Search results for: L. Major
4953 Towards Value-Based Healthcare through a Nursing Sector Management Approach
Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa
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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes
Procedia PDF Downloads 7684952 Risk Prediction Based on Heavy Metal Distribution in Groundwater
Authors: Rama Bhattacharyya, S. N. Ojha, Umesh K. Singh
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Anthropogenic control on groundwater chemistry has emerged as a critical concern now-a-days, especially in the industrial areas. In view of this, a comprehensive study on the distribution of the heavy metal in the groundwater was conducted to investigate the impact of urbanization in the aquatic media. Water samples either from well or borehole from Fourty different sites in and around, Durgapur, West Bengal were collected for this purpose. The samples were analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) for Calcium (Ca), Cobalt (Co), Chromium (Cr), Copper (Cu), Iron (Fe), Potassium (K), Magnesium (Mg), Manganese (Mn), Sodium (Na), Nickel (Ni), Lead (Pb), Zinc (Zn) content and the levels were compared with WHO specified maximum contaminant level as well as permissible limits given by the Bureau of Indian Standards (BIS). The result obtained from the present study indicates a significant risk to the population of this important emerging ‘smart city’ of eastern India. Because of the toxicity of these metals and the fact that for many tube-wells, dug-wells and bore-wells are the only sources of the water supply for a major fraction of the population in this environment. In this study, an attempt has been made to develop metal contamination risk map.Keywords: heavy metals, ground water, maximum contamination level, ICP-MS
Procedia PDF Downloads 2154951 Territories' Challenges and Opportunities to Promote Circular Economy in the Building Sector
Authors: R. Tirado, G. Habert, A. Mailhac, S. Laurenceau
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The rapid development of cities implies significant material inflows and outflows. The construction sector is one of the main consumers of raw materials and producers of waste. The waste from the building sector, for its quantity and potential for recovery, constitutes significant deposits requiring major efforts, by combining different actors, to achieve the circular economy's objectives. It is necessary to understand and know the current construction actors' knowledge of stocks, urban metabolism, deposits, and recovery practices in this context. This article aims to explore the role of local governments in planning strategies by facilitating a circular economy. In particular, the principal opportunities and challenges of communities for applying the principles of the circular economy in the building sector will be identified. The approach used for the study was to conduct semi-structured interviews with those responsible for circular economy projects within local administrations of some communities in France. The results show territories' involvement in the inclusion and application of the principles of the circular economy in the building sector. The main challenges encountered are numerous, hence the importance of having identified and described them so that the different actors can work to meet them.Keywords: building stock, circular economy, interview, local authorities
Procedia PDF Downloads 1274950 The Asia-European Union (EU) Traffic Safety Benchmarking
Authors: Ghazwan Al-Haji
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Traffic safety has become a major concern in Southeast Asia due to the increasing number of road accidents resulting in fatalities and injuries. Southeast Asia has one of the highest road traffic fatality rates in the world, in terms of both population and number of cars, nearly six times higher than the EU region. One of the reasons for this concerning trend is the increasing share of motorcycles as a form of transportation throughout Southeast Asia. The purpose of this study is to benchmark traffic safety situations and statistics in six countries in Asia and the EU, which Indonesia, Malaysia, Vietnam, Italy, Portugal and Sweden. The research will assess the priorities and causes of road accidents in the target nations. Further, the study will analyze the existing practices and promote best practices that can be implemented toward safer roads in Asian target countries. In order to achieve this goal, the study categorizes various factors contributing to traffic accidents and best practices into 4 pillars (Safer Behavior, Safer Roads, Safer Vehicles and Road Safety Management). The result of the study consists of a list of recommendations that can be applied by policymakers to promote safer roads in Asia towards 2030. The study is co-financed by the EU project ASIASAFE.Keywords: traffic safety, ASIASAFE, Southeast Asia, EU project
Procedia PDF Downloads 694949 An Alternative Stratified Cox Model for Correlated Variables in Infant Mortality
Authors: K. A. Adeleke
