Search results for: nutrition care process
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19025

Search results for: nutrition care process

16835 Removal of Problematic Organic Compounds from Water and Wastewater Using the Arvia™ Process

Authors: Akmez Nabeerasool, Michaelis Massaros, Nigel Brown, David Sanderson, David Parocki, Charlotte Thompson, Mike Lodge, Mikael Khan

Abstract:

The provision of clean and safe drinking water is of paramount importance and is a basic human need. Water scarcity coupled with tightening of regulations and the inability of current treatment technologies to deal with emerging contaminants and Pharmaceuticals and personal care products means that alternative treatment technologies that are viable and cost effective are required in order to meet demand and regulations for clean water supplies. Logistically, the application of water treatment in rural areas presents unique challenges due to the decentralisation of abstraction points arising from low population density and the resultant lack of infrastructure as well as the need to treat water at the site of use. This makes it costly to centralise treatment facilities and hence provide potable water direct to the consumer. Furthermore, across the UK there are segments of the population that rely on a private water supply which means that the owner or user(s) of these supplies, which can serve one household to hundreds, are responsible for the maintenance. The treatment of these private water supply falls on the private owners, and it is imperative that a chemical free technological solution that can operate unattended and does not produce any waste is employed. Arvia’s patented advanced oxidation technology combines the advantages of adsorption and electrochemical regeneration within a single unit; the Organics Destruction Cell (ODC). The ODC uniquely uses a combination of adsorption and electrochemical regeneration to destroy organics. Key to this innovative process is an alternative approach to adsorption. The conventional approach is to use high capacity adsorbents (e.g. activated carbons with high porosities and surface areas) that are excellent adsorbents, but require complex and costly regeneration. Arvia’s technology uses a patent protected adsorbent, Nyex™, which is a non-porous, highly conductive, graphite based adsorbent material that enables it to act as both the adsorbent and as a 3D electrode. Adsorbed organics are oxidised and the surface of the Nyex™ is regenerated in-situ for further adsorption without interruption or replacement. Treated water flows from the bottom of the cell where it can either be re-used or safely discharged. Arvia™ Technology Ltd. has trialled the application of its tertiary water treatment technology in treating reservoir water abstracted near Glasgow, Scotland, with promising results. Several other pilot plants have also been successfully deployed at various locations in the UK showing the suitability and effectiveness of the technology in removing recalcitrant organics (including pharmaceuticals, steroids and hormones), COD and colour.

Keywords: Arvia™ process, adsorption, water treatment, electrochemical oxidation

Procedia PDF Downloads 266
16834 Multiobjective Optimization of Wastwater Treatment by Electrochemical Process

Authors: Malek Bendjaballah, Hacina Saidi, Sarra Hamidoud

Abstract:

The aim of this study is to model and optimize the performance of a new electrocoagulation (E.C) process for the treatment of wastewater as well as the energy consumption in order to extrapolate it to the industrial scale. Through judicious application of an experimental design (DOE), it has been possible to evaluate the individual effects and interactions that have a significant influence on both objective functions (maximizing efficiency and minimizing energy consumption) by using aluminum electrodes as sacrificial anode. Preliminary experiments have shown that the pH of the medium, the applied potential and the treatment time with E.C are the main parameters. A factorial design 33 has been adopted to model performance and energy consumption. Under optimal conditions, the pollution reduction efficiency is 93%, combined with a minimum energy consumption of 2.60.10-3 kWh / mg-COD. The potential or current applied and the processing time and their interaction were the most influential parameters in the mathematical models obtained. The results of the modeling were also correlated with the experimental ones. The results offer promising opportunities to develop a clean process and inexpensive technology to eliminate or reduce wastewater,

Keywords: electrocoagulation, green process, experimental design, optimization

Procedia PDF Downloads 99
16833 The Effects of a Hippotherapy Simulator in Children with Cerebral Palsy: A Pilot Study

Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

Abstract:

Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

Procedia PDF Downloads 146
16832 Developing Critical-Process Skills Integrated Assessment Instrument as Alternative Assessment on Electrolyte Solution Matter in Senior High School

Authors: Sri Rejeki Dwi Astuti, Suyanta

Abstract:

The demanding of the asessment in learning process was impact by policy changes. Nowadays, the assessment not only emphasizes knowledge, but also skills and attitude. However, in reality there are many obstacles in measuring them. This paper aimed to describe how to develop instrument of integrated assessment as alternative assessment to measure critical thinking skills and science process skills in electrolyte solution and to describe instrument’s characteristic such as logic validity and construct validity. This instrument development used test development model by McIntire. Development process data was acquired based on development test step and was analyzed by qualitative analysis. Initial product was observed by three peer reviewer and six expert judgment (two subject matter expert, two evaluation expert and two chemistry teacher) to acquire logic validity test. Logic validity test was analyzed using Aiken’s formula. The estimation of construct validity was analyzed by exploratory factor analysis. Result showed that integrated assessment instrument has 0,90 of Aiken’s Value and all item in integrated assessment asserted valid according to construct validity.

