Search results for: GMC condition
526 A Rare Case Report of Non-Langerhans Cell Cutaneous Histiocytosis in a 6-Month Old Infant
Authors: Apoorva D. R.
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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.Keywords: histiocytosis, non langerhans cell, case report, fatal, rare
Procedia PDF Downloads 84525 Dependence of Androgen Status in Men with Primary Hypothyroidism on Duration and Condition of Compensation
Authors: Krytskyy T.
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Introduction: The role of androgen deficiency in men as a factor in the pathogenesis of many somatic diseases is unmistakable. The interaction of thyroid and sex hormones with hypothyroidism in men is still the subject of discussions. The purpose of the study is to assess the androgen status of men with primary hypothyroidism, depending on its duration and the state of compensation. Materials and methods: 45 men with primary hypothyroidism aged 35 to 60 years, as well as 25 healthy men, who formed a control group, were under supervision. A selection of men for examination was conducted in the process of outpatient and in-patient treatment at the endocrinology department of the University Hospital in Ternopil. The functional state of the pituitary-gonadal system was evaluated in order to characterize the androgen status of patients. The concentration of follicle stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone was determined in blood with the help of enzyme-linked method. Also, the content of hormones: total testosterone, linking sex hormones globulin were determined. Results: Reduced total testosterone (TT) content was found in 42.2% of patients with hypothyroidism. Herewith in 17.8% of patients, blood TT levels were lower than 8.0 nmol / L, and in 11 (24.4%) men, the rate was in the range of 8.0 to 12.0 nmol / L. Based on the results of the determination of the content of free testosterone (FT), the frequency of laboratory hypogonadism in men with hypothyroidism was higher than the results of the determination of TT. The degree of compensation of hypothyroidism probably did not affect the average levels of gonadotropic and sex hormones. Conclusions: Reduced total testosterone content was found in 42.2% of patients with primary hypothyroidism. Herewith, in 17.8% of patients blood TT levels were lower than 8.0 nmol / L, which is a sign of absolute deficiency of testosterone, and in 24.4% of men the rate ranged from 8.0 to 12.0 nmol / l , indicating partial androgen deficiency. Linking sex hormones globulin levels were believed to be lower in 46.7% of patients with hypothyroidism compared to control group. The average levels of E2 in the examined patients did not significantly differ from the mean of control group. FSH, LH, and prolactin levels in men with hypothyroidism were within the normal age limits and probably did not differ from those of control group. The degree of compensation of hypothyroidism probably did not affect the average levels of gonadotropic and sex hormones. The mean LH content in the blood was significantly increased in men with a duration of hypothyroidism up to 5 years and did not differ from that of the control group and in men with a duration of hypothyroidism over 5 years. In men with hypothyroidism, a probable reduction in T / LH coefficient is found. The obtained data may indicate a combined lesion of the central and peripheral parts of the pituitary-gonadal system in men with hypothyroidism.Keywords: androgenic status, hypothyroidism, testosterone, linking sex hormones globulin
Procedia PDF Downloads 183524 Clinical Outcomes and Symptom Management in Pediatric Patients Following Eczema Action Plans: A Quality Improvement Project
Authors: Karla Lebedoff, Susan Walsh, Michelle Bain
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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema
Procedia PDF Downloads 132523 Decision Support Tool for Water Re-used Systems
Authors: Katarzyna Pawęska, Aleksandra Bawiec, Ewa Burszta-Adamiak, Wiesław Fiałkiewicz
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The water shortage becomes a serious problem not only in African and Middle Eastern countries, but also recently in the European Union. Scarcity of water means that not all agricultural, industrial and municipal needs will be met. When the annual availability of renewable freshwater per capita is less than 1,700 cubic meters, countries begin to experience periodic or regular water shortages. The phenomenon of water stress is the result of an imbalance between the constantly growing demand for water and its availability. The constant development of industry, population growth, and climate changes make the situation even worse. The search for alternative water sources and independent supplies is becoming a priority for many countries. Data enabling the assessment of country’s condition regarding water resources, water consumption, water price, wastewater volume, forecasted climate changes e.g. temperature, precipitation, are scattered and their interpretation by common entrepreneurs may be difficult. For this purpose, a digital tool has been developed to support decisions related to the implementation of water and wastewater re-use systems, as a result of an international research project “Framework for organizational decision-making process in water reuse for smart cities” (SMART-WaterDomain) funded under the EIG-CONCERT Japan call on Smart Water Management for Sustainable Society. The developed geo-visualization tool graphically presents, among others, data about the capacity of wastewater treatment plants and the volume of water demand in the private and public sectors for Poland, Germany, and the Czech Republic. It is expected that such a platform, extended with economical water management data and climate forecasts (temperature, precipitation), will allow in the future independent investigation and assessment of water use rate and wastewater production on the local and regional scale. The tool is a great opportunity for small business owners, entrepreneurs, farmers, local authorities, and common users to analyze the impact of climate change on the availability of water in the regions of their business activities. Acknowledgments: The authors acknowledge the support of the Project Organisational Decision Making in Water Reuse for Smart Cities (SMART- WaterDomain), funded by The National Centre for Research and Development and supported by the EIG-Concert Japan.Keywords: circular economy, digital tool, geo-visualization, wastewater re-use
Procedia PDF Downloads 52522 Socio-Emotional Skills of Children with Learning Disability, Their Perceived Self-Efficacy and Academic Achievement
Authors: P. Maheshwari, M. Brindavan
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The present research aimed to study the level of socio-emotional skills and perceived self-efficacy of children with learning disability. The study further investigated the relationship between the levels of socio-emotional skills, perceived self-efficacy and academic achievement of children with learning disability. The sample comprised of 40 children with learning disability as their primary condition, belonging to middle or upper middle class, living with both the parents, residing in Mumbai. Purposive or Judgmental and snowball sampling technique was used to select the sample for the study. Proformas in the form of questionnaires were used to obtain the background information of the children with learning disability. A self-constructed Child’s Perceived Self-Efficacy Assessment Scale and Child’s Social and Emotional Skills Assessment Scale was used to measure the level of child’s perceived self-efficacy and their level of social and emotional skill respectively. Academic scores of the child were collected from the child’s parents or teachers and were converted into a percentage. The data was analyzed quantitatively using SPSS. Spearman rho or Pearson Product Moment correlation was used to ascertain the multiple relationships between child’s perceived self-efficacy, child’s social and emotional skills and child’s academic achievement. The findings revealed majority (27) of the children with learning disability perceived themselves having above average level of social and emotional skills while 13 out of 40 perceived their level of social and emotional skills at an average level. Domain wise analyses revealed that, in the domain of self- management (26) and relationship skills (22) more number of the children perceived themselves as having average or below average level of social and emotional skills indicating that they perceived themselves as having average or below average skills in regulating their emotions, thoughts, and behaviors effectively in different situations, establishing and maintaining healthy and rewarding relationships with diverse groups and individuals. With regard to perceived self-efficacy, the majority of the children with learning disability perceived themselves as having above average level of self-efficacy. Looking at the data domain wise it was found that, in the domains of self-regulated learning and emotional self-efficacy, 50% of the children perceived themselves at average or below average level, indicating that they perceived themselves as average on competencies like organizing academic activities, structuring environment to make it conducive for learning, expressing emotions in a socially acceptable manner. Further, the correlations were computed, and significant positive correlations were found between children’s social and emotional skills and academic achievement (r=.378, p < .01), and between children’s social and emotional skills and child’s perceived self-efficacy (r = .724, p < .01) and a positive significant correlation was also found between children’s perceived self-efficacy and academic achievement (r=.332, p < .05). Results of the study emphasize on planning intervention for children with learning disability focusing on improving self-management and relationship skills, self-regulated learning and emotional self-efficacy.Keywords: learning disability, social and emotional skills, perceived self-efficacy, academic achievement