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Often in epidemiological research, introducing stratified Cox model can account for the existence of interactions of some inherent factors with some major/noticeable factors. This research work aimed at modelling correlated variables in infant mortality with the existence of some inherent factors affecting the infant survival function. An alternative semiparametric Stratified Cox model is proposed with a view to take care of multilevel factors that have interactions with others. This, however, was used as a tool to model infant mortality data from Nigeria Demographic and Health Survey (NDHS) with some multilevel factors (Tetanus, Polio, and Breastfeeding) having correlation with main factors (Sex, Size, and Mode of Delivery). Asymptotic properties of the estimators are also studied via simulation. The tested model via data showed good fit and performed differently depending on the levels of the interaction of the strata variable Z*. An evidence that the baseline hazard functions and regression coefficients are not the same from stratum to stratum provides a gain in information as against the usage of Cox model. Simulation result showed that the present method produced better estimates in terms of bias, lower standard errors, and or mean square errors.Keywords: stratified Cox, semiparametric model, infant mortality, multilevel factors, cofounding variables
Procedia PDF Downloads 5574948 Experimental Study of Mixture of R290/R600 to Replace R134a in a Domestic Refrigerator
Authors: T. O. Babarinde, B. O. Bolaji, S. O. Ismaila
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Interest in natural refrigerants, such as hydrocarbons has been renewed in recent years because of the environmental problems associated with synthetic chlorofluorocarbon (CFC) and hydro-chlorofluorocarbon (HCFC) refrigerants. Due to the depletion of ozone-layer and global warming effects, synthetic refrigerants are being gradually phased out in accordance with the international protocols that aim to protect the environment. In this work, a refrigerator designed to work with R134a was used for this experiment, Liquefied Petroleum Gas (LPG) which consists of commercial propane and butane in a single evaporator domestic refrigerator with a total volume of 62 litres. In this experiment, type K thermocouples with their probes were used to measure the temperatures of four major components (evaporator, compressor, condenser and expansion device) of the refrigeration system. Also the system was instrumented with two pressure gauges at the inlet and outlet of the compressor for measuring the suction and discharged pressures. The experiments were carried out using 40, 60, 80,100g charges and the charges were measured with a digital charging scale. Thermodynamic properties of the LPG refrigerant were determined. The results obtained showed that using LPG charge of 60g. The system COP increased with 14.6% and the power consumption reduced with 9.8% when compared with R134a. Therefore, LPG can replace R134a in domestic refrigerator.Keywords: domestic refrigerator, experimental, LPG, R134a
Procedia PDF Downloads 4834947 Online Impulse Buying: A Study Based on Hedonic Shopping Value and Website Quality
Authors: Chechen Liao, Hung Wen Shaw
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Recently, online impulse buying has been growing rapidly. It has become a major issue of concern and provided a lot of opportunities for online businesses. This study examines the effect of hedonic shopping values on hedonic motivations, and in turn affecting the urge of impulse buying. The study also explores the effects of website quality and the individual characteristics of impulsiveness on the urge of impulse buying. A total of 459 valid questionnaires were collected. Structural equation modelling was used to test the research hypothesis. This study found that adventure shopping, value shopping, and social shopping have a positive effect on hedonic motivations, which in turn positively affect the urge of impulse buying. Website quality and the individual characteristics of impulsiveness have a positive effect on the urge of impulse buying. The result of this study validates the phenomenon of online impulse buying behavior. This study also suggests that having a good website quality is the most important factor for increasing the likelihood of consumer impulse purchase. The study could serve as a basis for future research regarding online impulse buying behavior.Keywords: hedonic motivation, hedonic shopping value, impulse buying, impulsiveness, website quality
Procedia PDF Downloads 2084946 Numerical Simulation of Air Flow, Exhaust and Their Mixture in a Helicopter Exhaust Injective Cooler
Authors: Mateusz Paszko, Konrad Pietrykowski, Krzysztof Skiba
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Due to low-altitude and relatively low flight speed, today’s combat assets like missile weapons equipped with infrared guidance systems are one of the most important threats to the helicopters performing combat missions. Especially meaningful in helicopter aviation is infrared emission by exhaust gases, regressed to the surroundings. Due to high temperature, exhaust gases are a major factor in detectability of a helicopter performing air combat operations. This study presents the results of simulating the flow of the mixture of exhaust and air in the flow duct of an injective exhaust cooler, adapted to cooperate with the PZL 10W turbine engine. The simulation was performed using a numerical model and the ANSYS Fluent software. Simulation computations were conducted for set flight conditions of the PZL W-3 Falcon helicopter. The conclusions resulting from the conducted numerical computations should allow for optimisation of the flow duct geometry in the cooler, in order to achieve the greatest possible temperature reduction of exhaust exiting into the surroundings. It is expected that the obtained results should be useful for further works related to the development of the final version of exhaust cooler for the PZL W-3 Falcon helicopter.Keywords: exhaust cooler, helicopter, numerical simulation, stealth
