Search results for: medical social work
709 Examining the Independent Effects of Early Exposure to Game Consoles and Parent-Child Activities on Psychosocial Development
Authors: Rosa S. Wong, Keith T. S. Tung, Frederick K. Ho, Winnie W. Y. Tso, King-wa Fu, Nirmala Rao, Patrick Ip
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As technology advances, exposures in early childhood are no longer confined to stimulations in the surrounding physical environments. Children nowadays are also subject to influences from the digital world. In particular, early access to game consoles can cause risks to child development, especially when the game is not developmentally appropriate for young children. Overstimulation is possible and could impair brain development. On the other hand, recreational parent-child activities, including outdoor activities and visits to museums, require child interaction with parents, which is beneficial for developing adaptive emotion regulation and social skills. Given the differences between these two types of exposures, this study investigated and compared the independent effects of early exposure to a game console and early play-based parent-child activities on children’s long-term psychosocial outcomes. This study used data from a subset of children (n=304, 142 male and 162 female) in the longitudinal cohort study, which studied the long-term impact of family socioeconomic status on child development. In 2012/13, we recruited a group of children at Kindergarten 3 (K3) randomly from Hong Kong local kindergartens and collected data regarding their duration of exposure to game console and recreational parent-child activities at that time. In 2018/19, we re-surveyed the parents of these children who were matriculated as Form 1 (F1) students (ages ranging from 11 to 13 years) in secondary schools and asked the parents to rate their children’s psychosocial problems in F1. Linear regressions were conducted to examine the associations between early exposures and adolescent psychosocial problems with and without adjustment for child gender and K3 family socioeconomic status. On average, K3 children spent about 42 minutes on a game console every day and had 2-3 recreational activities with their parents every week. Univariate analyses showed that more time spent on game consoles at K3 was associated with more psychosocial difficulties in F1 particularly more externalizing problems. The effect of early exposure to game console on externalizing behavior remained significant (B=0.59, 95%CI: 0.15 to 1.03, p=0.009) after adjusting for recreational parent-child activities and child gender. For recreational parent-child activities at K3, its effect on overall psychosocial difficulties became insignificant after adjusting for early exposure to game consoles and child gender. However, it was found to have significant protective effect on externalizing problems (B=-0.65, 95%CI: -1.23 to -0.07, p=0.028) even after adjusting for the confounders. Early exposure to game consoles has negative impact on children’s psychosocial health, whereas play-based parent-child activities can foster positive psychosocial outcomes. More efforts should be directed to propagate the risks and benefits of these activities and urge the parents and caregivers to replace child-alone screen time with parent-child play time in daily routine.Keywords: early childhood, electronic device, parenting, psychosocial wellbeing
Procedia PDF Downloads 159708 Urban Growth and Its Impact on Natural Environment: A Geospatial Analysis of North Part of the UAE
Authors: Mohamed Bualhamam
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Due to the complex nature of tourism resources of the Northern part of the United Arab Emirates (UAE), the potential of Geographical Information Systems (GIS) and Remote Sensing (RS) in resolving these issues was used. The study was an attempt to use existing GIS data layers to identify sensitive natural environment and archaeological heritage resources that may be threatened by increased urban growth and give some specific recommendations to protect the area. By identifying sensitive natural environment and archaeological heritage resources, public agencies and citizens are in a better position to successfully protect important natural lands and direct growth away from environmentally sensitive areas. The paper concludes that applications of GIS and RS in study of urban growth impact in tourism resources are a strong and effective tool that can aid in tourism planning and decision-making. The study area is one of the fastest growing regions in the country. The increase in population along the region, as well as rapid growth of towns, has increased the threat to natural resources and archeological sites. Satellite remote sensing data have been proven useful in assessing the natural resources and in monitoring the changes. The study used GIS and RS to identify sensitive natural environment and archaeological heritage resources that may be threatened by increased urban growth. The result of GIS analyses shows that the Northern part of the UAE has variety for tourism resources, which can use for future tourism development. Rapid urban development in the form of small towns and different economic activities are showing in different places in the study area. The urban development extended out of old towns and have negative affected of sensitive tourism resources in some areas. Tourism resources for the Northern part of the UAE is a highly complex resources, and thus requires tools that aid in effective decision making to come to terms with the competing economic, social, and environmental demands of sustainable development. The UAE government should prepare a tourism databases and a GIS system, so that planners can be accessed for archaeological heritage information as part of development planning processes. Applications of GIS in urban planning, tourism and recreation planning illustrate that GIS is a strong and effective tool that can aid in tourism planning and decision- making. The power of GIS lies not only in the ability to visualize spatial relationships, but also beyond the space to a holistic view of the world with its many interconnected components and complex relationships. The worst of the damage could have been avoided by recognizing suitable limits and adhering to some simple environmental guidelines and standards will successfully develop tourism in sustainable manner. By identifying sensitive natural environment and archaeological heritage resources of the Northern part of the UAE, public agencies and private citizens are in a better position to successfully protect important natural lands and direct growth away from environmentally sensitive areas.Keywords: GIS, natural environment, UAE, urban growth
Procedia PDF Downloads 252707 Tensile Behaviours of Sansevieria Ehrenbergii Fiber Reinforced Polyester Composites with Water Absorption Time
Authors: T. P. Sathishkumar, P. Navaneethakrishnan
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The research work investigates the variation of tensile properties for the sansevieria ehrenbergii fiber (SEF) and SEF reinforced polyester composites respect to various water absorption time. The experiments were conducted according to ATSM D3379-75 and ASTM D570 standards. The percentage of water absorption for composite specimens was measured according to ASTM D570 standard. The fiber of SE was cut in to 30 mm length for preparation of the composites. The simple hand lay-up method followed by compression moulding process adopted to prepare the randomly oriented SEF reinforced polyester composites at constant fiber weight fraction of 40%. The surface treatment was done on the SEFs with various chemicals such as NaOH, KMnO4, Benzoyl Peroxide, Benzoyl Chloride and Stearic Acid before preparing the composites. NaOH was used for pre-treatment of all other chemical treatments. The morphology of the tensile fractured specimens studied using the Scanning Electron Microscopic. The tensile strength of the SEF and SEF reinforced polymer composites were carried out with various water absorption time such as 4, 8, 12, 16, 20 and 24 hours respectively. The result shows that the tensile strength was drop off with increase in water absorption time for all composites. The highest tensile property of raw fiber was found due to lowest moistures content. Also the chemical bond between the cellulose and cementic materials such as lignin and wax was highest due to lowest moisture content. Tensile load was lowest and elongation was highest for the water absorbed fibers at various water absorption time ranges. During this process, the fiber cellulose inhales the water and expands the primary and secondary fibers walls. This increases the moisture content in the fibers. Ultimately this increases the hydrogen cation and the hydroxide anion from the water. In tensile testing, the water absorbed fibers shows highest elongation by stretching of expanded cellulose walls and the bonding strength between the fiber cellulose is low. The load carrying capability was stable at 20 hours of water absorption time. This could be directly affecting the interfacial bonding between the fiber/matrix and composite strength. The chemically treated fibers carry higher load and lower elongation which is due to removal of lignin, hemicellulose and wax content. The water time absorption decreases the tensile strength of the composites. The chemically SEF reinforced composites shows highest tensile strength compared to untreated SEF reinforced composites. This was due to highest bonding area between the fiber/matrix. This was proven in the morphology at the fracture zone of the composites. The intra-fiber debonding was occurred by water capsulation in the fiber cellulose. Among all, the tensile strength was found to be highest for KMnO4 treated SEF reinforced composite compared to other composites. This was due to better interfacial bonding between the fiber-matrix compared to other treated fiber composites. The percentage of water absorption of composites increased with time of water absorption. The percentage weight gain of chemically treated SEF composites at 4 hours to zero water absorption are 9, 9, 10, 10.8 and 9.5 for NaOH, BP, BC, KMnO4 and SA respectively. The percentage weight gain of chemically treated SEF composites at 24 hours to zero water absorption 5.2, 7.3, 12.5, 16.7 and 13.5 for NaOH, BP, BC, KMnO4 and SA respectively. Hence the lowest weight gain was found for KMnO4 treated SEF composites by highest percentage with lowest water uptake. However the chemically treated SEF reinforced composites is possible materials for automotive application like body panels, bumpers and interior parts, and household application like tables and racks etc.Keywords: fibres, polymer-matrix composites (PMCs), mechanical properties, scanning electron microscopy (SEM)
Procedia PDF Downloads 400706 Upgrade of Value Chains and the Effect on Resilience of Russia’s Coal Industry and Receiving Regions on the Path of Energy Transition
Authors: Sergey Nikitenko, Vladimir Klishin, Yury Malakhov, Elena Goosen
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Transition to renewable energy sources (solar, wind, bioenergy, etc.) and launching of alternative energy generation has weakened the role of coal as a source of energy. The Paris Agreement and assumption of obligations by many nations to orderly reduce CO₂ emissions by means of technological modernization and climate change adaptation has abridged coal demand yet more. This paper aims to assess current resilience of the coal industry to stress and to define prospects for coal production optimization using high technologies pursuant to global challenges and requirements of energy transition. Our research is based on the resilience concept adapted to the coal industry. It is proposed to divide the coal sector into segments depending on the prevailing value chains (VC). Four representative models of VC are identified in the coal sector. The most promising lines of upgrading VC in the coal industry include: •Elongation of VC owing to introduction of clean technologies of coal conversion and utilization; •Creation of parallel VC by means of waste management; •Branching of VC (conversion of a company’s VC into a production network). The upgrade effectiveness is governed in many ways by applicability of advanced coal processing technologies, usability of waste, expandability of production, entrance to non-rival markets and localization of new segments of VC in receiving regions. It is also important that upgrade of VC by means of formation of agile high-tech inter-industry production networks within the framework of operating surface and underground mines can reduce social, economic and ecological risks associated with closure of coal mines. Such promising route of VC upgrade is application of methanotrophic bacteria to produce protein to be used as feed-stuff in fish, poultry and cattle breeding, or in production of ferments, lipoids, sterols, antioxidants, pigments and polysaccharides. Closed mines can use recovered methane as a clean energy source. There exist methods of methane utilization from uncontrollable sources, including preliminary treatment and recovery of methane from air-and-methane mixture, or decomposition of methane to hydrogen and acetylene. Separated hydrogen is used in hydrogen fuel cells to generate power to feed the process of methane utilization and to supply external consumers. Despite the recent paradigm of carbon-free energy generation, it is possible to preserve the coal mining industry using the differentiated approach to upgrade of value chains based on flexible technologies with regard to specificity of mining companies.Keywords: resilience, resilience concept, resilience indicator, resilience in the Russian coal industry, value chains
