Search results for: case – II waters
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11615

Search results for: case – II waters

9215 Developing a Cultural Policy Framework for Small Towns and Cities

Authors: Raymond Ndhlovu, Jen Snowball

Abstract:

It has long been known that the Cultural and Creative Industries (CCIs) have the potential to aid in physical, social and economic renewal and regeneration of towns and cities, hence their importance when dealing with regional development. The CCIs can act as a catalyst for activity and investment in an area because the ‘consumption’ of cultural activities will lead to the activities and use of other non-cultural activities, for example, hospitality development including restaurants and bars, as well as public transport. ‘Consumption’ of cultural activities also leads to employment creation, and diversification. However, CCIs tend to be clustered, especially around large cities. There is, moreover, a case for development of CCIs around smaller towns and cities, because they do not rely on high technology inputs, and long supply chains, and, their direct link to rural and isolated places makes them vital in regional development. However, there is currently little research on how to craft cultural policy for regions with smaller towns and cities. Using the Sarah Baartman District (SBDM) in South Africa as an example, this paper describes the process of developing cultural policy for a region that has potential, and existing, cultural clusters, but currently no one, coherent policy relating to CCI development. The SBDM was chosen as a case study because it has no large cities, but has some CCI clusters, and has identified them as potential drivers of local economic development. The process of developing cultural policy is discussed in stages: Identification of what resources are present; including human resources, soft and hard infrastructure; Identification of clusters; Analysis of CCI labour markets and ownership patterns; Opportunities and challenges from the point of view of CCIs and other key stakeholders; Alignment of regional policy aims with provincial and national policy objectives; and finally, design and implementation of a regional cultural policy.

Keywords: cultural and creative industries, economic impact, intrinsic value, regional development

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9214 Detection of the Effectiveness of Training Courses and Their Limitations Using CIPP Model (Case Study: Isfahan Oil Refinery)

Authors: Neda Zamani

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The present study aimed to investigate the effectiveness of training courses and their limitations using the CIPP model. The investigations were done on Isfahan Refinery as a case study. From a purpose point of view, the present paper is included among applied research and from a data gathering point of view, it is included among descriptive research of the field type survey. The population of the study included participants in training courses, their supervisors and experts of the training department. Probability-proportional-to-size (PPS) was used as the sampling method. The sample size for participants in training courses included 195 individuals, 30 supervisors and 11 individuals from the training experts’ group. To collect data, a questionnaire designed by the researcher and a semi-structured interview was used. The content validity of the data was confirmed by training management experts and the reliability was calculated through 0.92 Cronbach’s alpha. To analyze the data in descriptive statistics aspect (tables, frequency, frequency percentage and mean) were applied, and inferential statistics (Mann Whitney and Wilcoxon tests, Kruskal-Wallis test to determine the significance of the opinion of the groups) have been applied. Results of the study indicated that all groups, i.e., participants, supervisors and training experts, absolutely believe in the importance of training courses; however, participants in training courses regard content, teacher, atmosphere and facilities, training process, managing process and product as to be in a relatively appropriate level. The supervisors also regard output to be at a relatively appropriate level, but training experts regard content, teacher and managing processes as to be in an appropriate and higher than average level.

Keywords: training courses, limitations of training effectiveness, CIPP model, Isfahan oil refinery company

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9213 Vertebral Artery Dissection Complicating Pregnancy and Puerperium: Case Report and Review of the Literature

Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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9212 Water Productivity as an Indicator of Bioenergetic Sustainability in Sugarcane

Authors: Rubens Duarte Coelho, Timóteo Herculino da Silva Barros, Jefferson de Olveira Costa

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Brazil has an electrical matrix of predominantly renewable origin, with emphasis on water sources, which account for 65.2%, biomass energy for 8.2%, wind for 6.8% and solar for 0.13% of the domestic supply. Among these sources, sugarcane cultivation stands out, aiming both at the production of bioethanol and biomass to supply “clean energy”. However, like all other crops, sugar cane demands a large volume of a natural resource that is increasingly “scarce” in quantity and quality: water. Adequate and strategic water management throughout the entire sugarcane cycle is of fundamental importance, and water productivity can be used to adjust irrigation planning and decision-making, increasing the productivity of stalks, bioethanol, biomass, and sugar. In this way, water productivity is a good indicator for analysis and decision-making considering the sustainability of cultivation, as it allows evaluation of the variation in the ratio between production and the amount of water used, suggesting values that maximize the use of this natural resource. In this context, studies that relate water demand, in this case, expressed by water productivity, with the energy production of this crop, in this case, expressed by the production of bioethanol, biomass and sugar, are fundamental to obtaining an efficient production of renewable energy, which aims at the rational use of natural resources, especially water. The objective of the present work was to evaluate the response of sugarcane varieties subjected to different water availability to obtain better sustainability in bioenergy production, presenting water productivity indices for Bioethanol, Sugar and Biomass. The variety that responded best was RB966928, with a bioethanol yield of 68.7 L Mg-1. Future research should focus on the water response under each of the sugarcane fractions in terms of their elemental composition so that the influence of water on the energy supply of this crop can be better understood.

