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Authors: Veronica Caprai, Katrin Schollbach, Miruna V. A. Florea, H. J. H. Brouwers

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Nowadays MSWI (Municipal Solid Waste Incineration) bottom ash (BA) produced by Waste-to-Energy (WtE) plants represents the majority of the solid residues derived from MSW incineration. Once processed, the BA is often landfilled resulting in possible environmental problems, additional costs for the plant and increasing occupation of public land. In order to limit this phenomenon, European countries such as the Netherlands aid the utilization of MSWI BA in the construction field, by providing standards about the leaching of contaminants into the environment (Dutch Soil Quality Decree). Commonly, BA has a particle size below 32 mm and a heterogeneous chemical composition, depending on its source. By washing coarser BA, an MSWI sludge is obtained. It is characterized by a high content of heavy metals, chlorides, and sulfates as well as a reduced particle size (below 0.25 mm). To lower its environmental impact, MSWI sludge is filtered or centrifuged for removing easily soluble contaminants, such as chlorides. However, the presence of heavy metals is not easily reduced, compromising its possible application. For lowering the leaching of those contaminants, the use of MSWI residues in combination with cement represents a precious option, due to the known retention of those ions into the hydrated cement matrix. Among the applications, the European standard for common cement EN 197-1:1992 allows the incorporation of up to 5% by mass of a minor additional constituent (MAC), such as fly ash or blast furnace slag but also an unspecified filler into cement. To the best of the author's knowledge, although it is widely available, it has the appropriate particle size and a chemical composition similar to cement, FC has not been investigated as possible MAC in cement production. Therefore, this paper will address the suitability of MSWI FC as MAC for CEM I 52.5 R, within a 5% maximum replacement by mass. After physical and chemical characterization of the raw materials, the crystal phases of the pastes are determined by XRD for 3 replacement levels (1%, 3%, and 5%) at different ages. Thereafter, the impact of FC on mechanical and environmental performances of cement is assessed according to EN 196-1 and the Dutch Soil Quality Decree, respectively. The investigation of the reaction products evidences the formation of layered double hydroxides (LDH), in the early stage of the reaction. Mechanically the presence of FC results in a reduction of 28 days compressive strength by 8% for a replacement of 5% wt., compared with the pure CEM I 52.5 R without any MAC. In contrast, the flexural strength is not affected by the presence of FC. Environmentally, the Dutch legislation for the leaching of contaminants for unshaped (granular) material is satisfied. Based on the collected results, FC represents a suitable candidate as MAC in cement production.

Keywords: environmental impact evaluation, Minor additional constituent, MSWI residues, X-ray diffraction crystallography

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Authors: Noor Zuhaira Abd Aziz

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Rice husk and kenaf filled with calcium carbonate (CaCO3) and high density polyethylene (HDPE) composite were prepared separately using twin-screw extruder at 50rpm. Different filler loading up to 30 parts of rice husk particulate and kenaf fiber were mixed with the fixed 30% amount of CaCO3 mineral filler to produce rice husk/CaCO3/HDPE and kenaf/CaCO3/HDPE hybrid composites. In this study, the effects of natural fiber for both rice husk and kenaf in CaCO3/HDPE composite on physical and mechanical properties were investigated. The property analyses showed that water absorption increased with the presence of kenaf and rice husk fillers. Natural fibers in composite significantly influence water absorption properties due to natural characters of fibers which contain cellulose, hemicellulose and lignin structures. The result showed that 10% of additional natural fibers into hybrid composite had caused decreased flexural strength, however additional of high natural fiber (>10%) filler loading has proved to increase its flexural strength.

Keywords: Hybrid composites, Water absorption, Mechanical properties

Procedia PDF Downloads 437

Authors: Seok Hong Min, Tae Kwon Ha

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With the increasing interest on Ti alloys, the extraction process of Ti from its typical ore, TiO₂, has long been and will be important issue. As an intermediate product for the production of pigment or titanium metal sponge, tetrachloride (TiCl₄) is produced by fluidized bed using high TiO₂ feedstock. The purity of TiCl₄ after chlorination is subjected to the quality of the titanium feedstock. Since the impurities in the TiCl₄ product are reported to final products, the purification process of the crude TiCl₄ is required. The purification process includes fractional distillation and chemical treatment, which depends on the nature of the impurities present and the required quality of the final product. In this study, thermodynamic analysis on the impurity effect in the chlorination process, which is the first step of extraction of Ti from TiO₂, has been conducted. All thermodynamic calculations were performed using the FactSage thermodynamical software.

Keywords: rutile, titanium, chlorination process, impurities, thermodynamic calculation, FactSage

Procedia PDF Downloads 279

Authors: M. Pappa, C. Efstathiou, G. Livanos, P. Xidas, D. Vakondios, E. Maravelakis, M. Zervakis, A. Antoniadis

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The choice of cutting tools in manufacturing processes is an essential parameter on which the required manufacturing time, the consumed energy and the cost effort all depend. If the number of tool changing times could be minimized or even eliminated by using a single convex tool providing multiple profiles, then a significant benefit of time and energy saving, as well as tool cost, would be achieved. A typical machine contains a variety of tools in order to deal with different curvatures and material removal rates. In order to minimize the required cutting tool changes, Actively Deformable micro-Cutters (ADmC) will be developed. The design of the Actively Deformable micro-Cutters will be based on the same cutting technique and mounting method as that in typical cutters.