Procedia PDF Downloads 98705 Conceptualizing a Biomimetic Fablab Based on the Makerspace Concept and Biomimetics Design Research
Authors: Petra Gruber, Ariana Rupp, Peter Niewiarowski
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This paper presents a concept for a biomimetic fablab as a physical space for education, research and development of innovation inspired by nature. Biomimetics as a discipline finds increasing recognition in academia and has started to be institutionalized at universities in programs and centers. The Biomimicry Research and Innovation Center was founded in 2012 at the University of Akron as an interdisciplinary venture for the advancement of innovation inspired by nature and is part of a larger community fostering the approach of bioimimicry in the Great Lakes region of the US. With 30 faculty members the center has representatives from Colleges of Arts and Sciences (e.g., biology, chemistry, geoscience, and philosophy) Engineering (e.g., mechanical, civil, and biomedical), Polymer Science, and Myers School of Arts. A platform for training PhDs in Biomimicry (17 students currently enrolled) is co-funded by educational institutions and industry partners. Research at the center touches on many areas but is also currently biased towards materials and structures, with highlights being materials based on principles found in spider silk and gecko attachment mechanisms. As biomimetics is also a novel scientific discipline, there is little standardisation in programming and the equipment of research facilities. As a field targeting innovation, design and prototyping processes are fundamental parts of the developments. For experimental design and prototyping, MIT's maker space concept seems to fit well to the requirements, but facilities need to be more specialised in terms of accessing biological systems and knowledge, specific research, production or conservation requirements. For the education and research facility BRIC we conceptualize the concept of a biomimicry fablab, that ties into the existing maker space concept and creates the setting for interdisciplinary research and development carried out in the program. The concept takes on the process of biomimetics as a guideline to define core activities that shall be enhanced by the allocation of specific spaces and tools. The limitations of such a facility and the intersections to further specialised labs housed in the classical departments are of special interest. As a preliminary proof of concept two biomimetic design courses carried out in 2016 are investigated in terms of needed tools and infrastructure. The spring course was a problem based biomimetic design challenge in collaboration with an innovation company interested in product design for assisted living and medical devices. The fall course was a solution based biomimetic design course focusing on order and hierarchy in nature with the goal of finding meaningful translations into art and technology. The paper describes the background of the BRIC center, identifies and discusses the process of biomimetics, evaluates the classical maker space concept and explores how these elements can shape the proposed research facility of a biomimetic fablab by examining two examples of design courses held in 2016.Keywords: biomimetics, biomimicry, design, biomimetic fablab
Procedia PDF Downloads 269704 Evaluation of Airborne Particulate Matter Early Biological Effects in Children with Micronucleus Cytome Assay: The MAPEC_LIFE Project
Authors: E. Carraro, Sa. Bonetta, Si. Bonetta, E. Ceretti, G. C. V. Viola, C. Pignata, S. Levorato, T. Salvatori, S. Vannini, V. Romanazzi, A. Carducci, G. Donzelli, T. Schilirò, A. De Donno, T. Grassi, S. Bonizzoni, A. Bonetti, G. Gilli, U. Gelatti
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In 2013, air pollution and particulate matter were classified as carcinogenic to human by the IARC. At present, PM is Europe's most problematic pollutant in terms of harm to health, as reported by European Environmental Agency (EEA) in the EEA Technical Report on Air quality in Europe, 2015. A percentage between 17-30 of the EU urban population lives in areas where the EU air quality 24-hour limit value for PM10 is exceeded. Many studies have found a consistent association between exposure to PM and the incidence and mortality for some chronic diseases (i.e. lung cancer, cardiovascular diseases). Among the mechanisms responsible for these adverse effects, genotoxic damage is of particular concern. Children are a high-risk group in terms of the health effects of air pollution and early exposure during childhood can increase the risk of developing chronic diseases in adulthood. The MAPEC_LIFE (Monitoring Air Pollution Effects on Children for supporting public health policy) is a project founded by EU Life+ Programme (LIFE12 ENV/IT/000614) which intends to evaluate the associations between air pollution and early biological effects in children and to propose a model for estimating the global risk of early biological effects due to air pollutants and other factors in children. This work is focused on the micronuclei frequency in child buccal cells in association with airborne PM levels taking into account the influence of other factors associated with the lifestyle of children. The micronucleus test was performed in exfoliated buccal cells of 6–8 years old children from 5 Italian towns with different air pollution levels. Data on air quality during the study period were obtained from the Regional Agency for Environmental Protection. A questionnaire administered to children’s parents was used to obtain details on family socio-economic status, children health condition, exposures to other indoor and outdoor pollutants (i.e. passive smoke) and life-style, with particular reference to eating habits. During the first sampling campaign (winter 2014-15) 1315 children were recruited and sampled for Micronuclei test in buccal cells. In the sampling period the levels of the main pollutants and PM10 were, as expected, higher in the North of Italy (PM10 mean values 62 μg/m3 in Torino and 40 μg/m3 in Brescia) than in the other towns (Pisa, Perugia, Lecce). A higher Micronucleus frequency in buccal cells of children was found in Brescia (0.6/1000 cells) than in the other towns (range 0.3-0.5/1000 cells). The statistical analysis underlines a relation of the micronuclei frequency with PM concentrations, traffic level near child residence, and level of education of parents. The results suggest that, in addition to air pollution exposure, some other factors, related to lifestyle or further exposures, may influence micronucleus frequency and cellular response to air pollutants.Keywords: air pollution, buccal cells, children, micronucleus cytome assay
Procedia PDF Downloads 246703 The Elimination of Fossil Fuel Subsidies from the Road Transportation Sector and the Promotion of Electro Mobility: The Ecuadorian Case
Authors: Henry Gonzalo Acurio Flores, Alvaro Nicolas Corral Naveda, Juan Francisco Fonseca Palacios
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In Ecuador, subventions on fossil fuels for the road transportation sector have always been part of its economy throughout time, mainly because of demagogy and populism from political leaders. It is clearly seen that the government cannot maintain the subsidies anymore due to its commercial balance and its general state budget; subsidies are a key barrier to implementing the use of cleaner technologies. However, during the last few months, the elimination of subsidies has been done gradually with the purpose of reaching international prices. It is expected that with this measure, the population will opt for other means of transportation, and in a certain way, it will promote the use of private electric vehicles and public, e.g., taxis and buses (urban transport). Considering the three main elements of sustainable development, an analysis of the social, economic, and environmental impacts of eliminating subsidies will be generated at the country level. To achieve this, four scenarios will be developed in order to determine how the subsidies will contribute to the promotion of electro-mobility. 1) A Business as Usual BAU scenario; 2) the introduction of 10 000 electric vehicles by 2025; 3) the introduction of 100 000 electric vehicles by 2030; 4) the introduction of 750 000 electric vehicles by 2040 (for all the scenarios buses, taxis, lightweight duty vehicles, and private vehicles will be introduced, as it is established in the National Electro Mobility Strategy for Ecuador). The Low Emissions Analysis Platform (LEAP) will be used, and it will be suitable to determine the cost for the government in terms of importing derivatives for fossil fuels and the cost of electricity to power the electric fleet that can be changed. The elimination of subventions generates fiscal resources for the state that can be used to develop other kinds of projects that will benefit Ecuadorian society. It will definitely change the energy matrix, and it will provide energy security for the country; it will be an opportunity for the government to incentivize a greater introduction of renewable energies, e.g., solar, wind, and geothermal. At the same time, it will also reduce greenhouse gas emissions (GHG) from the transportation sector, considering its mitigation potential, which as a result, will ameliorate the inhabitant quality of life by improving the quality of air, therefore reducing respiratory diseases associated with exhaust emissions, consequently, achieving sustainability, the Sustainable Development Goals (SDGs), and complying with the agreements established in the Paris Agreement COP 21 in 2015. Electro mobility in Latin America and the Caribbean can only be achieved by the implementation of the right policies at the central government, which need to be accompanied by a National Urban Mobility Policy (NUMP) and can encompass a greater vision to develop holistic, sustainable transport systems at local governments.Keywords: electro mobility, energy, policy, sustainable transportation
Procedia PDF Downloads 77702 Urban Open Source: Synthesis of a Citizen-Centric Framework to Design Densifying Cities
Authors: Shaurya Chauhan, Sagar Gupta