Procedia PDF Downloads 1504945 Choking among Infants and Young Children
Authors: Emad M.Abdullat, Hasan A. Ader-Rahman, Rayyan Al Ali, Arwa.A.Hudaib
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This retrospective study aims to determine the epidemiological features of such deaths in one of the general teaching hospitals in Jordan with a focus on weaning practices and its relation to sucking as major factors underlying the mechanism of choking in infants and young children. The study utilized a retrospective design to review the records of forensic cases due to foreign body aspiration examined at the forensic department at the Jordan University Hospital. A total of 27 cases of choking in the pediatric age group were retrieved from the reports of the autopsy cases dissected. All cases of children who died due to chocking by foreign bodies were under 11 years old. Choking by food materials constituted (44.4%) of cases under 3 years of age while choking by non-food material were less prevalent under 3 years of age and comprising 18.5% of the cases. Health care personnel and parents need to be aware that introduction of solid food, unlike exclusive breast or formula-milk feeding, can have serious consequences if occurring in inappropriate timing or consistency during early childhood physical and functional development. Parents need to be educated regarding the appropriate timing and process of weaning.Keywords: chocking, infants, weaning practices, young children
Procedia PDF Downloads 4884944 Control Effect of Flowering Chrysanthemum, the Trap Plant to the Western Flower Thrips, Frankliniella occidentalis (Thysanoptera: Thripidae) in Greenhouse
Authors: YongSeok Choi, HwaYoung Seo, InSu Whang, GeogKee Park
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Frankliniella. occidentalis is major pest in chrysanthemum in worldwide. The density of F. occidentalis increased continuously in spite of the periodical chemical control after planting in this study. F. occidentalis began to increase mid-May. The numbers of F. occidentalis collected on a tray with wet paper by heating the flowers of pink, white, and yellow Chrysanthemum standard mums were 18.4, 56.6, and 52.6 in the flowering season. Also, the numbers were 15.2, 45.8, and 41.6 in bud season, but in the case of the leaves, the numbers were 2, 8.8 and 3.4. In the Y-tube olfactometer test, the frequency of F. occidentalis’ visits to one side arm of the Y-tube olfactometer was higher in the odor cue of the white flower than of the yellow, red, and violet flowers, but the frequency was higher in the odor cue of the violet and red flowers than of the yellow without white. In the case of the four-choice olfactometer test, in the same visual cues as the odor cues of the pot mum flowers, the frequency of F. occidentalis was higher in the yellow flower than in the other flowers (white, red, and violet) in all the observation times (10, 15, and 20 minutes).Keywords: Frankliniella occidentalis, Chrysanthemum, trap plant, control effect
Procedia PDF Downloads 1884943 Conceptual and Funnel Methods Contribution to Critical Literature Review: PhD construction Management
Authors: Samuel Quashie
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This study is aimed at demonstrating the applicability and contribution of ‘Conceptual and Funnelling Methods’ during the literature review stages, for PhD in Construction Management, which focused on the ‘Development of an Integrated Management for Post-Disaster Reconstruction’, the viability of this approach using conceptual and funnel methods are demonstrated. The ‘conceptual review method’ builds upon the strengths of relevant material, detailing major points and areas covered and evaluates lesser relevant literature. Publications are reviewed in an integrated style, challenging the scientific theory and seeking to develop new insights. The funnel method grouped reviews by commonality, regardless of the topic or thesis statement. It shows that the literature review is acquired using different kinds of information to increase the variety and diversity of the investigation. Results demonstrated conceptual and funnel methods ability to reviewed and appraised the relevant literature. It puts them into an integrated style, allows an evaluation of credentials, originality, theory base, context and significance of the quality work to emerge. Objectives of the review are met and gaps in knowledge are identified and direct further studies to answer the research questions.Keywords: Ph.D, construction management, critical literature review, conceptual and funnel methods
Procedia PDF Downloads 4154942 Upgrading along Value Chains: Strategies for Thailand's Functional Milk Industry
