Search results for: Isabel Brás
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 99

Search results for: Isabel Brás

39 Clinical and Epidemiological Profile in Patients with Preeclampsia in a Private Institution in Medellin, Colombia 2015

Authors: Camilo Andrés Agudelo Vélez, Lina María Martínez Sánchez, Isabel Cristina Ortiz Trujillo, Evert Armando Jiménez Cotes, Natalia Perilla Hernández, María de los Ángeles Rodríguez Gázquez, Daniel Duque Restrepo, Felipe Hernández Restrepo, Dayana Andrea Quintero Moreno, Juan José Builes Gómez, Camilo Ruiz Mejía, Ana Lucia Arango Gómez

Abstract:

Preeclampsia is a clinical complication during pregnancy with high incidence in Colombia; therefore, it is important to evaluate the influence of external conditions and medical interventions, in order to promote measures that encourage improvements in the quality of life. Objective: Determine clinical and sociodemographic variables in women with preeclampsia. Methods: This cross-sectional study enrolled 50 patients with the diagnosis of preeclampsia, from a private institution in Medellin, during 2015. We used the software SPSS ver.20 for statistical analysis. For the qualitative variables, we calculated the mean and standard deviation, while, for ordinal and nominal levels of quantitative variables, ratios were estimated. Results: The average age was 26.8±5.9 years. The predominant characteristics were socioeconomic stratum 2 (48%), students (55%), mixed race (46%) and middle school as level of education (38%). As for clinical features, 72% of the cases were mild preeclampsia, and 22% were severe forms. The most common clinical manifestations were edema (46%), headache (62%), and proteinuria (55%). As for the Gyneco-obstetric history, 8% reported previous episodes of this disease and it was the first pregnancy for 60% of the patients. Conclusions: Preeclampsia is a frequent condition in young women; on the other hand, headache and edema were the most common reasons for consultation, therefore, doctors need to be aware of these symptoms in pregnant women.

Keywords: pre-eclampsia, hypertension, pregnancy complications, pregnancy, abdominal, edema

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38 Biomimetic Strategies to Design Non-Toxic Antimicrobial Textiles

Authors: Isabel Gouveia

Abstract:

Antimicrobial textile materials may significantly reduce the risk of infections and because they are able to absorb substances from the skin and release therapeutic compounds to the skin, they can also find applications as complementary therapy of skin-diseases as part of standard management. Although functional textiles may be a promising area in skin disease/injury management, as part of standard management, few offer complementary treatment even though they are well known to reduce scratching and aiding emollient absorption, reducing infection, and alleviating pruritus. The reason for this may rely on the low quality of supporting evidence and negative effect that antimicrobial agents may exert on skin microbiome, as for example additional irritation of the vulnerable skin, and by causing resistant bacteria. Several antimicrobial agents have been tested in textiles: quaternary ammonium compounds, silver, polyhexamethylene-biguanides and triclosan have been used, with success. They have powerful bactericidal activity but the majority have a reduce spectrum of microbial inhibition and may cause skin irritation, ecotoxicity and bacteria resistance. Furthermore, the rising flow of strains resistant to last-resort antibiotics rekindles interest in alternative strategies. In this regard, new functional textiles incorporating highly specific antimicrobial agents towards pathogenic bacteria, are required. Recent research has been conducted on naturally occurring antimicrobials as novel alternatives to antibiotics. Conscious of this need our team firstly reported new approaches using L-cysteine and antimicrobial peptides (AMP). Briefly, we were able to develop different immobilization processes towards 6 Log Reduction against bacteria such as S. aureus and K. pneumoniae. Therefore, here we present several innovative antimicrobial textiles incorporating AMP and L-Cysteine which may open new avenues for the medical textiles market and biomaterials in general. Team references will be discussed as an overview and for comparison purposes in terms of potential therapeutic applications.

Keywords: Antimicrobials, Antimicrobial Textiles, Biomedical Textiles, Biomimetic surface functionalization

Procedia PDF Downloads 97
37 Supply Chain Collaboration Comparison Practices between Developed and Developing Countries

Authors: Maria Jose Granero Paris, Ana Isabel Jimenez Zarco, Agustin Pablo Alvarez Herranz

Abstract:

In the industrial sector the collaboration along the supply chain is key especially in order to develop product, production methods or process innovations. The access to resources and knowledge not being available inside the company, the achievement of cost competitive solutions, the reduction of the time required to innovate are some of the benefits linked with the collaboration with suppliers. The big industrial manufacturers have a long tradition to collaborate with their suppliers to develop new products in the developed countries. Since they have increased their global supply chains and global sourcing activities, the objective of the research is to analyse if the same best practices, way of working, experiences, information technology tools, governance methodologies are applied when collaborating with suppliers in the developed world or in developing countries. Most of the current research focuses to analyse the Supply Chain Collaboration in the developed countries and in recent years the number of publications related to the Supply Chain Collaboration in developing countries has increased, but there is still a lack of research comparing both and analysing the similarities, differences and key success factors among the Supply Chain Collaboration practices in developed and developing countries. With this gap in mind, the research under preparation will focus on the following goals: -Identify the most important elements required for a successful supply chain collaboration in the developed and developing countries. -Set up the optimal governance framework to manage the supply chain collaboration in the developed and developing countries. -Define some recommendations about required improvements in the current supply chain collaboration business relationship practices in place. Following the case methodology we will analyze the way manufacturers and suppliers collaborate in the development of new products, production methods or process innovations and in the set up of new global supply chains in two industries with different level of technology intensity and collaboration history being the automotive and aerospace industries.

Keywords: global supply chain networks, Supply Chain Collaboration, supply chain governance, supply chain performance

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36 Effects of Acupuncture Treatment in Gait Parameters in Parkinson's Disease

Authors: Catarina Isabel Ramos Pereira, Jorge Machado, Begona Alonso Criado, Maria João Santos

Abstract:

Introduction: Gait disorders are one of the symptoms that have severe implications on the quality of life in Parkinson's disease (PD). Currently, there is no therapy to reverse or treat this condition. None of the drugs used in conventional medical treatment is entirely efficient, and all have a high incidence of side effects. Acupuncture treatment is believed to improve motor ability, but there is still little scientific evidence in individuals with PD. Aim: The aim of the study is to investigate the acute effect of acupuncture on gait parameters in Parkinson's disease. Methods: This is a randomized and controlled crossover study. The same individual patient was part of both the experimental (real acupuncture) and control group (false acupuncture/sham), and the sequence was randomized. Gait parameters were measured at two different moments, before and after treatment, using four force platforms as well as the collection of 3D markers positions taken by 11 cameras. Images were quantitatively analyzed using Qualisys Track Manager software that let us extract data related to the quality of gait and balance. Seven patients with the diagnosis of Parkinson's disease were included in the study. Results: Statistically significant differences were found in gait speed (p = 0.016), gait cadence (p = 0.006), support base width (p = 0.0001), medio-lateral oscillation (p = 0.017), left-right step length (p = 0.0002), and stride length: right-right (p = 0.0000) and left-left (p = 0.0018), time of left support phase (p = 0.029), right support phase (p = 0.025) and double support phase (p = 0.015), between the initial and final moments for the experimental group. Differences in right-left stride length were found for both groups. Conclusion: Our results show that acupuncture could enhance gait in Parkinson's disease patients. Deep research involving a larger number of volunteers should be accomplished to validate these encouraging findings.

