Search results for: long-term care cost

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

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Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni

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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.

Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm

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Authors: Tei Kim, Brooklynn McNeil, Kathryn Dunn, Douglas I. Walker

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To better characterize the relationship between complex chemical exposures and disease, our laboratory uses an approach that combines low-cost, polydimethylsiloxane (silicone) wristband samplers that absorb many of the chemicals we are exposed to with untargeted high-resolution mass spectrometry (HRMS) to characterize 1000’s of chemicals at a time. In studies with human populations, these wristbands can provide an important measure of our environment: however, there is a need to use this approach in large cohorts to study exposures associated with the disease. To facilitate the use of silicone samplers in large scale population studies, the goal of this research project was to establish automated sample preparation methods that improve throughput, robustness, and scalability of analytical methods for silicone wristbands. Using the Opentron OT2 automated liquid platform, which provides a low-cost and opensource framework for automated pipetting, we created two separate workflows that translate the manual wristband preparation method to a fully automated protocol that requires minor intervention by the operator. These protocols include a sequence generation step, which defines the location of all plates and labware according to user-specified settings, and a transfer protocol that includes all necessary instrument parameters and instructions for automated solvent extraction of wristband samplers. These protocols were written in Python and uploaded to GitHub for use by others in the research community. Results from this project show it is possible to establish automated and open source methods for the preparation of silicone wristband samplers to support profiling of many environmental exposures. Ongoing studies include deployment in longitudinal cohort studies to investigate the relationship between personal chemical exposure and disease.

Keywords: bioinformatics, automation, opentrons, research

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Authors: Ila Gupta

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The government hospitals in India by and large lack the necessary aesthetic therapeutic components, both in their interior and exterior space designs. These components especially in terms of color application are important to the emotional as well as physical well being of the patients and other participants of the space. The preliminary survey of few government hospitals in Uttarakhand, India, reveals that the government health care industry provides a wide scope for intervention. All most all of the spaces do not adhere to a proper therapeutic color scheme which directly helps the well-being of their patients and workers. The paper aims to conduct a survey and come up with recommendations in this regard. The government hospitals also lack a proper signage system which allows the space to be more user-friendly. The hospital spaces in totality also have scope for improvement in terms of space/landscape design which enhances the work environment in an efficient and positive way. This study will thus enable to come up with feasible recommendations for healthcare and built environment as well as retrofitting the existing spaces. The objective of the paper is mainly on few case studies. The present ambience in many government hospitals generally lacks a welcoming ambience. It is proposed to select one or two government hospitals and demonstrate application of appropriate and self-sustainable color schemes, placement of artifacts, changes in outdoor and indoor space design to bring about a change that is conducive for cognitive healing. Exterior changes to existing and old hospital buildings in depressed historic areas signify financial investment and change, and have the potential to play a significant role in both urban preservation and revitalization. Changes to exterior architectural colors are perhaps the most visible signifier of such revitalization, as the use of color changes as a tool in façade and interior improvement programs. The present project will provide its recommendations on the basis of case studies done in the Indian Public Health Care system. Furthermore, the recommendations will be in accordance with the extended study conducted in Indian Ayurvedic, Yogic texts as well as Vastu texts, which provides knowledge about built environments and healing properties of color.

Keywords: color, environment, facade, architectural color history, interior improvement programs, community development, district/government hospitals

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Authors: Merle Talvik, Taimi Tulva, Kristi Puusepp, Ülle Ernits

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Background data. In 1940–1941 and 1945–1991 Estonia was occupied by Soviet Union. Paternalism was a common principle in Soviet social policy, including health care. The Soviet government, not the individuals themselves, decided on achieving a person’s quality of life. With the help of Soviet ideology, the work culture of nurses was constructed and the education system was also reshaped according to the ideology. The “new period of awakening” was initiated under Gorbachev’s perestroika and glasnost (1985–1991), leading to democratization. Aim. The qualitative study aimed to analyze nursing education in Soviet Estonia in the conditions of paternalistic orientation and ideological pressure. Method. The research was conducted in 2021 and 2023. Senior nurses (aged 69–87) who had worked for at least 20 years during the Soviet era were surveyed. Thematic interviews were conducted in written form and orally (13 interviewees), followed by a focus group interview (8 interviewees). A thematic content analysis was performed. Results. Nursing is part of society’s culture and in this sense, in - terviews with nurses provide us with critical information about the functioning of society and cultural identity at a given time. During the Soviet era the training of nurses occured within vocational training institutions. The curricula underwent a shift towards a Soviet-oriented approach. A significant portion of lessons were dedicated to imparting knowledge on the principles and tenets of Communist-Marxist ideology. Therefore, practical subjects and nursing theory were frequently allocated limited space. A paternalistic orientation prevailed in health care: just as the state regulated how to cure, spread hygiene, and healthy lifestyles propaganda, training was also determined by the management of the institution, thereby limiting the person´s autonomy to decide what kind of training was needed. The research is of significant value in the context of the history of nursing, as it helps to understand the difficulties and complexity of the development of nursing on the timeline. The Soviet era still affects Estonian society today and will continue to do so in the future. The same type of developments occurred in other post-Soviet countries.

Keywords: Estonian SSR, nursing education, paternalism, senior nurse, Soviet ideology

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Authors: Arezoo Assarian, Reza Javaherdashti

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Microbiologically influenced corrosion (MIC) is an electrochemical process that can affect both metals and non-metals. The cost of MIC can amount to 40% of the cost of corrosion. MIC is enhanced via factors such as but not limited to the presence of certain bacteria and archaea as well as mechanisms such as external electron transfer. There are five methods by which electrochemical corrosion, including MIC, can be prevented, of which coatings are an effective method due to blinding anode, cathode and, electrolyte from each other. Conventional ordinary coatings may themselves become nutrient sources for the bacteria and therefore show low efficiency in dealing with MIC. Recently our works on polyaspartic coating (DTM) have shown promising results, therefore nominating DTM as the most appropriate coating material to manage both MIC and general electrochemical corrosion very efficiently. Nanosilver particles are known for their antimicrobial properties that make them of desirable distractive impacts on any germs. This coating will be formulated based on Nanosilver phosphate and copper II oxide in the resin network and co-reactant. The nanoparticles are light and heat-sensitive agents. The method which is used to keep nanoparticles in the film coating is the encapsulation of active ingredients. By this method, it will prevent incompatibility between different particles. For producing microcapsules, the interfacial cross-linking method will be used. This is achieved by adding an active ingredient to an aqueous solution of the cross-linkable polymer. In this paper, we will first explain the role of coating materials in controlling and preventing electrochemical corrosion. We will explain MIC and some of its fundamental principles, such as bacteria establishment (biofilm) and the role they play in enhancing corrosion via mechanisms such as the establishment of differential aeration cells. Later we will explain features of DTM coatings that highly contribute to preventing biofilm formation and thus microbial corrosion.