Keywords: deformable cutters, cutting tool, milling, turning, manufacturing

Procedia PDF Downloads 434

Authors: M. Ezati Kooshki, A. Abbaszadeh Shahri

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A number of devices used to control seismic structures have been developed during the past decades. One of the effective ways to reduce seismic forces transmitted to the buildings is through the base isolation systems, but the use of these devices is currently limited to large and expensive buildings. This study was an attempt to introduce an effective and low cost way to protect of structures against grand motions by a semi base isolation system. In this new way, structures were not completely decoupled of bases and the natural frequency of structures was changed due to earthquake by changing the horizontal stiffness; therefore, ground excitation energy was dissipated before entering the structures. For analyzing the dynamic behavior, the new method used finite element software (ABAQUS 6-10-1). This investigation introduced a new package of semi base isolation devices with a new material constitutive, but common in automobile industries, seeking to evaluate the effects of additional new devices on the seismic response when compared with structures without additional devises for different ground motions. The proposed semi base isolation devices were applied to a one story frame and the time history analysis was conducted on the record of Kobe earthquake (1995). The results showed that the efficiency reduced the floor acceleration and displacement, as well as velocity.

Keywords: semi base isolation system, finite element, natural frequency, horizontal stiffness

Procedia PDF Downloads 368

Authors: Carlos H. Cuadra

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Seismic isolation can be used as a retrofit method for historical buildings with the advantage that minimum intervention on super-structure is required. However, selection of isolation devices depends on weight and stiffness of upper structure. In this study, two buildings are considered for analyses to evaluate the applicability of this retrofitting methodology. Both buildings are located at Akita prefecture in the north part of Japan. One building is a wooden structure that corresponds to the old council meeting hall of Noshiro city. The second building is a brick masonry structure that was used as house of a foreign mining engineer and it is located at Ani town. Ambient vibration measurements were performed on both buildings to estimate their dynamic characteristics. Then, target period of vibration of isolated systems is selected as 3 seconds is selected to estimate required stiffness of isolation devices. For wooden structure, which is a light construction, it was found that natural rubber isolators in combination with friction bearings are suitable for seismic isolation. In case of masonry building elastomeric isolator can be used for its seismic isolation. Lumped mass systems are used for seismic response analysis and it is verified in both cases that seismic isolation can be used as retrofitting method of historical construction. However, in the case of the light building, most of the weight corresponds to the reinforced concrete slab that is required to install isolation devices.

Keywords: historical building, finite element method, masonry structure, seismic isolation, wooden structure

Procedia PDF Downloads 131

Authors: Sharda Nara, Bansi Dhar Malhotra

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Investigation of the vitamins as an electron transfer mediator could significantly assist in merging the area of tissue engineering and electronics required for the implantable therapeutic devices. The present study report that the molecules of folic acid released by Providencia rettgeri via fermentation route under the anoxic condition of the microbial fuel cell (MFC) exhibit characteristic electrochemical and optical properties, as indicated by absorption spectroscopy, photoluminescence (PL), and cyclic voltammetry studies. The absorption spectroscopy has depicted an absorption peak at 263 nm with a small bulge around 293 nm on day two of bacterial culture, whereas an additional peak was observed at 365 nm on the twentieth day. Furthermore, the PL spectra has indicated that the maximum emission occurred at various wavelengths 420, 425, 440, and 445 nm when excited by 310, 325, 350, and 365 nm. The change of emission spectra with varying excitation wavelength might be indicating the presence of tunable optical bands in the folic acid molecules co-related with the redox activity of the molecules. The results of cyclic voltammetry studies revealed that the oxidation and reduction occurred at 0.25V and 0.12V, respectively, indicating the electrochemical behavior of the folic acid. This could be inferred that the released folic acid molecules in a MFC might undergo inter as well as intra molecular electron transfer forming different intermediate states while transferring electrons to the electrode surface. Synchronization of electrochemical and optical properties of folic acid molecules could be potentially promising for the designing of electroactive scaffold and biocompatible conductive surface for the applications of tissue engineering and biofuel cells, respectively.

Keywords: biofuel cell, electroactivity, folic acid, tissue engineering

Procedia PDF Downloads 98

Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

Procedia PDF Downloads 36

Authors: Jing Ma, Guotong Qin

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We reported electro-confinement desalination (ECMD), a desalination method combining electric field effects and confinement effects using nanoporous carbon membranes as electrode. A carbon membrane with average pore size of 8.3 nm was prepared by organic sol-gel method. The precursor of support was prepared by curing porous phenol resin tube. Resorcinol-formaldehyde sol was coated on porous tubular resin support. The membrane was obtained by carbonisation of coated support. A well-combined top layer with the thickness of 35 μm was supported by macroporous support. Measurements of molecular weight cut-off using polyethylene glycol showed the average pore size of 8.3 nm. High salt rejection can be achieved because the water molecules need not overcome high energy barriers in confined space, while huge inherent dehydration energy was required for hydrated ions to enter the nanochannels. Additionally, carbon membrane with additional electric field can be used as an integrated membrane electrode combining the effects of confinement and electric potential gradient. Such membrane electrode can repel co-ions and attract counter-ions using pressure as the driving force for mass transport. When the carbon membrane was set as cathode, the rejection of SO₄²⁻ was 94.89%, while the removal of Na⁺ was less than 20%. We set carbon membrane as anode chamber to treat the effluent water from the cathode chamber. The rejection of SO₄²⁻ and Na⁺ reached to 100% and 88.86%, respectively. ECMD will be a promising energy efficient method for salt rejection.

Keywords: nanoporous carbon membrane, confined effect, electric field, desalination, membrane reactor

Procedia PDF Downloads 102

Authors: Réka Sárközi, Péter Iványi, Attila B. Széll

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The aim of this paper is to present the adaptation of the dome construction tool for formex algebra to the parametric design software Grasshopper. Formex algebra is a mathematical system, primarily used for planning structural systems such like truss-grid domes and vaults, together with the programming language Formian. The goal of the research is to allow architects to plan truss-grid structures easily with parametric design tools based on the versatile formex algebra mathematical system. To produce regular structures, coordinate system transformations are used and the dome structures are defined in spherical coordinate system. Owing to the abilities of the parametric design software, it is possible to apply further modifications on the structures and gain special forms. The paper covers the basic dome types, and also additional dome-based structures using special coordinate-system solutions based on spherical coordinate systems. It also contains additional structural possibilities like making double layer grids in all geometry forms. The adaptation of formex algebra and the parametric workflow of Grasshopper together give the possibility of quick and easy design and optimization of special truss-grid domes.