Keywords: energy matrix, water use, water use efficiency, sustainability

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9211 Social Media Advertising and Acceptability of Fast Moving Consumer Goods in Nigeria’s Manufacturing Industry

Authors: John Akinwumi Makinde

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Nigerian manufacturing industry, particularly the fast moving consumer producing firms play vital roles in Nigerian economy. This sector’s product acceptability is given very little attention along with social media advertising that communicate product information to audience across the globe need to be documented. Procter and Gamble Plc operate in Nigeria with appreciable number of fast moving consumer goods that service Nigerian economy. Social media advertising disposition of the company and product acceptability of the company deserve some elucidations. This study therefore examined the impact of social media advertising on product acceptability of FMCG in Nigerian manufacturing industry, using Procter and Gamble Plc as case study. The study employed the case study type of descriptive survey research design. The population consisted of 235 customers of G&P Plc, which were selected through random sampling method. A total of 235 copies of questionnaires titled 'Social Media Advertising and Product Acceptability (SMA-PA) Questionnaire' was administered and retrieved. Data generated were analysed using frequency distribution and regression analysis at 0.05 level. It was found that social media advertising positively and significantly motivated customers to buy product of P&G Plc (r =.147**, N= 235, p(.000) < .01). Findings also showed that social media advertising has significant impact on product acceptability of FCMG in P&G Plc (F(2,61)=22.250; R2=.629; P(.000) < .05). The study concluded that social media advertising is a determinant factor of consumer decision to accept fast moving consumer goods in Nigerian manufacturing industry. It is recommended that with the growing market of FMCG, there is need to educate the market with the product unique features, standard and quality on social media. Finally, Fast Moving Consumer Goods firms should deploy excellent marketing mix on social media.

Keywords: advertising, fast moving consumer goods, manufacturing industry, product acceptability, social media

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9210 Anaesthetic Management of Retropharyngeal Abscess in a Child

Authors: Sudha Puhal, Dr Rajmala Jaiswal

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Retropharyngeal abscess occurs most commonly in children following acute upper respiratory tract and ear infection. Airway management in retropharyngeal abscess is an anesthetic challenge due to distortion of airway anatomy and the possibility of spontaneous rupture of abscess leading to aspiration or stridor due to laryngeal edema.. In this report we present a case of retropharyngeal abscess in a child, which was drained under general anaesthesia successfully without any complications.

Keywords: abscess, airway, difficult, retropharyngeal

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9209 Homogeneity among Diversity

Authors: Yu Guang

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“Case studies are the preferred strategy when ‘how’ or ‘why’ questions are being posed.” Therefore, the study is based on two cases: strategy performed in JingNan War and by NIKE. The two samples are chosen as they are of comparability. Data are gathered and PEST and SWOT are used as analysis models to examine their strategic employment in order that the answer to brilliant strategies in variety is found. The niche strategy has been used in the past and present, in the battle fields and business. The homogeneity among diversity is the skill of performing strategies.

Keywords: challenger, homogeneity, managing diversity, niche strategy

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9208 Optimizing Stormwater Sampling Design for Estimation of Pollutant Loads

Authors: Raja Umer Sajjad, Chang Hee Lee

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Stormwater runoff is the leading contributor to pollution of receiving waters. In response, an efficient stormwater monitoring program is required to quantify and eventually reduce stormwater pollution. The overall goals of stormwater monitoring programs primarily include the identification of high-risk dischargers and the development of total maximum daily loads (TMDLs). The challenge in developing better monitoring program is to reduce the variability in flux estimates due to sampling errors; however, the success of monitoring program mainly depends on the accuracy of the estimates. Apart from sampling errors, manpower and budgetary constraints also influence the quality of the estimates. This study attempted to develop optimum stormwater monitoring design considering both cost and the quality of the estimated pollutants flux. Three years stormwater monitoring data (2012 – 2014) from a mix land use located within Geumhak watershed South Korea was evaluated. The regional climate is humid and precipitation is usually well distributed through the year. The investigation of a large number of water quality parameters is time-consuming and resource intensive. In order to identify a suite of easy-to-measure parameters to act as a surrogate, Principal Component Analysis (PCA) was applied. Means, standard deviations, coefficient of variation (CV) and other simple statistics were performed using multivariate statistical analysis software SPSS 22.0. The implication of sampling time on monitoring results, number of samples required during the storm event and impact of seasonal first flush were also identified. Based on the observations derived from the PCA biplot and the correlation matrix, total suspended solids (TSS) was identified as a potential surrogate for turbidity, total phosphorus and for heavy metals like lead, chromium, and copper whereas, Chemical Oxygen Demand (COD) was identified as surrogate for organic matter. The CV among different monitored water quality parameters were found higher (ranged from 3.8 to 15.5). It suggests that use of grab sampling design to estimate the mass emission rates in the study area can lead to errors due to large variability. TSS discharge load calculation error was found only 2 % with two different sample size approaches; i.e. 17 samples per storm event and equally distributed 6 samples per storm event. Both seasonal first flush and event first flush phenomena for most water quality parameters were observed in the study area. Samples taken at the initial stage of storm event generally overestimate the mass emissions; however, it was found that collecting a grab sample after initial hour of storm event more closely approximates the mean concentration of the event. It was concluded that site and regional climate specific interventions can be made to optimize the stormwater monitoring program in order to make it more effective and economical.

