Search results for: urban park

Authors: Chandan Kumar

Abstract:

Background and Context: Population growth and rapid urbanization resulted nearly 2 Lacs migrants along with families moving to Delhi each year in search of jobs. Most of these poor migrant families end up living in slums and constitute an estimated population of 1.87 lacs every year. Further, more than half (52 per cent) of Delhi’s population resides in places such as unauthorized and resettled colonies. Slum population is fully dependent on public toilet to defecate. In Public toilets, manholes either connected with Sewer line or septic tank. Septic tank connected public toilet faces major challenges to dispose of waste water. They have to dispose of waste water in outside open drain and waste water struck out side of public toilet complex and near to the slum area. As a result, outbreak diseases such as Malaria, Dengue and Chikungunya in slum area due to stagnated waste water. Intervention and Innovation took place by Save the Children in 21 Public Toilet Complexes of South Delhi and North Delhi. These public toilet complexes were facing same waste water disposal problem. They were disposing of minimum 1800 liters waste water every day in open drain. Which caused stagnated water-borne diseases among the nearest community. Construction of Soak Well: Construction of soak well in urban context was an innovative approach to minimizing the problem of waste water management and increased water table of existing borewell in toilet complex. This technique made solution in Ground water recharging system, and additional water was utilized in vegetable gardening within the complex premises. Soak well had constructed with multiple filter media with inlet and safeguarding bed on surrounding surface. After construction, soak well started exhausting 2000 liters of waste water to raise ground water level through different filter media. Finally, we brought a change in the communities by constructing soak well and with zero maintenance system. These Public Toilet Complexes were empowered by safe disposing waste water mechanism and reduced stagnated water-borne diseases.

Keywords: diseases, ground water recharging system, soak well, toilet complex, waste water

Procedia PDF Downloads 551

Authors: A. Olivi, P. Reyes Cabrera

Abstract:

Ageing and urbanization are two of the main trends that characterize the twenty-first century. Its trending is especially accelerated in the emerging countries of Asia and Latin America. Chile is one of the countries in the Latin American region, where the demographic transition to ageing is becoming increasingly visible. The challenges that the new demographic scenario poses to urban administrators call for searching innovative solutions to maximize the functional and psycho-social benefits derived from the relationship between older people and the environment in which they live. Although mobility is central to people's everyday practices and social relationships, it is not distributed equitably. On the contrary, it can be considered another factor of inequality in our cities. Older people are a particularly sensitive and vulnerable group to mobility. In this context, based on the ageing in place strategy and following the social innovation approach within a spatial context, the "Community Observatory of Territorial Information Control and Management" project aims at the collective search and validation of solutions for the satisfaction of mobility and accessibility specific needs of urban aged people. Specifically, the Observatory intends to: i) promote the direct participation of the aged population in order to generate relevant information on the territorial situation and the satisfaction of the mobility needs of this group; ii) co-create dynamic and efficient mechanisms for the reporting and updating of territorial information; iii) increase the capacity of the local administration to plan and manage solutions to environmental problems at the neighborhood scale. Based on a participatory mapping methodology and on the application of digital technology, the Observatory designed and developed, together with aged people, a crowdsourcing platform for smartphones, called DIMEapp, for reporting environmental problems affecting mobility and accessibility. DIMEapp has been tested at a prototype level in two neighborhoods of the city of Valparaiso. The results achieved in the testing phase have shown high potential in order to i) contribute to establishing coordination mechanisms with the local government and the local community; ii) improve a local governance system that guides and regulates the allocation of goods and services destined to solve those problems.

Keywords: accessibility, ageing, city, digital technology, local governance

Procedia PDF Downloads 130

Authors: Hyoun Joong Kim, Jin Woo Jun, Sib Sankar Giri, Cheng Chi, Saekil Yun, Sang Guen Kim, Sang Wha Kim, Jeong Woo Kang, Se Jin Han, Se Chang Park

Abstract:

Vibrio corallilyticus is a well-known pathogen of coral. It is also infectious to a variety of shellfish species, including Pacific oyster (Crassostrea gigas) larvae. V. corallilyticus is remained to be a major constraint in marine bivalve aquaculture practice, especially in artificial seed production facility. Owing to the high mortality and contagious nature of the pathogen, large amount of antibiotics has been used for disease prevention and control. However, indiscriminate use of antibiotics may result in food and environmental pollution, and development of antibiotic resistant strains. Therefore, eco-friendly disease preventative measures are imperative for sustainable bivalve culture. The present investigation proposes the application of bacteriophage (phage) as an effective alternative method for controlling V. corallilyticus infection in marine bivalve hatcheries. Isolation of phages from sea water sample was carried out using drop or double layer agar methods. The host range, stability and morphology of the phage isolates were studied. In vivo phage efficacy to prevent V. corallilyticus infection in oyster larvae was also performed. The isolated phages, named pVco-5 and pVco-7 was classified as a podoviridae and pVco-14, was classified as a siphoviridae. Each phages were infective to four strains of seven V. corallilyticus strains tested. When oyster larvae were pre-treated with the phage before bacterial challenge, mortality of the treated oyster larvae was lower than that in the untreated control. This result suggests that each phages have the potential to be used as therapeutic agent for controlling V. corallilyticus infection in marine bivalve hatchery.

Keywords: bacteriophage, Vibrio coralliilyticus, Oyster larvae, mortality

Procedia PDF Downloads 222

Authors: Tatipamula Samiksha Goud, .A.Naveena, M.sresta

Abstract:

Traffic congestion is a major issue in many cities throughout the world, particularly in urban areas, and it is past time to switch from a fixed timer mode to an automated system. The current traffic signalling system is a fixed-time system that is inefficient if one lane is more functional than the others. A structure for an intelligent traffic control system is being designed to address this issue. When traffic density is higher on one side of a junction, the signal's green time is extended in comparison to the regular time. This study suggests a technique in which the signal's time duration is assigned based on the amount of traffic present at the time. Infrared sensors can be used to do this.