Keywords: parametric design, structural morphology, space structures, spherical coordinate system

Procedia PDF Downloads 216

Authors: C. Watson, T. Glare, M. O'Callaghan, M. Hurst

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The endemic New Zealand grass grub (Costelytra giveni, Coleoptera: Scarabaeidae) is an economically significant grassland pest in New Zealand. Due to their impacts on production within the agricultural sector, one of New Zealand's primary industries, several methods are being used to either control or prevent the establishment of new grass grub populations in the pasture. One such method involves the use of a biopesticide based on the bacterium Serratia entomophila. This species is one of the causative agents of amber disease, a chronic disease of the larvae which results in death via septicaemia after approximately 2 to 3 months. The ability of S. entomophila to cause amber disease is dependant upon the presence of the amber disease associated plasmid (pADAP), which encodes for the key virulence determinants required for the establishment and maintenance of the disease. Following the collapse of grass grub populations within the soil, resulting from either natural population build-up or application of the bacteria, non-pathogenic plasmid-free Serratia strains begin to predominate within the soil. Whilst the interactions between S. entomophila and grass grub larvae are well studied, less information is known on the interactions between plasmid-bearing and plasmid-free strains, particularly the potential impact of these interactions upon the efficacy of an applied biopesticide. Using a range of constructed strains with antibiotic tags, in vitro (broth culture) and in vivo (soil and larvae) experiments were conducted using inoculants comprised of differing ratios of isogenic pathogenic and non-pathogenic Serratia strains, enabling the relative growth of pADAP+ and pADAP- strains under competition conditions to be assessed. In nutrient-rich, the non-pathogenic pADAP- strain outgrew the pathogenic pADAP+ strain by day 3 when inoculated in equal quantities, and by day 5 when applied as the minority inoculant, however, there was an overall gradual decline in the number of viable bacteria for both strains over a 7-day period. Similar results were obtained in additional experiments using the same strains and continuous broth cultures re-inoculated at 24-hour intervals, although in these cultures, the viable cell count did not diminish over the 7-day period. When the same ratios were assessed in soil microcosms with limited available nutrients, the strains remained relatively stable over a 2-month period. Additionally, in vivo grass grub co-infections assays using the same ratios of tagged Serratia strains revealed similar results to those observed in the soil, but there was also evidence of horizontal transfer of pADAP from the pathogenic to the non-pathogenic strain within the larval gut after a period of 4 days. Whilst the influence of competition is more apparent in broth cultures than within the soil or larvae, further testing is required to determine whether this competition between pathogenic and non-pathogenic Serratia strains has any influence on efficacy and disease progression, and how this may impact on the ability of S. entomophila to cause amber disease within grass grub larvae when applied as a biopesticide.

Keywords: biological control, entomopathogen, microbial ecology, New Zealand

Procedia PDF Downloads 120

Authors: K. Eryilmaz, G. Mercanoglu

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Aim: Purification of the final product, which is the last step in the synthesis of lanthanide-labeled peptide compounds, can be accomplished by different methods. Among these methods, the two most commonly used methods are C18 solid phase extraction (SPE) and weak cation exchanger cartridge elution. SPE C18 solid phase extraction method yields high purity final product, while elution from the weak cation exchanger cartridge is pH dependent and ineffective in removing colloidal impurities. The aim of this work is to develop an additional purification method for the lanthanide-labeled peptide compound in cases where the desired radionuclidic and radiochemical purity of the final product can not be achieved because of pH problem or colloidal impurity. Material and Methods: For colloidal impurity formation, 3 mL of water for injection (WFI) was added to 30 mCi of 177LuCl3 solution and allowed to stand for 1 day. 177Lu-DOTATATE was synthesized using EZAG ML-EAZY module (10 mCi/mL). After synthesis, the final product was mixed with the colloidal impurity solution (total volume:13 mL, total activity: 40 mCi). The resulting mixture was trapped in SPE-C18 cartridge. The cartridge was washed with 10 ml saline to remove impurities to the waste vial. The product trapped in the cartridge was eluted with 2 ml of 50% ethanol and collected to the final product vial via passing through a 0.22μm filter. The final product was diluted with 10 mL of saline. Radiochemical purity before and after purification was analysed by HPLC method. (column: ACE C18-100A. 3µm. 150 x 3.0mm, mobile phase: Water-Acetonitrile-Trifluoro acetic acid (75:25:1), flow rate: 0.6 mL/min). Results: UV and radioactivity detector results in HPLC analysis showed that colloidal impurities were completely removed from the 177Lu-DOTATATE/ colloidal impurity mixture by purification method. Conclusion: The improved purification method can be used as an additional method to remove impurities that may result from the lanthanide-peptide synthesis in which the weak cation exchange purification technique is used as the last step. The purification of the final product and the GMP compliance (the final aseptic filtration and the sterile disposable system components) are two major advantages.

