Search results for: approach to local and institutional level

Authors: Styliani Kotrotsiou, Evagelia Kotrotsiou, Fani Mokia, Theodosis Paralikas, Konstantinos Tsaras

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Objective: The objective of this study was the investigation of the mental health of patients undergoing chronic or transient hemodialysis at Artificial Kidney Unit, as well as its relationship to the demographic characteristic of patients. Material and Method: The study took place in Larisa during the month of December in 2016 and the sample was composed of 60 patients undergoing in chronic or transient hemodialysis at Artificial Kidney Unit of the University General Hospital of Larisa. For the investigation of the physical and mental health of patients who participated in the study, the tool measurement << General Health Questionnaire- 28 >> (GHQ-28) was used. The questionnaires were administered with the interview method during the hemodialysis. This survey is designed for the existence or not of a mental disorder. It examines four factors (physical symptoms, anxiety, social dysfunction and depression). Results: The hemodialysis patients gave the following scores: -to the physical symptoms, women showed a higher average value than men (1,16 ± 1,26 against 0,49 ± 0,93), -at the anxiety scale, it seems that women are superior to men (1,68 ± 1,20 against 0,90 ± 1,22), -at the social dysfunction scale, the elderly patients ( > 65 years old) were presented a with higher average (2,59), and -at the depression scale, patients with a higher average value were those who lived in non-urban areas. The appearance of mental disorder, in relation to patient characteristics, did not show significant statistical correlation. The sex, the age and the place of residence affect more the assessment of mental health, while education did not seem to have any significant effect on the other. Conclusions: The hemodialysis process can significantly affect the patient’s Quality of Life and it can bring adverse changes in lifestyle, affecting the physical, social and psychological state of the individual. For that reason, hemodialysis should be aimed not only at extending life but in upgrading the Quality of Life.

Keywords: hemodialysis, chronic kidney disease, depression, social dysfunction, physical condition

Procedia PDF Downloads 159

Authors: Maryam Borjali

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Introduction. Mortality due to noncommunicable diseases has increased in the world today with the advent of demographic shifts, growing age, and lifestyle patterns in the world, which have been affected by economic and social crises. Congenital heart defects are one of the forms of diseases that have raised infant mortality worldwide. e objective of present study was to identify nonmedical determinants related to this abnormality from the mother’s perspectives. Methods. is research was a qualitative study and the data collection method was a semistructured interview with mothers who had children with congenital heart diseases referring to the Shahid Rajaei Heart Hospital in Tehran, Iran. A thematic analysis approach was employed to analyze transcribed documents assisted by MAXQDA Plus version 12. Results. Four general themes and ten subthemes including social contexts (social harms, social interactions, and social necessities), psychological contexts (mood disorders and mental well-being), cultural contexts (unhealthy lifestyle, family culture, and poor parental health behaviors), and environmental contexts (living area and polluted air) were extracted from interviews with mothers of children with congenital heart diseases. Conclusions. Results suggest that factors such as childhood poverty, lack of parental awareness of congenital diseases, lack of proper nutrition and health facilities, education, and lack of medical supervision during pregnancy were most related with the birth of children with congenital heart disease from mothers’ prospective. In this regard, targeted and intersectorial collaborations are proposed to address nonmedical determinants related to the incidence of congenital heart diseases.

Keywords: congenital_cou, cultural, social, platform

Procedia PDF Downloads 93

Authors: Shamsulhaq Amin

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Drought can arise from several hydrometeorological phenomena that result in insufficient precipitation, soil moisture, and surface and groundwater flow, leading to conditions that are considerably drier than the usual water content or availability. Drought is often assessed using indices that are associated with meteorological, agricultural, and hydrological phenomena. In order to effectively handle drought disasters, it is essential to accurately determine the kind, intensity, and extent of the drought using drought characterization. This information is critical for managing the drought before, during, and after the rehabilitation process. Over a hundred drought assessments have been created in literature to evaluate drought disasters, encompassing a range of factors and variables. Some models utilise solely hydrometeorological drivers, while others employ remote sensing technology, and some incorporate a combination of both. Comprehending the entire notion of drought and taking into account drought indices along with their calculation processes are crucial for researchers in this discipline. Examining several drought metrics in different studies requires additional time and concentration. Hence, it is crucial to conduct a thorough examination of approaches used in drought indices in order to identify the most straightforward approach to avoid any discrepancies in numerous scientific studies. In case of practical application in real-world, categorizing indices relative to their usage in meteorological, agricultural, and hydrological phenomena might help researchers maximize their efficiency. Users have the ability to explore different indexes at the same time, allowing them to compare the convenience of use and evaluate the benefits and drawbacks of each. Moreover, certain indices exhibit interdependence, which enhances comprehension of their connections and assists in making informed decisions about their suitability in various scenarios. This study provides a comprehensive assessment of various drought indices, analysing their types and computation methodologies in a detailed and systematic manner.

Keywords: drought classification, drought severity, drought indices, agricultur, hydrological

Procedia PDF Downloads 32

Authors: Shannon Richards-Green, Suzanne Gough, Sharon Mickan

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Background: Healthcare leaders work in highly complex and rapidly changing environments. Consequently, they need both flexibility and the capacity to hold multiple perspectives simultaneously. My research explored how healthcare leaders understand and make sense (meaning) of their leadership experiences and how this understanding was manifested in their leadership behaviours. Methods: This grounded theory study was conducted via 2 x 1-hour interviews with healthcare leaders within acute care hospitals. A total of 33 hours of interviews were conducted with 17 participants. Participants were recruited using a combination of purposive and snowball sampling. Interviews were recorded, transcribed, and coded to explore emergent patterns and relationships within the data, utilising constant comparative analysis. Adult developmental stage was defined through a subject-object interview with each participant, in alignment with the tenets of constructive development theory. Findings: Participants from acute care hospitals within Australia have participated in the study, with the majority representing the executive leadership level. Broad categories emerging from the data include; Broadening perspectives and abilities as a leader, Dealing with and experiencing conflict within the workplace, Experiencing rewarding times as a leader, and Leading in alignment with a strong personal values system. Discussion: Successfully dealing with complex challenges requires an ability to engage with nuanced perspectives and responses, an integral part of adult developmental growth. In dealing with conflict, for example, leaders at various levels of adult development approached the situation quite differently. Understanding how healthcare leaders make sense of their experiences can assist in providing insights into the value of supporting adult developmental growth in healthcare leadership.