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Prominent urbanizing centres across the globe like Delhi, Dhaka, or Manila have exhibited that development often faces a challenge in bridging the gap among the top-down collective requirements of the city and the bottom-up individual aspirations of the ever-diversifying population. When this exclusion is intertwined with rapid urbanization and diversifying urban demography: unplanned sprawl, poor planning, and low-density development emerge as automated responses. In parallel, new ideas and methods of densification and public participation are being widely adopted as sustainable alternatives for the future of urban development. This research advocates a collaborative design method for future development: one that allows rapid application with its prototypical nature and an inclusive approach with mediation between the 'user' and the 'urban', purely with the use of empirical tools. Building upon the concepts and principles of 'open-sourcing' in design, the research establishes a design framework that serves the current user requirements while allowing for future citizen-driven modifications. This is synthesized as a 3-tiered model: user needs – design ideology – adaptive details. The research culminates into a context-responsive 'open source project development framework' (hereinafter, referred to as OSPDF) that can be used for on-ground field applications. To bring forward specifics, the research looks at a 300-acre redevelopment in the core of a rapidly urbanizing city as a case encompassing extreme physical, demographic, and economic diversity. The suggestive measures also integrate the region’s cultural identity and social character with the diverse citizen aspirations, using architecture and urban design tools, and references from recognized literature. This framework, based on a vision – feedback – execution loop, is used for hypothetical development at the five prevalent scales in design: master planning, urban design, architecture, tectonics, and modularity, in a chronological manner. At each of these scales, the possible approaches and avenues for open- sourcing are identified and validated, through hit-and-trial, and subsequently recorded. The research attempts to re-calibrate the architectural design process and make it more responsive and people-centric. Analytical tools such as Space, Event, and Movement by Bernard Tschumi and Five-Point Mental Map by Kevin Lynch, among others, are deep rooted in the research process. Over the five-part OSPDF, a two-part subsidiary process is also suggested after each cycle of application, for a continued appraisal and refinement of the framework and urban fabric with time. The research is an exploration – of the possibilities for an architect – to adopt the new role of a 'mediator' in development of the contemporary urbanity.Keywords: open source, public participation, urbanization, urban development
Procedia PDF Downloads 140701 Examining the Relationship Between Green Procurement Practices and Firm’s Performance in Ghana
Authors: Alexander Otchere Fianko, Clement Yeboah, Evans Oteng
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Prior research concludes that Green Procurement Practices positively drive Organisational Performance. Nonetheless, the nexus and conditions under which Green Procurement Practices contribute to a Firm’s Performance are less understood. The purpose of this quantitative relational study was to examine the relationship between Green Procurement Practices and 500 Firms’ Performances in Ghana. The researchers further seek to draw insights from the resource-based view to conceptualize Green Procurement Practices and Environmental Commitment as resource capabilities to enhance Firm Performance. The researchers used insights from the contingent resource-based view to examine Green Leadership Orientation conditions under which Green Procurement Practices contribute to Firm Performance through Environmental Commitment Capabilities. The study’s conceptual framework was tested on primary data from some firms in the Ghanaian market. PROCESS Macro was used to test the study’s hypotheses. Beyond that, Environmental Commitment Capabilities mediated the association between Green Procurement Practices and the Firm’s Performance. The study further seeks to find out whether Green Leadership Orientation positively moderates the indirect relationship between Green Procurement Practices and Firm Performance through Environmental Commitment Capabilities. While conventional wisdom suggests that improved Green Procurement Practices help improve a Firm’s Performance, this study tested this presumed relationship between Green Procurement Practices and Firm Performance and provides theoretical arguments and empirical evidence to justify how Environmental Commitment Capabilities uniquely and in synergy with Green Leadership Orientation transform this relationship. The study results indicated a positive correlation between Green Procurement Practices and Firm Performance. This result suggests that firms that prioritize environmental sustainability and demonstrate a strong commitment to environmentally responsible practices tend to experience better overall performance. This includes financial gains, operational efficiency, enhanced reputation, and improved relationships with stakeholders. The study's findings inform policy formulation in Ghana related to environmental regulations, incentives, and support mechanisms. Policymakers can use the insights to design policies that encourage and reward firms for their Green Procurement Practices, thereby fostering a more sustainable and environmentally responsible business environment. The findings from such research can influence the design and development of educational programs in Ghana, specifically in fields related to sustainability, environmental management, and corporate social responsibility (CSR). Institutions may consider integrating environmental and sustainability topics into their business and management courses to create awareness and promote responsible practices among future business professionals. Also, the study results can also promote the adoption of environmental accounting practices in Ghana. By recognizing and measuring the environmental impacts and costs associated with business activities, firms can better understand the financial implications of their Green Procurement Practices and develop strategies for improved performance.Keywords: environmental commitment, firm’s performance, green procurement practice, green leadership orientation
Procedia PDF Downloads 71700 Associated Factors of Hypercholesterolemia, Hyperuricemia and Double Burden of Hypercuricémia-Hypercholesterolemia in Gout Patients: Hospital Based Study
Authors: Pierre Mintom, Armel Assiene Agamou, Leslie Toukem, William Dakam, Christine Fernande Nyangono Biyegue
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Context: Hyperuricemia, the presence of high levels of uric acid in the blood, is a known precursor to the development of gout. Recent studies have suggested a strong association between hyperuricemia and disorders of lipoprotein metabolism, specifically hypercholesterolemia. Understanding the factors associated with these conditions in gout patients is essential for effective treatment and management. Research Aim: The objective of this study was to determine the prevalence of hyperuricemia, hypercholesterolemia, and the double burden of hyperuricemia-hypercholesterolemia in the gouty population. Additionally, the study aimed to identify the factors associated with these conditions. Methodology: The study utilized a database from a survey of 150 gouty patients recruited at the Laquintinie Hospital in Douala between August 2017 and February 2018. The database contained information on anthropometric parameters, biochemical markers, and the food and drugs consumed by the patients. Hyperuricemia and hypercholesterolemia were defined based on specific serum uric acid and total cholesterol thresholds, and the double burden was defined as the co-occurrence of hyperuricemia and hypercholesterolemia. Findings: The study found that the prevalence rates for hyperuricemia, hypercholesterolemia, and the double burden were 61.3%, 76%, and 50.7% respectively. Factors associated with these conditions included hypertriglyceridemia, atherogenicity index TC/HDL ratio, atherogenicity index LDL/HDL ratio, family history, and the consumption of specific foods and drinks. Theoretical Importance: The study highlights the strong association between hyperuricemia and dyslipidemia, providing important insights for guiding treatment strategies in gout patients. Additionally, it emphasizes the significance of nutritional education in managing these metabolic disorders, suggesting the need to address eating habits in gout patients. Data Collection and Analysis Procedures: Data was collected through surveys and medical records of gouty patients. Information on anthropometric parameters, biochemical markers, and dietary habits was recorded. Prevalence rates and associated factors were determined through statistical analysis, employing odds ratios to assess the risks. Question Addressed: The study aimed to address the prevalence rates and associated factors of hyperuricemia, hypercholesterolemia, and the double burden in gouty patients. It sought to understand the relationships between these conditions and determine their implications for treatment and nutritional education. Conclusion: Findings show that it’s exists an association between hyperuricemia and hypercholesterolemia in gout patients, thus creating a double burden. The findings underscore the importance of considering family history and eating habits in addressing the double burden of hyperuricemia-hypercholesterolemia. This study provides valuable insights for guiding treatment approaches and emphasizes the need for nutritional education in gout patients. This study specifically focussed on the sick population. A case–control study between gouty and non-gouty populations would be interesting to better compare and explain the results observed.Keywords: gout, hyperuricemia, hypercholesterolemia, double burden
Procedia PDF Downloads 47699 Lessons Learnt from Industry: Achieving Net Gain Outcomes for Biodiversity
Authors: Julia Baker
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Development plays a major role in stopping biodiversity loss. But the ‘silo species’ protection of legislation (where certain species are protected while many are not) means that development can be ‘legally compliant’ and result in biodiversity loss. ‘Net Gain’ (NG) policies can help overcome this by making it an absolute requirement that development causes no overall loss of biodiversity and brings a benefit. However, offsetting biodiversity losses in one location with gains elsewhere is controversial because people suspect ‘offsetting’ to be an easy way for developers to buy their way out of conservation requirements. Yet the good practice principles (GPP) of offsetting provide several advantages over existing legislation for protecting biodiversity from development. This presentation describes the learning from implementing NG approaches based on GPP. It regards major upgrades of the UK’s transport networks, which involved removing vegetation in order to construct and safely operate new infrastructure. While low-lying habitats were retained, trees and other habitats disrupting the running or safety of transport networks could not. Consequently, achieving NG within the transport corridor was not possible and offsetting was required. The first ‘lessons learnt’ were on obtaining a commitment from business leaders to go beyond legislative requirements and deliver NG, and on the institutional change necessary to embed GPP within daily operations. These issues can only be addressed when the challenges that biodiversity poses for business are overcome. These challenges included: biodiversity cannot be measured easily unlike other sustainability factors like carbon and water that have metrics for target-setting and measuring progress; and, the mindset that biodiversity costs money and does not generate cash in return, which is the opposite of carbon or waste for example, where people can see how ‘sustainability’ actions save money. The challenges were overcome by presenting the GPP of NG as a cost-efficient solution to specific, critical risks facing the business that also boost industry recognition, and by using government-issued NG metrics to develop business-specific toolkits charting their NG progress whilst ensuring that NG decision-making was based on rich ecological data. An institutional change was best achieved by supporting, mentoring and training sustainability/environmental managers for these ‘frontline’ staff to embed GPP within the business. The second learning was from implementing the GPP where business partnered with local governments, wildlife groups and land owners to support their priorities for nature conservation, and where these partners had a say in decisions about where and how best to achieve NG. From this inclusive approach, offsetting contributed towards conservation priorities when all collaborated to manage trade-offs between: -Delivering ecologically equivalent offsets or compensating for losses of one type of biodiversity by providing another. -Achieving NG locally to the development whilst contributing towards national conservation priorities through landscape-level planning. -Not just protecting the extent and condition of existing biodiversity but ‘doing more’. -The multi-sector collaborations identified practical, workable solutions to ‘in perpetuity’. But key was strengthening linkages between biodiversity measures implemented for development and conservation work undertaken by local organizations so that developers support NG initiatives that really count.Keywords: biodiversity offsetting, development, nature conservation planning, net gain