Procedia PDF Downloads 238521 Fahr Dsease vs Fahr Syndrome in the Field of a Case Report
Authors: Angelis P. Barlampas
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Objective: The confusion of terms is a common practice in many situations of the everyday life. But, in some circumstances, such as in medicine, the precise meaning of a word curries a critical role for the health of the patient. Fahr disease and Fahr syndrome are often falsely used interchangeably, but they are two different conditions with different physical histories of different etiology and different medical management. A case of the seldom Fahr disease is presented, and a comparison with the more common Fahr syndrome follows. Materials and method: A 72 years old patient came to the emergency department, complaining of some kind of non specific medal disturbances, like anxiety, difficulty of concentrating, and tremor. The problems had a long course, but he had the impression of getting worse lately, so he decided to check them. Past history and laboratory tests were unremarkable. Then, a computed tomography examination was ordered. Results: The CT exam showed bilateral, hyperattenuating areas of heavy, dense calcium type deposits in basal ganglia, striatum, pallidum, thalami, the dentate nucleus, and the cerebral white matter of frontal, parietal and iniac lobes, as well as small areas of the pons. Taking into account the absence of any known preexisting illness and the fact that the emergency laboratory tests were without findings, a hypothesis of the rare Fahr disease was supposed. The suspicion was confirmed with further, more specific tests, which showed the lack of any other conditions which could probably share the same radiological image. Differentiating between Fahr disease and Fahr syndrome. Fahr disease: Primarily autosomal dominant Symmetrical and bilateral intracranial calcifications The patient is healthy until the middle age Absence of biochemical abnormalities. Family history consistent with autosomal dominant Fahr syndrome :Earlier between 30 to 40 years old. Symmetrical and bilateral intracranial calcifications Endocrinopathies: Idiopathic hypoparathyroidism, secondary hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism ,pseudopseudohypoparathyroidism, e.t.c The disease appears at any age There are abnormal laboratory or imaging findings. Conclusion: Fahr disease and Fahr syndrome are not the same illness, although this is not well known to the inexperienced doctors. As clinical radiologists, we have to inform our colleagues that a radiological image, along with the patient's history, probably implies a rare condition and not something more usual and prompt the investigation to the right route. In our case, a genetic test could be done earlier and reveal the problem, and thus avoiding unnecessary and specific tests which cost in time and are uncomfortable to the patient.Keywords: fahr disease, fahr syndrome, CT, brain calcifications
Procedia PDF Downloads 57520 Effect of Laser Ablation OTR Films on the Storability of Endive and Pak Choi by Baby Vegetables in Modified Atmosphere Condition
Authors: In-Lee Choi, Min Jae Jeong, Jun Pill Baek, Ho-Min Kang
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As the consumption trends of vegetables become different from the past, it is increased using vegetable more convenience such as fresh-cut vegetables, sprouts, baby vegetables rather than an existing hole piece of vegetables. Selected baby vegetables have various functional materials but they have short shelf life. This study was conducted to improve storability by using suitable laser ablation OTR (oxygen transmission rate) films. Baby vegetable of endive (Cichorium endivia L.) and pak choi (Brassica rapa chinensis) for this research, around 10 cm height, cultivated in glass greenhouse during 3 weeks. Harvested endive and pak choi were stored at 8 ℃ for 5 days and were packed by PP (Polypropylene) container and covered different types of laser ablation OTR film (DaeRyung Co., Ltd.) such as 1,300 cc, 10,000 cc, 20,000 cc, 40,000 cc /m2•day•atm, and control (perforated film) with heat sealing machine (SC200-IP, Kumkang, Korea). All the samples conducted 5 times replication. Statistical analysis was carried out using a Microsoft Excel 2010 program and results were expressed as standard deviations. The fresh weight loss rate of both baby vegetables were less than 0.3 % in treated films as maximum weight loss rate. On the other hands, control in the final storage day had around 3.0 % weight loss rate and it followed decreasing quantity. Endive had less 2.0 % carbon dioxide contents as maximum contents in 20,000 cc and 40,000 cc. Oxygen contents was maintained between 17 and 20 % in endive, 19 and 20 % in pak choi. Ethylene concentration of both vegetables maintained little lower contents in 20,000 cc treatments than others at final storage day without statistical significance. In the case of hardness, 40,000 cc film was shown little higher value at both baby vegetables without statistical significance. Visual quality was good at 10,000 cc and 20,000 cc in endive and pak choi, and off-flavor was not appeard any off-flavor in both vegetables. Chlorophyll (SPAD-502, Minolta, Japan) value of endive was shown as similar result with initial in all treatments except 20,000 cc as little lower. And chlorophyll value of pak choi decreased in all treatments compared with initial value but was not shown significantly difference each other. Color of leaves (CR-400, Minolta, Japan) changed significantly in 40,000 cc at endive. In an event of pak choi, all the treatments started yellowing by increasing hunter b value, among them control increased substantially. As above the result, 10,000 cc film was most reasonable packaging film for storing at endive and 20,000 cc at pak choi with good quality.Keywords: carbon dioxide, shelf-life, visual quality, pak choi
Procedia PDF Downloads 785519 Enhancing Fault Detection in Rotating Machinery Using Wiener-CNN Method
Authors: Mohamad R. Moshtagh, Ahmad Bagheri
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Accurate fault detection in rotating machinery is of utmost importance to ensure optimal performance and prevent costly downtime in industrial applications. This study presents a robust fault detection system based on vibration data collected from rotating gears under various operating conditions. The considered scenarios include: (1) both gears being healthy, (2) one healthy gear and one faulty gear, and (3) introducing an imbalanced condition to a healthy gear. Vibration data was acquired using a Hentek 1008 device and stored in a CSV file. Python code implemented in the Spider environment was used for data preprocessing and analysis. Winner features were extracted using the Wiener feature selection method. These features were then employed in multiple machine learning algorithms, including Convolutional Neural Networks (CNN), Multilayer Perceptron (MLP), K-Nearest Neighbors (KNN), and Random Forest, to evaluate their performance in detecting and classifying faults in both the training and validation datasets. The comparative analysis of the methods revealed the superior performance of the Wiener-CNN approach. The Wiener-CNN method achieved a remarkable accuracy of 100% for both the two-class (healthy gear and faulty gear) and three-class (healthy gear, faulty gear, and imbalanced) scenarios in the training and validation datasets. In contrast, the other methods exhibited varying levels of accuracy. The Wiener-MLP method attained 100% accuracy for the two-class training dataset and 100% for the validation dataset. For the three-class scenario, the Wiener-MLP method demonstrated 100% accuracy in the training dataset and 95.3% accuracy in the validation dataset. The Wiener-KNN method yielded 96.3% accuracy for the two-class training dataset and 94.5% for the validation dataset. In the three-class scenario, it achieved 85.3% accuracy in the training dataset and 77.2% in the validation dataset. The Wiener-Random Forest method achieved 100% accuracy for the two-class training dataset and 85% for the validation dataset, while in the three-class training dataset, it attained 100% accuracy and 90.8% accuracy for the validation dataset. The exceptional accuracy demonstrated by the Wiener-CNN method underscores its effectiveness in accurately identifying and classifying fault conditions in rotating machinery. The proposed fault detection system utilizes vibration data analysis and advanced machine learning techniques to improve operational reliability and productivity. By adopting the Wiener-CNN method, industrial systems can benefit from enhanced fault detection capabilities, facilitating proactive maintenance and reducing equipment downtime.Keywords: fault detection, gearbox, machine learning, wiener method