Keywords: leadership, adult development, complexity, growth

Procedia PDF Downloads 68

Authors: Kok Hong Tan, Hing Wah Lee, Jhih-Wei Chen, Chang Fu Dee, Chung-Lin Wu, Siang-Piao Chai, Wei Sea Chang

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Semiconductor photocatalyst is known as one of the key roles in developing clean and sustainable energy. However, most of the semiconductor only possesses photoactivity within the UV light region, and hence, decreases the overall photocatalyst efficiency. Generally, the overall effectiveness of the photocatalyst activity is determined by three critical steps: (i) light absorption efficiency and photoexcitation electron-hole pair generation, (ii) separation and migration of charge carriers to the surface of the photocatalyst, and (iii) surface reaction of the carriers with its environment. Much effort has been invested on optimizing hierarchical nanostructures of semiconductors for efficient photoactivity due to the fact that the visible light absorption capability and occurrence of the chemical reactions mostly depend on the dimension of photocatalysts. In this work, we incorporated zero-dimensional (0D) gold nanoparticles (AuNPs) and one dimensional (1D) Zinc Oxide (ZnO) nanorods (NRs) onto strontium titanate (STO) for efficient visible light absorption, charge transfer, and separation. We demonstrate that the electrical and optical properties of the photocatalyst can be tuned by controlling the dimensional structures of AuNPs and ZnO NRs. We found that smaller AuNPs sizes exhibited higher photoactivity because of Fermi level shifting toward the conductive band of STO, STO band gap narrowing and broadening of absorption spectrum to the visible light region. For ZnO NRs, it was found that the average ZnO NRs c-axis length must achieve of certain length to induce multiphoton absorption as a result of light reflection and trapping behavior in the free space between adjacent ZnO NRs hence broadening the absorption spectrum of ZnO from UV to visible light region. This work opens up a new way of broadening the absorption spectrum by incorporating controllable nanostructures of semiconductors, which is important in optimizing the solar water splitting process.

Keywords: gold nanoparticles, photoelectrochemical, PEC, semiconductor photocatalyst, zinc oxide nanorods

Procedia PDF Downloads 156

Authors: Tansa Nisan Gunerhan

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Dementia comes in different forms, including Alzheimer's disease. The most common dementia diagnosis among elderly individuals is Alzheimer's disease. On average, for patients with Alzheimer’s, life expectancy is around 4-8 years after the diagnosis; however, expectancy can go as high as twenty years or more, depending on the shrinkage of the brain. Normally, along with aging, the brain shrinks at some level but doesn’t lose a vast amount of neurons. However, Alzheimer's patients' neurons are destroyed rapidly; hence problems with loss of memory, communication, and other metabolic activities begin. The toxic changes in the brain affect the stability of the neurons. Beta-amyloid and tau are two proteins that are believed to play a role in the development of Alzheimer's disease through their toxic changes. Beta-amyloid is a protein that is produced in the brain and is normally broken down and removed from the body. However, in people with Alzheimer's disease, the production of beta-amyloid increases, and it begins to accumulate in the brain. These plaques are thought to disrupt communication between nerve cells and may contribute to the death of brain cells. Tau is a protein that helps to stabilize microtubules, which are essential for the transportation of nutrients and other substances within brain cells. In people with Alzheimer's disease, tau becomes abnormal and begins to accumulate inside brain cells, forming neurofibrillary tangles. These tangles disrupt the normal functioning of brain cells and may contribute to their death, forming amyloid plaques which are deposits of a protein called amyloid-beta that build up between nerve cells in the brain. The accumulation of amyloid plaques and neurofibrillary tangles in the brain is thought to contribute to the shrinkage of brain tissue. As the brain shrinks, the size of the brain may decrease, leading to a reduction in brain volume. Brain atrophy in Alzheimer's disease is often accompanied by changes in the structure and function of brain cells and the connections between them, leading to a decline in brain function. These toxic changes that accumulate can cause symptoms such as memory loss, difficulty with thinking and problem-solving, and changes in behavior and personality.

Keywords: Alzheimer, amyloid-beta, brain atrophy, neuron, shrinkage

Procedia PDF Downloads 90

Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou

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The aim of this study was to evaluate the prevalence of dry-mouth symptoms (xerostomia) and compare it with alterations in salivary characteristics of children and adolescents with type 1 diabetes (DM1), as measured with the use of chair-side saliva tests. This study also investigated the possible association between salivary dysfunction and incidence of caries, in relation to the level of metabolic control. A cross-sectional study was performed on young patients (6-18 years old) allocated among 3 groups: 40 patients poorly-controlled (DM1-A, HbA1c>8%), 40 well-controlled (DM1-B, HbA1c≤8%) and 40 age- and sex-matched healthy controls. The study was approved by the Research Ethics Committee of University of Athens and the parents signed written informed consent. All subjects were examined for dental caries, oral hygiene and salivary factors. Assessments of salivary function included self-reported xerostomia, quantification of resting and stimulated whole saliva flow rates, pH values, buffering capacity and saliva’s viscosity. Salivary characteristics were evaluated with the use of GC Saliva Check Buffer (3Μ ESPE). Data were analysed by chi-square and Kruskal-Wallis tests. Subjects with diabetes reported xerostomia more frequently than healthy controls (p<0.05). Unstimulated salivary flow rate and pH values remained significantly lower in DM1-A compared to DM1-B and controls. Low values of resting salivary flow rate were associated with a higher prevalence of dental caries in children and adolescents with poorly-controlled DM1 (p<0.05). The results suggested that diabetes-induced alterations in salivary characteristics are indicative of higher caries susceptibility of diabetics and chair-side saliva tests are a useful tool for the evaluation of caries risk assessment.

