, N. Fujima, T. Hoshino, Y. Chen, T. Mohri
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We study the temperature dependence of the interaction energies (IEs) of X (=Ru, Rh) impurities in Pd, due to the Fermi-Dirac (FD) distribution and the thermal vibration effect by the Debye-Grüneisen model. The n-body (n=2~4) IEs among X impurities in Pd, being used to calculate the internal energies in the free energies of the Pd-rich PdX alloys, are determined uniquely and successively from the lower-order to higher-order, by the full-potential Korringa-Kohn-Rostoker Green’s function method (FPKKR), combined with the generalized gradient approximation in the density functional theory. We found that the temperature dependence of IEs due to the FD distribution, being usually neglected, is very important to reproduce the X-concentration dependence of the observed solvus temperatures of the Pd-rich PdX (X=Ru, Rh) alloys.Keywords: full-potential KKR-green’s function method, Fermi-Dirac distribution, GGA, phase diagram of Pd-rich PdX (X=Ru, Rh) alloys, thermal vibration effect
Procedia PDF Downloads 2753514 Pattern of Prostate Specific Antigen Request in a Tertiary Health Institution S’ Tumor Marker Laboratory in Nigeria: A Two Year Review
Authors: Ademola Azeez
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Background: This study is a two year review of requests pattern for Prostate Specific Antigen (PSA), in a Nigerian tertiary health care institution. Prostate specific antigen was first described about 44 years ago but is still in use today for, diagnosis, monitoring, screening and prognosis of prostatic carcinoma though not-very specific as was widely believed. Prostate cancer is an increasingly important public health problem among adult men worldwide. Nigeria, which was formerly regarded as a low-incidence area by several authors is now witnessing a steep rise in the occurrence of this disease. This has been suggested to be due to increasing availability of screening tests and diagnostic facilities and not necessarily because of increased incidence of the diseases. Many notable Nigerians have died due to this dreaded disease. Methods: All plasma samples for PSA from January 2021-December 2022 were analyzed weekly by abbot autoanalyser, chemiluminescence assay method. Bio-data from request form were collated and analyzed. A total of 385 requests were received for the period under review. Result: There was an increase of request from inception to the last year of review. Smoked food, consumption of local herb and alcohol in order of importance, respectively, appears to be prominent factor in patient requested for PSA. The mean age was 67.years; the youngest was 29, while the oldest was 93years. Age 70 has the highest frequency of 8.5% .Mean PSA was 12.9ng/ml. There was a positive correlation between age and PSA (R=0.255, P < 0.05).Significant increase in PSA with age were reported. Men who retired from active jobs constitute the highest request for PSA test. Conclusion: There was an increasing trend in the proportion of requests with values outside the reference interval especially in patients diagnosed of benign prostatic hyperplasia, prostate cancer, while some routine test for PSA were elevated for the first time .This is in line with earlier report of increasing incidence of prostate cancer in Nigeria despite the increasing knowledge of healthy lifestyle.Keywords: pattern, PSA, tertiary institution, Nigeria
Procedia PDF Downloads 283513 The Acquisition of Case in Biological Domain Based on Text Mining
Authors: Shen Jian, Hu Jie, Qi Jin, Liu Wei Jie, Chen Ji Yi, Peng Ying Hong
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In order to settle the problem of acquiring case in biological related to design problems, a biometrics instance acquisition method based on text mining is presented. Through the construction of corpus text vector space and knowledge mining, the feature selection, similarity measure and case retrieval method of text in the field of biology are studied. First, we establish a vector space model of the corpus in the biological field and complete the preprocessing steps. Then, the corpus is retrieved by using the vector space model combined with the functional keywords to obtain the biological domain examples related to the design problems. Finally, we verify the validity of this method by taking the example of text.Keywords: text mining, vector space model, feature selection, biologically inspired design
Procedia PDF Downloads 2623512 The Relationship between Resilient Qualities and Health Management in Video Testimonials of Adolescents and Young Adults with Cancer
Authors: A. Sainvil, J. Mallela, L. M. Pereira
