Search results for: tertiary treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8472

Search results for: tertiary treatment

8232 Correction of Urinary Incontinence in Severe Spinal Canal Stenosis, Treated Patients

Authors: Ilirian Laçi, Alketa Spahiu

Abstract:

Ageing causes an increase in the number of patients with spinal canal stenosis. Most of the patients have back pain, leg pain, numbness of the legs, as well as urinary incontinence as a very common symptoms. Urinary incontinence impairs the quality of life. Correction of the symptom of urinary incontinence is possible in the early and adequate treatment of spinal stenosis. Methods: This study observed patients with urinary incontinence and spinal canal stenosis. These patients underwent mechanical decompression of the spinal stenosis through surgery. At the same time, these patients were observed clinically with clinical consultations. Cystoscopy and urodynamic tests were conducted at intervals of 2 and 6 months. As a result of treatment, 60% of patients did recover. The patients in this group who benefit from treatment were the patients who were early diagnosed and treated. Conclusions: An important factor in the prognosis of this pathology is the early diagnosis and treatment. The proper treatment of this pathology makes it curable in most cases. An important role in this pathology is played by the neurosurgeon. Surgery accompanied by laminotomy and mechanical decompression is the best way of treatment. Other factors that played a role in this pathology are also a large number of childbirths for women, obesity, etc.

Keywords: urinary incontinence, quality of life, spinal canal stenosis, early diagnosis, treatment

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8231 Supporting the ESL Student in a Tertiary Setting: Carrot and Stick

Authors: Ralph Barnes

Abstract:

The internationalization and globalization of education are now a huge, multi-million dollar industry. The movement of international students across the globe has provided a rich vein of revenue for universities and institutions of higher learning to exploit and harvest. A concerted effort has been made by universities worldwide to court students from overseas, with some countries relying up to one-third of student fees, coming from international students. Australian universities and English Language Centres are coming under increased government scrutiny in respect to such areas as the academic progression of international students, management and understanding of student visa requirements and the design of higher education courses and effective assessment regimes. As such, universities and other higher education institutions are restructuring themselves more as service providers rather than as strictly education providers. In this paper, the high-touch, tailored academic model currently followed by some Australian educational institutions to support international students, is examined and challenged. Academic support services offered to international students need to be coordinated, sustained and reviewed regularly, in order to assess their effectiveness. Maintaining the delivery of high-quality educational programs and learning outcomes for this high income-generating student cohort is vital, in order to continue the successful academic and social engagement by international students across the Australian university and higher education landscape.

Keywords: ESL, engagement, tertiary, learning

Procedia PDF Downloads 178
8230 Effect of Heat Treatment on Columnar Grain Growth and Goss Texture on Surface in Grain-Oriented Electrical Steels

Authors: Jungkyun Na, Jaesang Lee, Yang Mo Koo

Abstract:

In this study to find a replacement for expensive secondary recrystallization in GO electrical steel production, effect of heat treatment on the formation of columnar grain and Goss texture is investigated. The composition of the sample is Fe-2.0Si-0.2C. This process involves repeating of cold rolling and decarburization as a replacement for secondary recrystallization. By cold-rolling shear band is made and Goss grain grows from shear band by decarburization. By doing another cold rolling, some Goss texture is newly formed from the shear band, and some Goss texture is retained in microbands. To determine whether additional heat treatment with H2 atmosphere is needed on decarburization process for growth of Goss texture, comparing between decarburization and heat treatment with H2 atmosphere is performed. Also, to find optimum condition for heat treatment, heat treatment with various time and temperature is performed. It was found that increase in the number of cold rolling and heat treatment increases Goss texture. Both high Goss texture and good columnar structure is achieved at 900℃, and this temperature is within a+r phase region. Heat treatment at a temperature higher than a+r phase region caused carbon diffusion and this made layer with Goss grain decrease.

Keywords: electrical steel, Goss texture, columnar structure, normal grain growth

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8229 Challenges in the Management of Her2 Neu Positive Breast Cancer Patients: Real World Data from India

Authors: Praveen Adusumilli, Meher Lakshmi Konatam, Sadashivudu Gundeti, Stalin Bala

Abstract:

The invention of trastuzumab has changed the treatment of breast cancer and lives of many patients all over the world. Despite many patients getting benefitted from the drug, it is out of reach for most of the patients. There is very limited real world data regarding the epidemiology and clinical outcome of Her2neu positive breast cancer patients. Materials and Methods: This is a retrospective analysis of breast cancer patients presenting to a tertiary care cancer centre in Southern India from 2007 to2013. All early and locally advanced breast cancer patients, who were Her2neu 3+ on IHC are included in the study and evaluated in terms of epidemiology, 3-year disease free survival (DFS)and 5-year overall survival(OS). Chemotherapy regimens used were-FAC 6 cycles or AC 4 cycles followed by 12 cycles of weekly paclitaxel . Trastuzumab was given after 6 cycles of FAC or weekly with paclitaxel followed by 3weekly maintenance until 1 year. Results: Over the period of this study there were 885 newly diagnosed cases of carcinoma breast, of which 242 (27%) were Her2neu positive, 360(40%) were hormone receptor positive, and 212(24%) were triple negative. A total of 71(8%) were Her2neu equivocal of which only 10 patients got FISH test done. Of the 212 newly diagnosed patients, only 74 (29%) opted to have standard of care therapy with trastuzumab at our centre, out of which 52(24%), 8(3%), received under insurance, paying basis respectively. 14(9%) patients received the care as part of clinical trial program (ALTTO trial). 7 (9.72%) patients developed decrease of ejection fraction by greater than 10%, requiring stoppage of trastuzumab out of which 5 were restarted in 2 months. Patients receiving trastuzumab along with chemotherapy had longer 3year DFS 92% vs. 60% (p value<0.0001) when compared to chemotherapy alone. 5 year OS was 87% vs 44% (p-value <0.0001) compared to chemotherapy alone. Conclusion: Trastuzumab with chemotherapy improves the DFS and OS in Her2neu positive patients. The biggest constraint is the cost of the treatment and absence of universal health security net to treat all patients with this diagnosis.

Keywords: breast cancer, Her 2 neu positive, real world data, Trastuzumab

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8228 Alternatives to the Disposal of Sludge from Water and Wastewater Treatment Plants

Authors: Lima Priscila, Gianotto Raiza, Arruda Leonan, Magalhães Filho Fernando

Abstract:

Industrialization and especially the accentuated population growth in developing countries and the lack of drainage, public cleaning, water and sanitation services has caused concern about the need for expansion of water treatment units and sewage. However, these units have been generating by-products, such as the sludge. This paper aims to investigate aspects of operation and maintenance of sludge from a wastewater treatment plant (WWTP - 90 L.s-1) and two water treatment plants (WTPs; 1.4 m3.s-1 and 0.5 m3.s-1) for the purpose of proper disposal and reuse, evaluating their qualitative and quantitative characteristics, the Brazilian legislation and standards. It was concluded that the sludge from the water treatment plants is directly related to the quality of raw water collected, and it becomes feasible for use in construction materials, and to dispose it in the sewage system, improving the efficiency of the WWTP regarding precipitation of phosphorus (35% of removal). The WTP Lageado had 55,726 kg/month of sludge production, more than WTP Guariroba (29,336 kg/month), even though the flow of WTP Guariroba is 1,400 L.s-1 and the WTP Lagedo 500 L.s-1, being explained by the quality that influences more than the flow. The WWTP sludge have higher concentrations of organic materials due to their origin and could be used to improve the fertility of the soil, crop production and recovery of degraded areas. The volume of sludge generated at the WWTP was 1,760 ton/month, with 5.6% of solid content in the raw sludge and in the dewatered sludge it increased its content to 23%.

Keywords: disposal, sludge, water treatment, wastewater treatment

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8227 Antifungal Susceptibility of Yeasts Isolated from Clinical Samples from a Tertiary Hospital from State of Puebla

Authors: Ricardo Munguia-Perez, Nayeli Remigio-Alvarado, M.Miriam Hernandez-Arroyo, Elsa Castañeda-Roldan

Abstract:

Fungi have emerged as important pathogens causing morbidity and mortality mainly in immunosuppressed, malnourished and elderly patients. It has detected an increase in resistance to azoles primarily to fluconazol. The fungal infections have become a problem of public health for the resistance to antifungal agents, they have developed new antifungals with broad-spectrum. The aim of this study was determine the antifungal susceptibility of yeasts isolated from clinical samples (respiratory secretions, exudates, wounds, blood cultures, urine cultures) obtained from inpatients and outpatients of a tertiary hospital from State of Puebla. The antifungal susceptibility of the yeast from several clinical samples were determined by the CLS M44-A disk diffusion methods. 149 samples of yeast were analyzed. All species were 100% susceptible to nystatin and amphotericin B. Candida albicans showed resistance of 95.5 % to fluconazole, 50.7 % to 5-flurocytosine and 55.2 % intermediate susceptibility to ketoconazole. Candida glabrata 81.3 % was susceptibility to ketoconazole and 75 % to fluconazole, for the case of 5-flurocytosine the 56.3 % was susceptible. Candida krusei 100 % was susceptible to ketoconazole, 50 % to fluconazole and 37.5 % to 5-flurocytosine. The internal medicine have greater diversity of yeast, the samples have susceptibility of 64.7% to ketoconazole, 47.1 % to fluconazole and 27.5 % to 5-flurocytosine. Hospitalized patients are more resistant to fluconazole and nystatin, but in the case of outpatients presents resistance to ketoconazole.