Keywords: caries risk assessment, saliva diagnostic tests, type 1 diabetes, xerostomia

Procedia PDF Downloads 279

Authors: Mara Gabrielli, Jordi Pamies Rovira

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From a theoretical and interdisciplinary approach to visual ethnography and visual anthropology, this small scale, in-depth study explores the potential of photography as a participatory ethnographic method for a deep-understanding of the socio-educational integration of young refugees and asylum-seekers in the host society as regards their daily experiences, their needs, desires, expectations, and future goals. Qualitative data is collected by the author by observing 12 young participants in the age group 12-24 years per week for 12 months. The data consists of field notes, participatory observation, in-depth interviews with professionals, and the use of visual participatory ethnographic methods. Therefore, the young participants build their stories through the implementation of two participatory photographic methods - the 'photo-diary' and the 'photo-elicitation' - that permit them to analyse and narrate their social and educational experiences from their perspectives, thus collaborating in the construction of knowledge during the different stages of the research. Preliminary findings show the high resilience and social adaptability of young refugees and asylum-seekers to achieve their goals and overcome structural and socio-cultural barriers. However, the uncertainty of their administrative situation during the asylum submission and the lack of specific resources might impact negatively on their educational pathways and the transition to the labour market. Finally, this study also highlights the benefits of participatory photographic methods in ethnographic research, which impacts positively the well-being of these young people, helps them to develop critical thinking, and it also allows them to access information more respectfully when narrating painful experiences.

Keywords: photo-diary, photo-elicitation, resilience, strategies, visual methodologies, young refugees and asylum seekers

Procedia PDF Downloads 118

Authors: Mardiyansyah Mardiyansyah, Hendrik Maulana, Eka Kurnia Sari, Imam Baehaki, Mohammad Agus Prihandono

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Mobile device has become a key feature in Indonesian society and the economy, including government and private sector. Enterprises and government agencies already have a concern about mobile device security. However, small and medium enterprises (SME) do not have that sense yet, especially the new startups company. Indonesia has several laws, regulations, and standards for managing security in mobile devices. Currently, Indonesian information security policies have not been harmonized, each government organization and large enterprise has its own rules and policies. It leads to a conflict of interest among government agencies. This will certainly cause ineffectiveness in the implementation of policies. Therefore, an analysis of various government policies, regulations, and standards related to information security, especially on mobile devices, is carried out. This analysis is conducted to map the existing regulatory policies and standards into practical guidelines regarding NIST's information security to show the effectiveness of NIST SP 1800-4 towards existing policies. This work focused on the mapping of the NIST SP 1800-4 framework towards existing regulations, standards, and guidelines in Indonesia. The research approach is literature study to identify existing regulations, standards, and guidelines then the regulation mapped into the NIST SP 1800-4 framework and analyzed whether the framework could be applied to the organization in Indonesia. Finally, the finding and recommendations by documenting the security characteristics can be concluded. Based on the research finding, some of the regulations, standards, and guidelines in Indonesia are relevant to the elements in the NIST SP 1800-4 framework. From mapping analysis, the strength and weakness of mobile device security in Indonesia can be reported. It also can be concluded that the application of NIST SP 1800-4 can improve the effectiveness of mobile device security policies in Indonesia.

Keywords: mobile security, mobile security framework, NIST SP 1800-4, regulations

Procedia PDF Downloads 143

Authors: Abraham J. Rizkalla, Tristan D. Yan

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Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.

Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection

Procedia PDF Downloads 80

Authors: Junita Batubara

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Children with special needs, especially those with disability in mental, physical or social/emotional interactions, are marginalized. Many people still view them as troublesome, inconvenience, having learning difficulties, unproductive and burdensome to society. This study intends to investigate; how musical drama can develop the ability to control the coordination of mental functions; how musical dramas can assist children to work together; how musical dramas can assist to maintain the child's emotional and physical health; how musical dramas can improve children creativity. The objectives of the research are: To know whether musical drama can control the coordination of mental function of children; to know whether musical drama can improve communication ability and expression of children; to know whether musical drama can help children work with people around them; to find out if musical dramas can develop the child's emotional and physical health; to find out if musical drama can improve children's creativity. The study employed a qualitative research approach. Data was collecting by listening, observing in depth through public hearings that select the key informants who were teachers and principals, parents and children. The data obtained from each public hearing was then processed (reduced), conclusion drawing/verification, presentation of data (data display). Furthermore, the model obtained was implementing for musical performance, where the benefits of the show are: musical drama can improve language skills; musical dramas are capable of developing memory and storage of information; developing communication skills and express themselves; helping children work together; assisting emotional and physical health; enhancing creativity.

Keywords: children Down syndrome, music, drama script, performance

Procedia PDF Downloads 232

Authors: Marcello De Falco, Gianluca Natrella, Mauro Capocelli

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CO₂ capture and utilization (CCU) is a promising approach to reduce GHG(greenhouse gas) emissions. Many technologies in this field are recently attracting attention. However, since CO₂ is a very stable compound, its utilization as a reagent is energetic intensive. As a consequence, it is unclear whether CCU processes allow for a net reduction of environmental impacts from a life cycle perspective and whether these solutions are sustainable. Among the tools to apply for the quantification of the real environmental benefits of CCU technologies, exergy analysis is the most rigorous from a scientific point of view. The exergy of a system is the maximum obtainable work during a process that brings the system into equilibrium with its reference environment through a series of reversible processes in which the system can only interact with such an environment. In other words, exergy is an “opportunity for doing work” and, in real processes, it is destroyed by entropy generation. The exergy-based analysis is useful to evaluate the thermodynamic inefficiencies of processes, to understand and locate the main consumption of fuels or primary energy, to provide an instrument for comparison among different process configurations and to detect solutions to reduce the energy penalties of a process. In this work, the exergy analysis of a process for the production of Dimethyl Ether (DME) from green hydrogen generated through an electrolysis unit and pure CO₂ captured from flue gas is performed. The model simulates the behavior of all units composing the plant (electrolyzer, carbon capture section, DME synthesis reactor, purification step), with the scope to quantify the performance indices based on the II Law of Thermodynamics and to identify the entropy generation points. Then, a plant optimization strategy is proposed to maximize the exergy efficiency.