Keywords: lanthanide, peptide, labeling, purification, radionuclide, radiopharmaceutical, synthesis

Procedia PDF Downloads 136

Authors: Song Hung Chi, Lee Chun Benn

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Follow by the “A Research on Types of Settlement Housing Alterations of Chinese New Village in Malaysia- A Study in Ampang New Village, Selangor” preliminary informed that the main factors for expansion and enlargement suitably due to the needs of user's life and restoration purpose. The alterations behavior generally derived at the rear position of main house with different types of derivatives, the averages expansion area are not exceeding of 100㎡, while building materials used were wooden, wooden structure, and zinc which are non-permanent building materials. Therefore, a subsequent studies taken in this paper, further to analyze the drawing with summarize method, to explore the derived forms and the constituted rules of housing alterations in Ampang Village, as a more complete presentation of housing alterations in New Village. Firstly, classified the existing housing alterations into three types by using summarize method, which are Type 1, Additional of Prototype House; Type 2, Expansion of Prototype House; and Type 3, Diffusion of Additional. The results shows that the derivative mode of alterations can be divided into the use of "continuous wall" or "non-continuous wall," this will affects the structural systems and roof styles of alterations, and formed the different layers of interior space with "stages" and "continuity". On the aspects of spatial distribution, sacrificial area as a prescriptive function of space, it was mostly remains in the original location which in the center of living area after alterations. It is an important characteristic in a New Village house, reflecting the traditional Ethics of Hakka Chinese communities in the settlement. In addition, wooden as the main building materials of constituted rules for the prototype house, although there were appeared other building materials, such as cement, brick, glass, metal and zinc after alterations, but still mostly as "wooden house" pattern. Result show because of the economy of village does not significantly improve, and also forming the similarity types in alterations and constructions of the additional building with the existing. It did not significantly improve on the quality of living, but only increased the area of usage space.

Keywords: Ampang new village, derived forms, constituted rules, alterations

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Authors: A. Ortuzar, I. Escondrillas, F. Mijangos

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There is a need for new systems that can be attached to drinking water treatment plants and have the required treatment capacity as well as the selectivity regarding components derived from anthropogenic activities. In a context of high volumes of water and low concentration of contaminants, adsorption/interchange processes are appealing since they meet the required features. Iron oxides such as siderite and molysite, which are respectively based on FeCO₃ and FeCl₃, can be found in nature. In this work, their observed performance, raw or roasted at different temperatures, as adsorbents of some inorganic anions is discussed. Roasted 1:1 FeCO₃: FeCl₃ mixture was very selective for arsenic and allowed a 100% removal of As from a 10 mg L^-1 As solution. Besides, the 1:1 FeCO₃ and FeCl₃ mixture roasted at 500 ºC showed good selectivity for, in order of preference, arsenate, bromate, phosphate, fluoride and nitrate anions with distribution coefficients of, respectively, 4200, 2800, 2500 0.4 and 0.03 L g^-1.

Keywords: drinking water, natural adsorbent materials, removal, selectivity

Procedia PDF Downloads 159

Authors: Courtley Pharaoh, D. J. Visser

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University management is often caught between competing interests from stakeholders like students, trustees, donors, government and the community it serves. This study aimed to identify what management competencies are required by executive management members of universities of technology to effectively manage a university of technology in South Africa from the perspective of the executive management members. This exploratory study will make use of a qualitative methodology to establish what management competencies are deemed as important to manage a university of technology in South Africa from the executive management perspective. Due to the consequences of the COVID-19 Pandemic, the study made use of online face-to-face interviews to ascertain from executive management members of universities of technology what the required management competencies needed by executive management members of universities of technology to effectively manage a University of Technology in South Africa. Qualitative Content Analysis was used to analyse the data collected. The findings of the study identified a total of 26 management competencies which were categorised into three groupings or themes. This study identified a list of required management competencies needed by executive management members of universities of technology to effectively manage a university of technology in South Africa, as per the lived experience of executive management members. The researcher recommends further studies at traditional and comprehensive universities and compares the results of those future studies with the results of this study. A comprehensive list of management competencies could then be identified, which could assist with the compilation of job descriptions of executive management members of universities in South Africa.

Keywords: university of technology, management competencies, executive management, executive management members, important

Procedia PDF Downloads 58

Authors: Ashiqul Amin Khan, Mohsin Ul Amin Khan

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The aim of this research is to find the relationship between good governance and shareholder wealth maximisation. The concept of good governance has become more objective in nature over time through various regulations, professionalisation, and practices. This has led to a number of methods for scoring and ranking corporate governance practices. Since shareholder wealth maximisation remains the key corporate goal for managers and governors alike, the effect of good governance in increasing the value of corporations is commented to be an important aspect. In measuring the value relevance of good governance, statistical measures of various yields of listed companies in the UK have been used in this research. Yields reflect required returns on investments from different investment tenets. Historical yields, calculated using historical fundamental data of such companies, reflect expected yields to a great extent. These yields, in turn, reflect the expected risk premium and growth associated with the stocks of the companies. Using fundamental data, the yields have been adjusted to reflect the risk premium required by the investors along various value paradigms. Good governance should naturally lead to lower required risk premium since good corporate governance provided assurance to the investors in terms of sustainability of future performance and desired financial conduct. This, in turn, increases the wealth of stockholders. The findings of this research confirm such nature of the relationship between good governance and value of the company in the long run.

Keywords: corporate governance, good governance practices, short-termism, shareholder value relevance, wealth maximisation, yield

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Authors: Ali Abdallah, Shaima Al Mohannadi

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This study explores shopping tourism in the UK and examines it as an attraction tool for wealthy tourists to the UK’s capital city London. The study aims to identify the scope of shopping tourism used by countries such as the UK as a tool for attracting wealthy tourists. This study adopts the quantitative research approach through surveys in attaining the results required. Results demonstrate how the UK tourism market is an experience-based market and has recently become an attraction for luxurious brand shoppers. The term Trexit is introduced as a new form of tourism generated by the Brexit. If addressed appropriately the Trexit can assist in any negative economic retaliations of the Brexit. The study concludes that shopping tourism is yet to further incline in years to come, however, government support and cooperative planning with the retail industry is required as a means of further strengthening this developing sector.

