Search results for: single-use medical device
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5101

Search results for: single-use medical device

2131 Monitoring the Production of Large Composite Structures Using Dielectric Tool Embedded Capacitors

Authors: Galatee Levadoux, Trevor Benson, Chris Worrall

Abstract:

With the rise of public awareness on climate change comes an increasing demand for renewable sources of energy. As a result, the wind power sector is striving to manufacture longer, more efficient and reliable wind turbine blades. Currently, one of the leading causes of blade failure in service is improper cure of the resin during manufacture. The infusion process creating the main part of the composite blade structure remains a critical step that is yet to be monitored in real time. This stage consists of a viscous resin being drawn into a mould under vacuum, then undergoing a curing reaction until solidification. Successful infusion assumes the resin fills all the voids and cures completely. Given that the electrical properties of the resin change significantly during its solidification, both the filling of the mould and the curing reaction are susceptible to be followed using dieletrometry. However, industrially available dielectrics sensors are currently too small to monitor the entire surface of a wind turbine blade. The aim of the present research project is to scale up the dielectric sensor technology and develop a device able to monitor the manufacturing process of large composite structures, assessing the conformity of the blade before it even comes out of the mould. An array of flat copper wires acting as electrodes are embedded in a polymer matrix fixed in an infusion mould. A multi-frequency analysis from 1 Hz to 10 kHz is performed during the filling of the mould with an epoxy resin and the hardening of the said resin. By following the variations of the complex admittance Y*, the filling of the mould and curing process are monitored. Results are compared to numerical simulations of the sensor in order to validate a virtual cure-monitoring system. The results obtained by drawing glycerol on top of the copper sensor displayed a linear relation between the wetted length of the sensor and the complex admittance measured. Drawing epoxy resin on top of the sensor and letting it cure at room temperature for 24 hours has provided characteristic curves obtained when conventional interdigitated sensor are used to follow the same reaction. The response from the developed sensor has shown the different stages of the polymerization of the resin, validating the geometry of the prototype. The model created and analysed using COMSOL has shown that the dielectric cure process can be simulated, so long as a sufficient time and temperature dependent material properties can be determined. The model can be used to help design larger sensors suitable for use with full-sized blades. The preliminary results obtained with the sensor prototype indicate that the infusion and curing process of an epoxy resin can be followed with the chosen configuration on a scale of several decimeters. Further work is to be devoted to studying the influence of the sensor geometry and the infusion parameters on the results obtained. Ultimately, the aim is to develop a larger scale sensor able to monitor the flow and cure of large composite panels industrially.

Keywords: composite manufacture, dieletrometry, epoxy, resin infusion, wind turbine blades

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2130 Impact of Reproductive Technologies on Women's Lives in New Delhi: A Study from Feminist Perspective

Authors: Zairunisha

Abstract:

This paper is concerned with the ways in which Assisted Reproductive Technologies (ARTs) affect women’s lives and perceptions regarding their infertility, contraception and reproductive health. Like other female animals, nature has ordained human female with the biological potential of procreation and becoming mother. However, during the last few decades, this phenomenal disposition of women has become a technological affair to achieve fertility and contraception. Medical practices in patriarchal societies are governed by male scientists, technical and medical professionals who try to control women as procreator instead of providing them choices. The use of ARTs presents innumerable waxed ethical questions and issues such as: the place and role of a child in a woman’s life, freedom of women to make their choices related to use of ARTs, challenges and complexities women face at social and personal levels regarding use of ARTs, effect of ARTs on their life as mothers and other relationships. The paper is based on a survey study to explore and analyze the above ethical issues arising from the use of Assisted Reproductive Technologies (ARTs) by women in New Delhi, the capital of India. A rapid rate of increase in fertility clinics has been noticed recently. It is claimed that these clinics serve women by using ARTs procedures for infertile couples and individuals who want to have child or terminate a pregnancy. The study is an attempt to articulate a critique of ARTs from a feminist perspective. A qualitative feminist research methodology has been adopted for conducting the survey study. An attempt has been made to identify the ways in which a woman’s life is affected in terms of her perceptions, apprehensions, choices and decisions regarding new reproductive technologies. A sample of 18 women of New Delhi was taken to conduct in-depth interviews to investigate their perception and response concerning the use of ARTs with a focus on (i) successful use of ARTs, (ii) unsuccessful use of ARTs, (iii) use of ARTs in progress with results yet to be known. The survey was done to investigate the impact of ARTs on women’s physical, emotional, psychological conditions as well as on their social relations and choices. The complexities and challenges faced by women in the voluntary and involuntary (forced) use of ARTs in Delhi have been illustrated. A critical analysis of interviews revealed that these technologies are used and developed for making profits at the cost of women’s lives through which economically privileged women and individuals are able to purchase services from lesser ones. In this way, the amalgamation of technology and cultural traditions are redefining and re-conceptualising the traditional patterns of motherhood, fatherhood, kinship and family relations within the realm of new ways of reproduction introduced through the use of ARTs.

Keywords: reproductive technologies, infertilities, voluntary, involuntary

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2129 Mobile Health Approaches in the Management of Breast Cancer: A Qualitative Content Analysis

Authors: Hyekyung Woo, Gwihyun Kim

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mHealth, which encompasses mobile health technologies and interventions, is rapidly evolving in various medical specialties, and its impact is evident in oncology. This review describes current trends in research addressing the integration of mHealth into the management of breast cancer by examining evaluations of mHealth and its contributions across the cancer care continuum. Mobile technologies are perceived as effective in prevention and as feasible for managing breast cancer, but the diagnostic accuracy of these tools remains in doubt. Not all phases of breast cancer treatment involve mHealth, and not all have been addressed by research. These drawbacks in the application of mHealth to breast cancer management call for intensified research to strengthen its role in breast cancer care.