Keywords: biofilm, corrosion, microbiologically influenced corrosion(MIC), nanosilver particles, polyaspartic coating (DTM)

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Authors: Wiseman Emmanuel Nkhomah, Chiyembekezo Kachimanga, Julia Huggins, Fabien Munyaneza

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Background: Partners In Health – Malawi introduced one of Operational Researches called Primary Health Care (PHC) Surveys in 2020, which seeks to assess progress of delivery of care in the district. The study consists of 5 long surveys, namely; Facility assessment, General Patient, Provider, Sick Child, Antenatal Care (ANC), primarily conducted in 4 health facilities in Neno district. These facilities include Neno district hospital, Dambe health centre, Chifunga and Matope. Usually, these annual surveys are conducted from January, and the target is to present final report by June. Once data is collected and analyzed, there are a series of reviews that take place before reaching final report. In the first place, the manual process took over 9 months to present final report. Initial findings reported about 76.9% of the data that added up when cross-checked with paper-based sources. Purpose: The aim of this approach is to run away from manually pulling the data, do fresh analysis, and reporting often associated not only with delays in reporting inconsistencies but also with poor quality of data if not done carefully. This automation approach was meant to utilize features of new technologies to create visualizations, reports, and dashboards in Power BI that are directly fished from the data source – CommCare hence only require a single click of a ‘refresh’ button to have the updated information populated in visualizations, reports, and dashboards at once. Methodology: We transformed paper-based questionnaires into electronic using CommCare mobile application. We further connected CommCare Mobile App directly to Power BI using Application Program Interface (API) connection as data pipeline. This provided chance to create visualizations, reports, and dashboards in Power BI. Contrary to the process of manually collecting data in paper-based questionnaires, entering them in ordinary spreadsheets, and conducting analysis every time when preparing for reporting, the team utilized CommCare and Microsoft Power BI technologies. We utilized validations and logics in CommCare to capture data with less errors. We utilized Power BI features to host the reports online by publishing them as cloud-computing process. We switched from sharing ordinary report files to sharing the link to potential recipients hence giving them freedom to dig deep into extra findings within Power BI dashboards and also freedom to export to any formats of their choice. Results: This data automation approach reduced research timelines from the initial 9 months’ duration to 5. It also improved the quality of the data findings from the original 76.9% to 98.9%. This brought confidence to draw conclusions from the findings that help in decision-making and gave opportunities for further researches. Conclusion: These results suggest that automating the research data process has the potential of reducing overall amount of time spent and improving the quality of the data. On this basis, the concept of data automation should be taken into serious consideration when conducting operational research for efficiency and decision-making.

Keywords: reporting, decision-making, power BI, commcare, data automation, visualizations, dashboards

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Authors: V. Ivanov, J. Chu, V. Stabnikov

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Different biotechnological methods for the production of construction materials and for the performance of construction processes in situ are developing within a new scientific discipline of Construction Biotechnology. The aim of this research was to develop and test new biotechnologies and biotechnological grouts for the minimization of the hydraulic conductivity of the fractured rocks and porous soil. This problem is essential to minimize flow rate of groundwater into the construction sites, the tunneling space before and after excavation, inside levies, as well as to stop water seepage from the aquaculture ponds, agricultural channels, radioactive waste or toxic chemicals storage sites, from the landfills or from the soil-polluted sites. The conventional fine or ultrafine cement grouts or chemical grouts have such restrictions as high cost, viscosity, sometime toxicity but the biogrouts, which are based on microbial or enzymatic activities and some not expensive inorganic reagents, could be more suitable in many cases because of lower cost and low or zero toxicity. Due to these advantages, development of biotechnologies for biogrouting is going exponentially. However, most popular at present biogrout, which is based on activity of urease- producing bacteria initiating crystallization of calcium carbonate from calcium salt has such disadvantages as production of toxic ammonium/ammonia and development of high pH. Therefore, the aim of our studies was development and testing of new biogrouts that are environmentally friendly and have low cost suitable for large scale geotechnical, construction, and environmental applications. New microbial biotechnologies have been studied and tested in the sand columns, fissured rock samples, in 1 m3 tank with sand, and in the pack of stone sheets that were the models of the porous soil and fractured rocks. Several biotechnological methods showed positive results: 1) biogrouting using sequential desaturation of sand by injection of denitrifying bacteria and medium following with biocementation using urease-producing bacteria, urea and calcium salt decreased hydraulic conductivity of sand to 2×10-7 ms-1 after 17 days of treatment and consumed almost three times less reagents than conventional calcium-and urea-based biogrouting; 2) biogrouting using slime-producing bacteria decreased hydraulic conductivity of sand to 1x10-6 ms-1 after 15 days of treatment; 3) biogrouting of the rocks with the width of the fissures 65×10-6 m using calcium bicarbonate solution, that was produced from CaCO3 and CO2 under 30 bars pressure, decreased hydraulic conductivity of the fissured rocks to 2×10-7 ms-1 after 5 days of treatment. These bioclogging technologies could have a lot of advantages over conventional construction materials and processes and can be used in geotechnical engineering, agriculture and aquaculture, and for the environmental protection.