Procedia PDF Downloads 73518 Effects of Forest Therapy on Depression among Healthy Adults
Authors: Insook Lee, Heeseung Choi, Kyung-Sook Bang, Sungjae Kim, Minkyung Song, Buhyun Lee
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Backgrounds: A clearer and comprehensive understanding of the effects of forest therapy on depression is needed for further refinements of forest therapy programs. The purpose of this study was to review the literature on forest therapy programs designed to decrease the level of depression among adults to evaluate current forest therapy programs. Methods: This literature review was conducted using various databases including PubMed, EMBASE, CINAHL, PsycArticle, KISS, RISS, and DBpia to identify relevant studies published up to January 2016. The two authors independently screened the full text articles using the following criteria: 1) intervention studies assessing the effects of forest therapy on depression among healthy adults ages 18 and over; 2) including at least one control group or condition; 3) being peer-reviewed; and 4) being published either in English. The Scottish Intercollegiate Guideline Network (SIGN) measurement tool was used to assess the risk of bias in each trial. Results: After screening current literature, a total of 14 articles (English: 6, Korean: 8) were included in the present review. None of the studies used randomized controlled (RCT) study design and the sample size ranged from 11 to 300. Walking in the forest and experiencing the forest using the five senses was the key component of the forest therapy that was included in all studies. The majority of studies used one-time intervention that usually lasted a few hours or half-day. The most widely used measure for depression was Profile of Mood States (POMS). Most studies used self-reported, paper-and-pencil tests, and only 5 studies used both paper-and-pencil tests and physiological measures. Regarding the quality assessment based on the SIGN criteria, only 3 articles were rated ‘acceptable’ and the rest of the 14 articles were rated ‘low quality.’ Regardless of the diversity in format and contents of forest therapies, most studies showed a significant effect of forest therapy in curing depression. Discussions: This systematic review showed that forest therapy is one of the emerging and effective intervention approaches for decreasing the level of depression among adults. Limitations of the current programs identified from the review were as follows; 1) small sample size; 2) a lack of objective and comprehensive measures for depression; and 3) inadequate information about research process. Futures studies assessing the long-term effect of forest therapy on depression using rigorous study designs are needed.Keywords: forest therapy, systematic review, depression, adult
Procedia PDF Downloads 287517 Challenges to Ensure Food Safety through Sanitation and Hygiene Coverage in Bangladesh
Authors: Moshiur Rahman, Tahmida Jakia
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Bangladesh, a densely populated South Asian country is home to more than 160 million people. In two decades ago, the people of this developing nation drank heavily contaminated surface water. Over the past thirty years, the country, and its development partners, has undertaken extensive efforts to provide microbiologically safe groundwater based drinking water through the use of tube-wells. About 85% of the people now drink tube-well water from about 11 million tube-wells/hand pumps. However, diarrhoeal and other water-related diseases are still reported among the major causes of morbidity and mortality among Bangladeshi children. This implies that the mode of transmission of pathogens through water and/or other modes continue. In addition, massive scale arsenic contamination has been recently reported in the ground water. Thirty five million people may be at risk of consuming arsenic contaminated water exceeding 0.05 mg/l in Bangladesh. Drinking of arsenic contaminated water has been linked with skin problems, cancer, cardiovascular diseases, neurological diseases, eye problems, cancer of the internal organs, and other diseases. In the study area, Narail district, recent investigations about existing water quality situations indicated presence of low to high levels of arsenic, salinity, iron, manganese and bacteriological contamination risks. As challenges for safe water exist; it is likely that sanitation and food hygiene practices are poor which lead threat to ensure food security.The main attempt of this study is to find out the challenges to ensure food security andprovide probable solutions to ensure food safety towards 0.7 million of people in study area. A survey has been conducted at Lohagara and Kalia sub district of Narail district with a pretested questionnaire. Primary data are collected through a questionnaire, while secondary data are collected from pertinent offices as well as academic journals. FGD has also been done to know the knowledge regarding water, sanitation as well as food preparation and consumption practice of community people in study area. The major focus of this study is to assess the state of sanitation and food hygiene condition of rural people. It is found that most of the villagers have lack of knowledge about food safety. Open defecation rate is high which lead threat to ensure food security.Keywords: food safety, challenges, hygiene, Bangladesh
Procedia PDF Downloads 319516 Transformation of Periodic Fuzzy Membership Function to Discrete Polygon on Circular Polar Coordinates
Authors: Takashi Mitsuishi
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Fuzzy logic has gained acceptance in the recent years in the fields of social sciences and humanities such as psychology and linguistics because it can manage the fuzziness of words and human subjectivity in a logical manner. However, the major field of application of the fuzzy logic is control engineering as it is a part of the set theory and mathematical logic. Mamdani method, which is the most popular technique for approximate reasoning in the field of fuzzy control, is one of the ways to numerically represent the control afforded by human language and sensitivity and has been applied in various practical control plants. Fuzzy logic has been gradually developing as an artificial intelligence in different applications such as neural networks, expert systems, and operations research. The objects of inference vary for different application fields. Some of these include time, angle, color, symptom and medical condition whose fuzzy membership function is a periodic function. In the defuzzification stage, the domain of the membership function should be unique to obtain uniqueness its defuzzified value. However, if the domain of the periodic membership function is determined as unique, an unintuitive defuzzified value may be obtained as the inference result using the center of gravity method. Therefore, the authors propose a method of circular-polar-coordinates transformation and defuzzification of the periodic membership functions in this study. The transformation to circular polar coordinates simplifies the domain of the periodic membership function. Defuzzified value in circular polar coordinates is an argument. Furthermore, it is required that the argument is calculated from a closed plane figure which is a periodic membership function on the circular polar coordinates. If the closed plane figure is continuous with the continuity of the membership function, a significant amount of computation is required. Therefore, to simplify the practice example and significantly reduce the computational complexity, we have discretized the continuous interval and the membership function in this study. In this study, the following three methods are proposed to decide the argument from the discrete polygon which the continuous plane figure is transformed into. The first method provides an argument of a straight line passing through the origin and through the coordinate of the arithmetic mean of each coordinate of the polygon (physical center of gravity). The second one provides an argument of a straight line passing through the origin and the coordinate of the geometric center of gravity of the polygon. The third one provides an argument of a straight line passing through the origin bisecting the perimeter of the polygon (or the closed continuous plane figure).Keywords: defuzzification, fuzzy membership function, periodic function, polar coordinates transformation
Procedia PDF Downloads 357515 The Application of Animal Welfare Certification System for Farm Animal in South Korea
Authors: Ahlyum Mun, Ji-Young Moon, Moon-Seok Yoon, Dong-Jin Baek, Doo-Seok Seo, Oun-Kyong Moon
