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Public health responses to CBRN terrorism in the Middle East and North Africa
No full textObjective: Escalating global challenges (such as disasters, conflict, and climate change) underline the importance of addressing Chemical, Biological, Radiological, and Nuclear (CBRN) terrorism for sustainable public health strategies. This study aims to provide a comprehensive epidemiological analysis of CBRN incidents in the Middle East and North Africa (MENA) region, emphasizing the necessity of sustainable responses to safeguard healthcare infrastructures. Method: Utilizing a retrospective approach, this research analyzes data from the Global Terrorism Database (GTD) covering the period from 2003 to 2020. The study focuses on examining the frequency, characteristics, and consequences of CBRN incidents in the MENA region to identify patterns and trends that pose significant challenges to public health systems. Results: The analysis revealed a significant clustering of CBRN incidents in Iraq and Syria, with a predominant involvement of chemical agents. These findings indicate the extensive impact of CBRN terrorism on healthcare infrastructures, highlighting the challenges in providing immediate health responses and the necessity for long-term recovery strategies. Conclusions: The study underscores the need for improved healthcare preparedness, robust emergency response systems, and the development of sustainable public health policies. Advocating for international collaboration, the research contributes to the strategic adaptation of healthcare systems to mitigate the impacts of CBRN terrorism, ensuring preparedness for future incidents in the MENA region and beyond. © The Author(s), 2024. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc
Senior nurse manager perceptions of nurse practitioner integration : a quantitative study
Get PDFAim. To determine Senior Nurse Managers' perceptions of integration of Nurse Practitioner roles in Healthcare Organisations across Ireland and Australia. Background. Introduction of the Nurse Practitioner role in both countries is well established with national policies aimed at developing a critical mass in the health workforce. Current policy requires Senior Nurse Managers to be actively involved in the introduction of and oversight of the integration of Nurse Practitioners across healthcare settings. This is integral in the context of the success and sustainability of the services provided by the Nurse Practitioner. Methods. A quantitative, cross-sectional cloud-based survey of senior nurse managers across Ireland and Australia from April to September 2022. Results. Of 300 responses received, 122 were eligible for analysis. Of these, 77% expressed that there should be a specific role to support the integration of Nurse Practitioner roles at local level, and 61% recommended that this should occur at a national level, whilst 48% reported the absence of a standardised governance structure. Three reporting structures were identified: professional, clinical, and operational. Autonomous clinical decision making and prescribing were two Nurse Practitioner functions most identified. Fifty-five percent reported having performance indicators for Nurse Practitioner roles, with 24% agreeing that performance indicators captured the quality of care provided. Thirty-five percent of senior nurse managers indicated that there were agreed reporting timelines for performance indicators and a requirement for the provision of an annual report. Conclusion. Whilst some participants reported structure to guide and evaluate the work and value of Nurse Practitioners, the approach was inconsistent across organisations and countries. This paper demonstrates that integration is not broadly established across both countries. Implications for the Profession. The main findings were that Nurse Practitioners were misunderstood and the development of a structured framework to support the integration of Nurse Practitioners would provide long-term benefits. © 2024 M. Ryder et al
Hemp as a sustainable carbon negative plant: a review of its properties, applications, challenges and future directions
Get PDFHemp is a versatile plant from the Cannabis sativa species, that has gained significant attention in recent years due to its potential to contribute to sustainable development and climate change mitigation. Hemp has the remarkable ability to absorb and store carbon dioxide not just during its growth phase, but also during its application and thus has the potential to be carbon negative. With the alarming global increase in carbon emissions and its implications, the cultivation and application of hemp can be a valuable tool in mitigating climate change. Although hemp is a versatile plant with many countries like Canada and China leading the way in its cultivation, it still faces challenges in Australia in terms of its acceptance, cultivation and widespread application. Much more needs to be done in terms of gaining a better understanding of the potential of hemp, growth opportunities, future prospects and challenges in further developing the industry. This review paper aims to provide a comprehensive overview of hemp's properties, applications, challenges, and future directions in the context of its role as a sustainable carbon-negative plant. The review begins by exploring the unique properties of hemp that make it an ideal candidate for carbon sequestration. The review also examines the diverse range of applications for hemp across multiple industries, ranging from construction materials, paper and packaging to biofuels and edible oil. The review has also identified several challenges and barriers to hemp's widespread adoption as a sustainable carbon-negative plant. © 2024 UTHM Publisher. This is an open access article under the CC BY-NC-SA 4.0 license
An optimized artificial neural network model of a limaçon-to-circular gas expander with an inlet valve
