Search results for: hospital waste
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4974

Search results for: hospital waste

2454 User Satisfaction in Rama-Chest Mouthpiece for Flexible Bronchoscopy in Ramathibodi Hospital

Authors: Chariya Laohavich

Abstract:

Background: Some limitations and complications have been found associated with commercial mouthpiece in bronchoscopic procedure. Therefore, we invented the Rama-chest mouthpiece from plastic normal saline bottle. Objective: The aim of this study was to compare user satisfaction in Rama-chest mouthpiece with the commercial mouthpiece. Methods: A prospective randomized controlled trial between commercial mouthpiece and Rama-chest mouthpiece was conducted on patients who were underwent bronchoscopy and required mouthpiece insertion from May to June 2014. The questionnaire about satisfaction was completed by the bronchoscopists, assistant nurses, and patients. Results: Thirty procedures in both groups were investigated. Mean satisfaction scores filled by the bronchoscopists and assistant nurses were not different between both groups. However, higher satisfaction score filled by the patients was found in Rama-chest mouthpiece than the comparator (p=0.011). Complications such as abrasion, pain, and itching were observed in commercial mouthpiece but not found in Rama-chest mouthpiece. Conclusion: We have introduced Rama-chest mouthpiece and proved its usefulness comparable to the commercial mouthpiece.

Keywords: mouthpiece, bronchoscopist, bronchology, pulmonology and respiratory diseases

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2453 Relations of Progression in Cognitive Decline with Initial EEG Resting-State Functional Network in Mild Cognitive Impairment

Authors: Chia-Feng Lu, Yuh-Jen Wang, Yu-Te Wu, Sui-Hing Yan

Abstract:

This study aimed at investigating whether the functional brain networks constructed using the initial EEG (obtained when patients first visited hospital) can be correlated with the progression of cognitive decline calculated as the changes of mini-mental state examination (MMSE) scores between the latest and initial examinations. We integrated the time–frequency cross mutual information (TFCMI) method to estimate the EEG functional connectivity between cortical regions, and the network analysis based on graph theory to investigate the organization of functional networks in aMCI. Our finding suggested that higher integrated functional network with sufficient connection strengths, dense connection between local regions, and high network efficiency in processing information at the initial stage may result in a better prognosis of the subsequent cognitive functions for aMCI. In conclusion, the functional connectivity can be a useful biomarker to assist in prediction of cognitive declines in aMCI.

Keywords: cognitive decline, functional connectivity, MCI, MMSE

Procedia PDF Downloads 383
2452 Lean: A Sustainable Approach to Design and Construction for Environmental Sustainability

Authors: Evelyn Lami Ashelo Allu, Fidelis A. Emuze

Abstract:

This study aims to contribute to the pursuit of environmental sustainability through the built environment practices of design and construction. Activities within the built environment and particularly within the construction industry have a significant role in ensuring environmental sustainability. The adoption of Lean principles and approaches would ensure that project deliverables are sustainable. This is because the processes that integrate lean principles reduce waste, add value to productivity, ensures customer satisfaction and are mindful of future productivity. Additionally, the lean principles for development are sustainable in themselves and thus promotes environmental sustainability. The study encourages further research with other methodologies and recommends the development of monitoring and evaluation mechanisms in order to promote the global concern for environmental sustainability.

Keywords: built environment, construction, design, lean, sustainability

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2451 Use of Opti-Jet Cs Md1mr Device for Biocide Aerosolisation in 3t Magnetic Resonance

Authors: Robert Pintaric, Joze Matela, Stefan Pintaric, Stanka Vadnjal

Abstract:

Introduction: This work is aimed to represent the use of the OPTI-JET CS MD1 MR prototype for application of neutral electrolyzed oxidizing water (NEOW) in magnetic resonance rooms. Material and Methods: We produced and used OPTI-JET CS MD1 MR aerosolisator whereby was performed aerosolization. The presence of microorganisms before and after the aerosolisation was recorded with the help of cyclone air sampling. Colony formed units (CFU) was counted. Results: The number of microorganisms in magnetic resonance 3T room was low as expected. Nevertheless, a possible CFU reduction of 87% was recorded. Conclusions: The research has shown that the use of EOW for the air and hard surface disinfection can considerably reduce the presence of microorganisms and consequently the possibility of hospital infections. It has also demonstrated that the use of OPTI-JET CS MD1 MR is very good. With this research, we started new guidelines for aerosolization in magnetic resonance rooms. Future work: We predict that presented technique works very good but we must focus also on time capacity sensors, and new appropriate toxicological studies.