Keywords: biocementation, bioclogging, biogrouting, fractured rocks, porous soil, tunneling space

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Authors: Augustus K. Lebechi, Kenneth I. Ozoemena

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Rechargeable zinc-air batteries (RZABs) have been described as one of the most viable next-generation ‘beyond-the-lithium-ion’ battery technologies with great potential for renewable energy storage. It is safe, with a high specific energy density (1086 Wh/kg), environmentally benign, and low-cost, especially in resource-limited African countries. For widespread commercialization, the sluggish oxygen reaction kinetics pose a major challenge that impedes the reversibility of the system. Hence, there is a need for low-cost and highly active bifunctional electrocatalysts. Manganese oxide catalysts on carbon conducting additives remain the best couple for the realization of such low-cost RZABs. In this work, hausmannite Mn₃O₄ nanoparticles were synthesized through the annealing method from commercial electrolytic manganese dioxide (EMD), multi-walled carbon nanotubes (MWCNTs) were synthesized via the chemical vapor deposition (CVD) method and carbon nanofibers (CNFs) were synthesized via the electrospinning process with subsequent carbonization. Both Mn₃O₄ catalysts and the carbon conducting additives (MWCNT and CNF) were thoroughly characterized using X-ray powder diffraction spectroscopy (XRD), scanning electron microscopy (SEM), thermogravimetry analysis (TGA) and X-ray photoelectron spectroscopy (XPS). Composite electrocatalysts (Mn₃O₄/CNT and Mn₃O₄/CNF) were investigated for oxygen evolution reaction (OER) and oxygen reduction reaction (ORR) in an alkaline medium. Using the established electrocatalytic modalities for evaluating the electrocatalytic performance of materials (including double layer, electrochemical active surface area, roughness factor, specific current density, and catalytic stability), CNFs proved to be the most efficient conducting additive material for the Mn₃O₄ catalyst. From the DFT calculations, the higher performance of the CNFs over the MWCNTs is related to the ability of the CNFs to allow for a more favorable distribution of the d-electrons of the manganese (Mn) and enhanced synergistic effect with Mn₃O₄ for weaker adsorption energies of the oxygen intermediates (O*, OH* and OOH*). In a proof-of-concept, Mn₃O₄/CNF was investigated as the air cathode for rechargeable zinc-air battery (RZAB) in a micro-3D-printed cell configuration. The RZAB showed good performance in terms of open circuit voltage (1.77 V), maximum power density (177.5 mW cm-2), areal-discharge energy and cycling stability comparable to Pt/C (20 wt%) + IrO2. The findings here provide fresh physicochemical perspectives on the future design and utility of CNFs for developing manganese-based RZABs.

Keywords: bifunctional electrocatalyst, oxygen evolution reaction, oxygen reduction reactions, rechargeable zinc-air batteries.

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Authors: Martin Mundo-Molina

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In Mexico, there are many small rural communities with serious water supply deficiencies. In Chiapas, Mexico, there are 19,972 poor rural communities, 15,712 of which have fewer than 100 inhabitants. The lack of a constant water supply is most severe in the highlands of Chiapas where the population is made up mainly of indigenous groups. The communities are on mountainous terrain with a widely dispersed population. These characteristics combine to make the provision of public utilities, such as water, electricity and sewerage, difficult with conventional means. The introduction of alternative, low-cost technologies represents means of supplying water such as through fog and rain catchment with zero greenhouse emissions. In this paper is presented the rainwater harvesting system (RWS) constructed in Yalentay, Chiapas Mexico. The RWS is able to store 1.2 M liters of water to provide drinking water to small rural indigenous communities of 500 people in the drought stage. Inside the system of rainwater harvesting there isn't photosynthesis in order to conserve water for long periods. The natural filters of the system of rainwater harvesting guarantee the drinking water for using to the community. The combination of potability and low cost makes rain collection a viable alternative for rural areas, weather permitting. The Mexican Institute of Water Technology and Chiapas University constructed a rainwater harvesting system in Yalentay Chiapas, it consists of four parts: 1. Roof of aluminum, for collecting rainwater, 2. Underground-cistern, divided in two tanks, 3. Filters, to improve the water quality and 4. The system of rainwater harvesting dignified the lives of people in Yalentay, saves energy, prevents the emission of greenhouse gases into the atmosphere, conserves natural resources such as water and air.

Keywords: appropriate technologies, climate change, greenhouse gases, rainwater harvesting

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Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, João C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Orphaned is a risk factor for mortality in newborns since it is a condition with total or partial absence of maternal care that is essential for neonatal survival, including nursing (nutrition, the transference of passive immunity and hydration), warmth, urination, and defecation stimuli, and protection. The most common causes of mortality in orphans are related to lack of assistance, handling mistakes and infections. This study aims to describe the orphans rates in neonatal puppies, the main causes, and the mortality rates. The study included 735 neonates admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, between January 2018 and November 2019. The orphans rate was 43.4% (319/735) of all neonates included, and the main causes for orphaned were related to maternal agalactia/hypogalactia (23.5%, 75/319); numerous litter (15.7%, 50/319), toxic milk syndrome due to maternal mastitis (14.4%, 46/319), absence of suction/weak neonate (12.2%, 39/319), maternal disease (9.4%, 30/319), cleft palate/lip (6.3%, 20/319), maternal death (5.9%, 19/319), prematurity (5.3%, 17/319), rejection/failure in maternal instinct (3.8%, 12/319) and abandonment by the owner/separation of mother and neonate (3.5%, 11/319). The main consequences of orphaned observed in the admitted neonates were hypoglycemia, hypothermia, dehydration, aspiration pneumonia, wasting syndrome, failure in the transference of passive immunity, infections and sepsis, which happened due to failure of identifying the problem early, lack of adequate assistance, negligence and handling mistakes by the owner. The total neonatal mortality rate was 8% (59/735) and the neonatal mortality rate among orphans was 18.5% (59/319). The orphaned and mortality rates were considered high, but even higher rates may be observed in locations without adequate neonatal assistance and owner orientation. The survival of these patients is related to constant monitoring of the litter, early diagnosis and assistance, and the implementation of effective handling for orphans. Understanding the correct handling for neonates and instructing the owners regarding proper handling are essential to minimize the consequences of orphaned and the mortality rates.