Keywords: construct validity, critical thinking skills, integrated assessment instrument, logic validity, science process skills

Procedia PDF Downloads 265
16831 The Relationship between the Skill Mix Model and Patient Mortality: A Systematic Review

Authors: Yi-Fung Lin, Shiow-Ching Shun, Wen-Yu Hu

Abstract:

Background: A skill mix model is regarded as one of the most effective methods of reducing nursing shortages, as well as easing nursing staff workloads and labor costs. Although this model shows several benefits for the health workforce, the relationship between the optimal model of skill mix and the patient mortality rate remains to be discovered. Objectives: This review aimed to explore the relationship between the skill mix model and patient mortality rate in acute care hospitals. Data Sources: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases and researchers retrieved studies published between January 1986 and March 2022. Review methods: Two independent reviewers screened the titles and abstracts based on selection criteria, extracted the data, and performed critical appraisals using the STROBE checklist of each included study. The studies focused on adult patients in acute care hospitals, and the skill mix model and patient mortality rate were included in the analysis. Results: Six included studies were conducted in the USA, Canada, Italy, Taiwan, and European countries (Belgium, England, Finland, Ireland, Spain, and Switzerland), including patients in medical, surgical, and intensive care units. There were both nurses and nursing assistants in their skill mix team. This main finding is that three studies (324,592 participants) show evidence of fewer mortality rates associated with hospitals with a higher percentage of registered nurse staff (range percentage of registered nurse staff 36.1%-100%), but three articles (1,122,270 participants) did not find the same result (range of percentage of registered nurse staff 46%-96%). However, based on appraisal findings, those showing a significant association all meet good quality standards, but only one-third of their counterparts. Conclusions: In light of the limited amount and quality of published research in this review, it is prudent to treat the findings with caution. Although the evidence is not insufficient certainty to draw conclusions about the relationship between nurse staffing level and patients' mortality, this review lights the direction of relevant studies in the future. The limitation of this article is the variation in skill mix models among countries and institutions, making it impossible to do a meta-analysis to compare them further.

Keywords: nurse staffing level, nursing assistants, mortality, skill mix

Procedia PDF Downloads 120
16830 Rating the Importance of Customer Requirements for Green Product Using Analytic Hierarchy Process Methodology

Authors: Lara F. Horani, Shurong Tong

Abstract:

Identification of customer requirements and their preferences are the starting points in the process of product design. Most of design methodologies focus on traditional requirements. But in the previous decade, the green products and the environment requirements have increasingly attracted the attention with the constant increase in the level of consumer awareness towards environmental problems (such as green-house effect, global warming, pollution and energy crisis, and waste management). Determining the importance weights for the customer requirements is an essential and crucial process. This paper used the analytic hierarchy process (AHP) approach to evaluate and rate the customer requirements for green products. With respect to the ultimate goal of customer satisfaction, surveys are conducted using a five-point scale analysis. With the help of this scale, one can derive the weight vectors. This approach can improve the imprecise ranking of customer requirements inherited from studies based on the conventional AHP. Furthermore, the AHP with extent analysis is simple and easy to implement to prioritize customer requirements. The research is based on collected data through a questionnaire survey conducted over a sample of 160 people belonging to different age, marital status, education and income groups in order to identify the customer preferences for green product requirements.

Keywords: analytic hierarchy process (AHP), green product, customer requirements for green design, importance weights for the customer requirements

Procedia PDF Downloads 244
16829 The Influence of the Method of Cooling Coffee Beans After Roasting on Their Mechanical Strength

Authors: Marek Gancarz, Katarzyna Grądecka-Jakubowska

Abstract:

The aim of the study was to analyze the cooling process of coffee beans after roasting in order to determine their mechanical strength. Arabica coffee beans came from two varieties of coffee: Brazil Diamantina and Ethiopia Refisha. Coffee beans were cooled with air or liquid nitrogen. The mechanical properties of roasted and then cooled coffee beans were determined using an INSTRON machine. It is equipped with a measuring head and a cylindrical probe that destroys the sample. The maximum force of the head used is 250 N. The process of cooling coffee beans using air was characterized by the lower mechanical strength of coffee beans compared to cooling with liquid nitrogen.