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There is a growing public concern over the standards of farm animal welfare, with higher standards of food safety. In addition, the recent low incidence of Avian Influenza in laying hens among certificated farms is receiving attention. In this study, we introduce animal welfare systems covering the rearing, transport and slaughter of farm animals in South Korea. The concepts of animal welfare farm certification are based on ensuring the five freedoms of animal. The animal welfare is also achieved by observing the condition of environment including shelter and resting area, feeding and water and the care for the animal health. The certification of farm animal welfare is handled by the Animal Protection & Welfare Division of Animal and Plant Quarantine Agency (APQA). Following the full amendment of Animal Protection Law in 2011, animal welfare farm certification program has been implemented since 2012. The certification system has expanded to cover laying hen, swine, broiler, beef cattle and dairy cow, goat and duck farms. Livestock farmers who want to be certified must apply for certification at the APQA. Upon receipt of the application, the APQA notifies the applicant of the detailed schedule of the on-site examination after reviewing the document and conducts the on-site inspection according to the evaluation criteria of the welfare standard. If the on-site audit results meet the certification criteria, APQA issues a certificate. The production process of certified farms is inspected at least once a year for follow-up management. As of 2017, a total of 145 farms have been certified (95 laying hen farms, 12 swine farms, 30 broiler farms and 8 dairy cow farms). In addition, animal welfare transportation vehicles and slaughterhouses have been designated since 2013 and currently 6 slaughterhouses have been certified. Animal Protection Law has been amended so that animal welfare certification marks can be affixed only to livestock products produced by animal welfare farms, transported through animal welfare vehicles and slaughtered at animal welfare slaughterhouses. The whole process including rearing–transportation- slaughtering completes the farm animal welfare system. APQA established its second 5-year animal welfare plan (2014-2019) that includes setting a minimum standard of animal welfare applicable to all livestock farms, transportation vehicles and slaughterhouses. In accordance with this plan, we will promote the farm animal welfare policy in order to truly advance the Korean livestock industry.Keywords: animal welfare, farm animal, certification system, South Korea
Procedia PDF Downloads 389514 Influence of Marital Status on Nutritional, Physical, Mental, and Social Health: A Study on Women in Faisalabad, Pakistan
Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq
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Unmarried women over thirty years of age as a health issue is a relatively young phenomenon, but it is rapidly growing in Pakistan; therefore, it is a public health issue. The challenges affecting nutrition and public health are some of the indispensable components that need to be met to achieve sustainable development goals (SDGs). This research intends to explain these goals in the context of nutrition and public health, especially analyzing the issues related to unmarried women above the age of thirty in Faisalabad, Pakistan. Still, this research is not feasible in Pakistan. In Pakistan alone, 10 million women over the age of 35 are unmarried, based on a recent United Nations report. The United Nations, in cooperation with the World Health Organization, has identified health as a state of being healthy, free from illness or disease, and not just a condition where there are no diseases or bodily disabilities. The current generation of women is unmarried and living a life under constant pressure from society to deliver changes like the diet these women take, and hence, their nutritional status defines their comprehensive health triangle, a mix of physical, mental, and social well-being. The research was carried out under the qualitative research paradigm, specifically through interviews with the participants who were unmarried women and married women above the age of thirty. This qualitative study explores how marriage affects the intake of nutrients, nutritional health, psychological and social well-being and their effects. The realization of well-being consisted of factors like physical health, mental and emotional health, pressure from society, social health, economic independence, and decision-making power to reveal the impact of singleness on well-being. The findings disclosed that marital status had a notable impact on the diet habits and nutritional behaviors of women in Faisalabad. Also, it was found that single women suffer from more stress and are not as positive as married women because they are lonely, as their husbands are absent from their lives. The findings established that nutritional understanding is differentially affected by marital status as a determinant of the health triangle consisting of physical, mental, and social health. Awareness of these factors is significant in designing specific goal-directed interventions that can enhance the nutritional well-being and general health status of unmarried women in Faisalabad. Hence, this study underscores the necessity of maintaining supportive environments and increasing the regard concerning the health state of single ladies beyond thirty.Keywords: health triangle, over thirty, singleness, age barriers, unmarried women, women’s health, well-being
Procedia PDF Downloads 18513 Case Study on the Effects of Early Mobilization in the Post-Surgical Recovery of Athletes with Open Triangular Fibrocartilage Complex Repair
Authors: Blair Arthur Agero Jr., Lucia Garcia Heras
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The triangular fibrocartilage complex (TFCC) is one of the crucial stabilizing ligaments of the wrist. The TFCC is also subject to excessive stress amongst performance athletes and enthusiasts. The excessive loading of the TFCC may lead to a partial or complete rupture that requires surgery. The recovery from an open TFCC surgical repair may take several months. Immobilization of the repaired wrist for a given period is part of all the current protocols in the post-surgical treatment. The immobilization to prevent the rotation of the forearm can last from six weeks to eight weeks with the wrist held in a neutral position. In all protocols reviewed, the pronosupination is only initiated between the 6th week and 8th week or even later after the cast is removed. The prolonged immobilization can cause stiffness of the wrist and hand. Furthermore, the entire period of post-surgical hand therapy has its economic impact, especially for performing athletes. However, delayed mobilization, specifically rotation of the wrist, is necessary to allow ligament healing. This study aims to report the effects of early mobilization of the wrist in athletes who had an open surgical repair of the TFCC. The surgery was done by the co-author, and the hand therapy was implemented by the main author. The cases documented spans from 2014 to 2019 and were all performed in Dubai, United Arab Emirates. All selected participants in this case study were provided with a follow-up questionnaire to ascertain their current condition since their surgery. The respondents reported high satisfaction in the results of their treatment and have verified zero re-rupture of their TFCC despite mobilizing and rotating the wrist at the third-week post-surgery during their hand therapy. There is also a negligible number of respondents who reported a limitation in their ranges of pronosupination. This case study suggests that early mobilization of the wrist after an open TFCC surgical repair can be more beneficial to the patient as opposed to the traditional treatment of prolonged immobilization. However, it should be considered that the patients selected in this case study are professional performance athletes and advanced fitness enthusiasts. Athletes are known to withstand vigorous physical stress in their training that may correlate to their ability to better cope with the progressive stress that was implemented during their hand therapy. Nevertheless, this approach has its merits, and application of it may be adjusted for patients with a similar injury and surgical procedure.Keywords: hand therapy, performance athlete, TFCC repair, wrist ligament
Procedia PDF Downloads 146512 Peers' Alterity in Inverted Inclusion: A Case Study
Authors: Johanna Sagner, María José Sandoval