Keywords: antifungal, susceptibility, yeast, clinical samples

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8226 The Impact of Centralisation on Radical Prostatectomy Outcomes: Our Outcomes

Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

Abstract:

Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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8225 Attitudes of University Students toward English Language Education Policy in Iraqi Kurdistan

Authors: Momen Yaseen M. Amin

Abstract:

Despite widespread coverage of language policy in the literature, there has been scant research probing into English language education policy at tertiary levels in general and in the case of higher education context of Iraqi Kurdistan in particular. The present qualitative study investigated the results of a questionnaire on attitudes toward English language education policy in terms of attitudes toward the English language in general, the current English education policy, and the purposes for learning English among Kurdish EFL university students. Moreover, this study aimed to investigate this topic in light of the participants’ gender and major. To this end, an adapted version of Yang’s (2012) questionnaire was administered to university EFL students majoring in soft and hard sciences (N=300, male 34%, female 67%, four and two disciplines, respectively) at two-state and private universities in Iraqi Kurdistan. The findings revealed positive attitudes toward English as an international language in both soft and hard sciences. While strongly subscribing to the idea that all Iraqi Kurdish students should learn the English language and the courses to be offered in English as well as Kurdish, the majority of the participants expressed their readiness and enthusiasm to excel in English and considered such competency a significant academic accomplishment. However, a good number felt dissatisfied with the status quo of English education at their institutions. This paper provides some implications and recommendations for English education policies makers, administrators, and English language instructors at tertiary levels.

Keywords: attitudes, language policy, English language education, Iraqi Kurdistan

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8224 Application of Latent Class Analysis and Self-Organizing Maps for the Prediction of Treatment Outcomes for Chronic Fatigue Syndrome

Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

Abstract:

Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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8223 Waste from Drinking Water Treatment: The Feasibility for Application in Building Materials

Authors: Marco Correa

Abstract:

The increasing reduction of the volumes of surface water sources supplying most municipalities, as well as the rising demand for treated water, combined with the disposal of effluents from washing of decanters and filters of water treatment plants generates a continuous search for correct environmentally solutions to these problems. The effluents generated by the water treatment industry need to be suitably processed for return to the environment or re-use. This article shows alternatives for sludge dehydration from the water treatment plants (WTP) and eventual disposal of sludge drained. Using the simple design methodology, it is presented a case study for drainage in tanks geotextile, full-scale, which involve five sledge drainage tanks from WTP of the city of Rio Verde. Aiming to the reutilization of drained water from the sledge and enabling its reuse both at the beginning of the treatment process at the WTP and in less noble services as for watering the gardens of the local town hall. The sludge will be used to in the production of building materials.

Keywords: dehydration, effluent discharges, re-use, sludge, WTP sludge

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8222 A Study on the Development of Self-Help Therapy for Bipolar Disorder

Authors: Bae Yu been, Choi Sung won, Lee Ju yeon, Yang Dan Bi

Abstract:

The purpose of this study is to develop a self-help therapy program for bipolar disorder (BD). Psychosocial treatment is adjunct to pharmacotherapy for BD, however, it is limited and they demand high costs. Therefore, the objective of the study is to overcome these limitations by developing the self-treatment for BD. The study was examined the efficacy of the self-treatment program for BD. A randomized controlled trial compared the self-help therapy (ST) intervention with a treatment as usual (TAU) group. ST group has conducted the program for 8 weeks (16 sessions). Mood chart, Quality of Life in Bipolar Disorder Questionnaire, Attitudes toward seeking professional help Scale, BIS, CERQ, YMRS, MADRS were used by pre, post, and follow up. The efficacy of the self-help therapy was analyzed by using mixed ANOVAs. There were significant differences in the rate of occurrence of mania or depression between the two groups. ST group reported stable moods on mood chart, and reductions in mood symptoms and improvements in quality of life and treatment adherence. This study was confirmed applicable to BD to the self-help therapy for patients with BD conducted first in Korea.