Authors: Panisa Harnpathananun
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This paper is 'Practical Experience Analysis' which aims to analyze critical obstacles hampering the growth of the functional milk industry and suggest recommendations to overcome those obstacles. Using the Sectoral Innovation System (SIS) along value chain analysis, it is found that restriction in regulation of milk disinfection process, difficulty of dairy entrepreneurs for health claim approval of functional food and beverage and lack of intermediary between entrepreneurs and certified units for certification of functional foods and milk are major causes that needed to be resolved. Consequently, policy recommendations are proposed to tackle the problems occurring throughout the value chain. For the upstream, a collaborative platform using the quadruple helix model is proposed in a pattern of effective dairy cooperatives. For the midstream, regulation issues of new process, extended shelf life (ESL) milk, or prolonged milk are necessary, which can be extended the global market opportunity. For the downstream, mechanism of intermediary between entrepreneurs and certified units can be assisted in certified process of functional milk, especially a process of 'health claim' approval.Keywords: Thailand, functional milk, supply chain, quadruple helix, intermediary, functional food
Procedia PDF Downloads 1484941 Genomic Diversity of Clostridium perfringens Strains in Food and Human Sources
Authors: Asma Afshari, Abdollah Jamshidi, Jamshid Razmyar, Mehrnaz Rad
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Clostridium perfringens is a serious pathogen which causes enteric diseases in domestic animals and food poisoning in humans. Spores can survive cooking processes and play an important role in the possible onset of disease. In this study RAPD-PCR and REP-PCR were used to examine the genetic diversity of 49isolates ofC. Perfringens type A from 3 different sources. The results of RAPD-PCR revealed the most genetic diversity among poultry isolates, while human isolates showed the least genetic diversity. Cluster analysis obtained from RAPD_PCR and based on the genetic distances split the 49 strains into five distinct major clusters (A, B, C, D, and E). Cluster A and C were composed of isolates from poultry meat, cluster B was composed of isolates from human feces, cluster D was composed of isolates from minced meat, poultry meat and human feces and cluster E was composed of isolates from minced meat. Further characterization of these strains by using (GTG) 5 fingerprint repetitive sequence-based PCR analysis did not show further differentiation between various types of strains. To our knowledge, this is the first study in which the genetic diversity of C. perfringens isolates from different types of meats and human feces has been investigated.Keywords: C. perfringens, genetic diversity, RAPD-PCR, REP-PCR
Procedia PDF Downloads 4924940 Investigation of Building Loads Effect on the Stability of Slope
Authors: Hadj Brahim Mounia, Belhamel Farid, Souici Messoud
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In big cities, construction on sloping land (landslide) is becoming increasingly prevalent due to the unavailability of flat lands. This has created a major challenge for structural engineers with regard to structure design, due to the difficulties encountered during the implementation of projects, both for the structure and the soil. This paper analyses the effect of the number of floors of a building, founded on isolated footing on the stability of the slope using the computer code finite element PLAXIS 2D v. 8.2. The isolated footings of a building in this case were anchored in soil so that the levels of successive isolated footing realize a maximum slope of base of three for two heights, which connects the edges of the nearest footings, according to the Algerian building code DTR-BC 2.331: Shallow foundations. The results show that the embedment of the foundation into the soil reduces the value of the safety factor due to the change of the stress state of the soil by these foundations. The number of floors a building has also influences the safety factor. It has been noticed from this case of study that there is no risk of collapse of slopes for an inclination between 5° and 8°. In the case of slope inclination greater than 10° it has been noticed that the urbanization is prohibited.Keywords: isolated footings, multi-storeys building, PLAXIS 2D, slope
Procedia PDF Downloads 2524939 Using Computational Fluid Dynamics to Model and Design a Preventative Application for Strong Wind
Authors: Ming-Hwi Yao, Su-Szu Yang