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Adolescents and young adults (AYA) diagnosed with cancer are tasked with managing their health through treatment, a time when reliance on and independence from parents may change in unexpected ways. Resilience allows patients to cope and manage their own health through treatment, promoting motivation and a healthier lifestyle. The film acts as a source of reflection through the cancer journey, which may have an impact on how patients cope. The current research investigated relationships between resilient linguistic qualities of the video narratives and attitudes toward personal health management. N=24 patients diagnosed between ages 11-18 were recruited. First, participants provided demographic information, then made a video testimonial about their cancer experience. After filming, participants then completed a questionnaire on the perceived benefits for themselves and others for making the video. Videos were transcribed and analyzed for thematic content via codebook and for linguistic qualities, indicating resilience with the use of the Linguistic Inquiry and Word Count Analysis Program (LIWC). Linear regressions were then calculated to explore relationships between resilient qualities, thematic content, and participants’ perceptions of their medical team and willingness to care for themselves. Participants who spoke with greater narrator connectedness were more likely to change their view of their medical team (β=.628 p=.034). When a participant believed that providers were likely to view their video, they were marginally more likely to want to take better care of themselves (β=.367, p=.078). Participants who spoke in depth about their health reported higher intention to take better care of themselves (β=.785, p=.033). AYAs with cancer who showcased certain resilient qualities within their narrative were more likely to consider taking better care of themselves. Additionally, the more patients reflected on their health, the more they wanted to take better care of themselves. These relationships were stronger when a patient believed that a provider would watch their video. Study findings highlight the utility of film in uncovering aspects of resilience and coping that may lead to healthier behaviors in AYAs with cancer.Keywords: adolescents, cancer, resilience, health management
Procedia PDF Downloads 893511 Connecting the Vulnerable in South Africa Through Urban Form and the Creation of Urban Moral Clusters - A Conceptual Analysis of Orphanages, Old Age Homes and Animal Cruelty Centres
Authors: Clive Greenstone, Kiara Lawrence
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This conceptual paper explains certain influences of urban planning and urban form on the design layout of housing specific vulnerable members of society. It reimagines how to use vulnerable groups and spaces that are designed for them as interventions instead of using outside intervention within these vulnerable groups. Questions of what are needed to ensure that collective values, ethics and certain moral principles are taken into consideration when creating spaces for individuals and communities are challenging. This conceptual paper offers a more appropriate approach to both offer better urban settlements as well as help solve several challenges facing the most vulnerable groups in society, namely, the elderly, vulnerable children and vulnerable domestic animals into new housing settlements that create better social connections and physical and emotional well-being, labeled urban moral clusters. This conceptual paper offers two potential case studies where these new moral clusters can be implemented.Keywords: vulnerability, inclusivity, urban planning, social capital, moral clusters
Procedia PDF Downloads 163510 To Include or Not to Include: Resolving Ethical Concerns over the 20% High Quality Cassava Flour Inclusion in Wheat Flour Policy in Nigeria
Authors: Popoola I. Olayinka, Alamu E. Oladeji, B. Maziya-Dixon
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Cassava, an indigenous crop grown locally by subsistence farmers in Nigeria has potential to bring economic benefits to the country. Consumption of bread and other confectionaries has been on the rise due to lifestyle changes of Nigerian consumers. However, wheat, being the major ingredient for bread and confectionery production does not thrive well under Nigerian climate hence the huge spending on wheat importation. To reduce spending on wheat importation, the Federal Government of Nigeria intends passing into law mandatory inclusion of 20% high-quality cassava flour (HQCF) in wheat flour. While the proposed policy may reduce post harvest loss of cassava, and also increase food security and domestic agricultural productivity, there are downsides to the policy which include reduction in nutritional quality and low sensory appeal of cassava-wheat bread, reluctance of flour millers to use HQCF, technology and processing challenges among others. The policy thus presents an ethical dilemma which must be resolved for its successful implementation. While