Keywords: self help therapy, bipolar disorder, self help, self therapy

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8221 Landfill Leachate and Settled Domestic Wastewater Co-Treatment Using Activated Carbon in Sequencing Batch Reactors

Authors: Amin Mojiri, Hamidi Abdul Aziz

Abstract:

Leachate is created while water penetrates through the waste in a landfill, carrying some forms of pollutants. In literature, for treatment of wastewater and leachate, different ways of biological treatment were used. Sequencing batch reactor (SBR) is a kind of biological treatment. This study investigated the co-treatment of landfill leachate and domestic waste water by SBR and powdered activated carbon augmented (PAC) SBR process. The response surface methodology (RSM) and central composite design (CCD) were employed. The independent variables were aeration rate (L/min), contact time (h), and the ratio of leachate to wastewater mixture (%; v/v)). To perform an adequate analysis of the aerobic process, three dependent parameters, i.e. COD, color, and ammonia-nitrogen (NH3-N or NH4-N) were measured as responses. The findings of the study indicated that the PAC-SBR showed a higher performance in elimination of certain pollutants, in comparison with SBR. With the optimal conditions of aeration rate (0.6 L/min), leachate to waste water ratio (20%), and contact time (10.8 h) for the PAC-SBR, the removal efficiencies for color, NH3-N, and COD were 72.8%, 98.5%, and 65.2%, respectively.

Keywords: co-treatment, landfill Leachate, wastewater, sequencing batch reactor, activate carbon

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8220 Ultrasonic Densitometry of Alveolar Bone Jaw during Retention Period of Orthodontic Treatment

Authors: Margarita A. Belousova, Sergey N. Ermoliev, Nina K. Loginova

Abstract:

The method of intraoral ultrasound densitometry developed to diagnose mineral density of alveolar bone jaws during retention period of orthodontic treatment (Patent of Russian Federation № 2541038). It was revealed significant decrease of the ultrasonic wave speed and bone mineral density in patients with relapses dentition anomalies during retention period of orthodontic treatment.

Keywords: intraoral ultrasonic densitometry, speed of sound, alveolar jaw bone, relapses of dentition anomalies, retention period of orthodontic treatment

Procedia PDF Downloads 348
8219 Detergent Removal from Rinsing Water by Peroxi Electrocoagulation Process

Authors: A. Benhadji, M. Taleb Ahmed

Abstract:

Among the various methods of treatment, advanced oxidation processes (AOP) are the most promising ones. In this study, Peroxi Electrocoagulation Process (PEP) was investigated for the treatment of detergent wastewater. The process was compared with electrooxidation treatment. The results showed that chemical oxygen demand (COD) was high 7584 mgO2.L-1, while the biochemical oxygen demand was low (250 mgO2.L-1). This wastewater was hardly biodegradable. Electrochemical process was carried out for the removal of detergent using a glass reactor with a volume of 1 L and fitted with three electrodes. A direct current (DC) supply was used. Samples were taken at various current density (0.0227 A/cm2 to 0.0378 A/cm2) and reaction time (1-2-3-4 and 5 hour). Finally, the COD was determined. The results indicated that COD removal efficiency of PEP was observed to increase with current intensity and reached to 77% after 5 h. The highest removal efficiency was observed after 5 h of treatment.

Keywords: AOP, COD, detergent, PEP, wastewater

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8218 Academic Skills Enhancement in Secondary School Students Undertaking Tertiary Studies

Authors: Richard White, Anne Drabble, Maureen O’Neill

Abstract:

The University of the Sunshine Coast (USC) offers secondary school students in the final two years of school (Years 11 and 12, 16 – 18 years of age) an opportunity to participate in a program which provides an accelerated pathway to tertiary studies. Whilst still at secondary school, the students undertake two first year university subjects that are required subjects in USC undergraduate degree programs. The program is called Integrated Learning Pathway (ILP) and offers a range of disciplines, including business, design, drama, education, and engineering. Between 2010 and 2014, 38% of secondary students who participated in an ILP program commenced undergraduate studies at USC following completion of secondary school studies. The research reported here considers “before and after” literacy and numeracy competencies of students to determine what impact participation in the ILP program has had on their academic skills. Qualitative and quantitative data has been gathered via numeracy and literacy testing of the students, and a survey asking the students to self-evaluate their numeracy and literacy skills, and reflect on their views of these academic skills. The research will enable improved targeting of teaching strategies so that students will acquire not only course-specific learning outcomes but also collateral academic skills. This enhancement of academic skills will improve undergraduate experience and improve student retention.

