Physicians’ attitudes, beliefs and barriers to a pulmonary rehabilitation for COPD patients in Saudi Arabia: a cross-sectional study

This study aimed to assess physicians’ attitudes toward delivering pulmonary rehabilitation (PR) to chronic obstructive pulmonary disease (COPD) patients and identify factors and barriers that might influence referral decisions. Between September 2021 and January 2022, a cross-sectional online survey was distributed to all physicians in Saudi Arabia. A total of 502 physicians completed the online survey, of which 62.0% (n = 312) were male. General physicians accounted for 51.2%, while internal-medicine specialists and pulmonologists accounted for 26.9% and 6.6%, respectively. Only 146 (29%) physicians had referred COPD patients to a PR program. The difference in referral rates between all specialties (p = 0.011) was statistically significant. Physicians with more years of experience were more likely to refer COPD patients to PR (p < 0.001). Moreover, a home-based PR program was preferred by 379 physicians (75.5%), and 448 (89.2%) perceived smoking cessation as an essential component of PR. Availability of PR centers (69%) was the most common barrier for not referring patients to PR. The overall referral rate was low among all physicians, owing to a lack of PR centers and trained staff. Home-based delivery was the preferred method of delivering PR, with smoking cessation as an essential component

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Objectives: To assess the attitude of healthcare providers (HCPs) towards the delivering of pulmonary rehabilitation (PR) to patients with chronic obstructive pulmonary disease (COPD) and identify factors and barriers that might influence referral. Design: A cross-sectional online survey consisting of nine multiple-choice questions. Settings: Saudi Arabia. Participants: 980 HCPs including nurses, respiratory therapists (RT) and physiotherapists. Primary outcome measures: HCPs attitudes towards and expectations of the delivery of PR to COPD patients and the identification of factors and barriers that might influence referral in Saudi Arabia. Results: Overall, 980 HCPs, 53.1% of whom were men, completed the survey. Nurses accounted for 40.1% of the total sample size, and RTs and physiotherapists accounted for 32.1% and 16.5%, respectively. The majority of HCPs strongly agreed that PR would improve exercise capacity 589 (60.1%), health-related quality of life 571 (58.3%), and disease self-management in patients with COPD 589 (60.1%). Moreover, the in-hospital supervised PR programme was the preferred method of delivering PR, according to 374 (38.16%) HCPs. Around 85% of HCPs perceived information about COPD, followed by smoking cessation 787 (80.3%) as essential components of PR besides the exercise component. The most common patient-related factor that strongly influenced referral decisions was ‘mobility affected by breathlessness’ (64%), while the ‘availability of PR centres’ (61%), the ‘lack of trained HCPs’ (52%) and the ‘lack of authority to refer patients’ (44%) were the most common barriers to referral. Conclusion: PR is perceived as an effective management strategy for patients with COPD. A supervised hospital-based programme is the preferred method of delivering PR, with information about COPD and smoking cessation considered essential components of PR besides the exercise component. A lack of PR centres, well-trained staff and the authority to refer patients were major barriers to referring patients with COPD. Further research is needed to confirm HCP perceptions of patient-related barriers

Cement degradation in CO2 storage sites: a review on potential applications of nanomaterials

© 2018 The Author(s) Carbon capture and sequestration (CCS) has been employed to reduce global warming, which is one of the critical environmental issues gained the attention of scientific and industrial communities worldwide. Once implemented successfully, CCS can store at least 5 billion tons of CO2per year as an effective and technologically safe method. However, there have been a few issues raised in recent years, indicating the potential leakages paths created during and after injection. One of the major issues might be the chemical interaction of supercritical CO2with the cement, which may lead to the partial or total loss of the cement sheath. There have been many approaches presented to improve the physical and mechanical properties of the cement against CO2attack such as changing the water-to-cement ratio, employing pozzolanic materials, and considering non-Portland cements. However, a limited success has been reported to the application of these approaches once implemented in a real-field condition. To date, only a few studies reported the application of nanoparticles as sophisticated additives which can reinforce oil well cements. This paper provides a review on the possible application of nanomaterials in the cement industry where physical and mechanical characteristics of the cement can be modified to have a better resistance against corrosive environments such as CO2storage sites. The results obtained indicated that adding 0.5 wt% of Carbon NanoTubes (CNTs) and NanoGlass Flakes (NGFs) can reinforce the thermal stability and coating characteristics of the cement which are required to increase the chance of survival in a CO2sequestrated site. Nanosilica can also be a good choice and added to the cement by as much as 3.0 wt% to improve pozzolanic reactivity and thermal stability as per the reports of recent studies

Thermal and mechanical properties of hemp fabric-reinforced nanoclay-cement nano-composites

The influence of nanoclay on thermal and mechanical properties of hemp fabric-reinforced cement composite is presented in this paper. Results indicate that these properties are improved as a result of nanoclay addition. An optimum replacement of ordinary Portland cement with 1 wt% nanoclay is observed through improved thermal stability, reduced porosity and water absorption as well as increased density, flexural strength, fracture toughness and impact strength of hemp fabric-reinforced nanocomposite. The microstructural analyses indicate that the nanoclay behaves not only as a filler to improve the microstructure but also as an activator to promote the pozzolanic reaction and thus improve the adhesion between hemp fabric and nanomatrix

Mechanical properties of cotton fabric reinforced geopolymer composites at 200-1000 °C