Keywords: infrared sensors, micro-controllers, LEDs, oscillators

Procedia PDF Downloads 140

Authors: Linna Li

Abstract:

The capability to move around places is doubtless very important for individuals to maintain good health and social functions. People’s activities in space and time have long been a research topic in behavioral and socio-economic studies, particularly focusing on the highly dynamic urban environment. By analyzing groups of people who share similar activity patterns, many socio-economic and socio-demographic problems and their relationships with individual behavior preferences can be revealed. Los Angeles, known for its large population, ethnic diversity, cultural mixing, and entertainment industry, faces great transportation challenges such as traffic congestion, parking difficulties, and long commuting. Understanding people’s travel behavior and movement patterns in this metropolis sheds light on potential solutions to complex problems regarding urban mobility. This project visualizes people’s trajectories in Greater Los Angeles (L.A.) Area over a period of two months using Twitter data. A Python script was used to collect georeferenced tweets within the Greater L.A. Area including Ventura, San Bernardino, Riverside, Los Angeles, and Orange counties. Information associated with tweets includes text, time, location, and user ID. Information associated with users includes name, the number of followers, etc. Both aggregated and individual activity patterns are demonstrated using various geovisualization techniques. Locations of individual Twitter users were aggregated to create a surface of activity hot spots at different time instants using kernel density estimation, which shows the dynamic flow of people’s movement throughout the metropolis in a twenty-four-hour cycle. In the 3D geovisualization interface, the z-axis indicates time that covers 24 hours, and the x-y plane shows the geographic space of the city. Any two points on the z axis can be selected for displaying activity density surface within a particular time period. In addition, daily trajectories of Twitter users were created using space-time paths that show the continuous movement of individuals throughout the day. When a personal trajectory is overlaid on top of ancillary layers including land use and road networks in 3D visualization, the vivid representation of a realistic view of the urban environment boosts situational awareness of the map reader. A comparison of the same individual’s paths on different days shows some regular patterns on weekdays for some Twitter users, but for some other users, their daily trajectories are more irregular and sporadic. This research makes contributions in two major areas: geovisualization of spatial footprints to understand travel behavior using the big data approach and dynamic representation of activity space in the Greater Los Angeles Area. Unlike traditional travel surveys, social media (e.g., Twitter) provides an inexpensive way of data collection on spatio-temporal footprints. The visualization techniques used in this project are also valuable for analyzing other spatio-temporal data in the exploratory stage, thus leading to informed decisions about generating and testing hypotheses for further investigation. The next step of this research is to separate users into different groups based on gender/ethnic origin and compare their daily trajectory patterns.

Keywords: geovisualization, human mobility pattern, Los Angeles, social media

Procedia PDF Downloads 114

Authors: Ritu Sarsoha

Abstract:

According to World Summit 2002 health is an integral component of sustainable development. Due to overpopulation and lack of employment opportunities in villages and small towns, the rural youth tend to migrate to the big cities causing mushrooming of slums. These slums lack most of the basic necessities of life particularly regarding environmental pollution and appropriate health care system. Present paper deals with the socio-economic and environmental status of people living in slum area of Chandigarh which has now grown as a big city today as it has become a hub for the migrants from U. P. and Bihar. Here is a case study of Colony no. 5 of Chandigarh which is divided into more than one block.

Keywords: slum, socio-economic, environment pollution, health

Procedia PDF Downloads 304

Authors: Paule Olivia Akotto

Abstract:

The recent literature suggests spending between 50%-85% of oil rents. However, there are not yet clear guidelines for allocating this windfall in the public investment system, while most of the resource-rich countries fail to improve their intergenerational mobility. We study a design of the optimal spending system in Senegal, a low-income developing country featuring newly discovered oil fields and low intergenerational mobility. We build a dynamic general equilibrium model in which rural and urban (Dakar and other urban centers henceforth OUC) households face different health, education, and employment opportunities based on their location, affecting their intergenerational mobility. The model captures the relationship between oil rents, public investment, and multidimensional inequality of opportunity. The government invests oil rents in three broad sectors: health and education, road and industries, and agriculture. Through endogenous productivity externality and human capital accumulation, our model generates the predominant position of Dakar and OUC households in terms of access to health, education, and employment in line with Senegal data. Rural households are worse off in all dimensions. We compute the optimal spending policy under two sets of simulation scenarios. Under the current Senegal public investment strategy, which weighs more health and education investments, we find that the reform maximizing the decline in inequality of opportunity between households, frontloads investment during the first eight years of the oil exploitation and spends the perpetual value of oil wealth thereafter. We will then identify the marginal winners and losers associated with this policy and its redistributive implications. Under our second set of scenarios, we will test whether the Senegalese economy can reach better equality of opportunity outcomes under this frontloading reform, by allowing the sectoral shares of investment to vary. The trade-off will be between cutting human capital investment in favor of agricultural and productive infrastructure or increasing the former. We will characterize the optimal policy by specifying where the higher weight should be. We expect that the optimal policy of the second set strictly dominates in terms of equality of opportunity, the optimal policy computed under the current investment strategy. Finally, we will quantify this optimal policy's aggregate and distributional effects on poverty, well-being, and gender earning gaps.

Keywords: developing countries, general equilibrium, inequality of opportunity, oil rents

Procedia PDF Downloads 237

Authors: Jung-Il Kang, Jeon Eon Park, Yu-Jin Moon, Young-Seok Ahn, Eun-Sook Yoo, Hee-Kyoung Kang

Abstract:

This study was conducted to evaluate the effect of Undariopsis peterseniana, a seaweed native to Jeju Island, Korea, on the growth of hair. The dermal papilla cells (DPCs) have known to regulate hair growth cycle and length of hair follicle through interact with epithelial cells. When immortalized vibrissa DPCs were treated with the U. peterseniana extract, the U. peterseniana extract significantly increased the proliferation of DPCs. The effect of U. peterseniana extract on the growth of vibrissa follicles was also examined. U. peterseniana extract significantly increased the hair-fiber lengths of the vibrissa follicles. Hair loss is partly caused by dihydrotestosterone (DHT) binding to androgen receptor in hair follicles, and the inhibition of 5α-reductase activity can prevent hair loss through the decrease of DHT level. The U. peterseniana extract inhibited 5α-reductase activity. Minoxidil, a potent hair-growth agent, can induce proliferation in NIH3T3 fibroblasts by opening KATP channels. We thus examined the proliferative effects of U. peterseniana extract in NIH3T3 fibroblasts. U. peterseniana extract significantly increased the proliferation of NIH3T3 fibroblasts. Tetraethylammonium chloride (TEA), a K+ channel blocker, inhibited U. peterseniana-induced proliferation in NIH3T3 fibroblasts. These results suggest that U. peterseniana could have the potential to treat alopecia through the proliferation of DPCs, the inhibition of 5α-reductase activity and the opening of KATP channels. [Acknowledgement] This research was supported by The Leading Human Resource Training Program of Regional Neo industry through the National Research Foundation of Korea(NRF) funded by the Ministry of Science, ICT and future Planning (2016H1D5A1908786).