Keywords: mobile application, breast cancer, content analysis, mHealth

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2128 Chromatography Study of Fundamental Properties of Medical Radioisotope Astatine-211

Authors: Evgeny E. Tereshatov

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Astatine-211 is considered one of the most promising radionuclides for Targeted Alpha Therapy. In order to develop reliable procedures to label biomolecules and utilize efficient delivery vehicle principles, one should understand the main chemical characteristics of astatine. The short half-life of 211At (~7.2 h) and absence of any stable isotopes of this element are limiting factors towards studying the behavior of astatine. Our team has developed a procedure for rapid and efficient isolation of astatine from irradiated bismuth material in nitric acid media based on 3-octanone and 1-octanol extraction chromatography resins. This process has been automated and it takes 20 min from the beginning of the target dissolution to the At-211 fraction elution. Our next step is to consider commercially available chromatography resins and their applicability in astatine purification in the same media. Results obtained along with the corresponding sorption mechanisms will be discussed.

Keywords: astatine-211, chromatography, automation, mechanism, radiopharmaceuticals

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2127 A Rare Case of Prolonged Pressure Rise Following Selective Laser Trabeculoplasty

Authors: Aneesha Fonseca, Arij Daas, Muhammed Abdulkader

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Transient intraocular pressure (IOP) rise is a common occurrence after glaucoma laser procedures. However, this pressure spike usually lasts only a few days. We describe a case of a 60-year-old Caucasian gentleman who underwent selective laser trabeculoplasty (SLT) in both eyes for ocular hypertension previously treated with Bimatoprost and Timolol and developed a sustained raised IOP. His IOP rose from 34 and 33 mmHg pre-laser to 48 and 42 mmHg after SLT in the right and left eye, respectively. Even after maximum medical therapy (Bimatoprost, Timolol, Brinzolamide Apraclonidine, and oral Acetozolamide), his IOP remained at 32 and 28mmHg. A provisional diagnosis of trabeculitis was made, and topical Ketorolac was commenced in addition to the IOP-lowering medications. Within a week, his IOP came down to 21 and 18mmHg in the right and left eye, respectively.

Keywords: complications, selective laser trabeculoplasty, sustained pressure rise, trabeculitis

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2126 Structural Equation Modeling Approach: Modeling the Impact of Social Marketing Programs on Combating Female Genital Mutilation in the Sudanese Society

Authors: Nada Abdelsadig Moahamed Saied

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Female Genital Mutilation (FGM) and other similar traditional cultural practices pose a significant problem for Sudanese society. Such actions are severe and seriously detrimental to people's health since they are based on false social perceptions. To address these problems, numerous institutions and organizations were compelled to act rapidly. Female circumcision, or FGM, is one of the riskiest practices. It is referred to as the excision of the genitalia. Any surgeries involving the total or partial removal of the external female genitalia for non-medical reasons fall under this category. The results of FGM can vary depending on the kind and degree of the operation. These can be categorized as short-term, mid-term, or long-term issues. Infections, including the Human, blood, discomfort, and difficulty urinating are the immediate effects. FGM is defined by the World Health Organization (WHO) as practices that purposefully damage or modify female genital organs for non-medical purposes. It often takes place between the ages of one and fifteen. The girl's right to decide on important choices affecting her sexual and reproductive health is violated because the act is usually performed without her consent and frequently against her will. UNICEF, the United Nations International Children's Emergency Fund, aggressively combats the issue of FGM in Sudan. Numerous programs were started by NGOs to stop the practice. To our knowledge, no scientific study has been conducted to evaluate the effects of such social marketing techniques on simulating and comprehending society’s feelings surrounding FGM. This study proposes the development of a structural equation model aiming to determine the impact of awareness programs on people’s intentions to adopt the behavior of abandoning FGM based on theoretical models of behavior change. The model incorporates all the relevant factors that contribute to FGM and possible strategic actions to tackle this problem. The theoretical backdrop for FGM is presented in the next section, which also explains the practice's history, justifications, and potential treatments. The methodology section that follows describes the structural equation model. The proposed model, which compiles all the pertinent elements into a single image, is presented in the fourth part. Finally, conclusions are reached, and suggestions for further research are made.

Keywords: social marketing, policy-making, behavioral change, female genital mutilation, culture

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2125 Improving a Stagnant River Reach Water Quality by Combining Jet Water Flow and Ultrasonic Irradiation

Authors: A. K. Tekile, I. L. Kim, J. Y. Lee

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Human activities put freshwater quality under risk, mainly due to expansion of agriculture and industries, damming, diversion and discharge of inadequately treated wastewaters. The rapid human population growth and climate change escalated the problem. External controlling actions on point and non-point pollution sources are long-term solution to manage water quality. To have a holistic approach, these mechanisms should be coupled with the in-water control strategies. The available in-lake or river methods are either costly or they have some adverse effect on the ecological system that the search for an alternative and effective solution with a reasonable balance is still going on. This study aimed at the physical and chemical water quality improvement in a stagnant Yeo-cheon River reach (Korea), which has recently shown sign of water quality problems such as scum formation and fish death. The river water quality was monitored, for the duration of three months by operating only water flow generator in the first two weeks and then ultrasonic irradiation device was coupled to the flow unit for the remaining duration of the experiment. In addition to assessing the water quality improvement, the correlation among the parameters was analyzed to explain the contribution of the ultra-sonication. Generally, the combined strategy showed localized improvement of water quality in terms of dissolved oxygen, Chlorophyll-a and dissolved reactive phosphate. At locations under limited influence of the system operation, chlorophyll-a was highly increased, but within 25 m of operation the low initial value was maintained. The inverse correlation coefficient between dissolved oxygen and chlorophyll-a decreased from 0.51 to 0.37 when ultrasonic irradiation unit was used with the flow, showing that ultrasonic treatment reduced chlorophyll-a concentration and it inhibited photosynthesis. The relationship between dissolved oxygen and reactive phosphate also indicated that influence of ultra-sonication was higher than flow on the reactive phosphate concentration. Even though flow increased turbidity by suspending sediments, ultrasonic waves canceled out the effect due to the agglomeration of suspended particles and the follow-up settling out. There has also been variation of interaction in the water column as the decrease of pH and dissolved oxygen from surface to the bottom played a role in phosphorus release into the water column. The variation of nitrogen and dissolved organic carbon concentrations showed mixed trend probably due to the complex chemical reactions subsequent to the operation. Besides, the intensive rainfall and strong wind around the end of the field trial had apparent impact on the result. The combined effect of water flow and ultrasonic irradiation was a cumulative water quality improvement and it maintained the dissolved oxygen and chlorophyll-a requirement of the river for healthy ecological interaction. However, the overall improvement of water quality is not guaranteed as effectiveness of ultrasonic technology requires long-term monitoring of water quality before, during and after treatment. Even though, the short duration of the study conducted here has limited nutrient pattern realization, the use of ultrasound at field scale to improve water quality is promising.

