Search results for: effective management includes political stability
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 24293

Search results for: effective management includes political stability

1373 The Nursing Rounds System: Effect of Patient's Call Light Use, Bed Sores, Fall and Satisfaction Level

Authors: Bassem Saleh, Hussam Nusair, Nariman Al Zubadi, Shams Al Shloul, Usama Saleh

Abstract:

The nursing round system (NRS) means checking patients on an hourly basis during the A (0700–2200 h) shift and once every 2 h during the B (2200–0700 h) by the assigned nursing staff. The overall goal of this prospective study is to implement an NRS in a major rehabilitation centre—Sultan Bin Abdulaziz Humanitarian City—in the Riyadh area of the Kingdom of Saudi Arabia. The purposes of this study are to measure the effect of the NRS on: (i) the use of patient call light; (ii) the number of incidences of patients’ fall; (iii) the number of incidences of hospital-acquired bed sores; and (iv) the level of patients’ satisfaction. All patients hospitalized in the male stroke unit will be involved in this study. For the period of 8 weeks (17 December 2009–17 February 2010) All Nursing staff on the unit will record each call light and the patient’s need. Implementation of the NRS would start on 18 February 2010 and last for 8 weeks, until 18 April 2010. Data collected throughout this period will be compared with data collected during the 8 weeks period immediately preceding the implementation of the NRS (17 December 2009–17 February 2010) in order to measure the impact of the call light use. The following information were collected on all subjects involved in the study: (i) the Demographic Information Form; (ii) authors’ developed NRS Audit Form; (iii) Patient Call Light Audit Form; (iv) Patient Fall Audit Record; (v) Hospital-Acquired Bed Sores Audit Form; and (vi) hospital developed Patient Satisfaction Records. The findings suggested that a significant reduction on the use of call bell (P < 0.001), a significant reduction of fall incidence (P < 0.01) while pressure ulcer reduced by 50% before and after the implementation of NRS. In addition, the implementation of NRS increased patient satisfaction by 7/5 (P < 0.05).

Keywords: call light, patient-care management, patient safety, patient satisfaction, rounds

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1372 Analysis of the Contribution of Coastal and Marine Physical Factors to Oil Slick Movement: Case Study of Misrata, Libya

Authors: Abduladim Maitieg, Mark Johnson

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Developing a coastal oil spill management plan for the Misratah coast is the motivating factor for building a database for coastal and marine systems and energy resources. Wind direction and speed, currents, bathymetry, coastal topography and offshore dynamics influence oil spill deposition in coastal water. Therefore, oceanographic and climatological data can be used to understand oil slick movement and potential oil deposits on shoreline area and the behaviour of oil spill trajectories on the sea surface. The purpose of this study is to investigate the effects of the coastal and marine physical factors under strong wave conditions and various bathymetric and coastal topography gradients in the western coastal area of Libya on the movement of oil slicks. The movement of oil slicks was computed using a GNOME simulation model based on current and wind speed/direction. The results in this paper show that (1) Oil slick might reach the Misratah shoreline area in two days in the summer and winter. Seasons. (2 ) The North coast of Misratah is the potential oil deposit area on the Misratah coast. (3) Tarball pollution was observed along the North coast of Misratah. (4) Two scenarios for the summer and the winter season were run, along the western coast of Libya . (5) The eastern coast is at a lower potential risk due to the influence of wind and current energy in the Gulf of Sidra. (6) The Misratah coastline is more vulnerable to oil spill movement in the summer than in winter seasons. (7) Oil slick takes from 2 to 5 days to reach the saltmarsh in the eastern Misratah coast. (8) Oil slick moves 300 km in 30 days from the spill resource location near the Libyan western border to the Misratah coast.(9) Bathymetric features have a profound effect on oil spill movement. (9)Oil dispersion simulations using GNOME are carried out taking into account high-resolution wind and current data.

Keywords: oil spill movement, coastal and marine physical factors, coast area, Libyan

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1371 Evaluation of Microstructure, Mechanical and Abrasive Wear Response of in situ TiC Particles Reinforced Zinc Aluminum Matrix Alloy Composites

Authors: Mohammad M. Khan, Pankaj Agarwal

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The present investigation deals with the microstructures, mechanical and detailed wear characteristics of in situ TiC particles reinforced zinc aluminum-based metal matrix composites. The composites have been synthesized by liquid metallurgy route using vortex technique. The composite was found to be harder than the matrix alloy due to high hardness of the dispersoid particles therein. The former was also lower in ultimate tensile strength and ductility as compared to the matrix alloy. This could be explained to be due to the use of coarser size dispersoid and larger interparticle spacing. Reasonably uniform distribution of the dispersoid phase in the alloy matrix and good interfacial bonding between the dispersoid and matrix was observed. The composite exhibited predominantly brittle mode of fracture with microcracking in the dispersoid phase indicating effective easy transfer of load from matrix to the dispersoid particles. To study the wear behavior of the samples three different types of tests were performed namely: (i) sliding wear tests using a pin on disc machine under dry condition, (ii) high stress (two-body) abrasive wear tests using different combinations of abrasive media and specimen surfaces under the conditions of varying abrasive size, traversal distance and load, and (iii) low-stress (three-body) abrasion tests using a rubber wheel abrasion tester at various loads and traversal distances using different abrasive media. In sliding wear test, significantly lower wear rates were observed in the case of base alloy over that of the composites. This has been attributed to the poor room temperature strength as a result of increased microcracking tendency of the composite over the matrix alloy. Wear surfaces of the composite revealed the presence of fragmented dispersoid particles and microcracking whereas the wear surface of matrix alloy was observed to be smooth with shallow grooves. During high-stress abrasion, the presence of the reinforcement offered increased resistance to the destructive action of the abrasive particles. Microcracking tendency was also enhanced because of the reinforcement in the matrix. The negative effect of the microcracking tendency was predominant by the abrasion resistance of the dispersoid. As a result, the composite attained improved wear resistance than the matrix alloy. The wear rate increased with load and abrasive size due to a larger depth of cut made by the abrasive medium. The wear surfaces revealed fine grooves, and damaged reinforcement particles while subsurface regions revealed limited plastic deformation and microcracking and fracturing of the dispersoid phase. During low-stress abrasion, the composite experienced significantly less wear rate than the matrix alloy irrespective of the test conditions. This could be explained to be due to wear resistance offered by the hard dispersoid phase thereby protecting the softer matrix against the destructive action of the abrasive medium. Abraded surfaces of the composite showed protrusion of dispersoid phase. The subsurface regions of the composites exhibited decohesion of the dispersoid phase along with its microcracking and limited plastic deformation in the vicinity of the abraded surfaces.