Keywords: coffee beans, cooling process, liquid nitrogen, mechanical properties

Procedia PDF Downloads 8
16828 Effect of Humidity on In-Process Crystallization of Lactose During Spray Drying

Authors: Amirali Ebrahimi, T. A. G. Langrish

Abstract:

The effect of various humidities on process yields and degrees of crystallinity for spray-dried powders from spray drying of lactose with humid air in a straight-through system have been studied. It has been suggested by Williams–Landel–Ferry kinetics (WLF) that a higher particle temperature and lower glass-transition temperature would increase the crystallization rate of the particles during the spray-drying process. Freshly humidified air produced by a Buchi-B290 spray dryer as a humidifier attached to the main spray dryer decreased the particle glass-transition temperature (Tg), while allowing the particle temperature (Tp) to reach higher values by using an insulated drying chamber. Differential scanning calorimetry (DSC) and moisture sorption analysis were used to measure the degree of crystallinity for the spray-dried lactose powders. The results showed that higher Tp-Tg, as a result of applying humid air, improved the process yield from 21 ± 4 to 26 ± 2% and crystallinity of the particles by decreasing the latent heat of crystallization from 43 ± 1 to 30 ± 11 J/g and the sorption peak height from 7.3 ± 0.7% to 6 ± 0.7%.

Keywords: lactose, crystallization, spray drying, humid air

Procedia PDF Downloads 430
16827 Ethnic and National Determinants in the Process of Building Peace in Afghanistan After the Withdrawal of Western Forces in 2021

Authors: Małgorzata Cichy

Abstract:

Afghanistan is a source of conflicts that affect security on a global scale. The role of ethnic and national determinants in the peacebuilding process in this country remains an extremely important factor in this respect. Research methods include literature and data analysis (scientific literature, documents of governmental and non-governmental organizations, statistical data and media reports), institutional and legal analysis, as well as decision-making method. The main objective of the research is a comprehensive answer to the question of how ethnic and national factors affect the process of building peace in Afghanistan after 2021 and what impact it has on international security.

Keywords: Afghanistan, pashtuns, peace, taliban

Procedia PDF Downloads 100
16826 Virtual Simulation as a Teaching Method for Community Health Nursing: An Investigation of Student Performance

Authors: Omar Mayyas

Abstract:

Clinical decision-making (CDM) is essential to community health nursing (CHN) education. For this reason, nursing educators are responsible for developing these skills among nursing students because nursing students are exposed to highly critical conditions after graduation. However, due to limited exposure to real-world situations, many nursing students need help developing clinical decision-making skills in this area. Therefore, the impact of Virtual Simulation (VS) on community health nursing students' clinical decision-making in nursing education has to be investigated. This study aims to examine the difference in CDM ability among CHN students who received traditional education compared to those who received VS classes, to identify the factors that may influence CDM ability differences between CHN students who received a traditional education and VS classes, and to provide recommendations for educational programs that can enhance the CDM ability of CHN students and improve the quality of care provided in community settings. A mixed-method study will conduct. A randomized controlled trial will compare the CDM ability of CHN students who received 1hr traditional class with another group who received 1hr VS scenario about diabetic patient nursing care. Sixty-four students in each group will randomly select to be exposed to the intervention from undergraduate nursing students who completed the CHN course at York University. The participants will receive the same Clinical Decision Making in Nursing Scale (CDMNS) questionnaire. The study intervention will follow the Medical Research Council (MRC) approach. SPSS and content analysis will use for data analysis.

Keywords: clinical decision-making, virtual simulation, community health nursing students, community health nursing education

Procedia PDF Downloads 70
16825 Optimal Maintenance Policy for a Three-Unit System

Authors: A. Abbou, V. Makis, N. Salari

Abstract:

We study the condition-based maintenance (CBM) problem of a system subject to stochastic deterioration. The system is composed of three units (or modules): (i) Module 1 deterioration follows a Markov process with two operational states and one failure state. The operational states are partially observable through periodic condition monitoring. (ii) Module 2 deterioration follows a Gamma process with a known failure threshold. The deterioration level of this module is fully observable through periodic inspections. (iii) Only the operating age information is available of Module 3. The lifetime of this module has a general distribution. A CBM policy prescribes when to initiate a maintenance intervention and which modules to repair during intervention. Our objective is to determine the optimal CBM policy minimizing the long-run expected average cost of operating the system. This is achieved by formulating a Markov decision process (MDP) and developing the value iteration algorithm for solving the MDP. We provide numerical examples illustrating the cost-effectiveness of the optimal CBM policy through a comparison with heuristic policies commonly found in the literature.