Procedia PDF Downloads 183698 Partnering With Key Stakeholders for Successful Implementation of Inhaled Analgesia for Specific Emergency Department Presentations
Authors: Sarah Hazelwood, Janice Hay
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Methoxyflurane is an inhaled analgesic administered via a disposable inhaler, which has been used in Australia for 40 years for the management of pain in children & adults. However, there is a lack of data for methoxyflurane as a frontline analgesic medication within the emergency department (ED). This study will investigate the usefulness of methoxyflurane in a private inner-city ED. The study concluded that the inclusion of all key stakeholders in the prescribing, administering & use of this new process led to comprehensive uptake & vastly positive outcomes for consumer & health professionals. Method: A 12-week prospective pilot study was completed utilizing patients presenting to the ED in pain (numeric pain rating score > 4) that fit the requirement of methoxyflurane use (as outlined in the Australian Prescriber information package). Nurses completed a formatted spreadsheet for each interaction where methoxyflurane was used. Patient demographics, day, time, initial numeric pain score, analgesic response time, the reason for use, staff concern (free text), & patient feedback (free text), & discharge time was documented. When clinical concern was raised, the researcher retrieved & reviewed patient notes. Results: 140 methoxyflurane inhalers were used. 60% of patients were 31 years of age & over (n=82) with 16% aged 70+. The gender split; 51% male: 49% female. Trauma-related pain (57%) saw the highest use of administration, with the evening hours (1500-2259) seeing the greatest numbers used (39%). Tuesday, Thursday & Sunday shared the highest daily use throughout the study. A minimum numerical pain score of 4/10 (n=13, 9%), with the ranges of 5 - 7/10 (moderate pain) being given by almost 50% of patients. Only 3 instances of pain scores increased post use of methoxyflurane (all other entries showed pain score < initial rating). Patients & staff noted obvious analgesic response within 3 minutes (n= 96, 81%, of administration). Nurses documented a change in patient vital signs for 4 of the 15 patient-related concerns; the remaining concerns were due to “gagging” on the taste, or “having a coughing episode”; one patient tried to leave the department before the procedure was attended (very euphoric state). Upon review of the staff concerns – no adverse events occurred & return to therapeutic vitals occurred within 10 minutes. Length of stay for patients was compared with similar presentations (such as dislocated shoulder or ankle fracture) & saw an average 40-minute decrease in time to discharge. Methoxyflurane treatment was rated “positively” by > 80% of patients – with remaining feedback related to mild & transient concerns. Staff similarly noted a positive response to methoxyflurane as an analgesic & as an added tool for frontline analgesic purposes. Conclusion: Methoxyflurane should be used on suitable patient presentations requiring immediate, short term pain relief. As a highly portable, non-narcotic avenue to treat pain this study showed obvious therapeutic benefit, positive feedback, & a shorter length of stay in the ED. By partnering with key stake holders, this study determined methoxyflurane use decreased work load, decreased wait time to analgesia, and increased patient satisfaction.Keywords: analgesia, benefits, emergency, methoxyflurane
Procedia PDF Downloads 117697 The Importance of School Culture in Supporting Student Mental Health Following the COVID-19 Pandemic: Insights from a Qualitative Study
Authors: Rhiannon Barker, Gregory Hartwell, Matt Egan, Karen Lock
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Background: Evidence suggests that mental health (MH) issues in children and young people (CYP) in the UK are on the rise. Of particular concern is data that indicates that the pandemic, together with the impact of school closures, have accentuated already pronounced inequalities; children from families on low incomes or from black and minority ethnic groups are reportedly more likely to have been adversely impacted. This study aimed to help identify specific support which may facilitate the building of a positive school climate and protect student mental health, particularly in the wake of school closures following the pandemic. It has important implications for integrated working between schools and statutory health services. Methods: The research comprised of three parts; scoping, case studies, and a stakeholder workshop to explore and consolidate results. The scoping phase included a literature review alongside interviews with a range of stakeholders from government, academia, and the third sector. Case studies were then conducted in two London state schools. Results: Our research identified how student MH was being impacted by a range of factors located at different system levels, both internal to the school and in the wider community. School climate, relating both to a shared system of beliefs and values, as well as broader factors including style of leadership, teaching, discipline, safety, and relationships -all played a role in the experience of school life and, consequently, the MH of both students and staff. Participants highlighted the importance of a whole school approach and ensuring that support for student MH was not separated from academic achievement, as well as the importance of identifying and applying universal measuring systems to establish levels of MH need. Our findings suggest that a school’s climate is influenced by the style and strength of its leadership, while this school climate - together with mechanisms put in place to respond to MH needs (both statutory and non-statutory) - plays a key role in supporting student MH. Implications: Schools in England have a responsibility to decide on the nature of MH support provided for their students, and there is no requirement for them to report centrally on the form this provision takes. The reality on the ground, as our study suggests, is that MH provision varies significantly between schools, particularly in relation to ‘lower’ levels of need which are not covered by statutory requirements. A valid concern may be that in the huge raft of possible options schools have to support CYP wellbeing, too much is left to chance. Work to support schools in rebuilding their cultures post-lockdowns must include the means to identify and promote appropriate tools and techniques to facilitate regular measurement of student MH. This will help establish both the scale of the problem and monitor the effectiveness of the response. A strong vision from a school’s leadership team that emphasises the importance of student wellbeing, running alongside (but not overshadowed by) academic attainment, should help shape a school climate to promote beneficial MH outcomes. The sector should also be provided with support to improve the consistency and efficacy of MH provision in schools across the country.Keywords: mental health, schools, young people, whole-school culture
Procedia PDF Downloads 55696 Cancer Stem Cell-Associated Serum Proteins Obtained by Maldi TOF/TOF Mass Spectrometry in Women with Triple-Negative Breast Cancer
Authors: Javier Enciso-Benavides, Fredy Fabian, Carlos Castaneda, Luis Alfaro, Alex Choque, Aparicio Aguilar, Javier Enciso
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Background: The use of biomarkers in breast cancer diagnosis, therapy, and prognosis has gained increasing interest. Cancer stem cells (CSCs) are a subpopulation of tumor cells that can drive tumor initiation and may cause relapse. Therefore, due to the importance of diagnosis, therapy, and prognosis, several biomarkers that characterize CSCs have been identified; however, in treatment-naïve triple-negative breast tumors, there is an urgent need to identify new biomarkers and therapeutic targets. According to this, the aim of this study was to identify serum proteins associated with cancer stem cells and pluripotency in women with triple-negative breast tumors in order to subsequently identify a biomarker for this type of breast tumor. Material and Methods: Whole blood samples from 12 women with histopathologically diagnosed triple-negative breast tumors were used after obtaining informed consent from the patient. Blood serum was obtained by conventional procedure and frozen at -80ºC. Identification of cancer stem cell-associated proteins was performed by matrix-assisted laser desorption/ionisation-assisted laser desorption/ionisation mass spectrometry (MALDI-TOF MS), protein analysis was obtained using the AB Sciex TOF/TOF™ 5800 system (AB Sciex, USA). Sequences not aligned by ProteinPilot™ software were analyzed by Protein BLAST. Results: The following proteins related to pluripotency and cancer stem cells were identified by MALDI TOF/TOF mass spectrometry: A-chain, Serpin A12 [Homo sapiens], AIEBP [Homo sapiens], Alpha-one antitrypsin, AT {internal fragment} [human, partial peptide, 20 aa] [Homo sapiens], collagen alpha 1 chain precursor variant [Homo sapiens], retinoblastoma-associated protein variant [Homo sapiens], insulin receptor, CRA_c isoform [Homo sapiens], Hydroxyisourate hydrolase [Streptomyces scopuliridis], MUCIN-6 [Macaca mulatta], Alpha-actinin-3 [Chrysochloris asiatica], Polyprotein M, CRA_d isoform, partial [Homo sapiens], Transcription factor SOX-12 [Homo sapiens]. Recommendations: The serum proteins identified in this study should be investigated in the exosome of triple-negative breast cancer stem cells and in the blood serum of women without breast cancer. Subsequently, proteins found only in the blood serum of women with triple-negative breast cancer should be identified in situ in triple-negative breast cancer tissue in order to identify a biomarker to study the evolution of this type of cancer, or that could be a therapeutic target. Conclusions: Eleven cancer stem cell-related serum proteins were identified in 12 women with triple-negative breast cancer, of which MUCIN-6, retinoblastoma-associated protein variant, transcription factor SOX-12, and collagen alpha 1 chain are the most representative and have not been studied so far in this type of breast tumor. Acknowledgement: This work was supported by Proyecto CONCYTEC–Banco Mundial “Mejoramiento y Ampliacion de los Servicios del Sistema Nacional de Ciencia Tecnología e Innovacion Tecnologica” 8682-PE (104-2018-FONDECYT-BM-IADT-AV).Keywords: triple-negative breast cancer, MALDI TOF/TOF MS, serum proteins, cancer stem cells
Procedia PDF Downloads 202695 Life-Saving Design Strategies for Nursing Homes and Long-Term Care Facilities
Authors: Jason M. Hegenauer, Nicholas Fucci