Keywords: abrasive wear, liquid metallurgy, metal martix composite, SEM

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1370 Reclamation of Saline and Alkaline Soils through Aquaculture: A Review and Prospects for Future Research

Authors: M. Shivakumar, S. R. Somashekhar, C. V. Raju

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Secondary salinization of agricultural lands in any command areas of the world is the major issue in the recent past. Currently, it is estimated that the 954 mh of saline and alkaline soil is present in the world. Thousands of hectares of land, getting added every year. Argentina, Bangladesh and Australia are most affected countries. In India, out of 142.80 million hectare (mh) cropped area, 56 mh is irrigated area. Of which, more than 9 mh (about 16.%) of land is found to be alkaline/saline. Due to continuous utilization of same land for same agricultural activities, excessive usage of fertilizers and water, most of the soils have become alkaline, saline or water logged. These lands are low productive and at times totally unfit for agricultural activities. These soils may or may not posses good physical condition, but plants may suffer from its inability to absorb water from salty solution. Plants suffer from dehydration and loose water to the soil, shrink, resulting death of plant. This process is called plasmolysis. It is the fact that soil is an independent, organic body of nature that acquires properties in accordance with forces which act upon it. Aquaculture is one of the solutions to utilize such problematic soils for food production. When the impoundments are constructed in an area 10-15% of the affected areas, the excess water along with the salts gets into impoundments and management of salt is easier in water than in the soil. Due to high organic input in aquaculture such as feed, manure and continuous deposition of fecal matter, pH of the soil gets reduced and over the period of time such soils can be put back into the original activity. Under National Agricultural Development Program (NADP), the project was implemented in 258 villages of Mandya District, Karnataka State, India and found that these lands can be effectively utilized for fish culture and increase the proteinacious food production by many folds while conserving the soils. The findings of the research can be adopted and up scaled in any country.

Keywords: saline and alkaline soils, Aquaculture, Problematic soils, Reclamation

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1369 Influence Activities in Destination, Destination Marketing, and Loyalty through Environmental Preservation toward Satisfaction at the Tourist Destinations in East Java, Indonesia

Authors: Christina Esti Susanti

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This study aimed to determine the effect Activities in marketing, Destination Marketing, and Environmental preservation loyalty through satisfaction at tourist destination in East Java, Indonesia. In this study population used is Surabaya citizens who had visited tourist destination in East Java, Indonesia. Characteristics of a sample of respondents in this study are: a minimum age of 17 years, and ever came in tourist destination in East Java, Indonesia with each destination more than 1 visits. Total sample 316 respondents. Data analysis tools which is used in this study is a structural equation modeling. Based on the analysis, the results of this study can be concluded that the hypothesis 1, 2, 5, and 6 are proposed in this study was rejected because not significant. The hypotheses are: (1) Activities in destination have influence which is positive effect on satisfaction in the tourist destination in East Java, Indonesia, (2) Destination marketing have influence which is positive effect on satisfaction in the tourist destination in East Java, Indonesia, (3) Activities in destination have influence which is positive effect towards loyalty through satisfaction in a tourist destination in East Java, Indonesia. (4) Destination marketing have influence which is positive effect on loyalty through satisfaction in a tourist destination in East Java, Indonesia. While the hypothesis 3, 4, and 7, is received. The hypotheses are: (1) Environmental preservation have influence which is positive effect and significant on satisfaction in the tourist destination in East Java, Indonesia. (2) Satisfaction have influence which is positive effect and significant on loyalty to the tourist destination in East Java, Indonesia. (3) Environmental preservation have influence which is positive effect and significant on loyalty through satisfaction in a tourist destination in East Java, Indonesia. Practical advice submitted to the management of tourist destinations, especially in the 10 areas where research was conducted for more attention to the condition of the physical environment to be around tourist spots / attractions, namely: the condition of roads, water supply conditions, the condition of drainage / sanitation, and the condition waste more seriously. Based on the proposal, the manager of a tourist destination seems to be working closely with the local municipal sanitation departments, local water companies local city and town local public works departments to jointly manage a tourist destination considering regional tourism is one of the region's assets and become one sources of local revenue (PAD) is vital.

Keywords: activities in marketing, destination amarketing, environmental preservation, satisfaction, loyalty

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1368 Assessment of Rangeland Condition in a Dryland System Using UAV-Based Multispectral Imagery

Authors: Vistorina Amputu, Katja Tielboerger, Nichola Knox

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Primary productivity in dry savannahs is constraint by moisture availability and under increasing anthropogenic pressure. Thus, considering climate change and the unprecedented pace and scale of rangeland deterioration, methods for assessing the status of such rangelands should be easy to apply, yield reliable and repeatable results that can be applied over large spatial scales. Global and local scale monitoring of rangelands through satellite data and labor-intensive field measurements respectively, are limited in accurately assessing the spatiotemporal heterogeneity of vegetation dynamics to provide crucial information that detects degradation in its early stages. Fortunately, newly emerging techniques such as unmanned aerial vehicles (UAVs), associated miniaturized sensors and improving digital photogrammetric software provide an opportunity to transcend these limitations. Yet, they have not been extensively calibrated in natural systems to encompass their complexities if they are to be integrated for long-term monitoring. Limited research using drone technology has been conducted in arid savannas, for example to assess the health status of this dynamic two-layer vegetation ecosystem. In our study, we fill this gap by testing the relationship between UAV-estimated cover of rangeland functional attributes and field data collected in discrete sample plots in a Namibian dryland savannah along a degradation gradient. The first results are based on a supervised classification performed on the ultra-high resolution multispectral imagery to distinguish between rangeland functional attributes (bare, non-woody, and woody), with a relatively good match to the field observations. Integrating UAV-based observations to improve rangeland monitoring could greatly assist in climate-adapted rangeland management.

Keywords: arid savannah, degradation gradient, field observations, narrow-band sensor, supervised classification

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1367 Exploring Women’S Leadership in China’S Sport National Governing Bodies

Authors: Han Zheng

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This research is being conducted to explore women's leadership in China's National Governing Bodies ( in order to identify the barriers to women's leadership and provide feasible solutions. Extensive research has been undertaken internationally, which has identified and acknowledged the underrepresentation of women in leadership positions across multiple industries and global contexts. According to these studies, leadership specifically within the sports industry was both historically and is still currently male-dominated. Within China, the underrepresentation of women in leadership positions is also evident, which women only occupy 16% of the leadership in business enterprises and 5.6% in scientific and technological research institutions, yet there is limited research that has looked to examine why this is the case regarding women's leadership in China, especially within in sports industry. Therefore, this research gap drives the purpose, which aims to explore the current situation of women's leadership in sports National Governing Bodies (NGBs) in China. By using both questionnaires and interviews, data from NGBs in China will be collected. This research will achieve the following three goals: 1, determine the representation level of women's leadership in the target organizations. 2, identify barriers to women's leadership and their causes. 3, provide feasible solutions. Based on the multi-level framework, this study develops a "barrier matrix" framework: according to the analysis of the previous literature, it concludes that there are eight main barriers that hinder the development of women's leadership. The research combines qualitative and quantitative analysis, using questionnaires and interviews. Key findings according to the analysis of the primary data collected: 1. The average proportion of female occupational leadership in China's sports NGBs is less than 17.5%. 2. 50.8% of China's sports NGBs have no equal employment opportunity policy. 3. According to the preliminary qualitative analysis of the interviews, it is found that the core barriers affecting women's leadership development are mainly in the following areas: male-dominated culture and gender stereotyping (macro-level), biased organizational policies and procedures (meso-level), work-family conflicts and self-limiting behaviors (micro-level).