Keywords: reliability, maintenance optimization, Markov decision process, heuristics

Procedia PDF Downloads 222
16824 Health Professions Students' Knowledge of and Attitude toward Complementary and Alternative Medicine

Authors: Peter R. Reuter

Abstract:

Health professionals play important roles in helping patients use Complementary and Alternative Medicine (CAM) practices safely and accurately. Consequently, it is important for future health professionals to learn about CAM practices during their time in undergraduate and graduate programs. To satisfy this need for education, teaching CAM in nursing and medical schools and other health professions programs is becoming more prevalent. Our study was the first to look specifically at the knowledge of, and attitude toward CAM of undergraduate health professions students at a university in the U.S. Students were invited to participate in one of two anonymous online surveys depending on whether they were pre-health professions students or graduating health professions seniors. Of the 763 responses analyzed, 71.7% were from pre-health professions students, and 28.3% came from graduating seniors. The overall attitude of participants toward and interest in learning about CAM practices was generally fairly positive with graduating seniors being more positive than pre-health professions students. Yoga, meditation, massage therapy, aromatherapy, and chiropractic care were the practices most respondents had personal experience with. Massage therapy, yoga, chiropractic care, meditation, music therapy, and diet-based therapy received the highest ratings from respondents. Three-quarters of respondents planned on including aspects of holistic medicine in their future career as a health professional. The top five practices named were yoga, meditation, massage therapy, diet-based therapy, and music therapy. The study confirms the need to educate health professions students about CAM practices to give them the background information they need to select or recommend the best practices for their patients' needs.

Keywords: CAM education, health professions, health professions students, pre-health professions students

Procedia PDF Downloads 148
16823 Quantifying Automation in the Architectural Design Process via a Framework Based on Task Breakdown Systems and Recursive Analysis: An Exploratory Study

Authors: D. M. Samartsev, A. G. Copping

Abstract:

As with all industries, architects are using increasing amounts of automation within practice, with approaches such as generative design and use of AI becoming more commonplace. However, the discourse on the rate at which the architectural design process is being automated is often personal and lacking in objective figures and measurements. This results in confusion between people and barriers to effective discourse on the subject, in turn limiting the ability of architects, policy makers, and members of the public in making informed decisions in the area of design automation. This paper proposes the use of a framework to quantify the progress of automation within the design process. The use of a reductionist analysis of the design process allows it to be quantified in a manner that enables direct comparison across different times, as well as locations and projects. The methodology is informed by the design of this framework – taking on the aspects of a systematic review but compressed in time to allow for an initial set of data to verify the validity of the framework. The use of such a framework of quantification enables various practical uses such as predicting the future of the architectural industry with regards to which tasks will be automated, as well as making more informed decisions on the subject of automation on multiple levels ranging from individual decisions to policy making from governing bodies such as the RIBA. This is achieved by analyzing the design process as a generic task that needs to be performed, then using principles of work breakdown systems to split the task of designing an entire building into smaller tasks, which can then be recursively split further as required. Each task is then assigned a series of milestones that allow for the objective analysis of its automation progress. By combining these two approaches it is possible to create a data structure that describes how much various parts of the architectural design process are automated. The data gathered in the paper serves the dual purposes of providing the framework with validation, as well as giving insights into the current situation of automation within the architectural design process. The framework can be interrogated in many ways and preliminary analysis shows that almost 40% of the architectural design process has been automated in some practical fashion at the time of writing, with the rate at which progress is made slowly increasing over the years, with the majority of tasks in the design process reaching a new milestone in automation in less than 6 years. Additionally, a further 15% of the design process is currently being automated in some way, with various products in development but not yet released to the industry. Lastly, various limitations of the framework are examined in this paper as well as further areas of study.

Keywords: analysis, architecture, automation, design process, technology

Procedia PDF Downloads 106
16822 The Impact of Diabetes Mellitus on Skin and Soft Tissue Infections

Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

Abstract:

Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

Procedia PDF Downloads 51
16821 Governance Question and the Participatory Policy Making: Making the Process Functional in Nigeria

Authors: Albert T. Akume, P. D. Dahida

Abstract:

This paper examines the effect of various epochs of governments on policy making in Nigeria. The character of governance and public policy making of both epochs was exclusive, non-participatory and self-centric. As a consequence the interests of citizenry were not represented, neither protected nor sought to meet fairly the needs of all groups. The introduction of the post-1999 democratic government demand that the hitherto skewed pattern of policy making cease to be a character of governance. Hence, the need for citizen participation in the policy making process. The question then is what mode is most appropriate to engender public participation so as to make the policy making process functional? Given the prevailing social, economic and political dilemmas the utilization of the direct mode of citizen participation to affect policy outcome is doubtful if not unattainable. It is due to these predicament that this paper uses the documentary research design argues for the utilization of the indirect mode of citizen participation in the policy making process so as to affect public policy outcome appropriately and with less cost, acrimony and delays.

Keywords: governance, public policy, participation, representation, civil society

Procedia PDF Downloads 378
16820 Limits of the Dot Counting Test: A Culturally Responsive Approach to Neuropsychological Evaluations and Treatment

Authors: Erin Curtis, Avraham Schwiger

Abstract:

Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.

Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility

Procedia PDF Downloads 115
16819 Implementation of a Program of Orientation for Travel Nursing Staff Based on Nurse-Identified Learning Needs

Authors: Olga C. Rodrigue

Abstract:

Long-term care and skilled nursing facilities experience ebbs and flows of nursing staffing, a problem compounded by the perception of the facilities as undesirable workplaces and competition for staff from other healthcare entities. Travel nurses are contracted to fill staffing needs due to increased admissions, increased and unexpected attrition of nurses, or facility expansion of services. Prior to beginning the contracted assignment, the travel nurse must meet industry, company, and regulatory requirements (The Joint Commission and CMS) for skills and knowledge. Travel nurses, however, inconsistently receive the pre-assignment orientation needed to work at the contracted facility, if any information is given at all. When performance expectations are not met, travel nurses may subsequently choose to leave the position without completing the terms of the contract, and some facilities may choose to terminate the contract prior to the expected end date. The overarching goal of the Doctor of Nursing Practice evidence-based practice improvement project is to provide travel nurses with the basic and necessary information to prepare them to begin a long-term and skilled nursing assignment. The project involves the identification of travel nurse learning needs through a survey and the development and provision of web-based learning modules to address those needs prior to arrival for a long-term and skilled nursing assignment.

Keywords: nurse staffing, travel nurse, travel staff, contract staff, contracted assignment, long-term care, skilled nursing, onboarding, orientation, staff development, supplemental staff

Procedia PDF Downloads 170
16818 Failure Inference and Optimization for Step Stress Model Based on Bivariate Wiener Model

Authors: Soudabeh Shemehsavar

Abstract:

In this paper, we consider the situation under a life test, in which the failure time of the test units are not related deterministically to an observable stochastic time varying covariate. In such a case, the joint distribution of failure time and a marker value would be useful for modeling the step stress life test. The problem of accelerating such an experiment is considered as the main aim of this paper. We present a step stress accelerated model based on a bivariate Wiener process with one component as the latent (unobservable) degradation process, which determines the failure times and the other as a marker process, the degradation values of which are recorded at times of failure. Parametric inference based on the proposed model is discussed and the optimization procedure for obtaining the optimal time for changing the stress level is presented. The optimization criterion is to minimize the approximate variance of the maximum likelihood estimator of a percentile of the products’ lifetime distribution.

Keywords: bivariate normal, Fisher information matrix, inverse Gaussian distribution, Wiener process

Procedia PDF Downloads 319
16817 ED Machining of Particulate Reinforced Metal Matrix Composites

Authors: Sarabjeet Singh Sidhu, Ajay Batish, Sanjeev Kumar

Abstract:

This paper reports the optimal process conditions for machining of three different types of metal matrix composites (MMCs): 65vol%SiC/A356.2; 10vol%SiC-5vol%quartz/Al and 30vol%SiC/A359 using PMEDM process. Metal removal rate (MRR), tool wear rate (TWR), surface roughness (SR) and surface integrity (SI) were evaluated after each trial and contributing process parameters were identified. The four responses were then collectively optimized using the technique for order preference by similarity to ideal solution (TOPSIS) and optimal process conditions were identified for each type of MMCS. The density of reinforced particles shields the matrix material from spark energy hence the high MRR and SR was observed with lowest reinforced particle. TWR was highest with Cu-Gr electrode due to disintegration of the weakly bonded particles in the composite electrode. Each workpiece was examined for surface integrity and ranked as per severity of surface defects observed and their rankings were used for arriving at the most optimal process settings for each workpiece.

Keywords: metal matrix composites (MMCS), metal removal rate (MRR), surface roughness (SR), surface integrity (SI), tool wear rate (TWR), technique for order preference by similarity to ideal solution (TOPSIS)

Procedia PDF Downloads 292
16816 Review of Suitable Advanced Oxidation Processes for Degradation of Organic Compounds in Produced Water during Enhanced Oil Recovery

Authors: Smita Krishnan, Krittika Chandran, Chandra Mohan Sinnathambi

Abstract:

Produced water and its treatment and management are growing challenges in all producing regions. This water is generally considered as a nonrevenue product, but it can have significant value in enhanced oil recovery techniques if it meets the required quality standards. There is also an interest in the beneficial uses of produced water for agricultural and industrial applications. Advanced Oxidation Process is a chemical technology that has been growing recently in the wastewater treatment industry, and it is highly recommended for non-easily removal of organic compounds. The efficiency of AOPs is compound specific, therefore, the optimization of each process should be done based on different aspects.