Keywords: biocide, electrolyzed oxidizing water (EOW), disinfection, microorganisms, OPTI-JET CS MD1MR

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2450 Influence of Recycled Glass Content on the Properties of Concrete and Mortar

Authors: Bourmatte Nadjoua, Houari Hacène

Abstract:

The effect of replacement of fine aggregates with recycled glass on the fresh and hardened properties of concrete and mortar is studied. Percentages of replacement are 0–25% and 50% of aggregates with fine waste glass to produce concrete and percentage of replacement of 100% to produce mortar. As a result of the conducted study, the slump flow increased with the increase of recycled glass content. On the other hand, the compressive strength and tensile strength of recycled glass mixtures were decreased with the increase in the recycled glass content. The results showed that recycled glass aggregate can successfully be used with limited level for producing concrete. Mortar based on glass shows a compressive strength with 50% lower than that of control mortar.

Keywords: compressive strength, concrete, mortar, recycled glass

Procedia PDF Downloads 447
2449 Augmented Reality as Enhancer of the Lean Philosophy: An Exploratory Study

Authors: P. Gil, F. Charrua-Santos, A. A. Baptista, S. Azevedo, A. Espirito-Santo, J. Páscoa

Abstract:

Lean manufacturing is a philosophy of industrial management that aims to identify and eliminate any waste that exists in the companies. The augmented reality is a new technology that stills being developed in terms of software and hardware. This technology consists of an image capture device, a device for data processing and an image visualization equipment to visualize collected and processed images. It is characterized by being a technology that merges the reality with the virtual environment, so there is an instantaneous interaction between the two environments. The present work intends to demonstrate that the use of the augmented reality will contribute to improve some tools and methods used in Lean manufacturing philosophy. Through several examples of application in industry it will be demonstrated that the technological impact of the augmented reality on the Lean Manufacturing philosophy contribute to added value improvements.

Keywords: lean manufacturing, augmented reality, case studies, value

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2448 Evaluation of Moringa oleifera in Decolourization of Dyes in Textile Wastewater

Authors: Nagia Ali, R. S. R. El-Mohamedy

Abstract:

The purpose of this paper is to irradiate the dyes biologically through the use of Moreinga oleifera. The study confirms the potential use of Moringa oleifera in decolourization of dyes and thus opens up a scope for future analysis pertaining to its performance in treatment of textile effluent. In this paper, the ability of natural products in removing dyes was tested using two reactive dyes and one acid dye. After a preliminary screening for dye removal capacity, a vegetal protein extract derived from Moeringa oleifera seed was fully studied. The influences of several parameters such as pH, temperature or initial dye concentration were tested and the behavior of coagulants was compared. It was found that dye removal decreased as pH increased. Temperature did not seem to have a considerable effect, while initial dye concentration appeared to be a very important variable.

Keywords: Moreinga oleifera, decolourization, waste water, reactive dyes, acid dyes

Procedia PDF Downloads 366
2447 Die Design for Flashless Forging of a Polymer Insulator Fitting

Authors: Pedram Khazaie, Sajjad Moein

Abstract:

In the conventional hot forging of Tongue, which is a fitting for polymer insulator, the material wasted to flash accounts for 20-30% of workpiece. In order to reduce the cost of forged products, this waste material must be minimized. In this study, a flashless forging die is designed and simulated using the finite element method (FEM). A solution to avoid overloading the die with a simple preform is also presented. Moreover, since in flashless forging, burr is formed on the edge of workpiece, a controlled flash forging method is proposed to solve this problem. The simulation results have been validated by experiments; achieving close agreement between simulated and experimental data. It was shown that numerical modeling is helpful in reducing cost and time in the manufacturing process.