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Typhoons are one of the major types of disasters that affect Taiwan each year and that cause severe damage to agriculture. Indeed, the damage exacted during a typical typhoon season can be up to $1 billion, and is responsible for nearly 75% of yearly agricultural losses. However, there is no consensus on how to reduce the damage caused by the strong winds and heavy precipitation engendered by typhoons. One suggestion is the use of windbreak nets, which are a low-cost and easy-to-use disaster mitigation strategy for crop production. In the present study, we conducted an evaluation to determine the optimal conditions of a windbreak net by using a computational fluid dynamics (CFD) model. This model may be used as a reference for crop protection. The results showed that CFD simulation validated windbreak nets of different mesh sizes and heights in the experimental area; thus, CFD is an efficient tool for evaluating the effectiveness of windbreak nets. Specifically, the effective wind protection length and height were found to be 6 and 1.3 times the length and height of the windbreak net, respectively. During a real typhoon, maximum wind gusts of 18 m s-1 can be reduced to 4 m s-1 by using a windbreak net that has a 70% blocking rate. In short, windbreak nets are significantly effective in protecting typhoon-affected areas.Keywords: computational fluid dynamics, disaster, typhoon, windbreak net
Procedia PDF Downloads 1914938 The Role of NAD+ and Nicotinamide (Vitamin B3) in Glaucoma: A Literature Review
Authors: James Pietris
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Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy
Procedia PDF Downloads 1064937 Effect of Oxidative Stress from Smoking on Erythrocyte Phosphatidylserine Externalization
Authors: Ratchaneewan Maneemaroj, Paveena Noisuwan, Chonlada Lakhonphon
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The smoking is one of the major risk factors in Non-Communicable Disease. Free radicals from cigarette smoke can cause oxidative stress. The oxidative insults can lead to red blood cell (RBC) senescence and are involved in the clearance of red blood cells. The objective of the present study is to assess the association between smoke, oxidative stress evaluated with serum Malondialdehyde (MDA) level and phosphatidylserine (PS) externalization (biomarker of RBC senescence) evaluated with annexin V binding. A total of sixty-four male volunteers aged 25-60 years old were recruited in this study. MDA was measured by colorimetric method. Annexin V binding was detected by flow cytometry. Our results show that there was a significant increase in MDA levels in cigarette smokers as compared to non-smokers (p < 0.001). However, there was no significant different between annexin V binding (% gate) in cigarette smokers and non-smokers (p = 0.978). These results provide evidence of free radical from smoking is associated with oxidative damage to erythrocytes. However, our results suggest that PS externalization is unlikely to have a role in RBC senescence pathway of stressed erythrocytes from cigarette smoke. The other biomarker of RBC senescence should be determined on cigarette smoker erythrocytes.Keywords: malondialdehyde, phosphatidylserine, RBC senescence, annexin V
Procedia PDF Downloads 4374936 Triassic and Liassic Paleoenvironments during the Central Atlantic Magmatique Province (CAMP) Effusion in the Moroccan Coastal Meseta: The Mohammedia-Benslimane-El Gara-Berrechid Basin
Authors: Rachid Essamoud, Abdelkrim Afenzar, Ahmed Belqadi
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During the Early Mesozoic, the northwestern part of the African continent was affected by initial fracturing associated with the early stages of the opening of the Central Atlantic (Atlantic Rift). During this rifting phase, the Moroccan Meseta experienced an extensive tectonic regime. This extension favored the formation of a set of rift-type basins, including the Mohammedia-Benslimane-ElGara-Berrechid basin. Thus, it is essential to know the nature of the deposits in this basin and their evolution over time as well as their relationship with the basaltic effusion of the Central Atlantic Magmatic Province (CAMP). These deposits are subdivided into two large series: The Lower clay-salt series attributed to the Triassic and the Upper clay-salt series attributed to the Liassic. The two series are separated by the Upper Triassic-Lower Liassic basaltic complex. The detailed sedimentological analysis made it possible to characterize four mega-sequences, fifteen types of facies and eight architectural elements and facies associations in the Triassic series. A progressive decrease observed in paleo-slope over time led to the evolution of the paleoenvironment from a proximal system of alluvial fans to a braided fluvial style, then to an anastomosed system. These environments eventually evolved into an alluvial plain associated with a coastal plain where playa lakes, mudflats and lagoons had developed. The pure and massive halitic facies at the top of the series probably indicate an evolution of the depositional environment towards a shallow subtidal environment. The presence of these evaporites indicates a climate that favored their precipitation, in this case, a fairly hot and humid climate. The sedimentological analysis of the supra-basaltic part shows that during the Lower Liassic, the paleopente after basaltic effusion remained weak with distal environments. The faciological analysis revealed the presence of four major sandstone, silty, clayey and evaporitic lithofacies organized in two mega-sequences: the sedimentation of the first rock-salt mega-sequence took place in a brine depression system free, followed by saline mudflats under continental influences. The upper clay mega-sequence displays facies documenting sea level fluctuations from the final transgression of the Tethys or the opening Atlantic. Saliferous sedimentation is therefore favored