Keywords: women leadership, sport management, gender equality, sport leadership, sport NGBs

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1366 Influence of the Quality of the Recycled Aggregates in Concrete Pavement

Authors: Viviana Letelier, Ester Tarela, Bianca Lopez, Pedro Muñoz, Giacomo Moriconi

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The environmental impact has become a global concern during the last decades. Several alternatives have been proposed and studied to minimize this impact in different areas. The reuse of aggregates from old concretes to manufacture new ones not only can reduce this impact but is also a way to optimize the resource management. The effect of the origin of the reused aggregates from two different origin materials in recycled concrete pavement is studied here. Using the dosing applied by a pavement company, coarse aggregates in the 6.3-25 mm fraction are replaced by recycled aggregates with two different origins: old concrete pavements with similar origin strength to the one of the control concrete, and precast concrete pipes with smaller strengths than the one of the control concrete. The replacement percentages tested are 30%, 40% and 50% in both cases. The compressive strength tests are performed after 7, 14, 28 and 90 curing days, the flexural strength tests and the elasticity modulus tests after 28 and 90 curing days. Results show that the influence of the quality of the origin concrete in the mechanical properties of recycled concretes is not despicable. Concretes with up to a 50% of recycled aggregates from the concrete pavement have similar compressive strengths to the ones of the control concrete and slightly smaller flexural strengths that, however, in all cases exceed the minimum of 5MPa after 28 curing days stablished by the Chilean regulation for pavement concretes. On the other hand, concretes with recycled aggregates from precast concrete pipes show significantly lower compressive strengths after 28 curing days. The differences with the compressive strength of the control concrete increase with the percentage of replacement, reaching a 13% reduction when 50% of the aggregates are replaced. The flexural strength also suffers significant reductions that increase with the percentage of replacement, only obeying the Chilean regulation when 30% of the aggregates are recycled after 28 curing days. Nevertheless, after 90 curing days, all series obey the regulation requirements. Results show, not only the importance of the quality of the origin concrete, but also the significance of the curing days, that may allow the use of less quality recycled material without important strength losses.

Keywords: flexural strength of recycled concrete., mechanical properties of recycled concrete, recycled aggregates, recycled concrete pavements

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1365 The Development of Assessment Criteria Framework for Sustainable Healthcare Buildings in China

Authors: Chenyao Shen, Jie Shen

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The rating system provides an effective framework for assessing building environmental performance and integrating sustainable development into building and construction processes; as it can be used as a design tool by developing appropriate sustainable design strategies and determining performance measures to guide the sustainable design and decision-making processes. Healthcare buildings are resource (water, energy, etc.) intensive. To maintain high-cost operations and complex medical facilities, they require a great deal of hazardous and non-hazardous materials, stringent control of environmental parameters, and are responsible for producing polluting emission. Compared with other types of buildings, the impact of healthcare buildings on the full cycle of the environment is particularly large. With broad recognition among designers and operators that energy use can be reduced substantially, many countries have set up their own green rating systems for healthcare buildings. There are four main green healthcare building evaluation systems widely acknowledged in the world - Green Guide for Health Care (GGHC), which was jointly organized by the United States HCWH and CMPBS in 2003; BREEAM Healthcare, issued by the British Academy of Building Research (BRE) in 2008; the Green Star-Healthcare v1 tool, released by the Green Building Council of Australia (GBCA) in 2009; and LEED Healthcare 2009, released by the United States Green Building Council (USGBC) in 2011. In addition, the German Association of Sustainable Building (DGNB) has also been developing the German Sustainable Building Evaluation Criteria (DGNB HC). In China, more and more scholars and policy makers have recognized the importance of assessment of sustainable development, and have adapted some tools and frameworks. China’s first comprehensive assessment standard for green building (the GBTs) was issued in 2006 (lately updated in 2014), promoting sustainability in the built-environment and raise awareness of environmental issues among architects, engineers, contractors as well as the public. However, healthcare building was not involved in the evaluation system of GBTs because of its complex medical procedures, strict requirements of indoor/outdoor environment and energy consumption of various functional rooms. Learn from advanced experience of GGHC, BREEAM, and LEED HC above, China’s first assessment criteria for green hospital/healthcare buildings was finally released in December 2015. Combined with both quantitative and qualitative assessment criteria, the standard highlight the differences between healthcare and other public buildings in meeting the functional needs for medical facilities and special groups. This paper has focused on the assessment criteria framework for sustainable healthcare buildings, for which the comparison of different rating systems is rather essential. Descriptive analysis is conducted together with the cross-matrix analysis to reveal rich information on green assessment criteria in a coherent manner. The research intends to know whether the green elements for healthcare buildings in China are different from those conducted in other countries, and how to improve its assessment criteria framework.

Keywords: assessment criteria framework, green building design, healthcare building, building performance rating tool

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1364 Traumatic Spinal Cord Injury; Incidence, Prognosis and the Time-Course of Clinical Outcomes: A 12 Year Review from a Tertiary Hospital in Korea

Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

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1363 Convolutional Neural Network Based on Random Kernels for Analyzing Visual Imagery

Authors: Ja-Keoung Koo, Kensuke Nakamura, Hyohun Kim, Dongwha Shin, Yeonseok Kim, Ji-Su Ahn, Byung-Woo Hong

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The machine learning techniques based on a convolutional neural network (CNN) have been actively developed and successfully applied to a variety of image analysis tasks including reconstruction, noise reduction, resolution enhancement, segmentation, motion estimation, object recognition. The classical visual information processing that ranges from low level tasks to high level ones has been widely developed in the deep learning framework. It is generally considered as a challenging problem to derive visual interpretation from high dimensional imagery data. A CNN is a class of feed-forward artificial neural network that usually consists of deep layers the connections of which are established by a series of non-linear operations. The CNN architecture is known to be shift invariant due to its shared weights and translation invariance characteristics. However, it is often computationally intractable to optimize the network in particular with a large number of convolution layers due to a large number of unknowns to be optimized with respect to the training set that is generally required to be large enough to effectively generalize the model under consideration. It is also necessary to limit the size of convolution kernels due to the computational expense despite of the recent development of effective parallel processing machinery, which leads to the use of the constantly small size of the convolution kernels throughout the deep CNN architecture. However, it is often desired to consider different scales in the analysis of visual features at different layers in the network. Thus, we propose a CNN model where different sizes of the convolution kernels are applied at each layer based on the random projection. We apply random filters with varying sizes and associate the filter responses with scalar weights that correspond to the standard deviation of the random filters. We are allowed to use large number of random filters with the cost of one scalar unknown for each filter. The computational cost in the back-propagation procedure does not increase with the larger size of the filters even though the additional computational cost is required in the computation of convolution in the feed-forward procedure. The use of random kernels with varying sizes allows to effectively analyze image features at multiple scales leading to a better generalization. The robustness and effectiveness of the proposed CNN based on random kernels are demonstrated by numerical experiments where the quantitative comparison of the well-known CNN architectures and our models that simply replace the convolution kernels with the random filters is performed. The experimental results indicate that our model achieves better performance with less number of unknown weights. The proposed algorithm has a high potential in the application of a variety of visual tasks based on the CNN framework. Acknowledgement—This work was supported by the MISP (Ministry of Science and ICT), Korea, under the National Program for Excellence in SW (20170001000011001) supervised by IITP, and NRF-2014R1A2A1A11051941, NRF2017R1A2B4006023.