inclusion of HQCF to wheat flour in bread and confectionery is a topic that may have been well addressed, resolving the ethical dilemma resulting from the act has not received much attention. This paper attempts to resolve this dilemma using various approaches in food ethics (cost benefits, utilitarianism, deontological and deliberative). The Cost-benefit approach did not provide adequate resolution of the dilemma as all the costs and benefits of the policy could not be stated in the quantitative term. The utilitarianism approach suggests that the policy delivers greatest good to the greatest number while the deontological approach suggests that the act (inclusion of HQCF to wheat flour) is right hence the policy is not utterly wrong. The deliberative approach suggests a win-win situation through deliberation with the parties involved.Keywords: HQCF, ethical dilemma, food security, composite flour, cassava bread
Procedia PDF Downloads 4063509 The Experimental Investigation of Temperature Influence on the Oscillations of Particles on Liquid Surfaces
Authors: Sathish K. Gurupatham, Farhad Sayedzada, Naji Dauk, Valmiki Sooklal, Laura Ruhala
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It was shown recently that small particles and powders spontaneously disperse on liquid surfaces when they come into contact with the interface for the first time. This happens due to the combined effect of the capillary force, buoyant weight of the particle and the viscous drag that the particle experiences in the liquid. The particle undergoes oscillations normal to the interface before it comes to rest on the interface. These oscillations, in turn, induce a flow on the interface which disperses the particles radially outward. This phenomenon has a significant role in the pollination of sea plants such as Ruppia in which the formation of ‘pollen rafts’ is the first step. This paper investigates, experimentally, the influence of the temperature of the liquid on which this dispersion occurs. It was observed that the frequency of oscillations of the particles decreased with the increase in the temperature of the liquid. It is because the magnitude of capillary force also decreased when the temperature of the liquid increased.Keywords: particle dispersion, capillary force, viscous drag, oscillations
Procedia PDF Downloads 3713508 A Study to Identify Resistant Hypertension and Role of Spironolactone in its Management
Authors: A. Kumar, D. Himanshu, Ak Vaish, K. Usman , A. Singh, R. Misra, V. Atam, S. P. Verma, S. Singhal
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Introduction: Resistant and uncontrolled hypertension offer great challenge, in terms of higher risk of morbidity, mortality and not the least, difficulty in diagnosis and management. Our study tries to identify the importance of two crucial aspects of hypertension management, i.e. drug compliance and optimum dosing and also the effect of spironolactone on blood pressure in cases of resistant hypertension. Methodology: A prospective study was carried out among patients, who were referred as case of resistant hypertension to Hypertension Clinic at Gandhi memorial and associated hospital, Lucknow, India from August, 2013 to July 2014. A total of 122 Subjects having uncontrolled BP with ≥3 antihypertensives were selected. After ruling out secondary resistance and with appropriate lifestyle modifications, effect of adherence and optimum doses was seen with monitoring of BP. Only those having blood pressure still uncontrolled were true resistant. These patients were given spironolactone to see its effect on BP over next 12 weeks. Results: Mean baseline BP of all (n=122) patients was 150.4±7.2 mmHg systolic and 92.1±5.7 mmHg diastolic. After promoting adherence to the regimen, there was reduction of 4.20±3.65 mmHg systolic and 2.08±4.74 mmHg Diastolic blood pressure, with 26 patients achieving target blood pressure goal. Further reduction of 6.66±5.99 mmHg in systolic and 2.59±3.67 mmHg in diastolic BP was observed after optimizing the drug doses with another 66 patients achieving target blood pressure goal. Only 30 patients were true resistant hypertensive and prescribed spironolactone. Over 12 weeks, mean reduction of 20.62±3.65 mmHg in systolic and 10.08 ± 6.46 mmHg in diastolic BP was observed. Out of these 30, BP was controlled in 24 patients. Side effects observed were hyperkalemia in 2 patients and breast tenderness in 2 patients. Conclusion: Improper adherence and suboptimal regimen appear to be the important reasons for uncontrolled hypertension. By virtue of maintaining proper adherence to an optimum regimen, target BP goal can be reached in many without adding much to the regimen. Spironolactone is effective in patients with resistant hypertension, in terms of blood pressure reduction with minimal side effects.Keywords: resistant, hypertension, spironolactone, blood pressure