Keywords: acupuncture, traditional Chinese medicine, Parkinson's disease, gait

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35 Use of Alternative and Complementary Therapies in Patients with Chronic Pain in a Medical Institution in Medellin, Colombia, 2014

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

Abstract:

Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

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34 Subdued Electrodermal Response to Empathic Induction Task in Intimate Partner Violence (IPV) Perpetrators

Authors: Javier Comes Fayos, Isabel Rodríguez Moreno, Sara Bressanutti, Marisol Lila, Angel Romero Martínez, Luis Moya Albiol

Abstract:

Empathy is a cognitive-affective capacity whose deterioration is associated with aggressive behaviour. Deficient affective processing is one of the predominant risk factors in men convicted of intimate partner violence (IPV perpetrators), since it makes their capacity to empathize very difficult. The objective of this study is to compare the response of electrodermal activity (EDA), as an indicator of emotionality, to an empathic induction task, between IPV perpetrators and men without a history of violence. The sample was composed of 51 men who attended the CONTEXTO program, with penalties for gender violence under two years, and 47 men with no history of violence. Empathic induction was achieved through the visualization of 4 negative emotional-eliciting videos taken from an emotional induction battery of videos validated for the Spanish population. The participants were asked to actively empathize with the video characters (previously pointed out). The psychophysiological recording of the EDA was accomplished by the "Vrije Universiteit Ambulatory Monitoring System (VU-AMS)." An analysis of repeated measurements was carried out with 10 intra-subject measurements (time) and "group" (IPV perpetrators and non-violent perpetrators) as the inter-subject factor. First, there were no significant differences between groups in the baseline AED levels. Yet, a significant interaction between the “time” and “group” was found with IPV perpetrators exhibiting lower EDA response than controls after the empathic induction task. These findings provide evidence of a subdued EDA response after an empathic induction task in IPV perpetrators with respect to men without a history of violence. Therefore, the lower psychophysiological activation would be indicative of difficulties in the emotional processing and response, functions that are necessary for the empathic function. Consequently, the importance of addressing possible empathic difficulties in IPV perpetrator psycho-educational programs is reinforced, putting special emphasis on the affective dimension that could hinder the empathic function.

Keywords: electrodermal activity, emotional induction, empathy, intimate partner violence

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33 Disentangling the Relationship between Sustainable Consumption and Psychological Well-Being

Authors: Isabel Carrero, Raquel Redondo, Carmen Valor

Abstract:

An unclosed issue in sustainable consumption (SC) literature is the relationship between SC and well-being. This paper seeks to address three limitations in past research. First, well-being has been measured as a single-faceted construct. However, other authors have defended the need to broaden the well-being construct since it goes beyond the emotional experiences and life satisfaction. By examining the relationship between SC and the multifaceted construct of psychological well-being, past contradictory results may be reconciled. To illustrate, past studies have shown that sustainable consumers experience negative emotions when they become aware of the harm that human beings inflict on the planet but they realize they have limited power to solving the problem or when they find limited alternatives or useful information to make sustainable decisions. Thus, these experiences may negatively affect the dimension of well-being 'environmental mastery'. However, as past studies have demonstrated that sustainable consumers feel meaningful, their assessment of the dimension 'purpose in life' would be positive. Thus, we need to understand how SC impinge on the different facets of psychological well-being, in order to better understand the relationship between SC and well-being. Another limitation of past research is that most studies failed to distinguish among different pro-environmental actions under SC (i.e., boycotting, buycotting) among others. For instance, activists have been found to experience higher levels of well-being and sense of meaning than less committed sustainable consumers but also burnt-out and social rejection, which should affect negatively the dimension of 'positive relations'. Finally, the influence of gender has been overlooked in the literature of SC and well-being when it has been identified consistently as a moderator variable in SC. Therefore, this study aims to (1) investigate the effect of SC on the six facets of psychological well-being, (2) distinguish between conventional SC behaviors vs. activism to examine whether these behaviors influence psychological well-being differently (3) and test gender as a moderator variable. It does so by surveying 861 individuals. This paper contributes to existing literature by showing that the relationship between well-being and SC is more intricate than it has been presented in previous literature, as it depends on the facet, the type of behavior carried out and gender.

Keywords: activism, gender, psychological well-being, structural equation modelling, sustainable consumption

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32 Creation and Implementation of A New Palliative Care Drug Chart, via A Closed-Loop Audit

Authors: Asfa Hussain, Chee Tang, Mien Nguyen

Abstract:

Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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31 Beak Size and Asynchronous Hatch in Broiler Chicks

Authors: Mariana Thimotheo, Gabriel Carvalho Ripamonte, Marina De Almeida Nogueira, Silvia Camila Da Costa Aguiar, Marcelo Henrique Santana Ulian, Euclides Braga Malheiros, Isabel Cristina Boleli

Abstract:

Beak plays a fundamental role in the hatching process of the chicks, since it is used for internal and external pipping. The present study examined whether the size of the beak influences the birth period of the broiler chicks in the hatching window. It was analyzed the beak size (length, height and width) of one-hundred twenty nine newly hatched chicks from light eggs (56.22-61.05g) and one-hundred twenty six chicks from heavy eggs (64.95-70.90g), produced by 38 and 45 weeks old broiler breeders (Cobb 500®), respectively. Egg incubation occurred at 37.5°C and 60% RH, with egg turning every hour. Length, height and width of the beaks were measured using a digital caliper (Zaas precision - digital caliper 6", 0.01mm) and the data expressed in millimeters. The beak length corresponded to distance between the tip of the beak and the rictus. The height of the beak was measured in the region of the culmen and its width in the region of the nostrils. Data were analyzed following a 3x2 factorial experimental design, being three birth periods within the hatching window (early: 471.78 to 485.42h, intermediate: 485.43 to 512.27h, and late: 512.28 to 528.72h) and two egg weights (light and heavy). There was a significant interaction between birth period and egg weight for beak height (P < 0.05), which was higher in the intermediate chicks from heavy eggs than in the other chicks from the same egg weight and chicks from light eggs (P < 0.05), that did not differ (P > 0.05). The beak length was influenced only for a birth period, and decreased through the hatch window (early < intermediate < late) (P < 0.05). The width of the beaks was influenced by both main factors, birth period and egg weight (P < 0.05). Early and intermediate chicks had similar beak width, but greater than late chicks, and chicks from heavy eggs presented greater beak width than chicks from light eggs (P < 0.05). In sum, the results show that chicks with longer beak hatch first and that beak length is an important variable for hatch period determination mainly for light eggs.