Keywords: first flush, pollutant load, stormwater monitoring, surrogate parameters

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9207 Identifying Lead Poisoning Risk Factors among Non-Pregnant Adults in New York City through Motivational Interviewing Techniques

Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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9206 Energy Retrofitting Application Research to Achieve Energy Efficiency in Hot-Arid Climates in Residential Buildings: A Case Study of Saudi Arabia

Authors: A. Felimban, A. Prieto, U. Knaack, T. Klein

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This study aims to present an overview of recent research in building energy-retrofitting strategy applications and analyzing them within the context of hot arid climate regions which is in this case study represented by the Kingdom of Saudi Arabia. The main goal of this research is to do an analytical study of recent research approaches to show where the primary gap in knowledge exists and outline which possible strategies are available that can be applied in future research. Also, the paper focuses on energy retrofitting strategies at a building envelop level. The study is limited to specific measures within the hot arid climate region. Scientific articles were carefully chosen as they met the expression criteria, such as retrofitting, energy-retrofitting, hot-arid, energy efficiency, residential buildings, which helped narrow the research scope. Then the papers were explored through descriptive analysis and justified results within the Saudi context in order to draw an overview of future opportunities from the field of study for the last two decades. The conclusions of the analysis of the recent research confirmed that the field of study had a research shortage on investigating actual applications and testing of newly introduced energy efficiency applications, lack of energy cost feasibility studies and there was also a lack of public awareness. In terms of research methods, it was found that simulation software was a major instrument used in energy retrofitting application research. The main knowledge gaps that were identified included the need for certain research regarding actual application testing; energy retrofitting strategies application feasibility; the lack of research on the importance of how strategies apply first followed by the user acceptance of developed scenarios.

Keywords: energy efficiency, energy retrofitting, hot arid, Saudi Arabia

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9205 The Effect of Ice in Pain Control before Digital Nerve Block

Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

Abstract:

Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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9204 One Way to Address the Complications of Dental Implantology

Authors: Predrag Kavaric, Vladimir L. Jubic, Maxim Cadenovic

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The patient was transferred from his dentist to our tertiary medical institution. In anamnesis, we got information that his dental intervention was two years ago when he got dental implants but because of the coronavirus pandemic event, he didn’t finish the whole procedure. After two years, he decided that he will continue his work at his dentist, then his dentist noticed that there is no earlier inserted implant in the upper jaw on the right side. They do Panoramic X-ray and find that the implant is all in the maxillary sinus cavity. The flour of the maxilla was intact without any fistula on the place where the implant was inserted in the maxilla bone, After that initial diagnostic they sent the patient to maxillofacial surgery and otorhinolaryngology. We asked for a CT scan of paranasal sinuses, which confirmed the foreign body in the right maxillary sinus. The plan was that in general anesthesia we do FESS and try to find a foreign body in the maxillary sinus or in case of failure to do Caldwel Luc on that side. After preoperative preparation in GA, we do FESS. In inspection, we find small polyps and chronically changed mucosa of osteomeatal complex and right maxillary sinus. After removing polyps we did uncinectomy and medial maxillectomy. With Heuweiser Antrum grasping forceps after several attempts we managed to extract a foreign body from the bottom of the right maxillary sinus. On the first postoperative day we did detamponade, and then we discharge the patient from hospital. The Covid pandemic has contributed to the postponement of a large number of planned operations, which has resulted in various complications in the treatment of a number of patients. In this case, it happened that the implant was most likely rejected by the bone but in the direction of the maxillary sinus, which is not a common cause. On the other hand, the success was that less traumatic intervention was able to remove the foreign body from the maxillary sinus in which it was located. Since the sinus floor is free of bone defects, it can be continued relatively quickly with dental procedures.

Keywords: x-ray, surgery, maxillar sinus, complication, fees

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9203 Healthcare Fire Disasters: Readiness, Response and Resilience Strategies: A Real-Time Experience of a Healthcare Organization of North India

Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

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9202 Numerical Modeling of Air Shock Wave Generated by Explosive Detonation and Dynamic Response of Structures

Authors: Michał Lidner, Zbigniew SzcześNiak

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The ability to estimate blast load overpressure properly plays an important role in safety design of buildings. The issue of studying of blast loading on structural elements has been explored for many years. However, in many literature reports shock wave overpressure is estimated with simplified triangular or exponential distribution in time. This indicates some errors when comparing real and numerical reaction of elements. Nonetheless, it is possible to further improve setting similar to the real blast load overpressure function versus time. The paper presents a method of numerical analysis of the phenomenon of the air shock wave propagation. It uses Finite Volume Method and takes into account energy losses due to a heat transfer with respect to an adiabatic process rule. A system of three equations (conservation of mass, momentum and energy) describes the flow of a volume of gaseous medium in the area remote from building compartments, which can inhibit the movement of gas. For validation three cases of a shock wave flow were analyzed: a free field explosion, an explosion inside a steel insusceptible tube (the 1D case) and an explosion inside insusceptible cube (the 3D case). The results of numerical analysis were compared with the literature reports. Values of impulse, pressure, and its duration were studied. Finally, an overall good convergence of numerical results with experiments was achieved. Also the most important parameters were well reflected. Additionally analyses of dynamic response of one of considered structural element were made.

Keywords: adiabatic process, air shock wave, explosive, finite volume method

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9201 The Impact of Housing Design on the Health and Well-Being of Populations: A Case-Study of Middle-Class Families in the Metropolitan Region of Port-Au-Prince, Haiti