Procedia PDF Downloads 2783507 The Combined Methodology To Detect Onboard Driver Fatigue
Authors: K. Senthil Nathan, P. Rajasekaran
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Fatigue is a feeling of extreme physical or mental tiredness. Almost everyone becomes fatigued at some time, but driver’s fatigue is a serious problem that leads to thousands of automobile crashes each year. Fatigue process is often a change from the alertness and vigor state to the tiredness and weakness state. It is not only accompanied by drowsiness but also has a negative impact on mood. There have been studies to detect and quantify fatigue from the measurement of physiology variables such as electroencephalogram (EEG), electrooculogram (EOG), and electromyogram (EMG). This project involves a multimodal sensing of driver’s drowsiness. The first method is to count the eye blinking rate. In the second level, we authenticate the results of eye blink module with a grip sensor. The Flexiforce sensor is placed over the steering wheel. In the third level, the activities are sensed, the time elapsed from the driver’s last activity is counted here. The activities in the sense: Changing gear, applying brake, pressing sound horns, and turning the steering wheel. Absence of these activities is also an indicator of fatigue.Keywords: eye blink sensor, Flexiforce sensor, EEG, EOG, EMG
Procedia PDF Downloads 4833506 Teachers’ Perceptions of the Efficacy of Social Stories in the Development of Social Skills for Students with Autism in Saudi Arabia
Authors: Faihan Alotaibi
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This study explores Saudi teachers’ perceptions of the efficacy of social stories in the development of social skills in students with autism in Riyadh, Saudi Arabia in two phases. Data were collected in sequential quantitative and qualitative phases. Participants in this study were 100 teachers in the quantitative phase and 15 teachers were interviewed. In this poster, the researcher will present the data result in the qualitative second phase in which an understanding of teachers’ experiences was deepened by conducting semi-structured interviews with a purposeful sample of fifteen teachers of diverse experience, covering six initial themes: the social story concept, sources of social stories, the effectiveness of social stories in improving social skills in students with autism, barriers to using social stories for students with autism, cultural consideration and context of social stories, and factors which contribute to the best use of social stories to developing of social skills for students with autism.Keywords: autism, social storyteachers’ perceptions, intervention, social skills
Procedia PDF Downloads 3823505 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 1033504 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 4443503 Evaluating Therapeutic Efficacy of Intravesical Xenogeneic Urothelial Cell Treatment Alone and in Combination with Chemotherapy or Immune Checkpoint Inhibitors in a Mouse Non-Muscle-Invasive Bladder Cancer Model
Authors: Chih-Rong Shyr, Chi-Ping Huang
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Intravesical BCG is the gold-standard therapy for high risk non-muscle invasive bladder cancer (NMIBC) after TURBT, but if not responsive to BCG, these BCG unresponsive patients face cystectomy that causes morbidity and comes with a morality risk. To provide the bladder sparing options for patients with BCG-unresponsive NMIBC, several new treatments have been developed to salvage the bladders and prevent progression to muscle invasive or metastatic, but however, most approved or developed treatments still fail in a significant proportion of patients without long term success. Thus more treatment options and the combination of different therapeutic modalities are urgently needed to change the outcomes. Xenogeneic rejection has been proposed to a mechanism of action to induce anti-tumor immunity for the treatment of cancers due to the similarities between rejection mechanism to xenoantigens (proteins, glycans and lipids) and anti-tumor immunities to tumor specific antigens (neoantigens, tumor associated carbohydrates and lipids). Xenogeneic urothelial cells (XUC) of porcine origin have been shown to induce anti-tumor immune responses to inhibit bladder tumor progression in mouse bladder cancer models. To further demonstrate the efficacy of the distinct intravesical XUC treatment in NMIBC, and the combined effects with chemotherapy and immune checkpoint inhibitors (ICIs) as a alternate therapeutic option, this study investigated the therapeutic effects and mechanisms of intravesical XUC immunotherapy in an orthotopic mouse immune competent model of NMIBC, generated from a mouse bladder cancer cell line. We found that the tumor progression was inhibited by intravescial XUC treatment and there was a synergy between