Keywords: beak dimensions, egg weight, hatching period, hatching window

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30 Determinants of Standard Audit File for Tax Purposes Accounting Legal Obligation Compliance Costs: Empirical Study for Portuguese SMEs of Leiria District

Authors: Isa Raquel Alves Soeiro, Cristina Isabel Branco de Sá

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In Portugal, since 2008, there has been a requirement to export the Standard Audit File for Tax Purposes (SAF-T) standard file (in XML format). This file thus gathers tax-relevant information from a company relating to a specific period of taxation. There are two types of SAF-T files that serve different purposes: the SAF-T of revenues and the SAF-T of accounting, which requires taxpayers and accounting firms to invest in order to adapt the accounting programs to the legal requirements. The implementation of the SAF-T accounting file aims to facilitate the collection of relevant tax data by tax inspectors as support of taxpayers' tax returns for the analysis of accounting records or other information with tax relevance (Portaria No. 321-A/2007 of March 26 and Portaria No. 302/2016 of December 2). The main objective of this research project is to verify, through quantitative analysis, what is the cost of compliance of Small and Medium Enterprises (SME) in the district of Leiria in the introduction and implementation of the tax obligation of SAF-T - Standard Audit File for Tax Purposes of accounting. The information was collected through a questionnaire sent to a population of companies selected through the SABI Bureau Van Dijk database in 2020. Based on the responses obtained to the questionnaire, the companies were divided into two groups: Group 1 -companies who are self-employed and whose main activity is accounting services; and Group 2 -companies that do not belong to the accounting sector. In general terms, the conclusion is that there are no statistically significant differences in the costs of complying with the accounting SAF-T between the companies in Group 1 and Group 2 and that, on average, the internal costs of both groups represent the largest component of the total cost of compliance with the accounting SAF-T. The results obtained show that, in both groups, the total costs of complying with the SAF-T of accounting are regressive, which appears to be similar to international studies, although these are related to different tax obligations. Additionally, we verified that the variables volume of business, software used, number of employees, and legal form explain the differences in the costs of complying with accounting SAF-T in the Leiria district SME.

Keywords: compliance costs, SAF-T accounting, SME, Portugal

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29 Rheumatoid Arthritis, Periodontitis and the Subgingival Microbiome: A Circular Relationship

Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

Abstract:

Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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28 Family Health in Families with Children with Autism

Authors: Teresa Isabel Lozano Pérez, Sandra Soca Lozano

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In Cuba, the childcare is one of the programs prioritized by the Ministry of Public Health and the birth of a child becomes a desired and rewarding event for the family, which is prepared for the reception of a healthy child. When this does not happen and after the first months of the child's birth begin to appear developmental deviations that indicate the presence of a disorder, the event becomes a live event potentially negative and generates disruptions in the family health. A quantitative, descriptive, and cross-sectional research methodology was conducted to describe the impact on family health of diagnosis of autism in a sample of 25 families of children diagnosed with infantile autism at the University Pediatric Hospital Juan Manuel Marquez Havana, Cuba; in the period between January 2014 and May 2015. The sample was non probabilistic and intentional from the inclusion criteria selected. As instruments, we used a survey to identify the structure of the family, life events inventory and an instrument to assess the relative impact, adaptive resources of family and social support perceived (IRFA) to identify the diagnosis of autism as life event. The main results indicated that the majority of families studied were nuclear, small and medium and in the formation stage. All households surveyed identified the diagnosis of autism in a child as an event of great importance and negative significance for the family, taking in most of the families studied a high impact on the four areas of family health and impact enhancer of involvement in family health. All the studied families do not have sufficient adaptive resources to face this situation, sensing that they received social support frequently, mainly in information and emotional areas. We conclude that the diagnosis of autism one of the members of the families studied is valued as a life event highly significant with unfavorably way causing an enhancer impact of involvement in family health especially in the areas ‘health’ and ‘socio-psychological’. Among the social support networks health institutions, partners and friends are highlighted. We recommend developing intervention strategies in families of these children to support them in the process of adapting the diagnosis.

Keywords: family, family health, infantile autism, life event

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27 Emotional Processing Difficulties in Recovered Anorexia Nervosa Patients: State or Trait

Authors: Telma Fontao de Castro, Kylee Miller, Maria Xavier Araújo, Isabel Brandao, Sandra Torres

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Objective: There is a dearth of research investigating the long-term emotional functioning of individuals recovered from anorexia nervosa (AN). This 15-year longitudinal study aimed to examine whether difficulties in cognitive processing of emotions persisted after long-term AN recovery and its link to anxiety and depression. Method: Twenty-four females, who were tested longitudinally during their acute and recovered AN phases, and 24 healthy control (HC) women, were screened for anxiety, depression, alexithymia, and emotion regulation difficulties (ER; only assessed in recovery phase). Results: Anxiety, depression, and alexithymia levels decreased significantly with AN recovery. However, scores on anxiety and difficulty in identifying feelings (alexithymia factor) remained high when compared to the HC group. Scores on emotion regulation difficulties were also lower in HC group. The abovementioned differences between AN recovered group and HC group in difficulties in identifying and accepting feelings and lack of emotional clarity were no longer present when the effect of anxiety and depression was controlled. Conclusions: Findings suggest that emotional dysfunction tends to decrease in AN recovered phase. However, using an HC group as a reference, we conclude that several emotional difficulties are still increased after long-term AN recovery, in particular, limited access to emotion regulation strategies, and difficulty controlling impulses and engaging in goal-directed behavior, thus suggesting to be a trait vulnerability. In turn, competencies related to emotional clarity and acceptance of emotional responses seem to be state-dependent phenomena linked to anxiety and depression. In sum, managing emotions remains a challenge for individuals recovered from AN. Under this circumstance, maladaptive eating behavior can serve as an affect regulatory function, increasing the risk of relapse. Emotional education and stabilization of depressive and anxious symptomatology after recovery emerge as an important avenue to protect from long-term AN relapse.