Keywords: green DME production, exergy analysis, energy penalties, exergy efficiency

Procedia PDF Downloads 244

Authors: Farhad Fakoursevom

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Heart disease is one of the diseases which is found in abundance today. Various types of surgeries, such as bypasses, angiography, angioplasty, etc., are used to treat patients. People may receive such surgeries, some of which are invasive and some non-invasive, throughout their lives. People might cope with pre-surgery anxiety and stress, which can disrupt their normal life and even reduce the effects of the surgery, so the desired result can not be achieved in surgery. Considering this issue, the present study aimed to do a comparative assessment of people who received sedatives before surgery and people who did not receive sedatives. In terms of the purpose, this is an applied research and descriptive survey in terms of method. The statistical population included patients who underwent surgeries in the specialist heart hospitals of Mashhad, Iran; 60 people were considered as a statistical population, 30 of them received sedatives before surgery, and 30 others had not received sedatives before surgery. Valid and up-to-date articles were systematically used to collect theoretical bases, and a researcher-made questionnaire was used to examine the level of stress and anxiety of people. The questionnaire content validity was assessed by a panel of experts in psychology and medicine. The construct validity was tested using the software. Cronbach's alpha and composite reliability were used for reliability, which shows the appropriate reliability of the questionnaire. SPSS software was used to compare the research results between two groups, and the research findings showed that there is no significant association between the people who received sedatives and those who did not receive sedatives in terms of the amount of stress and anxiety. The longer the time of taking the drugs before the surgery, the more the mental peace of the patients will be. According to the results, it can be said that if we don't need to have an emergency operation and need more time, we have to use sedative drugs with different doses compared to the severity of the surgery, and also in case of a medical emergency such as heart surgery due to a stroke, we have to take advantage of psychological services during and before the operation and sedative drugs so that the patients can control their stress and anxiety and achieve better outcomes.

Keywords: sedative drugs, stress, anxiety, surgery

Procedia PDF Downloads 92

Authors: Badli Shah Mohd Yusoff, Khairur Rijal Jamaludin, Rozetta Dollah

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The emerging of reverse logistics and product recovery management is an important concept in reconciling economic and environmental objectives through recapturing values of the end of life product returns. End of life products contains valuable modules, parts, residues and materials that can create value if recovered efficiently. The main objective of this study is to explore and develop a model to recover as much of the economic value as reasonably possible to find the optimality of return acquisition and sorting to meet demand and maximize profits over time. In this study, the benefits that can be obtained for remanufacturer is to develop demand forecasting of used products in the future with uncertainty of returns and quality of products. Formulated based on a generic disassembly tree, the proposed model focused on three reverse logistics activity, namely refurbish, remanufacture and disposal incorporating all plausible means quality levels of the returns. While stricter sorting policy, constitute to the decrease amount of products to be refurbished or remanufactured and increases the level of discarded products. Numerical experiments carried out to investigate the characteristics and behaviour of the proposed model with mathematical programming model using Lingo 16.0 for medium-term planning of return acquisition, disassembly (refurbish or remanufacture) and disposal activities. Moreover, the model seeks an analysis a number of decisions relating to trade off management system to maximize revenue from the collection of use products reverse logistics services through refurbish and remanufacture recovery options. The results showed that full utilization in the sorting process leads the system to obtain less quantity from acquisition with minimal overall cost. Further, sensitivity analysis provides a range of possible scenarios to consider in optimizing the overall cost of refurbished and remanufactured products.

Keywords: core acquisition, end of life, reverse logistics, quality uncertainty

Procedia PDF Downloads 295

Authors: Fairuz A. Ulinnuha, Bimo K. Fuadi

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The world’s population continues to grow resulting in steady migration from rural to urban areas. Increased numbers of people and cities hand in hand with greater exploitation of world’s resource. Every year, more cities are feeling the devastating of this impact of this situation. During the 1970’s, some of eco-concept were applied to urban settings, one of them is Ecological Cities. A non-profit organization, Urban Ecology, was founded in California in 1975 to 'rebuild cities in balance with nature'. Efforts to synthesize ecological and urban planning approaches were slowed somewhat in the 1980s, but useful refinements were made. Consideration of social impact acknowledges that the ecological design is not just about ecology itself. It is also about questioning and redefining our understanding of the ecology. When ecologist did recognize the existence of cities, they were usually concerned with resource flows. One popular approach was to study the flow and transformation of energy through urban ecosystem. This research method is descriptive method, following LEED Certification which is the international standard of the sustainable building, is more widely applied. But there remains problem that the moral imperative of sustainability and by implication of sustainable design, tends to supplant the disciplinary contribution. Sustainable design is not always seen as design excellence or design innovation. This can provoke the skepticism and cause the tension those who promote disciplinary knowledge and those who push for sustainability. The challenges of rapid urbanization and limited of global resources has become more pressing. So, there is a need to find an alternative design approaches. The urban, as the site of complex relation (economy, political, social, cultural), need a complex problem solving that can solve current and future condition. The aim of this study is to discussed about conjoining of ecology such as public park and sustainable design.