Keywords: stagnant, ultrasonic irradiation, water flow, water quality

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2124 Wetting Characterization of High Aspect Ratio Nanostructures by Gigahertz Acoustic Reflectometry

Authors: C. Virgilio, J. Carlier, P. Campistron, M. Toubal, P. Garnier, L. Broussous, V. Thomy, B. Nongaillard

Abstract:

Wetting efficiency of microstructures or nanostructures patterned on Si wafers is a real challenge in integrated circuits manufacturing. In fact, bad or non-uniform wetting during wet processes limits chemical reactions and can lead to non-complete etching or cleaning inside the patterns and device defectivity. This issue is more and more important with the transistors size shrinkage and concerns mainly high aspect ratio structures. Deep Trench Isolation (DTI) structures enabling pixels’ isolation in imaging devices are subject to this phenomenon. While low-frequency acoustic reflectometry principle is a well-known method for Non Destructive Test applications, we have recently shown that it is also well suited for nanostructures wetting characterization in a higher frequency range. In this paper, we present a high-frequency acoustic reflectometry characterization of DTI wetting through a confrontation of both experimental and modeling results. The acoustic method proposed is based on the evaluation of the reflection of a longitudinal acoustic wave generated by a 100 µm diameter ZnO piezoelectric transducer sputtered on the silicon wafer backside using MEMS technologies. The transducers have been fabricated to work at 5 GHz corresponding to a wavelength of 1.7 µm in silicon. The DTI studied structures, manufactured on the wafer frontside, are crossing trenches of 200 nm wide and 4 µm deep (aspect ratio of 20) etched into a Si wafer frontside. In that case, the acoustic signal reflection occurs at the bottom and at the top of the DTI enabling its characterization by monitoring the electrical reflection coefficient of the transducer. A Finite Difference Time Domain (FDTD) model has been developed to predict the behavior of the emitted wave. The model shows that the separation of the reflected echoes (top and bottom of the DTI) from different acoustic modes is possible at 5 Ghz. A good correspondence between experimental and theoretical signals is observed. The model enables the identification of the different acoustic modes. The evaluation of DTI wetting is then performed by focusing on the first reflected echo obtained through the reflection at Si bottom interface, where wetting efficiency is crucial. The reflection coefficient is measured with different water / ethanol mixtures (tunable surface tension) deposited on the wafer frontside. Two cases are studied: with and without PFTS hydrophobic treatment. In the untreated surface case, acoustic reflection coefficient values with water show that liquid imbibition is partial. In the treated surface case, the acoustic reflection is total with water (no liquid in DTI). The impalement of the liquid occurs for a specific surface tension but it is still partial for pure ethanol. DTI bottom shape and local pattern collapse of the trenches can explain these incomplete wetting phenomena. This high-frequency acoustic method sensitivity coupled with a FDTD propagative model thus enables the local determination of the wetting state of a liquid on real structures. Partial wetting states for non-hydrophobic surfaces or low surface tension liquids are then detectable with this method.

Keywords: wetting, acoustic reflectometry, gigahertz, semiconductor

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2123 Healing Architecture and Evidence Based Design: An Interior Design Example in Medicana KızıLtoprak Hospital

Authors: Yunus Emre Kara, Atilla Kuzu, Levent Cirpici

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Recently, in the interior design of hospitals, the effect of the physical environment on the healing process has been frequently emphasized, and the importance of psychological and behavioral factors has increased day by day. When designing new hospital interiors, it became important to create spaces that not only meet medical requirements but also support the healing process of patients with interior design. In this study, the patient rooms, corridor, atrium area, waiting area, and entrance counter in a hospital were handled with patient-centered design, evidence-based design, and remedial architectural approaches, and it was seen that the healing and reassuring elements in hospitals were extremely important.

Keywords: evidence based design, healing architecture, hospital, organic design, parametric design

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2122 Single-Crystal Kerfless 2D Array Transducer for Volumetric Medical Imaging: Theoretical Study

Authors: Jurij Tasinkiewicz

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The aim of this work is to present a theoretical analysis of a 2D ultrasound transducer comprised of crossed arrays of metal strips placed on both sides of thin piezoelectric layer (a). Such a structure is capable of electronic beam-steering of generated wave beam both in elevation and azimuth. In this paper, a semi-analytical model of the considered transducer is developed. It is based on generalization of the well-known BIS-expansion method. Specifically, applying the electrostatic approximation, the electric field components on the surface of the layer are expanded into fast converging series of double periodic spatial harmonics with corresponding amplitudes represented by the properly chosen Legendre polynomials. The problem is reduced to numerical solving of certain system of linear equations for unknown expansion coefficients.