Authors: A. L. Verret, N. Prince, Y. Jerome, A. Bras

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The effects of housing design on the health and well-being of populations are quite intangible. In fact, healthy housing parameters are generally difficult to establish scientifically. It is often unclear the direction of a cause-and-effect relationship between health variables and housing. However, the lack of clear and definite measurements does not entail the absence of relationship between housing, health, and well-being. Research has thus been conducted. It has mostly aimed the physical rather than the psychological or social well-being of a population, given the difficulties to establish cause-effect relationships because of the subjectivity of the psychological symptoms and of the challenge in determining the influence of other factors. That said, a strong relationship has been exposed between light and physiology. Both the nervous and endocrine systems, amongst others, are affected by different wavelengths of natural light within a building. Daylight in the workplace is indeed associated to decreased absenteeism, errors and product defects, fatigue, eyestrain, increased productivity and positive attitude. Similar associations can also be made to residential housing. Lower levels of sunlight within the home have been proven to result in impaired cognition in depressed participants of a cross-sectional case study. Moreover, minimum space (area and volume) has been linked to healthy housing and quality of life, resulting in norms and regulations for such parameters for home constructions. As a matter of fact, it is estimated that people spend the two-thirds of their lives within the home and its immediate environment. Therefore, it is possible to deduct that the health and well-being of the occupants are potentially at risk in an unhealthy housing situation. While the impact of architecture on health and well-being is acknowledged and considered somewhat crucial in various countries of the north and the south, this issue is barely raised in Haiti. In fact, little importance is given to architecture for many reasons (lack of information, lack of means, societal reflex, poverty…). However, the middle-class is known for its residential strategies and trajectories in search of better-quality homes and environments. For this reason, it would be pertinent to use this group and its strategies and trajectories to isolate the impact of housing design on the overall health and well-being. This research aims to analyze the impact of housing architecture on the health and well-being of middle-class families in the metropolitan region of Port-au-Prince. It is a case study which uses semi-structured interviews and observations as research methods. Although at an early stage, this research anticipates that homes affect their occupants both psychologically and physiologically, and consequently, public policies and the population should take into account the architectural design in the planning and construction of housing and, furthermore, cities.

Keywords: architectural design, health and well-being, middle-class housing, Port-au-Prince, Haiti

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9200 Managing Student Internationalization during the COVID-19 Pandemic: Three Approaches That Should Endure beyond the Present

Authors: David Cobham

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In higher education, a great degree of importance is placed on the internationalization of the student experience. This is seen as a valuable contributor to elements such as building confidence, broadening knowledge, creating networks and connections, and enhancing employability for current students who will become the next generation of managers in technology and business. The COVID-19 pandemic has affected all areas of people’s lives. The limitations of travel coupled with the fears and concerns generated by the health risks have dramatically reduced the opportunity for students to engage with this agenda. Institutions of higher education have been required to rethink fundamental aspects of their business model from recruitment and enrolment through learning approaches, assessment methods, and the pathway to employment. This paper presents a case study which focuses on student mobility and how the physical experience of being in another country, either to study, to work, to volunteer or to gain cultural and social enhancement, has of necessity been replaced by alternative approaches. It considers trans-national education as an alternative to physical study overseas, virtual mobility and internships as an alternative to international work experience, and adopting collaborative online projects as an alternative to in-person encounters. The paper concludes that although these elements have been adopted to address the current situation, the lessons learned and the feedback gained suggests that they have contributed successfully in new and sometimes unexpected ways and that they will persist beyond the present to become part of the 'new normal' for the future. That being the case, senior leaders of institutions of higher education will be required to revisit their international plans and to rewrite their international strategies to take account of and build upon these changes.

Keywords: higher education management, internationalization, transnational education, virtual mobility

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9199 Sustainability Assessment of a Deconstructed Residential House

Authors: Atiq U. Zaman, Juliet Arnott

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This paper analyses the various benefits and barriers of residential deconstruction in the context of environmental performance and circular economy based on a case study project in Christchurch, New Zealand. The case study project “Whole House Deconstruction” which aimed, firstly, to harvest materials from a residential house, secondly, to produce new products using the recovered materials, and thirdly, to organize an exhibition for the local public to promote awareness on resource conservation and sustainable deconstruction practices. Through a systematic deconstruction process, the project recovered around 12 tonnes of various construction materials, most of which would otherwise be disposed of to landfill in the traditional demolition approach. It is estimated that the deconstruction of a similar residential house could potentially prevent around 27,029 kg of carbon emission to the atmosphere by recovering and reusing the building materials. In addition, the project involved local designers to produce 400 artefacts using the recovered materials and to exhibit them to accelerate public awareness. The findings from this study suggest that the deconstruction project has significant environmental benefits, as well as social benefits by involving the local community and unemployed youth as a part of their professional skills development opportunities. However, the project faced a number of economic and institutional challenges. The study concludes that with proper economic models and appropriate institutional support a significant amount of construction and demolition waste can be reduced through a systematic deconstruction process. Traditionally, the greatest benefits from such projects are often ignored and remain unreported to wider audiences as most of the external and environmental costs have not been considered in the traditional linear economy.

Keywords: circular economy, construction and demolition waste, resource recovery, systematic deconstruction, sustainable waste management

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9198 Effect of Fire Retardant Painting Product on Smoke Optical Density of Burning Natural Wood Samples

Authors: Abdullah N. Olimat, Ahmad S. Awad, Faisal M. AL-Ghathian

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Natural wood is used in many applications in Jordan such as furniture, partitions constructions, and cupboards. Experimental work for smoke produced by the combustion of certain wood samples was studied. Smoke generated from burning of natural wood, is considered as a major cause of death in furniture fires. The critical parameter for life safety in fires is the available time for escape, so the visual obscuration due to smoke release during fire is taken into consideration. The effect of smoke, produced by burning of wood, depends on the amount of smoke released in case of fire. The amount of smoke production, apparently, affects the time available for the occupants to escape. To achieve the protection of life of building occupants during fire growth, fire retardant painting products are tested. The tested samples of natural wood include Beech, Ash, Beech Pine, and white Beech Pine. A smoke density chamber manufactured by fire testing technology has been used to perform measurement of smoke properties. The procedure of test was carried out according to the ISO-5659. A nonflammable vertical radiant heat flux of 25 kW/m2 is exposed to the wood samples in a horizontal orientation. The main objective of the current study is to carry out the experimental tests for samples of natural woods to evaluate the capability to escape in case of fire and the fire safety requirements. Specific optical density, transmittance, thermal conductivity, and mass loss are main measured parameters. Also, comparisons between samples with paint and with no paint are carried out between the selected samples of woods.