Keywords: deep learning, convolutional neural network, random kernel, random projection, dimensionality reduction, object recognition

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1362 Effect of the Diverse Standardized Patient Simulation Cultural Competence Education Strategy on Nursing Students' Transcultural Self-Efficacy Perceptions

Authors: Eda Ozkara San

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Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

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1361 Improving a Stagnant River Reach Water Quality by Combining Jet Water Flow and Ultrasonic Irradiation

Authors: A. K. Tekile, I. L. Kim, J. Y. Lee

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Human activities put freshwater quality under risk, mainly due to expansion of agriculture and industries, damming, diversion and discharge of inadequately treated wastewaters. The rapid human population growth and climate change escalated the problem. External controlling actions on point and non-point pollution sources are long-term solution to manage water quality. To have a holistic approach, these mechanisms should be coupled with the in-water control strategies. The available in-lake or river methods are either costly or they have some adverse effect on the ecological system that the search for an alternative and effective solution with a reasonable balance is still going on. This study aimed at the physical and chemical water quality improvement in a stagnant Yeo-cheon River reach (Korea), which has recently shown sign of water quality problems such as scum formation and fish death. The river water quality was monitored, for the duration of three months by operating only water flow generator in the first two weeks and then ultrasonic irradiation device was coupled to the flow unit for the remaining duration of the experiment. In addition to assessing the water quality improvement, the correlation among the parameters was analyzed to explain the contribution of the ultra-sonication. Generally, the combined strategy showed localized improvement of water quality in terms of dissolved oxygen, Chlorophyll-a and dissolved reactive phosphate. At locations under limited influence of the system operation, chlorophyll-a was highly increased, but within 25 m of operation the low initial value was maintained. The inverse correlation coefficient between dissolved oxygen and chlorophyll-a decreased from 0.51 to 0.37 when ultrasonic irradiation unit was used with the flow, showing that ultrasonic treatment reduced chlorophyll-a concentration and it inhibited photosynthesis. The relationship between dissolved oxygen and reactive phosphate also indicated that influence of ultra-sonication was higher than flow on the reactive phosphate concentration. Even though flow increased turbidity by suspending sediments, ultrasonic waves canceled out the effect due to the agglomeration of suspended particles and the follow-up settling out. There has also been variation of interaction in the water column as the decrease of pH and dissolved oxygen from surface to the bottom played a role in phosphorus release into the water column. The variation of nitrogen and dissolved organic carbon concentrations showed mixed trend probably due to the complex chemical reactions subsequent to the operation. Besides, the intensive rainfall and strong wind around the end of the field trial had apparent impact on the result. The combined effect of water flow and ultrasonic irradiation was a cumulative water quality improvement and it maintained the dissolved oxygen and chlorophyll-a requirement of the river for healthy ecological interaction. However, the overall improvement of water quality is not guaranteed as effectiveness of ultrasonic technology requires long-term monitoring of water quality before, during and after treatment. Even though, the short duration of the study conducted here has limited nutrient pattern realization, the use of ultrasound at field scale to improve water quality is promising.

Keywords: stagnant, ultrasonic irradiation, water flow, water quality

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1360 Diaper Dermatitis and Pancytopenia as the Primary Manifestation in an Infant with Vitamin B12 Deficiency

Authors: Ekaterina Sánchez Romero, Emily Gabriela Aguirre Herrera, Sandra Luz Espinoza Esquerra, Jorge García Campos

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Female, 7 months old, daughter of a mother with anemia during pregnancy, with no history of atopy in the family, since birth she presents with recurrent dermatological and gastrointestinal infections, chronically treated for recurrent diaper dermatitis. At 6 months of age, she begins with generalized pallor, hyperpigmentation in hands and feet, smooth tongue, psychomotor retardation with lack of head support, sedation, and hypoactivity. She was referred to our hospital for a fever of 38°C, severe diaper rash, and pancytopenia with HB 9.3, platelets 38000, neutrophils 0.39 MCV: 86.80 high for her age. The approach was initiated to rule out myeloproliferative syndrome, with negative immunohistochemical results of bone marrow aspirate; during her stay, she presented neurological regression, lack of sucking, and focal seizures. CT scan showed cortical atrophy. The patient was diagnosed with primary immunodeficiency due to history; gamma globulin was administered without improvement with normal results of immunoglobulins and metabolic screening. When dermatological and neurological diagnoses were ruled out as the primary cause, a nutritional factor was evaluated, and a therapeutic trial was started with the administration of vitamin B12 and zinc, presenting clinical neurological improvement and resolution of pancytopenia in 2 months. It was decided to continue outpatient management. Discussion: We present a patient with neurological, dermatological involvement, and pancytopenia, so the most common differential diagnoses in this population were ruled out. Vitamin B12 deficiency is an uncommon entity. Due to maternal and clinical history, a therapeutic trial was started resulting in an improvement. Conclusion: VitaminB12 deficiency should be considered one of the differential diagnoses in the approach to pancytopenia with megaloblastic anemia associated with dermatologic and neurologic manifestations. Early treatment can reduce irreversible damage in these patients.

Keywords: vitamin B12 deficiency, pediatrics, pancytopenia, diaper dermatitis

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1359 The Analgesic Effect of Electroacupuncture in a Murine Fibromyalgia Model

Authors: Bernice Jeanne Lottering, Yi-Wen Lin

Abstract:

Introduction: Chronic pain has a definitive lack of objective parameters in the measurement and treatment efficacy of diseases such as Fibromyalgia (FM). Persistent widespread pain and generalized tenderness are the characteristic symptoms affecting a large majority of the global population, particularly females. This disease has indicated a refractory tendency to conventional treatment ventures, largely resultant from a lack of etiological and pathogenic understanding of the disease development. Emerging evidence indicates that the central nervous system (CNS) plays a critical role in the amplification of pain signals and the neurotransmitters associated therewith. Various stimuli have been found to activate the channels existent on nociceptor terminals, thereby actuating nociceptive impulses along the pain pathways. The transient receptor potential vanalloid 1 (TRPV1) channel functions as a molecular integrator for numerous sensory inputs, such as nociception, and was explored in the current study. Current intervention approaches face a multitude challenges, ranging from effective therapeutic interventions to the limitation of pathognomonic criteria resultant from incomplete understanding and partial evidence on the mechanisms of action of FM. It remains unclear whether electroacupuncture (EA) plays an integral role in the functioning of the TRPV1 pathway, and whether or not it can reduce the chronic pain induced by FM. Aims: The aim of this study was to explore the mechanisms underlying the activation and modulation of the TRPV1 channel pathway in a cold stress model of FM applied to a murine model. Furthermore, the effect of EA in the treatment of mechanical and thermal pain, as expressed in FM was also to be investigated. Methods: 18 C57BL/6 wild type and 6 TRPV1 knockout (KO) mice, aged 8-12 weeks, were exposed to an intermittent cold stress-induced fibromyalgia-like pain model, with or without EA treatment at ZusanLi ST36 (2Hz/20min) on day 3 to 5. Von Frey and Hargreaves behaviour tests were implemented in order to analyze the mechanical and thermal pain thresholds on day 0, 3 and 5 in control group (C), FM group (FM), FM mice with EA treated group (FM + EA) and FM in KO group. Results: An increase in mechanical and thermal hyperalgesia was observed in the FM, EA and KO groups when compared to the control group. This initial increase was reduced in the EA group, which directs focus at the treatment efficacy of EA in nociceptive sensitization, and the analgesic effect EA has attenuating FM associated pain. Discussion: An increase in the nociceptive sensitization was observed through higher withdrawal thresholds in the von Frey mechanical test and the Hargreaves thermal test. TRPV1 function in mice has been scientifically associated with these nociceptive conduits, and the increased behaviour test results suggest that TRPV1 upregulation is central to the FM induced hyperalgesia. This data was supported by the decrease in sensitivity observed in results of the TRPV1 KO group. Moreover, the treatment of EA showed a decrease in this FM induced nociceptive sensitization, suggesting TRPV1 upregulation and overexpression can be attenuated by EA at bilateral ST36. This evidence compellingly implies that the analgesic effect of EA is associated with TRPV1 downregulation.