Get PDFIn this work, an artificial neural network (ANN)-based model is proposed to describe the input–output relationships in a Limaçon-To-Circular (L2C) gas expander with an inlet valve. The L2C gas expander is a type of energy converter that has great potential to be used in organic Rankine cycle (ORC)-based small-scale power plants. The proposed model predicts the different performance indices of a limaçon gas expander for different input pressures, rotor velocities, and valve cutoff angles. A network model is constructed and optimized for different model parameters to achieve the best prediction performance compared to the classic mathematical model of the system. An overall normalized mean square error of 0.0014, coefficient of determination ((Formula presented.)) of 0.98, and mean average error of 0.0114 are reported. This implies that the surrogate model can effectively mimic the actual model with high precision. The model performance is also compared to a linear interpolation (LI) method. It is found that the proposed ANN model predictions are about 96.53% accurate for a given error threshold, compared to about 91.46% accuracy of the LI method. Thus the proposed model can effectively predict different output parameters of a limaçon gas expander such as energy, filling factor, isentropic efficiency, and mass flow for different operating conditions. Of note, the model is only trained by a set of input and target values; thus, the performance of the model is not affected by the internal complex mathematical models of the overall valved-expander system. This neural network-based approach is highly suitable for optimization, as the alternative iterative analysis of the complex analytical model is time-consuming and requires higher computational resources. A similar modeling approach with some modifications could also be utilized to design controllers for these types of systems that are difficult to model mathematically. © 2024 by the authors
An optimum design for a fast-response solenoid valve : application to a limaçon gas expander
Get PDFOrganic Rankine Cycle (ORC)–based small-scale power plants are becoming a promising instrument in the recent drive to utilize renewable sources and reduce carbon emissions. But the effectiveness of such systems is limited by the low efficiency of gas expanders, which are the main part of an ORC system. Limaçon-based expansion machines with a fast inlet control valve have great prospects as they could potentially offer efficiencies over 50%. However, the lack of a highly reliable and significantly fast control valve is hindering its possible application. In this paper, a push–pull solenoid valve is optimized using a stochastic optimization technique to provide a fast response. The optimization yields about 56–58% improvement in overall valve response. A performance comparison of the initial and optimized valves applied to a limaçon expander thermodynamic model is also presented. Additionally, the sensitivity of the valve towards a changing inlet pressure and expander rotor velocity is analyzed to better understand the effectiveness of the valve and provide clues to overall performance improvement. © 2024 by the authors
A qualitative study of Australian indigenous perceptions of success
Get PDFThis study explored Australian Indigenous perspectives of the concept of success. Qualitative audio interviews with semi-structured questions and a conversational approach adhered to the Indigenous research paradigm. Participants were provided with an opportunity to share their views. The welcoming nature of Indigenous communities as well as other rewarding experiences for myself were echoed during this study and examples were reported. A local Indigenous individual noticed that Indigenous perspectives of success often differed from many common ideas within a mainstream Western society. This was confirmed by the comments of eleven research participants. The literature review highlighted an earlier literary emphasis on problems rather than the positive aspects of Indigenous communities. Investigating stories related to success was an attempt to avoid adding more unpleasant material that was present in the literature. The literature review empathised with Dennis Foley researching Indigenous success in entrepreneurism and Jeannie Herbert examining success in higher education, followed by an examination of the meaning of success. This study sought generalised community views of success, rather than success in one field. Most data for this research were collected in the central Gippsland region, supplemented with three interviews at Circular Quay in Sydney. All participants indicated they lived a suburban lifestyle; 29 qualitative interviews were conducted, with 26 rated as useful and transcribed verbatim. All interviews satisfied the ethical clearance requirements and followed the advice of key authors arguing for decolonisation when completing modern research. Interviews were analysed by employing grounded theory thematic analysis, using an interpretive method with elements of deductive reasoning. Five observed themes were classified as general comments about success: success is different, success is available to all, difficulty discussing success, determination, and creativity or spirituality. Five themes were classed as definition of success: family support, contribution to community, achieving goals, happiness and continuing culture. A discussion of links between themes argued the broad range of views of participants evinced communal implications for success as well as a devaluation of materialism. Other links included the support for cultural traditions and the inadequacy of common Western definitions of the concept of success. The analysis acknowledged the overlaps between cultures that can exist when comparing Indigenous with mainstream cultures, especially when recognising individual differences. Literature identified concurred with findings from this study. Research limits included sampling restrictions and a limited time frame. Suggestions for further research included extra research be completed in more regions in Australia with more women, a broader age range and more cultural groups. Differences were observed regarding the concept of success for Indigenous individuals when compared with more common mainstream Western views as well appreciating the value of continuing the culture were two examples of the claims made by most participants. Therefore, the findings of the research resulted in recommendations for policymakers, educationists, academic researchers and the general community to converse with Indigenous groups and increase the understanding of the views for the meaning of the concept of success.Doctor of Philosoph