Keywords: Brexit tourism, luxury shopping, UK tourism, wealthy tourists

Procedia PDF Downloads 135

Authors: Chen Shuwen, Nunthapin Chantachaimongkol

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Since the world has moved into a transitional period, known as globalization; the business environment is now more complicated than ever before. Corporate information has become a matter of great importance for stakeholders, in order to understand the current situation. As a result of this, the concept of corporate governance has been broadly introduced to manage and control the affairs of corporations while businesses are required to disclose both financial and non-financial information to public via various communication channels such as the annual report, the financial report, the company’s website, etc. However, currently there are several other issues related to asymmetric information such as moral hazard or adverse selection that still occur intensively in workplaces. To prevent such problems in the business, it is required to have an understanding of what factors strengthen their transparency, accountability, fairness, and responsibility. Under aforementioned arguments, this paper aims to propose a conceptual framework that enables an investigation on how corporate governance mechanism influences disclosure efficiency of listed companies in the Association of Southeast Asia Nations (ASEAN) and the factors that should be considered for further development of good behaviors, particularly in regards to voluntary disclosure practices. To achieve its purpose, extensive reviews of literature are applied as a research methodology. It is divided into three main steps. Firstly, the theories involved with both corporate governance and disclosure practices such as agency theory, contract theory, signaling theory, moral hazard theory, and information asymmetry theory are examined to provide theoretical backgrounds. Secondly, the relevant literatures based on multi- perspectives of corporate governance, its attributions and their roles on business processes, the influences of corporate governance mechanisms on business performance, and the factors determining corporate governance characteristics as well as capability are reviewed to outline the parameters that should be included in the proposed model. Thirdly, the well-known regulatory document OECD principles and previous empirical studies on the corporate disclosure procedures are evaluated to identify the similarities and differentiations with the disclosure patterns in the ASEAN. Following the processes and consequences of the literature review, abundant factors and variables are found. Further to the methodology, additional critical factors that also have an impact on the disclosure behaviors are addressed in two groups. In the first group, the factors which are linked to the national characteristics - the quality of national code, legal origin, culture, the level of economic development, and so forth. Whereas in the second group, the discoveries which refer to the firm’s characteristics - ownership concentration, ownership’s rights, controlling group, and so on. However, because of research limitations, only some literature are chosen and summarized to form part of the conceptual framework that explores the relationship between corporate governance and the disclosure practices of listed companies in ASEAN.

Keywords: corporate governance, disclosure practice, ASEAN, listed company

Procedia PDF Downloads 169

Authors: Prashant Neupane, Sumitra Kafle, Asmi Pandey, Laura Mitchell

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Pain following caesarean section can influence recovery, patient satisfaction, breast feeding success and mother-child bonding. Since the introduction of enhanced recovery protocols, mothers are often discharged 24 hours later. We identified concerns within our hospital with mothers tolerating poorly controlled pain in order to achieve earlier discharge and subsequently suffering significant pain at home with inadequate analgesia. Methods: We conducted a prospective audit of analgesic prescribing and post-operative pain scores after caesarean section. Mothers were seen on post-operative day one, their pain score recorded on a verbal analogue score from 0-10, and their prescription chart reviewed. A follow-up phone call was then made on post-operative day 3-7 to enquire about pain scores and analgesia use at home. Following this, a standardized proforma for prescribing after the caesarean section was introduced, including the addition of dihydrocodeine that patients can take home following discharge. There were educational update sessions for anesthetists and midwifes, and then a re-audit was conducted months later. Results: Data was collected from 50 women before and after the introduction of the change. Initial audit showed that there was considerable variation in prescribing, with four women prescribed no regular analgesia at all and inconsistency in the dose of oral morphine prescribed. Women were not given any form of analgesia to take home after discharge and were advised to take regular paracetamol and ibuprofen. However, 31/50 (62%) reported that they needed additional analgesia and eight women (16%) even sought prescription for additional analgesia from elsewhere. After the introduction of the change, prescribing was more consistent with all patients prescribed regular analgesia. 46/50 patients were given dihydrocodeine on discharge. Mean pain scores on post-operative day one improved from 5.16 to 3.9, and at home improved from 6.18 to 2.58. Use of dihydrocodeine at home significantly improved patients reporting of severe pain at home from 24% to zero. Discussion: Lack of strong analgesia out of the hospital and the increased demands on activity levels means that women are frequently in more pain at home after discharge. Introduction of a standardized prescription proforma, including the use of to-take-out dihydrocodeine, was successful in improving patient pain scores and the requirement for additional analgesia, both in hospital and at home.

Keywords: analgesia, caesarean section, post-operative pain, standardised

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Authors: R. Furutani, G. Kikuchi

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Generally, the optical interferometer system is too complicated and difficult to change the measurement items, pitch, yaw, and row, etc. In this article, the optical interferometer system using the transmissive Liquid Crystal Device (LCD) as the switch of the optical path was proposed. At first, the normal optical interferometer, Michelson interferometer, was constructed to measure the pitch angle and the yaw angle. In this optical interferometer, the ball lenses with the refractive indices of 2.0 were used as the retroreflectors. After that, the transmissive LCD was introduced as the switch to select the adequate optical path. In this article, these optical systems were constructed. Pitch measurement interferometer and yaw measurement interferometer were switched by the transmissive LCD. When the LCD was open for the yaw measurement, the yaw was sufficiently measured and optical path for the pitch measurement was blocked. On the other hand, when the LCD was open for the pitch measurement, the pitch was measured and the optical path for the yaw measurement was also blocked. In this article, the results of both of pitch measurement and yaw measurement were shown, and the result of blocked yaw measurement and pitch measurement were shown. As this measurement system was based on Michelson interferometer, the other measuring items, the deviation along the optical axis, the vertical deviation to the optical axis and row angle, could be measured by the additional ball lenses and the additional switching in future work.

