Search results for: Allison McKee
30 Screening for Diabetes in Patients with Chronic Pancreatitis: The Belfast Trust Experience
Authors: Riyas Peringattuthodiyil, Mark Taylor, Ian Wallace, Ailish Nugent, Mike Mitchell, Judith Thompson, Allison McKee, Philip C. Johnston
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Aim of Study: The purpose of the study was to screen for diabetes through HbA1c in patients with chronic pancreatitis (CP) within the Belfast Trust. Background: Patients with chronic pancreatitis are at risk of developing diabetes, earlier diagnosis with subsequent multi-disciplinary input has the potential to improve clinical outcomes. Methods: Clinical and laboratory data of patients with chronic pancreatitis were obtained through the Northern Ireland Electronic Healthcare Record (NIECR), specialist hepatobiliary, and gastrointestinal clinics. Patients were invited to have a blood test for HbA1c. Newly diagnosed patients with diabetes were then invited to attend a dedicated Belfast City Hospital (BCH) specialist chronic pancreatitis and diabetes clinic for follow up. Results: A total of 89 chronic pancreatitis patients were identified; Male54; Female:35, mean age 52 years, range 12-90 years. Aetiology of CP included alcohol 52/89 (58%), gallstones 18/89 (20%), idiopathic 10/89 11%, 2 were genetic, 1: post ECRP, 1: IgG autoimmune, 1: medication induced, 1: lipoprotein lipase deficiency 1: mumps, 1: IVDU and 1: pancreatic divisum. No patients had pancreatic carcinoma. Mean duration of CP was nine years, range 3-30 years. 15/89 (16%) of patients underwent previous pancreatic surgery/resections. Recent mean BMI was 25.1 range 14-40 kg/m². 62/89 (70%) patients had HbA1c performed. Mean HbA1c was 42 mmol/mol, range 27-97mmol/mol, 42/62 (68%) had normal HbA1c (< 42 mmol/mol) 13/62 (21%) had pre-diabetes (42-47mmol/mol) and 7/62 (11%) had diabetes (≥ 48 mmol/mol). Conclusions: Of those that participated in the screening program around one-third of patients with CP had glycaemic control in the pre and diabetic range. Potential opportunities for improving screening rates for diabetes in this cohort could include regular yearly testing at gastrointestinal and hepatobiliary clinics.Keywords: pancreatogenic diabetes, screening, chronic pancreatitis, trust experience
Procedia PDF Downloads 15829 Boundary Motion by Curvature: Accessible Modeling of Oil Spill Evaporation/Dissipation
Authors: Gary Miller, Andriy Didenko, David Allison
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The boundary of a region in the plane shrinks according to its curvature. A simple algorithm based upon this motion by curvature performed by a spreadsheet simulates the evaporation/dissipation behavior of oil spill boundaries.Keywords: mathematical modeling, oil, evaporation, dissipation, boundary
Procedia PDF Downloads 50828 Designing and Enacting an Adjunct Faculty Self-Study of Teaching Community
Authors: Anastasia P. Samaras, Allison Ward-Parsons, Beth Dalbec, Paula Cristina Azevedo, Anya Evmenova, Arvinder Johri, Lynne Scott Constantine, Lesley Smith
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Two cycles of qualitative data were collected. Cycle One sources included participant survey results, participant postings on Blackboard forums, facilitator memos, and meeting notes as well as reflections and notes from whole-group meetings.Keywords: adjunct faculty, professional development, self-study methodology, teaching
Procedia PDF Downloads 16027 Preliminary Seismic Hazard Mapping of Papua New Guinea
Authors: Hadi Ghasemi, Mark Leonard, Spiliopoulos Spiro, Phil Cummins, Mathew Moihoi, Felix Taranu, Eric Buri, Chris Mckee
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In this study the level of seismic hazard in terms of Peak Ground Acceleration (PGA) was calculated for return period of 475 years, using modeled seismic sources and assigned ground-motion equations. The calculations were performed for bedrock site conditions (Vs30=760 m/s). From the results it is evident that the seismic hazard reaches its maximum level (i.e. PGA≈1g for 475 yr return period) at the Huon Peninsula and southern New Britain regions. Disaggregation analysis revealed that moderate to large earthquakes occurring along the New Britain Trench mainly control the level of hazard at these locations. The open-source computer program OpenQuake developed by Global Earthquake Model foundation was used for the seismic hazard computations. It should be emphasized that the presented results are still preliminary and should not be interpreted as our final assessment of seismic hazard in PNG.Keywords: probabilistic seismic hazard assessment, Papua New Guinea, building code, OpenQuake
Procedia PDF Downloads 55526 Interactions within the School Setting and Their Potential Impact on the Wellbeing or Educational Success of High Ability Students: A Literature Review
Authors: Susan Burkett-McKee, Bruce Knight, Michelle Vanderburg
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The wellbeing and educational success of high ability students are interrelated concepts with each potentially hindering or enhancing the other. A student’s well-being and educational success are also influenced by intrapersonal and interpersonal factors. This presentation begins with an exploration of the literature pertinent to the wellbeing and educational success of this cohort before an ecological perspective is taken to discuss research into the impact of interactions within the school context. While the literature consistently states that interactions exchanged between high ability students and school community members impact the students’ wellbeing or educational success, no consensus has been reached about whether the impact is positive or negative. Findings from the review shared in this presentation inform an interpretative phenomenological study involving senior secondary students enrolled in inclusive Australian schools to highlight, from the students’ perspective, the ways school-based interactions impact their wellbeing or educational success.Keywords: educational success, interactions, literature review, wellbeing
Procedia PDF Downloads 30125 Elitism: Navigating Professional Diversity Barriers
Authors: Rachel Nir, Tina Mckee
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In the UK, reliance has been placed on the professions to ‘heal themselves’ in improving equality and diversity. This approach has faltered, in part due to the global economic climate, and stimulus is needed to make faster equality progress. Recent empirical evidence has identified specific diversity barriers, namely: the cost of training; the use of high school grades as a primary selection criteria; the significance of prior work experience in recruitment decisions; and recruitment from elite universities. Students from majority groups and affluent backgrounds are advantaged over their counterparts. We as educators are passionate about resisting this. We believe that education can be a key agent of change. As part of this belief, the presenters have recently designed learning and teaching materials for the 2015/16 academic year. These are aimed at undergraduate law students for the purpose of 1) educating them on career barriers; 2) helping them to develop personal strategies to overcome them; and 3) encouraging them to address their own biases, both conscious and implicit, so that they, themselves, may be fairer employers and managers in the future.Keywords: career barriers, challenging professional bias, education, elitism, personal student strategies
Procedia PDF Downloads 23624 Offline Signature Verification Using Minutiae and Curvature Orientation
Authors: Khaled Nagaty, Heba Nagaty, Gerard McKee