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At the early stages of adolescence, young people, regardless of a disability or not, start to establish closer friendship ties. Unlike previous developmental phases, these ties are rather reciprocal, more committed, and require more time. Friendship ties during adolescence allow the development of social and personal skills, specifically the skills to start constructing identity. In an inclusive context that incorporates young people with a disability, friendship among peers also takes place. Nonetheless, the relation is shaped, among others, by the alterity construction about the other with disability. Research about peers’ relation between young people with and without disability in an inclusive context has shown that the relation tends to become a helper-helpee relation, where those with a disability are seen as people in need. Prejudices about the others’ condition or distancing from the other because of his/hers disability are common. In this sense, the helper-helpee relation, as a non-reciprocal and protective relation, will not promote friendship between classmates, but a rather asymmetric alterity. Our research is an explorative case study that wants to know how the relation between peers is shaped within a different inclusive program, were also the integrated group has special educational needs. Therefore, we analyze from a qualitative and quantitative approach the data of an inverted inclusive program. This is a unique case of a special public school for visual disability in Germany that includes young people from a mainstream school who had learning difficulties. For the research, we analyze data from interviews, focal interviews and open-ended questions with an interpretative phenomenological analysis approach. The questionnaires include a five point Likert scale, for which we calculate the acceptance rate. The findings show that the alterity relation between pupils is less asymmetrical and represents a rather horizontal alterity. The helper-helpee relation is marked by exchange, since both groups have special educational needs and therefore, those with visual disability and those with learning difficulties help each other indistinctly. Friendship is more present among classmates. The horizontal alterity peers’ relation is influenced by a sort of tie, where none of the groups need more or less help than other groups. Both groups identify that they themselves and the other have special needs. The axiological axe of alterity is not of superiority or inferiority, recognizing each other’s differences and otherness. Another influential factor relates with the amount of time they spend together, since the program does not have a resource room or a teacher who teaches parallel lessons. Two probable causes for that rather equal peer relation might be the constellation of fewer pupils per classroom and the differentiated lessons taught by teachers with a special educational formation.Keywords: alterity, disability, inverted inclusion, peers’ relation
Procedia PDF Downloads 307511 Long Term Survival after a First Transient Ischemic Attack in England: A Case-Control Study
Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski
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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model
Procedia PDF Downloads 140510 Sequential Padding: A Method to Improve the Impact Resistance in Body Armor Materials
Authors: Ankita Srivastava, Bhupendra S. Butola, Abhijit Majumdar
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Application of shear thickening fluid (STF) has been proved to increase the impact resistance performance of the textile structures to further use it as a body armor material. In the present research, STF was applied on Kevlar woven fabric to make the structure lightweight and flexible while improving its impact resistance performance. It was observed that getting a fair amount of add-on of STF on Kevlar fabric is difficult as Kevlar fabric comes with a pre-coating of PTFE which hinders its absorbency. Hence, a method termed as sequential padding is developed in the present study to improve the add-on of STF on Kevlar fabric. Contrary to the conventional process, where Kevlar fabric is treated with STF once using any one pressure, in sequential padding method, the Kevlar fabrics were treated twice in a sequential manner using combination of two pressures together in a sample. 200 GSM Kevlar fabrics were used in the present study. STF was prepared by adding PEG with 70% (w/w) nano-silica concentration. Ethanol was added with the STF at a fixed ratio to reduce viscosity. A high-speed homogenizer was used to make the dispersion. Total nine STF treated Kevlar fabric samples were prepared by using varying combinations and sequences of three levels of padding pressure {0.5, 1.0 and 2.0 bar). The fabrics were dried at 80°C for 40 minutes in a hot air oven to evaporate ethanol. Untreated and STF treated fabrics were tested for add-on%. Impact resistance performance of samples was also tested on dynamic impact tester at a fixed velocity of 6 m/s. Further, to observe the impact resistance performance in actual condition, low velocity ballistic test with 165 m/s velocity was also performed to confirm the results of impact resistance test. It was observed that both add-on% and impact energy absorption of Kevlar fabrics increases significantly with sequential padding process as compared to untreated as well as single stage padding process. It was also determined that impact energy absorption is significantly better in STF treated Kevlar fabrics when 1st padding pressure is higher, and 2nd padding pressure is lower. It is also observed that impact energy absorption of sequentially padded Kevlar fabric shows almost 125% increase in ballistic impact energy absorption (40.62 J) as compared to untreated fabric (18.07 J).The results are owing to the fact that the treatment of fabrics at high pressure during the first padding is responsible for uniform distribution of STF within the fabric structures. While padding with second lower pressure ensures the high add-on of STF for over-all improvement in the impact resistance performance of the fabric. Therefore, it is concluded that sequential padding process may help to improve the impact performance of body armor materials based on STF treated Kevlar fabrics.Keywords: body armor, impact resistance, Kevlar, shear thickening fluid
Procedia PDF Downloads 234509 Staying When Everybody Else Is Leaving: Coping with High Out-Migration in Rural Areas of Serbia
Authors: Anne Allmrodt
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Regions of South-East Europe are characterised by high out-migration for decades. The reasons for leaving range from the hope of a better work situation to a better health care system and beyond. In Serbia, this high out-migration hits the rural areas in particular so that the population number is in the red repeatedly. It might not be hard to guess that this negative population growth has the potential to create different challenges for those who stay in rural areas. So how are they coping with the – statistically proven – high out-migration? Having this in mind, the study is investigating the people‘s individual awareness of the social phenomenon high out-migration and their daily life strategies in rural areas. Furthermore, the study seeks to find out the people’s resilient skills in that context. Is the condition of high out-migration conducive for resilience? The methodology combines a quantitative and a qualitative approach (mixed methods). For the quantitative part, a standardised questionnaire has been developed, including a multiple choice section and a choice experiment. The questionnaire was handed out to people living in rural areas of Serbia only (n = 100). The sheet included questions about people’s awareness of high out-migration, their own daily life strategies or challenges and their social network situation (data about the social network was necessary here since it is supposed to be an influencing variable for resilience). Furthermore, test persons were asked to make different choices of coping with high out-migration in a self-designed choice experiment. Additionally, the study included qualitative interviews asking citizens from rural areas of Serbia. The topics asked during the interview focused on their awareness of high out-migration, their daily life strategies, and challenges as well as their social network situation. Results have shown the following major findings. The awareness of high out-migration is not the same with all test persons. Some declare it as something positive for their own life, others as negative or not effecting at all. The way of coping generally depended – maybe not surprising – on the people’s social network. However – and this might be the most important finding - not everybody with a certain number of contacts had better coping strategies and was, therefore, more resilient. Here the results show that especially people with high affiliation and proximity inside their network were able to cope better and shew higher resilience skills. The study took one step forward in terms of knowledge about societal resilience as well as coping strategies of societies in rural areas. It has shown part of the other side of nowadays migration‘s coin and gives a hint for a more sustainable rural development and community empowerment.Keywords: coping, out-migration, resilience, rural development, social networks, south-east Europe
Procedia PDF Downloads 123508 Control for Fluid Flow Behaviours of Viscous Fluids and Heat Transfer in Mini-Channel: A Case Study Using Numerical Simulation Method
Authors: Emmanuel Ophel Gilbert, Williams Speret