Geopolymer composites containing woven cotton fabric (0–8.3 wt%) were fabricated using the hand lay-up technique, and were exposed to elevated temperatures of 200 °C, 400 °C, 600 °C, 800 °C and 1000 °C. With an increase in temperature, the geopolymer composites exhibited a reduction in compressive strength, flexural strength and fracture toughness. When heated above 600 °C, the composites exhibited a significant reduction in mechanical properties. They also exhibited brittle behavior due to severe degradation of cotton fibres and the creation of additional porosity in the composites. Microstructural images verified the existence of voids and small channels in the composites due to fibre degradation

High-performance natural fiber-reinforced cement composites

© 2018 Elsevier Ltd. All rights reserved. Cement nanocomposites reinforced with hemp fabrics and calcined nanoclay (CNC) have been fabricated and investigated. CNC is prepared by heating nanoclay (Cloisite 30B) at 900°C for 2h. The influences of CNC dispersion on the mechanical properties and thermal properties of these composites have been characterized in terms of porosity, density, water absorption, flexural strength, fracture toughness, durability impact strength, and thermal stability. The microstructure is investigated using quantitative X-ray diffraction analysis and high-resolution transmission electron microscopy. The effects of alkali (NaOH) treatment of hemp fabric on the mechanical properties of hemp fabric-reinforced cement composites with different fabric contents of 4.5, 5.7, 6.9, and 8.1 wt% are also investigated. Results show that the optimum hemp fabric content is 6.9 wt% (i.e., six fabric layers). Results also indicated that physical, mechanical, and thermal properties enhanced because of the addition of CNC into the cement matrix and the optimum content of CNC was 1 wt%. The treated hemp fabric-reinforced nanocomposites containing 1 wt% CNC exhibited the highest flexural strength, fracture toughness, impact strength, and thermal stability than their counterparts and good fiber-matrix interface. Results also indicated that the CNC effectively mitigated the degradation of hemp fiber. The durability and the degradation resistance of hemp fiber were enhanced due to the addition of CNC into the cement matrix and the optimum content of CNC was 1 wt%. This environmentally friendly nanocomposite can be used for various construction applications such as ceilings and roofs

Effect of calcined nanoclay on microstructural and mechanical properties of chemically treated hemp fabric-reinforced cement nanocomposites

The influence of calcined nanoclay (CNC) and chemical treatment on the microstructure and mechanical properties of treated hemp fabric-reinforced cement nanocomposites has been investigated. The optimum hemp fabric content for these nanocomposites is 6.9 wt% (i.e. 6 fabric layers). Alkali-treated hemp fabric-reinforced cement composites exhibit the highest flexural strength when compared to their non-treated counterparts. In addition, mechanical properties are improved as a result of CNC addition. An optimum replacement of ordinary Portland cement with 1 wt% CNC is observed through reduced porosity and increased density, flexural strength and fracture toughness in treated hemp fabric-reinforced nanocomposite. It is shown that CNC behaves not only as a filler to improve the microstructure, but also as the activator to facilitate the pozzolanic reaction and thus improved the adhesion between the treated hemp fabric and the matrix

Microstructures and mechanical properties of hemp fabrics reinforced organoclay-cement nanocomposites

Cement eco-nanocomposites reinforced with hemp fabric (HF) and nanoclay platelets (Cloisite30B) arefabricated and investigated in terms of XRD, SEM, physical and mechanical properties. Results indicated that the mechanical properties generally increased as a result of the addition of nanoclay into the cement matrix with and without HF. An optimum replacement of ordinary Portland cement by 1 wt% nanoclay is concluded from the current work. It is found that, 1 wt% nanoclay decreases the porosity and also significantly increases the density, flexural strength and fracture toughness of cement composite and HF reinforced nanocomposite. The microstructural analysis results indicate that the nanoclay behaves not only as a filler to improve microstructure, but also as an activator to promote pozzolanic reaction which modified cement matrix and improved the hemp fabric-matrix adhesion. The failure micromechanisms and energy dissipative processes in HF reinforced cement composite and nanocomposite are discussed in terms of microstructural observations

Thermal and mechanical properties of NaOH treated hemp fabric and calcined nanoclay-reinforced cement nanocomposites

© 2015. Cement nanocomposites reinforced with hemp fabrics and calcined nanoclay (CNC) have been fabricated and investigated. CNC is prepared by heating nanoclay (Cloisite 30B) at 900. °C for 2. h. The influences of CNC dispersion on the mechanical properties and thermal properties of these composites have been characterized in terms of porosity, density, water absorption, flexural strength, fracture toughness, impact strength and thermal stability. The microstructure is investigated using Quantitative X-ray Diffraction Analysis (QXDA) and High Resolution Transmission Electron Microscopy (HRTEM). The effects of alkali (NaOH) treatment of hemp fabric on the mechanical properties of hemp fabric-reinforced cement composites with different fabric contents of 4.5, 5.7, 6.9 and 8.1. wt% are also investigated. Results show that the optimum hemp fabric content is 6.9. wt% (i.e. 6 fabric layers). Results also indicated that physical, mechanical and thermal properties were enhanced due to the addition of CNC into the cement matrix and the optimum content of CNC was 1. wt%. The treated hemp fabric-reinforced nanocomposites containing 1. wt% CNC exhibited the highest flexural strength, fracture toughness, impact strength and thermal stability by virtue of good fibre-matrix interface. This environmentally friendly nanocomposite can be used for various construction applications such as ceilings and roofs