intravesical XUC with intravesical chemotherapeutic agent, gemcitabine or systemic ICI, anti-PD1 antibody treatment. The cancer cell proliferation was decreased but the cell death was increased by the intravecisal XUC treatment. Most importantly, the mechanisms of action of intravesical XUC immunotherapy were found to be linked to enhanced infiltration of CD4+ and CD8+ T-cell as well as NK cells, but decreased presence of myeloid immunosuppressive cells in XUC treated tumors. The increased stimulation of immune cells of XUC treated mice to xenogeneic urothelial cells and mouse bladder cancer cells in immune cell proliferation and cytokine secretion were observed both as a monotherapy and in combination with intravesical gemcitabine or systemic anti PD-L1 treatment. In sum, we identified the effects of intravesical XUC treatment in monotherapy and combined therapy on tumor progression and its cellular and molecular events related to immune activation to understand the anti-tumoral mechanisms behind intravesical XUC immunotherapy for NMIBC. These results contribute to the understanding of the mechanisms behind successful xenogeneic cell immunotherapy against NMIBC and characterize a novel therapeutic approach with a new xenogeneic cell modality for BCG-unresponsive NMIBC.Keywords: xenoantigen, neoantigen, rejection, immunity
Procedia PDF Downloads 73502 Investigation of the Level of Physical and Mental Health of Patients Undergoing in Chronic or Transient Hemodialysis at Artificial Kidney Unit
Authors: Styliani Kotrotsiou, Evagelia Kotrotsiou, Fani Mokia, Theodosis Paralikas, Konstantinos Tsaras
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Objective: The objective of this study was the investigation of the mental health of patients undergoing chronic or transient hemodialysis at Artificial Kidney Unit, as well as its relationship to the demographic characteristic of patients. Material and Method: The study took place in Larisa during the month of December in 2016 and the sample was composed of 60 patients undergoing in chronic or transient hemodialysis at Artificial Kidney Unit of the University General Hospital of Larisa. For the investigation of the physical and mental health of patients who participated in the study, the tool measurement << General Health Questionnaire- 28 >> (GHQ-28) was used. The questionnaires were administered with the interview method during the hemodialysis. This survey is designed for the existence or not of a mental disorder. It examines four factors (physical symptoms, anxiety, social dysfunction and depression). Results: The hemodialysis patients gave the following scores: -to the physical symptoms, women showed a higher average value than men (1,16 ± 1,26 against 0,49 ± 0,93), -at the anxiety scale, it seems that women are superior to men (1,68 ± 1,20 against 0,90 ± 1,22), -at the social dysfunction scale, the elderly patients ( > 65 years old) were presented a with higher average (2,59), and -at the depression scale, patients with a higher average value were those who lived in non-urban areas. The appearance of mental disorder, in relation to patient characteristics, did not show significant statistical correlation. The sex, the age and the place of residence affect more the assessment of mental health, while education did not seem to have any significant effect on the other. Conclusions: The hemodialysis process can significantly affect the patient’s Quality of Life and it can bring adverse changes in lifestyle, affecting the physical, social and psychological state of the individual. For that reason, hemodialysis should be aimed not only at extending life but in upgrading the Quality of Life.Keywords: hemodialysis, chronic kidney disease, depression, social dysfunction, physical condition
Procedia PDF Downloads 1643501 Trust and Conflict Resolution: Relationship Building for Learning
Authors: Jeff Dickie
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This research paper combined grounded coding and research questions with the objective to investigate conflict resolution in the classroom. The students’ answers concerning teaching were coded according to phrasal meanings which revealed concepts. These concept codes then became input data into theoretical frameworks. The investigation indicated two conflicts: whether the information was valid and whether to make the study effort which was discussed as perceptions of teacher’s competence in helping to learn. The relevant factors in helping to learn were predominately emotional. These factors were important in the negotiation process to develop relationships. Information validity seemed to be the motivator to begin and participate effectively with the learning process. In effect, confidence in the learning negotiation process with the focus towards relationship building with the subject matter seemed to be the motivator to make the study effort.Keywords: coding, confidence, competence, conflict resolution, risk, trust, relationship building