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A signature is a behavioral biometric that is used for authenticating users in most financial and legal transactions. Signatures can be easily forged by skilled forgers. Therefore, it is essential to verify whether a signature is genuine or forged. The aim of any signature verification algorithm is to accommodate the differences between signatures of the same person and increase the ability to discriminate between signatures of different persons. This work presented in this paper proposes an automatic signature verification system to indicate whether a signature is genuine or not. The system comprises four phases: (1) The pre-processing phase in which image scaling, binarization, image rotation, dilation, thinning, and connecting ridge breaks are applied. (2) The feature extraction phase in which global and local features are extracted. The local features are minutiae points, curvature orientation, and curve plateau. The global features are signature area, signature aspect ratio, and Hu moments. (3) The post-processing phase, in which false minutiae are removed. (4) The classification phase in which features are enhanced before feeding it into the classifier. k-nearest neighbors and support vector machines are used. The classifier was trained on a benchmark dataset to compare the performance of the proposed offline signature verification system against the state-of-the-art. The accuracy of the proposed system is 92.3%.Keywords: signature, ridge breaks, minutiae, orientation
Procedia PDF Downloads 14523 The Study of the Mutual Effect of Genotype in Environment by Percent of Oil Criterion in Sunflower
Authors: Seyed Mohammad Nasir Mousavi, Pasha Hejazi, Maryam Ebrahimian Dehkordi
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In order to study the Mutual effect of genotype × environment for the percent of oil index in sunflower items, an experiment was accomplished in form of complete random block designs in four iteration in four diverse researching station comprising Esfahan, Birjand, Sari, and Karaj. Complex variance analysis showed that there is an important diversity between the items under investigation. The results pertaining the coefficient variation of items Azargol and Vidoc has respectively allocated the minimum coefficient of variations. According to the results extrapolated from Shokla stability variance, the Items Brocar, Allison and Fabiola, are among the stable genotypes for oil percent respectively. in the biplot GGE, the location under investigations divided in two super-environment, first one comprised of locations naming Esfahan, Karaj, and Birjand, and second one were such a location as Sari. By this point of view, in the first super-environment, the Item Fabiola and in the second Almanzor item was among the best items and crops.Keywords: sunflower, stability, GGE bipilot, super-environment
Procedia PDF Downloads 54622 Testing the Feasibility of a Positive Psychology Mobile Health App for College Electronic Cigarette Users
Authors: Allison Futter
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Lifetime use of electronic cigarettes (EC) in college students has been estimated at around 50%; recent research shows Mobile Health (mHealth) technology is a promising tool to help address this public health issue, yet the majority of EC cessation mHealth tools found on smartphone app stores lack empirical support of their effectiveness. The Smiling Instead of Smoking (SiS) app is a positive psychology-based smartphone app for nondaily smokers. Due to previous success with brief, self-administered positive psychology exercises for cigarette cessation, this study examined the SiS App’s feasibility and effectiveness for EC cessation. Sixteen undergraduates used the SiS app for 3 weeks: one week before their quit date and 2 weeks after. As hypothesized, participants had significant declines in their craving and maintained pre-cessation levels of positive affect. There were no significant changes in dependency or self-efficacy. In the one-month follow-up survey, 38% of participants reported being abstinent. The app had an almost 4-star rating for its features (e.g., functionality, aesthetics, information, etc.) and participants reported moderate satisfaction with its use. Participants used the app, on average, 10 out of the 21 days of the prescribed app use. This study highlights the promise of mHealth support and positive psychology for EC cessation, adding to the understanding of possible ways to support EC quit attempts.Keywords: e-cigarette cessation, mHealth, positive psychology, smartphone app
Procedia PDF Downloads 11721 Effectiveness of Laughter Yoga in Reducing Anxiety among Pre-Operative Patients for Scheduled Major Surgery
Authors: Denise Allison D. Garcia, Camille C. Garcia, Keanu Raphael Garrido, Crestita B. Tan
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Introduction: Anxiety is a common problem among pre-operative patients. Several methods or interventions are being applied in order to relieve anxiety. Laughter yoga, however, is a method that has been used to relieve anxiety but has not yet been tested to pre-operative patients. Therefore, this study determined the effectiveness of laughter yoga in reducing anxiety among pre-operative middle-aged patients scheduled for major surgery. Methods: After Ethics Review Board approval, a quasi-experimental study was conducted among 40 purposely-selected pre-operative patients in two tertiary hospitals. Anxiety level was measured prior to administration of laughter yoga using the State-Trait Anxiety Inventory with a Cronbach alpha of 0.83. After Laughter yoga, anxiety level was then measured again. Gathered data were analyzed in SPSS version 20 using paired and independent t-test and ANCOVA. Results: After analysis of the data gathered, the results showed that there was a significant decrease in the anxiety level of patients in the experimental group. From an anxiety level of 44.00, the rating went down to 36.85. Meanwhile in the control group, the anxiety level at the pretest at 41.25 went up to 42.50. Laughter yoga was an effective non-pharmacologic intervention for reducing anxiety of pre-operative patients. Conclusion: It is therefore concluded that laughter yoga causes a significant decrease in the anxiety level of patients.Keywords: anxiety, laughter yoga, non-pharmacologic, pre-operative
Procedia PDF Downloads 44220 Automation of AAA Game Development Using AI
Authors: Branden Heng, Harsheni Siddharthan, Allison Tseng, Paul Toprac, Sarah Abraham, Etienne Vouga
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The goal of this project was to evaluate and document the capabilities and limitations of AI tools for empowering small teams to create high-budget, high-profile (AAA) 3D games typically developed by large studios. Two teams of novice game developers attempted to create two different games using AI and Unreal Engine 5.3. First, the teams evaluated 60 AI art, design, sound, and programming tools by considering their capability, ease of use, cost, and license restrictions. Then, the teams used a shortlist of 12 AI tools for game development. During this process, the following tools were found to be the most productive: (i) ChatGPT 4.0 for both game and narrative concepts and documentation; (ii) Dall-E 3 and OpenArt for concept art; (iii) Beatoven for music drafting; (iv) ChatGPT 4.0 and Github Copilot for generating simple code and to complement human-made tutorials as an additional learning resource. While current generative AI may appear impressive at first glance, the assets they produce fall short of AAA industry standards. Generative AI tools are helpful when brainstorming ideas such as concept art and basic storylines, but they still cannot replace human input or creativity at this time. Regarding programming, AI can only effectively generate simple code and act as an additional learning resource. Thus, generative AI tools are, at best, tools to enhance developer productivity rather than as a system to replace developers.Keywords: AAA games, AI, automation tools, game development
Procedia PDF Downloads 2519 Automation of AAA Game Development using AI and Procedural Generation
Authors: Paul Toprac, Branden Heng, Harsheni Siddharthan, Allison Tseng, Sarah Abraham, Etienne Vouga