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In the late 1990s, a major deinstitutionalization movement of elderly patients took place, since which, the design of long-term care facilities has not been adequately analyzed in the United States. Over the course of the last 25 years, major innovations in construction methods, technology, and medicine have been developed, drastically changing the landscape of healthcare architecture. In light of recent events, and the expected increase in elderly populations with the aging of the baby-boomer generation, it is evident that reconsideration of these facilities is essential for the proper care of aging populations. The global response has been effective in stifling this pandemic; however, widespread disease still poses an imminent threat to the human race. Having witnessed the devastation Covid-19 has reaped throughout nursing homes and long-term care facilities, it is evident that the current strategies for protecting our most vulnerable populations are not enough. Light renovation of existing facilities and previously overlooked considerations for new construction projects can drastically lower the risk at nursing homes and long-term care facilities. A reconfigured entry sequence supplements several of the features which have been long-standing essentials of the design of these facilities. This research focuses on several aspects identified as needing improvement, including indoor environment quality, security measures incorporated into healthcare architecture and design, and architectural mitigation strategies for sick building syndrome. The results of this study have been compiled as 'best practices' for the design of future healthcare construction projects focused on the health, safety, and quality of life of the residents of these facilities. These design strategies, which can easily be implemented through renovation of existing facilities and new construction projects, minimize risk of infection and spread of disease while allowing routine functions to continue with minimal impact, should the need for future lockdowns arise. Through the current lockdown procedures, which were implemented during the Covid-19 pandemic, isolation of residents has caused great unrest and worry for family members and friends as they are cut off from their loved ones. At this time, data is still being reported, leaving infection and death rates inconclusive; however, recent projections in some states list long-term care facility deaths as high as 60% of all deaths in the state. The population of these facilities consists of residents who are elderly, immunocompromised, and have underlying chronic medical conditions. According to the Centers for Disease Control, these populations are particularly susceptible to infection and serious illness. The obligation to protect our most vulnerable population cannot be overlooked, and the harsh measures recently taken as a response to the Covid-19 pandemic prove that the design strategies currently utilized for doing so are inadequate.Keywords: building security, healthcare architecture and design, indoor environment quality, new construction, sick building syndrome, renovation
Procedia PDF Downloads 86694 Urban Design as a Tool in Disaster Resilience and Urban Hazard Mitigation: Case of Cochin, Kerala, India
Authors: Vinu Elias Jacob, Manoj Kumar Kini
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Disasters of all types are occurring more frequently and are becoming more costly than ever due to various manmade factors including climate change. A better utilisation of the concept of governance and management within disaster risk reduction is inevitable and of utmost importance. There is a need to explore the role of pre- and post-disaster public policies. The role of urban planning/design in shaping the opportunities of households, individuals and collectively the settlements for achieving recovery has to be explored. Governance strategies that can better support the integration of disaster risk reduction and management has to be examined. The main aim is to thereby build the resilience of individuals and communities and thus, the states too. Resilience is a term that is usually linked to the fields of disaster management and mitigation, but today has become an integral part of planning and design of cities. Disaster resilience broadly describes the ability of an individual or community to 'bounce back' from disaster impacts, through improved mitigation, preparedness, response, and recovery. The growing population of the world has resulted in the inflow and use of resources, creating a pressure on the various natural systems and inequity in the distribution of resources. This makes cities vulnerable to multiple attacks by both natural and man-made disasters. Each urban area needs elaborate studies and study based strategies to proceed in the discussed direction. Cochin in Kerala is the fastest and largest growing city with a population of more than 26 lakhs. The main concern that has been looked into in this paper is making cities resilient by designing a framework of strategies based on urban design principles for an immediate response system especially focussing on the city of Cochin, Kerala, India. The paper discusses, understanding the spatial transformations due to disasters and the role of spatial planning in the context of significant disasters. The paper also aims in developing a model taking into consideration of various factors such as land use, open spaces, transportation networks, physical and social infrastructure, building design, and density and ecology that can be implemented in any city of any context. Guidelines are made for the smooth evacuation of people through hassle-free transport networks, protecting vulnerable areas in the city, providing adequate open spaces for shelters and gatherings, making available basic amenities to affected population within reachable distance, etc. by using the tool of urban design. Strategies at the city level and neighbourhood level have been developed with inferences from vulnerability analysis and case studies.Keywords: disaster management, resilience, spatial planning, spatial transformations
Procedia PDF Downloads 286693 Effect of Amiodarone on the Thyroid Gland of Adult Male Albino Rat and the Possible Protective Role of Vitamin E Supplementation: A Histological and Ultrastructural Study
Authors: Ibrahim Abdulla Labib, Medhat Mohamed Morsy, Gamal Hosny, Hanan Dawood Yassa, Gaber Hassan
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Amiodarone is a very effective drug, widely used for arrhythmia. Unfortunately it has many side effects involving many organs especially thyroid gland. The current work was conducted to elucidate the effect of amiodarone on the thyroid gland and the possible protective role of vitamin E. Fifty adult male albino rats weighed 200 – 250 grams were divided into five groups; ten rats each. Group I (Control): Five rats were sacrificed after three weeks and five rats were sacrificed after six weeks. Group II (Sham control): Each rat received sunflower oil orally; the solvent of vitamin E for three weeks. Group III (Amiodarone-treated): each rat received an oral dose of amiodarone; 150 mg/kg/day for three weeks. Group IV (Recovery): Each rat received amiodarone as group III then the drug was stopped for three weeks to evaluate recovery. Group V (Amiodarone + Vitamin E-treated): Each rat received amiodarone as group III followed by 100 mg/kg/day vitamin E orally for three weeks. Thyroid gland of the sacrificed animals were dissected out and prepared for light and electron microscopic studies. Amiodarone administration resulted in loss of normal follicular architecture as many follicles appeared either shrunken, empty or contained scanty pale colloid. Some follicles appeared lined by more than one layer of cells while others showed interruption of their membrane. Masson's Trichrome stained sections showed increased collagen fibers in between the thyroid follicles. Ultrastructurally, the apical border of the follicular cells showed few irregular detached microvilli. The nuclei of the follicular cells were almost irregular with chromatin condensation. The cytoplasm of most follicular cells revealed numerous dilated rough endoplasmic reticulum with numerous lysosomes. After three weeks of stopping amiodarone, the follicles were nearly regular in outline. Some follicles were filled with homogenous eosinophilic colloid and others had shrunken pale colloid or were empty. Some few follicles showed exfoliated cells in their lumina and others were still lined by more than one layer of follicular cells. Moderate amounts of collagen fibers were observed in-between thyroid follicles. Ultrastructurally, many follicular cells had rounded euchromatic nucleui, moderate number of lysosomes and moderately dilated rough endoplasmic reticulum. However, few follicular cells still showing irregular nucleui, dilated rough endoplasmic reticulum and many cytoplasmic vacuoles. Administration of vitamin E with amiodarone for three weeks resulted in obvious structural improvement. Most of the follicles were lined by a single layer of cuboidal cells and the lumina were filled with homogenous eosinophilic colloid with very few vacuolations. The majority of follicular cells had rounded nuclei with occasional detection of ballooned cells and dark nuclei. Scanty collagen fibers were detected among thyroid follicles. Ultrastructurally, most follicular cells exhibited rounded euchromatic nuclei with few short microvilli were projecting into the colloid. Few lysosomes were also noticed. It was concluded that amiodarone administration leads to many adverse histological changes in the thyroid gland. Some of these changes are reversible during the recovery period however concomitant vitamin E administration with amiodarone has a major protective role in preventing many of these changes.Keywords: amiodarone, recovery, ultrastructure, vitamin E.
Procedia PDF Downloads 343692 Consensual A-Monogamous Relationships: Challenges and Ways of Coping
Authors: Tal Braverman Uriel, Tal Litvak Hirsch
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Background and Objectives: Little or only partial emphasis has been placed on exploring the complexity of consensual non-monogamous relationships. The term "polyamory" refers to consensual non-monogamy, and it is defined as having emotional and/or sexual relations simultaneously with two or more people, the consent and knowledge of all the partners concerned. Managing multiple romantic relationships with different people evokes more emotions, leads to more emotional conflicts arising from different interests, and demands practical strategies. An individual's transition from a monogamous lifestyle to a consensual non-monogamous lifestyle yields new challenges, accompanied by stress, uncertainty, and question marks, as do other life-changing events, such as divorce or transition to parenthood. The study examines both the process of transition and adaptation to a consensually non-monogamous relationship, as well as the coping mechanism involved in the daily conduct of this lifestyle. The research focuses on understanding the consequences, challenges, and coping methods from a personal, marital, and familial point of view and focuses on 40 middle-aged individuals (20 men and 20 women ages 40-60). The research sheds light on a way of life that has not been previously studied in Israel and is still considered unacceptable. Theories of crisis (e.g., as Folkman and Lazarus) were applied, and as a result, a deeper understanding of the subject was reached, all while focusing on multiple aspects of dealing with stress. The basic research question examines the consequences of entering a polyamorous life from a personal point of view as an individual, partner, and parent and the ways of coping with these consequences. Method: The research is conducted with a narrative qualitative approach in the interpretive paradigm, including semi-structured in-depth interviews. The method of analysis is thematic. Results: The findings indicate that in most cases, an individual's motivation to open the relationship is mainly a longing for better sexuality and for an added layer of excitement to their lives. Most of the interviewees were assisted by their spouses in the process, as well as by social networks and podcasts on the subject. Some of them therapeutic professionals from the field are helpful. It also clearly emerged that among those who experienced acute emotional crises with the primary partner or painful separations from secondary partners, all believed polyamory to be the adequate way of life for them. Finally, a key resource for managing tension and stress is the ability to share and communicate with the primary partner. Conclusions: The study points to the challenges and benefits of a non-monogamous lifestyle as well as the use of coping mechanisms and resources that are consistent with the existing theory and research in the field in the context of life changes. The study indicates the need to expand the research canvas in the future in the context of parenting and the consequences for children.Keywords: a-monogamy, consent, family, stress, tension
Procedia PDF Downloads 66691 The Importance and Necessity for Acquiring Pedagogical Skills by the Practice Tutors for the Training of the General Nurses
Authors: Maria Luiza Fulga, Georgeta Truca, Mihaela Alexandru, Andriescu Mariana, Crin Marcean