Keywords: fibromyalgia, electroacupuncture, TRPV1, nociception

Procedia PDF Downloads 140
1358 Theoretical and Experimental Investigation of Structural, Electrical and Photocatalytic Properties of K₀.₅Na₀.₅NbO₃ Lead- Free Ceramics Prepared via Different Synthesis Routes

Authors: Manish Saha, Manish Kumar Niranjan, Saket Asthana

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The K₀.₅Na₀.₅NbO₃ (KNN) system has emerged as one of the most promising lead-free piezoelectric over the years. In this work, we perform a comprehensive investigation of electronic structure, lattice dynamics and dielectric/ferroelectric properties of the room temperature phase of KNN by combining ab-initio DFT-based theoretical analysis and experimental characterization. We assign the symmetry labels to KNN vibrational modes and obtain ab-initio polarized Raman spectra, Infrared (IR) reflectivity, Born-effective charge tensors, oscillator strengths etc. The computed Raman spectrum is found to agree well with the experimental spectrum. In particular, the results suggest that the mode in the range ~840-870 cm-¹ reported in the experimental studies is longitudinal optical (LO) with A_1 symmetry. The Raman mode intensities are calculated for different light polarization set-ups, which suggests the observation of different symmetry modes in different polarization set-ups. The electronic structure of KNN is investigated, and an optical absorption spectrum is obtained. Further, the performances of DFT semi-local, metal-GGA and hybrid exchange-correlations (XC) functionals, in the estimation of KNN band gaps are investigated. The KNN bandgap computed using GGA-1/2 and HSE06 hybrid functional schemes are found to be in excellant agreement with the experimental value. The COHP, electron localization function and Bader charge analysis is also performed to deduce the nature of chemical bonding in the KNN. The solid-state reaction and hydrothermal methods are used to prepare the KNN ceramics, and the effects of grain size on the physical characteristics these ceramics are examined. A comprehensive study on the impact of different synthesis techniques on the structural, electrical, and photocatalytic properties of ferroelectric ceramics KNN. The KNN-S prepared by solid-state method have significantly larger grain size as compared to that for KNN-H prepared by hydrothermal method. Furthermore, the KNN-S is found to exhibit higher dielectric, piezoelectric and ferroelectric properties as compared to KNN-H. On the other hand, the increased photocatalytic activity is observed in KNN-H as compared to KNN-S. As compared to the hydrothermal synthesis, the solid-state synthesis causes an increase in the relative dielectric permittivity (ε^') from 2394 to 3286, remnant polarization (P_r) from 15.38 to 20.41 μC/cm^², planer electromechanical coupling factor (k_p) from 0.19 to 0.28 and piezoelectric coefficient (d_33) from 88 to 125 pC/N. The KNN-S ceramics are also found to have a lower leakage current density, and higher grain resistance than KNN-H ceramic. The enhanced photocatalytic activity of KNN-H is attributed to relatively smaller particle sizes. The KNN-S and KNN-H samples are found to have degradation efficiencies of RhB solution of 20% and 65%, respectively. The experimental study highlights the importance of synthesis methods and how these can be exploited to tailor the dielectric, piezoelectric and photocatalytic properties of KNN. Overall, our study provides several bench-mark important results on KNN that have not been reported so far.

Keywords: lead-free piezoelectric, Raman intensity spectrum, electronic structure, first-principles calculations, solid state synthesis, photocatalysis, hydrothermal synthesis

Procedia PDF Downloads 52
1357 A Meta-Analysis towards an Integrated Framework for Sustainable Urban Transportation within the Concept of Sustainable Cities

Authors: Hande Aladağ, Gökçe Aydın

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The world’s population is increasing continuously and rapidly. Moreover, there are other problems such as the decline of natural energy resources, global warming, and environmental pollution. These facts have made sustainability an important and primary topic from future planning perspective. From this perspective, constituting sustainable cities and communities can be considered as one of the key issues in terms of sustainable development goals. The concept of sustainable cities can be evaluated under three headings such as green/sustainable buildings, self – contained cities and sustainable transportation. This study only concentrates on how to form and support a sustainable urban transportation system to contribute to the sustainable urbanization. Urban transportation system inevitably requires many engineering projects with various sizes. Engineering projects generally have four phases, in the following order: Planning, design, construction, operation. The order is valid but there are feedbacks from every phase to every phase in its upstream. In this regard, engineering projects are iterative processes. Sustainability is an integrated and comprehensive concept thus it should be among the primary concerns in every phase of transportation projects. In the study, a meta-analysis will be performed on the related studies in the literature. It is targeted and planned that, as a result of the findings of this meta-analysis, a framework for the list of principles and actions for sustainable transport will be formed. The meta-analysis will be performed to point out and clarify sustainability approaches in every phase of the related engineering projects, with also paying attention to the iterative nature of the process and relative contribution of the action for the outcomes of the sustainable transportation system. However, the analysis will not be limited to the engineering projects, non-engineering solutions will also be included in the meta-analysis. The most important contribution of this study is a determination of the outcomes of a sustainable urban transportation system in terms of energy efficiency, resource preservation and related social, environmental and economic factors. The study is also important because it will give light to the engineering and management approaches to achieve these outcomes.

Keywords: meta-analysis, sustainability, sustainable cities, sustainable urban transportation, urban transportation

Procedia PDF Downloads 332
1356 Medicinal Plants Supply Chain Innovations for Producer Surplus: Relationship Integration to Benefit the Rural Agrientrepreneurs in Bangladesh

Authors: Akm Shahidullah

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This paper assessed the medicinal plants production and related entrepreneurial and management aspects with a focus to understand the present medicinal plants-based supply chain of Bangladesh. It delineated the overall supply chain and the extent of benefit that the plant-producingagrientrepreneursderive out of the existing system of the chain. The key objective was to put forward innovative supply chain strategiesthatcan leverage the benefit of the rural farmer-entrepreneur of medicinal plants. A field-based investigation was carried out in the Natore district of northwest Bangladesh, where a total of 225 farmers and households from eight villages were engaged in the production of medicinal plant species. The research had a survey with the agrientrepreneurs of two of those villages and focus group discussions at a union level to gather information about the price, buyers, seasonality, and overall supply infrastructure and trading mechanisms of the plant products. The research also gathered explanations on the overall supply chain system of the plants and plant-based processed products through key informant interviews with the local and regional selling agents, stockists, wholesalers, and secondary processors. The findings revealed that, in the existing supply chain system, the primary and wholesale secondary markets were mostly dominated by middlemen who cause market distortions and inflated prices due to a lack of coordination between the primary producers and secondary processors. The discoordination and inefficiencies in the supply chain system could be offset by the producer-processor relationship integration that could result in a multitude of benefits to both the parties in terms of price, quality, lead time, and overall control of the supply chain. Therefore, to ensure the growth of medicinal plants production, the industry users, secondary processors, and policy stakeholders should ensure that the primary producers get the fair share of the benefit; the producer-processor relationship integration in the supply chain offers to ensure that fairness with maximum producer surplus.