Keywords: extinction coefficient, optical density, transmittance, visibility

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9197 CO₂ Recovery from Biogas and Successful Upgrading to Food-Grade Quality: A Case Study

Authors: Elisa Esposito, Johannes C. Jansen, Loredana Dellamuzia, Ugo Moretti, Lidietta Giorno

Abstract:

The reduction of CO₂ emission into the atmosphere as a result of human activity is one of the most important environmental challenges to face in the next decennia. Emission of CO₂, related to the use of fossil fuels, is believed to be one of the main causes of global warming and climate change. In this scenario, the production of biomethane from organic waste, as a renewable energy source, is one of the most promising strategies to reduce fossil fuel consumption and greenhouse gas emission. Unfortunately, biogas upgrading still produces the greenhouse gas CO₂ as a waste product. Therefore, this work presents a case study on biogas upgrading, aimed at the simultaneous purification of methane and CO₂ via different steps, including CO₂/methane separation by polymeric membranes. The original objective of the project was the biogas upgrading to distribution grid quality methane, but the innovative aspect of this case study is the further purification of the captured CO₂, transforming it from a useless by-product to a pure gas with food-grade quality, suitable for commercial application in the food and beverage industry. The study was performed on a pilot plant constructed by Tecno Project Industriale Srl (TPI) Italy. This is a model of one of the largest biogas production and purification plants. The full-scale anaerobic digestion plant (Montello Spa, North Italy), has a digestive capacity of 400.000 ton of biomass/year and can treat 6.250 m3/hour of biogas from FORSU (organic fraction of solid urban waste). The entire upgrading process consists of a number of purifications steps: 1. Dehydration of the raw biogas by condensation. 2. Removal of trace impurities such as H₂S via absorption. 3.Separation of CO₂ and methane via a membrane separation process. 4. Removal of trace impurities from CO₂. The gas separation with polymeric membranes guarantees complete simultaneous removal of microorganisms. The chemical purity of the different process streams was analysed by a certified laboratory and was compared with the guidelines of the European Industrial Gases Association and the International Society of Beverage Technologists (EIGA/ISBT) for CO₂ used in the food industry. The microbiological purity was compared with the limit values defined in the European Collaborative Action. With a purity of 96-99 vol%, the purified methane respects the legal requirements for the household network. At the same time, the CO₂ reaches a purity of > 98.1% before, and 99.9% after the final distillation process. According to the EIGA/ISBT guidelines, the CO₂ proves to be chemically and microbiologically sufficiently pure to be suitable for food-grade applications.

Keywords: biogas, CO₂ separation, CO2 utilization, CO₂ food grade

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9196 The Effects of Subsidised Irrigation Service Fees on Irrigation Performance in Vietnam

Authors: Trang Pham

Abstract:

Approximately 70% of the Vietnamese population lives in rural areas where the main livelihood is farming. For many years, the Vietnamese Government has been working towards improving farmers’ quality of life. In 2008, the Government issued the decree 115/2008/ND-CP to subsidize farmers’ water fees. The subsidy covers operation and management costs of major water infrastructure. Water users have only to pay for the operation and management of minor or tertiary canal systems. But the “subsidized water fee” has become contentious; there are two opposing schools of thought. One view is that the subsidy lessens the burden on farmers in terms of reducing their production costs, at the same time generating a sufficient budget for Irrigation Management Companies (IMCs) and Water User Association (WUAs). The alternate point of view is that the subsidy negatively effects irrigation performance, especially in tertiary canals. The aim of this study was to gain clear awareness of the perceptions of farmers, WUA members, and IMC staffs in regard to irrigation performance and management since the introduction of subsidies and local water fees. In order to find out how the government intervention has affected local farming communities, a series of questionnaires and interviews were administered in 2013. Four case studies were chosen which represent four different agricultural areas and four different irrigation systems in Vietnam. Interviews were conducted with IMC staffs and WUA members and questionnaires were used to gather information from farmers. The study compares the difference in operation and management costs across the four case studies both before and after the implementation of the decree. The results disclose factors behind the subsidized water fee that either allow or hinder improved irrigation performance and better irrigation management.

Keywords: water fee, irrigation performance, local farming, tertiary canal systems

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9195 Indonesian Food Safety Policy for Local Commodity against ASEAN Economic Community: An Uneven Battle in the Global War

Authors: Wahyu Riawanti

Abstract:

Food safety is the one of a prominent issue for globalization era. The more concern is paid in international food and agriculture trade; the more consumers will consider raising the standard of food safety. For this reason, the role of the issue is not only in term of added value but since then also the main requirement in import export activity, including agriculture products. Unfortunately, Indonesia and other developing countries found it difficult to fulfill some of the technical issues and end it up with the lower export activity. In this case, the technical requirements of food safety become an obstacle rather than challenging. Furthermore for local farmers’ activity, food safety is more or less a threat. The study is aimed to reveal on how Indonesian government had dealt with the certification regulation to face problem on competitiveness of Indonesian products. Local government has conducted the regulation of food certification. The study used the case of Salak Pondoh fruit (Salacca zalacca) certification process on Sleman District- Yogyakarta. Triangulation method was used to analyze the effectiveness of the certification program. The quantitative data series taken from 7 farmer groups during the certification processes were used for the research main data. The supporting qualitative data was obtained from in-depth interview with the members of farmers group. The pre-research result has shown that the impact varied from different groups. Conclusively the certification regulation has partly failed to make a significant change in local farmers’ competitiveness. Even the profit was increased, the highly amount budget of the program did not significantly increase the economic incentives for local farmers.