Keywords: burr formation, die design, finite element method, flashless forging

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2446 Genotyping of G/P No Typable Group a Rotavirus Strains Revealed G2 and G9 Genotype Circulations in Moroccan Children Fully Vaccinated with Rotarix™

Authors: H. Boulahyaoui, S. Alaoui Amine, C. Loutfi, H. El Annaz, N. Touil, El M. El Fahim, S. Mrani

Abstract:

Three Moroccan children fully vaccinated with Rotarix™ have been hospitalized for Rotavirus Gastroenteritis (RVGE) in the pediatric division of the Farabi Hospital, Oujda. Rotavirus G/P genotypes could not be typed because of their delayed crossing threshold (Ct) resolute with a group A rotavirus (RVA) real time RT-PCR. These strains were adapted to cell culture. All viruses replicated and caused extensive cytopathic effects after four or five passages in MA104 cell lines. Significant improvements have been obtained in the amount of viral particles. Each virus multiplied to a high titer (7.5 TCID50/ml). VP7 and VP4 partial gene sequencing revealed distinct genotypes compared to the Rotarix(®) vaccine strain. Two strains were of G2P[4] genotype whereas the third was G9P[8] genotype. Virus isolation while labor intensive, is recommended as a second test, especially when higher sensitivity for conventional RVA genotyping RT-PCR is needed. VP7 antigenic similarities between these strains and Rotarix were determined.

Keywords: esacpe-vaccine, Morocco, Rotarix, G2P[4], G9P[8]

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2445 Bioaccumulation of Polycyclic Aromatic Hydrocarbons in Padina boryana Alga Collected from a Contaminated Site at the Red Sea, Saudi Arabia

Authors: Huda Qari, I. A. Hassan

Abstract:

The brown alga Padina boryanawas was used for bioassay of polycyclic aromatic hydrocarbons (PAHs) accumulation at the seashore of Jeddah city. PAHs were determined in the coastal water and algal tissues by GC-MS. Acenaphthene (Ace) and dibenzo (a,h) anthracene (dB(a,h)An) were the main PAHs in seawater (50.02 and 46.18) and algal tissues (64.67 and 72.45), respectively. The ratios of low molecular weight/high molecular weight hydrocarbons (1.76 – 1.44), fluoranthene/pyrene (1.57 – 1.52) and phenanthrene/anthracene (0.86 – 0.67) in seawater and algal tissues, respectively, indicated the origin of the PAHs to be mainly petrogenic. This study has demonstrated the utility of using Padina boryanawas as a biomonitor of PAH contamination and bioavailability in the coastal waters.

Keywords: polycyclic aromatic hydrocarbons, Padina boryanawas, bioaccumulation, waste water

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2444 Computed Tomography Brain and Inpatient Falls: An Audit Evaluating the Indications and Outcomes

Authors: Zain Khan, Steve Ahn, Kathy Monypenny, James Fink

Abstract:

In Australian public hospitals, there were approximately 34,000 reported inpatient falls between 2015 to 2016. The gold standard for diagnosing intracranial injury is non-contrast enhanced brain computed tomography (CTB). Over a three-month timeframe, a total of one hundred and eighty (180) falls were documented between the hours of 4pm and 8am at a large metro hospital. Only three (3) of these scans demonstrated a positive intra-cranial finding. The rationale for scanning varied. The common indications included a fall with head strike, the presence of blood thinning medication, loss of consciousness, reduced Glasgow Coma Scale (GCS), vomiting and new neurological findings. There are several validated tools to aid in decision-making around ordering CTB scans in the acute setting, but no such accepted tool exists for the inpatient space. With further data collection, spanning a greater length of time and through involving multiple centres, work can be done towards generating such a tool that can be utilized for inpatient falls.