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The goal of this project was to evaluate and document the capabilities and limitations of AI tools for empowering small teams to create high budget, high profile (AAA) 3D games typically developed by large studios. Two teams of novice game developers attempted to create two different games using AI and Unreal Engine 5.3. First, the teams evaluated 60 AI art, design, sound, and programming tools by considering their capability, ease of use, cost, and license restrictions. Then, the teams used a shortlist of 13 AI tools for game development. During this process, the following tools were found to be the most productive: (1) ChatGPT 4.0 for both game and narrative concepting and documentation; (2) Dall-E 3 and OpenArt for concept art; (3) Beatoven for music drafting; (4) Epic PCG for level design; and (5) ChatGPT 4.0 and Github Copilot for generating simple code and to complement human-made tutorials as an additional learning resource. While current generative AI may appear impressive at first glance, the assets they produce fall short of AAA industry standards. Generative AI tools are helpful when brainstorming ideas such as concept art and basic storylines, but they still cannot replace human input or creativity at this time. Regarding programming, AI can only effectively generate simple code and act as an additional learning resource. Thus, generative AI tools are at best tools to enhance developer productivity rather than as a system to replace developers.Keywords: AAA games, AI, automation tools, game development
Procedia PDF Downloads 2218 Re-Storying School Culture Through Appreciative Inquiry
Authors: Allison Tucker, Carolyn Clarke
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This study arose from the understanding that school cultures are shaped by the stories of school as known by teachers, students, and families. These sometimes-conflicting stories, based on a myriad of influences, present challenges to school culture. Layered on stories of school are the policies, developed often from central jurisdictional agencies, that direct schools on their daily operations from things such as curriculum to schedules and school calendars. This study investigates the stories of one Canadian school with the teachers, students, and families of the community. Using appreciative inquiry to consider the influence stories of school have on the ways policies are interpreted and lived in their school community, participants interrogate the stories that currently overarch the school community, and explore ways they might actively foster a school community whose lived experience aligns with what they dream for their schools. Paradigmatic analysis was used to reveal commonalities in participant responses. The findings of the study indicate that schools face challenges in creating a cohesive school community due to related to conflicting interpretations of school stories and the attempts to integrate jurisdictional policies in ways that reflect and make sense in their communities. Differing beliefs about the structure of school, misalignment in what was felt was the purpose of school, diverse understandings of curriculum, and even disparities regarding what the role of each group was in the school community, all create barriers to the creation of a well-connected school community that shares a common purpose. Results from the study, assist the school community to more effectively respond to the impacts that stories from the community and factors external to the school have on the community, and by extension the daily lived experiences of teachers and students in the school. It also offers other school communities a framework through which they could respond sensitively to the lived experience and stories of the teachers, students, and families of their schools.Keywords: school community, appreciative inquiry, school policy, school culture
Procedia PDF Downloads 1517 A Fermatean Fuzzy MAIRCA Approach for Maintenance Strategy Selection of Process Plant Gearbox Using Sustainability Criteria
Authors: Soumava Boral, Sanjay K. Chaturvedi, Ian Howard, Kristoffer McKee, V. N. A. Naikan
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Due to strict regulations from government to enhance the possibilities of sustainability practices in industries, and noting the advances in sustainable manufacturing practices, it is necessary that the associated processes are also sustainable. Maintenance of large scale and complex machines is a pivotal task to maintain the uninterrupted flow of manufacturing processes. Appropriate maintenance practices can prolong the lifetime of machines, and prevent associated breakdowns, which subsequently reduces different cost heads. Selection of the best maintenance strategies for such machines are considered as a burdensome task, as they require the consideration of multiple technical criteria, complex mathematical calculations, previous fault data, maintenance records, etc. In the era of the fourth industrial revolution, organizations are rapidly changing their way of business, and they are giving their utmost importance to sensor technologies, artificial intelligence, data analytics, automations, etc. In this work, the effectiveness of several maintenance strategies (e.g., preventive, failure-based, reliability centered, condition based, total productive maintenance, etc.) related to a large scale and complex gearbox, operating in a steel processing plant is evaluated in terms of economic, social, environmental and technical criteria. As it is not possible to obtain/describe some criteria by exact numerical values, these criteria are evaluated linguistically by cross-functional experts. Fuzzy sets are potential soft-computing technique, which has been useful to deal with linguistic data and to provide inferences in many complex situations. To prioritize different maintenance practices based on the identified sustainable criteria, multi-criteria decision making (MCDM) approaches can be considered as potential tools. Multi-Attributive Ideal Real Comparative Analysis (MAIRCA) is a recent addition in the MCDM family and has proven its superiority over some well-known MCDM approaches, like TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) and ELECTRE (ELimination Et Choix Traduisant la REalité). It has a simple but robust mathematical approach, which is easy to comprehend. On the other side, due to some inherent drawbacks of Intuitionistic Fuzzy Sets (IFS) and Pythagorean Fuzzy Sets (PFS), recently, the use of Fermatean Fuzzy Sets (FFSs) has been proposed. In this work, we propose the novel concept of FF-MAIRCA. We obtain the weights of the criteria by experts’ evaluation and use them to prioritize the different maintenance practices according to their suitability by FF-MAIRCA approach. Finally, a sensitivity analysis is carried out to highlight the robustness of the approach.Keywords: Fermatean fuzzy sets, Fermatean fuzzy MAIRCA, maintenance strategy selection, sustainable manufacturing, MCDM
Procedia PDF Downloads 13816 Pandemic-Era WIC Participation in Delaware, U.S.: Participants' Experiences and Challenges
Authors: McKenna Halverson, Allison Karpyn
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Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC
Procedia PDF Downloads 7515 Clinical and Microbiologic Efficacy and Safety of Imipenem Cilastatin Relebactam in Complicated Infections: A Meta-analysis
Authors: Syeda Sahra, Abdullah Jahangir, Rachelle Hamadi, Ahmad Jahangir, Allison Glaser