Keywords: academic skills enhancement, accelerated pathways, improved teaching, student retention

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8217 Influence of Post Weld Heat Treatment on Mechanical and Metallurgical Properties of TIG Welded Aluminium Alloy Joints

Authors: Gurmeet Singh Cheema, Navjotinder Singh, Gurjinder Singh, Amardeep Singh

Abstract:

Aluminium and its alloys play have excellent corrosion resistant properties, ease of fabrication and high specific strength to weight ratio. In this investigation an attempt has been made to study the effect of different post weld heat treatment methods on the mechanical and metallurgical properties of TIG welded joints of the commercial aluminium alloy. Three different methods of post weld heat treatments are, solution heat treatment, artificial aged and combination of solution heat treatment and artificial aging are given to TIG welded aluminium joints. Mechanical and metallurgical properties of as welded and post weld treated joints of the aluminium alloys was examined.

Keywords: aluminium alloys, TIG welding, post weld heat treatment

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8216 Strategy and Maze Surgery (Atrial fibrillation Surgery)

Authors: Shirin Jalili, Ramin Ghasemi Shayan

Abstract:

Atrial fibrillation is the foremost common arrhythmia around the world, with expanding recurrence famous with age. Thromboembolic occasions and strokes are the number one cause of mortality and morbidity. For patients who don't react to restorative treatment for rate and beat control, the maze method offers an elective treatment mediation. pharmaco-medical treatment for atrial fibrillation is pointed at the control of rate or cadence, intrusive treatment for atrial fibrillation is pointed at cadence control. An obtrusive approach may comprise of percutaneous catheter treatment, surgery, or a crossover approach. Since the maze method is recognized as the foremost successful way to dispense with AF, combining the maze strategy amid major cardiac surgeries has been received in clinical hone. the maze strategy, moreover known as Cox¬maze iii or the ‘cut¬and¬sew’ method, involves making different incisions within the atria to make an arrangement of scars that dispose of each potential zone of re¬entry. The electrical drive is constrained through a maze of scars that coordinates the electrical drive from the sinus node to the av node. By settling the headstrong period between ranges of scar, re¬entry is disposed of. in this article, we evaluate the Maze surgery method that's the surgical method of choice for the treatment of restorative atrial fibrillation.

Keywords: atrial fibrillation, congenital heart disease, procedure, maze surgery, treatment

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8215 Ceramic Membrane Filtration Technologies for Oilfield Produced Water Treatment

Authors: Mehrdad Ebrahimi, Oliver Schmitz, Axel Schmidt, Peter Czermak

Abstract:

“Produced water” (PW) is any fossil water that is brought to the surface along with crude oil or natural gas. By far, PW is the largest waste stream by volume associated with oil and gas production operations. Due to the increasing volume of waste all over the world in the current decade, the outcome and effect of discharging PW on the environment has lately become a significant issue of environmental concerns. Therefore, there is a need for new technologies for PW treatment due to increase focus on water conservation and environmental regulation. The use of membrane processes for treatment of PW has several advantages over many of the traditional separation techniques. In oilfield produced water treatment with ceramic membranes, process efficiency is characterized by the specific permeate flux and by the oil separation performance. Apart from the membrane properties, the permeate flux during filtration of oily wastewaters is known to be strongly dependent on the constituents of the feed solution, as well as on process conditions, e.g. trans-membrane pressure (TMP) and cross-flow velocity (CFV). The research project presented in these report describes the application of different ceramic membrane filtration technologies for the efficient treatment of oil-field produced water and different model oily solutions.

Keywords: ceramic membrane, membrane fouling, oil rejection, produced water treatment

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8214 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study

Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

Abstract:

Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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8213 Introduction of a Multimodal Intervention for People with Autism: 'ReAttach'

Authors: P. Weerkamp Bartholomeus

Abstract:

Autism treatment evaluation is crucial for monitoring the development of an intervention at an early stage. ‘ReAttach’ is a new intervention based on the principles of attachment and social cognitive training. Practical research suggests promising results on a variety of developmental areas. Five years after the first ReAttach sessions these findings can be extended with qualitative research by means of follow-up interviews. The potential impact of this treatment on daily life functioning and well-being of autistic persons becomes clear.