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The control for fluid flow behaviours of viscous fluids and heat transfer occurrences within heated mini-channel is considered. Heat transfer and flow characteristics of different viscous liquids, such as engine oil, automatic transmission fluid, one-half ethylene glycol, and deionized water were numerically analyzed. Some mathematical applications such as Fourier series and Laplace Z-Transforms were employed to ascertain the behaviour-wave like structure of these each viscous fluids. The steady, laminar flow and heat transfer equations are reckoned by the aid of numerical simulation technique. Further, this numerical simulation technique is endorsed by using the accessible practical values in comparison with the anticipated local thermal resistances. However, the roughness of this mini-channel that is one of the physical limitations was also predicted in this study. This affects the frictional factor. When an additive such as tetracycline was introduced in the fluid, the heat input was lowered, and this caused pro rata effect on the minor and major frictional losses, mostly at a very minute Reynolds number circa 60-80. At this ascertained lower value of Reynolds numbers, there exists decrease in the viscosity and minute frictional losses as a result of the temperature of these viscous liquids been increased. It is inferred that the three equations and models are identified which supported the numerical simulation via interpolation and integration of the variables extended to the walls of the mini-channel, yields the utmost reliance for engineering and technology calculations for turbulence impacting jets in the near imminent age. Out of reasoning with a true equation that could support this control for the fluid flow, Navier-stokes equations were found to tangential to this finding. Though, other physical factors with respect to these Navier-stokes equations are required to be checkmated to avoid uncertain turbulence of the fluid flow. This paradox is resolved within the framework of continuum mechanics using the classical slip condition and an iteration scheme via numerical simulation method that takes into account certain terms in the full Navier-Stokes equations. However, this resulted in dropping out in the approximation of certain assumptions. Concrete questions raised in the main body of the work are sightseen further in the appendices.Keywords: frictional losses, heat transfer, laminar flow, mini-channel, number simulation, Reynolds number, turbulence, viscous fluids
Procedia PDF Downloads 168507 Economic Impact of Drought on Agricultural Society: Evidence Based on a Village Study in Maharashtra, India
Authors: Harshan Tee Pee
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Climate elements include surface temperatures, rainfall patterns, humidity, type and amount of cloudiness, air pressure and wind speed and direction. Change in one element can have an impact on the regional climate. The scientific predictions indicate that global climate change will increase the number of extreme events, leading to more frequent natural hazards. Global warming is likely to intensify the risk of drought in certain parts and also leading to increased rainfall in some other parts. Drought is a slow advancing disaster and creeping phenomenon– which accumulate slowly over a long period of time. Droughts are naturally linked with aridity. But droughts occur over most parts of the world (both wet and humid regions) and create severe impacts on agriculture, basic household welfare and ecosystems. Drought condition occurs at least every three years in India. India is one among the most vulnerable drought prone countries in the world. The economic impacts resulting from extreme environmental events and disasters are huge as a result of disruption in many economic activities. The focus of this paper is to develop a comprehensive understanding about the distributional impacts of disaster, especially impact of drought on agricultural production and income through a panel study (drought year and one year after the drought) in Raikhel village, Maharashtra, India. The major findings of the study indicate that cultivating area as well as the number of cultivating households reduced after the drought, indicating a shift in the livelihood- households moved from agriculture to non-agriculture. Decline in the gross cropped area and production of various crops depended on the negative income from these crops in the previous agriculture season. All the landholding categories of households except landlords had negative income in the drought year and also the income disparities between the households were higher in that year. In the drought year, the cost of cultivation was higher for all the landholding categories due to the increased cost for irrigation and input cost. In the drought year, agriculture products (50 per cent of the total products) were used for household consumption rather than selling in the market. It is evident from the study that livelihood which was based on natural resources became less attractive to the people to due to the risk involved in it and people were moving to less risk livelihood for their sustenance.Keywords: climate change, drought, agriculture economics, disaster impact
Procedia PDF Downloads 107506 Continuous Glucose Monitoring Systems and the Improvement in Hypoglycemic Awareness Post-Islet Transplantation: A Single-Centre Cohort Study
Authors: Clare Flood, Shareen Forbes
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Background: Type 1 diabetes mellitus (T1DM) is an autoimmune disorder affecting >400,000 people in the UK alone, with the global prevalence expected to double in the next decade. Islet transplant offers a minimally-invasive procedure with very low morbidity and almost no mortality, and is now as effective as whole pancreas transplant. The procedure was introduced to the UK in 2011 for patients with the most severe type 1 diabetes mellitus (T1DM) – those with unstable blood glucose, frequently occurring episodes of severe hypoglycemia and impaired awareness of hypoglycemia (IAH). Objectives: To evaluate the effectiveness of islet transplantation in improving glycemic control, reducing the burden of hypoglycemia and improving awareness of hypoglycemia through a single-centre cohort study at the Royal Infirmary of Edinburgh. Glycemic control and degree of hypoglycemic awareness will be determined and monitored pre- and post-transplantation to determine effectiveness of the procedure. Methods: A retrospective analysis of data collected over three years from the 16 patients who have undergone islet transplantation in Scotland. Glycated haemoglobin (HbA1c) was measured and continuous glucose monitoring systems (CGMS) were utilised to assess glycemic control, while Gold and Clarke score questionnaires tested IAH. Results: All patients had improved glycemic control following transplant, with optimal control seen visually at 3 months post-transplant. Glycemic control significantly improved, as illustrated by percentage time in hypoglycemia in the months following transplant (p=0.0211) and HbA1c (p=0.0426). Improved Clarke (p=0.0034) and Gold (p=0.0001) scores indicate improved glycemic awareness following transplant. Conclusion: While the small sample of islet transplant recipients at the Royal Infirmary of Edinburgh prevents definitive conclusions being drawn, it is indicated that through our retrospective, single-centre cohort study of 16 patients, islet transplant is capable of improving glycemic control, reducing the burden of hypoglycemia and IAH post-transplant. Data can be combined with similar trials at other centres to increase statistical power but from research in Edinburgh, it can be suggested that the minimally invasive procedure of islet transplantation offers selected patients with extremely unstable T1DM the incredible opportunity to regain control of their condition and improve their quality of life.Keywords: diabetes, islet, transplant, CGMS
Procedia PDF Downloads 266505 Asthma Nurse Specialist Improves the Management of Acute Asthma in a University Teaching Hospital: A Quality Improvement Project
Authors: T. Suleiman, C. Mchugh, H. Ranu
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Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.Keywords: asthma, nurse specialist, clinical audit, quality improvement
Procedia PDF Downloads 374504 Cardiac Pacemaker in a Patient Undergoing Breast Radiotherapy-Multidisciplinary Approach
Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović
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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment
Procedia PDF Downloads 432503 The Importance of Anthropometric Indices for Assessing the Physical Development and Physical Fitness of Young Athletes
Authors: Akbarova Gulnozakhon