Keywords: beamforming, transducer array, BIS-expansion, piezoelectric layer

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2121 Vitamin D and Prevention of Rickets in Children

Authors: Mousa Saleh Daoud

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Rickets is a condition that affects the development of bones in children. It causes soft bones, which can become bowed or curved, this bending and curvature is evident in the age of Walking. The most common cause of rickets is dietary deficiency of vitamin D or Lack of exposure to sunlight or both together. The link between vitamin D and rickets has been known for many years and is well understood by doctors and scientists. If a child does not get enough of the vitamin D, the bones cannot form hard outer shells. This is why they become soft and weak. This study was conducted on children who reviewed by our medical clinic between the years 2011-2013. The study included 400 children, aged between one and six years. 11 children had clear clinical manifestations of rickets of varying degrees and all of them due to lack of vitamin D except for one case of rickets resistant to vitamin D. 389 cases ranged between natural and deficiency in vitamin D without clinical manifestations of Rickets.

Keywords: rickts, bone metabolic diseases, vitamin D, child

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2120 Learn through AR (Augmented Reality)

Authors: Prajakta Musale, Bhargav Parlikar, Sakshi Parkhi, Anshu Parihar, Aryan Parikh, Diksha Parasharam, Parth Jadhav

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AR technology is basically a development of VR technology that harnesses the power of computers to be able to read the surroundings and create projections of digital models in the real world for the purpose of visualization, demonstration, and education. It has been applied to education, fields of prototyping in product design, development of medical models, battle strategy in the military and many other fields. Our Engineering Design and Innovation (EDAI) project focuses on the usage of augmented reality, visual mapping, and 3d-visualization along with animation and text boxes to help students in fields of education get a rough idea of the concepts such as flow and mechanical movements that may be hard to visualize at first glance.

Keywords: spatial mapping, ARKit, depth sensing, real-time rendering

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2119 Using the Micro Computed Tomography to Study the Corrosion Behavior of Magnesium Alloy at Different pH Values

Authors: Chia-Jung Chang, Sheng-Che Chen, Ming-Long Yeh, Chih-Wei Wang, Chih-Han Chang

Abstract:

Introduction and Motivation: In recent years, magnesium alloy is used to be a kind of medical biodegradable materials. Magnesium is an essential element in the body and is efficiently excreted by the kidneys. Furthermore, the mechanical properties of magnesium alloy is closest to human bone. However, in some cases magnesium alloy corrodes so quickly that it would release hydrogen on surface of implant. The other product is hydroxide ion, it can significantly increase the local pH value. The above situations may have adverse effects on local cell functions. On the other hand, nowadays magnesium alloy corrode too fast to maintain the function of implant until the healing of tissue. Therefore, much recent research about magnesium alloy has focused on controlling the corrosion rate. The in vitro corrosion behavior of magnesium alloys is affected by many factors, and pH value is one of factors. In this study, we will study on the influence of pH value on the corrosion behavior of magnesium alloy by the Micro-CT (micro computed tomography) and other instruments.Material and methods: In the first step, we make some guiding plates for specimens of magnesium alloy AZ91 by Rapid Prototyping. The guiding plates are able to be a standard for the degradation of specimen, so that we can use it to make sure the position of specimens in the CT image. We can also simplify the conditions of degradation by the guiding plates.In the next step, we prepare the solution with different pH value. And then we put the specimens into the solution to start the corrosion test. The CT image, surface photographs and weigh are measured on every twelve hours. Results: In the primary results of the test, we make sure that CT image can be a way to quantify the corrosion behavior of magnesium alloy. Moreover we can observe the phenomenon that corrosion always start from some erosion point. It’s possibly based on some defect like dislocations and the voids with high strain energy in the materials. We will deal with the raw data into Mass Loss (ML) and corrosion rate by CT image, surface photographs and weigh in the near future. Having a simple prediction, the pH value and degradation rate will be negatively correlated. And we want to find out the equation of the pH value and corrosion rate. We also have a simple test to simulate the change of the pH value in the local region. In this test the pH value will rise to 10 in a short time. Conclusion: As a biodegradable implant for the area with stagnating body fluid flow in the human body, magnesium alloy can cause the increase of local pH values and release the hydrogen. Those may damage the human cell. The purpose of this study is finding out the equation of the pH value and corrosion rate. After that we will try to find the ways to overcome the limitations of medical magnesium alloy.

Keywords: magnesium alloy, biodegradable materials, corrosion, micro-CT

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2118 The Role of Health Beliefs in Predicting and Explaining Risky Health Behaviours within Cystic Fibrosis