Keywords: hair growth, Undariopsis peterseniana, vibrissa follicles, dermal papilla cells, 5α-reductase, KATP channels

Procedia PDF Downloads 295

Authors: Carolyn Hatch, Laurent Simon

Abstract:

Urban mobility and the transportation industry are undergoing a transformation, shifting from an auto production-consumption model that has dominated since the early 20th century towards new forms of personal and shared multi-modality [1]. This is shaped by key forces such as climate change, which has induced a shift in production and consumption patterns and efforts to decarbonize and improve transport services through, for instance, the integration of vehicle automation, electrification and mobility sharing [2]. Advanced innovation practices and platforms for experimentation and validation of new mobility products and services that are increasingly complex and multi-stakeholder-oriented are shaping this new world of mobility. Transportation hubs – such as airports - are emblematic of these disruptive forces playing out in the mobility industry. Airports are emerging as the core of innovation ecosystems on and around contemporary mobility issues, and increasingly recognized as complex public/private nodes operating in many societal dimensions [3,4]. These include urban development, sustainability transitions, digital experimentation, customer experience, infrastructure development and data exploitation (for instance, airports generate massive and often untapped data flows, with significant potential for use, commercialization and social benefit). Yet airport innovation practices have not been well documented in the innovation literature. This paper addresses this gap by proposing a model of airport innovation that aims to equip airport stakeholders to respond to these new and complex innovation needs in practice. The methodology involves: 1 – a literature review bringing together key research and theory on airport innovation management, open innovation and innovation ecosystems in order to evaluate airport practices through an innovation lens; 2 – an international benchmarking of leading airports and their innovation practices, including such examples as Aéroports de Paris, Schipol in Amsterdam, Changi in Singapore, and others; and 3 – semi-structured interviews with airport managers on key aspects of organizational practice, facilitated through a close partnership with the Airport Council International (ACI), a major stakeholder in this research project. Preliminary results find that the most successful airports are those that have shifted to a multi-stakeholder, platform ecosystem model of innovation. The recent entrance of new actors in airports (Google, Amazon, Accor, Vinci, Airbnb and others) have forced the opening of organizational boundaries to share and exchange knowledge with a broader set of ecosystem players. This has also led to new forms of governance and intermediation by airport actors to connect complex, highly distributed knowledge, along with new kinds of inter-organizational collaboration, co-creation and collective ideation processes. Leading airports in the case study have demonstrated a unique capacity to force traditionally siloed activities to “think together”, “explore together” and “act together”, to share data, contribute expertise and pioneer new governance approaches and collaborative practices. In so doing, they have successfully integrated these many disruptive change pathways and forced their implementation and coordination towards innovative mobility outcomes, with positive societal, environmental and economic impacts. This research has implications for: 1 - innovation theory, 2 - urban and transport policy, and 3 - organizational practice - within the mobility industry and across the economy.

Keywords: airport management, ecosystem, innovation, mobility, platform, transport hubs

Procedia PDF Downloads 180

Authors: I. Yunusa, M. A. Ibrahim, A. H. Yakasai, L. U. S. Ezeanyika

Abstract:

This study was conducted to examine the level of heavy metals among 192 apparently healthy female adolescents randomly selected from three different boarding secondary schools in the urban area of the most populated city in north-western part of Nigeria. Atomic absorption spectrometry (AAS) was used to determine the plasma levels of the heavy metals which include cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), nickel (Ni), lead (Pb) and zinc (Zn). Our findings revealed the following mean±SD values for each of the heavy metal; 0.11±0.01µg Cd/L, 0.09 ± 0.02µg Co/L, 0.19 ± 0.02 µg Cr/L, 0.91 ± 0.02 µg Cu/L, 1.53 ± 0.31 µg Fe/L, 0.01 ± 0.04 µg Mn/L, 0.3.8 ± 0.04µg Mo/L, 0.04±0.01µg Ni/L, 0.04 ± 0.01µg Pb/L and 2.80 ± 0.24µg Zn/L respectively. It was concluded that toxicity from heavy metals did not exist among female adolescents.

Keywords: heavy metals, female, adolescents, Nigeria

Procedia PDF Downloads 386

Authors: Djamel Boussaa

Abstract:

Cultural heritage and tourism have become during the last two decades dynamic areas of development in the world. The idea of heritage is crucial to the critical decision-making process as to how irreplaceable resources are to be utilized by people of the present or conserved for future generations in a fast changing world. In view of the importance of ‘heritage’ to the development of a tourist destination the emphasis on developing appropriate adaptive reuse strategies cannot be overemphasized. In October 1999, the 12th general assembly of the ICOMOS in Mexico stated, that in the context of sustainable development, two interrelated issues need urgent attention, cultural tourism and historic towns and cities. These two issues underscore the fact that historic resources are non-renewable, belonging to all of humanity. Without adequate adaptive reuse actions to ensure a sustainable future for these historic resources, may lead to their complete vanishing. The growth of tourism and its role in dispersing cultural heritage to everyone is developing rapidly. According to the World Tourism Organization, natural and cultural heritage resources are and will remain motivating factors for travel in the foreseeable future. According to the experts, people choose travel destinations where they can learn about traditional and distinct cultures in their historic context. The Qatar rich urban heritage is now being recognized as a valuable resource for future development. This paper discusses the role of cultural heritage and tourism in regenerating Souk Waqif, and consequently the city of Doha. Therefore, in order to use cultural heritage wisely, it will be necessary to position heritage as an essential element of sustainable development, giving particular attention to cultural heritage and tourism. The research methodology is based on an empirical survey of the situation, based on several visits, meetings and interviews with the local heritage players. The rehabilitation project initiated since 2004 will be examined and assessed. Therefore, there is potential to assess the situation and propose directions for a sustainable future to this historic landmark. Conservation for the sake of conservation appears to be an outdated concept. Many irreplaceable natural and cultural sites are being compromised because local authorities are not giving economic consideration to the value of rehabilitating such sites. The question to be raised here is 'How can cultural heritage be used wisely for tourism without compromising its social sustainability within the emerging global world?'