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Background: Antimicrobial resistance is on the rise. The use of redundant and inappropriate antibiotics is contributing to recurrent infections and resistance. Newer antibiotics with more robust coverage for gram-negative bacteria are in great demand for complicated urinary tract infections (cUTIs), complicated intra-abdominal infections (cIAIs), hospital-acquired bacterial pneumonia (H.A.B.P.), and ventilator-associated bacterial pneumonia (V.A.B.P.). Objective: We performed this meta-analysis to evaluate the efficacy and safety profile of a new antibiotic, Imipenem/cilastatin/relebactam, compared to other broad-spectrum antibiotics for complicated infections. Search Strategy: We conducted a systemic review search on PubMed, Embase, and Central Cochrane Registry. Selection Criteria: We included randomized clinical trials (R.C.T.s) with the standard of care as comparator arm with Imipenem/cilastatin/relebactam as intervention arm. Analysis: For continuous variables, the mean difference was used. For discrete variables, we used the odds ratio. For effect sizes, we used a confidence interval of 95%. A p-value of less than 0.05 was used for statistical significance. Analysis was done using a random-effects model irrespective of heterogeneity. Heterogeneity was evaluated using the I2 statistic. Results: The authors observed similar efficacy at clinical and microbiologic response levels on early follow-up and late follow-up compared to the established standard of care. The incidence of drug-related adverse events, serious adverse events, and drug discontinuation due to adverse events were comparable across both groups. Conclusion: Imipenem/cilastatin/relebactam has a non-inferior safety and efficacy profile compared to peer antibiotics to treat severe bacterial infections (cUTIs, cIAIs, H.A.B.P., V.A.B.P.).Keywords: bacterial pneumonia, complicated intra-abdominal infections, complicated urinary tract infection, Imipenem, cilastatin, relebactam
Procedia PDF Downloads 20314 Bioengineering of a Plant System to Sustainably Remove Heavy Metals and to Harvest Rare Earth Elements (REEs) from Industrial Wastes
Authors: Edmaritz Hernandez-Pagan, Kanjana Laosuntisuk, Alex Harris, Allison Haynes, David Buitrago, Michael Kudenov, Colleen Doherty
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Rare Earth Elements (REEs) are critical metals for modern electronics, green technologies, and defense systems. However, due to their dispersed nature in the Earth’s crust, frequent co-occurrence with radioactive materials, and similar chemical properties, acquiring and purifying REEs is costly and environmentally damaging, restricting access to these metals. Plants could serve as resources for bioengineering REE mining systems. Although there is limited information on how REEs affect plants at a cellular and molecular level, plants with high REE tolerance and hyperaccumulation have been identified. This dissertation aims to develop a plant-based system for harvesting REEs from industrial waste material with a focus on Acid Mine Drainage (AMD), a toxic coal mining product. The objectives are 1) to develop a non-destructive, in vivo detection method for REE detection in Phytolacca plants (REE hyperaccumulator) plants utilizing fluorescence spectroscopy and with a primary focus on dysprosium, 2) to characterize the uptake of REE and Heavy Metals in Phytolacca americana and Phytolacca acinosa (REE hyperaccumulator) in AMD for potential implementation in the plant-based system, 3) to implement the REE detection method to identify REE-binding proteins and peptides for potential enhancement of uptake and selectivity for targeted REEs in the plants implemented in the plant-based system. The candidates are known REE-binding peptides or proteins, orthologs of known metal-binding proteins from REE hyperaccumulator plants, and novel proteins and peptides identified by comparative plant transcriptomics. Lanmodulin, a high-affinity REE-binding protein from methylotrophic bacteria, is used as a benchmark for the REE-protein binding fluorescence assays and expression in A. thaliana to test for changes in REE plant tolerance and uptake.Keywords: phytomining, agromining, rare earth elements, pokeweed, phytolacca
Procedia PDF Downloads 1413 Cultural Orientation as a Moderator between Social Support Needs and Psychological Well-Being among Canadian University Students
Authors: Allison Streutker, Josephine Tan
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Universities across Canada have experienced unprecedented growth in international student enrollment from across the world. As cultural diversity in Canada and other countries increases, understanding the social support needs of all students is important for providing them with the assistance they need to thrive psychologically and academically. Those from individualistic cultural orientations tend to seek explicit social support, which involves expressly asking for assistance in times of stress. However, those from collectivistic cultural orientations are more likely to seek implicit social support, where encouragement is obtained from spending time among valued social groups without explicitly talking about problems. This study explored whether the relationship between the type of social support needs (implicit or explicit) and psychological and academic functioning might be moderated by cultural orientations (individualistic, collectivistic) among university students. Participants were 110 university students (70 women, 40 men; mean age = 24.8 years, SD = 6.6). They completed the Individualism and Collectivism Scale (ICS), Perceived Stress Scale (PSS), Interpersonal Support Evaluation List (ISEL) which assesses implicit and explicit social support, Satisfaction with Life Scale (SWLS), Scale of Positive and Negative Experience (SPANE) which yields positive and negative experience scores, Flourishing Scale (FS), and reported their grade point average (GPA) as a measure of academic performance. Moderated regression analysis demonstrated that, for those scoring lower on individualism, reporting lower level of implicit support predicted higher levels of perceived stress. For those scoring higher on individualism, lower levels of explicit social support predicted higher levels of perceived stress and a greater number of negative experiences. Generally, higher levels of implicit support were associated with greater satisfaction with life for all students, with the association becoming stronger among students with higher collectivism scores. No other significant findings were found. The results point to the value of considering the cultural orientations of students when designing programs to maintain and improve their sense of well-being.Keywords: cultural orientation, social support, university students, well-being
Procedia PDF Downloads 23512 Urinary Volatile Organic Compound Testing in Fast-Track Patients with Suspected Colorectal Cancer
Authors: Godwin Dennison, C. E. Boulind, O. Gould, B. de Lacy Costello, J. Allison, P. White, P. Ewings, A. Wicaksono, N. J. Curtis, A. Pullyblank, D. Jayne, J. A. Covington, N. Ratcliffe, N. K. Francis
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Background: Colorectal symptoms are common but only infrequently represent serious pathology, including colorectal cancer (CRC). A large number of invasive tests are presently performed for reassurance. We investigated the feasibility of urinary volatile organic compound (VOC) testing as a potential triage tool in patients fast-tracked for assessment for possible CRC. Methods: A prospective, multi-centre, observational feasibility study was performed across three sites. Patients referred on NHS fast-track pathways for potential CRC provided a urine sample which underwent Gas Chromatography Mass Spectrometry (GC-MS), Field Asymmetric Ion Mobility Spectrometry (FAIMS) and Selected Ion Flow Tube Mass Spectrometry (SIFT-MS) analysis. Patients underwent colonoscopy and/or CT colonography and were grouped as either CRC, adenomatous polyp(s), or controls to explore the diagnostic accuracy of VOC output data supported by an artificial neural network (ANN) model. Results: 558 patients participated with 23 (4.1%) CRC diagnosed. 59% of colonoscopies and 86% of CT colonographies showed no abnormalities. Urinary VOC testing was feasible, acceptable to patients, and applicable within the clinical fast track pathway. GC-MS showed the highest clinical utility for CRC and polyp detection vs. controls (sensitivity=0.878, specificity=0.882, AUROC=0.884). Conclusion: Urinary VOC testing and analysis are feasible within NHS fast-track CRC pathways. Clinically meaningful differences between patients with cancer, polyps, or no pathology were identified therefore suggesting VOC analysis may have future utility as a triage tool. Acknowledgment: Funding: NIHR Research for Patient Benefit grant (ref: PB-PG-0416-20022).Keywords: colorectal cancer, volatile organic compound, gas chromatography mass spectrometry, field asymmetric ion mobility spectrometry, selected ion flow tube mass spectrometry