Keywords: medicinal-plants, agrientrepreneur, supply chain, relationship integration, Bangladesh

Procedia PDF Downloads 93
1355 Myocardial Reperfusion Injury during Percutaneous Coronary Intervention in Patient with Triple-Vessel Disease in Limited Resources Hospital: A Case Report

Authors: Fanniyah Anis, Bram Kilapong

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Myocardial reperfusion injury is defined as the cellular damage that results from a period of ischemia, followed by the reestablishment of the blood supply to the infarcted tissue. Ventricular tachycardia is one of the most commonly encountered reperfusion arrhythmia as one of the types of myocardial perfusion injury. Prompt and early treatment can reduce mortality, despite limited resources of the hospital in high risk patients with history of triple vessel disease. Case report, Male 53 years old has been diagnosed with NSTEMI with 3VD and comorbid disease of Hypertension and has undergone revascularization management with Percutaneous coronary intervention. Ventricular tachycardia leading to cardiac arrest occurred right after the stent was inserted. Resuscitation was performed for almost 2 hours until spontaneous circulation returned. Patient admitted in ICU with refractory cardiac shock despite using combination of ionotropic and vasopressor agents under standard non-invasive monitoring due to the limitation of the hospital. Angiography was performed again 5 hours later to exclude other possibilities of blockage of coronary arteries and conclude diagnosis of myocardial reperfusion injury. Patient continually managed with combination of antiplatelet agents and maintenance dose of anti-arrhythmia agents. The handling of the patient was to focus more on supportive and preventive from further deteriorating of the condition. Patient showed clinically improvement and regained consciousness within 24 hours. Patient was successfully discharged from ICU within 3 days without any neurological sequela and was discharge from hospital after 3 days observation in general ward. Limited Resource of hospital did not refrain the physician from attaining a good outcome for this myocardial reperfusion injury case and angiography alone can be used to confirm the diagnosis of myocardial reperfusion injury.

Keywords: limited resources hospital, myocardial reperfusion injury, prolonged resuscitation, refractory cardiogenic shock, reperfusion arrhythmia, revascularization, triple-vessel disease

Procedia PDF Downloads 307
1354 Evaluation and Risk Assessment of Heavy Metals Pollution Using Edible Crabs, Based on Food Intended for Human Consumption

Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

Procedia PDF Downloads 379
1353 CICAP: Promising Wound Healing Gel from Bee Products and Medicinal Plants

Authors: Laïd Boukraâ

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Complementary and Alternative Medicine is an inclusive term that describes treatments, therapies, and modalities that are not accepted as components of mainstream education or practice, but that are performed on patients by some practitioners. While these treatments and therapies often form part of post-graduate education, study and writing, they are generally viewed as alternatives or complementary to more universally accepted treatments. Ancient civilizations used bee products and medicinal plants, but modern civilization and ‘education’ have seriously lessened our natural instinctive ability and capability. Despite the fact that the modern Western establishment appears to like to relegate apitherapy and aromatherapy to the status of 'folklore' or 'old wives' tales', they contain a vast spread of pharmacologically-active ingredients and each one has its own unique combination and properties. They are classified in modern herbal medicine according to their spheres of action. Bee products and medicinal plants are well-known natural product for their healing properties and their increasing popularity recently as they are widely used in wound healing. Honey not only has antibacterial properties which can help as an antibacterial agent but also has chemical properties which may further help in the wound healing process. A formulation with honey as its main component was produced into a honey gel. This new formulation has enhanced texture and is more user friendly for usage as well. This new formulation would be better than other formulas as it is hundred percent consisting of natural products and has been made into a better formulation. In vitro assay, animal model study and clinical trials have shown the effectiveness of LEADERMAX for the treatment of diabetic foot, burns, leg ulcer and bed sores. This one hundred percent natural product could be the best alternative to conventional products for wound and burn management. The advantages of the formulation are: 100% natural, affordable, easy to use, strong power of absorption, dry surface on the wound making a film, will not stick to the wound bed; helps relieve wound pain, inflammation, edema and bruising while improving comfort.

Keywords: bed sore bee products, burns, diabetic foot, medicinal plants, leg ulcer, wounds

Procedia PDF Downloads 337
1352 Woody Carbon Stock Potentials and Factor Affecting Their Storage in Munessa Forest, Southern Ethiopia

Authors: Mojo Mengistu Gelasso

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The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

Procedia PDF Downloads 81
1351 Woody Carbon Stock Potentials and Factor Affecting Their Storage in Munessa Forest, Southern Ethiopia

Authors: Mengistu Gelasso Mojo

Abstract:

The tropical forest is considered the most important forest ecosystem for mitigating climate change by sequestering a high amount of carbon. The potential carbon stock of the forest can be influenced by many factors. Therefore, studying these factors is crucial for understanding the determinants that affect the potential for woody carbon storage in the forest. This study was conducted to evaluate the potential for woody carbon stock and how it varies based on plant community types, as well as along altitudinal, slope, and aspect gradients in the Munessa dry Afromontane forest. Vegetation data was collected using systematic sampling. Five line transects were established at 100 m intervals along the altitudinal gradient between two consecutive transect lines. On each transect, 10 quadrats (20 x 20 m), separated by 200 m, were established. The woody carbon was estimated using an appropriate allometric equation formulated for tropical forests. The data was analyzed using one-way ANOVA in R software. The results showed that the total woody carbon stock of the Munessa forest was 210.43 ton/ha. The analysis of variance revealed that woody carbon density varied significantly based on environmental factors, while community types had no significant effect. The highest mean carbon stock was found at middle altitudes (2367-2533 m.a.s.l), lower slopes (0-13%), and west-facing aspects. The Podocarpus falcatus-Croton macrostachyus community type also contributed a higher woody carbon stock, as larger tree size classes and older trees dominated it. Overall, the potential for woody carbon sequestration in this study was strongly associated with environmental variables. Additionally, the uneven distribution of species with larger diameter at breast height (DBH) in the study area might be linked to anthropogenic factors, as the current forest growth indicates characteristics of a secondary forest. Therefore, our study suggests that the development and implementation of a sustainable forest management plan is necessary to increase the carbon sequestration potential of this forest and mitigate climate change.

Keywords: munessa forest, woody carbon stock, environmental factors, climate mitigation

Procedia PDF Downloads 89
1350 Detection of Antibiotic Resistance Genes and Antibiotic Residues in Plant-based Products

Authors: Morello Sara, Pederiva Sabina, Bianchi Manila, Martucci Francesca, Marchis Daniela, Decastelli Lucia

Abstract:

Vegetables represent an integral part of a healthy diet due to their valuable nutritional properties and the growth in consumer demand in recent years is particularly remarkable for a diet rich in vitamins and micronutrients. However, plant-based products are involved in several food outbreaks connected to various sources of contamination and quite often, bacteria responsible for side effects showed high resistance to antibiotics. The abuse of antibiotics can be one of the main mechanisms responsible for increasing antibiotic resistance (AR). Plants grown for food use can be contaminated directly by spraying antibiotics on crops or indirectly by treatments with antibiotics due to the use of manure, which may contain both antibiotics and genes of antibiotic resistance (ARG). Antibiotic residues could represent a potential way of human health risk due to exposure through the consumption of plant-based foods. The presence of antibiotic-resistant bacteria might pose a particular risk to consumers. The present work aims to investigate through a multidisciplinary approach the occurrence of ARG by means of a biomolecular approach (PCR) and the prevalence of antibiotic residues using a multi residues LC-MS/MS method, both in different plant-based products. During the period from July 2020 to October 2021, a total of 74 plant samples (33 lettuces and 41 tomatoes) were collected from 57 farms located throughout the Piedmont area, and18 out of 74 samples (11 lettuces and 7 tomatoes) were selected to LC-MS/MS analyses. DNA extracted (ExtractME, Blirt, Poland) from plants used on crops and isolated bacteria were analyzed with 6 sets of end-point multiplex PCR (Qiagen, Germany) to detect the presence of resistance genes of the main antibiotic families, such as tet genes (tetracyclines), bla (β-lactams) and mcr (colistin). Simultaneous detection of 43 molecules of antibiotics belonging to 10 different classes (tetracyclines, sulphonamides, quinolones, penicillins, amphenicols, macrolides, pleuromotilines, lincosamides, diaminopyrimidines) was performed using Exion LC system AB SCIEX coupled to a triple quadrupole mass spectrometer QTRAP 5500 from AB SCIEX. The PCR assays showed the presence of ARG in 57% (n=42): tetB (4.8%; n=2), tetA (9.5%; n=4), tetE (2.4%; n=1), tetL (12%; n=5), tetM (26%; n=11), blaSHV (21.5%; n=9), blaTEM (4.8%; n =2) and blaCTX-M (19%; n=8). In none of the analyzed samples was the mcr gene responsible for colistin resistance detected. Results obtained from LC-MS/MS analyses showed that none of the tested antibiotics appear to exceed the LOQ (100 ppb). Data obtained confirmed the presence of bacterial populations containing antibiotic resistance determinants such as tet gene (tetracycline) and bla genes (beta-lactams), widely used in human medicine, which can join the food chain and represent a risk for consumers, especially with raw products. The presence of traces of antibiotic residues in vegetables, in concentration below the LOQ of the LC-MS/MS method applied, cannot be excluded. In conclusion, traces of antibiotic residues could be a health risk to the consumer due to potential involvement in the spread of AR. PCR represents a useful and effective approach to characterize and monitor AR carried by bacteria from the entire food chain.

Keywords: plant-based products, ARG, PCR, antibiotic residues

Procedia PDF Downloads 92
1349 The Impact of the COVID-19 Pandemic on the Nursing Workforce in Slovakia

Authors: Lukas Kober, Vladimir Littva, Vladimir Siska

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The pandemic has had a significant impact on our lives. One of the most affected professions is the nursing profession. Nurses are closest to the patient, spend the most time with him, support him, often replace the closest family members, and of course, are part of the whole treatment process. Current nurses have more competencies and roles than in the past. The healthcare system has reached a turning point, also in connection with the spreading Delta variant and the risk of the arrival of the third wave. The lack of nurses is a long-term problem, but it did not arise by itself. The reasons for the departure of nurses from the health care system are not only due to the increasing average age of nurses and midwives in Slovakia and their retirement. Thousands of nurses are leaving due to poor working conditions, low wages, and poor management of individual workplaces. We need to keep older nurses in the health care system, otherwise, we risk their early departure. The pandemic only exacerbates this situation, and the associated risks, such as occupational infections or enormous overload and exhaustion, only accelerate the exit from the profession. According to current data from the register of nurses and midwives, we canceled 772 registrations from January to September 2021, and 584 nurses requested the suspension of registration due to non-performance of the profession. During the same period, we registered only 240 new nurses graduate. We have had this significant disparity here for a long time. For the whole of 2020, we canceled 911 registrations and suspended 973 registrations. We registered a total of 389 graduates. Our system loses hundreds of graduates a year and loses experienced nurses with decades of experience who leave due to poor working conditions, wages and suffer from burnout. Such compensation should also be awarded to the families of health professionals who have lost their lives due to work and to COVID-19. These options can also be motivating for promising people interested in studying nursing, who can gradually replace the missing workforce. This purchase is supported by the KEGA project no. 015KU-4/2019.

Keywords: pandemic, COVID-19, nursing, nursing workforce, lack of nurses

Procedia PDF Downloads 218
1348 Mycobacterium Genome Extraction from Lymph Nodes of Sarcoidosis Cases Using Transbronchial Needle Aspiration: A Cross-Sectional Descriptive Essay On 1223 Patients

Authors: Atefeh Abedini, Pegah Soltani, Arda Kiani

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Background: Sarcoidosis and Tuberculosis are both considered granulomatous chronic diseases with some similar pulmonary and extra-pulmonary manifestations. It is hypothesized that given these morphological similarities, the genome of mycobacterium could have an impact on the development of Sarcoidosis. Identifying the potential correlation of these diseases may assist in the management of sarcoidosis. Herein, we aimed to inspect the lymph node biopsy of sarcoidosis patients for the existence of the HSP-65 mycobacterium DNA sequence. Methods: This cross-sectional survey was conducted on 1188 Sarcoidosis patients without active/latent tuberculosis infection who were diagnosed in Masih Daneshvari Hospital in Tehran, Iran, from January 2020 to January 2022. Trans-bronchial needle aspiration (TBNA) was performed due to bilateral hilar lymphadenopathy to take a specimen. Results: The under-evaluated patients were mainly women (N=815 (68.6%)), none-smoker (N=1016 (85.5%)), and middle-aged (50.1 (SD=4.22)) with average angiotensin-converting enzyme (ACE) index of 75.6 (SD=6.42). Dyslipidemias (n=314 (26.4%), Hypertension (n=295 (24.8%)), Diabetes mellitus (n=131 (11.0%)), and chronic heart diseases (n=97 (8.2%)) had the highest prevalence between comorbidities. Skin lesions (n= 655 (55.1%)), ophthalmic (n=341 (28.7%)), and cardiac involvement (n=229 (19.3%)) were obtained as the most common extra-pulmonary characteristics of the patients. Amongst 1188 enrolled patients who were not afflicted with Mycobacterium tuberculosis based on smear/culture essay, clinical symptoms, and Chest x-ray screening, 121 (10.2%) cases had detectable amplified DNA for Mycobacterium Tuberculosis extracted from mediastinal lung lymph nodes. Conclusion: In this survey, the mycobacterium genome was detected in almost 1 per 10 case biopsies of sarcoidosis. The remarkable number of cases (n=1188) evaluated in this study was the strength of this study which supported the hypothesis regarding sarcoidosis and mycobacterium genome correlation. Further investigation, such as case-control surveys, is required to better clarify this association.