Keywords: orphans, neonatal care, puppies, newborn dogs

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Authors: Pernille K. Christiansen, Mette Maria Skjøth, Line Lorenzen, Eva Draborg, Christina Anne Vinter, Trine Kjær, Mette Juel Rothmann

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Background and aims: Overweight and obesity are an increasing challenge on a global level. In Denmark, more than one-third of all pregnant women are overweight or obese, and many women exceed the gestational weight gain recommendations from the Institute of Medicine. Being overweight or obese, is associated with a higher risk of adverse maternal and fetal outcomes, including gestational diabetes and childhood obesity. Thus, it is important to focus on the women’s lifestyles between their pregnancies to lower the risk of gestational weight retention in the long run. The objective of this study was to explorer what barriers and challenges postpartum women experience with respect to healthy lifestyles during the postpartum period and to access whether an Information Technology based intervention might be a supportive tool to assist and motivate postpartum women to a healthy lifestyle. Materials and methods: The method is inspired by participatory design. A systematic text condensation was applied to semi-structured focus groups. Five focus group interviews were carried out with a total of 17 postpartum women and two interviews with a total of six health professionals. Participants were recruited through the municipality in Svendborg, Denmark, and at Odense University Hospital in Odense, Denmark, during a four-month period in early 2018. Results: From the women’s perspective, better assistance is needed from the health professionals to obtain or maintain a healthy lifestyle. The women need tools that inform and help them understand and prioritise their own health-related risks, and to motivate them to plan and take care of their own health. As the women use Information Technology on a daily basis, the solution could be delivered through Information Technology. Finally, there is room for engaging the partner more in the communication related to the baby and family’s lifestyle. Conclusion: Postpartum women need tools that inform and motivate a healthy lifestyle postpartum. The tools should allow access to high-quality information from health care professionals, when the information is needed, and also allow engagement from the partner. Finally, Information Technology is a potential tool for delivering tools.

Keywords: information technology, lifestyle, overweight, postpartum

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Authors: Lakshmi Sujeesh, Aaron Ramzeen, Ricky Ziming Guo, Abhishek Agrawal

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Introduction: Range of motion (ROM) is often measured by physiotherapists using hand-held goniometer as part of mobility assessment for diagnosis. Due to the nature of hand-held goniometer measurement procedure, readings often tend to have some variations depending on the physical therapist taking the measurements (Riddle et al.). This study aims to validate computer vision software readings against goniometric measurements for quick and consistent ROM measurements to be taken by clinicians. The use of this computer vision software hopes to improve the future of musculoskeletal space with more efficient diagnosis from recording of patient’s ROM with minimal human error across different physical therapists. Methods: Using the hand-held long arm goniometer measurements as the “gold-standard”, healthy study participants (n = 20) were made to perform 4 exercises: Front elevation, Abduction, Internal Rotation, and External Rotation, using both arms. Assessment of active ROM using computer vision software at different angles set by goniometer for each exercise was done. Interclass Correlation Coefficient (ICC) using 2-way random effects model, Box-Whisker plots, and Root Mean Square error (RMSE) were used to find the degree of correlation and absolute error measured between set and recorded angles across the repeated trials by the same rater. Results: ICC (2,1) values for all 4 exercises are above 0.9, indicating excellent reliability. Lowest overall RMSE was for external rotation (5.67°) and highest for front elevation (8.00°). Box-whisker plots showed have showed that there is a potential zero error in the measurements done by the computer vision software for abduction, where absolute error for measurements taken at 0 degree are shifted away from the ideal 0 line, with its lowest recorded error being 8°. Conclusion: Our results indicate that the use of computer vision software is valid and reliable to use in clinical settings by physiotherapists for measuring shoulder ROM. Overall, computer vision helps improve accessibility to quality care provided for individual patients, with the ability to assess ROM for their condition at home throughout a full cycle of musculoskeletal care (American Academy of Orthopaedic Surgeons) without the need for a trained therapist.

Keywords: physiotherapy, frozen shoulder, joint range of motion, computer vision

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Authors: Kyunghun Kang, Sangwoo Oh, Yongha Hwang

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PDMS (Polydimethylsiloxane)-based microfluidic device has been recently applied to area of biomedical research, tissue engineering, and diagnostics because PDMS is low cost, nontoxic, optically transparent, gas-permeable, and especially biocompatible. Generally, PDMS microfluidic devices are fabricated by conventional soft lithography. Microfabrication requires expensive cleanroom facilities and a lot of time; however, only two-dimensional or simple three-dimensional structures can be fabricated. In this study, we introduce fabricating method for complex three-dimensional microfluidic channels using soluble wax mold. Using the 3D printing technique, we firstly fabricated three-dimensional mold which consists of soluble wax material. The PDMS pre-polymer is cast around, followed by PDMS casting and curing. The three-dimensional casting mold was removed from PDMS by chemically dissolved with methanol and acetone. In this work, two preliminary experiments were carried out. Firstly, the solubility of several waxes was tested using various solvents, such as acetone, methanol, hexane, and IPA. We found the combination between wax and solvent which dissolves the wax. Next, side effects of the solvent were investigated during the curing process of PDMS pre-polymer. While some solvents let PDMS drastically swell, methanol and acetone let PDMS swell only 2% and 6%, respectively. Thus, methanol and acetone can be used to dissolve wax in PDMS without any serious impact. Based on the preliminary tests, three-dimensional PDMS microfluidic channels was fabricated using the mold which was printed out using 3D printer. With the proposed fabricating technique, PDMS-based microfluidic devices have advantages of fast prototyping, low cost, optically transparence, as well as having complex three-dimensional geometry. Acknowledgements: This research was supported by Supported by a Korea University Grant and Basic Science Research Program through the National Research Foundation of Korea(NRF).

Keywords: microfluidic channel, polydimethylsiloxane, 3D printing, casting

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Authors: Guler Duru Asiret, Cemile Kutmec Yilmaz, Gulcan Bagcivan, Tugce Turten Kaymaz