Procedia PDF Downloads 8911 Developing a Systemic Monoclonal Antibody Therapy for the Treatment of Large Burn Injuries
Authors: Alireza Hassanshahi, Xanthe Strudwick, Zlatko Kopecki, Allison J Cowin
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Studies have shown that Flightless (Flii) is elevated in human wounds, including burns, and reducing the level of Flii is a promising approach for improving wound repair and reducing scar formation. The most effective approach has been to neutralise Flii activity using localized, intradermal application of function blocking monoclonal antibodies. However, large surface area burns are difficult to treat by intradermal injection of therapeutics, so the aim of this study was to investigate if a systemic injection of a monoclonal antibody against Flii could improve healing in mice following burn injury. Flii neutralizing antibodies (FnAbs) were labelled with Alxa-Fluor-680 for biodistribution studies and the healing effects of systemically administered FnAbs to mice with burn injuries. A partial thickness, 7% (70mm2) total body surface area scald burn injury was created on the dorsal surface of mice (n=10/group), and 100µL of Alexa-Flour-680-labeled FnAbs were injected into the intraperitoneal cavity (IP) at time of injury. The burns were imaged on days 0, 1, 2, 3, 4, and 7 using IVIS Lumina S5 Imaging System, and healing was assessed macroscopically, histologically, and using immunohistochemistry. Fluorescent radiance efficiency measurements showed that IP injected Alexa-Fluor-680-FnAbs localized at the site of burn injury from day 1, remaining there for the whole 7-day study. The burns treated with FnAbs showed a reduction in macroscopic wound area and an increased rate of epithelialization compared to controls. Immunohistochemistry for NIMP-R14 showed a reduction in the inflammatory infiltrate, while CD31/VEGF staining showed improved angiogenesis post-systemic FnAb treatment. These results suggest that systemically administered FnAbs are active within the burn site and can improve healing outcomes. The clinical application of systemically injected Flii monoclonal antibodies could therefore be a potential approach for promoting the healing of large surface area burns immediately after injury.Keywords: biodistribution, burn, flightless, systemic, fnAbs
Procedia PDF Downloads 17010 Through the Robot’s Eyes: A Comparison of Robot-Piloted, Virtual Reality, and Computer Based Exposure for Fear of Injections
Authors: Bonnie Clough, Tamara Ownsworth, Vladimir Estivill-Castro, Matt Stainer, Rene Hexel, Andrew Bulmer, Wendy Moyle, Allison Waters, David Neumann, Jayke Bennett
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The success of global vaccination programs is reliant on the uptake of vaccines to achieve herd immunity. Yet, many individuals do not obtain vaccines or venipuncture procedures when needed. Whilst health education may be effective for those individuals who are hesitant due to safety or efficacy concerns, for many of these individuals, the primary concern relates to blood or injection fear or phobia (BII). BII is highly prevalent and associated with a range of negative health impacts, both at individual and population levels. Exposure therapy is an efficacious treatment for specific phobias, including BII, but has high patient dropout and low implementation by therapists. Whilst virtual reality approaches exposure therapy may be more acceptable, they have similarly low rates of implementation by therapists and are often difficult to tailor to an individual client’s needs. It was proposed that a piloted robot may be able to adequately facilitate fear induction and be an acceptable approach to exposure therapy. The current study examined fear induction responses, acceptability, and feasibility of a piloted robot for BII exposure. A Nao humanoid robot was programmed to connect with a virtual reality head-mounted display, enabling live streaming and exploration of real environments from a distance. Thirty adult participants with BII fear were randomly assigned to robot-pilot or virtual reality exposure conditions in a laboratory-based fear exposure task. All participants also completed a computer-based two-dimensional exposure task, with an order of conditions counterbalanced across participants. Measures included fear (heart rate variability, galvanic skin response, stress indices, and subjective units of distress), engagement with a feared stimulus (eye gaze: time to first fixation and a total number of fixations), acceptability, and perceived treatment credibility. Preliminary results indicate that fear responses can be adequately induced via a robot-piloted platform. Further results will be discussed, as will implications for the treatment of BII phobia and other fears. It is anticipated that piloted robots may provide a useful platform for facilitating exposure therapy, being more acceptable than in-vivo exposure and more flexible than virtual reality exposure.Keywords: anxiety, digital mental health, exposure therapy, phobia, robot, virtual reality
Procedia PDF Downloads 779 Innovative Fabric Integrated Thermal Storage Systems and Applications
Authors: Ahmed Elsayed, Andrew Shea, Nicolas Kelly, John Allison
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In northern European climates, domestic space heating and hot water represents a significant proportion of total primary total primary energy use and meeting these demands from a national electricity grid network supplied by renewable energy sources provides an opportunity for a significant reduction in EU CO2 emissions. However, in order to adapt to the intermittent nature of renewable energy generation and to avoid co-incident peak electricity usage from consumers that may exceed current capacity, the demand for heat must be decoupled from its generation. Storage of heat within the fabric of dwellings for use some hours, or days, later provides a route to complete decoupling of demand from supply and facilitates the greatly increased use of renewable energy generation into a local or national electricity network. The integration of thermal energy storage into the building fabric for retrieval at a later time requires much evaluation of the many competing thermal, physical, and practical considerations such as the profile and magnitude of heat demand, the duration of storage, charging and discharging rate, storage media, space allocation, etc. In this paper, the authors report investigations of thermal storage in building fabric using concrete material and present an evaluation of several factors that impact upon performance including heating pipe layout, heating fluid flow velocity, storage geometry, thermo-physical material properties, and also present an investigation of alternative storage materials and alternative heat transfer fluids. Reducing the heating pipe spacing from 200 mm to 100 mm enhances the stored energy by 25% and high-performance Vacuum Insulation results in heat loss flux of less than 3 W/m2, compared to 22 W/m2 for the more conventional EPS insulation. Dense concrete achieved the greatest storage capacity, relative to medium and light-weight alternatives, although a material thickness of 100 mm required more than 5 hours to charge fully. Layers of 25 mm and 50 mm thickness can be charged in 2 hours, or less, facilitating a fast response that could, aggregated across multiple dwellings, provide significant and valuable reduction in demand from grid-generated electricity in expected periods of high demand and potentially eliminate the need for additional new generating capacity from conventional sources such as gas, coal, or nuclear.Keywords: fabric integrated thermal storage, FITS, demand side management, energy storage, load shifting, renewable energy integration