Keywords: cultural heritage, tourism, regeneration, economy, social sustainability

Procedia PDF Downloads 418

Authors: Adedayo Adeleke, Dineo Pule

Abstract:

The ongoing load-shedding in most parts of South Africa, combined with climate change causing severe drought conditions in Cape Town, has left electricity consumers seeking alternative sources of power and water. Solar energy, which is abundant in most parts of South Africa and is regarded as a clean and renewable source of energy, allows for the generation of electricity via solar photovoltaic systems. Rainwater harvesting is the collection and storage of rainwater from building rooftops, allowing people without access to water to collect it. The lack of dependable energy and water source must be addressed by shifting to solar energy via solar photovoltaic systems and rainwater harvesting. Before this can be done, the potential of building rooftops must be assessed to determine whether solar energy and rainwater harvesting will be able to meet or significantly contribute to Atlantis industrial areas' electricity and water demands. This research project presents methods and approaches for automatically extracting building rooftops in Atlantis industrial areas and evaluating their potential for solar photovoltaics and rainwater harvesting systems using Light Detection and Ranging (LiDAR) data and aerial imagery. The four objectives were to: (1) identify an optimal method of extracting building rooftops from aerial imagery and LiDAR data; (2) identify a suitable solar radiation model that can provide a global solar radiation estimate of the study area; (3) estimate solar photovoltaic potential overbuilding rooftop; and (4) estimate the amount of rainwater that can be harvested from the building rooftop in the study area. Mapflow, a plugin found in Quantum Geographic Information System(GIS) was used to automatically extract building rooftops using aerial imagery. The mean annual rainfall in Cape Town was obtained from a 29-year rainfall period (1991- 2020) and used to calculate the amount of rainwater that can be harvested from building rooftops. The potential for rainwater harvesting and solar photovoltaic systems was assessed, and it can be concluded that there is potential for these systems but only to supplement the existing resource supply and offer relief in times of drought and load-shedding.

Keywords: roof potential, rainwater harvesting, urban plan, roof extraction

Procedia PDF Downloads 113

Authors: Wenqian Bai

Abstract:

Background: In response to the post-pandemic directives of Xi Jinping concerning the new era of ecological civilization, China has embarked on ecological restoration projects across its territorial spaces. This initiative faces challenges such as complex evaluation metrics and subpar informatization standards. Methodology: This research focuses on Mianzhu City, Sichuan Province, to assess its resource and environmental carrying capacities and the appropriateness of land use for development from ecological, agricultural, and urban perspectives. The study incorporates a range of spatial data to evaluate factors like ecosystem services (including water conservation, soil retention, and biodiversity), ecological vulnerability (addressing issues like soil erosion and desertification), and resilience. Utilizing the Minimum Cumulative Resistance model along with the ‘Three Zones and Three Lines’ strategy, the research maps out ecological corridors and significant ecological networks. These frameworks support the ecological restoration and environmental enhancement of the area. Results: The study identifies critical ecological zones in Mianzhu City's northwestern region, highlighting areas essential for protection and particularly crucial for water conservation. The southeastern region is categorized as a generally protected ecological zone with respective ratings for water conservation functionality and ecosystem resilience. The research also explores the spatial challenges of three ecological functions and underscores the substantial impact of human activities, such as mining and agricultural expansion, on the ecological baseline. The proposed spatial arrangement for ecological restoration, termed ‘One Mountain, One Belt, Four Rivers, Five Zones, and Multiple Corridors’, strategically divides the city into eight major restoration zones, each with specific tasks and projects. Conclusion: With its significant ‘mountain-plain’ geography, Mianzhu City acts as a crucial ecological buffer for the Yangtze River's upper reaches. Future development should focus on enhancing ecological corridors in agriculture and urban areas, controlling soil erosion, and converting farmlands back to forests and grasslands to foster ecosystem rehabilitation.

Keywords: ecological restoration, resource and environmental carrying capacity, land development suitability, ecosystem services, ecological vulnerability, ecological networks

Procedia PDF Downloads 39

Authors: Rajul Dwivedi, Mahesh Patel

Abstract:

Due to the scarcity of natural resources, common rivers and coastal structures are too expensive to build and maintain. One such method is to use geotextile tube technology to build marine protected structures, such as dams, canals, jetties, free breakwaters, etc. Geotextile tube technology has evolved from other construction technologies and improved into a more efficient solution. The coastal erosion problems have been exacerbated by the development of infrastructure associated with the expansion of urban and industrial activities. Resources and harbours and the removal of sea sand for use in this erosion event will accelerate the erosion of the sea. but in the coastal areas, due to depletion of sand or beach sand

Keywords: geotextile tubes, slurry, dewatering, response surface

Procedia PDF Downloads 138

Authors: Javier Alfonso Bonilla-Chávez, Angélica Lozano

Abstract:

In North America, more than 2,000 people annually die in accidents related to railroad tracks. In 2020, collisions at grade crossings were the main cause of deaths related to railway accidents in Mexico. Railway networks have constant interaction with motor transport users, cyclists, and pedestrians, mainly in grade crossings, where is the greatest vulnerability and risk of accidents. Usually, accidents at grade crossings are directly related to risky behavior and non-compliance with regulations by motorists, cyclists, and pedestrians, especially in developing countries. Around the world, countries classify these crossings in different ways. In Mexico, according to their dangerousness (high, medium, or low), types A, B and C have been established, recommending for each one different type of auditive and visual signaling and gates, as well as horizontal and vertical signaling. This classification is based in a weighting, but regrettably, it is not explained how the weight values were obtained. A review of the variables and the current approach for the grade crossing classification is required, since it is inadequate for some crossings. In contrast, North America (USA and Canada) and European countries consider a broader classification so that attention to each crossing is addressed more precisely and equipment costs are adjusted. Lack of a proper classification, could lead to cost overruns in the equipment and a deficient operation. To exemplify the lack of a good classification, six crossings are studied, three located in the rural area of Mexico and three in Mexico City. These cases show the need of: improving the current regulations, improving the existing infrastructure, and implementing technological systems, including informative signals with nomenclature of the involved crossing and direct telephone line for reporting emergencies. This implementation is unaffordable for most municipal governments. Also, an inventory of the most dangerous grade crossings in urban and rural areas must be obtained. Then, an approach for improving the classification of grade crossings is suggested. This approach must be based on criteria design, characteristics of adjacent roads or intersections which can influence traffic flow through the crossing, accidents related to motorized and non-motorized vehicles, land use and land management, type of area, and services and economic activities in the zone where the grade crossings is located. An expanded classification of grade crossing in Mexico could reduce accidents and improve the efficiency of the railroad.