Keywords: any direction angle, ball lens, laser interferometer, transmissive liquid crystal device

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Authors: A. A. M. Azoddein, Y. Nuratri, A. B. Bustary, F. A. M. Azli, S. C. Sayuti

Abstract:

Pseudomonas putida is a potential strain in biological treatment to remove mercury contained in the effluent of petrochemical industry due to its mercury reductase enzyme that able to reduce ionic mercury to elementary mercury. Freeze-dried P. putida allows easy, inexpensive shipping, handling and high stability of the product. This study was aimed to freeze dry P. putida cells with addition of lyoprotectant. Lyoprotectant was added into the cells suspension prior to freezing. Dried P. putida obtained was then mixed with synthetic mercury. Viability of recovery P. putida after freeze dry was significantly influenced by the type of lyoprotectant. Among the lyoprotectants, tween 80/ sucrose was found to be the best lyoprotectant. Sucrose able to recover more than 78% (6.2E+09 CFU/ml) of the original cells (7.90E+09CFU/ml) after freeze dry and able to retain 5.40E+05 viable cells after 4 weeks storage in 4oC without vacuum. Polyethylene glycol (PEG) pre-treated freeze dry cells and broth pre-treated freeze dry cells after freeze-dry recovered more than 64% (5.0 E+09CFU/ml) and >0.1% (5.60E+07CFU/ml). Freeze-dried P. putida cells in PEG and broth cannot survive after 4 weeks storage. Freeze dry also does not really change the pattern of growth P. putida but extension of lag time was found 1 hour after 3 weeks of storage. Additional time was required for freeze-dried P. putida cells to recover before introduce freeze-dried cells to more complicated condition such as mercury solution. The maximum mercury reduction of PEG pre-treated freeze-dried cells after freeze dry and after storage 3 weeks was 56.78% and 17.91%. The maximum of mercury reduction of tween 80/sucrose pre-treated freeze-dried cells after freeze dry and after storage 3 weeks were 26.35% and 25.03%. Freeze dried P. putida was found to have lower mercury reduction compare to the fresh P. putida that has been growth in agar. Result from this study may be beneficial and useful as initial reference before commercialize freeze-dried P. putida.

Keywords: Pseudomonas putida, freeze-dry, PEG, tween80/Sucrose, mercury, cell viability

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Authors: Kim Toyer, Belinda Thompson, Louise Koelmeyer

Abstract:

Lymphoedema is a chronic condition caused by dysfunction of the lymphatic system, which limits the drainage of fluid and tissue waste from the interstitial space of the affected body part. The normal physiological changes in pregnancy cause an increased load on a normal lymphatic system which can result in a transient lymphatic overload (oedema). The interaction between lymphoedema and pregnancy oedema is unclear. Women with pre-existing lymphoedema require accurate information and additional strategies to manage their lymphoedema during pregnancy. Currently, no resources are available to guide women or their healthcare providers with accurate advice and additional management strategies for coping with lymphoedema during pregnancy until they have recovered postnatally. This study explored the experiences of Australian women with pre-existing lymphoedema during recent pregnancy and the early postnatal period to determine how their usual lymphoedema management strategies were adapted and what were their additional or unmet needs. Interactions with their obstetric care providers, the hospital maternity services, and usual lymphoedema therapy services were detailed. Participants were sourced from several Australian lymphoedema community groups, including therapist networks. Opportunistic sampling is appropriate to explore this topic in a small target population as lymphoedema in women of childbearing age is uncommon, with prevalence data unavailable. Inclusion criteria were aged over 18 years, diagnosed with primary or secondary lymphoedema of the arm or leg, pregnant within the preceding ten years (since 2012), and had their pregnancy and postnatal care in Australia. Exclusion criteria were a diagnosis of lipedema and if unable to read or understand a reasonable level of English. A mixed-method qualitative design was used in two phases. This involved an online survey (REDCap platform) of the participants followed by online semi-structured interviews or focus groups to provide the transcript data for inductive thematic analysis to gain an in-depth understanding of issues raised. Women with well-managed pre-existing lymphoedema coped well with the additional oedema load of pregnancy; however, those with limited access to quality conservative care prior to pregnancy were found to be significantly impacted by pregnancy, including many reporting deterioration of their chronic lymphoedema. Misinformation and a lack of support increased fear and apprehension in planning and enjoying their pregnancy experience. Collaboration between maternity and lymphoedema therapy services did not happen despite study participants suggesting it. Helpful resources and unmet needs were identified in the recent Australian context to inform further research and the development of resources to assist women with lymphoedema who are considering or are pregnant and their supporters, including health care providers.

Keywords: lymphoedema, management strategies, pregnancy, qualitative

Procedia PDF Downloads 47

Authors: Pitchaporn Purngpiputtrakul, Suttasinee Petsakul, Sunisa Chatmongkolchart

Abstract:

Nasogastric tube (NGT) insertion in anaesthetized and intubated patients can be challenging even for experienced anesthesiologists. Various techniques have been proposed to facilitate NGT insertion in these patients. This study aimed to compare the success rate and time required for NGT insertion between the GlideScope visualization and neck flexion with lateral neck pressure techniques. This randomized clinical trial was performed at a teaching hospital on 86 adult patients undergoing abdominal surgery under relaxant general anaesthesia who required intraoperative NGT insertion. The patients were randomized into two groups, the GlideScope group (group G) and the neck flexion with lateral neck pressure group (group F). The success rate of first and second attempts, duration of insertion, and complications were recorded. The total success rate was 79.1% in Group G compared with 76.7% in Group F (P=1) The median time required for NGT insertion was significantly longer in Group G, for both first and second attempts (97 vs 42 seconds P<0.001) and (70 vs 48.5 seconds P=0.015), respectively. Complications were reported in 23 patients (53.5%) in group G and 13 patients (30.2%) in group F. Bleeding and kinking were the most common complications in both techniques. Using GlideScope visualization to facilitate NGT insertion was comparable to neck flexion with lateral neck pressure technique in degree of success rate of insertion, while neck flexion with lateral neck pressure technique had fewer complications and was less time-consuming.