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The significance of nursing as a subject in the post-secondary healthcare curriculum is a major. We aimed to enable our students to assess the patient's risk, to establish prevention measures and to adapt to a specific learning context, in order to acquire the skills and abilities necessary for the nursing profession. In order to achieve these objectives, during the three years of study, teachers put an emphasis on acquiring communication skills, because in our country after the first cycle of hospital accreditation concluded in 2016, the National Authority for Quality of Health Management has introduced the criteria for the implementation and application of the nursing process according to the accreditation standards. According to these requirements, the nurse has to carry out the nursing assessment, based on communication as a distinct component, so that they can identify nursing diagnoses and implement the nursing plan. In this respect, we, the teachers, have refocused, by approaching various teaching strategies and preparing students for the real context of learning and applying what they learn. In the educational process, the tutors in the hospitals have an important role to play in acquiring professional skills. Students perform their activity in the hospital in accordance with the curriculum, in order to verify the practical applicability of the theoretical knowledge acquired in the school classes and also have the opportunity to acquire their skills in a real learning context. In clinical education, the student nurse learns in the middle of a guidance team which includes a practice tutor, who is a nurse that takes responsibility for the practical/clinical learning of the students in their field of activity. In achieving this objective, the tutor's abilities involve pedagogical knowledge, knowledge for the good of the individual and nursing theory, in order to be able to guide clinical practice in accordance with current requirements. The aim of this study is to find out the students’ confidence level in practice tutors in hospitals, the students’ degree of satisfaction in the pedagogical skills of the tutors and the practical applicability of the theoretical knowledge. In this study, we used as a method of investigation a student satisfaction questionnaire regarding the clinical practice in the hospital and the sample of the survey consisted of 100 students aged between 20 and 50 years, from the first, second and third year groups, with the General Nurse specialty (nurses responsible for general care), from 'Fundeni' Healthcare Post-Secondary School, Bucharest, Romania. Following the analysis of the data provided, we arrived the conclusion that the hospital tutor needs to improve his/her pedagogical skills, the knowledge of nursing diagnostics, and the implementation of the nursing plan, so that the applicability of the theoretical notions would be increased. Future plans include the pedagogical training of the medical staff, as well as updating the knowledge needed to implement the nursing process in order to meet current requirements.Keywords: clinical training, nursing process, pedagogical skills, tutor
Procedia PDF Downloads 154690 Development of 3D Printed Natural Fiber Reinforced Composite Scaffolds for Maxillofacial Reconstruction
Authors: Sri Sai Ramya Bojedla, Falguni Pati
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Nature provides the best of solutions to humans. One such incredible gift to regenerative medicine is silk. The literature has publicized a long appreciation for silk owing to its incredible physical and biological assets. Its bioactive nature, unique mechanical strength, and processing flexibility make us curious to explore further to apply it in the clinics for the welfare of mankind. In this study, Antheraea mylitta and Bombyx mori silk fibroin microfibers are developed by two economical and straightforward steps via degumming and hydrolysis for the first time, and a bioactive composite is manufactured by mixing silk fibroin microfibers at various concentrations with polycaprolactone (PCL), a biocompatible, aliphatic semi-crystalline synthetic polymer. Reconstructive surgery in any part of the body except for the maxillofacial region deals with replacing its function. But answering both the aesthetics and function is of utmost importance when it comes to facial reconstruction as it plays a critical role in the psychological and social well-being of the patient. The main concern in developing adequate bone graft substitutes or a scaffold is the noteworthy variation in each patient's bone anatomy. Additionally, the anatomical shape and size will vary based on the type of defect. The advent of additive manufacturing (AM) or 3D printing techniques to bone tissue engineering has facilitated overcoming many of the restraints of conventional fabrication techniques. The acquired patient's CT data is converted into a stereolithographic (STL)-file which is further utilized by the 3D printer to create a 3D scaffold structure in an interconnected layer-by-layer fashion. This study aims to address the limitations of currently available materials and fabrication technologies and develop a customized biomaterial implant via 3D printing technology to reconstruct complex form, function, and aesthetics of the facial anatomy. These composite scaffolds underwent structural and mechanical characterization. Atomic force microscopic (AFM) and field emission scanning electron microscopic (FESEM) images showed the uniform dispersion of the silk fibroin microfibers in the PCL matrix. With the addition of silk, there is improvement in the compressive strength of the hybrid scaffolds. The scaffolds with Antheraea mylitta silk revealed higher compressive modulus than that of Bombyx mori silk. The above results of PCL-silk scaffolds strongly recommend their utilization in bone regenerative applications. Successful completion of this research will provide a great weapon in the maxillofacial reconstructive armamentarium.Keywords: compressive modulus, 3d printing, maxillofacial reconstruction, natural fiber reinforced composites, silk fibroin microfibers
Procedia PDF Downloads 180689 Marketing in the Fashion Industry and Its Critical Success Factors: The Case of Fashion Dealers in Ghana
Authors: Kumalbeo Paul Kamani
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Marketing plays a very important role in the success of any firm since it represents the means through which a firm can reach its customers and also promotes its products and services. In fact, marketing aids the firm in identifying customers who the business can competitively serve, and tailoring product offerings, prices, distribution, promotional efforts, and services towards those customers. Unfortunately, in many firms, marketing has been reduced to merely advertisement. For effective marketing, firms must go beyond this often-limited function of advertisement. In the fashion industry in particular, marketing faces challenges due to its peculiar characteristics. Previous research for instance affirms the idiosyncrasy and peculiarities that differentiate the fashion industry from other industrial areas. It has been documented that the fashion industry is characterized seasonal intensity, short product life cycles, the difficulty of competitive differentiation, and long time for companies to reach financial stability. These factors are noted to pose obstacles to the fashion entrepreneur’s endeavours and can be the reasons that explain their low survival rates. In recent times, the fashion industry has been described as a market that is accessible market, has low entry barriers, both in terms of needed capital and skills which have all accounted for the burgeoning nature of startups. Yet as already stated, marketing is particularly challenging in the industry. In particular, areas such as marketing, branding, growth, project planning, financial and relationship management might represent challenges for the fashion entrepreneur but that have not been properly addressed by previous research. It is therefore important to assess marketing strategies of fashion firms and the factors influencing their success. This study generally sought to examine marketing strategies of fashion dealers in Ghana and their critical success factors. The study employed the quantitative survey research approach. A total of 120 fashion dealers were sampled. Questionnaires were used as instrument of data collection. Data collected was analysed using quantitative techniques including descriptive statistics and Relative Importance Index. The study revealed that the marketing strategies used by fashion apparels are text messages using mobile phones, referrals, social media marketing, and direct marketing. Results again show that the factors influencing fashion marketing effectiveness are strategic management, marketing mix (product, price, promotion etc), branding and business development. Policy implications are finally outlined. The study recommends among others that there is a need for the top management executive to craft and adopt marketing strategies that enable that are compatible with the fashion trends and the needs of the customers. This will improve customer satisfaction and hence boost market penetration. The study further recommends that the fashion industry in Ghana should seek to ensure that fashion apparels accommodate the diversity and the cultural setting of different customers to meet their unique needs.Keywords: marketing, fashion, industry, success factors
Procedia PDF Downloads 30688 Design of Smart Catheter for Vascular Applications Using Optical Fiber Sensor
Authors: Lamiek Abraham, Xinli Du, Yohan Noh, Polin Hsu, Tingting Wu, Tom Logan, Ifan Yen
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In the field of minimally invasive, smart medical instruments such as catheters and guidewires are typically used at a remote distance to gain access to the diseased artery, often negotiating tortuous, complex, and diseased vessels in the process. Three optical fiber sensors with a diameter of 1.5mm each that are 120° apart from each other is proposed to be mounted into a catheter-based pump device with a diameter of 10mm. These sensors are configured to solve the challenges surgeons face during insertion through curvy major vessels such as the aortic arch. Moreover, these sensors deal with providing information on rubbing the walls and shape sensing. This study presents an experimental and mathematical models of the optical fiber sensors with 2 degrees of freedom. There are two eight gear-shaped tubes made up of 3D printed thermoplastic Polyurethane (TPU) material that are connected. The optical fiber sensors are mounted inside the first tube for protection from external light and used TPU material as a prototype for a catheter. The second tube is used as a flat reflection for the light intensity modulation-based optical fiber sensors. The first tube is attached to the linear guide for insertion and withdrawal purposes and can manually turn it 45° by manipulating the tube gear. A 3D hard material phantom was developed that mimics the aortic arch anatomy structure in which the test was carried out. During the insertion of the sensors into the 3D phantom, datasets are obtained in terms of voltage, distance, and position of the sensors. These datasets reflect the characteristics of light intensity modulation of the optical fiber sensors with a plane project of the aortic arch structure shape. Mathematical modeling of the light intensity was carried out based on the projection plane and experiment set-up. The performance of the system was evaluated in terms of its accuracy in navigating through the curvature and information on the position of the sensors by investigating 40 single insertions of the sensors into the 3D phantom. The experiment demonstrated that the sensors were effectively steered through the 3D phantom curvature and to desired target references in all 2 degrees of freedom. The performance of the sensors echoes the reflectance of light theory, where the smaller the radius of curvature, the more of the shining LED lights are reflected and received by the photodiode. A mathematical model results are in good agreement with the experiment result and the operation principle of the light intensity modulation of the optical fiber sensors. A prototype of a catheter using TPU material with three optical fiber sensors mounted inside has been developed that is capable of navigating through the different radius of curvature with 2 degrees of freedom. The proposed system supports operators with pre-scan data to make maneuverability and bendability through curvy major vessels easier, accurate, and safe. The mathematical modelling accurately fits the experiment result.Keywords: Intensity modulated optical fiber sensor, mathematical model, plane projection, shape sensing.