Keywords: accidents, grade crossing, railroad, traffic safety

Procedia PDF Downloads 106

Authors: Lee Cahaner, Nissim Leon

Abstract:

The segregation of populations is one of the main axes in the research of urban geography, which refers to the spatial and functional relationships between settlements. In Israel, this phenomenon has its unique expression in the spatial processes concerning the ultra-orthodox population. This population holds a set of interactions within itself as well as with the non-orthodox surrounding population because of historical and contemporary motivations on its which strength depends on its homogeneousness and separation. Its demographic growth rate and the internal social processes that the ultra-orthodox society undergoes create a new image of the ultra-orthodox concentration and its location in the Israeli space. The goals of the present study have also been defined with the express intention of filling the scholarly vacuum noted above: firstly, to discuss the development of the Israeli ultra-Orthodox sector’s hierarchical and spatial structure as of 2015, in light of the principles and mechanisms that guide it and vis-à-vis the general population’s hierarchical locality system; secondly, to map Israel’s ultra-Orthodox population, with attention to its physical boundaries, its subdivisions (Hassidic, Lithuanian, Sephardic) and the geographical and demographic processes that have characterized it in recent years; and thirdly, to shed light on the interactions between ultra-Orthodox localities via several different parameters, e.g. migration, education, transportation, employment, consumerism and community services. In order to understand the changes in ultra-Orthodox geographic distribution and the social processes that these changes have generated, a number of research activities were conducted during the course of this study− notably, gathering and assembling material from earlier academic studies, newspaper advertisements, state and private archives; in-depth interviews with major figures in the ultra-Orthodox community and others who come into contact with it; tours of the core areas of ultra-Orthodox settlement; and gathering quantitative and qualitative data from the statistical reports of governmental and other bodies. In addition, a multi-participant (2400-respondent) quantitative survey was conducted among residents of the new ultra-Orthodox cities, designed to elucidate the attributes and spatial attitudes of the residents− as a means of tracing and understanding this new settlement pattern within ultra-Orthodox space. A major portion of the quantitative and qualitative material was processed to form a system of maps that visually describe the distribution of Israel’s ultra-Orthodox population.

Keywords: migration, new cities, segregation, ultra-orthodox

Procedia PDF Downloads 400

Authors: Stamatis Zoras, Vasilis Evagelopoulos, Theodoros Staurakas

Abstract:

The association between elevated air pollution levels and extreme climate conditions (temperature, particulate matter, ozone levels, etc.) and mental consequences has been, recently, the focus of significant number of studies. It varies depending on the time of the year it occurs either during the hot period or cold periods but, specifically, when extreme air pollution and weather events are observed, e.g. air pollution episodes and persistent heatwaves. It also varies spatially due to different effects of air quality and climate extremes to human health when considering metropolitan or rural areas. An air pollutant concentration and a climate extreme are taking a different form of impact if the focus area is countryside or in the urban environment. In the built environment the climate extreme effects are driven through the formed microclimate which must be studied more efficiently. Variables such as biological, age groups etc may be implicated by different environmental factors such as increased air pollution/noise levels and overheating of buildings in comparison to rural areas. Gridded air quality and climate variables derived from the land surface observations network of West Macedonia in Greece will be analysed against mortality data in a spatial format in the region of West Macedonia. Artificial intelligence (AI) tools will be used for data correction and prediction of health deterioration with climatic conditions and air pollution at local scale. This would reveal the built environment implications against the countryside. The air pollution and climatic data have been collected from meteorological stations and span the period from 2000 to 2009. These will be projected against the mortality rates data in daily, monthly, seasonal and annual grids. The grids will be operated as AI-based warning models for decision makers in order to map the health conditions in rural and urban areas to ensure improved awareness of the healthcare system by taken into account the predicted changing climate conditions. Gridded data of climate conditions, air quality levels against mortality rates will be presented by AI-analysed gridded indicators of the implicated variables. An Al-based gridded warning platform at local scales is then developed for future system awareness platform for regional level.

Keywords: air quality, artificial inteligence, climatic conditions, mortality

Procedia PDF Downloads 112

Authors: Sungsoo Na, Chanho Park

Abstract:

Lung cancer is one of the most common severe diseases driving to the death of a human. Lung cancer can be divided into two cases of small-cell lung cancer (SCLC) and non-SCLC (NSCLC), and about 80% of lung cancers belong to the case of NSCLC. From several studies, the correlation between epidermal growth factor receptor (EGFR) and NSCLCs has been investigated. Therefore, EGFR inhibitor drugs such as gefitinib and erlotinib have been used as lung cancer treatments. However, the treatments result showed low response (10~20%) in clinical trials due to EGFR mutations that cause the drug resistance. Patients with resistance to EGFR inhibitor drugs usually are positive to KRAS mutation. Therefore, assessment of EGFR and KRAS mutation is essential for target therapies of NSCLC patient. In order to overcome the limitation of conventional therapies, overall EGFR and KRAS mutations have to be monitored. In this work, the only detection of EGFR will be presented. A variety of techniques has been presented for the detection of EGFR mutations. The standard detection method of EGFR mutation in ctDNA relies on real-time polymerase chain reaction (PCR). Real-time PCR method provides high sensitive detection performance. However, as the amplification step increases cost effect and complexity increase as well. Other types of technology such as BEAMing, next generation sequencing (NGS), an electrochemical sensor and silicon nanowire field-effect transistor have been presented. However, those technologies have limitations of low sensitivity, high cost and complexity of data analyzation. In this report, we propose a label-free and high-sensitive detection method of lung cancer using quartz crystal microbalance based platform. The proposed platform is able to sense lung cancer mutant DNA with a limit of detection of 1nM.