from the Upper Triassic, but experienced a sudden rupture by the emission of basaltic flows which are interstratified in the azoic salt clays of very shallow seas. This basaltic emission which belongs to the CAMP would come from a fissural volcanism probably carried out through transfer faults located in the NW and SE of the basin. Their emplacement is probably subaquatic to subaerial. From a chronological and paleogeographic point of view, this main volcanism, dated between the Upper Triassic and the Lower Liassic (180-200 MA), is linked to the fragmentation of Pangea and managed by a progressive expansion triggered in the West in close relation with the initial phases of Central Atlantic rifting and seems to coincide with the major mass extinction at the Triassic-Jurassic boundary.Keywords: Basalt, CAMP, Liassic, sedimentology, Triassic, Morocco
Procedia PDF Downloads 754935 The Use and Safety of Leave from an Acute Inpatient Psychiatry Unit: A Retrospective Review of Pass Outcomes Over Four Years Abstract
Authors: Vasilis C. Hristidis, Ricardo Caceda, Ji Soo Kim, Brian Bronson, Emily A. Hill
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Objective: Leave passes to provide authorized leave for hospitalized patients from a psychiatric inpatient unit. Though providing day passes was once a relatively common practice, there is relatively little data describing their safety and efficacy. Methods: This descriptive study examines the use of leave passes in an adult inpatient unit at a university hospital between 2017 and 2021, with attention to reasons for granting the day pass, duration, and outcome of the pass. Results: During the study period, ten patients with primary psychotic or mood disorders received 12 passes for either housing coordination, COVID-19 vaccination, or major family events. There were no fatalities or elopements. One patient experienced severe agitation and engaged in non-suicidal self-injurious behavior. A second patient showed mild, redirectable psychomotor agitation upon return to the unit. The remaining 10 passes were uneventful. Conclusions: Our findings support the view that patients with diverse diagnoses can safely be provided leave from an inpatient setting with adequate planning and support, yielding a low incidence of adverse events.Keywords: passes, inpatient, psychiatry, inpatient leave, outcome
Procedia PDF Downloads 1994934 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study
Authors: Elzbieta Sikorska-Simmons
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Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.Keywords: advanced dementia, family caregiver, medical decision-making, symptom management
Procedia PDF Downloads 1214933 Estimated Number of Mothers Suffering from Postnatal Depression
Authors: Kadhim Alabady
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Background: Mental illnesses after childbirth are common. After childbirth, women may experience a variety of postpartum complications such as developing depression during pregnancy and after childbirth. Postpartum depression might increases the risk of developing major depression in the future. The most common is postnatal depression also known as postpartum depression that is believed to affect between 10% – 15% of mothers and the most serious, puerperal psychosis (affecting less than 1%). Purpose: This research simply applies the predictions to the population of Dubai, without any adjustment for local conditions. It is intended to help stakeholders to discuss the scale of the issue locally. Method: Applying the above rates of postnatal depression prevalence (10%–15%) to the number of total live births in Dubai 2014. Setting: Birth registry for Dubai 2011/14. Key findings: it is estimated there would be approximately 2,928–4,392 mothers suffering from postnatal depression in 2014 of which 858–1,287 were nationals and 2,070–3,105 were non–nationals. These figures are likely to fluctuate depending on the number of mothers who have twin births, and these estimates of the level of postnatal depression do not take into account related factors such as the age of the mother and education. Recommendations: To establish mother-infant psychiatric care to target women suffering from depression during pregnancy and puerperium.Keywords: post natal depression, women, mental health, birth
Procedia PDF Downloads 1634932 Therapeutic Journey towards Self: Developing Positivity with Indications of Cluster B and C Personality Traits
Authors: Shweta Jha, Nandita Chaube
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The concept of self has a major role to play in the study of personality which drives the current study in its present form. This is a case of Miss S, a 17-year-old Hindu, currently in eleventh standard, with no family history of mental illness but with a past history of inability to manage relationships, multiple emotional and sexual relationships, repeated self harming behaviour, and sexual abuse over a period of 2 months at the age of 10 years. She comes with a psychiatric history of one episode of dissociative fall followed by a stressful event which left the patient with many psychological disturbances matching the criterion of Cluster B and C traits. Current episode precipitated due to the relationship failure, predisposing factor is her personality traits, and poor social and family support. Considering the patient’s aspiration for positivity and demand of the therapy, ventilation sessions were carried out which made her capable of understanding and dealing with her negative emotions, also strengthened mother child bond, helped her maintain meaningful and healthy relationships, also helped her increase her problem solving ability and adaptive coping skills making her feel more positive and acceptable towards herself, family members and others.Keywords: cluster B and C traits, personality, therapy, self