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This descriptive study was conducted to determine the relationship between caregiver burden and life satisfaction who give home care to elderly individuals. The sample was recruited from the internal medicine unit and palliative unit of a state hospital located in Turkey on June 2016-2017. The study sample consisted of 231 primary caregiver family member, who met the eligibility criteria and agreed to participate in the study. The inclusion criteria were as follows: inpatient’s caregiver, primary caregiver for at least 3 months, at least 18 years of age, no communication problem or mental disorder. Data were gathered using an Information Form prepared by the researchers based on previous literature, the Zarit Burden Interview (ZBI), and the Satisfaction with Life Scale (SWLS). The data were analyzed using IBM SPSS Statistics software version 20.0 (SPSS, Chicago, IL). The descriptive characteristics of the participant were analyzed using number, percentage, mean and standard deviation. The suitability of normal distribution of scale scores was analyzed using Kolmogorov-Smirnov and Shapiro-Wilk test. Relationships between scales were analyzed using Spearman’s rank-correlation coefficient. P values less than 0.05 were considered to be significant. The average age of the caregivers was 50.11±13.46 (mean±SD) years. Of the caregivers, 76.2% were women, 45% were primary school graduates, 89.2% were married, 38.1% were the daughters of their patients. Among these, 52.4% evaluated their income level to be good. Of them, 53.6% had been giving care less than 2 years. The patients’ average age was 77.1±8.0 years. Of the patients, 55.8% were women, 56.3% were illeterate, 70.6% were married, and 97.4% had at least one chronic disease. The mean Zarit Burden Interview score was 35.4±1.5 and the Satisfaction with Life Scale score was 20.6±6.8. A negative relationship was found between the patients’ score average on the ZBI, and on the SWLS (r= -0.438, p=0.000). The present study determined that the caregivers have a moderate caregiver burden and the life satisfaction. And the life satisfaction of caregivers decreased as their caregiver burden increase. In line with the results obtained from the research, it is recommended that to increase the effectiveness of discharge training, to arrange training and counseling programs for caregivers to cope with the problems they experienced, to monitor the caregivers at regular intervals and to provide necessary institutional support.

Keywords: caregiver burden, family caregivers, nurses, satisfaction

Procedia PDF Downloads 156

Authors: Akmez Nabeerasool, Michaelis Massaros, Nigel Brown, David Sanderson, David Parocki, Charlotte Thompson, Mike Lodge, Mikael Khan

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The provision of clean and safe drinking water is of paramount importance and is a basic human need. Water scarcity coupled with tightening of regulations and the inability of current treatment technologies to deal with emerging contaminants and Pharmaceuticals and personal care products means that alternative treatment technologies that are viable and cost effective are required in order to meet demand and regulations for clean water supplies. Logistically, the application of water treatment in rural areas presents unique challenges due to the decentralisation of abstraction points arising from low population density and the resultant lack of infrastructure as well as the need to treat water at the site of use. This makes it costly to centralise treatment facilities and hence provide potable water direct to the consumer. Furthermore, across the UK there are segments of the population that rely on a private water supply which means that the owner or user(s) of these supplies, which can serve one household to hundreds, are responsible for the maintenance. The treatment of these private water supply falls on the private owners, and it is imperative that a chemical free technological solution that can operate unattended and does not produce any waste is employed. Arvia’s patented advanced oxidation technology combines the advantages of adsorption and electrochemical regeneration within a single unit; the Organics Destruction Cell (ODC). The ODC uniquely uses a combination of adsorption and electrochemical regeneration to destroy organics. Key to this innovative process is an alternative approach to adsorption. The conventional approach is to use high capacity adsorbents (e.g. activated carbons with high porosities and surface areas) that are excellent adsorbents, but require complex and costly regeneration. Arvia’s technology uses a patent protected adsorbent, Nyex™, which is a non-porous, highly conductive, graphite based adsorbent material that enables it to act as both the adsorbent and as a 3D electrode. Adsorbed organics are oxidised and the surface of the Nyex™ is regenerated in-situ for further adsorption without interruption or replacement. Treated water flows from the bottom of the cell where it can either be re-used or safely discharged. Arvia™ Technology Ltd. has trialled the application of its tertiary water treatment technology in treating reservoir water abstracted near Glasgow, Scotland, with promising results. Several other pilot plants have also been successfully deployed at various locations in the UK showing the suitability and effectiveness of the technology in removing recalcitrant organics (including pharmaceuticals, steroids and hormones), COD and colour.

Keywords: Arvia™ process, adsorption, water treatment, electrochemical oxidation

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Authors: Abbas Sheikhtaheri, Nasim Hashemi

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Health information systems have great benefits for clinical and managerial processes of health care organizations. However, identifying and removing constraints and barriers of implementing and using health information systems before any implementation is essential. Physicians are one of the main users of health information systems, therefore, identifying the causes of their resistance and concerns about the barriers of the implementation of these systems is very important. So the purpose of this study was to determine the barriers of the development and implementation of health information systems in terms of the Iranian physicians’ perspectives. In this study conducted in 8 selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences, Tehran, Iran in 2014, physicians (GPs, residents, interns, specialists) in these hospitals were surveyed. In order to collect data, a research made questionnaire was used (Cronbach’s α = 0.95). The instrument included 25 about organizational (9), personal (4), moral and legal (3) and technical barriers (9). Participants were asked to answer the questions using 5 point scale Likert (completely disagree=1 to completely agree=5). By using a simple random sampling method, 200 physicians (from 600) were invited to study that eventually 163 questionnaires were returned. We used mean score and t-test and ANOVA to analyze the data using SPSS software version 17. 52.1% of respondents were female. The mean age was 30.18 ± 7.29. The work experience years for most of them were between 1 to 5 years (80.4 percent). The most important barriers were organizational ones (3.4 ± 0.89), followed by ethical (3.18 ± 0.98), technical (3.06 ± 0.8) and personal (3.04 ± 1.2). Lack of easy access to a fast Internet (3.67±1.91) and the lack of exchanging information (3.61±1.2) were the most important technical barriers. Among organizational barriers, the lack of efficient planning for the development and implementation systems (3.56±1.32) and was the most important ones. Lack of awareness and knowledge of health care providers about the health information systems features (3.33±1.28) and the lack of physician participation in planning phase (3.27±1.2) as well as concerns regarding the security and confidentiality of health information (3.15 ± 1.31) were the most important personal and ethical barriers, respectively. Women (P = 0.02) and those with less experience (P = 0.002) were more concerned about personal barriers. GPs also were more concerned about technical barriers (P = 0.02). According to the study, technical and ethics barriers were considered as the most important barriers however, lack of awareness in target population is also considered as one of the main barriers. Ignoring issues such as personal and ethical barriers, even if the necessary infrastructure and technical requirements were provided, may result in failure. Therefore, along with the creating infrastructure and resolving organizational barriers, special attention to education and awareness of physicians and providing solution for ethics concerns are necessary.