Keywords: advanced oxidation process, photochemical processes, degradation, organic contaminants

Procedia PDF Downloads 507
16815 An Innovative Equipment for ICU Infection Control

Authors: Ankit Agarwal

Abstract:

Background: To develop a fully indigenous equipment which is an innovation in critical care, which can effectively scavenge contaminated ICU ventilator air. Objectives: Infection control in ICUs is a concern the world over. Various modalities from simple hand hygiene to costly antibiotics exist. However, one simple and scientific fact has been unnoticed till date, that the air exhaled by patients harboring MDR and other microorganisms, is released by ventilators into ICU atmosphere itself. This increases infection in ICU atmosphere and poses risk to other patients. Material and Methods: Some parts of the ventilator are neither disposable nor sterilizable. Over time, microorganisms accumulate in ventilator and act as a source of infection and also contaminate ICU air. This was demonstrated by exposing microbiological culture plates to air from expiratory port of ventilator, whereby dense growth of pathogenic microorganisms was observed. The present prototype of the equipment is totally self-made. It has a mechanism of controlled negative pressure, active and passive systems and various alarms and is versatile to be used with any ventilator. Results: This equipment captures the whole of contaminated exhaled air from the expiratory port of the ventilator and directs it out of the ICU space. Thus, it does not allow contaminated ventilator air to release into the ICU atmosphere. Therefore, there is no chance of exposure of other patients to contaminated air. Conclusion: The equipment is first of its kind the world over and is already under patent process. It has rightly been called ICU Ventilator Air Removal System (ICU VARS). It holds a chance that this technique will gain widespread acceptance shall find use in all the ventilators in most of the ICUs throughout the world.

Keywords: innovative, ICU Infection Control, microorganism, negative pressure

Procedia PDF Downloads 353
16814 Effect of Maternal Factors and C-Peptide and Insulin Levels in Cord Blood on the Birth Weight of Newborns: A Preliminary Study from Southern Sri Lanka

Authors: M. H. A. D. de Silva, R. P. Hewawasam, M. A. G. Iresha

Abstract:

Macrosomia is common in infants born to not only women diagnosed with gestational diabetes mellitus but also non-diabetic obese women. Maternal Body Mass Index (BMI) correlates with the incidence of large for gestational age infants. Obesity has reached epidemic levels in modern societies. During the past two decades, obesity in children and adolescents has risen significantly in Asian populations including Sri Lanka. There is increasing evidence to believe that infants who are born large for gestational age are more likely to be obese in childhood and adolescence and are at risk of cardiovascular and metabolic complications later in life. It is also established that Asians have lower skeletal muscle mass, low bone mineral content and excess body fat for a given BMI indicating a genetic predisposition in the occurrence of obesity. The objective of this study is to determine the effect of maternal weight, weight gain during pregnancy, c-peptide and insulin concentrations in the cord blood on the birth of appropriate for and large for gestational age infants in a tertiary care center in Southern Sri Lanka. Umbilical cord blood was collected from 90 newborns (Male 40, Female 50; gestational age 35-42 weeks) after double clamping the umbilical cord before separation of the placenta and the concentration of insulin and C-peptide were measured by ELISA technique. Anthropometric parameters of the newborn such as birth weight, length, ponderal index, occipital frontal, chest, hip and calf circumferences were measured, and characteristics of the mother were collected. The relationship between insulin, C-peptide and anthropometrics were assessed by Spearman correlation. The multiple logistic regression analysis examined influences of maternal weight, weight gain during pregnancy, C-peptide and insulin concentrations in cord blood as covariates on the birth of large for gestational age infants. A significant difference (P<0.001) was observed between the insulin levels of infants born large for gestational age (18.73 ± 0.52 µlU/ml) and appropriate for gestational age (13.08 ± 0.56 µlU/ml). Consistently, A significant decrease in concentration (41.68%, P<0.001) was observed between C-peptide levels of infants born large for gestational age and appropriate for gestational age. Cord blood insulin and C-peptide levels had a significant correlation with birth weight (r=0.35, P<0.05) of the newborn at delivery. Maternal weight and BMI which are indicators of maternal nutrition were proven to be directly correlated with birth weight and length. To our knowledge, this relationship was investigated for the first time in a Sri Lankan setting and was also evident in our results. This study confirmed the fact that insulin and C-peptide play a major role in regulating fetal growth. According to the results obtained in this study, we can suggest that the increased BMI of the mother has a direct influence on increased maternal insulin secretion, which may subsequently affect cord insulin and C-peptide levels and also birth weight of the infant.