Keywords: autism, innovation, treatment, social cognitive training

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8212 Effect of Heat Treatment on the Corrosion Behavior of Stainless Steel

Authors: Altoumi Alndalusi

Abstract:

The work examines the aqueous corrosion behavior of grades of stain less steel which are used as corrosion resistant castings for applications such as valve and pump bodies. The corrosion behavior of steels in the as-cast condition has been examined using potentiostatic studies to illustrate the need for correct thermal treatment. A metallurgical examination and chemical analysis were carried out to establish the morphology of the steel structure. Heat treatment was carried out in order to compare damage in relation to microstructure. Optical and scanning electron microscopy examinations confirmed that the austenitic steels suffers from severe localized inter-dendritic pitting attack, while non homogenized castings highly alloyed duplex steels gave inferior corrosion resistance. Through the heat treatment conditions a significant of phase transformation of the duplex steel C were occurred (from ferrite to austenite and sigma plus carbides) and were gave reduction resistance.

Keywords: cast, corrosion, duplex stainless, heat treatment, material, steel

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8211 Occurrence of Illicit Drugs in Aqueous Environment and Removal Efficiency of Wastewater Treatment Plants

Authors: Meena K. Yadav, Rupak Aryal, Michael D. Short, Ben Van Den Akker, Christopher P. Saint, Cobus Gerber

Abstract:

Illicit drugs are considered as emerging contaminants of concern that have become an interesting issue for the scientific community from last few years due to their existence in the water environment. A number of the literature has revealed their occurrence in the environment. This is mainly due to the fact that some drugs are partially removed during wastewater treatment processes, and remaining being able to enter the environment and contaminate surface and groundwater and subsequently, drinking water. Therefore, this paper evaluates the occurrence of key illicit drugs in wastewater (influent and effluent) samples in 4 wastewater treatment plants across Adelaide, South Australia over a 1 year period. This paper also compares the efficiency of wastewater treatment plants adopting different technologies in the removal of selected illicit drugs, especially in the context of which technology has higher removal rates. The influent and effluent samples were analysed using Liquid Chromatography tandem Mass Spectrometry (LC-MS/MS). The levels of drugs detected were in the range of mg/L – ng/L in effluent samples; thus emphasising the influence on water quality of receiving water bodies and the significance of removal efficiency of WWTPs(Wastewater Treatment Plants). The results show that the drugs responded differently in the removal depending on the treatment processes used by the WWTPs.

Keywords: illicit drugs, removal efficiency, treatment technology, wastewater

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8210 Approved Cyclic Treatment System of Grey Water

Authors: Hanen Filali, Mohamed Hachicha

Abstract:

Treated grey water (TGW) reuse emerged as an alternative resource to meet the growing demand for water for agricultural irrigation and reduce the pressure on limited existing fresh water. However, this reuse needs adapted management in order to avoid environmental and health risks. In this work, the treatment of grey water (GW) was studied from a cyclic treatment system that we designed and implemented in the greenhouse of National Research Institute for Rural Engineering, Water and Forests (INRGREF). This system is composed of three levels for treatment (TGW 1, TGW 2, and TGW 3). Each level includes a sandy soil box. The use of grey water was moderated depending on the chemical and microbiological quality obtained. Different samples of soils and treated grey water were performed and analyzed for 14 irrigation cycles. TGW through cyclic treatment showed physicochemical parameters like pH, electrical conductivity (EC), chemical oxygen demand (COD), biological oxygen demand (BOD5) in the range of 7,35-7,91, 1,69-5,03 dS/m, 102,6-54,2 mgO2/l, and 31,33-15,74 mgO2/l, respectively. Results showed a reduction in the pollutant load with a significant effect on the three treatment levels; however, an increase in salinity was observed during all irrigation cycles. Microbiological results showed good grey water treatment with low health risk on irrigated soil. Treated water quality was below permissible Tunisian standards (NT106.03), and treated water is suitable for non-potable options.

Keywords: treated grey water, irrigation, cyclic treatment, soils, physico-chemical parameters, microbiological parameters

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8209 Treatment of Simulated Textile Wastewater Containing Reactive Azo Dyes Using Laboratory Scale Trickling Filter

Authors: Ayesha Irum, Sadia Mumtaz, Abdul Rehman, Iffat Naz, Safia Ahmed

Abstract:

The present study was conducted to evaluate the potential applicability of biological trickling filter system for the treatment of simulated textile wastewater containing reactive azo dyes with bacterial consortium under non-sterile conditions. The percentage decolorization for the treatment of wastewater containing structurally different dyes was found to be higher than 95% in all trials. The stable bacterial count of the biofilm on stone media of the trickling filter during the treatment confirmed the presence, proliferation, dominance and involvement of the added microbial consortium in the treatment of textile wastewater. Results of physicochemical parameters revealed the reduction in chemical oxygen demand (58.5-75.1%), sulphates (18.9-36.5%), and phosphates (63.6-73.0%). UV-Visible and FTIR spectroscopy confirmed decolorization of dye containing wastewater was the ultimate consequence of biodegradation. Toxicological studies revealed the nontoxic nature of degradative metabolites.