Procedia PDF Downloads 2874931 Optimization of Groundwater Utilization in Fish Aquaculture
Authors: M. Ahmed Eldesouky, S. Nasr, A. Beltagy
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Groundwater is generally considered as the best source for aquaculture as it is well protected from contamination. The most common problem limiting the use of groundwater in Egypt is its high iron, manganese and ammonia content. This problem is often overcome by applying the treatment before use. Aeration in many cases is not enough to oxidize iron and manganese in complex forms with organics. Most of the treatment we use potassium permanganate as an oxidizer followed by a pressurized closed green sand filter. The aim of present study is to investigate the optimum characteristics of groundwater to give lowest iron, manganese and ammonia, maximum production and quality of fish in aquaculture in El-Max Research Station. The major design goal of the system was determined the optimum time for harvesting the treated water, pH, and Glauconite weight to use it for aquaculture process in the research site and achieve the Egyptian law (48/1982) and EPA level required for aquaculture. The water characteristics are [Fe = 0.116 mg/L, Mn = 1.36 mg/L,TN = 0.44 mg/L , TP = 0.07 mg/L , Ammonia = 0.386 mg/L] by using the glauconite filter we obtained high efficiency for removal for [(Fe, Mn and Ammonia] ,but in the Lab we obtained result for (Fe, 43-97), ( Mn,92-99 ), and ( Ammonia, 66-88 )]. We summarized the results to show the optimum time, pH, Glauconite weight, and the best model for design in the region.Keywords: aquaculture, ammonia in groundwater, groundwater, iron and manganese in water, groundwater treatment
Procedia PDF Downloads 2334930 Sliding Mode Control of Variable Speed Wind Energy Conversion Systems
Authors: Zine Souhila Rached, Mazari Benyounes Bouzid, Mohamed Amine, Allaoui Tayeb
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Wind energy has many advantages, it does not pollute and it is an inexhaustible source. However, its high cost is a major constraint, especially on the less windy sites. The purpose of wind energy systems is to maximize energy efficiency, and extract maximum power from the wind speed. In other words, having a power coefficient is maximum and therefore the maximum power point tracking. In this case, the MPPT control becomes important.To realize this control, strategy conventional proportional and integral (PI) controller is usually used. However, this strategy cannot achieve better performance. This paper proposes a robust control of a turbine which optimizes its production, that is improve the quality and energy efficiency, namely, a strategy of sliding mode control. The proposed sliding mode control strategy presents attractive features such as robustness to parametric uncertainties of the turbine; the proposed sliding mode control approach has been simulated on three-blade wind turbine. The simulation result under Matlab\Simulink has validated the performance of the proposed MPPT strategy.Keywords: wind turbine, maximum power point tracking, sliding mode, energy conversion systems
Procedia PDF Downloads 6114929 Coastal Flood Mapping of Vulnerability Due to Sea Level Rise and Extreme Weather Events: A Case Study of St. Ives, UK
Authors: S. Vavias, T. R. Brewer, T. S. Farewell
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Coastal floods have been identified as an important natural hazard that can cause significant damage to the populated built-up areas, related infrastructure and also ecosystems and habitats. This study attempts to fill the gap associated with the development of preliminary assessments of coastal flood vulnerability for compliance with the EU Directive on the Assessment and Management of Flood Risks (2007/60/EC). In this context, a methodology has been created by taking into account three major parameters; the maximum wave run-up modelled from historical weather observations, the highest tide according to historic time series, and the sea level rise projections due to climate change. A high resolution digital terrain model (DTM) derived from LIDAR data has been used to integrate the estimated flood events in a GIS environment. The flood vulnerability map created shows potential risk areas and can play a crucial role in the coastal zone planning process. The proposed method has the potential to be a powerful tool for policy and decision makers for spatial planning and strategic management.Keywords: coastal floods, vulnerability mapping, climate change, extreme weather events
Procedia PDF Downloads 3974928 Villar Settlement Farm School for the Aetas: Assimilation through American Colonial Education in Zambales, Philippines
Authors: Julian E. Abuso, Alberto T. Paala Jr.