Keywords: cancer DNA, resonance frequency, quartz crystal microbalance, lung cancer

Procedia PDF Downloads 232

Authors: Waqas Hassan Tanveer, Yoon Ho Lee, Taehyun Park, Wonjong Yu, Yaegeun Lee, Yusung Kim, Suk Won Cha

Abstract:

Nickel-Gadolinium Doped Ceria (Ni-GDC) cermet anodic thin films were prepared on Scandia Stabilized Zirconia (ScSZ) electrolyte supports by radio frequency (RF) sputtering, with a range of different sputtering powers (50 – 200W) and background Ar gas pressures (30 – 90mTorr). The effects of varying sputtering power and pressure on the properties of Ni-GDC films were studied using Focused Ion Beam (FIB), X-ray Photoelectron Spectroscopy (XPS), X-ray Diffraction (XRD), Energy Dispersive X-ray (EDX), and Atomic Force Microscopy (AFM) techniques. The Ni content was found to be always higher than the Ce content, at all sputtering conditions. This increased Ni content was attributed to significantly higher energy transfer efficiency of Ni ions as compared to Ce ions with Ar background sputtering gas. The solid oxide fuel cell configuration was completed by using lanthanum strontium manganite (LSM/YSZ) cathodes on the other side of ScSZ supports. Performance comparison of cells was done by Voltage-Current-Power (VIP) curves, while the resistances of various cell components were observed by nyquist plots. Initial results showed that anode films made by higher powered RF sputtering performed better than lower powered ones for a specific Ar pressure. Interestingly, however, anodes made at highest power and pressure, were not the ones that showed the maximum power output at an intermediate solid oxide fuel cell temperature of 800°C. Finally, an optimal sputtering condition was reported for high performance Ni-GDC anodes.

Keywords: intermediate temperature solid oxide fuel cells, nickel-cermet anodic thin films, nyquist plots, radio frequency sputtering

Procedia PDF Downloads 237

Authors: Carmen García Sánchez

Abstract:

The UN's 17 Sustainable Development Goals – specifically the nº 3 and nº 11- urgently call for new architectural design solutions at different design scales to increase human contact with nature in the health and wellbeing promotion of primarily urban communities. The discipline of Interior Design offers an important alternative to large-scale nature-inclusive actions which are not always possible due to space limitations. These circumstances provide an immense opportunity to integrate biophilic design, a complex emerging and under-developed approach that pursues sustainable design strategies for increasing the human-nature connection through the experience of the built environment. Biophilic design explores the diverse ways humans are inherently inclined to affiliate with nature, attach meaning to and derive benefit from the natural world. It represents a biological understanding of architecture which categorization is still in progress. The internationally renowned Danish domestic architecture built in the 1950´s and early 1960´s - a golden age of Danish modern architecture - left a leading legacy that has greatly influenced the domestic sphere and has further led the world in terms of good design and welfare. This study examines how four existing post-war domestic buildings establish a dialogue with nature and her variations over time. The case-studies unveil both memorable and unique biophilic resources through sophisticated and original design expressions, where transformative processes connect the users to the natural setting and reflect fundamental ways in which they attach meaning to the place. In addition, fascinating analogies in terms of this nature interaction with particular traditional Japanese architecture inform the research. They embody prevailing lessons for our time today. The research methodology is based on a thorough literature review combined with a phenomenological analysis into how these case-studies contribute to the connection between humans and nature, after conducting fieldwork throughout varying seasons to document understanding in nature transformations multi-sensory perception (via sight, touch, sound, smell, time and movement) as a core research strategy. The cases´ most outstanding features have been studied attending the following key parameters: 1. Space: 1.1. Relationships (itineraries); 1.2. Measures/scale; 2. Context: Context: Landscape reading in different weather/seasonal conditions; 3. Tectonic: 3.1. Constructive joints, elements assembly; 3.2. Structural order; 4. Materiality: 4.1. Finishes, 4.2. Colors; 4.3. Tactile qualities; 5. Daylight interplay. Departing from an artistic-scientific exploration this groundbreaking study provides sustainable practical design strategies, perspectives, and inspiration to boost humans´ contact with nature through the experience of the interior built environment. Some strategies are associated with access to outdoor space or require ample space, while others can thrive in a dense urban context without direct access to the natural environment. The objective is not only to produce knowledge, but to phase in biophilic design in the built environment, expanding its theory and practice into a new dimension. Its long-term vision is to efficiently enhance the health and well-being of urban communities through daily interaction with Nature.

Keywords: sustainability, biophilic design, architectural design, interior design, nature, Danish architecture, Japanese architecture

Procedia PDF Downloads 98

Authors: Jong Yeop Kim, In Kyong Yi, Hyun Jeong Kwak, Sook Young Lee, Sung Yong Park

Abstract:

Background: Several video laryngoscopes (VLs) were used to facilitate tracheal intubation in the normal and potentially difficult airway, especially by novice personnel. The aim of this study was to compare tracheal intubation performance regarding the time to intubation, glottic view, difficulty, and dental click, by a novice using McGrath VL, Pentax Airway Scope (AWS) and Macintosh laryngoscope in normal and cervical immobilized manikin models. Methods: Thirty-five anesthesia nurses without previous intubation experience were recruited. The participants performed endotracheal intubation in a manikin model at two simulated neck positions (normal and fixed neck via cervical immobilization), using three different devices (McGrath VL, Pentax AWS, and Macintosh direct laryngoscope) at three times each. Performance parameters included intubation time, success rate of intubation, Cormack Lehane laryngoscope grading, dental click, and subjective difficulty score. Results: Intubation time and success rate at the first attempt were not significantly different between the 3 groups in normal airway manikin. In the cervical immobilized manikin, the intubation time was shorter (p = 0.012) and the success rate with the first attempt was significantly higher (p < 0.001) when using McGrath VL and Pentax AWS compared with Macintosh laryngoscope. Both VLs showed less difficulty score (p < 0.001) and more Cormack Lehane grade I (p < 0.001). The incidence of dental clicks was higher with McGrath VL than Macintosh laryngoscope in the normal and cervical immobilized airway (p = 0.005, p < 0.001, respectively). Conclusion: McGrath VL and Pentax AWS resulted in shorter intubation time, higher first attempt success rate, compared with Macintosh laryngoscope by a novice intubator in a cervical immobilized manikin model. McGrath VL could be reduced the risk of dental injury compared with Macintosh laryngoscope in this scenario.

Keywords: intubation, manikin, novice, videolaryngoscope

Procedia PDF Downloads 157

Authors: Luca Lezzerini

Abstract:

Albania is suffering a continuous shrinking of its population and demographic distribution that faces all the problems connected with age increase. The paper examines the case of Gjirokastër, a city in the south of Albania that, despite having a UNESCO label as a world heritage site, is experimenting with the same shrinking phenomenon. The paper analyses in detail the current situation and propose an interdisciplinary approach based on smart technologies and sunset tourism to restart Gjirokastër’s economy and invert bad demographic trends. The proposed approach needs to review the current urban planning, reshaping and connecting some areas. It also proposes a smart city architecture to support this process.