Keywords: barriers, development health information systems, implementation, physicians

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Authors: Padmesh Tirunelveli Narayanapillai, Joel Sharwinkumar, Gaitri Saravanan

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The biosorption of Xylenol Orange (XO) and Eriochrome Black T (EBT) from aqueous solutions by chemically activated Cocos nucifera and mango seed as a low-cost, natural, and eco-friendly biosorbents was investigated. The study for biosorption of XO and EBT was optimized by different experimental parameters, initial pH 2–7, temperature 30–60 °C, biosorbent dosage 0.1 – 0.5 g, and XO: EBT dye proportions 0 – 100 by weight %. Physicochemical characteristic studies were conducted by Fourier Transform Infrared (FTIR). The equilibrium uptake was increased with an increase in the initial dye concentrations in the solution. Biosorption kinetic data were properly fitted with the pseudo-second-order kinetic model. The experimental isotherms data were analyzed using Langmuir, Freundlich, Redlich-Peterson, and Toth isotherm equations. Thermodynamic parameters ∆Go, ∆Ho, and ∆So were calculated indicating that the biosorption of Xo and EBT dye is a spontaneous and endothermic process. The Langmuir model gave the best fit by higher correlation coefficient (R2 =0.9971) for both biosorbents at optimum circumstances as pH 3, temperature 30°C, dosage 0.5 g for chemically activated Cocos nucifera and 0.4 g for chemically activated mango seeds it assumes as monolayer adsorption. The maximum dye removal efficiency was determined as 79.75% with chemically activated mango seeds compared to chemically activated Cocos nucifera. In summary, this research work showed that chemically modified activated mango seed can be effectively used as a promising low-cost biosorbent for the removal of different XO and EBT mixed dye combinations from aqueous solutions.

Keywords: mixed dye proportions, xylenol orange and eriochrome black t, chemically activated cocos nucifera and mango seed, kinetic, isotherm and thermodynamic studies, FTIR

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Authors: M. Chavez, H. Juarez, M. Pacio, O. Portillo

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PbS chemical bath heterojunction sollar cells have shown significant improvements in performance. Here we demonstrate a solar cell based on the heterojunction formed between PbS layer and PbS:Bi3+ thin films that are deposited via solution process at 40°C. The device achieve an current density of 4 mA/cm2. The simple and low-cost deposition method of PbS:Bi3+ films is promising for the fabrication.

Keywords: PbS doped, Bismuth, solar cell, thin films

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Authors: Adishirin Mammadov

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Polymers and polymer composites play vital roles in diverse industries, including food and beverage packaging, transportation innovations, and medical advancements. However, the advancements in polymer technology bring certain risks, particularly concerning water and soil pollution due to the presence of polymers. The creation of new polymers is a critical aspect of this field. While the primary focus is on improving their physical and chemical properties, ensuring their ecological compatibility is equally important. An advanced method for developing innovative polymer types involves integrating fillers with diverse characteristics, offering advantages such as cost reduction and improved quality indicators. In the conducted research, efforts were made to enhance environmental aspects by employing waste fillers. Specifically, low-density polyethylene (LDPE) was used as the polymer, and waste from cocoon factories was chosen as the filler. Following a process of cleaning, drying, and crushing the filler to specific dimensions, it was incorporated into polyethylene through a mechanical-chemical method under laboratory conditions. The varied rheological properties of the resulting polyethylene compositions examined at temperatures ranging from 145 to 165 degrees Celsius. These compositions demonstrated different rheological properties at various temperature intervals. Achieving homogeneity in the obtained compositions is crucial in the polymers mechanochemical process. Beyond rheological properties, swelling rates in different environments and percentages of mass loss at different temperatures learned using the differential thermal analysis method. The research revealed that, to a certain extent, the physico-chemical properties of polyethylene were not significantly affected by the polymer compositions. This suggests that incorporating cocoon waste enables cost reduction in composite production while positively impacting the environment.

Keywords: polyethylene, polymer, composites, filler, reology

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Authors: Heide Imai

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The paper will introduce and discuss specific examples of urban practices which take place within the dynamic urban landscape of contemporary Tokyo. The rising interest and importance of derelict places as resilient and creative clusters will be analysed, before relating this to the rediscovery of small urban niches and the emergence of different forms of social entrepreneurs. Secondly, two different case study areas will be introduced before discussing different forms of hybrid lifestyles, social micro scale enterprises and social innovations, understanding the concept of ‘small places of resilience’ as zones of human interaction, desire and care in which spontaneous practices take place.

Keywords: entrepreneurship, social innovation, Tokyo, urban regeneration

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Authors: Soheila Sadeghi

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In construction projects, predicting project performance metrics accurately is essential for effective management and successful delivery. However, conventional methods often depend on fixed baseline plans, disregarding the evolving nature of project progress and external influences. To address this issue, we introduce a distinct approach based on machine learning to forecast key performance indicators, such as cost variance and earned value, for each Work Breakdown Structure (WBS) category within an urban road reconstruction project. Our proposed model leverages time series forecasting techniques, namely Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory (LSTM) networks, to predict future performance by analyzing historical data and project progress. Additionally, the model incorporates external factors, including weather patterns and resource availability, as features to improve forecast accuracy. By harnessing the predictive capabilities of machine learning, our performance forecasting model enables project managers to proactively identify potential deviations from the baseline plan and take timely corrective measures. To validate the effectiveness of the proposed approach, we conduct a case study on an urban road reconstruction project, comparing the model's predictions with actual project performance data. The outcomes of this research contribute to the advancement of project management practices in the construction industry by providing a data-driven solution for enhancing project performance monitoring and control.