Procedia PDF Downloads 1658 Preliminary Efficacy of a Pilot Paediatric Day Hospital Program Project to Address Severe Mental Illness, Obesity, and Binge Eating
Authors: Alene Toulany, Elizabeth Dettmer, Seena Grewal, Kaley Roosen, Andrea Regina, Cathleen Steinegger, Kate Stadelman, Melissa Chambers, Lindsay Lochhead, Kelsey Gallagher, Alissa Steinberg, Andrea Leyser, Allison Lougheed, Jill Hamilton
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Obesity and psychiatric disorders occur together so frequently that the combination has been coined an epidemic within an epidemic. Youth living with obesity are at increased risk for trauma, depression, anxiety and disordered eating. Although symptoms of binge eating disorder are common in paediatric obesity management programs, they are often not identified or addressed within treatment. At The Hospital for Sick Children (SickKids), a tertiary care paediatric hospital in Toronto, Canada, adolescents with obesity are treated in an interdisciplinary outpatient clinic (1-2 hours/week). This intensity of care is simply not enough to help these extremely complex patients. Existing day treatment programs for eating, and psychiatric disorders are not well suited for patients with obesity. In order to address this identified care gap, a unique collaboration was formed between the obesity, psychiatry, and eating disorder programs at SickKids in 2015. The aim of this collaboration was to provide an enhanced treatment arm to our general psychiatry day hospital program that addresses both the mental health issues and the lifestyle challenges common to youth with obesity and binge eating. The program is currently in year-one of a two-year pilot project and is designed for a length of stay of approximately 6 months. All youth participate in daily group therapy, academics, and structured mealtimes. The groups are primarily skills-based and are informed by cognitive/dialectical behavioural therapies. Weekly family therapy and individual therapy, as well as weekly medical appointments with a psychiatrist and a nurse, are provided. Youth in the enhanced treatment arm also receive regular sessions with a dietitian to establish normalized eating behaviours and monthly multifamily meal sessions to address challenges related to behaviour change and mealtimes in the home. Outcomes that will be evaluated include measures of mental health, anthropometrics, metabolic status, and healthcare satisfaction. At the end of the two years, it is expected that we will have had about 16 youth participants. This model of care delivery will be the first of its kind in Canada and is expected to inform future paediatric treatment practices.Keywords: adolescent, binge eating, mental illness, obesity
Procedia PDF Downloads 3567 ‘Nature Will Slow You Down for a Reason’: Virtual Elder-Led Support Services during COVID-19
Authors: Grandmother Roberta Oshkawbewisens, Elder Isabelle Meawasige, Lynne Groulx, Chloë Hamilton, Lee Allison Clark, Dana Hickey, Wansu Qiu, Jared Leedham, Nishanthini Mahendran, Cameron Maclaine
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In March of 2020, the world suddenly shifted with the onset of the COVID-19 pandemic; in-person programs and services were unavailable and a scramble to shift to virtual service delivery began. The Native Women’s Association of Canada (NWAC) established virtual programming through the Resiliency Lodge model and connected with Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people across Turtle Island and Inuit Nunangat through programs that provide a safe space to slow down and reflect on their lives, environment, and well-being. To continue to grow the virtual Resiliency Lodge model, NWAC needed to develop an understanding of three questions: how COVID-19 affects Elder-led support services, how Elder-led support services have adapted during the pandemic, and what Wise Practices need to be implemented to continue to develop, refine, and evaluate virtual Elder-led support services specifically for Indigenous women, girls, two-Spirit, transgender, and gender-diverse people. Through funding from the Canadian Institute of Health Research (CIHR), NWAC gained deeper insight into these questions and developed a series of key findings and recommendations that are outlined throughout this report. The goals of this project are to contribute to a more robust participatory analysis that reflects the complexities of Elder-led virtual cultural responses and the impacts of COVID-19 on Elder-led support services; develop culturally and contextually meaningful virtual protocols and wise practices for virtual Indigenous-led support; and develop an Evaluation Strategy to improve the capacity of the Resiliency Lodge model. Significant findings from the project include Resiliency Lodge programs, especially crafting and business sessions, have provided participants with a sense of community and contributed to healing and wellness; Elder-led support services need greater and more stable funding to offer more workshops to more Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people; and Elder- and Indigenous-led programs play a significant role in healing and building a sense of purpose and belonging among Indigenous people. Ultimately, the findings and recommendations outlined in this research project help to guide future Elder-led virtual support services and emphasize the critical need to increase access to Elder-led programming for Indigenous women, girls, Two-Spirit, transgender, and gender-diverse people.Keywords: indigenous women, traditional healing, virtual programs, covid-19
Procedia PDF Downloads 1386 Negotiating Communication Options for Deaf-Disabled Children
Authors: Steven J. Singer, Julianna F. Kamenakis, Allison R. Shapiro, Kimberly M. Cacciato
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Communication and language are topics frequently studied among deaf children. However, there is limited research that focuses specifically on the communication and language experiences of Deaf-Disabled children. In this ethnography, researchers investigated the language experiences of six sets of parents with Deaf-Disabled children who chose American Sign Language (ASL) as the preferred mode of communication for their child. Specifically, the researchers were interested in the factors that influenced the parents’ decisions regarding their child’s communication options, educational placements, and social experiences. Data collection in this research included 18 hours of semi-structured interviews, 20 hours of participant observations, over 150 pages of reflexive journals and field notes, and a 2-hour focus group. The team conducted constant comparison qualitative analysis using NVivo software and an inductive coding procedure. The four researchers each read the data several times until they were able to chunk it into broad categories about communication and social influences. The team compared the various categories they developed, selecting ones that were consistent among researchers and redefining categories that differed. Continuing to use open inductive coding, the research team refined the categories until they were able to develop distinct themes. Two team members developed each theme through a process of independent coding, comparison, discussion, and resolution. The research team developed three themes: 1) early medical needs provided time for the parents to explore various communication options for their Deaf-Disabled child, 2) without intervention from medical professionals or educators, ASL emerged as a prioritized mode of communication for