Authors: Rebecca Keyte, Helen Egan, Michail Mantzios

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It is well acknowledged that ongoing adherence is a major concern within CF. However recently literature has indicated that non-adherence should not be viewed just in terms of medical regimens. There are other damaging behaviours that some chronically ill patients engage in which can be viewed as a form of non-adherence, such as risky behaviours. Risky behaviours are a major concern within CF, as they can have adverse health effects on patients regardless of patients adherence to medical regimens. The risky behaviours this research is predominantly focusing on are smoking, excessive alcohol consumption, illicit drug use and risky sexual behaviour. This research investigates patient’s beliefs about their CF and the impact their CF has upon their life, exploring rationales for why some patients engage in risky behaviours. This research utilises qualitative semi-structured interviews taking an interpretive perspective. Twenty-four adult participants have been recruited (16 male, age range 19–66 yrs) from two UK regional CF centres, with a median FEV1 61.77% predicted. Participants were recruited via clinician guidance, with 13 participants identified by clinicians as partaking in risky behaviours. However, during the interviews 17 participants were identified as partaking in risky behaviours, illustrating that not all patients offer full disclosure of engagement in such behaviours to their clinicians. Preliminary findings illustrate a variety of reasons as to why some CF patients engage in risky behaviours, with many participants stating that one challenge in terms of living with CF is accepting their illness. Disclosure of illness was also an issue, the desire to be seen as ‘normal’ was important to many. It is often possible for CF patients to hide their illness as they do not always appear to be unwell. However, literature indicates a desire for normalcy can be accompanied with the engagement of normalised risky behaviours, enabling patients to retaliate against their illness identity. There was also evidence of a life-orientated perspective amongst participants, with some reporting that their desire for fun and enjoyment was the reason for why they were engaging in risky behaviours. Some participants did not acknowledge the impact their risky behaviours could have upon their CF, and others rationalised their continuation with the behaviours by suggesting that they were in fact beneficial to their health. There was an apparent lack of knowledge around the implications of risky behaviours, with participants indicating that they had not been informed of such potential consequences by their clinicians. Given the adverse health effects of risky behaviours within CF, more effective health promotion measures are needed to both reduce and more importantly prevent these behaviours. Due to the initiation of risky behaviours within the CF population commonly occurring during adolescence, the researcher now proposes to conduct semi-structured interviews with paediatric patients to investigate their awareness and beliefs towards risky behaviours. Overall, this research will highlight reasons why some CF patients engage in risky behaviours, in order to inform interventions aimed to prevent the initiation in risky behaviours by increasing patient awareness.

Keywords: cystic fibrosis, health beliefs, preliminary findings, risky health behaviours

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2117 A Randomized, Controlled Trial to Test Habit Formation Theory for Low Intensity Physical Exercise Promotion in Older Adults

Authors: Patrick Louie Robles, Jerry Suls, Ciaran Friel, Mark Butler, Samantha Gordon, Frank Vicari, Joan Duer-Hefele, Karina W. Davidson

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Physical activity guidelines focus on increasing moderate-intensity activity for older adults, but adherence to recommendations remains low. This is despite the fact that scientific evidence finds increasing physical activity is positively associated with health benefits. Behavior change techniques (BCTs) have demonstrated some effectiveness in reducing sedentary behavior and promoting physical activity. This pilot study uses a personalized trials (N-of-1) design, delivered virtually, to evaluate the efficacy of using five BCTs in increasing low-intensity physical activity (by 2,000 steps of walking per day) in adults aged 45-75 years old. The 5 BCTs described in habit formation theory are goal setting, action planning, rehearsal, rehearsal in a consistent context, and self-monitoring. The study recruited health system employees in the target age range who had no mobility restrictions and expressed interest in increasing their daily activity by a minimum of 2,000 steps per day at least five days per week. Participants were sent a Fitbit Charge 4 fitness tracker with an established study account and password. Participants were recommended to wear the Fitbit device 24/7 but were required to wear it for a minimum of ten hours per day. Baseline physical activity was measured by Fitbit for two weeks. Participants then engaged remotely with a clinical research coordinator to establish a “walking plan” that included a time and day interval (e.g., between 7am -8am on Monday-Friday), a location for the walk (e.g., park), and how much time the plan would need to achieve a minimum of 2,000 steps over their baseline average step count (20 minutes). All elements of the walking plan were required to remain consistent throughout the study. In the 10-week intervention phase of the study, participants received all five BCTs in a single, time-sensitive text message. The text message was delivered 30 minutes prior to the established walk time and signaled participants to begin walking when the context (i.e., day of the week, time of day) they pre-selected is encountered. Participants were asked to log both the start and conclusion of their activity session by pressing a button on the Fitbit tracker. Within 30 minutes of the planned conclusion of the activity session, participants received a text message with a link to a secure survey. Here, they noted whether they engaged in the BCTs when prompted and completed an automaticity survey to identify how “automatic” their walking behavior had become. At the end of their trial, participants received a personalized summary of their step data over time, helping them learn more about their responses to the five BCTs. Whether the use of these 5 ‘habit formation’ BCTs in combination elicits a change in physical activity behavior among older adults will be reported. This study will inform the feasibility of a virtually-delivered N-of-1 study design to effectively promote physical activity as a component of healthy aging.

Keywords: aging, exercise, habit, walking

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2116 Design of an Automated Deep Learning Recurrent Neural Networks System Integrated with IoT for Anomaly Detection in Residential Electric Vehicle Charging in Smart Cities

Authors: Wanchalerm Patanacharoenwong, Panaya Sudta, Prachya Bumrungkun

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The paper focuses on the development of a system that combines Internet of Things (IoT) technologies and deep learning algorithms for anomaly detection in residential Electric Vehicle (EV) charging in smart cities. With the increasing number of EVs, ensuring efficient and reliable charging systems has become crucial. The aim of this research is to develop an integrated IoT and deep learning system for detecting anomalies in residential EV charging and enhancing EV load profiling and event detection in smart cities. This approach utilizes IoT devices equipped with infrared cameras to collect thermal images and household EV charging profiles from the database of Thailand utility, subsequently transmitting this data to a cloud database for comprehensive analysis. The methodology includes the use of advanced deep learning techniques such as Recurrent Neural Networks (RNN) and Long Short-Term Memory (LSTM) algorithms. IoT devices equipped with infrared cameras are used to collect thermal images and EV charging profiles. The data is transmitted to a cloud database for comprehensive analysis. The researchers also utilize feature-based Gaussian mixture models for EV load profiling and event detection. Moreover, the research findings demonstrate the effectiveness of the developed system in detecting anomalies and critical profiles in EV charging behavior. The system provides timely alarms to users regarding potential issues and categorizes the severity of detected problems based on a health index for each charging device. The system also outperforms existing models in event detection accuracy. This research contributes to the field by showcasing the potential of integrating IoT and deep learning techniques in managing residential EV charging in smart cities. The system ensures operational safety and efficiency while also promoting sustainable energy management. The data is collected using IoT devices equipped with infrared cameras and is stored in a cloud database for analysis. The collected data is then analyzed using RNN, LSTM, and feature-based Gaussian mixture models. The approach includes both EV load profiling and event detection, utilizing a feature-based Gaussian mixture model. This comprehensive method aids in identifying unique power consumption patterns among EV owners and outperforms existing models in event detection accuracy. In summary, the research concludes that integrating IoT and deep learning techniques can effectively detect anomalies in residential EV charging and enhance EV load profiling and event detection accuracy. The developed system ensures operational safety and efficiency, contributing to sustainable energy management in smart cities.