Keywords: economic incentive, food security, government regulation, international trade, local commodity, Salacca zalacca

Procedia PDF Downloads 266
9194 Enhance Construction Visual As-Built Schedule Management Using BIM Technology

Authors: Shu-Hui Jan, Hui-Ping Tserng, Shih-Ping Ho

Abstract:

Construction project control attempts to obtain real-time as-built schedule information and to eliminate project delays by effectively enhancing dynamic schedule control and management. Suitable platforms for enhancing an as-built schedule visually during the construction phase are necessary and important for general contractors. As the application of building information modeling (BIM) becomes more common, schedule management integrated with the BIM approach becomes essential to enhance visual construction management implementation for the general contractor during the construction phase. To enhance visualization of the updated as-built schedule for the general contractor, this study presents a novel system called the Construction BIM-assisted Schedule Management (ConBIM-SM) system for general contractors in Taiwan. The primary purpose of this study is to develop a web ConBIM-SM system for the general contractor to enhance visual as-built schedule information sharing and efficiency in tracking construction as-built schedule. Finally, the ConBIM-SM system is applied to a case study of a commerce building project in Taiwan to verify its efficacy and demonstrate its effectiveness during the construction phase. The advantages of the ConBIM-SM system lie in improved project control and management efficiency for general contractors, and in providing BIM-assisted as-built schedule tracking and management, to access the most current as-built schedule information through a web browser. The case study results show that the ConBIM-SM system is an effective visual as-built schedule management platform integrated with the BIM approach for general contractors in a construction project.

Keywords: building information modeling (BIM), construction schedule management, as-built schedule management, BIM schedule updating mechanism

Procedia PDF Downloads 357
9193 Enhancement of Cross-Linguistic Effect with the Increase in the Multilingual Proficiency during Early Childhood: A Case Study of English Language Acquisition by a Pre-School Child

Authors: Anupama Purohit

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The paper is a study on the inevitable cross-linguistic effect found in the early multilingual learners. The cross-linguistic behaviour like code-mixing, code-switching, foreign accent, literal translation, redundancy and syntactic manipulation effected due to other languages on the English language output of a non-native pre-school child are discussed here. A case study method is adopted in this paper to support the claim of the title. A simultaneously tetra lingual pre-school child’s (within 1;3 to 4;0) language behaviour is analysed here. The sample output data of the child is gathered from the diary entries maintained by her family, regular observations and video recordings done since her birth. She is getting the input of her mother tongue, Sambalpuri, from her grandparents only; Hindi, the local language from her play-school and the neighbourhood; English only from her mother and occasional visit of other family friends; Odia only during the reading of the Odia story book. The child is exposed to code-mixing of all the languages throughout her childhood. But code-mixing, literal translation, redundancy and duplication were absent in her initial stage of multilingual acquisition. As the child was more proficient in English in comparison to her other first languages and had never heard code-mixing in English language; it was expected from her input pattern of English (one parent, English language) that she would maintain purity in her use of English while talking to the English language interlocutor. But with gradual increase in the language proficiency in each of the languages of the child, her handling of the multiple codes becomes deft cross-linguistically. It can be deduced from the case study that after attaining certain milestone proficiency in each language, the child’s linguistic faculty can operate at a metalinguistic level. The functional use of each morpheme, their arrangement in words and in the sentences, the supra segmental features, lexical-semantic mapping, culture specific use of a language and the pragmatic skills converge to give a typical childlike multilingual output in an intelligible manner to the multilingual people (with the same set of languages in combination). The result is appealing because for expressing the same ideas which the child used to speak (may be with grammatically wrong expressions) in one language, gradually, she starts showing cross-linguistic effect in her expressions. So the paper pleads for the separatist view from the very beginning of the holophrastic phase (as the child expresses in addressee-specific language); but development of a metalinguistic ability that helps the child in communicating in a sophisticated way according to the linguistic status of the addressee is unique to the multilingual child. This metalinguistic ability is independent of the mode if input of a multilingual child.

Keywords: code-mixing, cross-linguistic effect, early multilingualism, literal translation

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9192 Voters' Acceptance of Anti-guardians' Narratives: Electoral Politics in Establishmentarian Democracies

Authors: Rai Mansoor Imtiaz

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Guardians in hybrid regimes fragment opposition parties and ban their political leaders, and disenfranchise their voters' political participation. When guardians in hybrid regimes are so powerful that they remain decisive on electoral politics of states, and have powers to ban political parties and their leadership, then "why do political parties backed by those powerful guardians lose elections" and "how do anti-establishment parties make electoral inroads at the local and national levels." These two questions are interrelated with the key research question of my research "why do people vote for political parties rejected by powerful guardians in establishmentarian democracies." Furthermore, this research question is important to be explored for two reasons. First, existing literature only reflects the electoral victories of opposition parties or defeats of military-sponsored parties (see Thailand and Turkey) but remains silent on political change that led the anti-military parties to win the elections. Second, why is it a case that people belonging to the countries where militaries remain popular among the public (see Turkey and Pakistan) have started putting their trust in anti-establishment politicians who criticise the military against their intervention in politics? For instance, in Pakistan, where commenting against the military is meant to comment against the state –– an anti-military narrative is getting popular support. The conceptual framework of hybrid states in this research relies on the concept of a 'reserved domain/tutelary body' (guardians of hybrid states). However, this research makes a case that hybrid states are not consolidated separate political entities but rather vacillated states that fluctuate between democratic and authoritarian practices. This paper, therefore, uses the term establishmentarian democracy as a subtype of the hybrid regime, which is more consolidated than a hybrid democracy.