Homeostasis model assessment for insulin resistance mediates the positive association of triglycerides with diabetes
Get PDFElevated circulating triglyceride levels have been linked to an increased risk of diabetes, although the precise mechanisms remain unclear. This study aimed to investigate whether low-density lipoprotein (LDL) cholesterol, homeostatic model assessment (HOMA) for insulin resistance, and C-reactive protein (CRP) served as mediators in this association across a sample of 18,435 US adults. Mediation analysis was conducted using the PROCESS Version 4.3 Macro for SPSS. Simple mediation analysis revealed that all three potential mediators played a role in mediating the association. However, in parallel mediation analysis, where all three mediators were simultaneously included, HOMA for insulin resistance remained a significant mediator (indirect effect coefficient, 0.47; 95% confidence interval [CI], 0.43–0.52; p < 0.05) after adjusting for all tested confounding factors. Conversely, LDL cholesterol (indirect effect coefficient
Modelling the dynamics of microbubble undergoing stable and inertial cavitation : delineating the effects of ultrasound and microbubble parameters on sonothrombolysis
Get PDFSonothrombolysis induces clot breakdown using ultrasound waves to excite microbubbles. Despite the great potential, selecting optimal ultrasound (frequency and pressure) and microbubble (radius) parameters remains a challenge. To address this, a computational model was developed to investigate the bubble behaviour during sonothrombolysis. The blood and clot were assumed to be non-Newtonian and porous, respectively. The effects of ultrasound and microbubble parameters on flow-induced shear stress on the clot surface during stable and inertial cavitation were investigated. It was found that microbubble translation towards the clot and the shear stress on the clot surface during stable cavitation were significant when the bubble was about to undergo inertial cavitation. While insonation of large microbubble (radius of 1.6
Roadmap for recommended guidelines of leak detection of subsea pipelines
Get PDFThe leak of hydrocarbon-carrying pipelines represents a serious incident, and if it is in a gas line, the economic exposure would be significant due to the high cost of lost or deferred hydrocarbon production. In addition, the leakage of hydrocarbon could pose risks to human life, have an impact on the environment, and could cause an image loss for the operating company. Pipelines are designed to operate at full capacity under steady-state flow conditions. Normal operations may involve day-to-day transients such as the operations of pumps, valves, and changes in production/delivery rates. The basic leak detection problem is to distinguish between the normal operational transients and the occurrence of non-typical process conditions that would indicate a leak. To date, the industry has concentrated on a single-phase flow, primarily of oil, gas, and ethylene. The application of a leak-monitoring system to a particular pipeline system depends on environmental issues, regulatory imperatives, loss prevention of the operating company, and safety policy rather than pipe size and configuration. This paper provides a review of the recommended guidance for leak detection of subsea pipelines in the context of pipeline integrity management. The paper also presents a review of the capability and application of various leak detection techniques that can be used to offer a roadmap to potential users of the leak detection systems. © 2024 by the authors
Comprehensive quality assessment for aphasia rehabilitation after stroke : protocol for a multicentre, mixed-methods study
Get PDFIntroduction People with aphasia following stroke experience disproportionally poor outcomes, yet there is no comprehensive approach to measuring the quality of aphasia services. The Meaningful Evaluation of Aphasia SeRvicES (MEASuRES) minimum dataset was developed in partnership with people with lived experience of aphasia, clinicians and researchers to address this gap. It comprises sociodemographic characteristics, quality indicators, treatment descriptors and outcome measurement instruments. We present a protocol to pilot the MEASuRES minimum dataset in clinical practice, describe the factors that hinder or support implementation and determine meaningful thresholds of clinical change for core outcome measurement instruments. Methods and analysis This research aims to deliver a comprehensive quality assessment toolkit for poststroke aphasia services in four studies. A multicentre pilot study (study 1) will test the administration of the MEASuRES minimum dataset within five Australian health services. An embedded mixed-methods process evaluation (study 2) will evaluate the performance of the minimum dataset and explore its clinical applicability. A consensus study (study 3) will establish consumer-informed thresholds of meaningful change on core aphasia outcome constructs, which will then be used to establish minimal important change values for corresponding core outcome measurement instruments (study 4). Ethics and dissemination Studies 1 and 2 have been registered with the Australian and New Zealand Clinical Trial Registry (ACTRN12623001313628). Ethics approval has been obtained from the Royal Brisbane and Women's Hospital (HREC/2023/MNHB/95293) and The University of Queensland (2022/HE001946 and 2023/HE001175). Study findings will be disseminated through peer-reviewed publications, conference presentations and engagement with relevant stakeholders including healthcare providers, policy-makers, stroke and rehabilitation audit and clinical quality registry custodians, consumer support organisations, and individuals with aphasia and their families. © 2024 BMJ Publishing Group. All rights reserved