Keywords: alexithymia, anorexia nervosa, emotion recognition, emotion regulation

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26 Digital Game Fostering Spatial Abilities for Children with Special Needs

Authors: Pedro Barros, Ana Breda, Eugenio Rocha, M. Isabel Santos

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As visual and spatial awareness develops, children apprehension of the concept of direction, (relative) distance and (relative) location materializes. Here we present the educational inclusive digital game ORIESPA, under development by the Thematic Line Geometrix, for children aged between 6 and 10 years old, aiming the improvement of their visual and spatial awareness. Visual-spatial abilities are of crucial importance to succeed in many everyday life tasks. Unavoidable in the technological age we are living in, they are essential in many fields of study as, for instance, mathematics.The game, set on a 2D/3D environment, focusses in tasks/challenges on the following categories (1) static orientation of the subject and object, requiring an understanding of the notions of up–down, left–right, front–back, higher-lower or nearer-farther; (2) interpretation of perspectives of three-dimensional objects, requiring the understanding of 2D and 3D representations of three-dimensional objects; and (3) orientation of the subject in real space, requiring the reading and interpreting of itineraries. In ORIESPA, simpler tasks are based on a quadrangular grid, where the front-back and left-right directions and the rotations of 90º, 180º and 270º play the main requirements. The more complex ones are produced on a cubic grid adding the up and down movements. In the first levels, the game's mechanics regarding the reading and interpreting maps (from point A to point B) is based on map routes, following a given set of instructions. In higher levels, the player must produce a list of instructions taking the game character to the desired destination, avoiding obstacles. Being an inclusive game the user has the possibility to interact through the mouse (point and click with a single button), the keyboard (small set of well recognized keys) or a Kinect device (using simple gesture moves). The character control requires the action on buttons corresponding to movements in 2D and 3D environments. Buttons and instructions are also complemented with text, sound and sign language.

Keywords: digital game, inclusion, itinerary, spatial ability

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25 The Impact of WhatsApp Groups as Supportive Technology in Teaching

Authors: Pinn Tsin Isabel Yee

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With the advent of internet technologies, students are increasingly turning toward social media and cross-platform messaging apps such as WhatsApp, Line, and WeChat to support their teaching and learning processes. Although each messaging app has varying features, WhatsApp remains one of the most popular cross-platform apps that allow for fast, simple, secure messaging and free calls anytime, anywhere. With a plethora of advantages, students could easily assimilate WhatsApp as a supportive technology in their learning process. There could be peer to peer learning, and a teacher will be able to share knowledge digitally via the creation of WhatsApp groups. Content analysis techniques were utilized to analyze data collected by closed-ended question forms. Studies demonstrated that 98.8% of college students (n=80) from the Monash University foundation year agreed that the employment of WhatsApp groups was helpful as a learning tool. Approximately 71.3% disagreed that notifications and alerts from the WhatsApp group were disruptions in their studies. Students commented that they could silence the notifications and hence, it would not disturb their flow of thoughts. In fact, an overwhelming majority of students (95.0%) found it enjoyable to participate in WhatsApp groups for educational purposes. It was a common perception that some students felt pressured to post a reply in such groups, but data analysis showed that 72.5% of students did not feel pressured to comment or reply. It was good that 93.8% of students felt satisfactory if their posts were not responded to speedily, but was eventually attended to. Generally, 97.5% of students found it useful if their teachers provided their handphone numbers to be added to a WhatsApp group. If a teacher posts an explanation or a mathematical working in the group, all students would be able to view the post together, as opposed to individual students asking their teacher a similar question. On whether students preferred using Facebook as a learning tool, there was a 50-50 divide in the replies from the respondents as 51.3% of students liked WhatsApp, while 48.8% preferred Facebook as a supportive technology in teaching and learning. Taken altogether, the utilization of WhatsApp groups as a supportive technology in teaching and learning should be implemented in all classes to continuously engage our generation Y students in the ever-changing digital landscape.-

Keywords: education, learning, messaging app, technology, WhatsApp groups

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24 Time Fetching Water and Maternal Childcare Practices: Comparative Study of Women with Children Living in Ethiopia and Malawi

Authors: Davod Ahmadigheidari, Isabel Alvarez, Kate Sinclair, Marnie Davidson, Patrick Cortbaoui, Hugo Melgar-Quiñonez

Abstract:

The burden of collecting water tends to disproportionately fall on women and girls in low-income countries. Specifically, women spend between one to eight hours per day fetching water for domestic use in Sub-Saharan Africa. While there has been research done on the global time burden for collecting water, it has been mainly focused on water quality parameters; leaving the relationship between water fetching and health outcomes understudied. There is little available evidence regarding the relationship between water fetching and maternal child care practices. The main objective of this study was to help fill the aforementioned gap in the literature. Data from two surveys in Ethiopia and Malawi conducted by CARE Canada in 2016-2017 were used. Descriptive statistics indicate that women were predominantly responsible for collecting water in both Ethiopia (87%) and Malawi (99%) respectively, with the majority spending more than 30 minutes per day on water collection. With regards to child care practices, in both countries, breastfeeding was relatively high (77% and 82%, respectively); and treatment for malnutrition was low (15% and 8%, respectively). However, the same consistency was not found for weighing; in Ethiopia only 16% took their children for weighting in contrast to 94% in Malawi. These three practices were summed to create one variable for regressions analyses. Unadjusted logistic regression findings showed that only in Ethiopia was time fetching water significantly associated with child care practices. Once adjusted for covariates, this relationship was no longer found to be significant. Adjusted logistic regressions also showed that the factors that did influence child care practices differed slightly between the two countries. In Ethiopia, a lack of access to community water supply (OR= 0.668; P=0.010), poor attitudes towards gender equality (OR= 0.608; P=0.001), no access to land and (OR=0.603; P=0.000), significantly decreased a women’s odd of using positive childcare practices. Notably, being young women between 15-24 years (OR=2.308; P=0.017), and 25-29 (OR=2.065; P=0.028) increased probability of using positive childcare practices. Whereas in Malawi, higher maternal age, low decision-making power, significantly decreased a women’s odd of using positive childcare practices. In conclusion, this study found that even though amount of time spent by women fetching water makes a difference for childcare practices, it is not significantly related to women’s child care practices when controlling the covariates. Importantly, women’s age contributes to child care practices in Ethiopia and Malawi.

Keywords: time fetching water, community water supply, women’s child care practices, Ethiopia, Malawi

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23 Mediterranean Diet-Driven Changes in Gut Microbiota Decrease the Infiltration of Inflammatory Myeloid Cells into the Intestinal Tissue

Authors: Gema Gómez-Casado, Alba Rodríguez-Muñoz, Virginia Mela-Rivas, Pallavi Kompella, Francisco José Tinahones-Madueña, Isabel Moreno-Indias, Almudena Ortega-Gómez

Abstract:

Obesity is a high-priority health problem worldwide due to its high prevalence. The proportion of obese and overweight subjects in industrialized countries exceeds half of the population in most cases. Beyond the metabolic problem, obesity boosts inflammation levels in the organism. The gut microbiota, considered an organ by itself, controls a high variety of processes at a systemic level. In fact, the microbiota interacts closely with the immune system, being crucial in determining the maturation state of neutrophils, key effectors of the innate immune response. It is known that changes in the diet exert strong effects on the variety and activity of the gut microbiota. The effect that those changes have on the axis microbiota-immune response is an unexplored field. In this study, 10 patients with obesity (weight 114,3 ± 14,5Kg, BMI 40,47±3,66) followed a Mediterranean-hypocaloric diet for 3 months, reducing their initial weight by 12,71 ± 3%. A transplant of microbiota from these patients before and after the diet was performed into wild type “germ-free” mice (n=10/group), treated with antibiotics. Six weeks after the transplant, mice were euthanized, and the presence of cells from the innate immune system were analysed in different organs (bone marrow, blood, spleen, visceral adipose tissue, and intestine) by flow cytometry. No differences were observed in the number of myeloid cells in bone marrow, blood, spleen, or visceral adipose tissue of mice transplanted with patient’s microbiota before and after following the Mediterranean diet. However, the intestine of mice that received post-diet microbiota presented a marked decrease in the number of neutrophils (whose presence is associated with tissue inflammation), as well as macrophages. In line with these findings, intestine monocytes from mice with post-diet microbiota showed a less inflammatory profile (lower Ly6Gˡᵒʷ proportion of cells). These results point toward a decrease in the inflammatory state of the intestinal tissue, derived from changes in the gut microbiota, which occurred after a 3-month Mediterranean diet.