Keywords: Guardians, Hybrid Regimes, Voters, Elections, Democracy, South Asia

Procedia PDF Downloads 91
9191 A Case Study of Remote Location Viewing, and Its Significance in Mobile Learning

Authors: James Gallagher, Phillip Benachour

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As location aware mobile technologies become ever more omnipresent, the prospect of exploiting their context awareness to enforce learning approaches thrives. Utilizing the growing acceptance of ubiquitous computing, and the steady progress both in accuracy and battery usage of pervasive devices, we present a case study of remote location viewing, how the application can be utilized to support mobile learning in situ using an existing scenario. Through the case study we introduce a new innovative application: Mobipeek based around a request/response protocol for the viewing of a remote location and explore how this can apply both as part of a teacher lead activity and informal learning situations. The system developed allows a user to select a point on a map, and send a request. Users can attach messages alongside time and distance constraints. Users within the bounds of the request can respond with an image, and accompanying message, providing context to the response. This application can be used alongside a structured learning activity such as the use of mobile phone cameras outdoors as part of an interactive lesson. An example of a learning activity would be to collect photos in the wild about plants, vegetation, and foliage as part of a geography or environmental science lesson. Another example could be to take photos of architectural buildings and monuments as part of an architecture course. These images can be uploaded then displayed back in the classroom for students to share their experiences and compare their findings with their peers. This can help to fosters students’ active participation while helping students to understand lessons in a more interesting and effective way. Mobipeek could augment the student learning experience by providing further interaction with other peers in a remote location. The activity can be part of a wider study between schools in different areas of the country enabling the sharing and interaction between more participants. Remote location viewing can be used to access images in a specific location. The choice of location will depend on the activity and lesson. For example architectural buildings of a specific period can be shared between two or more cities. The augmentation of the learning experience can be manifested in the different contextual and cultural influences as well as the sharing of images from different locations. In addition to the implementation of Mobipeek, we strive to analyse this application, and a subset of other possible and further solutions targeted towards making learning more engaging. Consideration is given to the benefits of such a system, privacy concerns, and feasibility of widespread usage. We also propose elements of “gamification”, in an attempt to further the engagement derived from such a tool and encourage usage. We conclude by identifying limitations, both from a technical, and a mobile learning perspective.

Keywords: context aware, location aware, mobile learning, remote viewing

Procedia PDF Downloads 275
9190 Magnetic versus Non-Magnetic Adatoms in Graphene Nanoribbons: Tuning of Spintronic Applications and the Quantum Spin Hall Phase

Authors: Saurabh Basu, Sudin Ganguly

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Conductance in graphene nanoribbons (GNR) in presence of magnetic (for example, Iron) and non-magnetic (for example, Gold) adatoms are explored theoretically within a Kane-Mele model for their possible spintronic applications and topologically non-trivial properties. In our work, we have considered the magnetic adatoms to induce a Rashba spin-orbit coupling (RSOC) and an exchange bias field, while the non-magnetic ones induce an RSOC and an intrinsic spin-orbit (SO) coupling. Even though RSOC is present in both, they, however, represent very different physical situations, where the magnetic adatoms do not preserve the time reversal symmetry, while the non-magnetic case does. This has important implications on the topological properties. For example, the non-magnetic adatoms, for moderately strong values of SO, the GNR denotes a quantum spin Hall insulator as evident from a 2e²/h plateau in the longitudinal conductance and presence of distinct conducting edge states with an insulating bulk. Since the edge states are protected by time reversal symmetry, the magnetic adatoms in GNR yield trivial insulators and do not possess any non-trivial topological property. However, they have greater utility than the non-magnetic adatoms from the point of view of spintronic applications. Owing to the broken spatial symmetry induced by the presence of adatoms of either type, all the x, y and z components of the spin-polarized conductance become non-zero (only the y-component survives in pristine Graphene owing to a mirror symmetry present there) and hence become suitable for spintronic applications. However, the values of the spin polarized conductances are at least two orders of magnitude larger in the case of magnetic adatoms than their non-magnetic counterpart, thereby ensuring more efficient spintronic applications. Further the applications are tunable by altering the adatom densities.