Keywords: anaesthesia, nasogastric tube, GlideScope, intubation

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Authors: Tarannom Parhizkar, Halle Bakhteeyar

Abstract:

This paper presents a feasibility assessment of an expansion system applied to the natural gas transportation process in Iran. Power can be generated from the pressure energy of natural gas along its supply chain at various pressure reduction points by using turboexpanders. This technology is being applied in different countries around the world. The system consists of a turboexpander reducing the natural gas pressure and providing mechanical energy to drive electric generator. Moreover, gas pre-heating, required to prevent hydrate formation, is performed upstream of expansion stage using burner. The city gate station (CGS) has a nominal flow rate in range of 45000 to 270000 cubic meters per hour and a pressure reduction from maximum 62 bar at the upstream to 6 bar. Due to variable feed pressure and temperature in this station sensitivity analysis of generated electricity and required heat is performed. Results show that plant gain is more sensible to pressure variation than temperature changes. Furthermore, using turboexpander to reduce the pressure result in an electrical generation of 2757 to 17574 kW with the value of approximately 4 million US$ per year. Moreover, the required heat range to prevent a hydrate formation is almost 2189 to 14157 kW. To provide this heat, a burner is used with a maximum annual cost of 268,640 $ burner fuel. Therefore, the actual annual benefit of proposed plant modification is approximately over 6,5 million US$.

Keywords: feasibility study, simulation, turboexpander, feed characteristic

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Authors: J. van Vuuren, D. J. van Vuuren, R. Muigai

Abstract:

In recent times, South Africa has experienced extensive droughts that created the need for reliable small water reservoirs. These reservoirs have comparatively quick fabrication and installation times compared to market alternatives. An elevated water tank has inherent potential energy, resulting in that no additional water pumps are required to sustain water pressure at the outlet point – thus ensuring that, without electricity, a water source is available. The initial construction formwork and the complex geometric shape of concrete towers that requires casting can become time-consuming, rendering steel towers preferable. Reinforced concrete foundations, cast in advance, are required to be of sufficient strength. Thereafter, the prefabricated steel supporting structure and tank, which consist of steel panels, can be assembled and erected on site within a couple of days. Due to the time effectiveness of this system, it has become a popular solution to aid drought-stricken areas. These sites are normally in rural, schools or farmland areas. As these tanks can contain up to 2000kL (approximately 19.62MN) of water, combined with supporting lattice steel structures ranging between 5m and 30m in height, failure of one of the supporting members will result in system failure. Thus, there is a need to gain a comprehensive understanding of the operation conditions because of wind loadings on both the tank and the supporting structure. The aim of the research is to investigate the relationship between the theoretical wind loading on a lattice steel tower in combination with an elevated sectional steel tank, and the current wind loading codes, as applicable to South Africa. The research compares the respective design parameters (both theoretical and wind loading codes) whereby FEA analyses are conducted on the various design solutions. The currently available wind loading codes are not sufficient to design slender cantilever latticed steel towers that support elevated water storage tanks. Numerous factors in the design codes are not comprehensively considered when designing the system as these codes are dependent on various assumptions. Factors that require investigation for the study are; the wind loading angle to the face of the structure that will result in maximum load; the internal structural effects on models with different bracing patterns; the loading influence of the aspect ratio of the tank; and the clearance height of the tank on the structural members. Wind loads, as the variable that results in the highest failure rate of cantilevered lattice steel tower structures, require greater understanding. This study aims to contribute towards the design process of elevated steel tanks with lattice tower supporting structures.

Keywords: aspect ratio, bracing patterns, clearance height, elevated steel tanks, lattice steel tower, wind loads

Procedia PDF Downloads 121

Authors: Kim Kennedy, Daren Gibson, Stephanie Flukes, Chandra Diwakarla, Lisa Spalding, Leanne Pilkington, Andrew Redfern

Abstract:

Introduction: Head and neck cancer and treatments are known for their profound effect on nutrition and tube feeding is a common requirement to maintain nutrition. Aim: We aimed to evaluate the frequency of tube feeding in Aboriginal and non-Aboriginal patients, and to examine the relapse and survival outcomes in patients who require enteral tube feeding. Methods: We performed a retrospective cohort analysis of 320 head and neck cancer patients from a single centre in Western Australia, identifying 80 Aboriginal patients and 240 non-Aboriginal patients matched on a 1:3 ratio by site, histology, rurality, and age. Data collected included patient demographics, tumour features, treatment details, and cancer and survival outcomes. Results: Aboriginal and non-Aboriginal patients required feeding tubes at similar rates (42.5% vs 46.2% respectively), however Aboriginal patients were far more likely to fail to return to oral nutrition, with 26.3% requiring long-term tube feeding versus only 15% of non-Aboriginal patients. In the overall study population, 27.5% required short-term tube feeding, 17.8% required long-term enteral tube nutrition, and 45.3% of patients did not have a feeding tube at any point. Relapse was more common in patients who required tube feeding, with relapses in 42.1% of the patients requiring long-term tube feeding, 31.8% in those requiring a short-term tube, versus 18.9% in the ‘no tube’ group. Survival outcomes for patients who required a long-term tube were also significantly poorer when compared to patients who only required a short-term tube, or not at all. Long-term tube-requiring patients were half as likely to survive (29.8%) compared to patients requiring a short-term tube (62.5%) or no tube at all (63.5%). Patients requiring a long-term tube were twice as likely to die with active disease (59.6%) as patients with no tube (28%), or a short term tube (33%). This may suggest an increased relapse risk in patients who require long-term feeding, due to consequences of malnutrition on cancer and treatment outcomes, although may simply reflect that patients with recurrent disease were more likely to have longer-term swallowing dysfunction due to recurrent disease and salvage treatments. Interestingly long-term tube patients were also more likely to die with no active disease (10.5%) (compared with short-term tube requiring patients (4.6%), or patients with no tube (8%)), which is likely reflective of the increased mortality associated with long-term aspiration and malnutrition issues. Conclusions: Requirement for tube feeding was associated with a higher rate of cancer relapse, and in particular, long-term tube feeding was associated with a higher likelihood of dying from head and neck cancer, but also a higher risk of dying from other causes without cancer relapse. This data reflects the complex effect of head and neck cancer and its treatments on swallowing and nutrition, and ultimately, the effects of malnutrition, swallowing dysfunction, and aspiration on overall cancer and survival outcomes. Tube feeding was seen at similar rates in Aboriginal and non-Aboriginal patient, however failure to return to oral intake with a requirement for a long-term feeding tube was seen far more commonly in the Aboriginal population.