Keywords: cloud computing framework, recurrent neural networks, long short-term memory, Iot, EV charging, smart grids

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2115 Access the Knowledge, Awareness, and Factors Associated With Hypertension Among the Residents of Modeca District of Tiko, South West Region of Cameroon, in the Middle of a Separatist Violence Since 2017

Authors: Franck Kem Acho

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The trends of diseases have been changed from the last few years, now the burden of non-communicable diseases is increasing day by day. In all the non-communicable diseases, Hypertension is one of the leading causes of premature death and morbidity worldwide. This disease is a silent killer, it mostly affects the people with no obvious symptoms. Not only the heart it also increases the risk of brain, kidney and other diseases, now a days it is a serious medical problem. Over a billion people near about 1 in 4 men and 1 in 5 women having hypertension. In this case study men and women of ages between 30-80 years with Hypertension were identified in community remote area with their Health status being checked and monitored for one week and Health Education was provided for the importance of regular Health checkup alongside the continuous taking of medications.

Keywords: hypertension, health status, health check up, health education

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2114 Transverse Testicular Ectopia: A Case Report with Review of Literature

Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

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Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

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2113 Establishment of a Classifier Model for Early Prediction of Acute Delirium in Adult Intensive Care Unit Using Machine Learning

Authors: Pei Yi Lin

Abstract:

Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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2112 Using the Internet of Things to Deal with Ventilators for Minimizing the Direct Contact with COVID-19 Patients

Authors: Mohammed Al-Shalabi

Abstract:

In recent years, the Internet of Things (IoT) has become an important technology for connecting various smart objects in many applications, especially in health monitoring applications. The IoT technology develops healthcare applications from traditional to personalized ones by making the treatment and monitoring of patients easier. Nowadays, especially during the COVID-19 pandemic, the necessity of enhancing healthcare monitoring applications to avoid the spreading of this pandemic is increased. In this paper, a mechanism is proposed to minimize direct contact with COVID-19 patients who need ventilators by using IoT technology. The proposed mechanism saves medical providers from COVID-19 infection and then minimizes the spreading of this disease.

Keywords: internet of things, healthcare monitoring, COVID-19, ventilators, thingspeak, clouds

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2111 Investigating the Thermal Comfort Properties of Mohair Fabrics

Authors: Adine Gericke, Jiri Militky, Mohanapriya Venkataraman

Abstract:

Mohair, obtained from the Angora goat, is a luxury fiber and recognized as one of the best quality natural fibers. Expansion of the use of mohair into technical and functional textile products necessitates the need for a better understanding of how the use of mohair in fabrics will impact on its thermo-physiological comfort related properties. Despite its popularity, very little information is available on the quantification of the thermal and moisture management properties of mohair fabrics. This study investigated the effect of fibrous matter composition and fabric structural parameters on conductive and convective heat transfers to attain more information on the thermal comfort properties of mohair fabrics. Dry heat transfer through textiles may involve conduction through the fibrous phase, radiation through fabric interstices and convection of air within the structure. Factors that play a major role in heat transfer by conduction are fabric areal density (g/m2) and derived quantities such as cover factor and porosity. Convective heat transfer through fabrics is found in environmental conditions where there is wind-flow or the object is moving (e.g. running or walking). The thermal comfort properties of mohair fibers were objectively evaluated firstly in comparison with other textile fibers and secondly in a variety of fabric structures. Two sample sets were developed for this purpose, with fibre content, yarn structure and fabric design as main variables. SEM and microscopic images were obtained to closely examine the physical structures of the fibers and fabrics. Thermal comfort properties such as thermal resistance and thermal conductivity, as well as fabric thickness, were measured on the well-known Alambeta test instrument. Clothing insulation (clo) was calculated from the above. The thermal properties of fabrics under heat convection was evaluated using a laboratory model device developed at the Technical University of Liberec (referred to as the TP2-instrument). The effects of the different variables on fabric thermal comfort properties were analyzed statistically using TIBCO Statistica Software. The results showed that fabric structural properties, specifically sample thickness, played a significant role in determining the thermal comfort properties of the fabrics tested. It was found that regarding thermal resistance related to conductive heat flow, the effect of fiber type was not always statistically significant, probably as a result of the amount of trapped air within the fabric structure. The very low thermal conductivity of air, compared to that of the fibers, had a significant influence on the total conductivity and thermal resistance of the samples. This was confirmed by the high correlation of these factors with sample thickness. Regarding convective heat flow, the most important factor influencing the ability of the fabric to allow dry heat to move through the structure, was again fabric thickness. However, it would be wrong to totally disregard the effect of fiber composition on the thermal resistance of textile fabrics. In this study, the samples containing mohair or mohair/wool were consistently thicker than the others even though weaving parameters were kept constant. This can be ascribed to the physical properties of the mohair fibers that renders it exceptionally well towards trapping air among fibers (in a yarn) as well as among yarns (inside a fabric structure). The thicker structures trap more air to provide higher thermal insulation, but also prevent the free flow of air that allow thermal convection.