Keywords: ecology, cities, urban, sustainability

Procedia PDF Downloads 131

Authors: Xiaomin Zhong, Alexander Pate, Ya-Ting Yang, Ali Fahmi, Darren M. Ashcroft, Ben Goldacre, Brian Mackenna, Amir Mehrkar, Sebastian C. J. Bacon, Jon Massey, Louis Fisher, Peter Inglesby, Kieran Hand, Tjeerd van Staa, Victoria Palin

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Background: This study aimed to predict risks of potentially inappropriate antibiotic type and repeat prescribing and assess changes during COVID-19. Methods: With the approval of NHS England, we used the OpenSAFELY platform to access the TPP SystmOne electronic health record (EHR) system and selected patients prescribed antibiotics from 2019 to 2021. Multinomial logistic regression models predicted the patient’s probability of receiving an inappropriate antibiotic type or repeating the antibiotic course for each common infection. Findings: The population included 9.1 million patients with 29.2 million antibiotic prescriptions. 29.1% of prescriptions were identified as repeat prescribing. Those with same-day incident infection coded in the EHR had considerably lower rates of repeat prescribing (18.0%), and 8.6% had a potentially inappropriate type. No major changes in the rates of repeat antibiotic prescribing during COVID-19 were found. In the ten risk prediction models, good levels of calibration and moderate levels of discrimination were found. Important predictors included age, prior antibiotic prescribing, and region. Patients varied in their predicted risks. For sore throat, the range from 2.5 to 97.5th percentile was 2.7 to 23.5% (inappropriate type) and 6.0 to 27.2% (repeat prescription). For otitis externa, these numbers were 25.9 to 63.9% and 8.5 to 37.1%, respectively. Interpretation: Our study found no evidence of changes in the level of inappropriate or repeat antibiotic prescribing after the start of COVID-19. Repeat antibiotic prescribing was frequent and varied according to regional and patient characteristics. There is a need for treatment guidelines to be developed around antibiotic failure and clinicians provided with individualised patient information.

Keywords: antibiotics, infection, COVID-19 pandemic, antibiotic stewardship, primary care

Procedia PDF Downloads 111

Authors: Samira Eskandari

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The image of Tehran has been impacted in recent years due to poor urban management and fragmented governance. There is no cohesive urban beautification framework in Tehran to enforce builders take aesthetic factors seriously when design and construct new buildings. The existing guidelines merely provide people with recommendations, not regulations. Obviously, Tehran needs a more comprehensive and strict urban beautification framework to restore its image. The damaged image has impacted the city’s social, economic and environmental growth. This research aims to find and examine a solution by which the employment of urban beautification regulation would be guaranteed, and city image would be organized. The methodology is based on a qualitative approach associated with analytical methods, in-depth surveys and interviews with Tehran citizens, authorities and experts, and use of academic resources as well as simulation. As a result, one practical solution is to incorporate aesthetic guidelines into a survival-related framework like a seismic guideline. Tehran is a seismic site, and all the buildings in Tehran have to be retrofitted against earthquake during construction. Hence, by integrating seismic regulations and aesthetic disciplines, urban beautification will be somehow guaranteed. Besides, the seismic image can turn into Tehran’s brand and enhances city identity. This research is trying to increase the social, environmental, and economic interconnectedness between urban planning and seismic planning by the usage of landscape architecture methods. As a case study, the potential outcomes are simulated in Tajrish, a suburb located in the north of Tehran. The result is that, by the redefinition of the morphology of seismic retrofitting systems, used in the significant city image elements, and re-function them in accordance with the Iranian culture and traditions, the city image would become more harmonized and legible.

Keywords: earthquake, retrofitting systems, Tehran image, urban beautification

Procedia PDF Downloads 129

Authors: Mehmet Akif Bütüner, İlhan Koşalay

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Hydroelectric power plants (HEPPs) are renewable energy power plants with the highest installed power in the world. While the control systems operating in these power plants ensure that the system operates at the desired operating point, it is also responsible for stopping the relevant unit safely in case of any malfunction. While these control systems are expected not to miss signals that require stopping, on the other hand, it is desired not to cause unnecessary stops. In traditional control systems including modern systems with SCADA infrastructure, alarm conditions to create warnings or trip conditions to put relevant unit out of service automatically are usually generated with predefined limits regardless of different operating conditions. This approach results in alarm/trip conditions to be less likely to detect minimal changes which may result in serious malfunction scenarios in near future. With the methods proposed in this research, routine behavior of the oil circulation of hydraulic governor of a HEPP will be modeled with machine learning methods using historical data obtained from SCADA system. Using the created model and recently gathered data from control system, oil pressure of hydraulic accumulators will be estimated. Comparison of this estimation with the measurements made and recorded instantly by the SCADA system will help to foresee failure before becoming worse and determine remaining useful life. By using model outputs, maintenance works will be made more planned, so that undesired stops are prevented, and in case of any malfunction, the system will be stopped or several alarms are triggered before the problem grows.

Keywords: hydroelectric, governor, anomaly detection, machine learning, regression

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Authors: Carolina Aparicio-Fernández, Alejandro Vilar Abad, Mar Cañada Soriano, Jose-Luis Vivancos

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The building sector is responsible for 40% of the total energy consumption in the European Union (EU). Thus, implementation of strategies for quantifying and reducing buildings energy consumption is indispensable for reaching the EU’s carbon neutrality and energy efficiency goals. Each Member State has transposed the European Directives according to its own peculiarities: existing technical legislation, constructive solutions, climatic zones, etc. Therefore, in accordance with the Energy Performance of Buildings Directive, Member States have developed different Energy Performance Certificate schemes, using proposed energy simulation software-tool for each national or regional area. Energy Performance Certificates provide a powerful and comprehensive information to predict, analyze and improve the energy demand of new and existing buildings. Energy simulation software and databases allow a better understanding of the current constructive reality of the European building stock. However, Energy Performance Certificates still have to face several issues to consider them as a reliable and global source of information since different calculation tools are used that do not allow the connection between them. In this document, TRNSYS (TRaNsient System Simulation program) software is used to calculate the energy demand of a building, and it is compared with the energy labeling obtained with Spanish Official software-tools. We demonstrate the possibility of using not official software-tools to calculate the Energy Performance Certificate. Thus, this approach could be used throughout the EU and compare the results in all possible cases proposed by the EU Member States. To implement the simulations, an isolated single-family house with different construction solutions is considered. The results are obtained for every climatic zone of the Spanish Technical Building Code.