Keywords: biodegradation, textile dyes, waste water, trickling filters

Procedia PDF Downloads 399
8208 Introducing a Video-Based E-Learning Module to Improve Disaster Preparedness at a Tertiary Hospital in Oman

Authors: Ahmed Al Khamisi

Abstract:

The Disaster Preparedness Standard (DPS) is one of the elements that is evaluated by the Accreditation Canada International (ACI). ACI emphasizes to train and educate all staff, including service providers and senior leaders, on emergency and disaster preparedness upon the orientation and annually thereafter. Lack of awareness and deficit of knowledge among the healthcare providers about DPS have been noticed in a tertiary hospital where ACI standards were implemented. Therefore, this paper aims to introduce a video-based e-learning (VB-EL) module that explains the hospital’s disaster plan in a simple language which will be easily accessible to all healthcare providers through the hospital’s website. The healthcare disaster preparedness coordinator in the targeted hospital will be responsible to ensure that VB-EL is ready by 25 April 2019. This module will be developed based on the Kirkpatrick evaluation method. In fact, VB-EL combines different data forms such as images, motion, sounds, text in a complementary fashion which will suit diverse learning styles and individual learning pace of healthcare providers. Moreover, the module can be adjusted easily than other tools to control the information that healthcare providers receive. It will enable healthcare providers to stop, rewind, fast-forward, and replay content as many times as needed. Some anticipated limitations in the development of this module include challenges of preparing VB-EL content and resistance from healthcare providers.

Keywords: Accreditation Canada International, Disaster Preparedness Standard, Kirkpatrick evaluation method, video-based e-learning

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8207 Wastewater Treatment Sludge as a Potential Source of Heavy Metal Contamination in Livestock

Authors: Glynn K. Pindihama, Rabelani Mudzielwana, Ndamulelo Lilimu

Abstract:

Wastewater treatment effluents, particularly sludges, are known to be potential sources of heavy metal contamination in the environment, depending on how the sludge is managed. Maintenance of wastewater treatment infrastructure in developing countries such as South Africa has become an issue of grave concern, with many wastewater treatment facilities in dilapidating states. Among the problems is the vandalism of the periphery fence to many wastewater treatment facilities, resulting in livestock, such as cows from neighboring villages, grazing within the facilities. This raises human health risks since dried sludge from the treatment plants is usually spread on the grass around the plant, resulting in heavy metal contamination. Animal products such as meat and milk from these cows thus become an indirect route to heavy metals to humans. This study assessed heavy metals in sludges from 3 wastewater treatment plants in Limpopo Province of South Africa. In addition, cow dung and sludge liquors were collected from these plants and evaluated for their heavy metal content. The sludge and cow dung were microwave-digested using the aqua-regia method, and all samples were analyzed for heavy metals using ICP-OES. The loadings of heavy metals in the sludge were in the order Cu>Zn>Ni>Cr>Cd>As>Hg. In cow dung, the heavy metals were in the order Fe>Cu>Mn>Zn>Cr>Pb>Co>Cd. The levels of Zn and Cu in the sludge liquors where the animals were observed drinking were, in some cases, above the permissible limit for livestock consumption. Principal component and correlation analysis are yet to be done to determine if there is a correlation between the heavy metals in the cow dung and sludge and sludge liquors.

Keywords: cow dung, heavy metals, sludge, wastewater treatment plants, sludge.

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8206 Refining Sexual Assault Treatment: Recovered Survivors and Expert Therapists Concur on Effective Therapy Components

Authors: Avigail Moor, Michal Otmazgin, Hagar Tsiddon, , Avivit Mahazri

Abstract:

The goal of the present study was to refine sexual assault therapy through the examination of the level of agreement between survivor and therapist assessments of key recovery-promoting therapeutic interventions. This is the first study to explore the level of agreement between those who partake in the treatment process from either position. Semi structured interviews were conducted in this qualitative study with 10 survivors and 10 experienced therapists. The results document considerable concurrence between them regarding relational and trauma processing treatment components alike. Together, these reports outline key effective interventions, both common and specific in nature, concomitantly supported by both groups.