Keywords: smart city, sunset tourism, shrinking city, Gjirokastër

Procedia PDF Downloads 90

Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

Abstract:

This paper proposes a method to optimize the layout of an emergency department (ED) based on real executions of care processes by considering several planning objectives simultaneously. Recently, demand for healthcare services has been dramatically increased. As the demand for healthcare services increases, so do the need for new healthcare buildings as well as the need for redesign and renovating existing ones. The importance of implementation of a standard set of engineering facilities planning and design techniques has been already proved in both manufacturing and service industry with many significant functional efficiencies. However, high complexity of care processes remains a major challenge to apply these methods in healthcare environments. Process mining techniques applied in this study to tackle the problem of complexity and to enhance care process analysis. Process related information such as clinical pathways extracted from the information system of an ED. A 0-1 goal programming approach is then proposed to find a single layout that simultaneously satisfies several goals. The proposed model solved by optimization software CPLEX 12. The solution reached using the proposed method has 42.2% improvement in terms of walking distance of normal patients and 47.6% improvement in walking distance of critical patients at minimum cost of relocation. It has been observed that lots of patients must unnecessarily walk long distances during their visit to the emergency department because of an inefficient design. A carefully designed layout can significantly decrease patient walking distance and related complications.

Keywords: healthcare operation management, goal programming, facility layout problem, process mining, clinical processes

Procedia PDF Downloads 292

Authors: Mokhtar Nikgoo

Abstract:

Road definition and road construction: in engineering literature, a road is defined as a means of communication between two different places by air, land, and sea. In this way, all sea, land, and air routes are considered as roads. Road construction is an operation to create a road on the ground between 2 points with a specified width, which includes works such as subgrade, paving, placing tables, and traffic signs on the road. In this article, the stages of road construction are explained from the beginning to the end. Road construction is generally done in the construction of rural, urban, and inter-city roads, and according to the special conditions of this area, the precision of engineers in its design and calculations is very important. For example, if the design of a road does not pay enough attention to the way the road curves, there will undoubtedly be countless accidents. Also, adjusting the road surface and its durability and uniformity are among the things that engineers solve according to the upcoming obstacles.

Keywords: road construction, surveying, freeway, pavement, excavator

Procedia PDF Downloads 90

Authors: Eun-Taek Sin, Hyun-Ju Jang, Chang Geun Song, Yong-Sik Han

Abstract:

Due to the climate change, the coastal urban area repeatedly suffers from the loss of property and life by flooding. There are three main causes of inland submergence. First, when heavy rain with high intensity occurs, the water quantity in inland cannot be drained into rivers by increase in impervious surface of the land development and defect of the pump, storm sewer. Second, river inundation occurs then water surface level surpasses the top of levee. Finally, Coastal inundation occurs due to rising sea water. However, previous studies ignored the complex mechanism of flooding, and showed discrepancy and inadequacy due to linear summation of each analysis result. In this study, inland flooding and river inundation were analyzed together by HDM-2D model. Petrov-Galerkin stabilizing method and flux-blocking algorithm were applied to simulate the inland flooding. In addition, sink/source terms with exponentially growth rate attribute were added to the shallow water equations to include the inland flooding analysis module. The applications of developed model gave satisfactory results, and provided accurate prediction in comprehensive flooding analysis. The applications of developed model gave satisfactory results, and provided accurate prediction in comprehensive flooding analysis. To consider the coastal surge, another module was developed by adding seawater to the existing Inland Flooding-River Inundation binding module for comprehensive flooding analysis. Based on the combined modules, the Coastal Inundation – Inland & River Flow Interface was simulated by inputting the flow rate and depth data in artificial flume. Accordingly, it was able to analyze the flood patterns of coastal cities over time. This study is expected to help identify the complex causes of flooding in coastal areas where complex flooding occurs, and assist in analyzing damage to coastal cities. Acknowledgements—This research was supported by a grant ‘Development of the Evaluation Technology for Complex Causes of Inundation Vulnerability and the Response Plans in Coastal Urban Areas for Adaptation to Climate Change’ [MPSS-NH-2015-77] from the Natural Hazard Mitigation Research Group, Ministry of Public Safety and Security of Korea.

Keywords: flooding analysis, river inundation, inland flooding, 2D hydrodynamic model

Procedia PDF Downloads 361

Authors: Ahmed Abdulfatah Yusuf, Collins Oduor Ondiek

Abstract:

The automation of farming activities can have a transformational impact on the agricultural sector, especially from the emerging new technologies such as the Internet of Things (IoT). The system uses water level sensors and soil moisture sensors that measure the content of water in the soil as the values generated from the sensors enable the system to use an appropriate quantity of water, which avoids over or under irrigation. Due to the increase in the world’s population, there is a need to increase food production. With this demand in place, it is difficult to increase crop yield using the traditional manual approaches that lead to the wastage of water, thus affecting crop production. Food insecurity has become a scourge greatly affecting the developing countries and agriculture is an essential part of human life and tends to be the mainstay of the economy in most developing nations. Thus, without the provision of adequate food supplies, the population of those living in poverty is likely to multiply. The project’s main objective is to design and develop an IoT (Internet of Things) microcontroller-based Smart Irrigation System. In addition, the specific research objectives are to find out the challenges with traditional irrigation approaches and to determine the benefits of IoT-based smart irrigation systems. Furthermore, the system includes Arduino, a website and a database that works simultaneously in collecting and storing the data. The system is designed to pave the way in attaining the Sustainable Development Goal (SDG 1), which aims to end extreme poverty in all forms by 2030. The research design aimed at this project is a descriptive research design. Data was gathered through online questionnaires that used both quantitative and qualitative in order to triangulate the data. Out of the 32 questionnaires sent, there were 32 responses leading to a 100% response rate. In terms of sampling, the target group of this project is urban farmers, which account for about 25% of the population of Nairobi. From the findings of the research carried out, it is evident that there is a need to move away from manual irrigation approaches due to the high wastage of water to the use of smart irrigation systems that propose a better way of conserving water while maintaining the quality and moisture of the soil. The research also found out that urban farmers are willing to adopt this system to better their farming practices. However, this system can be improved in the future by incorporating it with other features and deploying it to a larger geographical area.