Keywords: obesity, nutrition, Mediterranean diet, gut microbiota, immune system

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22 Economic and Environmental Assessment of Heat Recovery in Beer and Spirit Production

Authors: Isabel Schestak, Jan Spriet, David Styles, Prysor Williams

Abstract:

Breweries and distilleries are well-known for their high water usage. The water consumption in a UK brewery to produce one litre of beer reportedly ranges from 3-9 L and in a distillery from 7-45 L to produce a litre of spirit. This includes product water such as mashing water, but also water for wort and distillate cooling and for cleaning of tanks, casks, and kegs. When cooling towers are used, cooling water can be the dominating water consumption in a brewery or distillery. Interlinked to the high water use is a substantial heating requirement for mashing, wort boiling, or distillation, typically met by fossil fuel combustion such as gasoil. Many water and waste water streams are leaving the processes hot, such as the returning cooling water or the pot ales. Therefore, several options exist to optimise water and energy efficiency of spirit production through heat recovery. Although these options are known in the sector, they are often not applied in practice due to planning efforts or financial obstacles. In this study, different possibilities and design options for heat recovery systems are explored in four breweries/distilleries in the UK and assessed from an economic but also environmental point of view. The eco-efficiency methodology, according to ISO 14045, is applied to combine both assessment criteria to determine the optimum solution for heat recovery application in practice. The economic evaluation is based on the total value added (TVA) while the Life Cycle Assessment (LCA) methodology is applied to account for the environmental impacts through the installations required for heat recovery. The four case study businesses differ in a) production scale with mashing volumes ranging from 2500 to 40,000 L, in b) terms of heating and cooling technology used, and in c) the extent to which heat recovery is/is not applied. This enables the evaluation of different cases for heat recovery based on empirical data. The analysis provides guidelines for practitioners in the brewing and distilling sector in and outside the UK for the realisation of heat recovery measures. Financial and environmental payback times are showcased for heat recovery systems in the four distilleries which are operating at different production scales. The results are expected to encourage the application of heat recovery where environmentally and economically beneficial and ultimately contribute to a reduction of the water and energy footprint in brewing and distilling businesses.

Keywords: brewery, distillery, eco-efficiency, heat recovery from process and waste water, life cycle assessment

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21 The Practices of Creative Tourism in Urban and Rural Areas at International Level

Authors: Isabel Freitas, Paula Remoaldo, Olga Matos, Ricardo Goja, Juliana Araujo, Vitor Ribeiro, Miguel Pereira

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Several destinations have been experiencing a transition from a massified cultural tourism to a creative tourism approach. In this new segment of tourism, urban territories have been the focus for several decades. Urban studies on creative industries and initiatives have been taking place in big cities marginalizing small towns and more specifically rural areas. This paper envisages evaluating the differences between rural and urban institutions/platforms, mostly certified by the Creative Tourism Network, in what concerns the practices and initiatives in creative tourism worldwide. In the research carried out between March 2017 and March 2018, we had three levels of primary data and qualitative analysis: i) research on Google (web) by using several keywords like 'creative tourism initiatives', 'creative cities', 'best practices in creative tourism' (from March to August 2017). With the help of the certification of institutions/platforms by the Creative Tourism Network, 24 institutions were found and declared to be developing creative initiatives. It was decided to try to unravel the type of activities and some practices and initiatives carried out by these institutions and the analysis of the differences between rural and urban initiatives. A database of 20 items (e.g., institutions in charge of implementing the initiatives, year of implementation, site, activities developed, place of development, country of origin, type of partners chosen) was created for each institution/platform; ii) A deeper analysis was made on the websites’ information on the institutions (from September to December 2017). The type of professionals involved in the activities, the language used in the activities and the type of activity performed were some of the data analysed and iii) To complement these data, semi-structured interviews were done to representatives of the institutions, conducted mainly by Skype from July 2017 to April 2018. The interviews consisted of 17 questions. In the present paper, these interviews are used to complement the analysis of the same items. Some of the qualitative analysis was supported by the narratives of the leaders of the twenty-four institutions that were surveyed. The results indicate that creative tourism is more active and diverse in urban areas. Some more consolidated communication strategies and partnerships are needed for these activities to become economically more sustainable. The findings of this research provide researchers and practitioners with a better understanding of creative tourism and give some information of how creative tourism is developed in rural and urban areas, the gaps and lack of information, and all the possible directions towards the development of the creative tourism industry.

Keywords: creative tourism, practices of creative tourism, rural areas, urban areas

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20 Synergistic Sorption of Cr(VI) and Cu(II) onto Sweet Potato Vine from Binary Mixtures Cr(VI)-Cu(II)

Authors: Chang Liu, Nuria Fiol, Isabel Villaescusa, Jordi Poch

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Over the last decades, biosorption has been an alternative to costly wastewaters treatment for metal removal. Most of the literature on metal biosorption was devoted to studying of single metal ions but nowadays studies on multi-components biosorption are booming. Hexavalent chromium is usually found in mixtures with divalent metal ions in industries wastewaters. However, studies on the simultaneous removal of Cr(VI) and divalent metals are hardly found and the cooperative or competitive mechanism governing each metal ions sorption is still unclear. In this work, simultaneous sorption of Cr(VI) and Cu(II) from their binary mixtures by using sweet potato vine (SPV) was investigated. Sweet potato is one of the four major grain crops in China. Each year about 2000 tons of SPV are generated as by-products. SPV could be a low-cost biosorbent for metal ions due to its rich in cellulose and lignin. In this work, the sorption of Cr(VI) and Cu(II) from their binary mixtures solutions was studied by using SPV sorbent. Equilibrium studies were carried out in binary mixtures in which Cr(VI) and Cu(II) concentration was both varied between 0.1 mM and 0.3 mM, Cr(VI) and Cu(II) single solutions were also prepared as comparison. All the experiments were performed at pH 3±0.05 under 30±2°C for 7 days to make sure sorption achieved equilibrium. Results showed that (i) chromium was partially (10.93%-42.04%) eliminated under studied conditions through reduction and sorption of hexavalent and trivalent forms. The presence of Cu(II) exerts a synergistic effect on the overall sorption process in all the cases of the 0.1-0.3 mM binary mixtures concentration range. (ii) Cr(VI) removal by SPV is favoured by the presence of Cu(II) in solution, because more protons needed for Cr(VI) reduction are available due to Cu(II)-proton competition; however sorption of the formed Cr(III) is unfavoured as a result of the competition between Cr(III) and Cu(II) for protons and sorbent active sites. (iii) Copper was partially (9.26%-13.91%) sorbed onto SPV under studied conditions. The presence of Cr(VI) in binary mixtures also exerts a synergistic effect on the Cu(II) removal in all the cases of the 0.1-0.3 mM binary mixtures concentration range. The results of the present work indicate that sweet potato vine can be successfully employed for the simultaneously removal of Cr(VI) and Cu(II) in binary mixtures, taking advantage of the synergistic effect provoked by one of the metal ion to each other, even though the acquisition of higher removal yields has to be further investigated. Acknowledgements—This work has been financially supported by Ministry of Human Resources and Social Security of PRC (Anhui15), Education Department of Anhui Province (KJ2016A270) and Anhui Normal University (2015rcpy33, 2014bsqdjj53).