Procedia PDF Downloads 4313500 Application Use of Slaughterhouse Waste to Improve Nutrient Level in Apium glaviolens
Authors: Hasan Basri Jumin
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Using the slaughterhouse waste combined to suitable dose of nitrogen fertilizer to Apium glaviolen gives the significant effect to mean relative growth rate. The same pattern also showed significantly in net assimilation rate. The net assimilation rate increased significantly during 42 days old plants. Combination of treatment of 100 ml/l animal slaughterhouse waste and 0.1 g/kg nitrogen fertilizer/kg soil increased the vegetative growth of Apium glaviolens. The biomass of plant and mean relative growth rate of Apium glaviolens were rapidly increased in 4 weeks after planting and gradually decreased after 35 days at the harvest time. Combination of 100 ml/l slaughterhouse waste and applied 0.1 g/kg nitrogen fertilizer has increased all parameters. The highest vegetative growth, biomass, mean relative growth rate and net assimilation rate were received from 0.56 mg-l.m-2.days-1.Keywords: Apium glaviolent, nitrogen, pollutant, slaughterhouse, waste
Procedia PDF Downloads 3663499 Plasticity in Matrix Dominated Metal-Matrix Composite with One Active Slip Based Dislocation
Authors: Temesgen Takele Kasa
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The main aim of this paper is to suggest one active slip based continuum dislocation approach to matrix dominated MMC plasticity analysis. The approach centered the free energy principles through the continuum behavior of dislocations combined with small strain continuum kinematics. The analytical derivation of this method includes the formulation of one active slip system, the thermodynamic approach of dislocations, determination of free energy, and evolution of dislocations. In addition zero and non-zero energy dissipation analysis of dislocation evolution is also formulated by using varational energy minimization method. In general, this work shows its capability to analyze the plasticity of matrix dominated MMC with inclusions. The proposed method is also found to be capable of handling plasticity of MMC.Keywords: active slip, continuum dislocation, distortion, dominated, energy dissipation, matrix dominated, plasticity
Procedia PDF Downloads 3883498 ESS Control Strategy for Primary Frequency Response in Microgrid Considering Ramp Rate
Authors: Ho-Jun Jo, Wook-Won Kim, Yong-Sung Kim, Jin-O Kim
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The application of ESS (Energy Storage Systems) in the future grids has been the solution of the microgrid. However, high investment costs necessitate accurate modeling and control strategy of ESS to justify its economic viability and further underutilization. Therefore, the reasonable control strategy for ESS which is subjected to generator and usage helps to curtail the cost of investment and operation costs. The rated frequency in power system is decreased when the load is increasing unexpectedly; hence the thermal power is operated at the capacity of only its 95% for the Governor Free (GF) to adjust the frequency as reserve (5%) in practice. The ESS can be utilized with governor at the same time for the frequency response due to characteristic of its fast response speed and moreover, the cost of ESS is declined rapidly to the reasonable price. This paper presents the ESS control strategy to extend usage of the ESS taken account into governor’s ramp rate and reduce the governor’s intervention as well. All results in this paper are simulated by MATLAB.Keywords: micro grid, energy storage systems, ramp rate, control strategy
Procedia PDF Downloads 3923497 Numeric Modeling of Condensation of Water Vapor from Humid Air in a Room
Authors: Nguyen Van Que, Nguyen Huy The
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This paper presents combined natural and forced convection of humid air flow. The film condensation of water vapour on a cold floor was investigated using ANSYS Fluent software. User-defined Functions(UDFs) were developed and added to address the issue of film condensation at the surface of the floor. Those UDFs were validated by analytical results on a flat plate. The film condensation model based on mass transfer was used to solve phase change. On the floor, condensation rate was obtained by mass fraction change near the floor. The study investigated effects of inlet velocity, inlet relative humidity and cold floor temperature on the condensation rate. The simulations were done in both 2D and 3D models to show the difference and need for 3D modeling of condensation.Keywords: heat and mass transfer, convection, condensation, relative humidity, user-defined functions
Procedia PDF Downloads 3313496 Using “Eckel” Model to Measure Income Smoothing Practices: The Case of French Companies