Keywords: mycobacterium tuberculosis, sarcoidosis, genome, DNA, trans-bronchial needle aspiration

Procedia PDF Downloads 33
1347 Determinants Affecting to Adoption of Climate Smart Agriculture Technologies in the Northern Bangladesh

Authors: Md. Rezaul Karim, Andreas Thiel

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Bangladesh is known as one of the most climate vulnerable countries in the world. Innovative technologies are always the key responses to the management of climate impacts. The objectives of this study are to determine the farmer’s perception of climate variability, to compare farmers’ perceptions with metrological data, and to explore the determinants that affect the likelihood of adoption of the selected Climate Smart Agricultural (CSA) technologies. Data regarding climate change perception, determinants and adoption were collected based on the household survey from stratified and randomly selected 365 farmers of the Biral sub-district under Dinajpur district in drought-prone northern Bangladesh. The likelihood of adoption of CSA technologies was analyzed following a multivariate probit model. The findings show that about 82.5% of the farmers perceived increasing temperature, and 75.1 % of farmers perceived decreasing dry season rainfall over the years, which is similarly relevant to metrological data. About 76.4.7% and 80.85% of farmers were aware of the drought tolerance crops and vermicompost, respectively; more than half of the farmers adopted these practices. Around 70.7% of farmers were aware of perching for insect control, but 46.3% of farmers adopted this practice. Although two-thirds of farmers were aware of crop diversification and pheromone trap, adoption was lower compared to the other three CSAs. Results also indicate that the likelihood of adoption of the selected CSAs is significantly influenced by different factors such as socio-economic characteristics, institutional factors and perceived technological or innovation attributes. The likelihood of adopting drought tolerance crops is affected by 11, while crop diversification and perching method by 7, pheromone trap by 9 and vermicompost by 8 determining factors. Lack of information and unavailability of input appear to be major obstacles to the non-adoption of CSA technologies. This study suggests that policy implications are necessary to promote extension services and overcome the obstacles to the non-adoption of individual CSA technologies. It further recommends that the research study should be conducted in a diverse context, nationally or globally.

Keywords: determinants, adoption, climate smart agriculture, northern Bangladesh

Procedia PDF Downloads 68
1346 Using Business Simulations and Game-Based Learning for Enterprise Resource Planning Implementation Training

Authors: Carin Chuang, Kuan-Chou Chen

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An Enterprise Resource Planning (ERP) system is an integrated information system that supports the seamless integration of all the business processes of a company. Implementing an ERP system can increase efficiencies and decrease the costs while helping improve productivity. Many organizations including large, medium and small-sized companies have already adopted an ERP system for decades. Although ERP system can bring competitive advantages to organizations, the lack of proper training approach in ERP implementation is still a major concern. Organizations understand the importance of ERP training to adequately prepare managers and users. The low return on investment, however, for the ERP training makes the training difficult for knowledgeable workers to transfer what is learned in training to the jobs at workplace. Inadequate and inefficient ERP training limits the value realization and success of an ERP system. That is the need to call for a profound change and innovation for ERP training in both workplace at industry and the Information Systems (IS) education in academia. The innovated ERP training approach can improve the users’ knowledge in business processes and hands-on skills in mastering ERP system. It also can be instructed as educational material for IS students in universities. The purpose of the study is to examine the use of ERP simulation games via the ERPsim system to train the IS students in learning ERP implementation. The ERPsim is the business simulation game developed by ERPsim Lab at HEC Montréal, and the game is a real-life SAP (Systems Applications and Products) ERP system. The training uses the ERPsim system as the tool for the Internet-based simulation games and is designed as online student competitions during the class. The competitions involve student teams with the facilitation of instructor and put the students’ business skills to the test via intensive simulation games on a real-world SAP ERP system. The teams run the full business cycle of a manufacturing company while interacting with suppliers, vendors, and customers through sending and receiving orders, delivering products and completing the entire cash-to-cash cycle. To learn a range of business skills, student needs to adopt individual business role and make business decisions around the products and business processes. Based on the training experiences learned from rounds of business simulations, the findings show that learners have reduced risk in making mistakes that help learners build self-confidence in problem-solving. In addition, the learners’ reflections from their mistakes can speculate the root causes of the problems and further improve the efficiency of the training. ERP instructors teaching with the innovative approach report significant improvements in student evaluation, learner motivation, attendance, engagement as well as increased learner technology competency. The findings of the study can provide ERP instructors with guidelines to create an effective learning environment and can be transferred to a variety of other educational fields in which trainers are migrating towards a more active learning approach.

Keywords: business simulations, ERP implementation training, ERPsim, game-based learning, instructional strategy, training innovation

Procedia PDF Downloads 142
1345 Use of Information and Communication Technologies in Enhancing Health Care Delivery for Human Immunodeficiency Virus Patients in Bamenda Health District

Authors: Abanda Wilfred Chick

Abstract:

Background: According to World Health Organization (WHO), the role of Information and Communication Technologies (ICT) in health sectors of developing nations has been demonstrated to have had a great improvement of fifty percent reduction in mortality and or twenty-five-fifty percent increase in productivity. The objective of this study was to assess the use of information and communication technologies in enhancing health care delivery for Human Immunodeficiency Virus (HIV) patients in Bamenda Health District. Methods: This was a descriptive-analytical cross-sectional study in which 388 participants were consecutively selected amongst health personnel and HIV patients from public and private health institutions involved in Human Immunodeficiency Virus management. Data on socio-demographic variables, the use of information and communication technologies tools, and associated challenges were collected using structured questionnaires. Descriptive statistics with a ninety-five percent confidence interval were used to summarize findings, while Cramer’s V test, logistic regression, and Chi-square test were used to measure the association between variables, Epi info version7.2, MS Excel, and SPSS version 25.0 were utilized for data entry and statistical analysis respectively. Results: Of the participants, one-quarter were health personnel, and three-quarters were HIV patients. For both groups of participants, there was a significant relationship between the use of ICT and demographic information such as level of education, marital status, and age (p<0.05). For the impediments to using ICT tools, a greater proportion identified the high cost of airtime or internet bundles, followed by an average proportion that indicated inadequate training on ICT tools; for health personnel, the majority said inadequate training on ICT tools/applications and half said unavailability of electricity. Conclusion: Not up to half of the HIV patients effectively make use of ICT tools/applications to receive health care. Of health personnel, three quarters use ICTs, and only one quarter effectively use mobile phones and one-third of computers, respectively, to render care to HIV patients.

Keywords: ICT tools, HIV patients, health personnel, health care delivery

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1344 Rethinking the Smartness for Sustainable Development Through the Relationship between Public and Private Actors

Authors: Selin Tosun

Abstract:

The improvements in technology have started to transform the way we live, work, play, and commute in our cities. The emerging smart city understanding has been paving the way for more efficient, more useful, and more profitable cities. Smart sensors, smart lighting, smart waste, water and electricity management, smart transportation and communication systems are introduced to cities at a rapid pace. In today's world, innovation is often correlated with start-up companies and technological pioneers seeking broader economic objectives such as production and competitiveness. The government's position is primarily that of an enabler, with creativity mostly coming from the private sector. The paper argues that to achieve sustainable development, the ways in which smart and sustainable city approaches are being applied to cities need to be redefined. The research aims to address common discussions in the discourse of smart and sustainable cities criticizing the priority of lifestyle sterilization over human-centered sustainable interventions and social innovation strategies. The dichotomy between the fact that smart cities are mostly motivated by the competitive global market and the fact that the delocalization is, in fact, their biggest problem in the way of becoming authentic, sustainable cities is the main challenge that we face today. In other words, the key actors in smart cities have different and somewhat conflicting interests and demands. By reviewing the roles of the public and private actors in smart city making, the paper aspires to reconceptualize the understanding of “smartness” in achieving sustainable development in which the “smartness” is understood as a multi-layered complex phenomenon that can be channeled through different dynamics. The case cities around the world are explored and compared in terms of their technological innovations, governance and policy innovations, public-private stakeholder relationships, and the understanding of the public realm. The study aims to understand the current trends and general dynamics in the field, key issues that are being addressed, the scale that is preferred to reflect upon and the projects that are designed for the particular issues.

Keywords: smart city, sustainable development, technological innovation, social innovation

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