Keywords: energy demand, energy performance certificate EPBD, trnsys, buildings

Procedia PDF Downloads 120

Authors: Amel M. A. Osman, Roy Mahony, Lisa Dann, McKenna S.

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Background: Computed Tomography (CT) is a significant source of radiation in the pediatric population. A new head injury (HI) pathway was introduced in 2021, which altered the previous process of HI being jointly admitted with general pediatrics and surgery to admit these patients under the Emergency Medicine Team. Admitted patients included those with positive CT findings not requiring immediate neurosurgical intervention and those who did not meet current criteria for urgent CT brain as per NICE guidelines but were still symptomatic for prolonged observations. This approach aims to decrease the number of CT scans performed. The main aim is to assess the variation in CT scanning rates since the change in the admitting process. A retrospective review of patients presenting to CHI PECU with HI over 6-month period (01/01/19-31/05/19) compared to a 6-month period post introduction of the new pathway (01/06/2022-31/12/2022). Data was collected from the electronic record databases, symphony, and PACS. Results: In 2019, there were 869 presentations of HI, among which 32 (3.68%) had CT scans performed. 2 (6.25%) of those scanned had positive findings. In 2022, there were 1122 HI presentations, with 47 (4.19%) CT scans performed and positive findings in 5 (10.6%) cases. 57 patients were admitted under the new pathway for observation, with 1 having a CT scan following admission. Conclusion: Quantitative lifetime radiation risks for children are not negligible. While there was no statistically significant reduction in CTs performed amongst HIs presenting to our department, a significant group met the criteria for admission under the PECU consultant for prolonged monitoring. There was also a greater proportion of abnormalities on CT scans performed in 2022, demonstrating improved patient selection for imaging. Further data analysis is ongoing to determine if those who were admitted would have previously been scanned under the old pathway.

Keywords: head injury, CT, admission, guidline

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Authors: Bhairi Lakshminarayana, Surajit Sarker, Ch. Subrahmanyam

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The present study reports the development of noble metal free nano catalysts for low-temperature CO oxidation and water gas shift reaction. Mn-substituted CeO2 solid solution catalysts were synthesized by co-precipitation, combustion and hydrothermal methods. The formation of solid solution was confirmed by XRD with Rietveld refinement and the percentage of carbon and nitrogen doping was ensured by CHNS analyzer. Raman spectroscopic confirmed the oxygen vacancies. The surface area, pore volume and pore size distribution confirmed by N2 physisorption analysis, whereas, UV-visible diffuse reflectance spectroscopy and XPS data confirmed the oxidation state of the Mn ion. The particle size and morphology (spherical shape) of the material was confirmed using FESEM and HRTEM analysis. Ce0.8Mn0.2O2-δ was calcined at 400 °C, 600 °C and 800 °C. Raman spectroscopy confirmed that the catalyst calcined at 400 °C has the best redox properties. The activity of the designed catalysts for CO oxidation (0.2 vol%), carried out with GHSV of 21,000 h-1 and it has been observed that co-precipitation favored the best active catalyst towards CO oxidation and water gas shift reaction, due to the high surface area, improved reducibility, oxygen mobility and highest quantity of surface oxygen species. The activation energy of low temperature CO oxidation on Ce0.8Mn0.2O2- δ (combustion) was 5.5 kcal.K-1.mole-1. The designed catalysts were tested for water gas shift reaction. The present study demonstrates that Mn ion substituted ceria at 400 °C calcination temperature prepared by co-precipitation method promise to revive a green sustainable energy production approach.

Keywords: Ce0.8Mn0.2O2-ð, CO oxidation, physicochemical characterization, water gas shift reaction (WGS)

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Authors: Md. Mizanoor Rahman, Md. Zakir Hossain Talukder, M. Mahruf C. Shohel, Prithvi Shrestha

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In Bangladesh, classroom practice and English Learning (EL) competencies acquired both by the teacher and learner in primary and secondary schools are still very weak. Therefore, English is the most commonly failed examination subject at the school level; in addition, there are severe problems in communicative English by the Bangladeshi nationals– this has been characterized as a constraint to economic development. Job applicants and employees often lack English language skills necessary to work effectively. As a result; both government and its international development partners such as DFID, UNESCO, and CIDA have been very active to uplift the quality of the English language learning and implementing projects with innovative approaches. Recently; the economy has been increasing and in line with this, the technology has been deployed in English learning to improve reading, writing, speaking and listening skills. Young Bangladeshi creative, from a variety of backgrounds including film, animation, photography, and digital media are being trained to develop ideas for English Language Teaching (ELT) media. They are being motivated to develop a wide range of ideas for low cost English learning media products. English Language education policy in Bangladesh supports communicative language teaching practices and accordingly, actors have been influencing curriculum, textbook, deployment of technology and assessment changes supporting communicative ELT. The various projects are also being implemented to reform the curriculum, revise the textbook and adjust the assessment mechanism so that the country can increase in proficiency in communicative English among the population. At present; the numbers of teachers, students and adult learners classified at higher levels of proficiency because of deployment of technology and motivation for learning and using English among school population of Bangladesh. The current paper discusses the various interventions in Bangladesh with appropriate media to improve the competencies of the ELT among population.