Keywords: C-peptide, insulin, large for gestational age, maternal weight

Procedia PDF Downloads 169
16813 Effect of Punch Diameter on Optimal Loading Profiles in Hydromechanical Deep Drawing Process

Authors: Mehmet Halkaci, Ekrem Öztürk, Mevlüt Türköz, H. Selçuk Halkacı

Abstract:

Hydromechanical deep drawing (HMD) process is an advanced manufacturing process used to form deep parts with only one forming step. In this process, sheet metal blank can be drawn deeper by means of fluid pressure acting on sheet surface in the opposite direction of punch movement. High limiting drawing ratio, good surface quality, less springback characteristic and high dimensional accuracy are some of the advantages of this process. The performance of the HMD process is affected by various process parameters such as fluid pressure, blank holder force, punch-die radius, pre-bulging pressure and height, punch diameter, friction between sheet-die and sheet-punch. The fluid pressure and bank older force are the main loading parameters and affect the formability of HMD process significantly. The punch diameter also influences the limiting drawing ratio (the ratio of initial sheet diameter to punch diameter) of the sheet metal blank. In this research, optimal loading (fluid pressure and blank holder force) profiles were determined for AA 5754-O sheet material through fuzzy control algorithm developed in previous study using LS-DYNA finite element analysis (FEA) software. In the preceding study, the fuzzy control algorithm was developed utilizing geometrical criteria such as thinning and wrinkling. In order to obtain the final desired part with the developed algorithm in terms of the punch diameter requested, the effect of punch diameter, which is the one of the process parameters, on loading profiles was investigated separately using blank thickness of 1 mm. Thus, the practicality of the previously developed fuzzy control algorithm with different punch diameters was clarified. Also, thickness distributions of the sheet metal blank along a curvilinear distance were compared for the FEA in which different punch diameters were used. Consequently, it was found that the use of different punch diameters did not affect the optimal loading profiles too much.

Keywords: Finite Element Analysis (FEA), fuzzy control, hydromechanical deep drawing, optimal loading profiles, punch diameter

Procedia PDF Downloads 433
16812 Comparative Study of Fenton and Activated Carbon Treatment for Dyeing Waste Water

Authors: Prem Mohan, Namrata Jariwala

Abstract:

In recent years 10000 dyes are approximately used by dying industry which makes dyeing wastewater more complex in nature. It is very difficult to treat dyeing wastewater by conventional methods. Here an attempt has been made to treat dyeing wastewater by the conventional and advanced method for removal of COD. Fenton process is the advanced method and activated carbon treatment is the conventional method. Experiments have been done on synthetic wastewater prepared from three different dyes; acidic, disperse and reactive. Experiments have also been conducted on real effluent obtained from industry. The optimum dose of catalyst and hydrogen peroxide in Fenton process and optimum activated carbon dose for each of these wastewaters were obtained. In Fenton treatment, COD removal was obtained up to 95% whereas 70% removal was obtained with activated carbon treatment.

Keywords: activated carbon, advanced oxidation process, dyeing waste water, fenton oxidation process

Procedia PDF Downloads 214
16811 Common Health Problems of Filipino Overseas Household Service Workers: Implications for Wellness

Authors: Veronica Ramirez

Abstract:

For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.

Keywords: health, household service worker, overseas, wellness

Procedia PDF Downloads 261
16810 Conceptual Solution and Thermal Analysis of the Final Cooling Process of Biscuits in One Confectionary Factory in Serbia

Authors: Duško Salemović, Aleksandar Dedić, Matilda Lazić, Dragan Halas

Abstract:

The paper presents the conceptual solution for the final cooling of the chocolate dressing of biscuits in one confectionary factory in Serbia. The proposed concept solution was derived from the desired technological process of final cooling of biscuits and the required process parameters that were to be achieved, and which were an integral part of the project task. The desired process parameters for achieving proper hardening and coating formation are the exchanged amount of heat in the time unit between the two media (air and chocolate dressing), the speed of air inside the tunnel cooler, and the surface of all biscuits in contact with the air. These parameters were calculated in the paper. The final cooling of chocolate dressing on biscuits could be optimized by changing process parameters and dimensions of the tunnel cooler and looking for the appropriate values for them. The accurate temperature predictions and fluid flow analysis could be conducted by using heat balance and flow balance equations, having in mind the theory of similarity. Furthermore, some parameters were adopted from previous technology processes, such as the inlet temperature of biscuits and input air temperature. A thermal calculation was carried out, and it was demonstrated that the percentage error between the contact surface of the air and the chocolate biscuit topping, which is obtained from the heat balance and geometrically through the proposed conceptual solution, does not exceed 0.67%, which is a very good agreement. This enabled the quality of the cooling process of chocolate dressing applied on the biscuit and the hardness of its coating.