Keywords: magnetic and non-magnetic adatoms, quantum spin hall phase, spintronic applications, spin polarized conductance, time reversal symmetry

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9189 A Settlement Strategy for Health Facilities in Emerging Countries: A Case Study in Brazil

Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Piero Favino, Luca Preis

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A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: healthcare, settlement strategy, urban health, rural

Procedia PDF Downloads 348
9188 Enablers and Inhibitors of Effective Waste Management Measures in Informal Settlements in South Africa: A Case of Alaska

Authors: Lynda C. Mbadugha, Bankole Awuzie, Kwanda Khumalo, Lindokuhle Matsebula, Masenoke Kgaditsi

Abstract:

Inadequate waste management remains a fundamental issue in the majority of cities around the globe, but it becomes a threat when it concerns informal settlements. Although studies have evaluated the performance of waste management measures, only a few have addressed that with a focus on South African informal settlements and the reasons for their apparent ineffectiveness in such locations. However, there may be evidence of variations in the extant problems due to the uniqueness of each location and the factors influencing the performance. Thus, there is a knowledge deficit regarding implementing waste management measures in South African informal settlements. This study seeks to evaluate the efficacy of waste management measures in the Alaska informal settlement in South Africa to assess the previously collected data of other areas using the degree of correlation. The research investigated a real-world scenario in the specified location using a case study approach and multiple data sources. The findings described various waste management practices used in Alaska's informal settlements; however, a correlation was found between the performance of these measures and those already used. The observed differences are primarily attributable to the physical characteristics of the locations, the lack of understanding of the environmental and health consequences of careless waste disposal, and the negative attitudes of the residents toward waste management practices. This study elucidates waste management implementation in informal settlements. It contributes to the relevant bodies of knowledge by describing these practices in South Africa. This paper's practical value emphasizes the general waste management characteristics of South Africa's informal settlements to facilitate the planning and provision of necessary interventions. The study concludes that the enablers and inhibitors are mainly political, behavioral, and environmental concerns.

Keywords: factors, informal settlement, performance, waste management

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9187 Slums in Casablanca: A Conceptive Approach for Better Implementation of VSB Program, Case Study: ER-Hamna Slum

Authors: Sakina Boufarsi, Mehmet Emre Aysu, Behiye Isik Aksulu

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Morocco appears to be on its way to eradicating all of the country's slums by assuring the resettlement and improvement of all affected households' living circumstances through the VSB “Villes sans Bidonvilles” program established in 2004 to eradicate the slums in Morocco. Although many attempts have been made to curb their growth none have proven to be a permanent accomplishment. In Morocco, resettlement projects through satellite towns are perceived as the answer to the problem of the slums. However, the new satellite towns are the good intention of the program VSB, but they are environmentally unsustainable, socially isolated and culturally inappropriate, such conditions imposed continuous readjustments of the slum upgrading program. Although slum research is ongoing, they primarily concentrated on two constructs: exploring socio-economic and policy problems and analyzing physical characteristics. Considering that the two constructs mentioned are crucial, this study will demonstrate that a more systematic approach is needed to eradicate them efficiently. The slums issues in Casablanca are a solution that the poor devise for themselves due to government bureaucracy and failing housing policies, they reflect governments' incapacity to respond to urban development’s requiring decent housing for the vulnerable population. This issue will be addressed by exploring the previous strategies and analyzing in detail the strengths and shortcomings of the recent VSB Program. In addition to a comprehensive overview of the slums' situations by combining the social and physical characteristics through Erhamna case study in Sidi Moumen district for a deeper understanding, and therefore to direct improved and valuable recommendations to address the slum problem at all levels.

Keywords: Casablanca slums, resettlement projects, eradication of slums, satellite town, VSB program

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9186 Benign Recurrent Unilateral Abducens (6th) Nerve Palsy in 14 Months Old Girl: A Case Report

Authors: Khaled Alabduljabbar

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Background: Benign, isolated, recurrent sixth nerve palsy is very rare in children. Here we report a case of recurrent abducens nerve palsy with no obvious etiology. It is a diagnosis of exclusion. A recurrent benign form of 6th nerve palsy, a rarer still palsy, has been described in the literature, and it is of most likely secondary to inflammatory causes, e.g, following viral and bacterial infections. Purpose: To present a case of 14 months old girl with recurrent attacks of isolated left sixth cranial nerve palsy following upper respiratory tract infection. Observation: The patient presented to opthalmology clinic with sudden onset of inward deviation (esotropia) of the left eye with a compensatory left face turn one week following signs of upper respiratory tract infection. Ophthalmological examination revealed large angle esotropia of the left eye in primary position, with complete limitation of abduction of the left eye, no palpebral fissure changes, and abnormal position of the head (left face turn). Visual acuity was normal, and no significant refractive error on cycloplegic refraction for her age. Fundus examination was normal with no evidence of papilledema. There was no relative afferent pupillary defect (RAPD) and no anisocoria. Past medical history and family history were unremarkable, with no history of convulsion attacks or head trauma. Additional workout include CBC. Erythrocyte sedimentation rate, Urgent magnetic resonance imaging (MRI), and angiography of the brain were performed and demonstrated the absence of intracranial and orbital lesions. Referral to pediatric neurologist was also done and concluded no significant finding. The patient showed improvement of the left sixth cranial nerve palsy and left face turn over a period of two months. Seven months since the first attack, she experienced a recurrent attack of left eye esotropia with left face turn concurrent with URTI. The rest of eye examination was again unremarkable. CT scan and MRI scan of brain and orbit were performed and showed only signs of sinusitis with no intracranial pathology. The palsy resolved spontaneously within two months. A third episode of left 6th nerve palsy occurred 6 months later, whichrecovered over one month. Examination and neuroimagingwere unremarkable. A diagnosis of benign recurrent left 6th cranial nerve palsy was made. Conclusion: Benign sixth cranial nerve palsy is always a diagnosis of exclusion given the more serious and life-threatening alternative causes. It seems to have a good prognosis with only supportive measures. The likelihood of benign 6th cranial nerve palsy to resolve completely and spontaneously is high. Observation for at least 6 months without intervention is advisable.

Keywords: 6th nerve pasy, abducens nerve pasy, recurrent nerve palsy, cranial nerve palsy

Procedia PDF Downloads 75