Keywords: computed tomography, falls, inpatient, intracranial hemorrhage

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2443 Gestational Diabetes Mellitus (GDM) Increasing Postpartum Screening to Prevent T2D

Authors: Boma Nellie S, Nambiar Ritu, K. Kanchanmala, T. Rashida, Israell Imelda, Moul Khusnud, Michael Marina

Abstract:

Gestational diabetes (GDM) imparts an increased life long risk of developing Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease in women. Once diagnosed with GDM women have up to 74% increased cumulative risk developing T2DM in 10-15 years. Identifying women at increased risk of developing T2DM and offering them pharmacological and lifestyle management interventions will delay or eliminate the development of diabetes in this population. While ADA recommends that all gestational diabetics be offered postnatal screening, worldwide the screening rates from 35-75% and Al Rahba Hospital with a robust universal antenatal screening program for GDM was at a dismal 9% in 2011. A multidisciplinary team was put together involving OB/Gyn Physicians, Midwives, Nurses (ward and OPD) Diabetic Educators, Dietitians, Medical Records, Laboratory & IT with the implementation of multiple strategies to increase the uptake of postpartum screening of the gestational diabetic.

Keywords: GDM, postnatal screening, preventing type 2 diabetes, lifestyle management

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2442 Concrete Recycling in Egypt for Construction Applications: A Technical and Financial Feasibility Model

Authors: Omar Farahat Hassanein, A. Samer Ezeldin

Abstract:

The construction industry is a very dynamic field. Every day new technologies and methods are developing to fasten the process and increase its efficiency. Hence, if a project uses fewer resources, it will be more efficient. This paper examines the recycling of concrete construction and demolition (C&D) waste to reuse it as aggregates in on-site applications for construction projects in Egypt and possibly in the Middle East. The study focuses on a stationary plant setting. The machinery set-up used in the plant is analyzed technically and financially. The findings are gathered and grouped to obtain a comprehensive cost-benefit financial model to demonstrate the feasibility of establishing and operating a concrete recycling plant. Furthermore, a detailed business plan including the time and hierarchy is proposed.

Keywords: construction wastes, recycling, sustainability, financial model, concrete recycling, concrete life cycle

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2441 Total Productive Maintenance (TPM) as a Strategy for Competitiveness

Authors: Ignatio Madanhire, Charles Mbohwa

Abstract:

This research examines the effect of a human resource strategy and the overall equipment effectiveness as well as assessing how the combination of the two can increase a firm’s productivity. The human resource aspect is looked at in detail to assess motivation of operators through training to reduce wastage on the manufacturing shop floor. The waste was attributed to operators, maintenance personal, idle machines, idle manpower and break downs. This work seeks to investigate the concept of Total Productive Maintenance (TPM) in addressing these short comings in the manufacturing case study. The impact of TPM to increase production while, as well as increasing employee morale and job satisfaction is assessed. This can be resource material for practitioners who seek to improve overall equipment efficiency (OEE) to achieve higher level productivity and competitiveness.

Keywords: maintenance, TPM, efficiency, productivity, strategy

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2440 Environmental Impacts on Urban Agriculture in Algiers

Authors: Sara Bouzekri, Said Madani

Abstract:

In many Mediterranean cities such as Algiers, the human activity, the strong mobility the urban sprawl, the air pollution, the problems of waste management, the wasting of the resources and the degradation of the environment weaken in an unquestionable way the farming. The question of sustainable action vis-a-vis these threats arises then in order to maintain a level of desired local development. The methodology is based on a multi-criteria method based on the AFOM diagnosis, which classifies agricultural strength indicators and those of threat, according to an analytical approach. In a sustainable development perspective, it will be appropriate to link the threat factors of the case study with the factors of climate change to see their impact on the future of agriculture. This will be accompanied by a SWOT analysis, which crosses the most significant criteria to arrive at the necessary recommendations based on future projects for urban agriculture.