Keywords: chocolate dressing, air, cooling, heat balance

Procedia PDF Downloads 85
16809 Probiotics in Anxiety and Depression

Authors: Pilar Giffenig, Avanna Kotlarz, Taylor Dehring

Abstract:

Anxiety and depression are common mental illnesses in the U.S today. While there are various treatments for these mental health disorders, many of the medications come with a large variety of side effects that decrease medication compliance. Recent studies have looked at the impact of probiotics on anxiety and depression. Our goal was to determine whether probiotics could help relieve symptoms of anxiety and or depression. We conducted a literature search of three databases focusing on systematic reviews and RTC and found 25 articles, 8 of which were used for our analysis. Seven out of the eight articles showed that probiotics have the potential to significantly reduce symptoms of anxiety and depression. However, larger study sample sizes, type of probiotic, and correct dosage are required in future research to determine the role of probiotics in the treatment of anxiety and depression.

Keywords: probiotics, anxiety, depression, treatment, psychology, nutrition

Procedia PDF Downloads 273
16808 Improving Dyeability of Cotton Fabric with Juglans regia L. Natural Dyestuff

Authors: M. Heysem Arslan, Ikilem Gocek, U. Kivanc Sahin

Abstract:

Natural dyestuff, extracted from Juglans Regia L., a kind of walnut, was used to dye 100% cotton gabardine fabric. The main goal of this study was to enhance dyeing process of cotton fabric with Juglans Regia L. dyestuff in terms of color fastness values by designing and developing a mordant application process. Within the context of this study, different mordants such as tannic acid, gallic acid, ascorbic acid, potassium sodium tartrate tetrahydrate, calcium carbonate, iron (II) sulphate heptahydrate, aluminum potassium sulphate dodecahydrate and their combinations were applied in the mordanting processes. Spectrophotometric analysis, color fastness to washing and color fastness to light tests were carried out on the fabric samples. In this study, it was shown that by using the right combination of mordants with a proper application process, it is possible to improve color fastness values of cotton fabric samples dyed with natural dyestuff.

Keywords: extraction, Juglans Regia L., mordanting process, natural dyestuff

Procedia PDF Downloads 312
16807 Metropolitan Governance in Statutory Plan Making Process

Authors: Vibhore Bakshi

Abstract:

This research paper is a step towards understanding the role of governance in the plan preparation process. It addresses the complexities of the peri-urban, historical constructions, politics and policies of sustainability, and legislative frameworks. The paper reflects on the Delhi NCT as one of the classical cases that have happened to witness different structural changes in the master plan around 1981, 2001, 2021, and Proposed Draft 2041. The Delhi Landsat imageries for 1989 and 2018 show an increase in the built-up areas around the periphery of NCT. The peri-urbanization has been a result of increasing in-migration to peri–urban areas of Delhi. The built-up extraction for years 1981, 1991, 2001, 2011, and 2018 highlights the growing peri-urbanization on scarce land therefore, it becomes equally important to research the history of the land and its legislative measures. It is interesting to understand the streaks of changes that have occurred in the land of Delhi in accordance with the different master plans and land legislative policies. The process of masterplan process in Delhi has experienced a lot of complexities in juxtaposition to other metropolitan regions of the world. The paper identifies the shortcomings in the current master planning process approach in regard to the stage of the planning process, traditional planning approach, and lagging ICT-based interventions. The metropolitan governance systems across the globe and India depict diversity in the organizational setup and varied dissemination of functions. It addresses the complexity of the peri-urban, historical constructions, politics and policies of sustainability, and legislative frameworks.

Keywords: governance, land provisions, built-up areas, in migration, built up extraction, master planning process, legislative policies, metropolitan governance systems

Procedia PDF Downloads 173
16806 Opportunities for Effective Communication Through the Delivery of an Autism Spectrum Disorder Diagnosis: A Scoping Review

Authors: M. D. Antoine

Abstract:

When a child is diagnosed with an illness, condition, or developmental disorder, the process involved in understanding and accepting this diagnosis can be a very stressful and isolating experience for parents and families. The healthcare providers’ ability to effectively communicate in such situations represents a vital lifeline for parents. In this context, communication becomes a crucial element not only for getting through the period of grief but also for the future. We mobilized the five stages of grief model to summarize existing literature regarding the ways in which the experience ofan autism spectrum disorder diagnosis disclosurealigns with the experience of grief to explore how this can inform best practices for effective communication with parents through the diagnosis disclosure. Fifteen publications met inclusion criteria. Findings from the scoping review of empirical studies show that parents/families experience grief-like emotions during the diagnosis disclosure. However, grief is not an outcome of the encounter itself. In fact, the experience of the encounter can help mitigate the grief experience. The way parents/families receive and react to the ‘news’ depends on their preparedness, knowledge, and the support received through the experience. Individual communication skills, as well as policies and regulations, should be examined to alleviate adverse reactions in this context. These findings highlight the importance of further research into effective parent-provider communication strategies and their place in supporting quality autism care.

Keywords: autism spectrum disorder, autism spectrum disorder diagnosis, diagnosis disclosure, parent-provider communication, parental grief

Procedia PDF Downloads 177