Keywords: sexual assault, rape treatment, therapist training, psychotherapy

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8205 Advanced Oxidation Processes as a Pre-oxidation Step for Biological Treatment of Leachate from Technical Landfills

Authors: Ala Abdessemed, Mohamed Seddik Oussama Belahmadi, Nabil Charchar, Abdefettah Gherib, Bradai Fares, Boussadia Chouaib Nour El-Islem

Abstract:

Algerian cities are confronted with large quantities of waste generated by the disposal of household and similar residues in technical landfills (CET), such as the one in the location of Batna. The interaction between waste components and incoming water generates leachates rich in organic matter and trace elements, which require treatment before discharge. The aim of this study was to propose an effective process for treating the leachates, which were subjected to an initial chemical treatment using the (H₂O₂/UV) system. Optimal treatment conditions were determined at [H₂O₂] of 0.3 M and pH of 8.6. Next, two hybrid biological treatment systems were applied: hybrid system I (H₂O₂/UV/bacteria) and hybrid system II (H₂O₂/UV/bacteria/microalgae). The three processes resulted in the following degradation rates, expressed in terms of total organic carbon (TOC) 27.4% for the (H₂O₂/UV) system; 58.1% for the hybrid system I (H₂O₂/UV/Bacteria); 67.86% for the hybrid system II (H₂O₂/UV/Bacteria/Microalgae). This study demonstrates that a hybrid approach combining advanced oxidation processes and biological treatments is a highly effective alternative to achieve satisfactory treatment.

Keywords: leachate, landfill, advanced oxidation processes, biological treatment, bacteria, microalgae, total organic carbon

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8204 Studying in the Outback: A Hermeneutic Phenomenological Study of the Lived Experience of Women in Regional, Rural and Remote Areas Studying Nursing Online

Authors: Keden Montgomery, Kathie Ardzejewska, Alison Casey, Rosemarie Hogan

Abstract:

Research was undertaken to explore the question “what is known about the experiences of regional, rural and remote Australian women undertaking a Bachelor of Nursing program delivered online?”. The findings will support future research aimed at improving the retention and completion rates of women studying nursing in regional, rural and remote areas.  There is a critical shortage of nurses working in regional, rural and remote (RRR) Australia. It is well supported that this shortage of nurses is most likely to be addressed by nursing students who are completing their studies in RRR areas. Despite this, students from RRR Australia remain an equity group and experience poorer outcomes than their metropolitan counterparts. Completion rates for RRR students who enrol in tertiary education courses are much less than students from metropolitan areas. In addition to this, RRR students are less likely than students from metropolitan areas to gain a tertiary level qualification at all, and even less likely to gain a Bachelor level degree which is required for Registered Nurses. Supporting students to remain in regional, rural and remote areas while they study reduces the need for students to relocate to metropolitan areas and to continue living and working in RRR areas after graduation. This research holds implications for workforce shortages internationally.

Keywords: nurse education, online education, regional, rural, remote, workforce

Procedia PDF Downloads 54
8203 The Effect of Incorporating Animal Assisted Interventions with Trauma Focused Cognitive Behavioral Therapy

Authors: Kayla Renteria

Abstract:

This study explored the role animal-assisted psychotherapy (AAP) can play in treating Post-Traumatic Stress Disorder (PTSD) when incorporated into Trauma-informed cognitive behavioral therapy (TF-CBT). A review of the literature was performed to show how incorporating AAP could benefit TF-CBT since this treatment model often presents difficulties, such as client motivation and avoidance of the exposure element of the intervention. In addition, the fluidity of treatment goals during complex trauma cases was explored, as this issue arose in the case study. This study follows the course of treatment of a 12-year-old female presenting with symptoms of PTSD. Treatment consisted of traditional components of the TF-CBT model, with the added elements of AAP to address typical treatment obstacles in TF-CBT. A registered therapy dog worked with the subject in all sessions throughout her treatment. The therapy dog was incorporated into components such as relaxation and coping techniques, narrative therapy techniques, and psychoeducation on the cognitive triangle. Throughout the study, the client’s situation and clinical needs required the therapist to switch goals to focus on current safety and stability. The therapy dog provided support and neurophysiological benefits to the client through AAP during this shift in treatment. The client was assessed quantitatively using the Child PTSD Symptom Scale Self Report for DSM-5 (CPSS-SR-5) before and after therapy and qualitatively through a feedback form given after treatment. The participant showed improvement in CPSS-SR-V scores, and she reported that the incorporation of the therapy animal improved her therapy. The results of this study show how the use of AAP provided the client a solid, consistent relationship with the therapy dog that supported her through processing various types of traumas. Implications of the results of treatment and for future research are discussed.

Keywords: animal-assisted therapy, trauma-focused cognitive behavioral therapy, PTSD in children, trauma treatment

Procedia PDF Downloads 184