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Relevance. Physical exercises can prolong the function of the growth zones of long tubular bones, delay the fusion of the epiphyses and diaphyses of bones and, thus, increase the growth of the body. At the same time, intensive strength exercises can accelerate the process of ossification of bone growth zones and slow down their growth in length. The influence of physical exercises on the process of biological maturation is noted. Gymnastics, which requires intense speed and strength loads, delays puberty. On the other hand, it is indicated that the relatively slow puberty of gymnasts is associated with the selection of girls with a special somatotype in this sport. It was found that the later onset of menstruation in female athletes does not have a negative effect on the maturation process and fertility (the ability to procreate). Observations are made about the normalizing influence of sports on the puberty of girls. The purpose of the study. Our goal is to study physical activity of varying intensity on the formation of secondary sexual characteristics and hormonal status of girls in adolescence. Each biological process peculiar to a given organism is not in a stationary state, but fluctuates with a certain frequency. According to the duration, there are, for example, circadian cycles, and infradian cycles, a typical example of which is the menstrual cycle. Materials and methods, results. Violations of menstrual function in athletes were detected by applying a questionnaire survey that contains several paragraphs and sub-paragraphs where passport data, anthropometric indicators, taking into account anthropometric indices, information about the menstrual cycle are indicated. Of 135 female athletes aged 1-3 to 16 years engaged in various sports - gymnasts, menstrual function disorders were noted in 86.7% (primary or secondary amenorrhea, irregular MC), in swimming-in 57.1%. The general condition also changes during the menstrual cycle. In a large percentage of cases, athletes indicate an increase in irritability in the premenstrual (45%) and menstrual (36%) phases. During these phases, girls note an increase in fatigue of 46.5% and 58% (respectively). In girls, secondary sexual characteristics continue to form during puberty and the clearest indicator of the onset of puberty is the age of the onset of the first menstruation - menarche. Conclusions. 1. Physical exercise has a positive effect on all major systems of the body and thus promotes health.2. Along with a beneficial effect on human health, physical exercise, if the requirements of sports are not observed, can be harmful.Keywords: girls health, anthropometric, physical development, reproductive health
Procedia PDF Downloads 100502 A Design Research Methodology for Light and Stretchable Electrical Thermal Warm-Up Sportswear to Enhance the Performance of Athletes against Harsh Environment
Authors: Chenxiao Yang, Li Li
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In this decade, the sportswear market rapidly expanded while numerous sports brands are conducting fierce competitions to hold their market shares and trying to act as a leader in professional competition sports areas to set the trends. Thus, various advancing sports equipment is being deeply explored to improving athletes’ performance in fierce competitions. Although there is plenty protective equipment such as cuff, running legging, etc., on the market, there is still blank in the field of sportswear during prerace warm-up this important time gap, especially for those competitions host in cold environment. Because there is always time gaps between warm-up and race due to event logistics or unexpected weather factors. Athletes will be exposed to chilly condition for an unpredictable long period of time. As a consequence, the effects of warm-up will be negated, and the competition performance will be degraded. However, reviewing the current market, there is none effective sports equipment provided to help athletes against this harsh environment or the rare existing products are so blocky or heavy to restrict the actions. An ideal thermal-protective sportswear should be light, flexible, comfort and aesthetic at the same time. Therefore, this design research adopted the textile circular knitting methodology to integrate soft silver-coated conductive yarns (ab. SCCYs), elastic nylon yarn and polyester yarn to develop the proposed electrical, thermal sportswear, with the strengths aforementioned. Meanwhile, the relationship between heating performance, stretch load, and energy consumption were investigated. Further, a simulation model was established to ensure providing sufficient warm and flexibility at lower energy cost and with an optimized production, parameter determined. The proposed circular knitting technology and simulation model can be directly applied to instruct prototype developments to cater different target consumers’ needs and ensure prototypes’’ safety. On the other hand, high R&D investment and time consumption can be saved. Further, two prototypes: a kneecap and an elbow guard, were developed to facilitate the transformation of research technology into an industrial application and to give a hint on the blur future blueprint.Keywords: cold environment, silver-coated conductive yarn, electrical thermal textile, stretchable
Procedia PDF Downloads 266501 Method for Controlling the Groundwater Polluted by the Surface Waters through Injection Wells
Authors: Victorita Radulescu
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Introduction: The optimum exploitation of agricultural land in the presence of an aquifer polluted by the surface sources requires close monitoring of groundwater level in both periods of intense irrigation and in absence of the irrigations, in times of drought. Currently in Romania, in the south part of the country, the Baragan area, many agricultural lands are confronted with the risk of groundwater pollution in the absence of systematic irrigation, correlated with the climate changes. Basic Methods: The non-steady flow of the groundwater from an aquifer can be described by the Bousinesq’s partial differential equation. The finite element method was used, applied to the porous media needed for the water mass balance equation. By the proper structure of the initial and boundary conditions may be modeled the flow in drainage or injection systems of wells, according to the period of irrigation or prolonged drought. The boundary conditions consist of the groundwater levels required at margins of the analyzed area, in conformity to the reality of the pollutant emissaries, following the method of the double steps. Major Findings/Results: The drainage condition is equivalent to operating regimes on the two or three rows of wells, negative, as to assure the pollutant transport, modeled with the variable flow in groups of two adjacent nodes. In order to obtain the level of the water table, in accordance with the real constraints, are needed, for example, to be restricted its top level below of an imposed value, required in each node. The objective function consists of a sum of the absolute values of differences of the infiltration flow rates, increased by a large penalty factor when there are positive values of pollutant. In these conditions, a balanced structure of the pollutant concentration is maintained in the groundwater. The spatial coordinates represent the modified parameters during the process of optimization and the drainage flows through wells. Conclusions: The presented calculation scheme was applied to an area having a cross-section of 50 km between two emissaries with various levels of altitude and different values of pollution. The input data were correlated with the measurements made in-situ, such as the level of the bedrock, the grain size of the field, the slope, etc. This method of calculation can also be extended to determine the variation of the groundwater in the aquifer following the flood wave propagation in envoys.Keywords: environmental protection, infiltrations, numerical modeling, pollutant transport through soils
Procedia PDF Downloads 154500 Common Health Problems of Filipino Overseas Household Service Workers: Implications for Wellness
Authors: Veronica Ramirez
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For over 40 years now, the Philippines has been supplying Household Service Workers (HSWs) globally. As a requirement of the Philippine Overseas Employment Agency (POEA), all Filipinos applying for overseas work undergo medical examination and a certificate of good health is submitted to the foreign employer before hiring. However, there are workplace-related health problems that develop during employment such as musculoskeletal strain or injury, back pain, hypertension and other illnesses. Some workers are in good working conditions but are on call more than 12 hours per day. There are also those who experience heavy physical work with short rest periods or time off. They can also be easily exposed to disease outbreaks and epidemics. It was the objective of this study to determine the common health problems of Filipino Overseas Service Workers and analyze their implications to wellness in the workplace. Specifically, it sought to describe the work conditions of HSWs and determine the work-related factors affecting their health. It also identified the medical care they avail of and how they perceive their health and wellness as determinants of well-being. Finally, it proposes ways to promote wellness among HSWs. This study focused on physical illnesses and does not include mental problems experienced by HSWs. Using a questionnaire, primary data were gathered online and through survey of HSW rehires who were retaking Pre-Departure Orientation Seminar at recruitment agencies. The 2010 Health Benefit Availment data from the Overseas Workers Welfare Administration (OWWA) was also utilized. Descriptive analysis was employed on the data gathered. Key stakeholders in the migration industry were also interviewed. Previous research studies, reports and literature on migration and wellness were used as secondary data. The study found that Filipino overseas HSWs are vulnerable to physical injury and experience body pains such as back, hip and shoulder pain. Long hours of work, work hazards and lack of rest due to poor accommodations can aggravate their physical condition. Although health insurance and health care are available, HSWs are not aware how to avail them. On the basis of the findings, a Wellness Program can be designed that include health awareness, health care availment, occupational ergonomics, safety and health, work and leisure balance, developing emotional intelligence, anger management and spirituality.Keywords: health, household service worker, overseas, wellness