Keywords: sweet potato vine, chromium reduction, divalent metal, synergistic sorption

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19 Preventing the Septic Shock in an Oncological Patient with Febrile Neutropenia Submitted to Chemotherapy: The Nurse's Responsibility

Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

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18 Spatial Analysis of the Socio-Environmental Vulnerability in Medium-Sized Cities: Case Study of Municipality of Caraguatatuba SP-Brazil

Authors: Katia C. Bortoletto, Maria Isabel C. de Freitas, Rodrigo B. N. de Oliveira

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The environmental vulnerability studies are essential for priority actions to the reduction of disasters risk. The aim of this study is to analyze the socio-environmental vulnerability obtained through a Census survey, followed by both a statistical analysis (PCA/SPSS/IBM) and a spatial analysis by GIS (ArcGis/ESRI), taking as a case study the Municipality of Caraguatatuba-SP, Brazil. In the municipal development plan analysis the emphasis was given to the Special Zone of Social Interest (ZEIS), the Urban Expansion Zone (ZEU) and the Environmental Protection Zone (ZPA). For the mapping of the social and environmental vulnerabilities of the study area the exposure of people (criticality) and of the place (support capacity) facing disaster risk were obtained from the 2010 Census from the Brazilian Institute of Geography and Statistics (IBGE). Considering the criticality, the variables of greater influence were related to literate persons responsible for the household and literate persons with 5 or more years of age; persons with 60 years or more of age and income of the person responsible for the household. In the Support Capacity analysis, the predominant influence was on the good household infrastructure in districts with low population density and also the presence of neighborhoods with little urban infrastructure and inadequate housing. The results of the comparative analysis show that the areas with high and very high vulnerability classes cover the classes of the ZEIS and the ZPA, whose zoning includes: Areas occupied by low-income population, presence of children and young people, irregular occupations and land suitable to urbanization but underutilized. The presence of zones of urban sprawl (ZEU) in areas of high to very high socio-environmental vulnerability reflects the inadequate use of the urban land in relation to the spatial distribution of the population and the territorial infrastructure, which favors the increase of disaster risk. It can be concluded that the study allowed observing the convergence between the vulnerability analysis and the classified areas in urban zoning. The occupation of areas unsuitable for housing due to its characteristics of risk was confirmed, thus concluding that the methodologies applied are agile instruments to subsidize actions to the reduction disasters risk.

Keywords: socio-environmental vulnerability, urban zoning, reduction disasters risk, methodologies

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17 One Year Follow up of Head and Neck Paragangliomas: A Single Center Experience

Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

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16 Morphological Process of Villi Detachment Assessed by Computer-Assisted 3D Reconstruction of Intestinal Crypt from Serial Ultrathin Sections of Rat Duodenum Mucosa

Authors: Lise P. Labéjof, Ivna Mororó, Raquel G. Bastos, Maria Isabel G. Severo, Arno H. de Oliveira

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This work presents an alternative mode of intestine mucosa renewal that may allow to better understand the total loss of villi after irradiation. It was tested a morphological method of 3d reconstruction using micrographs of serial sections of rat duodenum. We used hundreds of sections of each specimen of duodenum placed on glass slides and examined under a light microscope. Those containing the detachment, approximately a dozen, were chosen for observation under a transmission electron microscope (TEM). Each of these sections was glued on a block of epon resin and recut into a hundred of 60 nm-thick sections. Ribbons of these ultrathin sections were distributed on a series of copper grids in the same order of appearance than during the process of microstomia. They were then stained by solutions of uranyl and lead salts and observed under a TEM. The sections were pictured and the electron micrographs showing signs of cells detachment were transferred into two softwares, ImageJ to align the cellular structures and Reconstruct to realize the 3d reconstruction. It has been detected epithelial cells that exhibited all signs of programmed cell death and localized at the villus-crypt junction. Their nucleus was irregular in shape with a condensed chromatin in clumps. Their cytoplasm was darker than that of neighboring cells, containing many swollen mitochondria. In some places of the sections, we could see intercellular spaces enlarged by the presence of shrunk cells which displayed a plasma membrane with an irregular shape in thermowell as if the cell interdigitations would distant from each other. The three-dimensional reconstruction of the crypts has allowed observe gradual loss of intercellular contacts of crypt cells in the longitudinal plan of the duodenal mucosa. In the transverse direction, there was a gradual increase of the intercellular space as if these cells moved away from one another. This observation allows assume that the gradual remoteness of the cells at the villus-crypt junction is the beginning of the mucosa detachment. Thus, the shrinking of cells due to apoptosis is the way that they detach from the mucosa and progressively the villi also. These results are in agreement with our initial hypothesis and thus have demonstrated that the villi become detached from the mucosa at the villus-crypt junction by the programmed cell death process. This type of loss of entire villus helps explain the rapid denudation of the intestinal mucosa in case of irradiation.