Keywords: head and neck cancer, enteral tube feeding, malnutrition, survival, relapse, aboriginal patients

Procedia PDF Downloads 64

Authors: Nishi Bhuvandas, P. V. Timbadiya, P. L. Patel, P. D. Porey

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Recent perceived climate variability raises concerns with unprecedented hydrological phenomena and extremes. Distribution and circulation of the waters of the Earth become increasingly difficult to determine because of additional uncertainty related to anthropogenic emissions. According to the sixth Intergovernmental Panel on Climate Change (IPCC) Technical Paper on Climate Change and water, changes in the large-scale hydrological cycle have been related to an increase in the observed temperature over several decades. Although many previous research carried on effect of change in climate on hydrology provides a general picture of possible hydrological global change, new tools and frameworks for modelling hydrological series with nonstationary characteristics at finer scales, are required for assessing climate change impacts. Of the downscaling techniques, dynamic downscaling is usually based on the use of Regional Climate Models (RCMs), which generate finer resolution output based on atmospheric physics over a region using General Circulation Model (GCM) fields as boundary conditions. However, RCMs are not expected to capture the observed spatial precipitation extremes at a fine cell scale or at a basin scale. Statistical downscaling derives a statistical or empirical relationship between the variables simulated by the GCMs, called predictors, and station-scale hydrologic variables, called predictands. The main focus of the paper is on the need for using statistical downscaling techniques for projection of local hydrometeorological variables under climate change scenarios. The projections can be then served as a means of input source to various hydrologic models to obtain streamflow, evapotranspiration, soil moisture and other hydrological variables of interest.

Keywords: climate change, downscaling, GCM, RCM

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Authors: Sakshi Gupta, Seema Joshi

Abstract:

Thiosemicarbazones (TSCs) have garnered significant attention in coordination chemistry due to their versatile coordination modes and pharmacological properties. Mixed ligand complexes of TSCs represent a promising area of research, offering enhanced antimicrobial activities compared to their parent compounds. This review provides an overview of the synthesis, characterization, and antimicrobial properties of mixed ligand complexes incorporating thiosemicarbazones. The synthesis of mixed ligand complexes typically involves the reaction of a metal salt with TSC ligands and additional ligands, such as nitrogen- or oxygen-based ligands. Various transition metals, including copper, nickel, and cobalt, have been employed to form mixed ligand complexes with TSCs. Characterization techniques such as spectroscopy, X-ray crystallography, and elemental analysis are commonly utilized to confirm the structures of these complexes. One of the key advantages of mixed ligand complexes is their enhanced antimicrobial activity compared to pure TSC compounds. The synergistic effect between the TSC ligands and additional ligands contributes to increased efficacy, possibly through improved metal-ligand interactions or enhanced membrane permeability. Furthermore, mixed ligand complexes offer the potential for selective targeting of microbial species while minimizing toxicity to mammalian cells. This selectivity arises from the specific interactions between the metal center, TSC ligands, and biological targets within microbial cells. Such targeted antimicrobial activity is crucial for developing effective treatments with minimal side effects. Moreover, the versatility of mixed ligand complexes allows for the design of tailored antimicrobial agents with optimized properties. By varying the metal ion, TSC ligands, and additional ligands, researchers can fine-tune the physicochemical properties and biological activities of these complexes. This tunability opens avenues for the development of novel antimicrobial agents with improved efficacy and reduced resistance. In conclusion, mixed ligand complexes of thiosemicarbazones represent a promising class of compounds with potent antimicrobial activities. Further research in this field holds great potential for the development of novel therapeutic agents to combat microbial infections effectively.

Keywords: metal complex, thiosemicarbazones, mixed ligand, selective targeting, antimicrobial activity

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Authors: Mufide Cotuk, Muslim Bakir

Abstract:

National education in Turkey aims to provide superior education opportunities to students in order to develop their intellectual abilities in accordance with contemporary pedagogy. Physical education (PE) plays an important role in this context. Various factors affect the quality and efficiency of the process of PE. Factors related to governance are crucially important, especially those of authority and responsibility. For educational institutions at high school level, the factors affecting authority and responsibility have not been clearly delineated. Therefore, the aim of this study was to examine authority and responsibility of PE teachers as the balance between them. The study sample consisted of 60 PE teachers (19 women, 41 men) at 57 high schools in Istanbul (65% state and 35% private institutions). All PE teachers completed the study questionnaire collecting demographic and institutional data as knowledge and attitudes regarding authority and responsibility issues. The determination of authority and responsibility of PE teachers has been grounded on the law for government officials, course-passing regulations, and school sports regulations. The PE teachers declared as the primary source of their authority and responsibility ‘school sports regulations’ (56,7% of PE teachers), ‘course-passing regulations’ (36,7% of PE teachers) and ‘the law for government officials’ (30,0% of PE teachers). The PE teachers mentioned that the school administration burdened them with additional responsibilities (58,3% of PE teachers). Such ‘additional’ responsibilities were primarily related to ‘disciplinary regulations’ (21,7% of PE teachers) and ‘maintenance of school order’ (16,0% of PE teachers). In conclusion, authority and responsibility of PE teachers were not well balanced. As authority issues were not clearly stated, ‘compulsory’ responsibilities increased causing this imbalance.

Keywords: authority, PE teacher, responsibility, sport management

Procedia PDF Downloads 316

Authors: Melissa K. Hord, Stephen P. Whiteside

Abstract:

With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

Procedia PDF Downloads 237