Keywords: English learning, technology, education, psychological sciences

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Authors: Annisa Ulfah Pristya, Andi Setiawan

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Indonesia placed in sixth rank total Acute Respiratory Infection (ARI) patient in the world and Riau as one of the province with the highest number of people with respiratory infection in Indonesia reached 37 thousand people. Usually society using a mask as prevention action. Unfortunately the commercial mouth mask only can work maximum for 4 hours and the pores are too large to filter out microorganisms and viruses carried by infectious droplets nucleated 1-5 μm. On the other hand, Indonesia is rich with Titanium dioxide (TiO2) and purple sweet potato anthocyanin pigment. Therefore, offered Bio-nano-mask which is a antimicrobial and antiviral mouth mask with Nano-TiO2 coating and purple sweet potato anthocyanins utilization as an effective solution to high ARI patients in Riau, which has the advantage of the mask surface can’t be attached by infectious droplets, self-cleaning and have anthocyanins biosensors that give visual response can be understood easily by the general public in the form of a mask color change from blue/purple to pink when acid levels increase. Acid level is an indicator of microorganisms accumulation in the mouth and surrounding areas. Bio-nano mask making process begins with the preparation (design, Nano-TiO2 liquid preparation, anthocyanins biosensors manufacture) and then superimposing the Nano-TiO2 on the outer surface of spunbond color using a sprayer, then superimposing anthocyanins biosensors film on the Meltdown surface, making bio nano-mask and it pack. Bio-nano mask has the advantage is effectively preventing pathogenic microorganisms and infectious droplets and has accumulated indicator microorganisms that color changes which easily observed by the common people though.

Keywords: anthocyanins, ARI, nano-TiO2 liquid, self cleaning

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Authors: Trunov V.O., Ryabov A. B., Poddubny I.V

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Introduction: cystic and solid pancreatic tumors have a relevant and disruptive position in many positions. The results of the treatment of children with tumors and pancreatic cysts aged 3 to 17 years for the period from 2008 to 2019 on the basis of the Morozov State Children's Clinical Hospital in Moscow were analyzed. The total number of children with solid tumors was 17, and 31 with cysts. In all children, the diagnosis was made on the basis of ultrasound, followed by CT and MRI. In most patients with solid tumors, they were located in the area of the pancreas tail - 58%, in the body area - 14%, in the area of the pancreatic head - 28%. In patients with pancreatic cysts, the distribution of patients by topography was as follows: head of the pancreas - 10%, body of the pancreas - 16%, tail of the pancreas - 68%, total cystic transformation of the Wirsung duct - 6%. In pancreatic cysts, the method of surgical treatment was based on the results of MRCP, the level of amylase in the contents of the cyst, and the localization of the cyst. Thus, pathogenetically substantiated treatment included: excision of cysts, internal drainage on an isolated loop according to Ru, the formation of pancreatojejunoanastomosis in a child with the total cystic transformation of the Wirsung duct. In patients with solid pancreatic lesions, pancretoduodenalresection, central resection of the pancreas, and distal resection from laparotomy and laparoscopic access were performed. In the postoperative period, in order to prevent pancreatitis, all children underwent antisecretory therapy, parenteral nutrition, and drainage of the omental bursa. Results: hospital stay ranged from 7 to 12 days. The duration of postoperative fermentemia in patients with solid formations lasted from 3 to 6 days. In all cases, according to the histological examination, a pseudopapillary tumor of the pancreas was revealed. In the group of children with pancreatic cysts, fermentemia was observed from 2 to 4 days, recurrence of cysts in the long term was detected in 3 children (10%). Conclusions: the treatment of cystic and solid pancreatic neoplasms is a difficult task in connection with the anatomical and functional features of the organ.

Keywords: pancreas, tumors, cysts, resection, laparoscopy, children

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Authors: Shazia Anwer

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This paper has discussed the unusual form of resistance in theatre against censorship board in Pakistan. The atypical approach of dramaturgy created massive space for performers and audiences to integrate and communicate. The social and religious absolutes creates suffocation in Pakistani society, strict control over all Fine and Performing Art has made art political, contemporary dramatics has started an amalgamated theatre to avoid censorship. Contemporary Punjabi theatre techniques are directly dependent on human cognition. The idea of indirect thought processing is not unique but dependent on spectators. The paper has provided an account of these techniques and their specific use for conveying specific messages across the audiences. For the Dramaturge of today, theatre space is an expression representing a linguistic formulation that includes qualities of experimental and non-traditional use of classical theatrical space in the context of fulfilling the concept of open theatre. Paper has explained the transformation of the theatrical experience into an event where the actor and the audience are co-existing and co-experiencing the dramatical experience. The denial of the existence of the 4th -Wall made two-way communication possible. This paper has elaborated that the previously marginalized genres such as naach, jugat, miras, are extensively included to counter the censorship board. Figurativeness, visual elements, allegory, scenic imagery are basic support system for contemporary Punjabi theatre. The body of the actor is used as a source for non-verbal communication, and for an escape from traditional theatrical space which by every means has every element that could be controlled and reprimanded by the controlling authority.

Keywords: communication, Punjabi theatre, figurativeness, censorship

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Authors: Mohammed Ahmed Ahmed Odah

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DNA barcoding is a crucial method for assessing and monitoring species diversity amidst escalating threats to global biodiversity. The author explores DNA barcoding's potential as a robust and reliable tool for biodiversity assessment. It begins with a comprehensive review of existing literature, delving into the theoretical foundations, methodologies and applications of DNA barcoding. The suitability of various DNA regions, like the COI gene, as universal barcodes is extensively investigated. Additionally, the advantages and limitations of different DNA sequencing technologies and bioinformatics tools are evaluated within the context of DNA barcoding. To evaluate the efficacy of DNA barcoding, diverse ecosystems, including terrestrial, freshwater and marine habitats, are sampled. Extracted DNA from collected specimens undergoes amplification and sequencing of the target barcode region. Comparison of the obtained DNA sequences with reference databases allows for the identification and classification of the sampled organisms. Findings demonstrate that DNA barcoding accurately identifies species, even in cases where morphological identification proves challenging. Moreover, it sheds light on cryptic and endangered species, aiding conservation efforts. The author also investigates patterns of genetic diversity and evolutionary relationships among different taxa through the analysis of genetic data. This research contributes to the growing knowledge of DNA barcoding and its applicability for biodiversity assessment. The advantages of this approach, such as speed, accuracy and cost-effectiveness, are highlighted, along with areas for improvement. By unlocking the genetic code, DNA barcoding enhances our understanding of biodiversity, supports conservation initiatives and informs evidence-based decision-making for the sustainable management of ecosystems.