Keywords: mohair fabrics, convective heat transfer, thermal comfort properties, thermal resistance

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2110 Optimism, Skepticism, and Uncertainty: A Qualitative Study on the Knowledge and Perceived Impact of the Affordable Care Act among Adult Patients Seeking Care in a Free Clinic

Authors: Mike Wei, Mario Cedillo, Jiahui Lin, Carol Lorraine Storey-Johnson, Carla Boutin-Foster

Abstract:

Purpose: The extent to which health insurance enrollment succeeds under the Affordable Care Act (ACA) rests heavily on the ability to reach the uninsured and motivate them to enroll. We sought to identify perceptions about the ACA among uninsured patients at a free clinic in New York City. Background: The ACA holds tremendous promise for reducing the number of uninsured Americans. As of April 2014, nearly 8 million people had signed up for health insurance through the Health Insurance Marketplace. Despite this early success, future and continued enrollment rests heavily on the degree of public awareness. Reaching eligible individuals and increasing their awareness and understanding remains a fundamental challenge to realizing the full potential of the ACA. Reaching out to uninsured patients who are seeking care through safety net facilities such as free clinics may provide important avenues for reaching potential enrollees. This project focuses on the experience at the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic (WCCC), and seeks to understand perceptions about the ACA among its patient population. Methods: This was a cross-sectional study of all patients who visited the free clinic at Weill Cornell Medical College, the Weill Cornell Community Clinic, from July 2013 to May 2014. Patients who provided informed consent at their visit and completed a semi-structured questionnaire were included (N=62). The questionnaire comprised of questions about demographic characteristics and open-ended questions about their knowledge and perception of the impact of the ACA. Descriptive statistics were used to characterize the population demographics. Qualitative coding techniques were used for open-ended items. Results: Approximately one third of patients surveyed never had health insurance. Of the remaining 65%, 20% lost their insurance within the past year. Only 55% had heard about the ACA, and only 10% knew about the Health Benefits Exchange. Of those who had heard about the ACA, sentiments were tinged with optimistic misperceptions, such as “it will be free health care for all.” While optimistic, most of the responses focused on the economic implications of the ACA. Conclusions: These findings reveal the immense amount of misconception and lack of understanding with regards to the ACA. As such, the study highlights the need to educate and address the concerns of those who remain skeptical or uncertain about the implications of the ACA.

Keywords: Affordable Care Act, demographics, free clinics, underserved.

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2109 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit

Authors: Gokulan Vethanayakam, Daniel Aston

Abstract:

Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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2108 An Integrated DEMATEL-QFD Model for Medical Supplier Selection

Authors: Mehtap Dursun, Zeynep Şener

Abstract:

Supplier selection is considered as one of the most critical issues encountered by operations and purchasing managers to sharpen the company’s competitive advantage. In this paper, a novel fuzzy multi-criteria group decision making approach integrating quality function deployment (QFD) and decision making trial and evaluation laboratory (DEMATEL) method is proposed for supplier selection. The proposed methodology enables to consider the impacts of inner dependence among supplier assessment criteria. A house of quality (HOQ) which translates purchased product features into supplier assessment criteria is built using the weights obtained by DEMATEL approach to determine the desired levels of supplier assessment criteria. Supplier alternatives are ranked by a distance-based method.

Keywords: DEMATEL, group decision making, QFD, supplier selection

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2107 Discover a New Technique for Cancer Recognition by Analysis and Determination of Fractal Dimension Images in Matlab Software

Authors: Saeedeh Shahbazkhany

Abstract:

Cancer is a terrible disease that, if not diagnosed early, therapy can be difficult while it is easily medicable if it is diagnosed in early stages. So it is very important for cancer diagnosis that medical procedures are performed. In this paper we introduce a new method. In this method, we only need pictures of healthy cells and cancer cells. In fact, where we suspect cancer, we take a picture of cells or tissue in that area, and then take some pictures of the surrounding tissues. Then, fractal dimension of images are calculated and compared. Cancer can be easily detected by comparing the fractal dimension of images. In this method, we use Matlab software.

Keywords: Matlab software, fractal dimension, cancer, surrounding tissues, cells or tissue, new method

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2106 Unified Structured Process for Health Analytics

Authors: Supunmali Ahangama, Danny Chiang Choon Poo

Abstract:

Health analytics (HA) is used in healthcare systems for effective decision-making, management, and planning of healthcare and related activities. However, user resistance, the unique position of medical data content, and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. The success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose an HA process model with features from the rational unified process (RUP) model and agile methodology.

Keywords: agile methodology, health analytics, unified process model, UML

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2105 Educational Diagnosis and Evaluation Processes of Disabled Preschoolers in Turkey: Family Opinions

Authors: Şule Yanık, Hasan Gürgür

Abstract:

It is thought that it is important for disabled children to have the opportunity to benefit preschool education that smoothens transition process to formal education, and for the constitution of a precondition for their success. Within this context, it is important for the disabled in Turkey to be evaluated medically firstly and then educational-wise in order for them to benefit early inclusive education. Thus, disabled people are both diagnosed in hospitals and at Guidance and Research Centers (GRC) attached to Ministry of Education educational-wise. It is seen that standard evaluation tools are used and evaluations are done by special education teachers (SET) in order for educational diagnosis and evaluation (EDAE) to be realized. The literature emphasizes the importance of informal evaluation tools as well as formal ones. According to this, it is thought that another party, besides students in EDAE process and SETs, is family, because families are primary care takers for their children, and that the most correct and real information can be obtained via families beside results of educational evaluation processes (EEP). It is thought that obtaining opinions of families during EEP is important to be able to exhibit the present EDAE activities in Turkey, materialize any existing problems, and increase quality of the process. Within this context, the purpose of this study is to exhibit experiences regarding EDAE processes of 10 families having preschool children with hearing loss (CHL). The process of research is designed to be descriptive based on qualitative research paradigms. Data were collected via semi-structured interview questions, and the themes were obtained. As a result, it is seen that families, after they realize the hearing loss of their children, do not have any information regarding the subject, and that they consult to an ear-nose-throat doctor or an audiologist for support. It is seen that families go to hospitals for medical evaluation which is a pre-requisite for benefiting early education opportunities. However, during this process, as some families do not have any experience of having a CHL, it is seen that they are late for medical evaluation and hearing aids. Moreover, families stated that they were directed to GRC via audiologists for educational evaluation. Families stated that their children were evaluated regarding language, academic and psychological development in proportion with their ages in GRC after they were diagnosed medically. However, families stated that EEP realized in GRC was superficial, short and lacked detail. It is seen that many families were not included in EEP process, whereas some families stated that they were asked questions because their children are too small to answer. Regarding the benefits of EEP for themselves and their children, families stated that GRC had to give a report to them for benefiting the free support of Special Education and Rehabilitation Center, and that families had to be directed to inclusive education. As a result, it is seen that opinions of families regarding EDAE processes at GRC indicate inefficiency of the process as it is short and superficial, regardless being to the point.