Keywords: project performance forecasting, machine learning, time series forecasting, cost variance, schedule variance, earned value management

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Authors: Ian Kingsbury

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The rapid expansion of charter schools (public schools that receive government but do not face the same regulations as traditional public schools) over the preceding two decades has raised concerns over the potential for graft and fraud. These concerns are largely justified: Incidents of financial crime and mismanagement are not unheard of, and the charter sector has become a darling of hedge fund managers. In response, several states have strengthened their charter school regulatory regimes. Imposing regulations and attempting to increase accountability seem like sensible measures, and perhaps they are necessary. However, increased regulation may come at the cost of imposing barriers to entry. Specifically, increased regulation often entails evidence for a high likelihood of fiscal solvency. That should theoretically entail access to capital in the short-term, which may systematically preclude Black or Hispanic applicants from opening charter schools. Moreover, increased regulation necessarily entails more red tape. The institutional wherewithal and the number of hours required to complete an application to open a charter school might favor those who have partnered with an education service provider, specifically a charter management organization (CMO) or education management organization (EMO). These potential barriers to entry pose a significant policy concern. Just as policymakers hope to increase the share of minority teachers and principals, they should sensibly care whether individuals who open charter schools look like the students in that school. Moreover, they might be concerned if successful applications in states with stringent regulations are overwhelmingly affiliated with education service providers. One of the original missions of charter schools was to serve as a laboratory of innovation. Approving only those applications affiliated with education service providers (and in effect establishing a parallel network of schools rather than a diverse marketplace of schools) undermines that mission. Data and methods: The analysis examines more than 2,000 charter school applications from 15 states. It compares the outcomes of applications from states with a strong regulatory environment (those with high scores) from NACSA-the National Association of Charter School Authorizers- to applications from states with a weak regulatory environment (those with a low NACSA score). If the hypothesis is correct, applicants not affiliated with an ESP are more likely to be rejected in high-regulation states compared to those affiliated with an ESP, and minority candidates not affiliated with an education service provider (ESP) are particularly likely to be rejected. Initial returns indicate that the hypothesis holds. More applications in low NASCA-scoring Arizona come from individuals not associated with an ESP, and those individuals are as likely to be accepted as those affiliated with an ESP. On the other hand, applicants in high-NACSA scoring Indiana and Ohio are more than 20 percentage points more likely to be accepted if they are affiliated with an ESP, and the effect is particularly pronounced for minority candidates. These findings should spur policymakers to consider the drawbacks of charter school accountability and consider accountability regimes that do not impose barriers to entry.

Keywords: accountability, barriers to entry, charter schools, choice

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Authors: Mariana Roberta Ribeiro, Isabela de Cássia Caramello, Roberto Saverio Souza Costa

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Currently, one of the most important environmental problems is soil degradation. This wear is the result of inadequate agricultural practices, with water erosion as the main agent. As the runoff water is concentrated in certain points, it can reach a more advanced stage, which are the gullies. In view of this, the objective of this work was to evaluate which methodology is most suitable for the purpose of elaborating a project for the recovery of a gully, relating work time, data reliability, and the final cost. The work was carried out on a rural road in Monte Alto - SP, where there is 0.30 hectares of area under the influence of a gully. For the evaluation, an aerophotogrammetric survey was used with RPA, with georeferenced points, and with a GNSS L1/L2 receiver. To assess the importance of georeferenced points, there was a comparison of altimetric data using the support points with altimetric data using only the aircraft's internal GPS. Another method used was the survey by conventional topography, where coordinates were collected by total station and L1/L2 Geodetic GPS receiver. Statistical analysis was performed using analysis of variance (ANOVA) using the F test (p<0.05), and the means between treatments were compared using the Tukey test (p<0.05). The results showed that the surveys carried out by aerial photogrammetry and by conventional topography showed no significant difference for the analyzed parameters. Considering the data presented, it is possible to conclude that, when comparing the parameters of accuracy, the final volume of the gully, and cost, for the purpose of elaborating a project for the recovery of a gully, the methodologies of aerial photogrammetric survey and conventional topography do not differ significantly. However, when working time, use of labor, and project detail are compared, the aerial photogrammetric survey proves to be more viable.

Keywords: drones, erosion, soil conservation, technology in agriculture

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Authors: Jorge Prada, Christina Cordes, Carsten Harms, Walter Lang

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The development of microfluidic-based biosensors over the last years has shown an increasing employ of thermoplastic polymers as constitutive material. Their low-cost production, high replication fidelity, biocompatibility and optical-mechanical properties are sought after for the implementation of disposable albeit functional lab-on-chip solutions. Among the range of thermoplastic materials on use, the Cyclo-Olefin Copolymer (COC) stands out due to its optical transparency, which makes it a frequent choice as manufacturing material for fluorescence-based biosensors. Moreover, several processing techniques to complete a closed COC microfluidic biosensor have been discussed in the literature. The reported techniques differ however in their implementation, and therefore potentially add more or less complexity when using it in a mass production process. This work introduces and reports results on the application of a purely thermal bonding process between COC substrates, which were produced by the hot-embossing process, and COC foils containing screen-printed circuits. The proposed procedure takes advantage of the transition temperature difference between two COC grades foils to accomplish the sealing of the microfluidic channels. Patterned heat injection to the COC foil through the COC substrate is applied, resulting in consistent channel geometry uniformity. Measurements on bond strength and bursting pressure are shown, suggesting that this purely thermal bonding process potentially renders a technique which can be easily adapted into the thermoplastic microfluidic chip production workflow, while enables a low-cost as well as high-quality COC biosensor manufacturing process.

Keywords: biosensor, cyclo-olefin copolymer, hot embossing, thermal bonding, thermoplastics

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Authors: Arun Dhakal, Rajesh Kumar Rai

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Agroforestry is long practiced in Nepal as a means of subsistence livelihoods. Given its potential to climate change mitigation, this practice is being recommended as a climate-smart farming practice in the recent years. However, the financial attractiveness of this practice is not well-documented in a labor scarce economy such as Nepal. This study attempts to examine the financial suitability of an agroforestry-based farming practice in the present socio-economic context of Nepal where labor is in short supply. A total of 200 households were randomly selected for household surveys in Dhanusha district during April to July 2015. Two farming practices were found to be dominant in the study area: 1) conventional farming (field crops only) in which at least two field crops are annually grown, and 2) agroforestry-based farming (agroforest, home garden and field crops combined) practice (ABFP). The ABFP was found to be less labor intensive than the conventional farming (137 Man days/yr/ha vs 218 Man days/yr/ha). The ex-ante financial analysis indicated that both the farming practices generated positive NPVs (Net Present Values) and B/C (Benefit-Cost) ratios greater than one, indicating both are financially attractive farming enterprises under the base discount rate of 12%. However, the ABFP generated higher NPV and greater B/C ratio than the conventional farming, indicating the former was financially more attractive than the later. The sensitivity analysis showed that the conventional farming was more sensitive to change in labor wage rate than that of the ABFP. Up to the 24% discount rate, the ABFP generated higher NPV and in case of B/C ratio, the ratio was found greater for ABFP even in 50% discount rate.