the family, 3) atypical gender roles affected familial communication dynamics. While managing the significant health issues of their Deaf-Disabled child at birth, families and medical professionals were so fixated on tending to the medical needs of the child that the typical pressures of determining a mode of communication were deprioritized. This allowed the families to meticulously research various methods of communication, resulting in an informed, rational, and well-considered decision to use ASL as the primary mode of communication with their Deaf-Disabled child. It was evident that having a Deaf-Disabled child meant an increased amount of labor and responsibilities for parents. This led to a shift in the roles of the family members. During the child’s development, the mother transformed from fulfilling the stereotypical roles of nurturer and administrator to that of administrator and champion. The mother facilitated medical proceedings and educational arrangements while the father became the caretaker and nurturer of their Deaf-Disabled child in addition to the traditional role of earning the family’s primary income. Ultimately, this research led to a deeper understanding of the critical role that time plays in parents’ decision-making process regarding communication methods with their Deaf-Disabled child.Keywords: American Sign Language, deaf-disabled, ethnography, sociolinguistics
Procedia PDF Downloads 1195 Navigating Complex Communication Dynamics in Qualitative Research
Authors: Kimberly M. Cacciato, Steven J. Singer, Allison R. Shapiro, Julianna F. Kamenakis
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This study examines the dynamics of communication among researchers and participants who have various levels of hearing, use multiple languages, have various disabilities, and who come from different social strata. This qualitative methodological study focuses on the strategies employed in an ethnographic research study examining the communication choices of six sets of parents who have Deaf-Disabled children. The participating families varied in their communication strategies and preferences including the use of American Sign Language (ASL), visual-gestural communication, multiple spoken languages, and pidgin forms of each of these. The research team consisted of two undergraduate students proficient in ASL and a Deaf principal investigator (PI) who uses ASL and speech as his main modes of communication. A third Hard-of-Hearing undergraduate student fluent in ASL served as an objective facilitator of the data analysis. The team created reflexive journals by audio recording, free writing, and responding to team-generated prompts. They discussed interactions between the members of the research team, their evolving relationships, and various social and linguistic power differentials. The researchers reflected on communication during data collection, their experiences with one another, and their experiences with the participating families. Reflexive journals totaled over 150 pages. The outside research assistant reviewed the journals and developed follow up open-ended questions and prods to further enrich the data. The PI and outside research assistant used NVivo qualitative research software to conduct open inductive coding of the data. They chunked the data individually into broad categories through multiple readings and recognized recurring concepts. They compared their categories, discussed them, and decided which they would develop. The researchers continued to read, reduce, and define the categories until they were able to develop themes from the data. The research team found that the various communication backgrounds and skills present greatly influenced the dynamics between the members of the research team and with the participants of the study. Specifically, the following themes emerged: (1) students as communication facilitators and interpreters as barriers to natural interaction, (2) varied language use simultaneously complicated and enriched data collection, and (3) ASL proficiency and professional position resulted in a social hierarchy among researchers and participants. In the discussion, the researchers reflected on their backgrounds and internal biases of analyzing the data found and how social norms or expectations affected the perceptions of the researchers in writing their journals. Through this study, the research team found that communication and language skills require significant consideration when working with multiple and complex communication modes. The researchers had to continually assess and adjust their data collection methods to meet the communication needs of the team members and participants. In doing so, the researchers aimed to create an accessible research setting that yielded rich data but learned that this often required compromises from one or more of the research constituents.Keywords: American Sign Language, complex communication, deaf-disabled, methodology
Procedia PDF Downloads 1164 Cicadas: A Clinician-assisted, Closed-loop Technology, Mobile App for Adolescents with Autism Spectrum Disorders
Authors: Bruno Biagianti, Angela Tseng, Kathy Wannaviroj, Allison Corlett, Megan DuBois, Kyu Lee, Suma Jacob
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Background: ASD is characterized by pervasive Sensory Processing Abnormalities (SPA) and social cognitive deficits that persist throughout the course of the illness and have been linked to functional abnormalities in specific neural systems that underlie the perception, processing, and representation of sensory information. SPA and social cognitive deficits are associated with difficulties in interpersonal relationships, poor development of social skills, reduced social interactions and lower academic performance. Importantly, they can hamper the effects of established evidence-based psychological treatments—including PEERS (Program for the Education and Enrichment of Relationship Skills), a parent/caregiver-assisted, 16-weeks social skills intervention—which nonetheless requires a functional brain capable of assimilating and retaining information and skills. As a matter of fact, some adolescents benefit from PEERS more than others, calling for strategies to increase treatment response rates. Objective: We will present interim data on CICADAS (Care Improving Cognition for ADolescents on the Autism Spectrum)—a clinician-assisted, closed-loop technology mobile application for adolescents with ASD. Via ten mobile assessments, CICADAS captures data on sensory processing abnormalities and associated cognitive deficits. These data populate a machine learning algorithm that tailors the delivery of ten neuroplasticity-based social cognitive training (NB-SCT) exercises targeting sensory processing abnormalities. Methods: In collaboration with the Autism Spectrum and Neurodevelopmental Disorders Clinic at the University of Minnesota, we conducted a fully remote, three-arm, randomized crossover trial with adolescents with ASD to document the acceptability of CICADAS and evaluate its potential as a stand-alone treatment or as a treatment enhancer of PEERS. Twenty-four adolescents with ASD (ages 11-18) have been initially randomized to 16 weeks of PEERS + CICADAS (Arm A) vs. 16 weeks of PEERS + computer games vs. 16 weeks of CICADAS alone (Arm C). After 16 weeks, the full battery of assessments has been remotely administered. Results: We have evaluated the acceptability of CICADAS by examining adherence rates, engagement patterns, and exit survey data. We found that: 1) CICADAS is able to serve as a treatment enhancer for PEERS, inducing greater improvements in sensory processing, cognition, symptom reduction, social skills and behaviors, as well as the quality of life compared to computer games; 2) the concurrent delivery of PEERS and CICADAS induces greater improvements in study outcomes compared to CICADAS only. Conclusion: While preliminary, our results indicate that the individualized assessment and treatment approach designed in CICADAS seems effective in inducing adaptive long-term learning about social-emotional events. CICADAS-induced enhancement of processing and cognition facilitates the application of PEERS skills in the environment of adolescents with ASD, thus improving their real-world functioning.Keywords: ASD, social skills, cognitive training, mobile app