Authors: Feddaoui Amina
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Income smoothing represents an attempt on the part of the company's management to reduce variations in earnings through the manipulation of the accounting principles. In this study, we aimed to measure income smoothing practices in a sample of 30 French joint stock companies during the period (2007-2009), we used Dummy variables method and “ECKEL” model to measure income smoothing practices and Binomial test accourding to SPSS program, to confirm or refute our hypothesis. This study concluded that there are no significant statistical indicators of income smoothing practices in the sample studied of French companies during the period (2007-2009), so the income series in the same sample studied of is characterized by stability and non-volatility without any intervention of management through accounting manipulation. However, this type of accounting manipulation should be taken into account and efforts should be made by control bodies to apply Eckel model and generalize its use at the global level.Keywords: income, smoothing, 'Eckel', French companies
Procedia PDF Downloads 1523495 Predicting Shot Making in Basketball Learnt Fromadversarial Multiagent Trajectories
Authors: Mark Harmon, Abdolghani Ebrahimi, Patrick Lucey, Diego Klabjan
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In this paper, we predict the likelihood of a player making a shot in basketball from multiagent trajectories. Previous approaches to similar problems center on hand-crafting features to capture domain-specific knowledge. Although intuitive, recent work in deep learning has shown, this approach is prone to missing important predictive features. To circumvent this issue, we present a convolutional neural network (CNN) approach where we initially represent the multiagent behavior as an image. To encode the adversarial nature of basketball, we use a multichannel image which we then feed into a CNN. Additionally, to capture the temporal aspect of the trajectories, we use “fading.” We find that this approach is superior to a traditional FFN model. By using gradient ascent, we were able to discover what the CNN filters look for during training. Last, we find that a combined FFN+CNN is the best performing network with an error rate of 39%.Keywords: basketball, computer vision, image processing, convolutional neural network
Procedia PDF Downloads 1533494 A Virtual Electrode through Summation of Time Offset Pulses
Authors: Isaac Cassar, Trevor Davis, Yi-Kai Lo, Wentai Liu
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Retinal prostheses have been successful in eliciting visual responses in implanted subjects. As these prostheses progress, one of their major limitations is the need for increased resolution. As an alternative to increasing the number of electrodes, virtual electrodes may be used to increase the effective resolution of current electrode arrays. This paper presents a virtual electrode technique based upon time-offsets between stimuli. Two adjacent electrodes are stimulated with identical pulses with too short of pulse widths to activate a neuron, but one has a time offset of one pulse width. A virtual electrode of twice the pulse width was then shown to appear in the center, with a total width capable of activating a neuron. This can be used in retinal implants by stimulating electrodes with pulse widths short enough to not elicit responses in neurons, but with their combined pulse width adequate to activate a neuron in between them.Keywords: electrical stimulation, neuroprosthesis, retinal implant, retinal prosthesis, virtual electrode
Procedia PDF Downloads 3033493 Nano Liquid Thin Film Flow over an Unsteady Stretching Sheet
Authors: Prashant G. Metri
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A numerical model is developed to study nano liquid film flow over an unsteady stretching sheet in the presence of hydromagnetic have been investigated. Similarity transformations are used to convert unsteady boundary layer equations to a system of non-linear ordinary differential equations. The resulting non-linear ordinary differential equations are solved numerically using Runge-Kutta-Fehlberg and Newton-Raphson schemes. A relationship between film thickness β and the unsteadiness parameter S is found, the effect of unsteadiness parameter S, and the hydromagnetic parameter S, on the velocity and temperature distributions are presented. The present analysis shows that the combined effect of magnetic field and viscous dissipation has a significant influence in controlling the dynamics of the considered problem. Comparison with known results for certain particular cases is in excellent agreement.Keywords: boundary layer flow, nanoliquid, thin film, unsteady stretching sheet
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