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The creation of settlement farm schools at the outset of American colonization of the Philippines was not a matter of accident; rather, their establishment was a major component of a grand plan on public education based on the benevolent assimilation policy of the United States. This argument is illustrated by the case of Villar Settlement Farm School, a school for the Aetas as a non-Christian tribal community in 1907. The study aims to: (1) identify and describe the antecedents for the establishment of Settlement Farm School, (2) explicate the cultural conflicts encountered by Aetas in school, (3) appraise the consequences of education as acculturation among Aeta population. The study made use of the following: historical data based on primary and secondary sources and life histories from primary informants. The Settlement Farm School for the Aetas was borne out of the American’s change in policy from military to civilian authority, recognition of education as a tool for benevolent assimilation. The narratives of informants manifested resistance to certain aspects of the educational process.Keywords: settlement farm school Aetas, tribe, colonial education, Aeta, non-Christian tribal community
Procedia PDF Downloads 3194927 Elasto-Viscoplastic Constitutive Modelling of Slow-Moving Landslides
Authors: Deepak Raj Bhat, Kazushige Hayashi, Yorihiro Tanaka, Shigeru Ogita, Akihiko Wakai
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Slow-moving landslides are one of the major natural disasters in mountainous regions. Therefore, study of the creep displacement behaviour of a landslide and associated geological and geotechnical issues seem important. This study has addressed and evaluated the slow-moving behaviour of landslide using the 2D-FEM based Elasto-viscoplastic constitutive model. To our based knowledge, two new control constitutive parameters were incorporated in the numerical model for the first time to better understand the slow-moving behaviour of a landslide. First, the predicted time histories of horizontal displacement of the landslide are presented and discussed, which may be useful for landslide displacement prediction in the future. Then, the simulation results of deformation pattern and shear strain pattern is presented and discussed. Moreover, the possible failure mechanism along the slip surface of such landslide is discussed based on the simulation results. It is believed that this study will be useful to understand the slow-moving behaviour of landslides, and at the same time, long-term monitoring and management of the landslide disaster will be much easier.Keywords: numerical simulation, ground water fluctuations, elasto-viscoplastic model, slow-moving behaviour
Procedia PDF Downloads 784926 Thermodynamic Analysis of a Vapor Absorption System Using Modified Gouy-Stodola Equation
Authors: Gulshan Sachdeva, Ram Bilash
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In this paper, the exergy analysis of vapor absorption refrigeration system using LiBr-H2O as working fluid is carried out with the modified Gouy-Stodola approach rather than the classical Gouy-Stodola equation and effect of varying input parameters is also studied on the performance of the system. As the modified approach uses the concept of effective temperature, the mathematical expressions for effective temperature have been formulated and calculated for each component of the system. Various constraints and equations are used to develop program in EES to solve these equations. The main aim of this analysis is to determine the performance of the system and the components having major irreversible loss. Results show that exergy destruction rate is considerable in absorber and generator followed by evaporator and condenser. There is an increase in exergy destruction in generator, absorber and condenser and decrease in the evaporator by the modified approach as compared to the conventional approach. The value of exergy determined by the modified Gouy Stodola equation deviates maximum i.e. 26% in the generator as compared to the exergy calculated by the classical Gouy-Stodola method.Keywords: exergy analysis, Gouy-Stodola, refrigeration, vapor absorption
Procedia PDF Downloads 4004925 Structure Analysis of Text-Image Connection in Jalayrid Period Illustrated Manuscripts
Authors: Mahsa Khani Oushani
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Text and image are two important elements in the field of Iranian art, the text component and the image component have always been manifested together. The image narrates the text and the text is the factor in the formation of the image and they are closely related to each other. The connection between text and image is an interactive and two-way connection in the tradition of Iranian manuscript arrangement. The interaction between the narrative description and the image scene is the result of a direct and close connection between the text and the image, which in addition to the decorative aspect, also has a descriptive aspect. In this article the connection between the text element and the image element and its adaptation to the theory of Roland Barthes, the structuralism theorist, in this regard will be discussed. This study tends to investigate the question of how the connection between text and image in illustrated manuscripts of the Jalayrid period is defined according to Barthes’ theory. And what kind of proportion has the artist created in the composition between text and image. Based on the results of reviewing the data of this study, it can be inferred that in the Jalayrid period, the image has a reference connection and although it is of major importance on the page, it also maintains a close connection with the text and is placed in a special proportion. It is not necessarily balanced and symmetrical and sometimes uses imbalance for composition. This research has been done by descriptive-analytical method, which has been done by library collection method.Keywords: structure, text, image, Jalayrid, painter
Procedia PDF Downloads 2334924 Introduction of Knowledge Management in a Public Sector Organization in India
Authors: Siddharth Vashisth, Varun Mathur
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This review provides an overview of the impact that implementation of various Knowledge Management (KM) strategies has had on the growth of a department in a Public Sector Company in India. In a regulated utility controlled by the government, the growth of an organization such as Hindustan Petroleum Corporation Limited (HPCL) had depended largely on the efficiencies of the systems and its people. However, subsequent to the de-regularization & to the entry of the private competition, the need for a ‘systematic templating’ of knowledge was recognized. This necessitated the introduction of Knowledge Management Centre (KMC). Projects & Pipelines Department (P&P) of HPCL introduced KMC that contributed significantly towards KM by adopting various strategies such as standardization, leveraging information system, competency enhancement, and improvements & innovations. These strategies gave both tangible as well as intangible benefits towards KM. Knowledge, technology & people are the three pillars that need to be catered for effective knowledge management in any organization. In HPCL, the initiative of KMC has served as an intermediary between these three major pillars as each activity of the strategy was centered on them and contributed significantly to their growth and up-gradation, ensuring overall growth of KM in the department.Keywords: knowledge, knowledge management, public sector organization, standardization, technology, people, skill, information system, innovation, competency, impact
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