Procedia PDF Downloads 240687 Guests’ Satisfaction and Intention to Revisit Smart Hotels: Qualitative Interviews Approach
Authors: Raymond Chi Fai Si Tou, Jacey Ja Young Choe, Amy Siu Ian So
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Smart hotels can be defined as the hotel which has an intelligent system, through digitalization and networking which achieve hotel management and service information. In addition, smart hotels include high-end designs that integrate information and communication technology with hotel management fulfilling the guests’ needs and improving the quality, efficiency and satisfaction of hotel management. The purpose of this study is to identify appropriate factors that may influence guests’ satisfaction and intention to revisit Smart Hotels based on service quality measurement of lodging quality index and extended UTAUT theory. Unified Theory of Acceptance and Use of Technology (UTAUT) is adopted as a framework to explain technology acceptance and use. Since smart hotels are technology-based infrastructure hotels, UTATU theory could be as the theoretical background to examine the guests’ acceptance and use after staying in smart hotels. The UTAUT identifies four key drivers of the adoption of information systems: performance expectancy, effort expectancy, social influence, and facilitating conditions. The extended UTAUT modifies the definitions of the seven constructs for consideration; the four previously cited constructs of the UTAUT model together with three new additional constructs, which including hedonic motivation, price value and habit. Thus, the seven constructs from the extended UTAUT theory could be adopted to understand their intention to revisit smart hotels. The service quality model will also be adopted and integrated into the framework to understand the guests’ intention of smart hotels. There are rare studies to examine the service quality on guests’ satisfaction and intention to revisit in smart hotels. In this study, Lodging Quality Index (LQI) will be adopted to measure the service quality in smart hotels. Using integrated UTAUT theory and service quality model because technological applications and services require using more than one model to understand the complicated situation for customers’ acceptance of new technology. Moreover, an integrated model could provide more perspective insights to explain the relationships of the constructs that could not be obtained from only one model. For this research, ten in-depth interviews are planned to recruit this study. In order to confirm the applicability of the proposed framework and gain an overview of the guest experience of smart hotels from the hospitality industry, in-depth interviews with the hotel guests and industry practitioners will be accomplished. In terms of the theoretical contribution, it predicts that the integrated models from the UTAUT theory and the service quality will provide new insights to understand factors that influence the guests’ satisfaction and intention to revisit smart hotels. After this study identifies influential factors, smart hotel practitioners could understand which factors may significantly influence smart hotel guests’ satisfaction and intention to revisit. In addition, smart hotel practitioners could also provide outstanding guests experience by improving their service quality based on the identified dimensions from the service quality measurement. Thus, it will be beneficial to the sustainability of the smart hotels business.Keywords: intention to revisit, guest satisfaction, qualitative interviews, smart hotels
Procedia PDF Downloads 196686 Operation '1 Household Dry Toilet for Planting 20 Fruit Trees and/or Acacias on Cropland': Strategy for Promoting Adoption of Well-Managed Agroforestry Systems and Prevent Streaming and Soil Erosion
Authors: Stanis Koko Nyalongomo, Benjamin Mputela Bankanza, Moise Kisempa Mahungudi
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Several areas in the Democratic Republic of Congo (DRC) experience serious problems of streaming and soil erosion. Erosion leads to degradation of soil health, and the three main causative factors of similar importance are deforestation, overgrazing, and land agricultural mismanagement. Degradation of soil health leads to a decrease in agricultural productivity and carbon dioxide (CO₂), and other greenhouse gas emissions. Agricultural productivity low, and sanitation-related diseases are a concern of a majority of DRC rural people -whose main livelihoods are conventional smallholder agriculture- due to degradation of agricultural soil health and prevalence of inappropriate sanitation in rural areas. Land management practices that increase soil carbon stocks on agricultural lands with practices including conservation agriculture and agroforestry do not only limit CO₂ emissions but also help prevent erosion while enhancing soil health and productivity. Promotion to adopt sustainable land management practices, especially conversion to well-managed agroforestry practices, is a necessity. This needs to be accompanied by incentives. Methods that incite smallholders to adopt practices that increase carbon stocks in agricultural lands and enhance soil health and productivity for social, economic, and environmental benefits, and give them the ability to get and use household dry toilets -included activities to inform and raise smallholder households awareness on the conversion of croplands to well-managed agroforestry systems through planting at least 20 fruit trees and/or acacias, soil carbon and practices that sequester it in soil and ecological sanitation; and offer smallholders technique and material supports and incentives under the form of dry toilets constructed for free for well-managed agroforestry implementation- were carried out to address problems of soil erosion as well as agricultural productivity and sanitation-related diseases. In 2018 and 2019, 19 of 23 targeted smallholder households expressed their satisfaction and converted their croplands to agroforestry through planting 374 trees, and each gotten 1 dry toilet constructed for free. Their neighbors expressed a willingness to participate in the project. Conversion to well-managed agroforestry practices offers many advantages to both farmers and the environment. The strategy of offering smallholders incentives for soil-friendly agricultural practices, especially well-managed agroforestry, is one of the solutions to prevent soil erosion. DRC rural people whose majority are smallholder households, need to be able to get and use dry toilets. So, dry toilets could be offered like incentives for well-managed agroforestry practices. Given the many advantages agroforestry and dry toilet can offer, recommendations are made for funding organizations to support such projects that promote the adoption of soil health practices.Keywords: agroforestry, croplands, soil carbon, soil health
Procedia PDF Downloads 116685 Dynamic Simulation of IC Engine Bearings for Fault Detection and Wear Prediction
Authors: M. D. Haneef, R. B. Randall, Z. Peng
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Journal bearings used in IC engines are prone to premature failures and are likely to fail earlier than the rated life due to highly impulsive and unstable operating conditions and frequent starts/stops. Vibration signature extraction and wear debris analysis techniques are prevalent in the industry for condition monitoring of rotary machinery. However, both techniques involve a great deal of technical expertise, time and cost. Limited literature is available on the application of these techniques for fault detection in reciprocating machinery, due to the complex nature of impact forces that confounds the extraction of fault signals for vibration based analysis and wear prediction. This work is an extension of a previous study, in which an engine simulation model was developed using a MATLAB/SIMULINK program, whereby the engine parameters used in the simulation were obtained experimentally from a Toyota 3SFE 2.0 litre petrol engines. Simulated hydrodynamic bearing forces were used to estimate vibrations signals and envelope analysis was carried out to analyze the effect of speed, load and clearance on the vibration response. Three different loads 50/80/110 N-m, three different speeds 1500/2000/3000 rpm, and three different clearances, i.e., normal, 2 times and 4 times the normal clearance were simulated to examine the effect of wear on bearing forces. The magnitude of the squared envelope of the generated vibration signals though not affected by load, but was observed to rise significantly with increasing speed and clearance indicating the likelihood of augmented wear. In the present study, the simulation model was extended further to investigate the bearing wear behavior, resulting as a consequence of different operating conditions, to complement the vibration analysis. In the current simulation, the dynamics of the engine was established first, based on which the hydrodynamic journal bearing forces were evaluated by numerical solution of the Reynold’s equation. Also, the essential outputs of interest in this study, critical to determine wear rates are the tangential velocity and oil film thickness between the journal and bearing sleeve, which if not maintained appropriately, have a detrimental effect on the bearing performance. Archard’s wear prediction model was used in the simulation to calculate the wear rate of bearings with specific location information as all determinative parameters were obtained with reference to crank rotation. Oil film thickness obtained from the model was used as a criterion to determine if the lubrication is sufficient to prevent contact between the journal and bearing thus causing accelerated wear. A limiting value of 1 µm was used as the minimum oil film thickness needed to prevent contact. The increased wear rate with growing severity of operating conditions is analogous and comparable to the rise in amplitude of the squared envelope of the referenced vibration signals. Thus on one hand, the developed model demonstrated its capability to explain wear behavior and on the other hand it also helps to establish a correlation between wear based and vibration based analysis. Therefore, the model provides a cost-effective and quick approach to predict the impending wear in IC engine bearings under various operating conditions.Keywords: condition monitoring, IC engine, journal bearings, vibration analysis, wear prediction
Procedia PDF Downloads 303684 Adapting an Accurate Reverse-time Migration Method to USCT Imaging
Authors: Brayden Mi
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Reverse time migration has been widely used in the Petroleum exploration industry to reveal subsurface images and to detect rock and fluid properties since the early 1980s. The seismic technology involves the construction of a velocity model through interpretive model construction, seismic tomography, or full waveform inversion, and the application of the reverse-time propagation of acquired seismic data and the original wavelet used in the acquisition. The methodology has matured from 2D, simple media to present-day to handle full 3D imaging challenges in extremely complex geological conditions. Conventional Ultrasound computed tomography (USCT) utilize travel-time-inversion to reconstruct the velocity structure of an organ. With the velocity structure, USCT data can be migrated with the “bend-ray” method, also known as migration. Its seismic application counterpart is called Kirchhoff depth migration, in which the source of reflective energy is traced by ray-tracing and summed to produce a subsurface image. It is well known that ray-tracing-based migration has severe limitations in strongly heterogeneous media and irregular acquisition geometries. Reverse time migration (RTM), on the other hand, fully accounts for the wave phenomena, including multiple arrives and turning rays due to complex velocity structure. It has the capability to fully reconstruct the image detectable in its acquisition aperture. The RTM algorithms typically require a rather accurate velocity model and demand high computing powers, and may not be applicable to real-time imaging as normally required in day-to-day medical operations. However, with the improvement of computing technology, such a computational bottleneck may not present a challenge in the near future. The present-day (RTM) algorithms are typically implemented from a flat datum for the seismic industry. It can be modified to accommodate any acquisition geometry and aperture, as long as sufficient illumination is provided. Such flexibility of RTM can be conveniently implemented for the application in USCT imaging if the spatial coordinates of the transmitters and receivers are known and enough data is collected to provide full illumination. This paper proposes an implementation of a full 3D RTM algorithm for USCT imaging to produce an accurate 3D acoustic image based on the Phase-shift-plus-interpolation (PSPI) method for wavefield extrapolation. In this method, each acquired data set (shot) is propagated back in time, and a known ultrasound wavelet is propagated forward in time, with PSPI wavefield extrapolation and a piece-wise constant velocity model of the organ (breast). The imaging condition is then applied to produce a partial image. Although each image is subject to the limitation of its own illumination aperture, the stack of multiple partial images will produce a full image of the organ, with a much-reduced noise level if compared with individual partial images.Keywords: illumination, reverse time migration (RTM), ultrasound computed tomography (USCT), wavefield extrapolation