Keywords: Algiers, environment, urban agriculture, threat factors

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2439 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education

Authors: Lauren G. Coggins

Abstract:

Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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2438 An Exploration of Policy-related Documents on District Heating and Cooling in Flanders: A Slow and Bottom-up Process

Authors: Isaura Bonneux

Abstract:

District heating and cooling (DHC) is increasingly recognized as a viable path towards sustainable heating and cooling. While some countries like Sweden and Denmark have a longstanding tradition of DHC, Belgium is lacking behind. The Northern part of Belgium, Flanders, had only a total of 95 heating networks in July 2023. Nevertheless, it is increasingly exploring its possibilities to enhance the scope of DHC. DHC is a complex energy system, requiring a lot of collaboration between various stakeholders on various levels. Therefore, it is of interest to look closer at policy-related documents at the Flemish (regional) level, as these policies set the scene for DHC development in the Flemish region. This kind of analysis has not been undertaken so far. This paper has the following research question: “Who talks about DHC, and in which way and context is DHC discussed in Flemish policy-related documents?” To answer this question, the Overton policy database was used to search and retrieve relevant policy-related documents. Overton retrieves data from governments, think thanks, NGOs, and IGOs. In total, out of the 244 original results, 117 documents between 2009 and 2023 were analyzed. Every selected document included theme keywords, policymaking department(s), date, and document type. These elements were used for quantitative data description and visualization. Further, qualitative content analysis revealed patterns and main themes regarding DHC in Flanders. Four main conclusions can be drawn: First, it is obvious from the timeframe that DHC is a new topic in Flanders with still limited attention; 2014, 2016 and 2017 were the years with the most documents, yet this number is still only 12 documents. In addition, many documents talked about DHC but not much in depth and painted it as a future scenario with a lot of uncertainty around it. The largest part of the issuing government departments had a link to either energy or climate (e.g. Flemish Environmental Agency) or policy (e.g. Socio-Economic Council of Flanders) Second, DHC is mentioned most within an ‘Environment and Sustainability’ context, followed by ‘General Policy and Regulation’. This is intuitive, as DHC is perceived as a sustainable heating and cooling technique and this analysis compromises policy-related documents. Third, Flanders seems mostly interested in using waste or residual heat as a heating source for DHC. The harbors and waste incineration plants are identified as potential and promising supply sources. This approach tries to conciliate environmental and economic incentives. Last, local councils get assigned a central role and the initiative is mostly taken by them. The policy documents and policy advices demonstrate that Flanders opts for a bottom-up organization. As DHC is very dependent on local conditions, this seems a logic step. Nevertheless, this can impede smaller councils to create DHC networks and slow down systematic and fast implementation of DHC throughout Flanders.

Keywords: district heating and cooling, flanders, overton database, policy analysis

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2437 Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

Abstract:

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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2436 Defectoscopy of Reinforced Concrete Structures with Using an Ultrasonic Method for Failure Monitoring

Authors: Sabina Hublova, Kristyna Hrabova, Petr Cikrle

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Sustainable development and preservation of existing buildings are becoming increasingly important worldwide. In order to reduce the amount of CO2 emissions in the air and to reduce the amount of waste from building structures, we can predict an increasing demand for maintenance of some existing buildings in the future. The use of modern diagnostic methods, which allow detailed determination of the properties of structures, the identification of critical points, could be the great importance for the better assessment of existing structures. Non-destructive methods could be one of the options. From these methods, ultrasonic appears to be a highly perspective method, thanks to which we are able to identify critical points of an element or a structure. The experiment will focus on the use of electroacoustic methods for defectoscopy in reinforced concrete columns.