Keywords: agroforestry, benefit-cost analysis, conventional farming, net present value

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Authors: Muhammad Cheema, Tahir Shah, Subhash Anand

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The cost of making apparel fabrics for garment manufacturing is very high because of their conventional manufacturing processes and new methods/processes are being constantly developed for making fabrics by unconventional methods. With the advancements in technology and the availability of the innovative fibres, durable nonwoven fabrics by using the hydroentanglement process that can compete with the woven fabrics in terms of their aesthetic and tensile properties are being developed. In the work reported here, the hydroentangled nonwoven fabrics were developed through a hybrid nonwoven manufacturing processes by using fibrillated Tencel® and bi-component (sheath/core) polyethylene/polyester (PE/PET) fibres, in which the initial nonwoven fabrics were prepared by the needle-punching method followed by hydroentanglement process carried out at optimal pressures of 50 to 250bars. The prepared fabrics were characterized according to the British Standards (BS 3356:1990, BS 9237:1995, BS 13934-1:1999) and the attained results were compared with those for a standard plain-weave cotton, polyester woven fabric and commercially available nonwoven fabric (Evolon®). The developed hydroentangled fabrics showed better drape properties owing to their flexural rigidity of 252 mg.cm in the machine direction, while the corresponding commercial hydroentangled fabric displayed a value of 1340 mg.cm in the machine direction. The tensile strength of the developed hydroentangled fabrics showed an approximately 200% increase than the commercial hydroentangled fabrics. Similarly, the developed hydroentangled fabrics showed higher properties in term of air permeability, such as the developed hydroentangled fabric exhibited 448 mm/sec and Evolon fabric exhibited 69 mm/sec at 100 Pa pressure. Thus for apparel fabrics, the work combining the existing methods of nonwoven production, provides additional benefits in terms of cost, time and also helps in reducing the carbon footprint for the apparel fabric manufacture.

Keywords: hydroentanglement, nonwoven apparel, durable nonwoven, wearable nonwoven

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Authors: Muhammad Mukhtar

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The aim of this study is to evaluate the antioxidant activity and acute toxicity of the extracts of Ficus iteophylla by reactions with 1, 1-diphenyl-2-picryhydrazyl radical (DPPH) and method developed by Lork 1983, respectively. Stem bark of Ficus iteophylla was collected, air dried, pulverized to fine powdered and sequentially extracted using acetone, methanol and water in order of increasing polarity. The result shows strong radical scavenging activity against DPPH for all the extracts when compared with ascorbic acid. The LD50 of 316 mg/kg was calculated for all the three extras, and the values were found to be within the practically toxic range, and therefore, care should be taken when using the plants in traditional medicine.

Keywords: antioxidant, acute toxicity, Ficus iteophylla

Procedia PDF Downloads 149

Authors: Salman Al-Alyani

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In line with the Kingdom’s Vision 2030, the Saudi Green initiative was announced aimed at reducing carbon emissions by more than 4% of the global contribution. The initiative included plans to generate 50% of its energy from renewables by 2030. The geographical location of Saudi Arabia makes it among the best countries in terms of solar irradiation and has good wind resources in many areas across the Kingdom. Saudi Arabia is a wide country and has many remote locations where it is not economically feasible to connect those loads to the national grid. With the improvement of battery innovation and reduction in cost, different renewable technologies (primarily wind and solar) can be integrated to meet the need for energy in a more effective and cost-effective way. Saudi Arabia is famous for high solar irradiations in which solar power generation can extend up to six (6) hours per day (25% capacity factor) in some locations. However, the net present value (NPV) falls down to negative in some locations due to distance and high installation costs. Wind generation in Saudi Arabia is a promising technology. Hybrid renewable generation will increase the net present value and lower the payback time due to additional energy generated by wind. The infrastructure of the power system can be capitalized to contain solar generation and wind generation feeding the inverter, controller, and load. Storage systems can be added to support the hours that have an absence of wind or solar energy. Also, the smart controller that can help integrate various renewable technologies primarily wind and solar, to meet demand considering load characteristics. It could be scalable for grid or off-grid applications. The objective of this paper is to study the feasibility of introducing a hybrid renewable system in remote locations and the concept for the development of a smart controller.

Keywords: battery storage systems, hybrid power generation, solar energy, wind energy

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Authors: Kingsley Agyapong

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Research conducted in recent years has delved into the concept of patient-perceived value within the context of co-creation, particularly in the realm of doctor-patient interactions within healthcare settings. However, existing scholarly discourse lacks exploration regarding the emergence of patient-derived value in the co-creation process, specifically within encounters involving patients and stakeholders such as doctors, nurses, pharmacists, and other healthcare professionals. This study aims to fill this gap by elucidating the perspectives of patients regarding the value they derive from their interactions with multiple stakeholders in the delivery of healthcare services. The fieldwork was conducted at a university clinic located in Ghana. Data collection procedures involved conducting 20 individual interviews with key informants on distinct value accrued from co-creation practices and interactions with stakeholders. The key informants consisted of patients receiving care at the university clinic during the Malaria Treatment Process. Three themes emerged from both the existing literature and the empirical data collected. The first theme, labeled as "patient value needs in co-creation," encapsulates elements such as communication effectiveness, interpersonal interaction quality, treatment efficacy, and enhancements to the overall quality of life experienced by patients during their interactions with healthcare professionals. The second theme, designated as "services that enhance patients' experience in value co-creation," pertains to patients' perceptions of services that contribute favourably to co-creation experiences, including initiatives related to health promotion and the provision of various in-house services that patients deem pertinent for augmenting their overall experiences. The third theme, titled "Challenges in the co-creation of patients' value," delineates obstacles encountered within the co-creation process, including health professionals' challenges in effectively following up with patients scheduled for review and prolonged waiting times for healthcare delivery. This study contributes to the patients' perceptions of value within the co-creation process during their interactions with service providers, particularly healthcare professionals. By gaining a deeper insight into this process, healthcare providers can enhance the delivery of patient-centered care, thereby leading to improved healthcare outcomes. The study further offers managerial implications derived from its findings, providing actionable insights for healthcare managers and policymakers aiming to optimize patient value creation in healthcare services. Furthermore, it suggests avenues for future research endeavors within healthcare settings.

Keywords: patient, healthcare, co-creation, malaria

Procedia PDF Downloads 29