Keywords: crop production, food security, smart irrigation system, sustainable development goal

Procedia PDF Downloads 150

Authors: Shalini TV, Gangadharan GG, Sriranjini S Jaideep, ASN Seshasayee, Awadhesh Pandit

Abstract:

Introduction: Prakriti (body-mind constitution of an individual) is a conventional, customized and unique understanding of which is essential for the personalized medicine described in Ayurveda, Indian System of Medicine. Based on the Doshas( functional, bio humoral unit in the body), individuals are categorized into three major Prakriti- Vata, Pitta, and Kapha. The human gut microbiome hosts plenty of highly diverse and metabolically active microorganisms, mainly dominated by the bacteria, which are known to influence the physiology of an individual. Few researches have shown the correlation between the Prakriti and the biochemical parameters. In this study, an attempt was made to explore any correlation between the Prakriti (phenotype of an individual) with the Genetic makeup of the gut microbiome in healthy individuals. Materials and methods: 270 multi-ethnic, healthy volunteers of both sex with the age group between 18 to 40 years, with no history of antibiotics in the last 6 months were recruited into three groups of Vata, Pitta, and Kapha. The Prakriti of the individual was determined using Ayusoft, a software designed by CDAC, Pune, India. The volunteers were subjected to initial screening for the assessment of their height, weight, Body Mass Index, Vital signs and Blood investigations to ensure they are healthy. The stool and saliva samples of the recruited volunteers were collected as per the standard operating procedure developed, and the bacterial DNA was isolated using Qiagen kits. The extracted DNA was subjected to 16s rRNA sequencing using the Illumina kits. The sequencing libraries are targeting the variable V3 and V4 regions of the 16s rRNA gene. Paired sequencing was done on the MiSeq system and data were analyzed using the CLC Genomics workbench 11. Results: The 16s rRNA sequencing of the V3 and V4 regions showed a diverse pattern in both the oral and stool microbial DNA. The study did not reveal any specific pattern of bacterial flora amongst the Prakriti. All the p-values were more than the effective alpha values for all OTUs in both the buccal cavity and stool samples. Therefore, there was no observed significant enrichment of an OTU in the patient samples from either the buccal cavity or stool samples. Conclusion: In healthy volunteers of multi-ethnicity, due to the influence of the various factors, the correlation between the Prakriti and the gut microbiome was not seen.

Keywords: gut microbiome, ayurveda Prakriti, sequencing, multi-ethnic urban population

Procedia PDF Downloads 133

Authors: Jubaida Gulshan Ara, Zebun Nasreen Ahmed

Abstract:

Urban flood and drought has been a major problem of Dhaka city, particularly in recent years. Continuous increase of the city built up area, and limiting rainwater infiltration zone, are thought to be the main causes of the problem. Proper rainwater management, even at the individual plot level, might bring significant improvement in this regard. As residential use pattern occupies a significant portion of the city surface, the scope of rainwater harvesting (RWH) in residential buildings can be investigated. This paper reports on a research which explored the scope of rainwater harvesting in residential plots, with multifamily apartment buildings, in Dhaka city. The research investigated the basics of RWH, contextual information, i.e., hydro-geological, meteorological data of Dhaka city and the rules and legislations for residential building construction. The study also explored contemporary rainwater harvesting practices in the local and international contexts. On the basis of theoretical understanding, 21 sample case-studies, in different phases of construction, were selected from seven different categories of plot sizes, in different residential areas of Dhaka city. Primary data from the 21 case-study buildings were collected from a physical survey, from design drawings, accompanied by a questionnaire survey. All necessary secondary data were gathered from published and other relevant sources. Collected primary and secondary data were used to calculate and analyze the RWH needs for each case study, based on the theoretical understanding. The main findings have been compiled and compared, to observe residential development trends with regards to building rainwater harvesting system. The study has found that, in ‘Multifamily Apartment Building’ of Dhaka city, storage, and recharge structure size for rainwater harvesting, increases along with occupants’ number, and with the increasing size of the plot. Hence, demand vs. supply ratio remains almost the same for different sizes of plots, and consequently, the size of the storage structure increases significantly, in large-scale plots. It has been found that rainwater can meet only 12%-30% of the total restricted water demand of these residential buildings of Dhaka city. Therefore, artificial groundwater recharge might be the more suitable option for RWH, than storage. The study came up with this conclusion that, in multifamily residential apartments of Dhaka city, artificial groundwater recharge might be the more suitable option for RWH, than storing the rainwater on site.

Keywords: Dhaka city, rainwater harvesting, residential plots, urban flood

Procedia PDF Downloads 192

Authors: Jin Hwa Yang, Hwang Bae, Sung Uk Ryu, Byong Guk Jeon, Sung Jae Yi, Hyun Sik Park

Abstract:

Experimental studies using a large-scale thermal-hydraulic integral test facility, System–integrated Modular Advanced Reactor Integral Test Loop (SMART-ITL), have been carried out to validate the performance of the prototype, SMART. After Fukushima accident, the passive safety systems have been dealt as important designs for retaining of nuclear safety. One of the concerned scenarios for evaluating the passive safety system is a Complete Loss of Coolant Flow (CLOF). The flowrate of coolant in the primary system is maintained by Reactor Coolant Pump (RCP). When the supply of electric power of RCP is shut off, the flowrate of coolant decreases sharply, and the temperature of the coolant increases rapidly. Therefore, the reactor trip signal is activated to prevent the over-heating of the core. In this situation, Passive Residual Heat Removal System (PRHRS) plays a significant role to assure the soundness of the SMART. The PRHRS using a two-phase natural circulation is a passive safety system in the SMART to eliminate the heat of steam generator in the secondary system with heat exchanger submarined in the Emergency Cooling Tank (ECT). As the RCPs continue to coast down, inherent natural circulation in the primary system transfers heat to the secondary system. The transferred heat is removed by PRHRS in the secondary system. In this paper, the progress of the CLOF accident is described with experimental data of transient condition performed by SMART-ITL. Finally, the capability of passive safety system and inherent natural circulation will be evaluated.

Keywords: CLOF, natural circulation, PRHRS, SMART-ITL

Procedia PDF Downloads 436

Authors: Rebeca V. Tholen, Elaine Bundy

Abstract:

Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

Procedia PDF Downloads 115