Keywords: 3dr, transmission electron microscopy, ionizing radiations, rat small intestine, apoptosis

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15 Antimicrobial Resistance: Knowledge towards Antibiotics in a Mexican Population

Authors: L. D. Upegui, Isabel Alvarez-Solorza, Karina Garduno-Ulloa, Maren Boecker

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Introduction: The increasing prevalence rate of resistant and multiresistant bacterial strains to antibiotics is a threat to public health and requires a rapid multifunctional answer. Individuals that are affected by resistant strains present a higher morbidity and mortality than individuals that are infected with the same species of bacteria but with sensitive strains. There have been identified risk factors that are related to the misuse and overuse of antibiotics, like socio-demographic characteristics and psychological aspects of the individuals that have not been explored objectively due to a lack of valid and reliable instruments for their measurement. Objective: To validate a questionnaire for the evaluation of the levels of knowledge related to the use of antibiotics in a Mexican population. Materials and Methods: Analytical cross-sectional observational study. The questionnaire consists of 12 items to evaluated knowledge (1=no, 2=not sure, 3=yes) regarding the use of antibiotics, with higher scores corresponding to a higher level of knowledge. Data are collected in a sample of students. Data collection is still ongoing. In this abstract preliminary results of 30 respondents are reported which were collected during pilot-testing. The validation of the instrument was done using the Rasch model. Fit to the Rasch model was tested checking overall fit to the model, unidimensionality, local independence and evaluating the presence of Differential Item Functioning (DIF) by age and gender. The software Rumm2030 and the SPSS were used for the analyses. Results: The participants of the pilot-testing presented an average age of 32 years ± 12.6 and 53% were women. The preliminary results indicated that the items showed good fit to the Rasch model (chi-squared=12.8 p=0.3795). Unidimensionality (number of significant t-tests of 3%) could be proven, the items were locally independent, and no DIF was observed. Knowledge was the smallest regarding statements on the role of antibiotics in treating infections, e.g., most of the respondents did not know that antibiotics would not work against viral infections (70%) and that they could also cause side effects (87%). The knowledge score ranged from 0 to 100 points with a transformed measurement (mean of knowledge 27.1 ± 4.8). Conclusions: The instrument showed good psychometric proprieties. The low scores of knowledge about antibiotics suggest that misinterpretations on the use of these medicaments were prevalent, which could influence the production of antibiotic resistance. The application of this questionnaire will allow the objective identification of 'Hight risk groups', which will be the target population for future educational campaigns, to reduce the knowledge gaps on the general population as an effort against antibiotic resistance.

Keywords: antibiotics, knowledge, misuse, overuse, questionnaire, Rasch model, validation

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14 Assessment of Pedestrian Comfort in a Portuguese City Using Computational Fluid Dynamics Modelling and Wind Tunnel

Authors: Bruno Vicente, Sandra Rafael, Vera Rodrigues, Sandra Sorte, Sara Silva, Ana Isabel Miranda, Carlos Borrego

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Wind comfort for pedestrians is an important condition in urban areas. In Portugal, a country with 900 km of coastline, the wind direction are predominantly from Nor-Northwest with an average speed of 2.3 m·s -1 (at 2 m height). As a result, a set of city authorities have been requesting studies of pedestrian wind comfort for new urban areas/buildings, as well as to mitigate wind discomfort issues related to existing structures. This work covers the efficiency evaluation of a set of measures to reduce the wind speed in an outdoor auditorium (open space) located in a coastal Portuguese urban area. These measures include the construction of barriers, placed at upstream and downstream of the auditorium, and the planting of trees, placed upstream of the auditorium. The auditorium is constructed in the form of a porch, aligned with North direction, driving the wind flow within the auditorium, promoting channelling effects and increasing its speed, causing discomfort in the users of this structure. To perform the wind comfort assessment, two approaches were used: i) a set of experiments using the wind tunnel (physical approach), with a representative mock-up of the study area; ii) application of the CFD (Computational Fluid Dynamics) model VADIS (numerical approach). Both approaches were used to simulate the baseline scenario and the scenarios considering a set of measures. The physical approach was conducted through a quantitative method, using hot-wire anemometer, and through a qualitative analysis (visualizations), using the laser technology and a fog machine. Both numerical and physical approaches were performed for three different velocities (2, 4 and 6 m·s-1 ) and two different directions (NorNorthwest and South), corresponding to the prevailing wind speed and direction of the study area. The numerical results show an effective reduction (with a maximum value of 80%) of the wind speed inside the auditorium, through the application of the proposed measures. A wind speed reduction in a range of 20% to 40% was obtained around the audience area, for a wind direction from Nor-Northwest. For southern winds, in the audience zone, the wind speed was reduced from 60% to 80%. Despite of that, for southern winds, the design of the barriers generated additional hot spots (high wind speed), namely, in the entrance to the auditorium. Thus, a changing in the location of the entrance would minimize these effects. The results obtained in the wind tunnel compared well with the numerical data, also revealing the high efficiency of the purposed measures (for both wind directions).

Keywords: urban microclimate, pedestrian comfort, numerical modelling, wind tunnel experiments

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13 Prenatal Paraben Exposure Impacts Infant Overweight Development and in vitro Adipogenesis

Authors: Beate Englich, Linda Schlittenbauer, Christiane Pfeifer, Isabel Kratochvil, Michael Borte, Gabriele I. Stangl, Martin von Bergen, Thorsten Reemtsma, Irina Lehmann, Kristin M. Junge

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The worldwide production of endocrine disrupting compounds (EDC) has risen dramatically over the last decades, as so has the prevalence for obesity. Many EDCs are believed to contribute to this obesity epidemic, by enhancing adipogenesis or disrupting relevant metabolism. This effect is most tremendous in the early prenatal period when priming effects find a highly vulnerable time window. Therefore, we investigate the impact of parabens on childhood overweight development and adipogenesis in general. Parabens are ester of 4-hydroxy-benzoic acid and part of many cosmetic products or food packing. Therefore, ubiquitous exposure can be found in the westernized world, with exposure already starting during the sensitive prenatal period. We assessed maternal cosmetic product consumption, prenatal paraben exposure and infant BMI z-scores in the prospective German LINA cohort. In detail, maternal urinary concentrations (34 weeks of gestation) of methyl paraben (MeP), ethyl paraben (EtP), n-propyl paraben (PrP) and n-butyl paraben (BuP) were quantified using UPLC-MS/MS. Body weight and height of their children was assessed during annual clinical visits. Further, we investigated the direct influence of those parabens on adipogenesis in-vitro using a human mesenchymal stem cell (MSC) differentiation assay to mimic a prenatal exposure scenario. MSC were exposed to 0.1 – 50 µM paraben during the entire differentiation period. Differentiation outcome was monitored by impedance spectrometry, real-time PCR and triglyceride staining. We found that maternal cosmetic product consumption was highly correlated with urinary paraben concentrations at pregnancy. Further, prenatal paraben exposure was linked to higher BMI Z-scores in children. Our in-vitro analysis revealed that especially the long chained paraben BuP stimulates adipogenesis by increasing the expression of adipocyte specific genes (PPARγ, ADIPOQ, LPL, etc.) and triglyceride storage. Moreover, we found that adiponectin secretion is increased whereas leptin secretion is reduced under BuP exposure in-vitro. Further mechanistic analysis for receptor binding and activation of PPARγ and other key players in adipogenesis are currently in process. We conclude that maternal cosmetic product consumption is linked to prenatal paraben exposure of children and contributes to the development of infant overweight development by triggering key pathways of adipogenesis.