Keywords: children with hearing loss, educational diagnosis and evaluation, guidance and research center, inclusion

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2104 Reduction of Speckle Noise in Echocardiographic Images: A Survey

Authors: Fathi Kallel, Saida Khachira, Mohamed Ben Slima, Ahmed Ben Hamida

Abstract:

Speckle noise is a main characteristic of cardiac ultrasound images, it corresponding to grainy appearance that degrades the image quality. For this reason, the ultrasound images are difficult to use automatically in clinical use, then treatments are required for this type of images. Then a filtering procedure of these images is necessary to eliminate the speckle noise and to improve the quality of ultrasound images which will be then segmented to extract the necessary forms that exist. In this paper, we present the importance of the pre-treatment step for segmentation. This work is applied to cardiac ultrasound images. In a first step, a comparative study of speckle filtering method will be presented and then we use a segmentation algorithm to locate and extract cardiac structures.

Keywords: medical image processing, ultrasound images, Speckle noise, image enhancement, speckle filtering, segmentation, snakes

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2103 Case Report: Complex Regional Pain Syndrome

Authors: Farah Al Zaabi, Sarah Amrani

Abstract:

Complex regional pain syndrome (CRPS) is a chronic pain condition that develops in an extremity following a fracture, soft tissue injury, or surgery. It is a neuropathic pain disorder that is accompanied by the characteristic skin manifestations that are needed for the diagnosis. We report the case of a 30 year old male, who has findings consistent with CRPS and has been followed for over two years by multiple specialties within the healthcare system without obtaining a diagnosis. The symptoms he presented with were treated based on the specialty he was seeing, rather than unified and recognized as a single disease process. Our case highlights the complexity of chronic pain, which can sometimes present with skin manifestations, and the importance of involving a pain specialist early for both the medical and physical recovery of CRPS patients.

Keywords: complex regional pain syndrome, chronic pain, skin changes of CRPS, dermatological manifestions of CRPS

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2102 External Program Evaluation: Impacts and Changes on Government-Assisted Refugee Mothers

Authors: Akiko Ohta, Masahiro Minami, Yusra Qadir, Jennifer York

Abstract:

The Home Instruction for Parents of Preschool Youngsters (HIPPY) is a home instruction program for mothers of children 3 to 5 years old. Using role-play as a method of teaching, the participating mothers work with their home visitors and learn how to deliver the HIPPY curriculum to their children. Applying HIPPY, Reviving Hope and Home for High-risk Refugee Mothers Program (RHH) was created to provide more personalized peer support and to respond to ongoing settlement challenges for isolated and vulnerable Government Assisted Refugee (GAR) mothers. GARs often have greater needs and vulnerabilities than other refugee groups. While the support is available, they often face various challenges and barriers in starting their new lives in Canada, such as inadequate housing, low first-language literacy levels, low competency in English or French, and social isolation. The pilot project was operated by Mothers Matter Centre (MMC) from January 2019 to March 2021 in partnership with the Immigrant Services Society of BC (ISSofBC). The formative evaluation was conducted by a research team at Simon Fraser University. In order to provide more suitable support for GAR mothers, RHH intended to offer more flexibility in HIPPY delivery, supported by a home visitor, to meet the need of refugee mothers facing various conditions and challenges; to have a pool of financial resources to be used for the RHH families when necessitated during the program period; to have another designated staff member, called a community navigator, assigned to facilitate the support system for the RHH families in their settlement; to have a portable device available for each RHH mother to navigate settlement support resources; and to provide other variations of the HIPPY curriculum as an option for the RHH mothers, including a curriculum targeting pre-HIPPY age children. Reflections on each program component was collected from RHH mothers and staff members of MMC and ISSofBC, including frontline workers and management staff, through individual interviews and focus group discussions. Each of the RHH program components was analyzed and evaluated by applying Moore’s four domains framework to identify key information and generate new knowledge (data). To capture RHH mothers’ program experience more in depth based on their own reflections, the photovoice method was used. Some photos taken by the mothers will be shared to illustrate their RHH experience as part of their life stories. Over the period of the program, this evaluation observed how RHH mothers became more confident in various domains, such as communicating with others, taking public transportations alone, and teaching their own child(ren). One of the major factors behind the success was their home visitors’ flexibility and creativity to create a more meaningful and tailored approach for each mother, depending on her background and personal situation. The role of the community navigator was tested out and improved during the program period. The community navigators took the key role to assess the needs of the RHH families and connect them with community resources. Both the home visitors and community navigators were immigrant mothers themselves and owing to their dedicated care for the RHH mothers; they were able to gain trust and work closely and efficiently with RHH mothers.

Keywords: refugee mothers, settlement support, program evaluation, Canada

Procedia PDF Downloads 159