Keywords: DNA barcoding, biodiversity assessment, genetic code, species identification, taxonomic resolution, next-generation sequencing

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Authors: Atour Taghipour

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In the real world each manufacturing company is an independent business unit. These business units are linked to each other through upstream and downstream linkages. The management of these linkages is called coordination which, could be considered as a difficult engineering task. The degree of difficulty of coordination depends on the type and the nature of information exchanged between partners as well as the structure of relationship from mutual to the network structure. The literature of manufacturing systems comprises a wide range of varieties of methods and approaches of coordination. In fact, two main streams of research can be distinguished: central coordination versus decentralized coordination. In the centralized systems a high degree of information exchanges is required. The high degree of information exchanges sometimes leads to difficulties when independent members do not want to share information. In order to address these difficulties, decentralized approaches of coordination of operations planning decisions based on some minimal information sharing have been proposed in many academic disciplines. This paper first proposes a framework of analysis in order to analyze the proposed approaches in the literature, based on this framework which includes the similarities between approaches we categorize the existing approaches. This classification can be used as a research map for future researches. The result of our paper highlights several opportunities for future research. First, it is proposed to develop more dynamic and stochastic mechanisms of planning coordination of manufacturing units. Second, in order to exploit the complementarities of approaches proposed by diverse science discipline, we propose to integrate the techniques of coordination. Finally, based on our approach we proposed to develop coordination standards to guaranty both the complementarity of these approaches as well as the freedom of companies to adopt any planning tools.

Keywords: network coordination, manufacturing, operations planning, supply chain

Procedia PDF Downloads 273

Authors: R. Barros, J. Azevedo, P. Padrão, M. Gregório, I. Pádua, C. Almeida, C. Rodrigues, P. Fontes, A. Coelho

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Recent evidence shows a positive association between nutritional literacy and healthy eating. Traditional nutrition education strategies for childhood obesity prevention have shown weak effect. The Nutriscience project aims to create and evaluate an innovative and multidisciplinary strategy for promoting effective and accessible nutritional information to children, their families, and educators. Nutriscience is a one-year prospective follow-up evaluation study including pre-school children (3-5 y), who attend national schools’ network (29). The project is structured around a web-based intervention, using an on-line interactive platform, and focus on increasing fruit and vegetable consumption, and reducing sugar and salt intake. The platform acts as a social network where educational materials, games, and nutritional challenges are proposed in a gamification approach that promotes family and community social ties. A nutrition Massive Online Open Course is developed for educators, and a national healthy culinary contest will be promoted on TV channel. A parental self-reported questionnaire assessing sociodemographic and nutritional literacy (knowledge, attitudes, skills) is administered (baseline and end of the intervention). We expect that results on nutritional literacy from the presented strategy intervention will give us important information about the best practices for health intervention with kindergarten families. This intervention program using a digital interactive platform could be an educational tool easily adapted and disseminated for childhood obesity prevention.

Keywords: childhood obesity, educational tool, nutritional literacy, web-based intervention

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Authors: Pinar Sali, Esim Gursoy, Ebru Atak Damar

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Teachers’ awareness of and involvement in educational research (ER) is regarded as an indispensable aspect of professional growth and development. It is also believed to be a catalyst for effective teaching and learning. This strong emphasis on the significance of teacher research engagement has sparked inquiry into how teachers construe ER and whether or not they practice it. However, there seems to exist a few researches on teachers’ perceptions of and experience with ER in the field of English Language Teaching (ELT). The present study thus attempts to fill this gap in the ELT literature and aims to unearth English language teachers’ perceptions of ER. Understanding these perceptions would undoubtedly aid in the development of strategies to promote teacher interest and involvement in research. The participants of the present study are 70 English language teachers in public and private schools in Turkey. A mixed-method approach has been used in the study. Both qualitative and quantitative data have been gathered by means of a questionnaire consisting of two parts. The first part of the questionnaire consists of 20 close-ended items of Teachers’ Attitude Scale Towards Educational Research (TASTER). The second part of the questionnaire has been developed by the researchers via an extensive literature review and consists of a mixture of close- and open-ended questions. In addition, 15 language teachers have been interviewed for an in-depth understanding of the results. Descriptive statistics and dual comparisons have been employed for the quantitative data, and the qualitative data have been analyzed by means of content analysis. The present study provides intriguing information as to the English language teachers’ perceptions of the usefulness and practicality of ER as well as the value they attain to it. The findings are discussed in relation to language teacher education. The research has implications for the teacher education process, teacher trainers and policy makers.

Keywords: attitudes toward educational research, educational research, language teachers, teacher research

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Authors: Steve Fish, Chris Lambert

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Cumbria is a geo-political county in Northwest England within which the Lake District National Park, a UNESCO World Heritage site is located. Whilst the area has a formidable reputation for natural beauty and historic assets, the innovation ecosystem is described as ‘patchy’ for a number of reasons. The county is one of the largest in England by area and is sparsely populated. This paper describes the needs, development and delivery of an SME business-support programme funded by the European Regional Development Fund, Lancaster University and the University of Cumbria. The Cumbria Innovations Platform (CUSP) Project has been designed to respond to the nuanced needs of SMEs in this locale, whilst promoting the adoption of research and innovation. CUSP utilizes a funnel method to support rural businesses with access to university innovation intervention. CUSP has been built on a three-tier model: Communicate, Collaborate and Create. The paper describes this project in detail and presents results in terms of output indicators achieved, a beneficiary telephone survey and wider economic forecasts. From a pragmatic point-of-view, the paper provides experiences and reflections of those people who are delivering and evaluating knowledge exchange. The authors discuss some of the benefits, challenges and implications for both policy makers and practitioners. Finally, the paper aims to serve as an invitation to others who may consider adopting a similar method of university-industry collaboration in their own region.

Keywords: regional business support, rural business support, university-industry collaboration, collaborative R&D, SMEs, knowledge exchange

Procedia PDF Downloads 112