Procedia PDF Downloads 64683 Transition Metal Bis(Dicarbollide) Complexes in Design of Molecular Switches
Authors: Igor B. Sivaev
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Design of molecular machines is an extraordinary growing and very important area of research that it was recognized by awarding Sauvage, Stoddart and Feringa the Nobel Prize in Chemistry in 2016 'for the design and synthesis of molecular machines'. Based on the type of motion being performed, molecular machines can be divided into two main types: molecular motors and molecular switches. Molecular switches are molecules or supramolecular complexes having bistability, i.e., the ability to exist in two or more stable forms, among which may be reversible transitions under external influence (heating, lighting, changing the medium acidity, the action of chemicals, exposure to magnetic or electric field). Molecular switches are the main structural element of any molecular electronics devices. Therefore, the design and the study of molecules and supramolecular systems capable of performing mechanical movement is an important and urgent problem of modern chemistry. There is growing interest in molecular switches and other devices of molecular electronics based on transition metal complexes; therefore choice of suitable stable organometallic unit is of great importance. An example of such unit is bis(dicarbollide) complexes of transition metals [3,3’-M(1,2-C₂B₉H₁₁)₂]ⁿ⁻. The control on the ligand rotation in such complexes can be reached by introducing substituents which could provide stabilization of certain rotamers due to specific interactions between the ligands, on the one hand, and which can participate as Lewis bases in complex formation with external metals resulting in a change in the rotation angle of the ligands, on the other hand. A series of isomeric methyl sulfide derivatives of cobalt bis(dicarbollide) complexes containing methyl sulfide substituents at boron atoms in different positions of the pentagonal face of the dicarbollide ligands [8,8’-(MeS)₂-3,3’-Co(1,2-C₂B₉H₁₀)₂]⁻, rac-[4,4’-(MeS)₂-3,3’-Co(1,2-C₂B₉H₁₀)₂]⁻ and meso-[4,7’-(MeS)₂-3,3’-Co(1,2-C₂B₉H₁₀)₂]⁻ were synthesized by the reaction of CoCl₂ with the corresponding methyl sulfide carborane derivatives [10-MeS-7,8-C₂B₉H₁₁)₂]⁻ and [10-MeS-7,8-C₂B₉H₁₁)₂]⁻. In the case of asymmetrically substituted cobalt bis(dicarbollide) complexes the corresponding rac- and meso-isomers were successfully separated by column chromatography as the tetrabutylammonium salts. The compounds obtained were studied by the methods of ¹H, ¹³C, and ¹¹B NMR spectroscopy, single crystal X-ray diffraction, cyclic voltammetry, controlled potential coulometry and quantum chemical calculations. It was found that in the solid state, the transoid- and gauche-conformations of the 8,8’- and 4,4’-isomers are stabilized by four intramolecular CH···S(Me)B hydrogen bonds each one (2.683-2.712 Å and 2.709-2.752 Å, respectively), whereas gauche-conformation of the 4,7’-isomer is stabilized by two intramolecular CH···S hydrogen bonds (2.699-2.711 Å). The existence of the intramolecular CH·S(Me)B hydrogen bonding in solutions was supported by the 1H NMR spectroscopy. These data are in a good agreement with results of the quantum chemical calculations. The corresponding iron and nickel complexes were synthesized as well. The reaction of the methyl sulfide derivatives of cobalt bis(dicarbollide) with various labile transition metal complexes results in rupture of intramolecular hydrogen bonds and complexation of the methyl sulfide groups with external metal. This results in stabilization of other rotational conformation of cobalt bis(dicarbollide) and can be used in design of molecular switches. This work was supported by the Russian Science Foundation (16-13-10331).Keywords: molecular switches, NMR spectroscopy, single crystal X-ray diffraction, transition metal bis(dicarbollide) complexes, quantum chemical calculations
Procedia PDF Downloads 164682 Intelligent Cooperative Integrated System for Road Safety and Road Infrastructure Maintenance
Authors: Panagiotis Gkekas, Christos Sougles, Dionysios Kehagias, Dimitrios Tzovaras
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This paper presents the architecture of the “Intelligent cooperative integrated system for road safety and road infrastructure maintenance towards 2020” (ODOS2020) advanced infrastructure, which implements a number of cooperative ITS applications based on Internet of Things and Infrastructure-to-Vehicle (V2I) technologies with the purpose to enhance the active road safety level of vehicles through the provision of a fully automated V2I environment. The primary objective of the ODOS2020 project is to contribute to increased road safety but also to the optimization of time for maintenance of road infrastructure. The integrated technological solution presented in this paper addresses all types of vehicles and requires minimum vehicle equipment. Thus, the ODOS2020 comprises a low-cost solution, which is one of its main benefits. The system architecture includes an integrated notification system to transmit personalized information on road, traffic, and environmental conditions, in order for the drivers to receive real-time and reliable alerts concerning upcoming critical situations. The latter include potential dangers on the road, such as obstacles or road works ahead, extreme environmental conditions, etc., but also informative messages, such as information on upcoming tolls and their charging policies. At the core of the system architecture lies an integrated sensorial network embedded in special road infrastructures (strips) that constantly collect and transmit wirelessly information about passing vehicles’ identification, type, speed, moving direction and other traffic information in combination with environmental conditions and road wear monitoring and predictive maintenance data. Data collected from sensors is transmitted by roadside infrastructure, which supports a variety of communication technologies such as ITS-G5 (IEEE-802.11p) wireless network and Internet connectivity through cellular networks (3G, LTE). All information could be forwarded to both vehicles and Traffic Management Centers (TMC) operators, either directly through the ITS-G5 network, or to smart devices with Internet connectivity, through cloud-based services. Therefore, through its functionality, the system could send personalized notifications/information/warnings and recommendations for upcoming events to both road users and TMC operators. In the course of the ODOS2020 project pilot operation has been conducted to allow drivers of both C-ITS equipped and non-equipped vehicles to experience the provided added value services. For non-equipped vehicles, the provided information is transmitted to a smartphone application. Finally, the ODOS2020 system and infrastructure is appropriate for installation on both urban, rural, and highway environments. The paper presents the various parts of the system architecture and concludes by outlining the various challenges that had to be overcome during its design, development, and deployment in a real operational environment. Acknowledgments: Work presented in this paper was co-financed by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation (call RESEARCH–CREATE–INNOVATE) under contract no. Τ1EDK-03081 (project ODOS2020).Keywords: infrastructure to vehicle, intelligent transportation systems, internet of things, road safety
Procedia PDF Downloads 104681 Concept Mapping to Reach Consensus on an Antibiotic Smart Use Strategy Model to Promote and Support Appropriate Antibiotic Prescribing in a Hospital, Thailand
Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa
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Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams
Procedia PDF Downloads 109680 Antimicrobial Properties of SEBS Compounds with Zinc Oxide and Zinc Ions
Authors: Douglas N. Simões, Michele Pittol, Vanda F. Ribeiro, Daiane Tomacheski, Ruth M. C. Santana
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The increasing demand of thermoplastic elastomers is related to the wide range of applications, such as automotive, footwear, wire and cable industries, adhesives and medical devices, cell phones, sporting goods, toys and others. These materials are susceptible to microbial attack. Moisture and organic matter present in some areas (such as shower area and sink), provide favorable conditions for microbial proliferation, which contributes to the spread of diseases and reduces the product life cycle. Compounds based on SEBS copolymers, poly(styrene-b-(ethylene-co-butylene)-b-styrene, are a class of thermoplastic elastomers (TPE), fully recyclable and largely used in domestic appliances like bath mats and tooth brushes (soft touch). Zinc oxide and zinc ions loaded in personal and home care products have become common in the last years due to its biocidal effect. In that sense, the aim of this study was to evaluate the effect of zinc as antimicrobial agent in compounds based on SEBS/polypropylene/oil/ calcite for use as refrigerator seals (gaskets), bath mats and sink squeegee. Two zinc oxides from different suppliers (ZnO-Pe and ZnO-WR) and one masterbatch of zinc ions (M-Zn-ion) were used in proportions of 0%, 1%, 3% and 5%. The compounds were prepared using a co-rotating double screw extruder (L/D ratio of 40/1 and 16 mm screw diameter). The extrusion parameters were kept constant for all materials. Tests specimens were prepared using the injection molding machine. A compound with no antimicrobial additive (standard) was also tested. Compounds were characterized by physical (density), mechanical (hardness and tensile properties) and rheological properties (melt flow rate - MFR). The Japan Industrial Standard (JIS) Z 2801:2010 was applied to evaluate antibacterial properties against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). The Brazilian Association of Technical Standards (ABNT) NBR 15275:2014 were used to evaluate antifungal properties against Aspergillus niger (A. niger), Aureobasidium pullulans (A. pullulans), Candida albicans (C. albicans), and Penicillium chrysogenum (P. chrysogenum). The microbiological assay showed a reduction over 42% in E. coli and over 49% in S. aureus population. The tests with fungi showed inconclusive results because the sample without zinc also demonstrated an inhibition of fungal development when tested against A. pullulans, C. albicans and P. chrysogenum. In addition, the zinc loaded samples showed worse results than the standard sample when tested against A. niger. The zinc addition did not show significant variation in mechanical properties. However, the density values increased with the rise in ZnO additives concentration, and had a little decrease in M-Zn-ion samples. Also, there were differences in the MFR results in all compounds compared to the standard.Keywords: antimicrobial, home device, SEBS, zinc
Procedia PDF Downloads 315