Procedia PDF Downloads 251499 Assessment of the Effect of Ethanolic Leaf Extract of Annona squamosa L. on Den Induced Hepatocellular Carcinoma in Experimental Animals
Authors: Vanitha Varadharaj, Vijalakshmi Krishnamurthy
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Annona squamosa Linn, commonly known as Sugar apple, belonging to the family Annonaceae, is said to show varied medicinal effects, including insecticide, antiovulatory and abortifacient. The alkaloid and flavonoids present in Annona squamosa leaf has proved to have antioxidant activity. The present work has been planned to investigate the effect of ethanolic leaf extract of Annona squamosa leaf on Den Induced wistar albino rats. The study was carried out to analyze the biochemical Parmeters like Total Proteins, Bilirubin, Enzymatic and Non –Enzymatic enzymes, Marker enzymes and Tumor markers in serum and also the histopathological studies in liver is carried out in control and DEN induced rats. Supplementation of ELAS (Ethanolic Leaf Extract Of Annona squamosa) reduced the liver weight and also reduced the tumour incidence. Chemoprevention group showed near normal values of bilirubin when compared with the control rats. Total protein was decreased in the cancer bearing group and on treatment with the extract the levels of protein were restored. Both in pre and post treatment group, the activities of enzymatic antioxidants such as superoxide dismutase, catalase, and Glutathione peroxidase were increased but in pre treated animals it was more effective than post treated animals. The non- enzymatic antioxidants such as vitamin C and vitamin E were brought back to normal level significantly in post and pre treated animals. Activities of marker enzymes such as SGOT, SGPT, ALP, γ GT were significantly elevated in the serum of cancer animals and the values returned to normal after treatment with the extract suggesting the hepato protective effect of the extract. Lipid peroxide was found to be elevated in the cancer induced group. This condition was brought back to the normal in the pre and post treated animals with ELAS. Histological examination also confirmed the anti- carcinogenic potential of ELAS, Cancer induced groups had a triple fold increase in their AFP values when compared to other groups. DEN treatment increased the level of AFP expression while ELAS partially counteracted the effect of it. So the scientific validation obtained from this study may pave way to many budding scientists to find new drugs from Annona squamosa for various ailments.Keywords: annona squamosa, biochemical parmeters, cancer, leaf extract
Procedia PDF Downloads 328498 Growth and Yield Response of an Indian Wheat Cultivar (HD 2967) to Ozone and Water Stress in Open-Top Chambers with Emphasis on Its Antioxidant Status, Photosynthesis and Nutrient Allocation
Authors: Annesha Ghosh, S. B. Agrawal
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Agricultural sector is facing a serious threat due to climate change and exacerbation of different atmospheric pollutants. Tropospheric ozone (O₃) is considered as a dynamic air pollutant imposing substantial phytotoxicity to natural vegetations and agriculture worldwide. Naturally, plants are exposed to different environmental factors and their interactions. Amongst such interactions, studies related to O₃ and water stress are still rare. In the present experiment, wheat cultivar HD2967 were grown in open top chambers (OTC) under two O₃ concentration; ambient O₃ level (A) and elevated O₃ (E) (ambient + 20 ppb O₃) along with two different water supply; well-watered (W) and 50% water stress conditions (WS), with an aim to assess the individual and interactive effect of two most prevailing stress factors in Indo-Gangetic Plains of India. Exposure to elevated O₃ dose caused early senescence symptoms and reduction in growth and biomass of the test cultivar. The adversity was more pronounced under the combined effect of EWS. Significant reduction of stomatal conductance (gs) and assimilation rate were observed under combined stress condition compared to the control (AW). However, plants grown under individual stress conditions displayed higher gs, biomass, and antioxidant defense mechanism compared to the plants grown under the presence of combined stresses. Higher induction in most of the enzyme activities of catalase (CAT), ascorbate peroxidase (APX), glutathione reductase (GR), peroxidase (POD) and superoxide dismutase (SOD) was displayed by HD 2967 under EW while, under the presence of combined stresses (EWS), a moderate increment of APX and CAT activity was observed only at its vegetative phase. Furthermore, variations in nutrient uptake and redistribution to different plants parts were also observed in the present study. Reduction in water availability has checked nutrient uptake (N, K, P, Ca, Cu, Mg, Zn) in above-ground parts (leaf) and below-ground parts (root). On the other hand, carbon (C) accumulation with subsequent C-N ratio was observed to be higher in the leaves under EWS. Such major nutrient check and limitation in carbon fixation due to lower gs under combined stress conditions might have weakened the defense mechanisms of the test cultivar. Grain yield was significantly reduced under EWS followed by AWS and EW as compared to their control, exhibiting an additive effect on the grain yield.Keywords: antioxidants, open-top chambers, ozone, water stress, wheat, yield
Procedia PDF Downloads 112497 A Qualitative Study of Unmet Needs of Families of Children with Cerebral Palsy in Bangladesh
Authors: Reshma Parvin Nuri, Heather Michelle Aldersey, Setareh Ghahari
Abstract:
Objectives: Worldwide, it is well known that taking care of children with disabilities (CWD) can have a significant impact on the entire family unit. Over the last few decades, an increased number of studies have been conducted on families of CWD in higher income countries, and much of this research has identified family needs and strategies to meet those needs. However, family needs are incredibly under-studied in developing countries. Therefore, the aims of this study were to: (a) explore the needs of families of children with cerebral palsy (CP) in Bangladesh; (b) investigate how some of the family needs have been met and (c) identify the sources of supports that might help the families to meet their needs in the future. Methods: A face to face, semi-structured in-depth interview was conducted with 20 family members (12 mothers, 4 fathers, 1 sister, 2 grandmothers, and 1 aunt) who visited the Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh between June and August 2016. Constant comparison method of grounded theory approach within the broader spectrum of qualitative study was used to analyze the data. Results: Participants identified five categories of needs: (a) financial needs, (b) access to disability-related services, (c) family and community cohesion, (d) informational needs, and (e) emotional needs. Participants overwhelmingly reported that financial need is their greatest family need. Participants noted that families encountered additional financial expenses for a child with CP, beyond what they would typically pay for their other children. Participants were seeing education as their non-primary need as they had no hope that their children would be physically able to go to school. Some participants also shared their needs for social inclusion and participation and receiving emotional support. Participants further expressed needs to receive information related to the child’s health condition and availability/accessibility of governmental support programs. Besides unmet needs, participants also highlighted that some of their needs have been met through formal and informal support systems. Formal support systems were mainly institution-based and run by non-governmental organizations, whereas participants identified informal support coming from family, friends and community members. Participants overwhelmingly reported that they receive little to no support from the government. However, participants identified the government as the key stakeholder who can play vital role in meeting their unmet needs. Conclusions: In the next phase of this research, the plan is to understand how the Government of the People’s Republic of Bangladesh is working to meet the needs of families of CWD. There is also need for further study on needs of families of children with conditions other than CP and those who live in the community and do not have access to the CRP Services. There is clear need to investigate ways to enable children with CP have better access to education in Bangladesh.Keywords: Bangladesh, children with cerebral palsy, family needs, support
Procedia PDF Downloads 372