Procedia PDF Downloads 2133 Video Club as a Pedagogical Tool to Shift Teachers’ Image of the Child
Authors: Allison Tucker, Carolyn Clarke, Erin Keith
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Introduction: In education, the determination to uncover privileged practices requires critical reflection to be placed at the center of both pre-service and in-service teacher education. Confronting deficit thinking about children’s abilities and shifting to holding an image of the child as capable and competent is necessary for teachers to engage in responsive pedagogy that meets children where they are in their learning and builds on strengths. This paper explores the ways in which early elementary teachers' perceptions of the assets of children might shift through the pedagogical use of video clubs. Video club is a pedagogical practice whereby teachers record and view short videos with the intended purpose of deepening their practices. The use of video club as a learning tool has been an extensively documented practice. In this study, a video club is used to watch short recordings of playing children to identify the assets of their students. Methodology: The study on which this paper is based asks the question: What are the ways in which teachers’ image of the child and teaching practices evolve through the use of video club focused on the strengths of children demonstrated during play? Using critical reflection, it aims to identify and describe participants’ experiences of examining their personally held image of the child through the pedagogical tool video club, and how that image influences their practices, specifically in implementing play pedagogy. Teachers enrolled in a graduate-level play pedagogy course record and watch videos of their own students as a means to notice and reflect on the learning that happens during play. Using a co-constructed viewing protocol, teachers identify student strengths and consider their pedagogical responses. Video club provides a framework for teachers to critically reflect in action, return to the video to rewatch the children or themselves and discuss their noticings with colleagues. Critical reflection occurs when there is focused attention on identifying the ways in which actions perpetuate or challenge issues of inherent power in education. When the image of the child held by the teacher is from a deficit position and is influenced by hegemonic dimensions of practice, critical reflection is essential in naming and addressing power imbalances, biases, and practices that are harmful to children and become barriers to their thriving. The data is comprised of teacher reflections, analyzed using phenomenology. Phenomenology seeks to understand and appreciate how individuals make sense of their experiences. Teacher reflections are individually read, and researchers determine pools of meaning. Categories are identified by each researcher, after which commonalities are named through a recursive process of returning to the data until no more themes emerge or saturation is reached. Findings: The final analysis and interpretation of the data are forthcoming. However, emergent analysis of the data collected using teacher reflections reveals the ways in which the use of video club grew teachers’ awareness of their image of the child. It shows video club as a promising pedagogical tool when used with in-service teachers to prompt opportunities for play and to challenge deficit thinking about children and their abilities to thrive in learning.Keywords: asset-based teaching, critical reflection, image of the child, video club
Procedia PDF Downloads 1052 Screening for Women with Chorioamnionitis: An Integrative Literature Review
Authors: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo
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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women
Procedia PDF Downloads 1221 Economic Analysis of a Carbon Abatement Technology
Authors: Hameed Rukayat Opeyemi, Pericles Pilidis Pagone Emmanuele, Agbadede Roupa, Allison Isaiah
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Climate change represents one of the single most challenging problems facing the world today. According to the National Oceanic and Administrative Association, Atmospheric temperature rose almost 25% since 1958, Artic sea ice has shrunk 40% since 1959 and global sea levels have risen more than 5.5cm since 1990. Power plants are the major culprits of GHG emission to the atmosphere. Several technologies have been proposed to reduce the amount of GHG emitted to the atmosphere from power plant, one of which is the less researched Advanced zero-emission power plant. The advanced zero emission power plants make use of mixed conductive membrane (MCM) reactor also known as oxygen transfer membrane (OTM) for oxygen transfer. The MCM employs membrane separation process. The membrane separation process was first introduced in 1899 when Walter Hermann Nernst investigated electric current between metals and solutions. He found that when a dense ceramic is heated, the current of oxygen molecules move through it. In the bid to curb the amount of GHG emitted to the atmosphere, the membrane separation process was applied to the field of power engineering in the low carbon cycle known as the Advanced zero emission power plant (AZEP cycle). The AZEP cycle was originally invented by Norsk Hydro, Norway and ABB Alstom power (now known as Demag Delaval Industrial turbomachinery AB), Sweden. The AZEP drew a lot of attention because its ability to capture ~100% CO2 and also boasts of about 30-50% cost reduction compared to other carbon abatement technologies, the penalty in efficiency is also not as much as its counterparts and crowns it with almost zero NOx emissions due to very low nitrogen concentrations in the working fluid. The advanced zero emission power plants differ from a conventional gas turbine in the sense that its combustor is substituted with the mixed conductive membrane (MCM-reactor). The MCM-reactor is made up of the combustor, low-temperature heat exchanger LTHX (referred to by some authors as air preheater the mixed conductive membrane responsible for oxygen transfer and the high-temperature heat exchanger and in some layouts, the bleed gas heat exchanger. Air is taken in by the compressor and compressed to a temperature of about 723 Kelvin and pressure of 2 Mega-Pascals. The membrane area needed for oxygen transfer is reduced by increasing the temperature of 90% of the air using the LTHX; the temperature is also increased to facilitate oxygen transfer through the membrane. The air stream enters the LTHX through the transition duct leading to inlet of the LTHX. The temperature of the air stream is then increased to about 1150 K depending on the design point specification of the plant and the efficiency of the heat exchanging system. The amount of oxygen transported through the membrane is directly proportional to the temperature of air going through the membrane. The AZEP cycle was developed using the Fortran software and economic analysis was conducted using excel and Matlab followed by optimization case study. The Simple bleed gas heat exchange layout (100 % CO2 capture), Bleed gas heat exchanger layout with flue gas turbine (100 % CO2 capture), Pre-expansion reheating layout (Sequential burning layout)–AZEP 85% (85% CO2 capture) and Pre-expansion reheating layout (Sequential burning layout) with flue gas turbine–AZEP 85% (85% CO2 capture). This paper discusses monte carlo risk analysis of four possible layouts of the AZEP cycle.Keywords: gas turbine, global warming, green house gas, fossil fuel power plants
Procedia PDF Downloads 397