Keywords: adipogenesis, endocrine disruptors, paraben, prenatal exposure

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12 Optical and Near-UV Spectroscopic Properties of Low-Redshift Jetted Quasars in the Main Sequence in the Main Sequence Context

Authors: Shimeles Terefe Mengistue, Ascensión Del Olmo, Paola Marziani, Mirjana Pović, María Angeles Martínez-Carballo, Jaime Perea, Isabel M. Árquez

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Quasars have historically been classified into two distinct classes, radio-loud (RL) and radio-quiet (RQ), taking into account the presence and absence of relativistic radio jets, respectively. The absence of spectra with a high S/N ratio led to the impression that all quasars (QSOs) are spectroscopically similar. Although different attempts were made to unify these two classes, there is a long-standing open debate involving the possibility of a real physical dichotomy between RL and RQ quasars. In this work, we present new high S/N spectra of 11 extremely powerful jetted quasars with radio-to-optical flux density ratio > 1000 that concomitantly cover the low-ionization emission of Mgii𝜆2800 and Hbeta𝛽 as well as the Feii blends in the redshift range 0.35 < z < 1, observed at Calar Alto Observatory (Spain). This work aims to quantify broad emission line differences between RL and RQ quasars by using the four-dimensional eigenvector 1 (4DE1) parameter space and its main sequence (MS) and to check the effect of powerful radio ejection on the low ionization broad emission lines. Emission lines are analysed by making two complementary approaches, a multicomponent non-linear fitting to account for the individual components of the broad emission lines and by analysing the full profile of the lines through parameters such as total widths, centroid velocities at different fractional intensities, asymmetry, and kurtosis indices. It is found that broad emission lines show large reward asymmetry both in Hbeta𝛽 and Mgii2800A. The location of our RL sources in a UV plane looks similar to the optical one, with weak Feii UV emission and broad Mgii2800A. We supplement the 11 sources with large samples from previous work to gain some general inferences. The result shows, compared to RQ, our extreme RL quasars show larger median Hbeta full width at half maximum (FWHM), weaker Feii emission, larger 𝑀BH, lower 𝐿bol/𝐿Edd, and a restricted space occupation in the optical and UV MS planes. The differences are more elusive when the comparison is carried out by restricting the RQ population to the region of the MS occupied by RL quasars, albeit an unbiased comparison matching 𝑀BH and 𝐿bol/𝐿Edd suggests that the most powerful RL quasars show the highest redward asymmetries in Hbeta.

Keywords: galaxies, active, line, profiles, quasars, emission lines, supermassive black holes

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11 Modelling of Meandering River Dynamics in Colombia: A Case Study of the Magdalena River

Authors: Laura Isabel Guarin, Juliana Vargas, Philippe Chang

Abstract:

The analysis and study of Open Channel flow dynamics for River applications has been based on flow modelling using discreet numerical models based on hydrodynamic equations. The overall spatial characteristics of rivers, i.e. its length to depth to width ratio generally allows one to correctly disregard processes occurring in the vertical or transverse dimensions thus imposing hydrostatic pressure conditions and considering solely a 1D flow model along the river length. Through a calibration process an accurate flow model may thus be developed allowing for channel study and extrapolation of various scenarios. The Magdalena River in Colombia is a large river basin draining the country from South to North with 1550 km with 0.0024 average slope and 275 average width across. The river displays high water level fluctuation and is characterized by a series of meanders. The city of La Dorada has been affected over the years by serious flooding in the rainy and dry seasons. As the meander is evolving at a steady pace repeated flooding has endangered a number of neighborhoods. This study has been undertaken in pro of correctly model flow characteristics of the river in this region in order to evaluate various scenarios and provide decision makers with erosion control measures options and a forecasting tool. Two field campaigns have been completed over the dry and rainy seasons including extensive topographical and channel survey using Topcon GR5 DGPS and River Surveyor ADCP. Also in order to characterize the erosion process occurring through the meander, extensive suspended and river bed samples were retrieved as well as soil perforation over the banks. Hence based on DEM ground digital mapping survey and field data a 2DH flow model was prepared using the Iber freeware based on the finite volume method in a non-structured mesh environment. The calibration process was carried out comparing available historical data of nearby hydrologic gauging station. Although the model was able to effectively predict overall flow processes in the region, its spatial characteristics and limitations related to pressure conditions did not allow for an accurate representation of erosion processes occurring over specific bank areas and dwellings. As such a significant helical flow has been observed through the meander. Furthermore, the rapidly changing channel cross section as a consequence of severe erosion has hindered the model’s ability to provide decision makers with a valid up to date planning tool.

Keywords: erosion, finite volume method, flow dynamics, flow modelling, meander

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10 Mobulid Ray Fishery Characteristics and Trends in East Java to Inform Management Decisions

Authors: Muhammad G. Salim, Betty J.L. Laglbauer, Sila K. Sari, Irianes C. Gozali, Fahmi, Didik Rudianto, Selvia Oktaviyani, Isabel Ender

Abstract:

Muncar, East Java, is one of the largest artisanal fisheries in Indonesia. Sharks and rays are caught as both target and bycatch, for local meat consumption and with some derived products exported. Of the seven mobulid ray species occurring in Indonesia, five have been recorded as retained bycatch at Muncar fishing port: the spinetail devil ray (Mobula mobular), the bentfin devil ray (Mobula thurstoni), the sicklefin devil ray (Mobula tarapacana), the oceanic manta ray (Mobula birostris) and the reef manta ray (Mobula alfredi). Both manta ray species are listed as Vulnerable by the International Union for the Conservation of Nature and are protected in Indonesia despite still being captured as bycatch, while all the three devil ray species mentioned here are listed as Endangered and do not currently benefit from any protection in Indonesian waters. Mobulid landings in East Java are caused primarily by small-scale drift gillnets but they also occasionally occur on longlines and in purse-seines operating off the coast of East Java and occasionally in fishing grounds located as far as the Makassar and Sumba Straits. Landing trends from 2015-2019 (non-continuous surveys) revealed that the highest abundance of mobulid rays at Muncar fishing port occurs during the upwelling season from June-October. During El-Nino or above-average temperature years, this may extend until November (such as in 2015 and 2019). The strong seasonal upwelling along the East Java coast is linked to higher zooplankton abundance (inferred from chlorophyll-a sea-surface concentrations), on which mobulids forage, along with teleost fishes constituting the primary target of gillnet fisheries in the Bali Strait. Mobulid ray landings in Muncar were dominated by Mobula mobular, followed by M. thurstoni, M. tarapacana, M. birostris and M. alfredi, however, the catch varied across years and seasons. A majority of immature individuals were recorded in M. mobular and M. thurstoni, and slight decreases in landings, despite no known changes in fishing effort, were observed across the upwelling seasons of 2015-2018 for M. mobular. While all mobulids are listed on Appendix II of the Convention on International Trade in Endangered Species, which regulates international trade in gill plates sought after in the Chinese Medicine Trade, local and national-level management measures are required to sustain mobulid populations. The findings presented here provide important baseline data, from which potential management approaches can be identified.

Keywords: devil ray, mobulid, manta ray, Indonesia

Procedia PDF Downloads 142