Keywords: sustainability, defectoscopy, ultrasonic method, non-destructive methods, electroacoustic methods

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2435 Applicability of the Rapid Estimate of Adult Health Literacy in Medicine (Short Form) among Patients in Dakshina Kannada District, Karnataka, India

Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

Abstract:

Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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2434 A Green Analytical Curriculum for Renewable STEM Education

Authors: Mian Jiang, Zhenyi Wu

Abstract:

We have incorporated green components into existing analytical chemistry curriculum with the aims to present a more environment benign approach in both teaching laboratory and undergraduate research. These include the use of cheap, sustainable, and market-available material; minimized waste disposal, replacement of non-aqueous media; and scale-down in sample/reagent consumption. Model incorporations have covered topics in quantitative chemistry as well as instrumental analysis, lower division as well as upper level, and research in traditional titration, spectroscopy, electrochemical analysis, and chromatography. The green embedding has made chemistry more daily life relevance, and application focus. Our approach has the potential to expand into all STEM fields to make renewable, high-impact education experience for undergraduate students.

Keywords: green analytical chemistry, pencil lead, mercury, renewable

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2433 Surgical Skills in Mulanje

Authors: Nick Toossi, Joseph Hartland

Abstract:

Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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2432 Effects of Drying and Extraction Techniques on the Profile of Volatile Compounds in Banana Pseudostem

Authors: Pantea Salehizadeh, Martin P. Bucknall, Robert Driscoll, Jayashree Arcot, George Srzednicki

Abstract:

Banana is one of the most important crops produced in large quantities in tropical and sub-tropical countries. Of the total plant material grown, approximately 40% is considered waste and left in the field to decay. This practice allows fungal diseases such as Sigatoka Leaf Spot to develop, limiting plant growth and spreading spores in the air that can cause respiratory problems in the surrounding population. The pseudostem is considered a waste residue of production (60 to 80 tonnes/ha/year), although it is a good source of dietary fiber and volatile organic compounds (VOC’s). Strategies to process banana pseudostem into palatable, nutritious and marketable food materials could provide significant social and economic benefits. Extraction of VOC’s with desirable odor from dried and fresh pseudostem could improve the smell of products from the confectionary and bakery industries. Incorporation of banana pseudostem flour into bakery products could provide cost savings and improve nutritional value. The aim of this study was to determine the effects of drying methods and different banana species on the profile of volatile aroma compounds in dried banana pseudostem. The banana species analyzed were Musa acuminata and Musa balbisiana. Fresh banana pseudostem samples were processed by either freeze-drying (FD) or heat pump drying (HPD). The extraction of VOC’s was performed at ambient temperature using vacuum distillation and the resulting, mostly aqueous, distillates were analyzed using headspace solid phase microextraction (SPME) gas chromatography – mass spectrometry (GC-MS). Optimal SPME adsorption conditions were 50 °C for 60 min using a Supelco 65 μm PDMS/DVB Stableflex fiber1. Compounds were identified by comparison of their electron impact mass spectra with those from the Wiley 9 / NIST 2011 combined mass spectral library. The results showed that the two species have notably different VOC profiles. Both species contained VOC’s that have been established in literature to have pleasant appetizing aromas. These included l-Menthone, D-Limonene, trans-linlool oxide, 1-Nonanol, CIS 6 Nonen-1ol, 2,6 Nonadien-1-ol, Benzenemethanol, 4-methyl, 1-Butanol, 3-methyl, hexanal, 1-Propanol, 2-methyl- acid، 2-Methyl-2-butanol. Results show banana pseudostem VOC’s are better preserved by FD than by HPD. This study is still in progress and should lead to the optimization of processing techniques that would promote the utilization of banana pseudostem in the food industry.

Keywords: heat pump drying, freeze drying, SPME, vacuum distillation, VOC analysis

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2431 Ocular Complications in Type 1 Diabetes Mellitus in Zahedan: A Tropical Region in Southeast of Iran

Authors: Mohammad Hossain Validad, Maryam Nakhaei-Moghadam, Monire Mahjoob

Abstract:

Introduction: The prevalence of type 1 diabetes is increasing worldwide, and given the role of ethnicity and race in complications of diabetes, this study was designed to evaluate the ocular complications of type 1 diabetes mellitus in Zahedan. Methods: This prospective cross-sectional study was conducted on Type 1 diabetic children that referred to Alzahra Eye Hospital. All patients had a dilated binocular indirect ophthalmoscopy using a +90 D condensing lens and slit-lamp biomicroscopy. Age, gender, onset, duration of diabetes, and HbA1c level were recorded. Results: 76 type 1 diabetes patients with an age of 11.93 ± 3.76 years participated in this study. Out of 76 patients with diabetes, 19 people (25%) had ocular complications. There was a significant difference in age (P=0.01) and disease duration (P=0.07) between the two groups with and without ocular complications. Odd ratios for ocular complications with age and duration of diabetes were 1.32 and 1.32, respectively. Conclusion: Cataract was the most common ocular complication in type 1 diabetes in Zahedan, a tropical region that was significantly related to the duration of the disease and the age of the patients.

Keywords: diabet mellitus type one, cataract, ocular complication, hemoglobin A1C

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2430 Knowledge Engineering Based Smart Healthcare Solution

Authors: Rhaed Khiati, Muhammad Hanif

Abstract:

In the past decade, smart healthcare systems have been on an ascendant drift, especially with the evolution of hospitals and their increasing reliance on bioinformatics and software specializing in healthcare. Doctors have become reliant on technology more than ever, something that in the past would have been looked down upon, as technology has become imperative in reducing overall costs and improving the quality of patient care. With patient-doctor interactions becoming more necessary and more complicated than ever, systems must be developed while taking into account costs, patient comfort, and patient data, among other things. In this work, we proposed a smart hospital bed, which mixes the complexity and big data usage of traditional healthcare systems with the comfort found in soft beds while taking certain concerns like data confidentiality, security, and maintaining SLA agreements, etc. into account. This research work potentially provides users, namely patients and doctors, with a seamless interaction with to their respective nurses, as well as faster access to up-to-date personal data, including prescriptions and severity of the condition in contrast to the previous research in the area where there is lack of consideration of such provisions.

Keywords: big data, smart healthcare, distributed systems, bioinformatics

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2429 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit

Authors: Gokulan Vethanayakam, Daniel Aston

Abstract:

Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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2428 The Leaching Kinetics of Zinc from Industrial Zinc Slag Waste

Authors: Hilary Rutto

Abstract:

The investigation was aimed at determining the extent at which the zinc will be extracted from secondary sources generated from galvanising process using dilute sulphuric acid under controlled laboratory conditions of temperature, solid-liquid ratio, and agitation rate. The leaching experiment was conducted for a period of 2 hours and to total zinc extracted calculated in relation to the amount of zinc dissolved at a unit time in comparison to the initial zinc content of the zinc ash. Sulphuric acid was found to be an effective leaching agent with an overall extraction of 91.1% when concentration is at 2M, and solid/liquid ratio kept at 1g/200mL leaching solution and temperature set at 65ᵒC while slurry agitation is at 450rpm. The leaching mechanism of zinc ash with sulphuric acid was conformed well to the shrinking core model.

Keywords: leaching, kinetics, shrinking core model, zinc slag

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2427 Improving Sanitation and Hygiene Using a Behavioral Change Approach in Public and Private Schools in Kampala, Uganda

Authors: G. Senoga, D. Nakimuli, B. Ndagire, B. Lukwago, D. Kyamagwa

Abstract:

Background: The COVID-19 epidemic affected the education sector, with some private schools closing while other children missed schooling for fear contracting COVID-19. Post COVID-19, PSIU in collaborated with Kampala City Council Authority Directorate of Education and Social Science, Water and Sanitation department, and Directorate of Public Health and Environment to improve sanitation and hygiene among pupils and staff in 50 public and private school system in Kampala city. The “Be Clean, Stay Healthy Campaign” used a behavioral change approach in educating, reinforcing and engaging learners on proper hand washing behaviors, proper toilet usage and garbage disposal. In April 2022, 40 Washa lots were constructed, to reduce the pupil - hand wash station ratio; distributed KCCA approved printed materials; oriented 50 teachers, WASH committees to execute and implement hygiene promotion. To ensure sustainability, WASH messages were memorized and practiced through hand washing songs, Pledge, prayer, Poems, Skits, Music, dance and drama, coupled with participatory, practical demonstrations using peer to peer approach, guest speakers at assemblies and in classes. This improved hygiene and sanitation practices. Premised on this, PSI conducted an end line assessment to explore the impact of a hand washing campaign in regards to improvements in hand washing practices and hand hygiene among pupils, accessibility, functionality and usage of the constructed hygiene and sanitation facilities. Method: A cross-sectional post intervention assessment using a mixed methods approach, targeting headteachers, wash committee members and pupils less <17 years was used. Quantitative approaches with a mix of open-ended questions were used in purposively selected respondents in 50 schools. Primary three to primary seven pupils were randomly selected, data was analyzed using the Statistical Package for Social Scientists (SPSS) Outcomes and Findings: 46,989 pupils (51% female), 1,127 and 524 teaching and non-teaching staff were reached by the intervention, respectively. 96% of schools trained on sanitation, sustainable water usage and hygiene constituted 17-man school WASH committees with teacher, parents and pupils representatives. (31%) of the WASH committees developed workplans, (78%) held WASH meetings monthly. This resulted into improved sanitation, water usage, waste management, proper use of toilets, and improved pupils’ health with reduced occurrences of stomach upsets, diarrhoea initially attributed to improper use of latrines and general waste management. Teachers reported reduced number of school absenteeism due to improved hygiene and general waste management at school, especially proper management of sanitary pads. School administrations response rate in purchase of hygiene equipment’s and detergents like soap improved. Regular WASH meetings in classes, teachers and community supervision ensured WASH facilities are used appropriately. Conclusion and Recommendations: Practical behaviour change innovations improves pupil’s knowledge and understanding of hygiene messages and usage. Over 70% of pupils had clear recall of key WASH Messages. There is need for continuous water flow in the Washa lots, harvesting rain water would reduce water bills while complementing National water supply coupled with increasing on Washa lots in densely populated schools.

Keywords: handwashing, hygyiene, sanitation, behaviour change

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2426 Mechanical Simulation with Electrical and Dimensional Tests for AISHa Containment Chamber

Authors: F. Noto, G. Costa, L. Celona, F. Chines, G. Ciavola, G. Cuttone, S. Gammino, O. Leonardi, S. Marletta, G. Torrisi

Abstract:

At Istituto Nazionale di Fisica Nucleare – Laboratorio Nazionale del Sud (INFN-LNS), a broad experience in the design, construction and commissioning of ECR and microwave ion sources is available. The AISHa ion source has been designed by taking into account the typical requirements of hospital-based facilities, where the minimization of the mean time between failures (MTBF) is a key point together with the maintenance operations, which should be fast and easy. It is intended to be a multipurpose device, operating at 18 GHz, in order to achieve higher plasma densities. It should provide enough versatility for future needs of the hadron therapy, including the ability to run at larger microwave power to produce different species and highly charged ion beams. The source is potentially interesting for any hadron therapy facility using heavy ions. In this paper, we analyzed the dimensional test and electrical test about an innovative solution for the containment chamber that allows us to solve our isolation and structural problems.

Keywords: FEM analysis, electron cyclotron resonance ion source, dielectrical measurement, hadron therapy

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2425 Process of Research, Development and Application of New Pelletizer

Authors: Ľubomír Šooš, Peter Križan, Juraj Beniak, Miloš Matúš

Abstract:

The success of introducing a new product on the market is the new principle of production, or progressive design, improved efficiency or high quality of manufactured products. Proportionally with the growth of interest in press-biofuels - pellets or briquettes, is also growing interest in the new design better, more efficiently machines produce pellets, briquettes or granules completely new shapes. Our department has for years dedicated to the development of new highly productive designs pressing machines and new optimized press-biofuels. In this field, we have more than 40 national and international patents. The aim of paper is description of the introduction of a new principle pelleting mill and the description of his process of research, development, manufacturing and testing to deployment into production.

Keywords: compacting process, pellets mill, design, new conception, press-biofuels, patent, waste

Procedia PDF Downloads 383